Negotiation of values as driver in community-based PD

DEFF Research Database (Denmark)

Gronvall, Erik; Malmborg, Lone; Messeter, Jörn

2016-01-01

Community-based PD projects are often characterized by the meeting of conflicting values among stakeholder groups, but in research there is no uncontested account of the relation between design and conflicting values. Through analysis of three community-based PD cases in Denmark and South Africa......, this paper identifies and discusses challenges for community-based PD that exist in these settings based on the emergence of contrasting and often conflicting values among participants and stakeholders. Discussions of participation are shaped through two theoretical perspectives: the notion of thinging...... and design things; and different accounts of values in design. Inspired by the concept of design things, and as a consequence of the need for continuous negotiation of values observed in all three cases, we suggest the concept of thinging as fruitful for creating productive agonistic spaces with a stronger...

Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

Science.gov (United States)

Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

2015-12-01

To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program

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Gil, Elizabeth

2017-01-01

The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

VOICES AGAINST EXTREMISM: A CASE STUDY OF A COMMUNITY-BASED CVE COUNTER-NARRATIVE CAMPAIGN

Directory of Open Access Journals (Sweden)

Logan Macnair

2017-03-01

Full Text Available This article presents a case study of the recently conceived and ongoing counter-extremism campaign, Voices Against Extremism, a campaign designed and implemented by university students from Vancouver, Canada. Through a multifaceted approach that includes extensive use of social media, academic research, and grassroots community activities and involvement, Voices Against Extremism operates under the mission statement of countering and preventing violent extremism and radicalization through the humanization of minority groups and through the education and engagement of the silent majority. This article examines the effectiveness of this campaign as a proactive counter-radicalization strategy by outlining its specific components and activities. Based on the results of this campaign, suggestions are then offered regarding specific counter-extremism and counter-radicalizations policies that may be adopted by law enforcement, policymakers – or any other organizations concerned with countering and preventing radicalization and violent extremism – with a specific focus on the potential benefits of proactive and long-term social and community engagement.

Case Studies of Community-Academic Partnerships Established Using the Give-Get Grid Model.

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Behringer, Bruce; Southerland, Jodi L; Plummer, Robert M

2017-11-01

While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups' coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders' expected benefits ("gets") and contributions ("gives") needed to establish and maintain long-term, mutually advantageous community-academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid's utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community-academic relationships. Steps are explained with practical lessons learned in using the Grid.

Evaluating Community-Based Participatory Research to Improve Community-Partnered Science and Community Health

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Hicks, Sarah; Duran, Bonnie; Wallerstein, Nina; Avila, Magdalena; Belone, Lorenda; Lucero, Julie; Magarati, Maya; Mainer, Elana; Martin, Diane; Muhammad, Michael; Oetzel, John; Pearson, Cynthia; Sahota, Puneet; Simonds, Vanessa; Sussman, Andrew; Tafoya, Greg; Hat, Emily White

2013-01-01

Background Since 2007, the National Congress of American Indians (NCAI) Policy Research Center (PRC) has partnered with the Universities of New Mexico and Washington to study the science of community-based participatory research (CBPR). Our goal is to identify facilitators and barriers to effective community–academic partnerships in American Indian and other communities, which face health disparities. Objectives We have described herein the scientific design of our National Institutes of Health (NIH)-funded study (2009–2013) and lessons learned by having a strong community partner leading the research efforts. Methods The research team is implementing a mixed-methods study involving a survey of principal investigators (PIs) and partners across the nation and in-depth case studies of CBPR projects. Results We present preliminary findings on methods and measures for community-engaged research and eight lessons learned thus far regarding partnership evaluation, advisory councils, historical trust, research capacity development of community partner, advocacy, honoring each other, messaging, and funding. Conclusions Study methodologies and lessons learned can help community–academic research partnerships translate research in communities. PMID:22982842

Community-based wetland comanagement in Bangladesh

OpenAIRE

Sherwood, D.B.

2009-01-01

Metadata only record This chapter explains new solutions to problems resulting from top-down approaches to resource conservation and sustainability. The management of natural resources - in this case, wetlands - is complicated and risky. To address the risks involved with resource management, a case study was done in Bangladesh to evaluate the effectiveness of community-based comanagement. Using multidisciplinary approaches and adaptive management strategies, the Management of Aquatic Ecos...

Community perceptions and attitudes on malaria case management and the role of community health workers.

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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

Concept and Method of Asset-Based Community Development Planning: A Case Study on Minlecun Community in Chongqing’s Yuzhong District

Institute of Scientific and Technical Information of China (English)

Huang; Ling; Liu; Yang; Xu; Jianfeng

2015-01-01

With the transformation of the Chinese economy from an extensive growth to intensive development, city development is also gradually turning from incremental construction to stock management. Community, as a basic unit of human settlements, is an important platform to build and improve the social governance capability. In 2013, Shiyoulu Jiedao Offi ce of Yuzhong District led the 1st urban community development planning, which was a milestone of Chongqing’s city regeneration and governance innovation. This paper focuses on two key issues: how to understand the community values and make the community development planning based on the above, and how to integrate with the local forces so that the community development planning can be integrated into the action plan. Combined with the practice of Minlecun Community Development Planning, using the concept of asset-based community development, a comprehensive survey is conducted on community assets(including three aspects of physical, human, and social capital), and a community comprehensive planning strategy is formulated which covers two parts: the optimization of community spaces and the upgrading of community governance. The paper explores the local-based community planning theories and methods from such aspects as value attitude, public participation, role transformation of urban planners, and others.

Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools

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Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather

2016-01-01

This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…

Strategy community development based on local resources

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Meirinawati; Prabawati, I.; Pradana, G. W.

2018-01-01

The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

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Lorent, Natalie; Choun, Kimcheng; Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

2015-01-01

While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

Directory of Open Access Journals (Sweden)

Natalie Lorent

Full Text Available While community-based active case finding (ACF for tuberculosis (TB holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers.Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively.Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs.TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers

Teaching community diagnosis to medical students: evaluation of a case study approach.

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Bair, C W

1980-01-01

A unique case study approach to training medical students in community diagnosis techniques was initiated at the Medical College of Ohio at Toledo. This paper describes the five elements of this teaching method: preliminary specification of target community and data base; group problem-solving requirement; specification of desired output; defined performance objectives; and regularly scheduled time for analysis. Experience with the case study method over two years was evaluated to identify specific strengths and weaknesses. The identified strengths include use of limited educational time to introduce community health problems, development of experience in a collegial team work setting, and specific awareness of the types of data useful to the analysis of community health service problems. Negative evaluations suggested that the method was not conducive to the development of skills in three areas: ability to establish the relative importance of health problems in communities; ability to identify an appropriate health system response to a community health problem from feasible alternatives; and ability to anticipate the community impact of health program modifications or improvements. Potential explanations for these deficiencies include: need for increased didactic support in the classroom for particular skill areas; need to establish a direct field experience in community diagnosis; inappropriateness of the data base used for evaluation of particular skills; and the probability that quantitative analysis, as used in this evaluation, may not be sufficient in and of itself to measure the outcome of a community diagnosis experience.

Planning for Community Based Tourism in a Remote Location

Directory of Open Access Journals (Sweden)

Sharon Harwood

2010-07-01

Full Text Available Remote areas are difficult to access, tend to lack critical infrastructure, are highly susceptible to shocks in the marketplace, and are perceived by industry to possess limited development opportunities. Accordingly a community orientated and territorial approach to development planning in a remote area will be more successful than a top down industry based approach [1]. Given the limitations of being remote, the case study community examined in this research manages and sustains a bird watching tourism product within a global market place. This paper examines how a remotely located community in the Arfak Mountains of West Papua overcomes these difficulties and plans for community based tourism (CBT in their locale.

Cohorts and community: a case study of community engagement in the establishment of a health and demographic surveillance site in Malaysia

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Allotey, Pascale; Reidpath, Daniel D.; Devarajan, Nirmala; Rajagobal, Kanason; Yasin, Shajahan; Arunachalam, Dharmalingam; Imelda, Johanna Debora; Soyiri, Ireneous; Davey, Tamzyn; Jahan, Nowrozy

2014-01-01

Background Community engagement is an increasingly important requirement of public health research and plays an important role in the informed consent and recruitment process. However, there is very little guidance about how it should be done, the indicators for assessing effectiveness of the community engagement process and the impact it has on recruitment, retention, and ultimately on the quality of the data collected as part of longitudinal cohort studies. Methods An instrumental case study approach, with data from field notes, policy documents, unstructured interviews, and focus group discussions with key community stakeholders and informants, was used to explore systematically the implementation and outcomes of the community engagement strategy for recruitment of an entire community into a demographic and health surveillance site in Malaysia. Results For a dynamic cohort, community engagement needs to be an ongoing process. The community engagement process has likely helped to facilitate the current response rate of 85% in the research communities. The case study highlights the importance of systematic documentation of the community engagement process to ensure an understanding of the effects of the research on recruitment and the community. Conclusions A critical lesson from the case study data is the importance of relationships in the recruitment process for large population-based studies, and the need for ongoing documentation and analysis of the impact of cumulative interactions between research and community engagement. PMID:24804983

Nationwide implementation of integrated community case management of childhood illness in Rwanda

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Mugeni, Catherine; Levine, Adam C; Munyaneza, Richard M; Mulindahabi, Epiphanie; Cockrell, Hannah C; Glavis-Bloom, Justin; Nutt, Cameron T; Wagner, Claire M; Gaju, Erick; Rukundo, Alphonse; Habimana, Jean Pierre; Karema, Corine; Ngabo, Fidele; Binagwaho, Agnes

2014-01-01

ABSTRACT Background: Between 2008 and 2011, Rwanda introduced integrated community case management (iCCM) of childhood illness nationwide. Community health workers in each of Rwanda's nearly 15,000 villages were trained in iCCM and equipped for empirical diagnosis and treatment of pneumonia, diarrhea, and malaria; for malnutrition surveillance; and for comprehensive reporting and referral services. Methods: We used data from the Rwanda health management information system (HMIS) to calculate monthly all-cause under-5 mortality rates, health facility use rates, and community-based treatment rates for childhood illness in each district. We then compared a 3-month baseline period prior to iCCM implementation with a seasonally matched comparison period 1 year after iCCM implementation. Finally, we compared the actual changes in all-cause child mortality and health facility use over this time period with the changes that would have been expected based on baseline trends in Rwanda. Results: The number of children receiving community-based treatment for diarrhea and pneumonia increased significantly in the 1-year period after iCCM implementation, from 0.83 cases/1,000 child-months to 3.80 cases/1,000 child-months (P = .01) and 0.25 cases/1,000 child-months to 5.28 cases/1,000 child-months (P<.001), respectively. On average, total under-5 mortality rates declined significantly by 38% (P<.001), and health facility use declined significantly by 15% (P = .006). These decreases were significantly greater than would have been expected based on baseline trends. Conclusions: This is the first study to demonstrate decreases in both child mortality and health facility use after implementing iCCM of childhood illness at a national level. While our study design does not allow for direct attribution of these changes to implementation of iCCM, these results are in line with those of prior studies conducted at the sub-national level in other low-income countries. PMID:25276592

Mobile devices for community-based REDD+ monitoring: a case study for Central Vietnam.

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Pratihast, Arun Kumar; Herold, Martin; Avitabile, Valerio; de Bruin, Sytze; Bartholomeus, Harm; Souza, Carlos M; Ribbe, Lars

2012-12-20

Monitoring tropical deforestation and forest degradation is one of the central elements for the Reduced Emissions from Deforestation and Forest Degradation in developing countries (REDD+) scheme. Current arrangements for monitoring are based on remote sensing and field measurements. Since monitoring is the periodic process of assessing forest stands properties with respect to reference data, adopting the current REDD+ requirements for implementing monitoring at national levels is a challenging task. Recently, the advancement in Information and Communications Technologies (ICT) and mobile devices has enabled local communities to monitor their forest in a basic resource setting such as no or slow internet connection link, limited power supply, etc. Despite the potential, the use of mobile device system for community based monitoring (CBM) is still exceptional and faces implementation challenges. This paper presents an integrated data collection system based on mobile devices that streamlines the community-based forest monitoring data collection, transmission and visualization process. This paper also assesses the accuracy and reliability of CBM data and proposes a way to fit them into national REDD+ Monitoring, Reporting and Verification (MRV) scheme. The system performance is evaluated at Tra Bui commune, Quang Nam province, Central Vietnam, where forest carbon and change activities were tracked. The results show that the local community is able to provide data with accuracy comparable to expert measurements (index of agreement greater than 0.88), but against lower costs. Furthermore, the results confirm that communities are more effective to monitor small scale forest degradation due to subsistence fuel wood collection and selective logging, than high resolution remote sensing SPOT imagery.

International Community-Based Service Learning: Two Comparative Case Studies of Benefits and Tensions

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Akhurst, Jacqueline

2016-01-01

The drives to internationalise the UK curriculum and psychology students' desires to work in communities are brought together in this paper. International community-based learning (ICBL) links with many psychology students' motivations to make contributions to others; with the potential to enhance students' learning and cultural sensitivities. The…

Systems Thinking Tools as Applied to Community-Based Participatory Research: A Case Study

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BeLue, Rhonda; Carmack, Chakema; Myers, Kyle R.; Weinreb-Welch, Laurie; Lengerich, Eugene J.

2012-01-01

Community-based participatory research (CBPR) is being used increasingly to address health disparities and complex health issues. The authors propose that CBPR can benefit from a systems science framework to represent the complex and dynamic characteristics of a community and identify intervention points and potential "tipping points."…

A case study in the use of community-based participatory research in public health nursing.

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Savage, Christine L; Xu, Yin; Lee, Rebecca; Rose, Barbara L; Kappesser, Mary; Anthony, Jean Spann

2006-01-01

There is growing demand for research using a community-based participatory (CBPR) approach. CBPR requires that the academic research team actively partner with community members and stakeholders in the entire research process. The community members are full partners with the researchers in relation to the development and implementation of the study, analysis of the data, and dissemination of the findings. The purpose of this article is to review four basic principles of CBPR and provide an example of how these CBPR principles were used in an ethnographic study related to the culture of African American infant health. In the pilot study, CBPR provided the framework for recruitment and retention of participants, ongoing data analysis, and dissemination of findings. Using CBPR provided the researchers an introduction into the selected community. Community members served as key informants about the culture of the community and provided access to potential participants. The community partners contributed to analysis of emerging themes and in the dissemination of findings to the community, stakeholders, and the scientific community. CBPR provides opportunities for community health nurse researchers to conduct research with vulnerable populations and sets the stage for implementing evidenced-based nursing interventions in the community.

Multilevel governance in community-based environmental management: a case study comparison from Latin America

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Claudia Sattler

2016-12-01

Full Text Available We analyze four case studies from Latin America using the concept of multilevel governance to assess at what vertical and horizontal levels and in what roles various state, market, and civil society actors interact for successful community-based environmental management (CBEM. In particular, we address the problem of how a conflict over natural resources with high negative impacts on the livelihoods of the respective communities could be overcome by a governance change that resulted in a multilevel governance arrangement for CBEM. The analysis involves a mixed-methods approach that combines a variety of empirical methods in social research such as field visits, personal interviews, participant observations, and stakeholder workshops. To visualize results, we introduce two schemes to present the composition of the governance structures for cross-case comparison. The first scheme plots the different actors into an arrangement that shows their associations with different societal spheres and at which territorial scales they are primarily involved. The second scheme differentiates these actors based on their complementing governance roles. Active roles are attributed to actors who implement activities on the ground, whereas passive roles are assigned to actors who provide specific resources such as knowledge, funding, legislative framework, or others. All cases involved governance actors from more than one societal sphere who operate on at least three different territorial levels (local to international and in distinct roles. Results show that multilevel governance can strengthen CBEM in different ways. First, the success of CBEM is an outcome of the sum of horizontal and vertical interactions of all involved actors, and there is no most appropriate single level of social organization at which a problem can best be addressed. Only the cooperation of actors from different societal spheres within and across levels ensures accessibility to needed

Implementation of Policy, Systems, and Environmental Community-Based Interventions for Cardiovascular Health Through a National Not-for-Profit: A Multiple Case Study.

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Garney, Whitney R; Szucs, Leigh E; Primm, Kristin; King Hahn, Laura; Garcia, Kristen M; Martin, Emily; McLeroy, Kenneth

2018-05-01

In 2014, the Centers for Disease Control and Prevention funded the American Heart Association to implement policy, systems, and environment-focused strategies targeting access to healthy food and beverages, physical activity, and smoke-free environments. To understand factors affecting implementation and variations in success across sites, evaluators conducted a multiple case study. Based on past literature, community sites were categorized as capacity-building or implementation-ready, for comparison. A sample of six communities were selected using a systematic selection tool. Through site visits, evaluators conducted interviews with program staff and community partners and assessed action plans. Evaluators identified important implications for nationally coordinated community-based prevention programming. Differences in implementation varied by the communities' readiness, with the most notable differences in how they planned activities and defined success. Existing partner relationships (or lack thereof) played a significant role, regardless of the American Heart Association's existing presence within the communities, in the progression of initiatives and the differences observed among phases. Last, goals in capacity-building sites were tied to organizational goals while goals in implementation-ready sites were more incremental with increased community influence and buy-in. Using national organizations as a mechanism to carry out large-scale community-based prevention work is a viable option that provides coordinated, wide-scale implementation without sacrificing a community's priorities or input. In funding future initiatives, the presence of relationships and the time needed to cultivate such relationships should be accounted for in the planning and implementation processes, as well as both local and national expectations.

Ethics and Community-Based Participatory Research: Perspectives From the Field

OpenAIRE

Bastida, Elena M.; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard

2010-01-01

Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues r...

Ecotourism and community development: a case study of Olumirin ...

African Journals Online (AJOL)

Ecotourism and community development: a case study of Olumirin Waterfall, ... of ecotourism to the community development of the host community and her environs. ... Tourist survey, staff survey, local business sector survey and community ...

Building climate change adaptation on community experiences: Lessons from community-based natural resource management in southern Africa

Energy Technology Data Exchange (ETDEWEB)

Chishakwe, Nyasha; Murray, Laurel; Chambwera, Muyeye

2012-05-15

This publication, produced in collaboration with WWF Southern Africa, looks at how community-based natural resource management (CBNRM) can inform and contribute to climate change adaptation at the community level, specifically to community-based adaptation (CBA) to climate change. It provides a framework for analysing the two approaches at conceptual and practical levels. Using case studies from southern Africa, the publication demonstrates the synergies between CBA and CBNRM, most important of which are the adaptation co-benefits between the two. While local incentives have driven community action in CBNRM, it is the evolution of an enabling environment in the region, in the form of institutions, policies, capacity and collaboration which characterises the scaling up of CBNRM to national and regional levels.

The keys to governance and stakeholder engagement: the southeast michigan beacon community case study.

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Des Jardins, Terrisca R

2014-01-01

Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals.

The Keys to Governance and Stakeholder Engagement: The Southeast Michigan Beacon Community Case Study

Science.gov (United States)

Des Jardins, Terrisca R.

2014-01-01

Community-based health information exchanges (HIEs) and efforts to consolidate and house data are growing, given the advent of Accountable Care Organizations (ACOs) under the Affordable Care Act and other similar population health focused initiatives. The Southeast Michigan Beacon Community (SEMBC) can be looked to as one case study that offers lessons learned, insights on challenges faced and accompanying workarounds related to governance and stakeholder engagement. The SEMBC case study employs an established Data Warehouse Governance Framework to identify and explain the necessary governance and stakeholder engagement components, particularly as they relate to community-wide data sharing and data warehouses or repositories. Perhaps the biggest lesson learned through the SEMBC experience is that community-based work is hard. It requires a great deal of community leadership, collaboration and resources. SEMBC found that organizational structure and guiding principles needed to be continually revisited and nurtured in order to build the relationships and trust needed among stakeholder organizations. SEMBC also found that risks and risk mitigation tactics presented challenges and opportunities at the outset and through the duration of the three year pilot period. Other communities across the country embarking on similar efforts need to consider realistic expectations about community data sharing infrastructures and the accompanying and necessary governance and stakeholder engagement fundamentals. PMID:25848612

Home/community-based services: a two-tier approach.

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Aponte, H J; Zarski, J J; Bixenstine, C; Cibik, P

1991-07-01

A two-tier model for work with high-risk families is presented. It combines multiple-family groups in the community with home-based family therapy for individual families. The ecostructural conceptual framework of the model is discussed, and its application is illustrated by a case vignette.

Community-Based Field Experiences in Teacher Education: Possibilities for a Pedagogical Third Space

Science.gov (United States)

Hallman, Heidi L.

2012-01-01

The present article discusses the importance of community-based field experiences as a feature of teacher education programs. Through a qualitative case study, prospective teachers' work with homeless youth in an after-school initiative is presented. Framing community-based field experiences in teacher education through "third space" theory, the…

Tourism Communication in Community Based Tourism in Dieng Community, Central Java, Indonesia

Directory of Open Access Journals (Sweden)

Manik Sunuantari

2017-08-01

Full Text Available To encourage a community’s role in the field of tourism, the local government of Central Java, Indonesia promotes a Community Based Tourism (CBT as a tourism development for the sustainable economy. It involves the community in decision-making processes, especially related to the acquisition of income, employment, and the preservation of the environment, and culture of the indigenous people. This research aimed to determine communication activities in the implementation of CBT. The theory used was tourism communication using Attention, Interest, Desire, Action (AIDA model. Then, the method was a case study by choosing Dieng as a tourist destination, and the tourism communication activities were undertaken in Dieng’s society, especially in the activities of Dieng Culture Festival (DCF. The results show that the tourism communication activities involving the community, POKDARWIS (Kelompok Sadar Wisata - Tourism Awareness Group, tourism advocates, and local governments should pay attention to the cultural and natural tourism potentials, and empower the local communities.

Innovation technological energetics in rural communities. Case of study community of “Manantiales”, Villa Clara, Cuba

Directory of Open Access Journals (Sweden)

Raul Olalde Font

2016-10-01

Full Text Available This investigation is framed in the analysis of impacts in the local development starting from the taking of decisions on projects of rural energy in Cuban communities that have as economic main activity the agricultural sector, illustrated the results of a case study where the technological most viable options are selected under the optics of the improvement of indicators of community resources. The methods and used materials are characteristic of a field work with application model are characterized for the taking of decisions in the energy area and their sources SURE, as geographical region the community isolated rural “Manantiales” linked to the agrarian sector in the republic of Cuba and the present period review in the thematic one approached. The main indicators are sketched in each resource of the rural community under the optics of the SURE in their version 3.0, as well the characterization of the prediction of the impacts at each technological option on the resources, is exhibited a mean of impacts and the classification of the technologies according to the level of achievements contribute to the indicators of community resources, obtaining as a result that the hydro energy technology is the most viable option with a value of 100 points in the scale from 0 to 100, followed by the GRID with 91.11 and of the photovoltaic systems based on silicon panels with 90.57, in this case all technologies contribute a significant level of achievements to the local community development.

The contribution of a non-governmental organisation's Community Based Tuberculosis Care Programme to case finding in Myanmar: trend over time.

Science.gov (United States)

Maung, Htet Myet Win; Saw, Saw; Isaakidis, Petros; Khogali, Mohammed; Reid, Anthony; Hoa, Nguyen Binh; Zaw, Ko Ko; Thein, Saw; Aung, Si Thu

2017-04-03

It is estimated that the standard, passive case finding (PCF) strategy for detecting cases of tuberculosis (TB) in Myanmar has not been successful: 26% of cases are missing. Therefore, alternative strategies, such as active case finding (ACF) by community volunteers, have been initiated since 2011. This study aimed to assess the contribution of a Community Based TB Care Programme (CBTC) by local non-government organizations (NGOs) to TB case finding in Myanmar over 4 years. This was a descriptive study using routine, monitoring data. Original data from the NGOs were sent to a central registry within the National TB Programme and data for this study were extracted from that database. Data from all 84 project townships in five regions and three states in Myanmar were used. The project was launched in 2011. Over time, the number of presumptive TB cases that were referred decreased, except in the Yangon Region, although in some areas, the numbers fluctuated. At the same time, there was a trend for the proportion of cases treated, compared to those referred, that decreased over time (P = 0.051). Overall, among 84 townships, the contribution of CBTC to total case detection deceased from 6% to 4% over time (P < 0.001). Contrary to expectations and evidence from previous studies in other countries, a concerning reduction in TB case finding by local NGO volunteer networks in several areas in Myanmar was recorded over 4 years. This suggests that measures to support the volunteer network and improve its performance are needed. They may include discussion with local NGOs human resources personnel, incentives for the volunteers, closer supervision of volunteers and improved monitoring and evaluation tools.

An Asset-Based Approach to Tribal Community Energy Planning

Energy Technology Data Exchange (ETDEWEB)

Gutierrez, Rachael A. [Pratt Inst., Brooklyn, NY (United States). City and Regional Planning; Martino, Anthony [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Materials, Devices, and Energy Technologies; Begay, Sandra K. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Materials, Devices, and Energy Technologies

2016-08-01

Community energy planning is a vital component of successful energy resource development and project implementation. Planning can help tribes develop a shared vision and strategies to accomplish their energy goals. This paper explores the benefits of an asset-based approach to tribal community energy planning. While a framework for community energy planning and federal funding already exists, some areas of difficulty in the planning cycle have been identified. This paper focuses on developing a planning framework that offsets those challenges. The asset-based framework described here takes inventory of a tribe’s capital assets, such as: land capital, human capital, financial capital, and political capital. Such an analysis evaluates how being rich in a specific type of capital can offer a tribe unique advantages in implementing their energy vision. Finally, a tribal case study demonstrates the practical application of an asset-based framework.

Community-Associated Methicillin-Resistant Staphylococcus aureus Case Studies

Science.gov (United States)

Sowash, Madeleine G.; Uhlemann, Anne-Catrin

2014-01-01

Over the past decade, the emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has changed the landscape of S. aureus infections around the globe. Initially recognized for its ability to cause disease in young and healthy individuals without healthcare exposures as well as for its distinct genotype and phenotype, this original description no longer fully encompasses the diversity of CA-MRSA as it continues to expand its niche. Using four case studies, we highlight a wide range of the clinical presentations and challenges of CA-MRSA. Based on these cases we further explore the globally polygenetic background of CA-MRSA with a special emphasis on generally less characterized populations. PMID:24085688

Penerapan Corporate Social Responsibility dengan Konsep Community Based Tourism

Directory of Open Access Journals (Sweden)

Linda Suriany

2013-12-01

Full Text Available Abstract: Business is not only economic institution, but social institution too. As social institution, business has responsibility to help society in solving social problem. This responsibility called Corporate Social Responsibility (CSR. CSR pays attention about social problem and environment, so CSR support continuous development to help government role. Nowadays, our government has national development’s agenda. One of them is tourism sector (Visit Indonesia Year 2008 programmed. But tourism sector has challenge in human resources. In this case, business role in practice CSR is needed to help tourism sector. With CSR activities, the quality of local community will increase to participate in tourism activities. CSR activities include training that based on research. When the quality of local community increase, local community can practice the concept of community based tourism (CBT. In the future, Indonesia has a power to compete with other countries.

Deterministic and fuzzy-based methods to evaluate community resilience

Science.gov (United States)

Kammouh, Omar; Noori, Ali Zamani; Taurino, Veronica; Mahin, Stephen A.; Cimellaro, Gian Paolo

2018-04-01

Community resilience is becoming a growing concern for authorities and decision makers. This paper introduces two indicator-based methods to evaluate the resilience of communities based on the PEOPLES framework. PEOPLES is a multi-layered framework that defines community resilience using seven dimensions. Each of the dimensions is described through a set of resilience indicators collected from literature and they are linked to a measure allowing the analytical computation of the indicator's performance. The first method proposed in this paper requires data on previous disasters as an input and returns as output a performance function for each indicator and a performance function for the whole community. The second method exploits a knowledge-based fuzzy modeling for its implementation. This method allows a quantitative evaluation of the PEOPLES indicators using descriptive knowledge rather than deterministic data including the uncertainty involved in the analysis. The output of the fuzzy-based method is a resilience index for each indicator as well as a resilience index for the community. The paper also introduces an open source online tool in which the first method is implemented. A case study illustrating the application of the first method and the usage of the tool is also provided in the paper.

Lessons learned from community-based approaches to sodium reduction.

Science.gov (United States)

Kane, Heather; Strazza, Karen; Losby, Jan L; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S; Frost, Corey; Margolis, Marjorie; Hersey, James

2015-01-01

This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. A multiple case study design was used. This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. The project team conducted a document review of program materials and semistructured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption.

ANTI-DISCRIMINATORY PRACTICE AND COMMUNITY DEVELOPMENT : A case study of a clubhouse community

OpenAIRE

Louko, Tiina

2011-01-01

Louko, Tiina. Anti-discriminatory practice and community development - A case study of a clubhouse community. Järvenpää, Spring 2011, 54 p. Diaconia University of Applied Sciences, Diak South Järvenpää. Degree Programme in Social Services. Bachelor´s Degree in Social Services. This study was conducted in the context of Eastern Helsinki Clubhouse, which is a community for mental health rehabilitees. The purpose of the research was to describe the clubhouse community from the aspects o...

Reconsidering Community-based Retailing

OpenAIRE

Maughan, Rebecca; O'Driscoll, Aidan

2012-01-01

One of the areas with great potential for economic, social and environmental benefit is community-based retailing. The concept of community based retailing can incorporate a number of different tenets. We suggest that it is retailing that is based close to the community it serves, usually within the town or village centre rather than out-of-town locations, and which is composed of a diverse range of small and medium sized business that are often independently or co-operatively owned. These co...

A Case Study Examination of Best Practices of Professional Learning Communities

Science.gov (United States)

Akopoff, Tanya M.

2010-01-01

A current trend in education is that small teacher groups, called professional learning communities (PLC), are being advocated as a tool to help teachers reach struggling students. Educators planning to use PLC as an intervention strategy can benefit from research-based information about PLC best practices. This multiple case study addressed the…

Place-power-prognosis: Community-based conservation, partnerships, and ecotourism enterprises in Namibia

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Arthur Frederick Hoole

2009-08-01

Full Text Available Namibia’s community-based natural resource management program (CBRNM and communal conservancies have gained international acclaim for rural poverty alleviation and wildlife conservation on the commons. Community-based ecotourism enterprise development has played a central role in the generation of community revenues, employment and additional benefits. The place of community-based ecotourism enterprises in the evolution of Namibia’s conservancies is examined. A participatory rural appraisal (PRA approach was conducted in Namibia as part of recent doctoral research in 2006 and 2007, featuring participant observation, semi-structured key informant interviews and structured communal villager interviews. Findings demonstrate some tangible successes of community-based ecotourism enterprise development, as well as emerging issues in related benefits distribution and power brokering. The case of the Torra Conservancy is profiled as a leading model for success in partnerships between conservancies, as community-based conservation institutions, and tourism enterprises. The experience of Ehi-rovipuka Conservancy is also detailed, to illuminate challenges and prospects for replicating the Torra model. Power relationships between and among private enterprise, community, and the state are elucidated. Ecotourism enterprise development can contribute successfully to community-based conservation. But, issues of power sharing, governance and competition necessitate the further evolution of commons institutions to capture future, sustainable benefits from community-based conservation premised on wildlife and related ecotourism development.

Local and national trends in general surgery residents' operative experience: do work hour limitations negatively affect case volume in small community-based programs?

Science.gov (United States)

Markelov, Alexey; Sakharpe, Aniket; Kohli, Harjeet; Livert, David

2011-12-01

The goals of this study were to analyze the impact of work hour restrictions on the operative case volume at a small community-based general surgery residency training program and compare changes with the national level. Annual national resident case log data from Accreditation Council for Graduate Medical Education (ACGME) website and case logs of graduating Easton Hospital residents (years 2002-2009) were used for analysis. Weighted average change in total number of cases in our institution was -1.20 (P = 0.52) vs 1.78 (P = 0.07) for the national program average with statistically significant difference on comparison (P = 0.027). We also found significant difference in case volume changes at the national level compared with our institution for the following ACGME defined subcategories: alimentary tract [8.19 (P < 0.01) vs -1.08 (P = 0.54)], abdomen [8.48 (P < 0.01) vs -6.29 (P < 0.01)], breast [1.91 (P = 0.89) vs -3.6 (P = 0.02)], and vascular [4.03 (P = 0.02) vs -3.98 (P = 0.01)]. Comparing the national trend to the community hospital we see that there is total increase in cases at the national level whereas there is a decrease in case volume at the community hospital. These trends can also be followed in ACGME defined subcategories which form the major case load for a general surgical training such as alimentary tract, abdominal, breast, and vascular procedures. We hypothesize that work hour restrictions have been favorable for the larger programs, as these programs were able to better integrate the night float system, restructure their call schedule, and implement institutional modifications which are too resource demanding for smaller training programs.

Community-based approaches to strategic environmental assessment: Lessons from Costa Rica

International Nuclear Information System (INIS)

Sinclair, A. John; Sims, Laura; Spaling, Harry

2009-01-01

This paper describes a community-based approach to strategic environmental assessment (SEA) using a case study of the Instituto Costarricense de Electricidad's (ICE) watershed management agricultural program (WMAP) in Costa Rica. The approach focused on four highly interactive workshops that used visioning, brainstorming and critical reflection exercises. Each workshop represented a critical step in the SEA process. Through this approach, communities in two rural watersheds assessed the environmental, social and economic impacts of a proposed second phase for WMAP. Lessons from this community-based approach to strategic environmental assessment include a recognition of participants learning what a participatory SEA is conceptually and methodologically; the role of interactive techniques for identifying positive and negative impacts of the proposed program and generating creative mitigation strategies; the effect of workshops in reducing power differentials among program participants (proponent, communities, government agencies); and, the logistical importance of notice, timing and location for meaningful participation. The community-based approach to SEA offers considerable potential for assessing regional (watershed) development programs focused on sustainable resource-based livelihoods

Teaching Community-Based Learning Course in Retailing Management

Science.gov (United States)

Rhee, Eddie

2018-01-01

This study outlines the use of a community-based learning (CBL) applied to a Retailing Management course conducted in a 16-week semester in a private institution in the East Coast. The study addresses the case method of teaching and its potential weaknesses, and discusses experiential learning for a real-world application. It further addresses CBL…

Lessons Learned From Community-Based Approaches to Sodium Reduction

Science.gov (United States)

Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

2017-01-01

Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

Immigrant-Host Community Relations in Malawi's Community Based ...

African Journals Online (AJOL)

government sponsored settlement schemes in Zimbabwe, for example, are viewed as ... diversity of community development projects and state provided public ..... Development Project in Malawi: case studies of beneficiary groups in Machinga ...

Promoting community socio-ecological sustainability through technology: A case study from Chile

Science.gov (United States)

Aguayo, Claudio; Eames, Chris

2017-12-01

The importance of community learning in effecting social change towards ecological sustainability has been recognised for some time. More recently, the use of Information and Communication Technology (ICT) tools to promote socio-ecological sustainability has been shown to have potential in community education for sustainable development (ESD). The effective design and use of technology for community learning implies an understanding of a range of cross-dimensional factors including: socio-cultural characteristics and needs of the target audience; considerations of available and culturally responsive types of technology; and non-formal pedagogical ESD strategies for community empowerment. In addition, both technology itself and social communities are dynamically evolving and complex entities. This article presents a case study which evaluated the potential of ICT for promoting ecological literacy and action competence amongst community members in southern Chile. The case study addressed the ecological deterioration of a lake, which is having deep social, economic, recreational and cultural implications locally. The authors' research involved developing a theoretical framework for the design, implementation and use of ICT for community learning for sustainability. The framework was based on key ideas from ESD, ICT and community education, and was underpinned by a systems thinking approach to account for the dynamism and complexity of such settings. Activity theory provided a frame to address overarching socio-cultural elements when using technology as a mediating tool for community learning. The authors' findings suggest that the use of an ICT tool, such as a website, can enhance ecological literacy in relation to a local socio-ecological issue.

Community-Based Care

Science.gov (United States)

... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

Cost-effectiveness analysis of the national implementation of integrated community case management and community-based health planning and services in Ghana for the treatment of malaria, diarrhoea and pneumonia.

Science.gov (United States)

Escribano Ferrer, Blanca; Hansen, Kristian Schultz; Gyapong, Margaret; Bruce, Jane; Narh Bana, Solomon A; Narh, Clement T; Allotey, Naa-Korkor; Glover, Roland; Azantilow, Naa-Charity; Bart-Plange, Constance; Sagoe-Moses, Isabella; Webster, Jayne

2017-07-05

Ghana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia: the integrated community case management (iCCM) and the community-based health planning and services (CHPS). The aim of the study was to assess the cost-effectiveness of these strategies under programme conditions. A cost-effectiveness analysis was conducted. Appropriate diagnosis and treatment given was the effectiveness measure used. Appropriate diagnosis and treatment data was obtained from a household survey conducted 2 and 8 years after implementation of iCCM in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-5 years who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. Costs data was obtained mainly from the National Malaria Control Programme (NMCP), the Ministry of Health, CHPS compounds and from a household survey. Appropriate diagnosis and treatment of malaria, diarrhoea and suspected pneumonia was more cost-effective under the iCCM than under CHPS in the Volta Region, even after adjusting for different discount rates, facility costs and iCCM and CHPS utilization, but not when iCCM appropriate treatment was reduced by 50%. Due to low numbers of carers visiting a CBA in the Northern Region it was not possible to conduct a cost-effectiveness analysis in this region. However, the cost analysis showed that iCCM in the Northern Region had higher cost per malaria, diarrhoea and suspected pneumonia case diagnosed and treated when compared to the Volta Region and to the CHPS strategy in the Northern Region. Integrated community case management was more cost-effective than CHPS for the treatment of malaria, diarrhoea and suspected pneumonia when utilized by carers of children under-5 years in the Volta Region. A revision of the iCCM strategy in the Northern Region is needed to improve its cost-effectiveness. Long-term financing

Rural Action: A Collection of Community Work Case Studies.

Science.gov (United States)

Henderson, Paul, Ed.; Francis, David, Ed.

This book contains 10 case studies of rural community development in England, Wales, Scotland, Ireland, and Catalonia, as seen from the perspective of community-work practitioners. Development projects encompassed such activities as promotion of tourism, establishment of community centers, vocational training for school dropouts, adult community…

Network-Based Community Brings forth Sustainable Society

Science.gov (United States)

Kikuchi, Toshiko

It has already been shown that an artificial society based on the three relations of social configuration (market, communal, and obligatory relations) functioning in balance with each other formed a sustainable society which the social reproduction is possible. In this artificial society model, communal relations exist in a network-based community with alternating members rather than a conventional community with cooperative mutual assistance practiced in some agricultural communities. In this paper, using the comparison between network-based communities with alternating members and conventional communities with fixed members, the significance of a network-based community is considered. In concrete terms, the difference in appearance rate for sustainable society, economic activity and asset inequality between network-based communities and conventional communities is analyzed. The appearance rate for a sustainable society of network-based community is higher than that of conventional community. Moreover, most of network-based communities had a larger total number of trade volume than conventional communities. But, the value of Gini coefficient in conventional community is smaller than that of network-based community. These results show that communal relations based on a network-based community is significant for the social reproduction and economic efficiency. However, in such an artificial society, the inequality is sacrificed.

Are community-based forest enterprises in the tropics financially viable? Case studies from the Brazilian Amazon

Science.gov (United States)

Shoana Humphries; Thomas P. Holmes; Karen Kainer; Carlos Gabriel Goncalves Koury; Edson Cruz; Rosana de Miranda Rocha

2012-01-01

Community-based forest management is an integral component of sustainable forest management and conservation in the Brazilian Amazon, where it has been heavily subsidized for the last ten years. Yet knowledge of the financial viability and impact of community-based forest enterprises (CFEs) is lacking. This study evaluates the profitability of three CFEs in the...

International Journal of Web Based Communities

DEFF Research Database (Denmark)

2006-01-01

Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ......Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ...

CMAM integration: Lessons learned from a case study on community-based child survival programmes in Bangladesh

International Nuclear Information System (INIS)

Sadler, Kate; Puett, Chloe; Myatt, Mark

2014-01-01

Bangladesh ranks among the five countries with the highest burden of acute malnutrition in the world. Barisal Division is one of the poorest areas of southern Bangladesh, with low access to health care and high prevalence of malnutrition. This prospective cohort study examined the effectiveness and feasibility of adding the diagnosis and treatment of severe acute malnutrition (SAM) to the community case management (CCM) package delivered by community health workers (CHWs) outside health facilities in Bhola District, Barisal Division. CHWs were paid a monthly stipend of 800 Taka (US$11.80). A mid-upper arm circumference measurement and an oedema check for all children under three years old were introduced into routine CHW activities, including monthly growth monitoring and promotion sessions and household visits. CHWs provided ongoing sensitization to households and community members on the causes and consequences of SAM, encouraging early treatment seeking. Integration into the CCM package of services supported high quality of care for cases of SAM, and promoted program effectiveness. The recovery rate (92%), length of stay (37.4 days) and rate of weight gain (6.7 g/kg/day) were all significantly better than international Sphere standards. Further, the coverage achieved by CHWs in this program was 89% (CI 78%–96%), one of the highest levels achieved by SAM treatment services. CHWs achieved high quality of care, with 89% of workers attaining 90% error-free case management or higher in managing cases of SAM. In receiving SAM treatment within a package of integrated services, children treated by CHWs in this study had low levels of complications and co-morbidities. Doorstep delivery promoted early treatment in this remote area. Therefore cases were easier to treat and average caseloads appeared to be manageable for CHWs. While SAM treatment increased CHW workloads, this did not negatively affect the quality of other preventive and curative services delivered

Community-Based Programming: An Opportunity and Imperative for the Community College.

Science.gov (United States)

Boone, Edgar J.

1992-01-01

Defines community-based programing as a cooperative process in which the community college serves as leader and catalyst in effecting collaboration among community members, leaders, and groups. Recommends 15 tasks for community college leaders involved in community-based programing, including environmental scanning and coalition building. (DMM)

A professional learning community model: a case study of primary teachers community in west Bandung

Science.gov (United States)

Sari, A.; Suryadi, D.; Syaodih, E.

2018-05-01

The purpose of this study is to provide an alternative model of professional learning community for primary school teachers in improving the knowledge and professional skills. This study is a qualitative research with case study method with data collection is an interview, observation and document and triangulation technique for validation data that focuses on thirteen people 5th grade elementary school teacher. The results showed that by joining a professional learning community, teachers can share both experience and knowledge to other colleagues so that they can be able to continue to improve and enhance the quality of their learning. This happens because of the reflection done together before, during and after the learning activities. It was also revealed that by learning in a professional learning community, teachers can learn in their own way, according to need, and can collaborate with their colleagues in improving the effectiveness of learning. Based on the implementation of professional learning community primary school teachers can be concluded that teachers can develop the curriculum, the students understand the development, overcome learning difficulties faced by students and can make learning design more effective and efficient.

Innovating for Transformation in First Nations Health Using Community-Based Participatory Research.

Science.gov (United States)

Kyoon-Achan, Grace; Lavoie, Josée; Avery Kinew, Kathi; Phillips-Beck, Wanda; Ibrahim, Naser; Sinclair, Stephanie; Katz, Alan

2018-06-01

Community-based participatory research (CBPR) provides the opportunity to engage communities for sustainable change. We share a journey to transformation in our work with eight Manitoba First Nations seeking to improve the health of their communities and discuss lessons learned. The study used community-based participatory research approach for the conceptualization of the study, data collection, analysis, and knowledge translation. It was accomplished through a variety of methods, including qualitative interviews, administrative health data analyses, surveys, and case studies. Research relationships built on strong ethics and protocols to enhance mutual commitment to support community-driven transformation. Collaborative and respectful relationships are platforms for defining and strengthening community health care priorities. We further discuss how partnerships were forged to own and sustain innovations. This article contributes a blueprint for respectful CBPR. The outcome is a community-owned, widely recognized process that is sustainable while fulfilling researcher and funding obligations.

Community case management improves use of treatment for ...

African Journals Online (AJOL)

Objective: Evaluate the performance of volunteers in providing Community Case Management (CCM) for diarrhea, fever and pneumonia – in a pre-HEW setting in Liben Woreda, Oromiya Regional State. Methods: Save the Children supported Ministry of Health and communities to deliver child survival interventions from ...

An academic practice's transition to the business of medicine in the community. A case study.

Science.gov (United States)

Griffin, S L; Schryver, D L

2000-01-01

This case study highlights the problems confronting a clinical practice corporation affiliated with a major medical school, and the business realizations it made in the acquisition of a community-based clinic. Launching a financially viable enterprise requires careful planning, determination of formal goals and expectations, an appropriate mix of physicians and services, a specific marketing campaign and community support.

Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease

DEFF Research Database (Denmark)

Sørensen, Sabrina Storgaard; Pedersen, Kjeld Møller; Weinreich, Ulla Møller

2017-01-01

Objectives: To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD). Methods: The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months...... was the incremental cost-effectiveness ratio (ICER) as cost per quality-adjusted life year (QALY) from the perspective of the healthcare sector. Costs were valued in British Pounds (£) at price level 2016. Scenario analyses and probabilistic sensitivity analyses were conducted in order to assess uncertainty...... of the ICER estimate. Results: The intervention resulted in a QALY improvement of 0.0146 (95% CI −0.0216; 0.0585), and a cost increase of £494 (95% CI −1778; 2766) per patient. No statistically significant difference was observed either in costs or effects. The ICER was £33,865 per QALY gained. Scenario...

Blessings for All? Community-Based Ecotourism in Bali Between Global, National, and Local Interests – A Case Study

Directory of Open Access Journals (Sweden)

Christian Byczek

2011-01-01

Full Text Available As a major island destination in South-East Asia, Bali has won a global reputation as one of the last paradises on earth. As one of the largest industries in the world, global tourism is utilised by the governments of many developing countries as an agent for development and national integration. However, local communities level the criticism that mass tourism has not only brought economic growth but also caused ecological and social costs. In reaction to the excessive developments of the past decades, local Balinese have started to actively implement community-based tourism. The ecotourism village-network Jaringan Ekowisata Desa seeks a more sustainable approach to tourism through stronger ownership and the minimisation of negative ecological impacts. The case study presented is based on fieldwork which took place in 2010. It aims to find answers to the questions of whether and to what extent community-based ecotourism initiatives may constitute a sustainable alternative to the negative effects associated with mass tourism. --- Bali gilt innerhalb der Tourismusindustrie als Inbegriff von Exotik und als eines der letzen Paradiese auf Erden. Seit jeher werden die vielfältigen Auswirkungen des Tourismus auf der Insel kontrovers diskutiert. Während vornehmlich Eliten an der in nationalem Interesse forcierten Tourismusentwicklung der südostasiatischen Top-Destination profitieren, kritisiert die einheimische Bevölkerung unzureichende Mitspracherechte und die Vernachlässigung von Nachhaltigkeitskriterien. In Reakti- on wurden seitens der Balinesen Projekte des gemeindebasierten Tourismus ins Leben gerufen. Das Ökotourismus-Dorf-Netzwerk Jaringan Ekowisata Desa ist eine solche Initiative, die sich der lokalen Eigentümerschaft und der Minimierung negativer ökologischer Folgen verschreibt. Anhand der hier präsentierten Fallstudie zu dem zivilgesellschaftlichen Projekt soll beantwortet werden, inwiefern gemeindebasierter Ökotourismus eine

Dropping out of Ethiopia’s Community Based Health Insurance scheme

NARCIS (Netherlands)

A.D. Mebratie (Anagaw); R.A. Sparrow (Robert); Z.Y. Debebe (Zelalem); G. Alemu (Getnet ); A.S. Bedi (Arjun Singh)

2014-01-01

textabstractLow contract renewal rates have been identified as one of the challenges facing the development of community based health insurance schemes (CBHI). This paper uses longitudinal household survey data to examine dropout in the case of Ethiopia’s pilot CBHI scheme, which saw enrolment

"Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

Science.gov (United States)

Mukherjee, Dhrubodhi; Saxon, Verletta

2018-01-27

This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

Sustainability of a Community-Based Enterprise through shared value. Case: Mallay Communal Company

Directory of Open Access Journals (Sweden)

William Munoz Marticorena

2018-01-01

Full Text Available The relationship of a community-based enterprise (CBE and a mining company was reviewed from the perspective of shared value creation. Specifically, through the study of the Mallay CBE and its interaction with the Buenaventura mining company, the opportunity to create economic value by creating value for the community was verified. The CBE is an organizational innovation whose management is oriented towards the market, integrating its activities with the operative dynamics of the mining company through the provision of services. CBE focuses on member’s economic benefit and the social welfare of the broader community. There are, however, barriers that limit the growth and optimization of the desired impacts caused by this articulation. Despite this, the economic and social value generated is significant and the defined growth model under certain circumstances could be replicable and scalable.

Preliminary energy demand studies for Ireland: base case and high case for 1980, 1985 and 1990

Energy Technology Data Exchange (ETDEWEB)

Henry, E W

1981-01-01

The framework of the Base Case and the High Case for 1990 for Ireland, related to the demand modules of the medium-term European Communities (EC) Energy Model, is described. The modules are: Multi-national Macre-economic Module (EURECA); National Input-Output Model (EXPLOR); and National Energy Demand Model (EDM). The final results of the EXPLOR and EDM are described; one set related to the Base Case and the other related to the High Case. The forecast or projection is termed Base Case because oil prices are assumed to increase with general price inflation, at the same rate. The other forecast is termed High Case because oil prices are assumed to increase at 5% per year more rapidly than general price inflation. The EXPLOR-EDM methodology is described. The lack of data on energy price elasticities for Ireland is noted. A comparison of the Base Case with the High Case is made. (MCW)

Sense of community: perceptions of individual and group members of online communities

NARCIS (Netherlands)

Kommers, Petrus A.M.; Bishop, Jonathan

2014-01-01

This chapter addresses the relation community-society in the case of Web-based constellations; how is society represented if we meet Web-based communities? Why are Web-based societies kept invisible while Web-communities emerge as a quasi-natural consequence of Web presence? Did Web-communities

Community-based enterprises: The significance of partnerships and institutional linkages

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Seixas, Cristiana Simão; Berkes, Fikret

2010-01-01

Community-based institutions used to be driven by local needs, but in recent decades, some of them have been responding to national and global economic opportunities. These cases are of interest because they make it possible to investigate how local institutions can evolve in response to new

Benchmarking Alumni Relations in Community Colleges: Findings from a 2012 CASE Survey. CASE White Paper

Science.gov (United States)

Paradise, Andrew; Heaton, Paul

2013-01-01

In 2011, CASE founded the Center for Community College Advancement to provide training and resources to help community colleges build and sustain effective fundraising, alumni relations and communications and marketing programs. This white paper summarizes the results of a groundbreaking survey on alumni relations programs at community colleges…

Leadership to Build a Democratic Community within School: A Case Study of Two Korean High Schools

Science.gov (United States)

Kang, Young Taek; Printy, Susan

2009-01-01

This article aims to explore how democratic community is manifest in schools in Korea. It also tries to examine how leadership, specifically transformational leadership, functions in shaping a democratic community within a school. Toward this aim, we have conducted a case study of two religious high schools in Korea. Based on the findings from the…

Assessing participatory practices in community-based natural resource management: experiences in community engagement from southern Africa.

Science.gov (United States)

Dyer, J; Stringer, L C; Dougill, A J; Leventon, J; Nshimbi, M; Chama, F; Kafwifwi, A; Muledi, J I; Kaumbu, J-M K; Falcao, M; Muhorro, S; Munyemba, F; Kalaba, G M; Syampungani, S

2014-05-01

The emphasis on participatory environmental management within international development has started to overcome critiques of traditional exclusionary environmental policy, aligning with shifts towards decentralisation and community empowerment. However, questions are raised regarding the extent to which participation in project design and implementation is meaningful and really engages communities in the process. Calls have been made for further local-level (project and community-scale) research to identify practices that can increase the likelihood of meaningful community engagement within externally initiated projects. This paper presents data from three community-based natural resource management (CBNRM) project case studies from southern Africa, which promote Joint Forest Management (JFM), tree planting for carbon and conservation agriculture. Data collection was carried out through semi-structured interviews with key stakeholders, community-level meetings, focus groups and interviews. We find that an important first step for a meaningful community engagement process is to define 'community' in an open and participatory manner. Two-way communication at all stages of the community engagement process is shown to be critical, and charismatic leadership based on mutual respect and clarity of roles and responsibilities is vital to improve the likelihood of participants developing understanding of project aims and philosophy. This can lead to successful project outcomes through community ownership of the project goals and empowerment in project implementation. Specific engagement methods are found to be less important than the contextual and environmental factors associated with each project, but consideration should be given to identifying appropriate methods to ensure community representation. Our findings extend current thinking on the evaluation of participation by making explicit links between the community engagement process and project outcomes, and by

Results from the 2014 CASE Survey of Community College Foundations. CASE White Paper

Science.gov (United States)

Paradise, Andrew

2015-01-01

In 2011, the Council for Advancement and Support of Education (CASE) founded the Center for Community College Advancement to provide training and resources to help community colleges build and sustain effective fundraising, alumni relations, and communications and marketing programs. A goal for the center is to collect data on best practices at…

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

International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

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Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

2017-03-24

National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

Integrating interprofessional education in community-based learning activities: case study.

Science.gov (United States)

Hosny, Somaya; Kamel, Mohamed H; El-Wazir, Yasser; Gilbert, John

2013-01-01

Faculty of Medicine/Suez Canal University (FOM/SCU) students are exposed to clinical practice in primary care settings within the community, in which they encounter patients and begin to work within interprofessional health teams. However, there is no planned curricular interaction with learners from other professions at the learning sites. As in other schools, FOM/SCU faces major challenges with the coordination of community-based education (CBE) program, which include the complexity of the design required for Interprofessional Education (IPE) as well as the attitudinal barriers between professions. The aim of the present review is to: (i) describe how far CBE activities match the requirements of IPE, (ii) explore opinions of graduates about the effectiveness of IPE activities, and (iii) present recommendations for improvement. Graduates find the overall outcome of their IPE satisfactory and believe that it produces physicians who are familiar with the roles of other professions and can work in synergy for the sake of better patient care. However, either a specific IPE complete module needs to be developed or more IPE specific objectives need to be added to current modules. Moreover, coordination with stakeholders from other health profession education institutes needs to be maximized to achieve more effective IPE.

Building the Case: Changing Consumer Perceptions of the Value of Expanded Community Pharmacist Services.

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Steckowych, Kathryn; Smith, Marie; Spiggle, Susan; Stevens, Andrew; Li, Hao

2018-01-01

The role of the community pharmacist has traditionally been a medication dispenser; however, community pharmacists' responsibilities must expand to include more direct patient care services in order to transform primary care practice. Use case-based scenarios to (1) determine factors that contribute to positive and negative consumer perceptions of expanded community pharmacist patient care roles, (2) identify facilitators and barriers that contribute to consumer perceptions of the value of expanded community pharmacist patient care services, and (3) develop a successful approach and strategies for increasing consumer advocacy for the value of expanded community pharmacist patient care services. Two consumer focus groups used scenario-based guided discussions and Likert scale questionnaires to elicit consumer reactions, facilitators, and barriers to expanded community pharmacist services. Convenience, timeliness, and accessibility were common positive reactions across all 3 scenarios. Team approach to care and trust were viewed as major facilitators. Participant concerns included uncertainty about pharmacist training and qualifications, privacy, pharmacists' limited bandwidth to accept new tasks, and potential increased patient costs. Common barriers to service uptake included a lack of insurance payment and physician preference to provide the services. Consumer unfamiliarity with non-traditional community pharmacist services is likely an influencer of consumers' hesitancy to utilize such services; therefore, an opportunity exists to engage consumers and advocacy organizations in supporting expanded community pharmacist roles. This study can inform consumers, advocates, community pharmacists, primary care providers, and community-based organizations on methods to shape consumer perceptions on the value of community pharmacist expanded services.

Renewal strategy and community based organisations in community ...

African Journals Online (AJOL)

Renewal strategy and community based organisations in community ... the local population and resources to do that which the governments had failed to do. ... country with a view to reducing poverty and developmental imbalance in Nigeria.

First 101 Robotic General Surgery Cases in a Community Hospital

Science.gov (United States)

Robertson, Jarrod C.; Alrajhi, Sharifah

2016-01-01

Background and Objectives: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. Methods: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics. Results: Between March 2014 and August 2015, 101 robotic general surgery cases were performed by a single surgeon in a 266-bed community hospital, including laparoscopic cholecystectomies, inguinal hernia repairs; ventral, incisional, and umbilical hernia repairs; and colorectal, foregut, bariatric, and miscellaneous procedures. Ninety-nine of the cases were completed robotically. Seven patients were readmitted within 30 days. There were 8 complications (7.92%). There were no mortalities and all complications were resolved with good outcomes. The mean operative time was 233.0 minutes. The mean console operative time was 117.6 minutes. Conclusion: A robotic general surgery program can be safely implemented in a small community hospital with extensive training of the surgical team through basic robotic skills courses as well as supplemental educational experiences. Although the use of the robotic platform in general surgery could be limited to complex procedures such as foregut and colorectal surgery, it can also be safely used in a large variety of operations with results similar to those of conventional laparoscopy. PMID:27667913

Final base case community analysis: Indian Springs, Nevada for the Clark County socioeconomic impact assessment of the proposed high- level nuclear waste repository at Yucca Mountain, Nevada

Energy Technology Data Exchange (ETDEWEB)

NONE

1992-06-18

This document provides a base case description of the rural Clark County community of Indian Springs in anticipation of change associated with the proposed high-level nuclear waste repository at Yucca Mountain. As the community closest to the proposed site, Indian Springs may be seen by site characterization workers, as well as workers associated with later repository phases, as a logical place to live. This report develops and updates information relating to a broad spectrum of socioeconomic variables, thereby providing a `snapshot` or `base case` look at Indian Springs in early 1992. With this as a background, future repository-related developments may be analytically separated from changes brought about by other factors, thus allowing for the assessment of the magnitude of local changes associated with the proposed repository. Given the size of the community, changes that may be considered small in an absolute sense may have relatively large impacts at the local level. Indian Springs is, in many respects, a unique community and a community of contrasts. An unincorporated town, it is a small yet important enclave of workers on large federal projects and home to employees of small- scale businesses and services. It is a rural community, but it is also close to the urbanized Las Vega Valley. It is a desert community, but has good water resources. It is on flat terrain, but it is located within 20 miles of the tallest mountains in Nevada. It is a town in which various interest groups diverge on issues of local importance, but in a sense of community remains an important feature of life. Finally, it has a sociodemographic history of both surface transience and underlying stability. If local land becomes available, Indian Springs has some room for growth but must first consider the historical effects of growth on the town and its desired direction for the future.

Final base case community analysis: Indian Springs, Nevada for the Clark County socioeconomic impact assessment of the proposed high- level nuclear waste repository at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

1992-01-01

This document provides a base case description of the rural Clark County community of Indian Springs in anticipation of change associated with the proposed high-level nuclear waste repository at Yucca Mountain. As the community closest to the proposed site, Indian Springs may be seen by site characterization workers, as well as workers associated with later repository phases, as a logical place to live. This report develops and updates information relating to a broad spectrum of socioeconomic variables, thereby providing a 'snapshot' or 'base case' look at Indian Springs in early 1992. With this as a background, future repository-related developments may be analytically separated from changes brought about by other factors, thus allowing for the assessment of the magnitude of local changes associated with the proposed repository. Given the size of the community, changes that may be considered small in an absolute sense may have relatively large impacts at the local level. Indian Springs is, in many respects, a unique community and a community of contrasts. An unincorporated town, it is a small yet important enclave of workers on large federal projects and home to employees of small- scale businesses and services. It is a rural community, but it is also close to the urbanized Las Vega Valley. It is a desert community, but has good water resources. It is on flat terrain, but it is located within 20 miles of the tallest mountains in Nevada. It is a town in which various interest groups diverge on issues of local importance, but in a sense of community remains an important feature of life. Finally, it has a sociodemographic history of both surface transience and underlying stability. If local land becomes available, Indian Springs has some room for growth but must first consider the historical effects of growth on the town and its desired direction for the future

The ‘community’ in community case management of childhood illnesses in Malawi

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Wanga Z. Zembe-Mkabile

2016-01-01

Full Text Available Background: Malawi has achieved a remarkable feat in reducing its under-5 mortality in time to meet its MDG 4 target despite high levels of poverty, low female literacy rates, recurrent economic crises, a severe shortage of human resources for health, and poor health infrastructure. The country's community-based delivery platform (largely headed by Health Surveillance Assistants, or HSAs has been well established since the 1960s, although their tasks and responsibilities have evolved from surveillance to health promotion and prevention, and more recently to include curative services. However, the role of and the form that community involvement takes in community-based service delivery in Malawi is unclear. Design: A qualitative rapid appraisal approach was utilised to explore the role of community involvement in the HSA programme in Malawi to better understand how the various community providers intersect to support the delivery of integrated community case management by HSAs. Twelve focus group discussions and 10 individual interviews were conducted with HSAs, HSA supervisors, mothers, members of village health committees (VHCs, senior Ministry of Health officials, district health teams, and implementing partners. Results: Our findings reveal that HSAs are often deployed to areas outside of their village of residence as communities are not involved in selecting their own HSAs in Malawi. Despite this lack of involvement in selection, the high acceptance of the HSAs by community members and community accountability structures such as VHCs provide the programme with legitimacy and credibility. Conclusions: This study provides insight into how community involvement plays out in the context of a government-managed professionalised community service delivery platform. It points to the need for further research to look at the impact of removing the role of HSA selection and deployment from the community and placing it at the central level.

University-Community Engagement: Case Study of University Social Responsibility

Science.gov (United States)

Chile, Love M.; Black, Xavier M.

2015-01-01

Corporatisation of universities has drawn parallels between contemporary universities and business corporations, and extended analysis of corporate social responsibility to universities. This article reports on a case study of university-community engagement with schools and school communities through youth engagement programmes to enhance…

Analysing a Web-Based E-Commerce Learning Community: A Case Study in Brazil.

Science.gov (United States)

Joia, Luiz Antonio

2002-01-01

Demonstrates the use of a Web-based participative virtual learning environment for graduate students in Brazil enrolled in an electronic commerce course in a Masters in Business Administration program. Discusses learning communities; computer-supported collaborative work and collaborative learning; influences on student participation; the role of…

An Agent-Based Model of Evolving Community Flood Risk.

Science.gov (United States)

Tonn, Gina L; Guikema, Seth D

2017-11-17

Although individual behavior plays a major role in community flood risk, traditional flood risk models generally do not capture information on how community policies and individual decisions impact the evolution of flood risk over time. The purpose of this study is to improve the understanding of the temporal aspects of flood risk through a combined analysis of the behavioral, engineering, and physical hazard aspects of flood risk. Additionally, the study aims to develop a new modeling approach for integrating behavior, policy, flood hazards, and engineering interventions. An agent-based model (ABM) is used to analyze the influence of flood protection measures, individual behavior, and the occurrence of floods and near-miss flood events on community flood risk. The ABM focuses on the following decisions and behaviors: dissemination of flood management information, installation of community flood protection, elevation of household mechanical equipment, and elevation of homes. The approach is place based, with a case study area in Fargo, North Dakota, but is focused on generalizable insights. Generally, community mitigation results in reduced future damage, and individual action, including mitigation and movement into and out of high-risk areas, can have a significant influence on community flood risk. The results of this study provide useful insights into the interplay between individual and community actions and how it affects the evolution of flood risk. This study lends insight into priorities for future work, including the development of more in-depth behavioral and decision rules at the individual and community level. © 2017 Society for Risk Analysis.

Recruitment Strategies and Costs Associated with Community-Based Research in a Mexican-Origin Population

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Mendez-Luck, Carolyn A.; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S.; Mangione, Carol M.

2011-01-01

Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study…

Ethics and community-based participatory research: perspectives from the field.

Science.gov (United States)

Bastida, Elena M; Tseng, Tung-Sung; McKeever, Corliss; Jack, Leonard

2010-01-01

Exploring the importance of ethical issues in the conduct of community-based participatory research (CBPR) continues to be an important topic for researchers and practitioners. This article uses the Beyond Sabor Project, a CBPR project implemented in the Lower Rio Grande Valley, as a case example to discuss ethical issues such as the importance of increasing community involvement in research, ensuring that communities benefit from the research, sharing leadership roles, and sensitive issues regarding data collection and sharing. Thereafter, this article concludes with a brief discussion of six principles that can inform the practice of ethical conduct when implementing CBPR studies. This article also lists additional reading resources on the importance of ethics in the conduct of CBPR.

Equity, Inclusion and Conflict in Community Based Forest Management: A Case of Salghari Community Forest in Nepal

Directory of Open Access Journals (Sweden)

Sushant Acharya

2015-12-01

Full Text Available The equity and inclusion issues are widely observed in Community Based Forest Management (CBFM and Community Forestry (CF is not an exception. Community Forest User Groups (CFUGs are portrayed as robust grassroots institutions for forest management and group governance. However, many contemporary researches have shown that CFUGs are still governed by some influential local elites who hardly practice equity and inclusion. In this context, objectives of this paper are: to explore how equity and inclusion issues lead CFUGs fall into internal conflicts; and to demonstrate how CFUGs are able to address such issues locally. The study was carried out in Salghari CFUG of Ratnechaur, Myagdi. Semi-structured interview and focused group discussion were key tools used for data collection. Livelihoods and Social Inclusion Framework and Equity Framework are used for data analysis. The findings of the research revealed that dalits and non-dalits of Salghari fall into internal conflict regarding the use of forest products. The conflict was then managed through amendments in CF provisions and change in CF leadership. This paper concludes that execution of equity and inclusion provisions in CF, secures access to assets for disadvantaged people from CBFM. However, this demands empowerment of these people and facilitating role of external agency.

Formulation of an Integrated Community Based Disaster Management for Hydroelectric facilities: The Malaysia Case

Science.gov (United States)

Hijazzi, Norshamirra; Thiruchelvam, Sivadass; Sabri Muda, Rahsidi; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Ghazali, Azrul; Kamal Kadir, Ahmad; Hakimie, Hazlinda; Sahari, Khairul Salleh Mohamed; Hasini, Hasril; Mohd Sidek, Lariyah; Itam, Zarina; Fadhli Mohamad, Mohd; Razad, Azwin Zailti Abdul

2016-03-01

Dams, however significant their contributions are to the society, are not immune to failures and diminishing lifespan not unlike other structural elements in our infrastructure. Despite continuing efforts on design, construction, operation, and maintenance of dams to improve the safety of the dams, the possibility of unforeseen events of dam failures is still possible. Seeing that dams are usually integrated into close approximities with the community, dam failures may consequent in tremendous loss of lives and properties. The aims of formulation of Integrated Community Based Disaster Management (ICBDM) is to simulate evacuation modelling and emergency planning in order to minimize loss of life and property damages in the event of a dam-related disaster. To achieve the aim above, five main pillars have been identified for the formulation of ICBDM. A series of well-defined program inclusive of hydrological 2-D modelling, life safety modelling, community based EWS and CBTAP will be conducted. Finally, multiple parties’ engagement is to be carried out in the form of table top exercise to measure the readiness of emergency plans and response capabilities of key players during the state of a crisis.

Spatial distribution and deployment of community-based distributors implementing integrated community case management (iCCM): Geographic information system (GIS) mapping study in three South Sudan states.

Science.gov (United States)

Pratt, Abigail; Dale, Martin; Olivi, Elena; Miller, Jane

2014-12-01

In late 2012 and in conjunction with South Sudan's Ministry of Health - National Malaria Control Program, PSI (Population Services International) conducted a comprehensive mapping exercise to assess geographical coverage of its integrated community case management (iCCM) program and consider scope for expansion. The operational research was designed to provide evidence and support for low-cost mapping and monitoring systems, demonstrating the use of technology to enhance the quality of programming and to allow for the improved allocation of resources through appropriate and need-based deployment of community-based distributors (CBDs). The survey took place over the course of three months and program staff gathered GPS (global positioning system) data, along with demographic data, for over 1200 CBDs and 111 CBD supervisors operating in six counties in South Sudan. Data was collated, cleaned and quality assured, input into an Excel database, and subsequently uploaded to geographic information system (GIS) for spatial analysis and map production. The mapping results showed that over three-quarters of CBDs were deployed within a five kilometer radius of a health facility or another CBD, contrary to program planning and design. Other characteristics of the CBD and CBD supervisor profiles (age, gender, literacy) were more closely matched with other regional programs. The results of this mapping exercise provided a valuable insight into the contradictions found between a program "deployment plan" and the realities observed during field implementation. It also highlighted an important need for program implementers and national-level strategy makers to consider the natural and community-driven diffusion of CBDs, and take into consideration the strength of the local health facilities when developing a deployment plan.

Integrating Community into the Classroom: Community Gardening, Community Involvement, and Project-Based Learning.

Science.gov (United States)

Langhout, Regina Day; Rappaport, Julian; Simmons, Doretha

2002-01-01

Culturally relevant, ongoing project-based learning was facilitated in a predominantly African American urban elementary school via a community garden project. The project involved teachers, students, university members, and community members. This article evaluates the project through two classroom-community collaboration models, noting common…

A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia.

Science.gov (United States)

Biemba, Godfrey; Chiluba, Boniface; Yeboah-Antwi, Kojo; Silavwe, Vichaels; Lunze, Karsten; Mwale, Rodgers K; Russpatrick, Scott; Hamer, Davidson H

2017-09-27

Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide real-time, community-based health information from community health workers (CHWs) to health center staff and higher levels of the health system. We developed a C-HMIS mobile platform for use by CHWs providing integrated community case management (iCCM) services and their supervisors to address challenges of frequent stock-outs and inadequate supportive supervision of iCCM-trained CHWs. The platform used simple feature mobile phones on which were loaded the District Health Information System version 2 (DHIS2) software and Java 2 platform micro edition (J2ME) aggregation and tracker applications. This project was implemented in Chipata and Chadiza districts, which supported previous mHealth programs and had cellular coverage from all 3 major network carriers in Zambia. A total of 40 CHWs and 20 CHW supervisors received mobile phones with data bundles and training in the mobile application, after which they implemented the program over a period of 5.5 months, from February to mid-July 2016. CHWs used the mobile phones to submit data on iCCM cases seen, managed, and referred, as well as iCCM medical and diagnostic supplies received and dispensed. Using their mobile phones, the supervisors tracked CHWs' reported cases with medicine consumption, sent CHWs feedback on their referrals, and received SMS reminders to set up mentorship sessions. CHWs were able to use the mobile application to send weekly reports to health center supervisors on disease caseloads and medical commodities consumed, to make drug and supply requisitions, and to send pre-referral notices to health centers. Health center staff used the mobile system to provide feedback to CHWs on the case outcomes of referred patients and to receive automated monthly SMS reminders to invite CHWs to

Implementing a low-cost web-based clinical trial management system for community studies: a case study.

Science.gov (United States)

Geyer, John; Myers, Kathleen; Vander Stoep, Ann; McCarty, Carolyn; Palmer, Nancy; DeSalvo, Amy

2011-10-01

Clinical trials with multiple intervention locations and a single research coordinating center can be logistically difficult to implement. Increasingly, web-based systems are used to provide clinical trial support with many commercial, open source, and proprietary systems in use. New web-based tools are available which can be customized without programming expertise to deliver web-based clinical trial management and data collection functions. To demonstrate the feasibility of utilizing low-cost configurable applications to create a customized web-based data collection and study management system for a five intervention site randomized clinical trial establishing the efficacy of providing evidence-based treatment via teleconferencing to children with attention-deficit hyperactivity disorder. The sites are small communities that would not usually be included in traditional randomized trials. A major goal was to develop database that participants could access from computers in their home communities for direct data entry. Discussed is the selection process leading to the identification and utilization of a cost-effective and user-friendly set of tools capable of customization for data collection and study management tasks. An online assessment collection application, template-based web portal creation application, and web-accessible Access 2007 database were selected and customized to provide the following features: schedule appointments, administer and monitor online secure assessments, issue subject incentives, and securely transmit electronic documents between sites. Each tool was configured by users with limited programming expertise. As of June 2011, the system has successfully been used with 125 participants in 5 communities, who have completed 536 sets of assessment questionnaires, 8 community therapists, and 11 research staff at the research coordinating center. Total automation of processes is not possible with the current set of tools as each is loosely

Local perceptions on social-ecological dynamics in Latin America in three community-based natural resource management systems

Directory of Open Access Journals (Sweden)

Maria del Mar Delgado-Serrano

2015-12-01

Full Text Available Several examples of community-based natural resource management in Latin American social-ecological systems exist in which communities control the management of common-pool resources. Understanding community perceptions of the performance of these systems is essential to involve communities in sustainable management strategies. In this analysis of three areas in Colombia, Mexico, and Argentina, we analyzed the local perceptions of the social and environmental challenges faced by these social-ecological systems and how these challenges and drivers affect their resilience. To do this, we combined prospective structural analysis to unravel stakeholders' perceptions of each system's functioning along with network analysis to assess resilience. We identified external variables as the most influential variables in the Colombian and Argentine cases. In the Mexican case, larger influence is exerted by internal variables, particularly those linked to the governance system. The case study analysis revealed that the community-based natural resource management approach needs external support and recognition to work effectively. In the Argentine and Colombian cases, megaprojects were perceived as controllers with medium or strong influence but low dependence. The use of ancestral knowledge (Colombia, the history of land use (Mexico, and the history of the artisanal fishery (Argentina were all perceived as common challenges to community-based natural resource management. In terms of social-ecological resilience, framed within the three-dimensional model of the adaptive cycle, all three social-ecological systems were considered to be highly connected and resilient but with different degrees of capacity or cumulative potential.

Teaching nutrition to medical students: a community-based problem-solving approach.

Science.gov (United States)

Bhattacharji, S; Joseph, A; Abraham, S; Muliyil, J; John, K R; Ethirajan, N

1990-01-01

This paper presents a community-based problem-solving educational programme which aims at teaching medical and other health science students the importance of nutrition and its application. Through community surveys students assess the nutritional status of children under five using different anthropometric methods. They understand the cultural beliefs and customs related to food fads and the reasons for them. They also acquire the skill to educate the community using the information gathered. They use epidemiological methods such as case control study to find associations between malnutrition and other causative factors. Feedback from students has been positive and evaluation of students' knowledge before and after the programme has shown significant improvement.

A robust University-NGO partnership: Analysing school efficiencies in Bolivia with community-based management techniques

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Joao Neiva de Figueiredo

2013-09-01

Full Text Available Community-based management research is a collaborative effort between management, academics and communities in need with the specific goal of achieving social change to foster social justice. Because it is designed to promote and validate joint methods of discovery and community-based sources of knowledge, community-based management research has several unique characteristics, which may affect its execution. This article describes the process of a community-based management research project which is descriptive in nature and uses quantitative techniques to examine school efficiencies in low-income communities in a developing country – Bolivia. The article describes the partnership between a US-based university and a Bolivian not-for-profit organisation, the research context and the history of the research project, including its various phases. It focuses on the (yet unpublished process of the community-based research as opposed to its content (which has been published elsewhere. The article also makes the case that the robust partnership between the US-based university and the Bolivian NGO has been a determining factor in achieving positive results. Strengths and limitations are examined in the hope that the experience may be helpful to others conducting descriptive quantitative management research using community-engaged frameworks in cross-cultural settings. Keywords: international partnership, community-engaged scholarship, education efficiency, multicultural low-income education.

Benchmarking Alumni Relations in Community Colleges: Findings from a 2015 CASE Survey. CASE White Paper

Science.gov (United States)

Paradise, Andrew

2016-01-01

Building on the inaugural survey conducted three years prior, the 2015 CASE Community College Alumni Relations survey collected additional insightful data on staffing, structure, communications, engagement, and fundraising. This white paper features key data on alumni relations programs at community colleges across the United States. The paper…

Success Factors for Community-Based Natural Resource Management (CBNRM): Lessons from Kenya and Australia

Science.gov (United States)

Measham, Thomas G.; Lumbasi, Jared A.

2013-09-01

Recent concerns over a crisis of identity and legitimacy in community-based natural resource management (CBNRM) have emerged following several decades of documented failure. A substantial literature has developed on the reasons for failure in CBNRM. In this paper, we complement this literature by considering these factors in relation to two successful CBNRM case studies. These cases have distinct differences, one focusing on the conservation of hirola in Kenya on community-held trust land and the other focusing on remnant vegetation conservation from grazing pressure on privately held farm land in Australia. What these cases have in common is that both CBNRM projects were initiated by local communities with strong attachments to their local environments. The projects both represent genuine community initiatives, closely aligned to the original aims of CBNRM. The intrinsically high level of "ownership" held by local residents has proven effective in surviving many challenges which have affected other CBNRM projects: from impacts on local livelihoods to complex governance arrangements involving non-government organizations and research organizations. The cases provide some signs of hope among broader signs of crisis in CBNRM practice.

Engineering Hybrid Learning Communities: The Case of a Regional Parent Community

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Sven Strickroth

2014-09-01

Full Text Available We present an approach (and a corresponding system design for supporting regionally bound hybrid learning communities (i.e., communities which combine traditional face-to-face elements with web based media such as online community platforms, e-mail and SMS newsletters. The goal of the example community used to illustrate the approach was to support and motivate (especially hard-to-reach underprivileged parents in the education of their young children. The article describes the design process used and the challenges faced during the socio-technical system design. An analysis of the community over more than one year indicates that the hybrid approach works better than the two separated “traditional” approaches separately. Synergy effects like advertising effects from the offline trainings for the online platform and vice versa occurred and regular newsletters turned out to have a noticeable effect on the community.

From Campuses to Communities: Community-Based Cultism and ...

African Journals Online (AJOL)

Due to the criminal activities of the cult groups in the NDR and ineptitude of the police, communities have responded by creating vigilante groups but this has only promoted cycle of violence. The paper recommended that government should tackle community-based cultism and also strengthen the Nigeria Police Force to be ...

Harvesting energy: Place and local entrepreneurship in community-based renewable energy transition

International Nuclear Information System (INIS)

Süsser, Diana; Döring, Martin; Ratter, Beate M.W.

2017-01-01

Transition towards a renewable energy supply initiates a physical (re)shaping of places and a social transformation of communities into renewable energy communities. Although socio-cultural challenges of energy transition have been recognised (), understandings about socio-geographic places of energy transition and their underlying social processes and structures are insufficiently studied and often remain underestimated. To close this gap, we theoretically and empirically analysed the multifaceted interplay between place, local entrepreneurship and ‘community renewable energy’. Our study is based on an analysis of regional documents and policy reports, and on qualitative interviews undertaken with inhabitants in the case-study municipality of Reußenköge (Germany). Our findings reveal two important aspects: Firstly, people's individual and shared place meanings which materialised in social, physical, historical and climate-related place-attachments and meanings of contested and innovative place are important ingredients bearing an impact on processes of adopting or rejecting renewables. Secondly, differentiated characteristics of entrepreneurs, namely grounded, collaborative, innovative, change-making, economic, communicating, networking and political aspects, appeared to be relevant for the acceptance and support in community-based renewable energy projects. Our findings reveal that energy policies, funding schemes and administrative structures should recognise local socio-geographic important elements in the context of a sustained and decentralised energy transition. - Highlights: • Places are resources of experiences, creativity and innovation for community renewables. • Energy policies should recognise place-based approaches to grassroots community energy actions. • A located view of multifaceted entrepreneurship is relevant to support community renewable energy. • Supportive funding schemes should empower community-based concepts.

Transgressing the norm: Transformative agency in community-based learning for sustainability in southern African contexts

Science.gov (United States)

Lotz-Sisitka, Heila; Mukute, Mutizwa; Chikunda, Charles; Baloi, Aristides; Pesanayi, Tichaona

2017-12-01

Environment and sustainability education processes are often oriented to change and transformation, and frequently involve the emergence of new forms of human activity. However, not much is known about how such change emerges from the learning process, or how it contributes to the development of transformative agency in community contexts. The authors of this article present four cross-case perspectives of expansive learning and transformative agency development in community-based education in southern Africa, studying communities pursuing new activities that are more socially just and sustainable. The four cases of community learning and transformative agency focus on the following activities: (1) sustainable agriculture in Lesotho; (2) seed saving and rainwater harvesting in Zimbabwe; (3) community-based irrigation scheme management in Mozambique; and (4) biodiversity conservation co-management in South Africa. The case studies all draw on cultural-historical activity theory to guide learning and change processes, especially third-generation cultural-historical activity theory (CHAT), which emphasises expansive learning in collectives across interacting activity systems. CHAT researchers, such as the authors of this article, argue that expansive learning can lead to the emergence of transformative agency. The authors extend their transformative agency analysis to probe if and how expansive learning might also facilitate instances of transgressing norms - viewed here as embedded practices which need to be reframed and changed in order for sustainability to emerge.

Community members’ initiatives in public open spaces: two case studies from Slovenia

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Sabina Jelenc Krašovec

2017-10-01

Full Text Available The paper deals with public spaces as open, everyday arenas where people share experiences beyond their immediate circle of friends, family and age group. Public space is understood as a forum for social and personal change (Harvey, 2011; Lefebvre, 2013; Arendt, 1996; Habermas, 1989; 2001. Questions are analysed from the point of view of community members, who are strongly attached to the space and who are interested in belonging and in proactive changes in their living environment (Iecovich, 2014; Kohn 2004; Mean and Tims, 2005. The paper is based on the presumptions that public space has an important role in generating ideas and activities of community members and that it is an important venue for community members’ informal learning. Ethnomethodological research in two public spaces (the Tabor community in Ljubljana and a small community in the coastal town of Izola show that there are differences between both public spaces regarding top-down initiatives and bottom-up, self-organized activities. However, although the activity initiators were in one case different associations rooted in the community, and in the other the local people themselves, most of the activities were conducted by people living in the selected communities/public spaces themselves as is typical of grassroots activities. It was confirmed that learning was not often mentioned by members of either community and was mostly a hidden activity, resulting in tacit knowledge.

Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

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A. Gero

2011-01-01

Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

DESA WISATA SEBAGAI COMMUNITY BASED TOURISM

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Dhimas Setyo Nugroho

2017-12-01

Full Text Available The concept of community-based tourism in the dome house tourism village has succeeded in becoming a tool to trigger the development of the dome house resident and its environment. All of the development can be obviously seen from the economic, social, cultural, environmental and political aspects with a very enthusiastic participation of the resident. The rapid development of the resident and their high participation can emerge a strategy to make the tourist village survive from the tourism industry competition. In this case, the author found that there is a connection between the high level of community participation and the rapid development as the result of it. Therefore, the more the resident willing to participate, the more it will affect the development of the resident and its environment. This research uses qualitative method. The data were obtained by conducting interview, observation, and documentation. After those steps, the data were processed by interactive and SWOT analysis. Then, questionnaire was used to validate the data towards 21 residents.

Development of a community-based diabetes and hypertension preventive program.

Science.gov (United States)

Wang, C Y; Abbott, L J

1998-12-01

The purpose of this project was to develop rapport with a Chinese Community Association and then establish preventive diabetic and hypertension programs with the Chinese in Chinatown, Hawaii. Subjects were recruited from this Chinese Community Association. Two hundred Chinese responded to the invitation. Among these, 75 individuals had either Type 2 diabetes, hypertension or both. Thirty-six males and 39 females ranging in age from 51 years old to 96 years old (Mean = 71.76, SD = 9.58) participated. Surveys and educational programs were carried out in Chinese. Results were described in terms of quantitative measures (family support and health outcomes) and qualitative experiences (case studies). Eighty percent of participants had decreased their diastolic blood pressure from above 95 mmHg to below 90 mmHg and systolic blood pressure from above 155 mmHg to below 140 mmHg. Ninety-five (n = 71) percent of participants had maintained their glucose level within the 90 mg/dL to 150 mg/dL range with a mean reduction of 57.86 mg/dL in one year. The hardest thing for families was the glucose self-monitoring. Case studies suggested that open-minded active listening and persistence formed the basis for developing a culturally sensitive community-based self management program for chronic diseases. Collaboration among the community, public health nurses, and diabetes nurse educators facilitated the process of community education and health promotion.

Community referral for presumptive TB in Nigeria: a comparison of four models of active case finding

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A. O. Adejumo

2016-02-01

Full Text Available Abstract Background Engagement of communities and civil society organizations is a critical part of the Post-2015 End TB Strategy. Since 2007, many models of community referral have been implemented to boost TB case detection in Nigeria. Yet clear insights into the comparative TB yield from particular approaches have been limited. Methods We compared four models of active case finding in three Nigerian states. Data on presumptive TB case referral by community workers (CWs, TB diagnoses among referred clients, active case finding model characteristics, and CWs compensation details for 2012 were obtained from implementers and CWs via interviews and log book review. Self-reported performance data were triangulated against routine surveillance data to assess concordance. Analysis focused on assessing the predictors of presumptive TB referral. Results CWs referred 4–22 % of presumptive TB clients tested, and 4–24 % of the total TB cases detected. The annual median referral per CW ranged widely among the models from 1 to 48 clients, with an overall average of 13.4 referrals per CW. The highest median referrals (48 per CW/yr and mean TB diagnoses (7.1/yr per CW (H =70.850, p < 0.001 was obtained by the model with training supervision, and $80/quarterly payments (Comprehensive Quotas-Oriented model. The model with irregularly supervised, trained, and compensated CWs contributed the least to TB case detection with a median of 13 referrals per CW/yr and mean of 0.53 TB diagnoses per CW/yr. Hours spent weekly on presumptive TB referral made the strongest unique contribution (Beta = 0.514, p < 0.001 to explaining presumptive TB referral after controlling for other variables. Conclusion All community based TB case-finding projects studied referred a relative low number of symptomatic individuals. The study shows that incentivized referral, appropriate selection of CWs, supportive supervision, leveraged treatment support roles, and a

Community-based recreational football

DEFF Research Database (Denmark)

Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter

2014-01-01

is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under...... the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport...

Stirring up the Mud: Using a Community-Based Participatory Approach to Address Health Disparities through a Faith-Based Initiative

Science.gov (United States)

Kaplan, Sue A.; Ruddock, Charmaine; Golub, Maxine; Davis, Joyce; Foley, Robert; Devia, Carlos; Rosen, Rosa; Berry, Carolyn; Barretto, Brenda; Carter, Toni; Irish-Spencer, Evalina; Marchena, Maria; Purcaro, Ellenrita; Calman, Neil

2011-01-01

This case study provides a mid-course assessment of the Bronx Health REACH faith-based initiative four years into its implementation. The study uses qualitative methods to identify lessons learned and to reflect on the benefits and challenges of using a community-based participatory approach for the development and evaluation of a faith-based program designed to address health disparities. Key findings concern the role of pastoral leadership, the importance of providing a religious context for health promotion and health equality messages, the challenges of creating a bilingual/bi-cultural program, and the need to provide management support to the lay program coordinators. The study also identifies lessons learned about community-based evaluation and the importance of addressing community concern about the balance between evaluation and program. Finally, the study identifies the challenges that lie ahead, including issues of program institution-alization and sustainability. PMID:20168022

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

Science.gov (United States)

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes

Embracing a competency-based specialty curriculum for community-based nursing roles.

Science.gov (United States)

Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

2013-01-01

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

Natural history of benign prostatic hyperplasia: Appropriate case definition and estimation of its prevalence in the community

OpenAIRE

Bosch, Ruud; Hop, Wim; Kirkels, Wim; Schröder, Fritz

1995-01-01

textabstractThere is no consensus about a case definition of benign prostatic hyperplasia (BPH). In the present study, BPH prevalence rates were determined using various case definitions based on a combination of clinical parameters used to describe the properties of BPH: symptoms of prostatism, prostate volume increase, and bladder outflow obstruction. The aim of this study—in a community-based population of 502 men (55–74 years of age) without prostate cancer—was to determine the relative i...

Participatory evaluation of community actions as a learning methodology for personal and community empowerment: case studies and empowerment processes

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Xavier Úcar Martínez

2014-06-01

Full Text Available Introduction: Participatory evaluation (PE is a hybrid methodology that can be used simultaneously to investigate and act in groups and communities. It can generate new knowledge about reality, but italso allows changes in the participants and their sociocultural context. This research project, developed over three years, aims to find out whether PE processes are useful and appropriate to evaluate community actionsand to generate learning that contribute to the empowerment of people who develop them.Method: The methodological structure of the research process design Participatory Evaluation processes that are applied in three selected communities-cases, over one year. The steering groups in each caseevaluated four dimensions of Community Development Plans: context, evolution, performance and results, using different techniques and group dynamics. Throughout this process, participants identify the acquiredknowledge and this is linked to indicators of empowerment, using questionnaires, content analysis and semi-structured interviews.Results: The development PE process in the three analyzed cases confirmed that PE is a useful strategy to assess participatory community actions of a territory; to report them to the people of the community; andto make shared decisions, about initiatives in order to improve community actions. The obtained results also verify that, throughout PE, there has been learning in the participants.Conclusions: The involvement of community members in the evaluation makes it more useful, fairer and more valid, but also a fourth positive consequence of PE is empowerment. From the process and the resultsof these cases of Participatory Evaluation, we consider that community EP is social transformation.

A Community-Based Research Approach to Develop an Educational Web Portal

Science.gov (United States)

Preiser-Houy, Lara; Navarrete, Carlos J.

2011-01-01

Service-learning projects are becoming more prevalent in Information Systems education. This study explores the use of community-based research, a special kind of a service-learning strategy, in an Information Systems web development course. The paper presents a case study of a service-learning project to develop an educational web portal for a…

Community and evidence-based approaches to healthcare ...

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

2016-04-29

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

Use of Case-Based Learning in Dental Hygiene Curricula.

Science.gov (United States)

Vaughan, Dina Agnone; DeBiase, Christina B.; Gibson-Howell, Joan C.

1998-01-01

A survey investigated the extent of use of case-based learning in 141 dental hygiene programs. A majority of responding schools use the approach, most frequently in clinical dental hygiene, community dental health, and dental science courses. Proportion of instructional time was greatest in the content areas of special needs, ethics, medical…

Developing quality indicators for community services: the case of district nursing.

Science.gov (United States)

Davies, Philippa; Wye, Lesley; Horrocks, Sue; Salisbury, Chris; Sharp, Debbie

2011-01-01

Quality indicators exist for the acute and primary care sectors in the National Health Service (NHS), but until recently little attention has been given to measuring the quality of community services. The innovative project described in this paper attempted to address that gap. To produce a framework for developing quality indicators for Bristol Community Health services. To develop a set of initial indicators for Bristol Community Health services using the proposed framework. After familiarising ourselves with community services and NHS policy, gathering the views of stakeholders and consulting the literature on quality indicators, we designed a framework for indicator development, using the 'test' case of the district nursing service. The long list of possible indicators came from best practice guidelines for wound, diabetes and end of life care, the three conditions most commonly treated by district nurses. To narrow down this list we surveyed and held workshops with district nurses, interviewed service users by telephone and met with commissioners and senior community health managers. The final set of quality indicators for district nurses included 23 organisational and clinical process and outcome indicators and eight patient experience indicators. These indicators are now being piloted, together with two potential tools identified to capture patient reported outcomes. Developing quality indicators for community services is time consuming and resource intensive. A range of skills are needed including clinical expertise, project management and skills in evidence-based medicine. The commitment and involvement of front-line professionals is crucial.

Off-grid community electrification projects based on wind and solar energies: A case study in Nicaragua

OpenAIRE

Ranaboldo, Matteo; Domenech, Bruno; Reyes, Gustavo Alberto; Ferrer Martí, Laia; Pastor Moreno, Rafael; García Villoria, Alberto

2015-01-01

Despite various institutional efforts, about 22% of the total Nicaraguan population still do not have access to electricity. Due to the dispersed nature of many rural inhabitants, off-grid electrification systems that use renewable energy sources are a reliable and sustainable option to provide electricity to isolated communities. In this study, the design of an off-grid electrification project based on hybrid wind-photovoltaic systems in a rural community of Nicaragua is developed. Firstly t...

Facilitating Low-Carbon Living? A Comparison of Intervention Measures in Different Community-Based Initiatives

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Martina Schäfer

2018-04-01

Full Text Available The challenge of facilitating a shift towards sustainable housing, food and mobility has been taken up by diverse community-based initiatives ranging from “top-down” approaches in low-carbon municipalities to “bottom-up” approaches in intentional communities. This paper compares intervention measures in four case study areas belonging to these two types, focusing on their potential of re-configuring daily housing, food, and mobility practices. Taking up critics on dominant intervention framings of diffusing low-carbon technical innovations and changing individual behavior, we draw on social practice theory for the empirical analysis of four case studies. Framing interventions in relation to re-configuring daily practices, the paper reveals differences and weaknesses of current low-carbon measures of community-based initiatives in Germany and Austria. Low-carbon municipalities mainly focus on introducing technologies and offering additional infrastructure and information to promote low-carbon practices. They avoid interfering into residents’ daily lives and do not restrict carbon-intensive practices. In contrast, intentional communities base their interventions on the collective creation of shared visions, decisions, and rules and thus provide social and material structures, which foster everyday low-carbon practices and discourage carbon-intensive ones. The paper discusses the relevance of organizational and governance structures for implementing different types of low-carbon measures and points to opportunities for broadening current policy strategies.

Review of performance-based incentives in community-based family planning programmes

Science.gov (United States)

Bellows, Nicole M; Askew, Ian; Bellows, Benjamin

2015-01-01

Background One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. Results A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. Conclusion For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing. PMID:25037703

COASTAL COMMUNITY PARTICIPATION IN KELURAHAN SUKOLILO, BULAK, BASED ON LOCAL ECONOMY

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Dyah Kusuma Wardhani

2017-07-01

Full Text Available Kelurahan Sukolilo, Bulak Settlement is an area of fishermen settlement with great potential of resources such as fish and sea cucumber. Kelurahan Sukolilo also well known as Prominent Kampung in fish processed products. Despite having a great potential in marine resources, most of the fishermen still live in a low environmental and economic condition. Theres hould be effective environmental management in coastal area so the fiherman vulnerability can be reduced through a criteria of developing coastal area that is able to accomodate the fisherman economic activities. The researcher will apply community based development in developing coastal area criteria.. In this case community-based development approach needs to be developed in the management of coastal areas, especially for the improvement of the environmental quality. This is because the coastal characteristic and resources are very complex and diverse, so in the coastal area management should involve the local community directly. Community based management shows the importance of community participation in development planning and implementation. This research was in form of qualitative research, data sources obtained by primary and secondary data. Primary data were collected through observations, visual documentations and interview with the fishermen and fish processors. Secondary data were obtained from literature and theory. Research results showed that  level of community participation that need to be done in the development process using active participatory. Active participatory should be done through partnership and delegated power level to accomodate fishermen and fish processors activities and support sustainable environment. Co-working space for inhabitants is needed  to accomodate community activities related to water and odor and drying process and to create area to socialize

Community-based management of environmental challenges in Latin America and the Caribbean

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Maria del Mar Delgado-Serrano

2017-03-01

Full Text Available This Special Feature gathers the results of five research projects funded by the 7th Research Framework Program of the European Union and aims to identify successful cases of community-based management of environmental challenges in Latin America. The funding scheme, Research for the benefit of Civil Society Organizations, fostered innovative research approaches between civil society and research organizations. More than 20 field sites have been explored, and issues such as trade-offs between conservation and development, scientific versus local knowledge, social learning, ecosystem services, community owned solutions, scaling-up and scaling-out strategies, the influence of context and actors in effective environmental management and governance, and the conflicts of interests around natural resources have been addressed. Based on our experiences as project coordinators, in this editorial we reflect on some of the important lessons gained for research praxis and impact, focusing on knowledge of governance models and their scaling-out and scaling-up, and on methods and tools to enable action research at the science-civil society interface. The results highlight the richness of community-based management experiences that exist in Latin America and the diversity of approaches to encourage the sustainable community-based management of environmental challenges.

Implementing community-based provider participation in research: an empirical study

Science.gov (United States)

2012-01-01

Background Since 2003, the United States National Institutes of Health (NIH) has sought to restructure the clinical research enterprise in the United States by promoting collaborative research partnerships between academically-based investigators and community-based physicians. By increasing community-based provider participation in research (CBPPR), the NIH seeks to advance the science of discovery by conducting research in clinical settings where most people get their care, and accelerate the translation of research results into everyday clinical practice. Although CBPPR is seen as a promising strategy for promoting the use of evidence-based clinical services in community practice settings, few empirical studies have examined the organizational factors that facilitate or hinder the implementation of CBPPR. The purpose of this study is to explore the organizational start-up and early implementation of CBPPR in community-based practice. Methods We used longitudinal, case study research methods and an organizational model of innovation implementation to theoretically guide our study. Our sample consisted of three community practice settings that recently joined the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP) in the United States. Data were gathered through site visits, telephone interviews, and archival documents from January 2008 to May 2011. Results The organizational model for innovation implementation was useful in identifying and investigating the organizational factors influencing start-up and early implementation of CBPPR in CCOP organizations. In general, the three CCOP organizations varied in the extent to which they achieved consistency in CBPPR over time and across physicians. All three CCOP organizations demonstrated mixed levels of organizational readiness for change. Hospital management support and resource availability were limited across CCOP organizations early on, although they improved in one CCOP organization

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-based natural resource management

DEFF Research Database (Denmark)

Treue, Thorsten; Nathan, Iben

that deliver credible and easily accessible information. Checks and balances can be supported through civil society as well as the media. Finally, the private sector plays a key and potentially beneficial role in the harvest, transport and marketing of CBNRM products. Thus, dialogue partners should include......This technical note is the product of a long process of consultation with a wide range of resource persons who have over the years been involved in the Danish support to Community Based Natural Resource Management. It gives a brief introduction to community-based natural resource management (CBNRM...... from CBNRM will be useful when designing community-based climate adaptation strategies. Thus, this note is a contribution to an ongoing debate as well as a product of the long-standing experiences of Danida's environmental portfolio. CBNRM is not a stand-alone solution to secure poverty reduction...

SOMWeb: a semantic web-based system for supporting collaboration of distributed medical communities of practice.

Science.gov (United States)

Falkman, Göran; Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-08-26

Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one's own

Shifting the burden or expanding access to care? Assessing malaria trends following scale-up of community health worker malaria case management and reactive case detection.

Science.gov (United States)

Larsen, David A; Winters, Anna; Cheelo, Sanford; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Bridges, Daniel J

2017-11-02

Malaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia. An estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p malaria testing and treating in the community. These results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.

The case for the community partner in economic development

OpenAIRE

Anna Steiger; Tessa Hebb; Lisa A. Hagerman

2007-01-01

Community-based organizations promote economic development by assembling investments in affordable housing, mixed-use real estate, community facilities, and small business in specific geographies. A principal way that community-based organizations tap institutional investors for deals is by partnering with investment intermediaries who manage the risk of these transactions by pooling assets, spreading risk across investors, and pricing the transaction up to the associated risk. Such a partner...

The World of Wonder Accelerated Learning Community: A Case Study.

Science.gov (United States)

Biddle, Julie K.

This report presents a case study of the World of Wonders Accelerated Learning Community School (WOW). A community school in Ohio is a new kind of public school-an independent public school that is nonsectarian and nondiscriminatory. The report presents three contexts for the study--historical, local and methodological--and highlights some of the…

Energy Collectives: a Community and Fairness based Approach to Future Electricity Markets

DEFF Research Database (Denmark)

Moret, Fabio; Pinson, Pierre

2018-01-01

for the community reflects prosumers' preferences. We show that community members can be influenced by a supervisory third-party in charge of interfacing with the market and system operator and of guaranteeing the collective common agreements. We simulate a number of test cases and we apply typical principles from......While power system organization has evolved from a hierarchical structure to a more decentralized model, electricity markets are still not up to date with the ongoing transformation towards more consumer-centric economies. As Information and Communication Technologies (ICT) are broadly adopted......, they allow prosumers to have a more proactive role in power system operation. This work introduces the concept of energy collectives, as a community-based electricity market structure. We find that when prosumers are allowed to share energy at community level, overall electricity procurement...

Incidence and 30-day case fatality rate of first-ever stroke in urban Nigeria: the prospective community based Epidemiology of Stroke in Lagos (EPISIL) phase II results.

Science.gov (United States)

Danesi, Mustapha A; Okubadejo, Njideka U; Ojini, Frank I; Ojo, Oluwadamilola O

2013-08-15

Stroke is a leading cause of death worldwide and a major contributor to global disease burden. Although epidemiologic information from a community perspective is important in determining the magnitude of the burden in specific regions, and directing equitable distribution of health resources, data on the incidence of stroke in developing countries in Africa are scarce. To determine the current incidence rate and short-term (30-day) case fatality rate (CFR) of stroke in urban Nigeria, and provide age-adjusted and gender-specific incidence rates to enable comparison with global populations. The study was a prospective community-based stroke registry enrolling hospitalized and non-hospitalized first-ever in a lifetime stroke cases presenting at all health facilities (hospitals, homeopathic caregivers, physiotherapy clinics) located in the designated community. Pre-hospitalization deaths due to stroke were not included in our study. The study was conducted between January 1st and December 31st 2007 in Surulere Local Government Area of Lagos State, south western Nigeria, a mixed-income urban locality with a population of approximately 750,000 based on data from the National Population Commission. Stroke was defined using the World Health Organization (WHO) clinical criteria. Case fatality at 30-days post stroke was determined at follow-up on 160 hospitalized stroke cases. 189 first-ever strokes, comprised of 112 men and 77 women (mean±SD age 58.5±13.5 years) were documented, giving a crude incidence rate of 25.2 per 100,000 per year (95% confidence interval 21.6- 28.8). The gender-specific rates were 28.3/100,000 and 21.3/100,000 for males and females respectively. The age-adjusted incidence rate was 54.08 per 100,000 per year (adjusted to the WHO New World Population). Hospitalization rate was 84.6%, while the CFR (hospitalized) was 16.2%. The stroke incidence in this urban sub-Saharan African community remains lower than that in emerging and developed economies

Practice Change in Community Pharmacy: A Case Study of Multiple Stakeholders' Perspectives

Directory of Open Access Journals (Sweden)

Shara Elrod

2012-01-01

Full Text Available Objective: To obtain a multi-stakeholder perspective of community pharmacy practice change. Design: Qualitative study. Setting: Community pharmacy in rural Mississippi. Participants: Fourteen key stakeholders of the patient care practice including pharmacists (n=4, support staff (n=2, collaborating providers (n=4, patients (n=3, and a payer (n=1. Intervention: Semi-structured interviews and participant-observation techniques were used. Main outcome measures: Description of the community pharmacy's practice and business model and identification of practice change facilitators. Results: Change facilitators for this practice included: a positive reputation in the community, forming solid relationships with providers, and convenience of patient services. Communication in and outside of the practice, adequate reimbursement, and resource allocation were identified as challenges. Conclusions: This case study is a multi-stakeholder examination of community pharmacy practice change and readers are provided with a real-world example of a community pharmacy's successful establishment of a patient care practice.   Type: Case Study

Cultural and Rhetorical Bases for communicating knowledge in web based communities

DEFF Research Database (Denmark)

Kampf, Constance; Kommers, Piet

2008-01-01

Cultural and Rhetorical Bases for communicating knowledge in web based communities How can we extend learner-centred theories for educational technology to include, for instance, the cultural and rhetorical backgrounds which influence participants in online communities as they engage in knowledge...... via web-based communities the intersection of culture and rhetoric in web-based communication rhetoric and discourse in the process of communicating knowledge via technology heuristics for knowledge communication from teaching in online forums connections between identity and knowledge communication...... This call for papers invites papers focused on theoretical frameworks or empirical research which highlights the cultural and/or rhetorical aspects of communicating knowledge in web based communities. We are looking for work that brings together methods and perspectives across disciplines...

Community Garden Information Systems: Analyzing and Strengthening Community-Based Resource Sharing Networks

Science.gov (United States)

Loria, Kristen

2013-01-01

Extension professionals play an increasingly central role in supporting community garden and other community-based agriculture projects. With growing interest in community gardens as tools to improve community health and vitality, the best strategies for supporting these projects should be explored. Due to the importance of inter-personal networks…

A Case Study in Organizing for Livable and Sustainable Communities

Directory of Open Access Journals (Sweden)

Jerry Marx

2015-12-01

Full Text Available Citizens in the U.S. are making organized efforts to demand a new approach to planning urban communities, one that results in more sustainable and livable communities. The profession of social work in the U.S. once had a primary role in organizing urban residents to advocate for healthier environments in their neighborhoods. Yet, recent research documents the diminishing emphasis on community organization as an intervention method in social work. This paper offers a descriptive case study of a successful community organizing effort to promote a more livable city in Portland, Maine (USA. Data was collected by the authors using in-depth personal interviews; archival records (census data, architect models; documents (e-mails, newspaper clippings as well as direct observation of the impacted community and development site. Implications for social work practitioners and educators involved in community organization promoting healthy communities are presented.

Population-based family case-control proband study on familial aggregation of metabolic syndrome: finding from Taiwanese people involved in Keelung community-based integrated screening (KCIS no. 5).

Science.gov (United States)

Chiu, Yueh-Hsia; Lin, Wen-Yuan; Wang, Po-En; Chen, Yao-Der; Wang, Ting-Ting; Warwick, Jane; Chen, Tony Hsiu-Hsi

2007-03-01

A population-based case-control proband study was undertaken to elucidate familial aggregation, independent environmental factors, and the interaction between them. A total of 7308 metabolic syndrome (MET-S) cases were identified from the Keelung community-based integrated screening programme between 1999 and 2002. The study has a case-control/family sampling design. A total of 1417 case probands were randomly selected from 3225 metabolic syndrome cases and the corresponding 2458 controls selected from 16,519 subjects without metabolic syndrome by matching on sex, age (+/-3 years) and place of residence. The generalized estimation equation model was used to estimate odds ratios and corresponding 95% confidence intervals. The risk for having metabolic syndrome among family members for cases versus control probands was 1.56-fold (1.29-1.89) after controlling for significant environmental factors. Higher risk of metabolic syndrome was found in parents than spouse. Low education against high education had 2.06-fold (1.36-3.13) risk for metabolic syndrome. Betel quid chewing was positively associated with the risk of MET-S, with 1.99-fold (1.13-3.53) risk for 1-9 pieces and 1.76-fold (0.96-3.23) risk for >or=10 pieces compared with non-chewer. Moderate and high intensity of non-occupational exercise led to 21.0% (OR=0.79 (0.63-0.98)) and 26.0% (OR=0.74 (0.59-0.94)) reduction in the risk for metabolic syndrome, respectively. The frequent consumption of vegetable reduced 24.0% (OR=0.76 (0.62-0.92)) risk for MET-S. The frequent consumption of coffee was associated the increased risk for metabolic syndrome (OR=1.32 (1.07-1.64)). The present study confirmed the risk of metabolic syndrome not only has the tendency towards familial aggregation but is affected by independent effect of environmental or individual correlates.

Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia.

Science.gov (United States)

Mableson, Hayley E; Martindale, Sarah; Stanton, Michelle C; Mackenzie, Charles; Kelly-Hope, Louise A

2017-01-01

Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted for global elimination by 2020. Currently there is considerable international effort to scale-up morbidity management activities in endemic countries, however there remains a need for rapid, cost-effective methods and adaptable tools for obtaining estimates of people presenting with clinical manifestations of LF, namely lymphoedema and hydrocele. The mHealth tool ' MeasureSMS-Morbidity ' allows health workers in endemic areas to use their own mobile phones to send clinical information in a simple format using short message service (SMS). The experience gained through programmatic use of the tool in five endemic countries across a diversity of settings in Africa and Asia is used here to present implementation scenarios that are suitable for adapting the tool for use in a range of different programmatic, endemic, demographic and health system settings. A checklist of five key factors and sub-questions was used to determine and define specific community-based field implementation scenarios for using the MeasureSMS-Morbidity tool in a range of settings. These factors included: (I) tool feasibility (acceptability; community access and ownership); (II) LF endemicity (high; low prevalence); (III) population demography (urban; rural); (IV) health system structure (human resources; community access); and (V) integration with other diseases (co-endemicity). Based on experiences in Bangladesh, Ethiopia, Malawi, Nepal and Tanzania, four implementation scenarios were identified as suitable for using the MeasureSMS-Morbidity tool for searching and reporting LF clinical case data across a range of programmatic, endemic, demographic and health system settings. These include: (I) urban, high endemic setting with two-tier reporting; (II) rural, high endemic setting with one-tier reporting; (III) rural, high endemic setting with two-tier reporting; and (IV) low-endemic, urban and rural setting with one

Facilitators' perceptions of problem-based learning and community-based education

Directory of Open Access Journals (Sweden)

Annali E Fichardt

2000-10-01

Full Text Available In 1997 the School for Nursing, University of the Orange Free State, changed from the traditional lecture method of teaching to problem-based learning and from a curative to a community-based approach. Lecturers from a traditional environment became facilitators and new skills such as listening, dialogue, negotiation, counselling and problemsolving were expected from them. Besides the role change, the environment changed from a structural classroom to an unstructured community. The aim of this research was to determine the perceptions and experiences of facilitators in problem-based learning and community-base education. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research.

Science.gov (United States)

Xia, Ruiping; Stone, John R; Hoffman, Julie E; Klappa, Susan G

2016-03-01

In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted. © 2016 American Physical Therapy Association.

Examining Enabling Conditions for Community-Based Fisheries Comanagement: Comparing Efforts in Hawai'i and American Samoa

Directory of Open Access Journals (Sweden)

Arielle S. Levine

2014-03-01

Full Text Available Much attention in global fisheries management has been directed toward increasing the involvement of local communities in managing marine resources. Although community-based fisheries comanagement has the potential to address resource conservation and societal needs, the success of these programs is by no means guaranteed, and many comanagement regimes have struggled. Although promising in theory, comanagement programs meet a variety of political, social, economic, ecological, and logistical challenges upon implementation. We have provided an analysis of two community-based fisheries comanagement initiatives: Hawai'i's Community-Based Subsistence Fishing Area (CBSFA legislation and American Samoa's Community-Based Fisheries Management Program (CFMP. Although Hawai'i's initiative has struggled with only two CBSFAs designated, neither of which has an approved management plan, American Samoa's program has successfully established a functioning network of 12 villages. We have explored the factors contributing to the divergent outcomes of these initiatives, including cultural and ethnic diversity, the intactness of traditional tenure systems and community organizing structures, local leadership, and government support. Differences in program design, including processes for program implementation and community involvement, supportive government institutions, adequate enforcement, and adaptive capacity, have also played important roles in the implementation of comanagement regimes on the two island groups. The different outcomes manifested in these case studies provide insight regarding the conditions necessary to enable successful community-based comanagement, particularly within U.S.-affiliated jurisdictions.

Performance of an electronic health record-based phenotype algorithm to identify community associated methicillin-resistant Staphylococcus aureus cases and controls for genetic association studies

Directory of Open Access Journals (Sweden)

Kathryn L. Jackson

2016-11-01

Full Text Available Abstract Background Community associated methicillin-resistant Staphylococcus aureus (CA-MRSA is one of the most common causes of skin and soft tissue infections in the United States, and a variety of genetic host factors are suspected to be risk factors for recurrent infection. Based on the CDC definition, we have developed and validated an electronic health record (EHR based CA-MRSA phenotype algorithm utilizing both structured and unstructured data. Methods The algorithm was validated at three eMERGE consortium sites, and positive predictive value, negative predictive value and sensitivity, were calculated. The algorithm was then run and data collected across seven total sites. The resulting data was used in GWAS analysis. Results Across seven sites, the CA-MRSA phenotype algorithm identified a total of 349 cases and 7761 controls among the genotyped European and African American biobank populations. PPV ranged from 68 to 100% for cases and 96 to 100% for controls; sensitivity ranged from 94 to 100% for cases and 75 to 100% for controls. Frequency of cases in the populations varied widely by site. There were no plausible GWAS-significant (p < 5 E −8 findings. Conclusions Differences in EHR data representation and screening patterns across sites may have affected identification of cases and controls and accounted for varying frequencies across sites. Future work identifying these patterns is necessary.

Cases of Lyme disease reported in a military community.

Science.gov (United States)

Underwood, P K; Armour, V M

1993-02-01

Lyme disease, a growing public health problem in the United States, is also an increasing threat in Europe. Cases identified in a military community in West Germany are presented and problems of diagnosis and treatment discussed.

Research on Livable Community Evaluation Based on GIS

Science.gov (United States)

Yin, Zhangcai; Wu, Yang; Jin, Zhanghaonan; Zhang, Xu

2018-01-01

Community is the basic unit of the city. Research on livable community could provide a bottom-up research path for the realization of livable city. Livability is the total factor affecting the quality of community life. In this paper, livable community evaluation indexes are evaluated based on GIS and fuzzy comprehensive evaluation method. Then the sum-index and sub-index of community livability are both calculated. And community livable evaluation index system is constructed based on the platform of GIS. This study provides theoretical support for the construction and management of livable communities, so as to guide the development and optimization of city.

Philosophy of sufficiency economy for community-based adaptation to climate change: Lessons learned from Thai case studies

Directory of Open Access Journals (Sweden)

Kulvadee Kansuntisukmongkol

2017-01-01

Full Text Available Major components within the philosophy of a sufficiency economy include moderation, prudence, and self-immunity together with knowledge and morality. These components were proposed to safeguard local communities from adverse changes and crises. Climatic crises due to global warming can impact upon local agricultural production and consumption systems. Yet, it is still questionable whether communities following the sufficiency economy philosophy can cope with climate change. The objective of this research was to study the coping and adaptive capacity to climate change of local agricultural communities following the sufficiency economy philosophy and to analyze the success factors of adaptation to climate change. The research found five adaptive strategies leading to a resilient livelihood: (1 self-evaluation, (2 diversity dependency, (3 storage and reserve, (4 cooperation, and (5 mobility over space and time. These strategies help to reduce exposure and sensitivity, while increasing adaptive capacity to climate change with the aims of sustainability and adaptation for survival, and protecting natural resource bases for food and settlement security. Moderation, prudence, and self-immunity are critical success factors of adaptation measures, whereas local ecological knowledge with morality is a core enabling factor for adapting to climate change. These factors can be applied in community-based climate change adaptation in the National Adaptation Plan.

The Business Case for Provider Participation in Clinical Trials Research: An Application to the National Cancer Institute's Community Clinical Oncology Program

Science.gov (United States)

Song, Paula H.; Reiter, Kristin L.; Weiner, Bryan J.; Minasian, Lori; McAlearney, Ann Scheck

2012-01-01

Background Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. Purpose This study explores whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. Methodology/Approach We use a multiple case study methodology approach to examine the National Cancer Institute's Community Clinical Oncology Program, a longstanding federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semi-structured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. Findings We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis, and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. Practice Implications As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally-funded PBRNs outside of oncology or to providers considering participation in any clinical trials research. PMID:23044836

The business case for provider participation in clinical trials research: an application to the National Cancer Institute's community clinical oncology program.

Science.gov (United States)

Song, Paula H; Reiter, Kristin L; Weiner, Bryan J; Minasian, Lori; McAlearney, Ann Scheck

2013-01-01

Provider-based research networks (PBRNs) make clinical trials available in community-based practice settings, where most people receive their care, but provider participation requires both financial and in-kind contributions. The aim of this study was to explore whether providers believe there is a business case for participating in PBRNs and what factors contribute to the business case. We use a multiple case study methodology approach to examine the National Cancer Institute's community clinical oncology program, a long-standing federally funded PBRN. Interviews with 41 key informants across five sites, selected on the basis of organizational maturity, were conducted using a semistructured interview guide. We analyzed interview transcripts using an iterative, deductive process to identify themes and subthemes in the data. We found that a business case for provider participation in PBRNs may exist if both direct and indirect financial benefits are identified and included in the analysis and if the time horizon is long enough to allow those benefits to be realized. We identified specific direct and indirect financial benefits that were perceived as important contributors to the business case and the perceived length of time required for a positive return to accrue. As the lack of a business case may result in provider reluctance to participate in PBRNs, knowledge of the benefits we identified may be crucial to encouraging and sustaining participation, thereby preserving patient access to innovative community-based treatments. The results are also relevant to federally funded PBRNs outside of oncology or to providers considering participation in any clinical trials research.

Evaluating community-based public health leadership training.

Science.gov (United States)

Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

2011-01-01

Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

Community-Based Nursing versus Community Health Nursing: What Does It All Mean?

Science.gov (United States)

Zotti, Marianne E.; And Others

1996-01-01

Offers practice models for community-based nursing and community health nursing that demonstrate the different roles, philosophies, and activities of the two approaches. Points to curriculum changes that are needed to prepare students to practice in an increasingly community-oriented health care industry. (Author)

Validity of calendar day-based definitions for community-onset bloodstream infections.

Science.gov (United States)

Laupland, Kevin B; Gregson, Daniel B; Church, Deirdre L

2015-04-02

Community-onset (CO) bloodstream infections (BSI) are those BSI where the blood culture is drawn culture draw or hospital admission are not always available. We evaluated the validity of using 2- or 3- calendar day based definitions for CO-BSI by comparing to a "gold standard" 48-hour definition. Among the population-based cohort of 14,106 episodes of BSI studied, 10,543 were classified as CO based on "gold standard" 48-hour criteria. When 2-day and 3-day definitions were applied, 10,396 and 10,707 CO-BSI episodes were ascertained, respectively. All but 147 (1.4%) true CO-BSI cases were included by using the 2-day definition. When the 3-day definition was applied, all cases of CO-BSI were identified but and additional 164 (1.5%) cases of hospital-onset HO-BSI were also included. Thus the sensitivity and specificity of the 2-day definition was 98.6% and 100% and for the 3-day definition was 100% and 98.5%, respectively. Overall, only 311 (2.2%) cases were potentially miss-classifiable using either the 2- or 3-calendar day based definitions. Use of either a 2- or 3-day definition is highly accurate for classifying CO-BSI.

The Importance of Documenting and Including Traditional Wisdom in Community-Based Ecotourism Planning

Directory of Open Access Journals (Sweden)

Vesna Đukić

2017-01-01

Full Text Available This article accords to the theory of community-based tourism, which represents a concept that respects natural and cultural resources of a particular community and encourages participation of its members in the process of tourist product creation. The article operates in the planning phase and aims to give insights into the process of establishing the groundwork for community-based tourism. The key element is documenting and illustrating everything that could be a part of what is known as “traditional wisdom,” namely, the skills and knowledge of traditional life practices. The methods of case study, content analysis, and observation of the village of Omoljica, Serbia, were used. The positive aspect of this locality is reflected in the existing short-term initiatives of organizations and individuals engaging in preserving traditional practices, but without systematic, long-term planning and management of community-based tourism, these individual efforts to revalue traditional life practices would stay unrecognizable and invisible for visitors and stakeholders. Thus, the main goal of this article is to understand the relation between short-term bottom-up initiatives and long-term top-down strategic planning of specific ecotourism destinations, one that would embrace the traditional ways of rural community life. The contribution of this study, in addition to documenting and illustrating “traditional wisdom” of the specific rural community placed in the protected area which encompasses a particular local social system, will be reflected in the creation of a set of guidelines for sustainable, rural, community-based ecotourism as a soft-driver development of protected areas near big cities of the postsocialist countries.

Developing and Conducting a Dissertation Study through the Community-Based Participatory Research Approach.

Science.gov (United States)

Nadimpalli, S B; Van Devanter, N; Kavathe, R; Islam, N

2016-06-01

The community-based participatory research (CBPR) approach has been shown to be innovative and effective in conducting research with communities experiencing health disparities. Doctoral nursing students, and other doctoral students in the health sciences, who are interested in this approach can benefit through structured CBPR training experiences in learning how to engage with communities, build community capacity, share resources, implement CBPR study plans, and disseminate results of CBPR-focused studies. The objectives of this case-study are to demonstrate ways in which one doctoral student aligned with academic mentors and a funded CBPR project to build a relationship with the Sikh Asian Indian (AI) community of New York City to develop and implement a CBPR-focused doctoral dissertation study. The purpose of the research was to examine the relationship between the experience of perceived discrimination and health outcomes in this community. CBPR methods utilized in developing the study entailed the author partaking in formal and informal CBPR learning experiences, building relationships with community and academic partners early on through volunteering, developing a research plan in collaboration with members of the community and academic partners, identifying an appropriate setting and methods for recruitment and data collection, increasing capacity and resources for all partners (the author, community, and academic), and presenting dissertation study findings to the community. In conclusion, CBPR-focused doctoral experiences are novel pedagogical and professional approaches for nursing and health science students which can lead to mutual benefits for all involved, and ultimately successful and effective community-based health research.

A community-based approach and its impact to sustainable rural water supply – A case of Kgotlopong ‘Mountain Water Harvesting’

CSIR Research Space (South Africa)

Maponya, G

2013-07-01

Full Text Available communities, especially in the remote rural areas, that face daunting challenges in accessing basic water. To address these challenges, other communities have developed community-based water supply initiatives. This paper takes a keen interest...

Case Studies: Improving Environmental Performance and Economic Prosperity at Ports and in Near-Port Communities

Science.gov (United States)

Case Study links for improving environmental performance and economic prosperity at ports and in near-port communities. Case studies on equipment upgrades, jobs and benefits, land use and transportation, port-community engagement, and citizen science.

Socio economic community mapping around Dumai Timur (case study: Tanjung Palas Village)

Science.gov (United States)

Dilham, Ami; Putra, M. Umar Maya

2018-03-01

This study aimed to analyze the socio economic community mapping around Dumai Timur Sub District with a case study: Tanjung Palas Village. The problem in this research is to analyze community needs and potential contained there. The data used are primary data that have been obtained to do data entry based on the guidance from the actors concerned, there is a transfer in the form of qualitative data into quantitative measurement techniques reference instrument of socio economic mapping activities. From the results of this study indicate that the necessary empowerment of social management in which short-term policy for the addition of water discharge, training on the concept of raising entrepreneurial innovation. For the long term necessary to make a business innovation and sustainability development pattern with operational assistance in the form of seeds, the manufacture of cages and chicken feed.

LYNX community advocacy & service engagement (CASE) project final report.

Science.gov (United States)

2009-05-14

This report is a final assessment of the Community Advocacy & Service Engagement (CASE) project, a LYNX-FTA research project designed : to study transit education and public engagement methods in Central Florida. In the Orlando area, as in other part...

Adaptive capacity and community-based natural resource management.

Science.gov (United States)

Armitage, Derek

2005-06-01

Why do some community-based natural resource management strategies perform better than others? Commons theorists have approached this question by developing institutional design principles to address collective choice situations, while other analysts have critiqued the underlying assumptions of community-based resource management. However, efforts to enhance community-based natural resource management performance also require an analysis of exogenous and endogenous variables that influence how social actors not only act collectively but do so in ways that respond to changing circumstances, foster learning, and build capacity for management adaptation. Drawing on examples from northern Canada and Southeast Asia, this article examines the relationship among adaptive capacity, community-based resource management performance, and the socio-institutional determinants of collective action, such as technical, financial, and legal constraints, and complex issues of politics, scale, knowledge, community and culture. An emphasis on adaptive capacity responds to a conceptual weakness in community-based natural resource management and highlights an emerging research and policy discourse that builds upon static design principles and the contested concepts in current management practice.

Design, and participant enrollment, of a randomized controlled trial evaluating effectiveness and cost-effectiveness of a community-based case management intervention, for patients suffering from COPD

DEFF Research Database (Denmark)

Sørensen, Sabrina Storgaard; Pedersen, Kjeld Møller; Weinreich, Ulla Møller

2015-01-01

Background: Case management interventions are recommended to improve quality of care and reduce costs in chronic care, but further evidence on effectiveness and cost-effectiveness is needed. The objective of this study is the reporting of the design and participant enrollment of a randomized...... controlled trial, conducted to evaluate the effectiveness and cost-effectiveness of a community-based case management model for patients suffering from chronic obstructive pulmonary disease (COPD). With a focus on support for self-care and care coordination, the intervention was hypothesized to result...... patients were randomized into two groups: the case-managed group and the usual-care group. Participant characteristics were obtained at baseline, and measures on effectiveness and costs were obtained through questionnaires and registries within a 12-month follow-up period. In the forthcoming analysis...

Impact of community-based presumptive chloroquine treatment of fever cases on malaria morbidity and mortality in a tribal area in Orissa State, India

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Sadanandane Candasamy

2008-05-01

Full Text Available Abstract Background In the Global Strategy for Malaria Control, one of the basic elements is early detection and prompt treatment of malaria cases, especially in areas where health care facilities are inadequate. Establishing or reviving the existing drug distribution centers (DDC at the peripheral levels of health care can achieve this. The DDCs should be operationally feasible, acceptable by community and technical efficient, particularly in remote hard-core malaria endemic areas. Methods Volunteers from villages were selected for distribution of chloroquine and the selection was made either by villagers or head of the village. The services of the volunteers were absolutely free and voluntary in nature. Chloroquine was provided free of charge to all fever cases. The impact was evaluated based on the changes observed in fever days, fever incidence, parasite incidence and parasite prevalence (proportion of persons harbouring malaria parasite in the community. Comparisons were made between 1st, 2nd and 3rd year of operation in the experimental villages and between the experimental and check areas. Results A total of 411 village volunteers in 378 villages in the experimental community health center with a population of 125,439 treated 88,575 fever cases with a mean annual incidence of 331.8 cases per 1,000 population during the three-year study period. The average morbid days due to fever (AFD was reduced to 1.6 ± 0.1 from 5.9 ± 2.1 in the experimental villages while it remained at 5.0 ± 1.0 in the check villages. There was a significant reduction, (p 0.05. In plain villages that were low endemic, the reductions in AFI and API in experimental villages were statistically significant (p nd and 3rd year when compared with the check area (p 0.0.5. Mortality due to malaria declined by 75% in the experimental villages in the adult age group whereas there was an increasing trend in check villages. Conclusion The study demonstrated that a passive

Managing Tourism in the Greater Mekong Region (GMS: A Case Study of Chiang Khan Community, Northeast Thailand

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Rawee Hanpachern

2014-05-01

Full Text Available This study aims to examine complex ‘sustainability’ aspects of the Community-based tourism concept in tourism and destination management in the Greater Mekong Sub-region (GMS. This research is conceptualized in assessing the potential for Community-Based Tourism (CBT development in Chiang Khan, a small village by the Mekong River in the Northeast of Thailand. For collecting data, semi-interviews questions are designed. Focus-group discussion and indepth interviews are carried to include tourism stakeholders of the destination. This study argues that although a community may contain many tourism assets, it is not the only factor necessary for a ‘sustainable’ tourism to be developed in that community. Through a case study, its natural features, cultural activities, local lifestyle and the serene landscape of its location are exemplified as the important community-based tourism assets. However, a number of complex components and holistic approaches that worked well together Chiang Khan becoming a sustainable tourism destination. There elements and approaches that contribute to starting up Chiang Khan as a sustainable tourist destination include: its unique features of recreational activities and local businesses, knowledge and skills of the locals to develop tourism related businesses, and direct proper marketing strategies.

An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.

LENUS (Irish Health Repository)

Doran, J-P

2012-02-01

INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

Measuring disaster-resilient communities: a case study of coastal communities in Indonesia.

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Kafle, Shesh Kanta

2012-01-01

Vulnerability reduction and resilience building of communities are central concepts in recent policy debates. Although there are fundamental linkages, and complementarities exist between the two concepts, recent policy and programming has focused more on the latter. It is assumed here that reducing underlying causes of vulnerabilities and their interactions with resilience elements is a prerequisite for obtaining resilience capabilities. An integrated approach, incorporating both the vulnerability and resilience considerations, has been taken while developing an index for measuring disaster-resilient communities. This study outlines a method for measuring community resilience capabilities using process and outcome indicators in 43 coastal communities in Indonesia. An index was developed using ten process and 25 outcome indicators, selected on the basis of the ten steps of the Integrated Community Based Risk Reduction (ICBRR) process, and key characteristics of disaster resilient communities were taken from various literatures. The overall index value of all 43 communities was 63, whereas the process and outcome indicator values were measured as 63 and 61.5 respectively. The core components of this index are process and outcome indicators. The tool has been developed with an assumption that both the process and outcome indicators are equally important in building disaster-resilient communities. The combination of both indicators is an impetus to quality change in the community. Process indicators are important for community understanding, ownership and the sustainability of the programme; whereas outcome indicators are important for the real achievements in terms of community empowerment and capacity development. The process of ICBRR approach varies by country and location as per the level of community awareness and organisational strategy. However, core elements such as the formation of community groups, mobilising those groups in risk assessment and planning

Establishment and Implementation of the Balingasay Marine Protected Area: A Community-Based Approach

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Severino Salmo III

2000-12-01

Full Text Available A community-based approach in the establishment and implementation of a marine protected area (MPA in Balingasay, Bolinao, Pangasinan is presented. The factors necessary to facilitate the successful establishment and implementation of a community-managed MPA include heightening of environmental awareness, community mobilization, and legal/institutional and financial assistance. A heightened environmental awareness encouraged the community to undertake resource management action. The formation of a people’s organization, SAMMABAL (Samahan ng mga Mangingisda at Mamamayan ng Balingasay, was crucial in assessing environmental problems (e.g., overfishing and identifying the establishment of an MPA as a management tool to address the problem. SAMMABAL was also instrumental in eliciting community support for the issuance of a municipal ordinance in the establishment of the MPA. Subsequently, the organization initiated the patrolling of the MPA. Institutions involved in the community-based management of the MPA also included the multi-sectoral council (BRMC – Balingasay Resource Management Council and representatives from the barangay council and the municipal government. This institutional arrangement has proven to be very resilient, indicating a high probability of sustaining its successes despite some obstacles and shortcomings. Clear delineation of the role and functions of the institutions and the stakeholders was essential in advancing the initiative. This case study will draw on the lessons from the experience of a four-year community-managed MPA.

An Adult Education Model of Resident Participation: Building Community Capacity and Strengthening Neighborhood-Based Activities in a Comprehensive Community Initiative (CCI.

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Daniel Brisson

2008-12-01

Full Text Available Comprehensive Community Initiatives (CCIs are of growing interest to social work and the social services field as they are an effort to move away from remediation of individual problems within neighborhoods to a comprehensive change effort that builds resident and institutional capacity for long term sustainability of healthy communities. Built on ongoing lessons learned from the community development field, CCIs are largely foundation supported projects that engage low-income neighborhood residents in a holistic change effort. However, based on what is known about community organizing, CCIs will likely face challenges as long as they involve a top-down approach with an outside funder entering a community to make change. This manuscript frames an adult education model of resident participation that can be used in CCIs and provides a case example illustrating the model in action. A discussion of how the model can be an effective means for communities to take advantage of outside resources while maintaining their power and voice for change is offered in conclusion.

Veterans' Transitions to Community College: A Case Study

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Wheeler, Holly A.

2012-01-01

Veterans on college campuses are not new; however, the recent influx of veterans returning home from war-time service present challenges to the colleges they attend. The purpose of this qualitative case study was to examine the transition process experienced by veterans leaving military service and attending community college for the first time.…

Exploring Collaborative and Community Based Planning in Tourism Case Study Sitia-Cavo Sidero Project

OpenAIRE

Katsouli, Penelope

2007-01-01

The present paper has explored the policy planning and development in emerging tourism settings in Sitia. Comprehensively, this study, in the name of sustainable development, focused on the extent of collaborative and community-based planning. For that reason exploratory research has been used; the context and the structure of this paper aimed to uncover the socially constructed reality of Sitia's stakeholders, within the dynamic environment, and respond to and questions. Therein significant ...

Social capital, community-based governance and resilience in an ...

African Journals Online (AJOL)

While the Mozambique government policy promotes community-based fisheries management in artisanal fisheries, we argue that under current conditions of ineffective community-based governance, a strong focus on reconstruction of social capital will be required before a community-based resource management process ...

The Journey to Meet Emerging Community Benefit Requirements in a Rural Hospital: A Case Study

Science.gov (United States)

Sabin, Allison V; Levin, Pamela F

2015-10-22

The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates.

A Case for Community-Run Pre-Schools and Daycare Centres.

Science.gov (United States)

Renard, Rosamunde

This booklet advocates and describes the establishment of community run preschool and day care centers. The type described is based on the Laborie Community Education Centre in Saint Lucia, West Indies. Chapter 1 advocates establishing small, local institutions that are community managed, community owned, concerned with quality, and sustainable.…

Comparative Study on the Characteristics of Community-Based Tourism between Pentingsari and Nglanggeran Tourism Village, Special Region Yogyakarta

Science.gov (United States)

Purbasari, Novia; Manaf, Asnawi

2018-02-01

Community-based tourism is one of the tourism development models that effectively used as a tool to alleviate poverty through empowerment strategy of the local community. Nevertheless, many people do not have adequate understanding on the characteristics of community-based tourism, which are used as a determinant in the tourism development. This article describes the comparison on characteristics of community-based tourism between Pentingsari and Nglanggeran. These villages were chosen because Pentingsari was a tourism village that able to apply the principles ethical codes of world tourism, shown by an award from the World Committee on Tourism Ethics Code and Nglanggeran was awarded as Best Tourism Village award in Indonesia from ASEAN Community Based Tourism Award 2017.The objectives of this study is to explore the characteristics of community-based tourism applied in the Pentingsari and Nglanggeran, and to identify any indicators that could be used to indicate those characteristics. The research achieves through in-depth interviews, observation, and review of documents. There were 17 persons as informants. Further, the observation was reached by directly observing in the both study cases. In addition, the data obtained through the review of secondary data from the local manager of tourism village. Generally, Pentingsari has characteristics as a community-based rural tourism, while Nglanggeran has characteristics as community-based ecotourism.

Using community-based participatory research and organizational diagnosis to characterize relationships between community leaders and academic researchers.

Science.gov (United States)

Wang, Karen H; Ray, Natasha J; Berg, David N; Greene, Ann T; Lucas, Georgina; Harris, Kenn; Carroll-Scott, Amy; Tinney, Barbara; Rosenthal, Marjorie S

2017-09-01

Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR) in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011-May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders and university-based researchers' relationships on the inter-organizational level include: 1) Both groups described that community-engaged university-based researchers are exceptions to typical university culture; 2) Both groups described that the interpersonal skills university-based researchers need for CEnR require a change in organizational culture and training; 3) Both groups described skepticism about the sustainability of a meaningful institutional commitment to community-engaged research 4) Both groups described the historical impact on research relationships of race, power, and privilege, but only community leaders described its persistent role and relevance in research relationships. Challenges to community-academic research partnerships include researcher interpersonal skills and different perceptions of the importance of organizational history. Solutions to improve research partnerships may include transforming university culture and community-university discussions on race

ESD and Lifelong Learning: A Case Study of the Shangri-La Institute's Current Engagement with the Bazhu Community in Diqing, China

Science.gov (United States)

Liu, Yunhua; Constable, Alicia

2010-01-01

This article argues that ESD should be integrated into lifelong learning and provides an example of how this might be done. It draws on a case study of a joint project between the Shangri-la Institute and the Bazhu community in Diqing, southwest China, to analyse a community-based approach to Education for Sustainable Development and assess its…

Community-Based Programming: An Opportunity and Imperative for the Community College. Institutes & Workshops.

Science.gov (United States)

Boone, Edgar J.

Community-based programming (CBP) is a cooperative process in which a community college serves as the leader and catalyst in effecting collaboration among the people, leaders and community organizations in its service area. This report discusses the changing role of the community college, the nature of CBP, and expected outcomes of the process,…

Reflective learning in community-based dental education.

Science.gov (United States)

Deogade, Suryakant C; Naitam, Dinesh

2016-01-01

Community-based dental education (CBDE) is the implementation of dental education in a specific social context, which shifts a substantial part of dental clinical education from dental teaching institutional clinics to mainly public health settings. Dental students gain additional value from CBDE when they are guided through a reflective process of learning. We propose some key elements to the existing CBDE program that support meaningful personal learning experiences. Dental rotations of 'externships' in community-based clinical settings (CBCS) are year-long community-based placements and have proven to be strong learning environments where students develop good communication skills and better clinical reasoning and management skills. We look at the characteristics of CBDE and how the social and personal context provided in communities enhances dental education. Meaningfulness is created by the authentic context, which develops over a period of time. Structured reflection assignments and methods are suggested as key elements in the existing CBDE program. Strategies to enrich community-based learning experiences for dental students include: Photographic documentation; written narratives; critical incident reports; and mentored post-experiential small group discussions. A directed process of reflection is suggested as a way to increase the impact of the community learning experiences. We suggest key elements to the existing CBDE module so that the context-rich environment of CBDE allows for meaningful relations and experiences for dental students and enhanced learning.

Case-based reasoning

CERN Document Server

Kolodner, Janet

1993-01-01

Case-based reasoning is one of the fastest growing areas in the field of knowledge-based systems and this book, authored by a leader in the field, is the first comprehensive text on the subject. Case-based reasoning systems are systems that store information about situations in their memory. As new problems arise, similar situations are searched out to help solve these problems. Problems are understood and inferences are made by finding the closest cases in memory, comparing and contrasting the problem with those cases, making inferences based on those comparisons, and asking questions whe

Business-Community Relationships for Extractive Industries: A Case Study in Peru

Directory of Open Access Journals (Sweden)

Jose Ventura

2017-07-01

Full Text Available Natural resource-based economies have long relied on foreign demand to fuel their growth. For instance, the extractive sectors in Peru have experienced a rapid expansion, driven by a rising demand for commodities. Alongside economic growth, extractive operations have triggered social and environmental concerns among the various stakeholders, thus resulting in either social conflict or a deterioration of the relationship between companies in the extractive industries and local communities. In this context, the purpose of this paper is to understand the relationships between companies in the extractive industries and rural families. This research uses the case-study method. The findings show that a trustful relationship is supported by a beneficiary-society approach that builds upon philanthropic and ethical types of relationships. Unlike the type of relationship based on economic or legal interests, a trust-based relationship offers avenues for managing social conflict that have yet to be explored.

The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

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Yu Hatano

2017-04-01

Full Text Available Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities.  Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system.  Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy.  Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas.

The Vanguard of Community-based Integrated Care in Japan: The Effect of a Rural Town on National Policy

Science.gov (United States)

Matsumoto, Masatoshi; Okita, Mitsuaki; Inoue, Kazuo; Takeuchi, Keisuke; Tsutsui, Takako; Nishimura, Shuhei; Hayashi, Takuo

2017-01-01

Introduction: Japan has the largest percentage of elderly people in the world. In 2012 the government implemented a community-based integrated care system which provides seamless community healthcare resources for elderly people with chronic diseases and disabilities. Methods: This paper describes the challenges of establishing a community-based integrated care system in 1974 in Mitsugi, a rural town of Japan. This system has influenced the government and become the model for the nationwide system. Results: In the 1970s, Mitsugi’s aging population was growing faster than Japan’s, but elder care was fragmented among a variety of service sections. A community-based integrated care system evolved because of the small but aging population size and the initiative of some local leaders of medical care and politics. After the system took effect, the proportion of bedridden people and medical care costs for the elderly dropped in Mitsugi while it continued to rise everywhere else in Japan. Mitsugi’s community-based integrated care system is now shaping national policy. Conclusion: Mitsugi is in the vanguard of Japan’s community-based integrated care system. The case showed the community-based integrated care system can diffuse from rural to urban areas. PMID:28970743

Developing and pilot testing of a tool for "clinicosocial case study" assessment of community medicine residents.

Science.gov (United States)

Gohel, Manisha; Singh, Uday Shankar; Bhanderi, Dinesh; Phatak, Ajay

2016-01-01

Practical and clinical skills teaching should constitute a core part of the postgraduate curriculum of Community Medicine. The clinicosocial case study is a method to enhance learners' skills but there is no generally accepted organized system of formative assessment and structured feedback to guide students. A new tool based on the principles of mini-Clinical Evaluation Exercise (mini CEX) was developed and pilot tested as a 'clinicosocial case study' assessment of community medicine residents with feedback as a core component. Ten core domains of clinicosocial skills were identified after reviewing the relevant literature and input from local experts in community medicine and medical education. We pilot tested the tool with eight faculty members to assess five residents during clinicosocial case presentations on a variety of topics. Kappa statistic and Bland Altman plots were used to assess agreement between faculty members' average assessment scores. Cronbach's alpha was used to test the internal consistency with faculty members as domains. All 95% confidence limits using the Bland-Altman method were within the predetermined limit of 2 points. The overall Kappa between two faculty members was fair ranging from 0.2 to 0.3. Qualitative feedback revealed that both faculty and residents were enthusiastic about the process but faculty suggested further standardization, while residents suggested streamlining of the process. This new assessment tool is available for objective and unbiased assessment of residents through 'clinicosocial case study,' which enriches learning through comprehensive feedback. Further validation in different settings is needed.

Developing Community-Based Rehabilitation Programs for Musculoskeletal Diseases in Low-Income Areas of Mexico: The Community-Based Rehabilitation for Low-Income Communities Living With Rheumatic Diseases (CONCORD) Protocol

Science.gov (United States)

2014-01-01

Background The negative impact of musculoskeletal diseases on the physical function and quality of life of people living in developing countries is considerable. This disabling effect is even more marked in low-socioeconomic communities within developing countries. In Mexico, there is a need to create community-based rehabilitation programs for people living with musculoskeletal diseases in low-socioeconomic areas. These programs should be directed to prevent and decrease disability, accommodating the specific local culture of communities. Objective The objective of this paper is to describe a research protocol designed to develop, implement, and evaluate culturally sensitive community-based rehabilitation programs aiming to decrease disability of people living with musculoskeletal diseases in two low-income Mexican communities. Methods A community-based participatory research approach is proposed, including multi and transdisciplinary efforts among the community, medical anthropology, and the health sciences. The project is structured in 4 main stages: (1) situation analysis, (2) program development, (3) program implementation, and (4) program evaluation. Each stage includes the use of quantitative and qualitative methods (mixed method program). Results So far, we obtained resources from a Mexican federal agency and completed stage one of the project at Chankom, Yucatán. We are currently receiving funding from an international agency to complete stage two at this same location. We expect that the project at Chankom will be concluded by December of 2017. On the other hand, we just started the execution of stage one at Nuevo León with funding from a Mexican federal agency. We expect to conclude the project at this site by September of 2018. Conclusions Using a community-based participatory research approach and a mixed method program could result in the creation of culturally sensitive community-based rehabilitation programs that promote community development and

Corporate America and community health: exploring the business case for investment.

Science.gov (United States)

Pronk, Nicolaas P; Baase, Catherine; Noyce, Jerry; Stevens, Denise E

2015-05-01

The principal aim of this project was to learn from corporate executives about the most important components of a business case for employer leadership in improving community health. We used dialogue sessions to gain insight into this issue. The strongest elements included metrics and measurement, return on investment, communications, shared values, shared vision, shared definitions, and leadership. Important barriers included lack of understanding, lack of clear strategy, complexity of the problem, trust, lack of resources and leadership, policies and regulations, and leadership philosophy. Substantial variability was observed in the degree of understanding of the relationship between corporate health and community health. The business case for intentional and strategic corporate investment in community health occurs along a continuum has a set of clearly defined elements that address why investment may make sense, but also asks questions about the "what-to-do" and the "how-to-do-it."

Diagnostic challenges of early Lyme disease: Lessons from a community case series

Directory of Open Access Journals (Sweden)

Schwarzwalder Alison

2009-06-01

Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

Research partnerships with local communities: two case studies from Papua New Guinea and Australia

Science.gov (United States)

Almany, G. R.; Hamilton, R. J.; Williamson, D. H.; Evans, R. D.; Jones, G. P.; Matawai, M.; Potuku, T.; Rhodes, K. L.; Russ, G. R.; Sawynok, B.

2010-09-01

Partnerships between scientists and local communities can increase research capacity and data delivery while improving management effectiveness through enhanced community participation. To encourage such collaboration, this study demonstrates how these partnerships can be formed, drawing on two case studies in coral reef ecosystems in very different social settings (Papua New Guinea and Australia). In each case, steps towards successfully engaging communities in research were similar. These included: (1) early engagement by collaborating organizations to build trust, (2) ensuring scientific questions have direct relevance to the community, (3) providing appropriate incentives for participation, and (4) clear and open communication. Community participants engaged in a variety of research activities, including locating and capturing fishes, collecting and recording data (weight, length and sex), applying external tags, and removing otoliths (ear bones) for ageing and elemental analysis. Research partnerships with communities enhanced research capacity, reduced costs and, perhaps more importantly, improved the likelihood of long-term community support for marine protected areas (MPAs).

Using community-based participatory research and organizational diagnosis to characterize relationships between community leaders and academic researchers

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Karen H. Wang

2017-09-01

Full Text Available Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders and university-based researchers' relationships on the inter-organizational level include: 1 Both groups described that community-engaged university-based researchers are exceptions to typical university culture; 2 Both groups described that the interpersonal skills university-based researchers need for CEnR require a change in organizational culture and training; 3 Both groups described skepticism about the sustainability of a meaningful institutional commitment to community-engaged research 4 Both groups described the historical impact on research relationships of race, power, and privilege, but only community leaders described its persistent role and relevance in research relationships. Challenges to community-academic research partnerships include researcher interpersonal skills and different perceptions of the importance of organizational history. Solutions to improve research partnerships may include transforming university culture and community

Health impact assessments in hospital community benefit: A multiple case study of the use of HIAs at Children’s Hospital Colorado

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Gregory Jackson Tung

2017-09-01

Full Text Available Objective:  To explore the use of Health Impact Assessments (HIAs within non-profit hospital community benefit activities. Methods:  We constructed case studies of three HIAs that were conducted in collaboration with Children’s Hospital Colorado as part of the hospital’s community benefit portfolio. These HIAs were part of a pilot that was funded by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. Results:  HIAs provided Children’s Hospital Colorado with a transparent and systematic process for generating evidence-based recommendations with community and stakeholder feedback within the hospital’s community benefit activities. HIAs were used to generate recommendations to inform community benefit planning activities and to generate public policy recommendations to enhance child health. The case studies highlighted several issues that need to be addressed in order to further advance the use of HIA within hospital community benefit activities including: use of HIA on explicit health issues, hospital capacity for HIA, potentially broadening the scope of HIA recommendations, and the use of HIA to generate recommendations from broad priority areas. Conclusion: HIAs can help meet the need for established, evidence-based, and stakeholder responsive tools and processes to be used within non-profit hospital community benefit activities. In meeting this need, the non-profit hospital community benefit area can potentially serve as a major institutional home for the practice of HIA. There is a need for additional research and practice innovation to further explore and refine the use of HIA within non-profit hospital community benefit activities.

Acceptability by community health workers in Senegal of combining community case management of malaria and seasonal malaria chemoprevention

DEFF Research Database (Denmark)

Tine, Roger Ck; Ndiaye, Pascal; Ndour, Cheikh T

2013-01-01

Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. However, little is known about the social acceptability of these interventions. A study was undertaken...... to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs)....

Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

Science.gov (United States)

Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

2016-01-01

We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

Burden of leprosy in Malawi: community camp-based cross-sectional study

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Msyamboza Kelias P

2012-08-01

Full Text Available Abstract Background Although leprosy was eliminated globally in 2000, the disease continues to be the significant cause of peripheral neuropathy, disability and disfigurement in some developing countries. However, recent population-based prevalence data are lacking to inform evidence-based renewed commitment for the final push for leprosy elimination at national and sub-national levels. Methods Community camp-based cross-sectional descriptive study was conducted in four selected districts. World Health Organisation guidelines and tools for leprosy elimination monitoring were used to evaluate the Malawi National Leprosy Programme. Results A total of 6,338 people (60% females, 35% children aged less than 15 years were examined for leprosy and other skin diseases. Prevalence of skin diseases was 18%, the commonest being fungal (9%, eczema/dermatitis (3% and leprosy (1%. Of the fungal skin conditions, pityriasis versicolor and Tinea capatis were the commonest (22% and 21% respectively then Tinea corporis (9%, Tinea cruris (6% and Tinea pedis (2%. A total of 66 leprosy cases were detected out of 6,338 people screened giving a prevalence of 104.1 per 10,000 population (range by district 67.1 to 194.1. Of the leprosy cases, 37 were new, 6 were defaulters and 23 were on treatment, 30 were females and 9 were children aged less than 15 years old. Of the 37 new leprosy cases, 9 (24.3% were children, 25 (67.6% had 1–5 leprosy lesions and 8 (21.6% had grade 2 disability. The most frequent location of leprosy lesions was the head and neck (24.1%, arms (24.1%, chest (17.2%, legs (13.8%, back (13.8% and abdomen (7.0%. Between 2006 and 2011, trends of leprosy prevalence and detection increased, prevalence/detection ratios were over 1 and cure rates by cohort analysis of 2009 multibacillary and 2010 paucibacillary cases were 33% and 63% respectively far below the expected 80% although the national prevalence remained at less than 1 case per 10

Virtual Communities as Commons: Case Study of “Connect”

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Jasmina Božić

2008-06-01

Full Text Available In a world increasingly networked with the help of information technology, where face-to-face communities are more and more supported by computer-mediated communication, and some communities exist solely in virtual space, the perennial social dilemma of cooperation has resurged, intriguing social researchers’ attention with new elements brought about by technological advances, such as software applications enabling simultaneous communication of community members through public and private channels, easy access to a variety of documents, anonymous messaging, forums for potentially unlimited number of members who may join or observe, and a number of other IT-enabled community-building tools. In this paper the authors discuss the cooperation problem in virtual communities through the case-study of “Connect”, an online community of Croatian scientists. Starting point of the analysis is the observation that cooperation in virtual communities may be encouraged by implementing technological solutions that provide users with incentives to cooperate. With this in mind, the authors inspect the compliance of “Connect” to a set of design principles of robust common-pool resource institutions elaborated by Elinor Ostrom. The study demonstrates that the “Connect” satisfies the majority of Ostrom’s principles, with some room for improvement, and fails to satisfy two of them, mainly due to non-existence of technical prerequisites and due to relatively small size of the community. The analysis lays ground for further work aimed at obtaining more prescriptive guidelines that would point to possible improvements in management of common pool resources in virtual communities.

A complex network based model for detecting isolated communities in water distribution networks

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Sheng, Nan; Jia, Youwei; Xu, Zhao; Ho, Siu-Lau; Wai Kan, Chi

2013-12-01

Water distribution network (WDN) is a typical real-world complex network of major infrastructure that plays an important role in human's daily life. In this paper, we explore the formation of isolated communities in WDN based on complex network theory. A graph-algebraic model is proposed to effectively detect the potential communities due to pipeline failures. This model can properly illustrate the connectivity and evolution of WDN during different stages of contingency events, and identify the emerging isolated communities through spectral analysis on Laplacian matrix. A case study on a practical urban WDN in China is conducted, and the consistency between the simulation results and the historical data are reported to showcase the feasibility and effectiveness of the proposed model.

Source Materials for the Healthy Communities Toolkit: A Resource Guide for Community and Faith-Based Organizations.

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Acosta, Joie; Chandra, Anita; Williams, Malcolm; Davis, Lois M

2011-01-01

The Patient Protection and Affordable Care Act places significant emphasis on the role of community-based health promotion initiatives; within this focus, community and faith-based organizations (CFBOs) are seen as critical partners for improving community well-being. This article describes a report that provides the content for a toolkit that will prepare community and faith-based organizations to take advantage of opportunities presented in the Patient Protection and Affordable Care Act and engage faith and community leaders in promoting health in their communities. This includes key facts and figures about health topics, handouts for community groups, and web links for resources and other information in the following areas: healthcare reform; community health centers and development of the community health workforce; promotion of healthy families; mental health; violence and trauma; prevention of teen and unintended pregnancy and HIV/AIDS; and chronic disease prevention. The report also includes recommendations for testing the content of the toolkit with communities and considerations for its implementation.

Approaches for building community participation: A qualitative case study of Canadian food security programs.

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Hyett, Nerida; Kenny, Amanda; Dickson-Swift, Virginia

2017-10-01

There is increasing opportunity and support for occupational therapists to expand their scope of practice in community settings. However, evidence is needed to increase occupational therapists' knowledge, confidence, and capacity with building community participation and adopting community-centered practice roles. The purpose of this study is to improve occupational therapists' understanding of an approach to building community participation, through case study of a network of Canadian food security programs. Qualitative case study was utilized. Data were semistructured interviews, field observations, documents, and online social media. Thematic analysis was used to identify and describe four themes that relate to processes used to build community participation. The four themes were use of multiple methods, good leaders are fundamental, growing participation via social media, and leveraging outcomes. Occupational therapists can utilize an approach for building community participation that incorporates resource mobilization. Challenges of sustainability and social exclusion must be addressed.

Privatizing community animal health worker based veterinary ...

African Journals Online (AJOL)

Privatizing community animal health worker based veterinary services delivery system in West Kordofan, Southern Sudan; The needed roles of community animal health assistant (CAHA) and Pastoral unions.

Perception-based analysis of climate change effect on forest-based livelihood: The case of Vhembe District in South Africa

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Chidiebere Ofoegbu

2016-07-01

Full Text Available Forests are vulnerable to climate change and are also major sources of livelihood for many rural households in Africa. This study examines rural people’s perceptions of climate change impacts on forest-based livelihoods using rural communities of Vhembe District in South Africa as a case study. The study was based on the principles of perceived impact-based assessment, and sustainable livelihoods framework. Using the stratified proportionate random sampling procedure in combination with weighted Enumeration Area for the selected communities, 366 households were chosen and interviewed. Data analysis involved computing frequencies and conducting the Chi-square, binomial tests and binary logistic regression analysis. The respondents identified erratic rainfall, extreme temperature, extreme drought and flooding as key climatic events in their community. But not all identified key climatic events were perceived to constitute risk to forest products and forest-based livelihood. Only extreme drought was indicated to constitute risk to availability of forest products. In addition, the binary logistic regression showed a significant difference (p < 0.05 in the perceived risk of climate change to the availability of essential forest products across the three municipalities. Hence the need for forest development initiatives that target vulnerable forest products per community as a means of enhancing resilience of forest-based livelihood to climate change impacts in rural community development in South Africa.

Obstacles to action in arthritis: a community case-control study.

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Hutton, Ingrid; Gamble, Greg; McLean, Grant; Butcher, Hugh; Gow, Peter; Dalbeth, Nicola

2009-07-01

Despite the benefits of physical activity, people with arthritis are less active than the general population. The aim of this study was to determine the motivators and obstacles to physical activity for adults with arthritis. Participants were identified from the Obstacles to Action Study, a community based study of 8163 adults, which explored barriers and motivators to physical activity. A 1:1 case-control study was designed; cases were identified as those participants who reported arthritis (n = 1106). Each case was matched with an age, sex and ethnicity-matched non-arthritis control (n = 1106). Cases were less likely to achieve recommended physical activity targets (58.8% vs. 68.1% P = 0.00001). Furthermore, fewer people with arthritis believed that physical activity would help them lead healthy lives (86.7% vs. 91.3% P = 0.006) or viewed physical activity as a priority (53.8% vs. 59.8% P = 0.005). Cases were less confident in their abilities to try a new activity (37.1% vs. 43.7% P = 0.002) or maintain a healthy weight (65.0% vs. 74.3% P = 0.00001). Cases also reported greater negative impact scores for barriers to activity, particularly arthritis, accessibility, cost and discomfort while exercising. Motivators and environmental barriers to activity were similar for cases and controls. These findings persisted after adjusting for educational level, body mass index and comorbidities. People with arthritis are less active and demonstrate different attitudes toward physical activity. Although people with arthritis identify similar environmental barriers, they have different psychosocial barriers. In order to design effective physical activity programs for people with arthritis, these barriers must be specifically addressed.

Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

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Crowley, Max; Jones, Damon

2017-12-01

Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed. © Society for Community Research and Action 2017.

Community-Based Ecotourism: The Transformation of Local Community

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Pookhao Nantira

2014-01-01

Full Text Available Community-based ecotourism (CBET is considered a sustainable form of tourism that improves the quality of life of hosts at the tourist destination. Scholars have yet to explore the long-term operation of CBET in relation to its effects on the local way of life. Consequently, the purpose of this paper is to examine the transformation of a local community due to the operation of CBET in relation to sociocultural, economic and environmental aspects. The findings reveal that the community encounters both positive and negative impacts of transformation. However, unintended impacts of the CBET operation lay embedded in the transformation of relationships among the community members. The study identifies that close relationships among the villagers has been initially transformed to loose relationships due to forgotten communal goals; CBET has transformed from being a conservation tool to being a business-oriented goal which causes conflicts of interest among local people and alters traditional social structure. The study also agrees with the notion of social exchange theory for villagers to enhance environmental sustainability, and proposes that slight inequalities of benefits received from CBET causes social transformation at the local level.

Community-based organizations in the health sector: A scoping review

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Wilson Michael G

2012-11-01

Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

Successful Student Goal Completion: A Community College Case Study

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Cady, Sara C.

2013-01-01

Research studies have shown that one half of all students who begin college fail to realize their goals. This case study of one community college provided a comprehensive examination of best practices developed over several years through strategic enrollment planning. Additionally, this dissertation examined the decision-making processes that…

Tribal Community-Based Social Marketing Training Guide

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The Community-Based Social Marketing (CBSM) Training Guide and recycling toolkit provides an overview of how to increase the adoption of sustainable behaviors and recycling practices with a community.

Auditing and Evaluating University-Community Engagement: Lessons from a UK Case Study

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Hart, Angie; Northmore, Simon

2011-01-01

The growing importance of community and public engagement activities in universities has led to an increasing emphasis on auditing and evaluating university-community partnerships. However, the development of effective audit and evaluation tools is still at a formative stage. This article presents a case study of the University of Brighton's…

An attempt to implement tools to support examination of community-based activities for disaster mitigation: A case study in Toyokawa city, Japan

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Karashima, Kazuki; Ohgai, Akira

2017-10-01

Japan is a country with a high risk for earthquake disasters. The measures used to promote structures' seismic safety, such as reconstruction, widening narrow roads, and the response capacities to deal with huge earthquakes are important. Techniques to support the examination of countermeasures to huge earthquakes are required. To improve this capability, the authors developed tools to: (1) evaluate fire-spread risk, (2) evaluate the difficulty of emergency response and evacuation, and (3) evaluate capacities of neighborhood communities for disaster mitigation. The usefulness of the tools was clarified by the demonstration experiments of previous studies. The next step was implementation of the tools in community-based activities for disaster mitigation. This study aimed to clarify the usability and problems of implementing the tools in community-based activities. The tools were used at several workshops in actual community-based activities for disaster mitigation for one year. After the last workshop, interviews and a questionnaire were conducted on municipal staff and consultant staff. The results found that the tools visually showed the fire-spread risk, the difficulty of evacuation under current conditions and after improvements, and the effects of each disaster mitigation activity. The users could easily explore the draft plans to promote seismic safety of urban structures and response capabilities. The tools were positively incorporated into some community-based activities for disaster mitigation. Thus, the tools have the possibility of successful use at continuing community-based activities and the possibility of implementing the tools will be promoted.

“On the Margins and Not the Mainstream:” Case Selection for the Implementation of Community based Primary Health Care in Canada and New Zealand

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Kerry Kuluski

2017-06-01

Full Text Available Healthcare system reforms are pushing beyond primary care to more holistic, integrated models of community based primary health care (CBPHC to better meet the needs of the population. Across the world CBPHC is at varying stages of development and few standard models exist. In order to scale up and spread successful models of care it is important to study what works and why. The first step is to select ‘appropriate’ cases to study. In this commentary we reflect on our journey in the selection of CBPHC models for older adults, revealing the limited utility of sourcing the empirical literature; the difficulty in identifying “successful” models to study when outcomes of importance differ across stakeholders; the value of drawing on clinical and organisational networks and experts; and the association between policy context and ease of case selection. Such insights have important implications for case study methodology in health services and policy research.

Looking Similar Promotes Group Stability in a Game-Based Virtual Community.

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Lortie, Catherine L; Guitton, Matthieu J

2012-08-01

Online support groups are popular Web-based resources that provide tailored information and peer support through virtual communities and fulfill the users' needs for empowerment and belonging. However, the therapeutic potential of online support groups is at present limited by the lack of systematic research on the cognitive mechanisms underlying social group cohesion in virtual communities. We might increase the benefits of participation in online support groups if we gain more insight into the factors that promote long-term commitment to peer support. One approach to foster the therapeutic potential of online support groups could be to increase social selection based on visual similarity. We performed a case study using the popular virtual setting of "World of Warcraft" (Blizzard Entertainment, Irvine, CA). We monitored the social dynamics of a virtual community composed of avatars whose appearance was identical during a period of 3 months, biweekly, for a total of 24 measures. We observed that this homogeneous community displayed a very high level of group stability over time in terms of the total number of members, the number of members that stayed the same, and the number of arrivals and departures, despite the fact that belonging to a heterogeneous group typically favors the success of the group with respect to game progression. Our results confirm that appearance can trigger social selection in online virtual communities. Displaying a similar appearance could be one way to strengthen social bonds among peers who share various health and well-being issues. Thus, the therapeutic potential of online support groups could be promoted through visual cohesion.

Developing a Deeper Understanding of Community-Based Pedagogies with Teachers: Learning with and from Teachers in Colombia

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Sharkey, Judy; Clavijo Olarte, Amparo; Ramírez, Luz Maribel

2016-01-01

Here we share findings from a 9-month qualitative case study involving a school-university professional development inquiry into how teachers develop, implement, and interpret community-based pedagogies (CBPs), an asset-based approach to curriculum that acknowledges mandated standards but begins with recognizing and valuing local knowledge. After…

A review of studies on community based early warning systems

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Margaret Macherera

2016-04-01

Full Text Available Community-based early warning systems involve community driven collection and analysis of information that enable warning messages to help a community to react to a hazard and reduce the resulting loss or harm. Most early warning systems are designed at the national or global level. Local communities’ capacity to predict weather conditions using indigenous knowledge has been demonstrated in studies focusing on climate change and agriculture in some African countries. This review was motivated by successes made in non-disease specific community-based early warning systems with a view to identify opportunities for developing similar systems for malaria. This article reviewed the existing community-based early warning systems documented in literature. The types of disasters that are addressed by these systems and the methodologies utilised in the development of the systems were identified. The review showed that most of the documented community-based early warning systems focus on natural disasters such as floods, drought, and landslides. Community-based early warning systems for human diseases are very few, even though such systems exist at national and regional and global levels. There is a clear gap in terms of community-based malaria early warning systems. The methodologies for the development of the community-based early warning systems reviewed mainly derive from the four elements of early warning systems; namely risk knowledge, monitoring, warning communication and response capability. The review indicated the need for the development of community based early warning systems for human diseases. Keywords: community; early warning; disaster; hazards

Urban Community, poverty and corruption: the case of Annaba, Algeria

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Nadji KAHOUA

2010-01-01

Full Text Available The population in the most Mediterranean countries, particularly in Algeria, is concentrated to the urban communities, cities with more or less importance, urban and coastal regions. This trend of rapid growth of the urban communities leads to multiple consequences both economically and socially on the use of resources and their distribution. The urban is the area where cross the resources, the population and the production activities and yours management. To analyze the corruption as a phenomenon triple (economic, social and institutional through an urban community (as Annaba’s case in this research it may well prove very fruitful in terms of lessons on this central phenomenon and its impacts in the North African countries.

Team sponsors in community-based health leadership programs.

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Patterson, Tracy Enright; Dinkin, Donna R; Champion, Heather

2017-05-02

Purpose The purpose of this article is to share the lessons learned about the role of team sponsors in action-learning teams as part of community-based health leadership development programs. Design/methodology/approach This case study uses program survey results from fellow participants, action learning coaches and team sponsors to understand the value of sponsors to the teams, the roles they most often filled and the challenges they faced as team sponsors. Findings The extent to which the sponsors were perceived as having contributed to the work of the action learning teams varied greatly from team to team. Most sponsors agreed that they were well informed about their role. The roles sponsors most frequently played were to provide the teams with input and support, serve as a liaison to the community and serve as a sounding board, motivator and cheerleader. The most common challenges or barriers team sponsors faced in this role were keeping engaged in the process, adjusting to the role and feeling disconnected from the program. Practical implications This work provides insights for program developers and community foundations who are interested in building the capacity for health leadership by linking community sponsors with emerging leaders engaged in an action learning experience. Originality/value This work begins to fill a gap in the literature. The role of team sponsors has been studied for single organization work teams but there is a void of understanding about the role of sponsors with multi-organizational teams working to improve health while also learning about leadership.

COPD case finding by spirometry in high-risk customers of urban community pharmacies: a pilot study.

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Castillo, D; Guayta, R; Giner, J; Burgos, F; Capdevila, C; Soriano, J B; Barau, M; Casan, P

2009-06-01

COPD case finding is currently recommended at primary and tertiary care levels only. To evaluate the feasibility of a community pharmacy program for COPD case finding in high-risk customers by means of spirometry. Pilot cross-sectional descriptive study in 13 urban community pharmacies in Barcelona, Spain, from April to May 2007. Customers >40 years old with respiratory symptoms and/or a history of smoking were invited to participate in the study during pharmacists' routine work shifts. High-risk customers were identified by means of a 5-item COPD screening questionnaire based on criteria of the Global Initiative for Chronic Obstructive Lung Disease, and were invited to perform spirometry accordingly. Those with an FEV(1)/FVC ratio less than 0.70 were referred to the hospital for a repeat spirometry. Of the 161 pharmacy customers studied, 100 (62%) scored 3 or more items in the COPD screening questionnaire, and after spirometry, 21 (24%) had an FEV(1)/FVC ratiocustomers of urban community pharmacies is feasible. Similarly to primary care practitioners, pharmacists have access to high-risk, middle-aged subjects who have never been tested for COPD. Pharmacists can help with early detection of COPD if they are correctly trained.

Communities of Practice and the Mediation ofTeachers' Responses to Standards-based Reform

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Chrysan Gallucci

2003-09-01

Full Text Available This paper evaluates the usefulness of a sociocultural approach for analyzing teachers’ responses to the professional learning demands of standards-based reform policies. A policy-oriented case study of the practice of six elementary teachers who worked in two high poverty schools in a demographically changing district in the state of Washington is summarized. Key findings of that study conclude that communities of teaching practice are sites for teacher learning and are mediators of teachers’ responses to standards-based reform. Characteristics of the communities of practice, including their relative strength and openness (to learning, influence the degree to which teachers work out negotiated and thoughtful responses to policy demands. The present paper discusses the efficacy of Wenger’s (1998 theory of learning for the study of policy to practice connections.

The environment as an unrecognized reservoir for community-associated methicillin resistant Staphylococcus aureus USA300: a case-control study.

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Anne-Catrin Uhlemann

Full Text Available BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA infections are spreading, but the source of infections in non-epidemic settings remains poorly defined. METHODS: We carried out a community-based, case-control study investigating socio-demographic risk factors and infectious reservoirs associated with MRSA infections. Case patients presented with CA-MRSA infections to a New York hospital. Age-matched controls without infections were randomly selected from the hospital's Dental Clinic patient population. During a home visit, case and control subjects completed a questionnaire, nasal swabs were collected from index respondents and household members and standardized environmental surfaces were swabbed. Genotyping was performed on S. aureus isolates. RESULTS: We enrolled 95 case and 95 control subjects. Cases more frequently reported diabetes mellitus and a higher number of skin infections among household members. Among case households, 53 (56% were environmentally contaminated with S. aureus, compared to 36 (38% control households (p = .02. MRSA was detected on fomites in 30 (32% case households and 5 (5%; p<.001 control households. More case patients, 20 (21% were nasally colonized with MRSA than were control indexes, 2 (2%; p<.001. In a subgroup analysis, the clinical isolate (predominantly USA300, was more commonly detected on environmental surfaces in case households with recurrent MRSA infections (16/36, 44% than those without (14/58, 24%, p = .04. CONCLUSIONS: The higher frequency of environmental contamination of case households with S. aureus in general and MRSA in particular implicates this as a potential reservoir for recolonization and increased risk of infection. Environmental colonization may contribute to the community spread of epidemic strains such as USA300.

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

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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.

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

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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-Based Research as a Mechanism to Reduce Environmental Health Disparities in American Indian and Alaska Native Communities

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Cynthia Agumanu McOliver

2015-04-01

Full Text Available Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities, variably causing drought, increased flooding and forced relocation affecting tribal water resources, traditional foods, forests and forest resources, and tribal health. This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA Science to Achieve Results (STAR tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by tribal communities. The tribal research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STAR research program was developed under the premise that tribal populations may be at an increased risk for environmentally-induced diseases as a result of unique subsistence and traditional practices of the tribes and Alaska Native villages, community activities, occupations and customs, and/or environmental releases that significantly and disproportionately impact tribal lands. Through a series of case studies, this article will demonstrate how grantees—tribal community leaders and members and academic collaborators—have been addressing these complex environmental concerns by developing capacity, expertise and tools through community-engaged research.

Community-Based Research as a Mechanism to Reduce Environmental Health Disparities in American Indian and Alaska Native Communities

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McOliver, Cynthia Agumanu; Camper, Anne K.; Doyle, John T.; Eggers, Margaret J.; Ford, Tim E.; Lila, Mary Ann; Berner, James; Campbell, Larry; Donatuto, Jamie

2015-01-01

Racial and ethnic minority communities, including American Indian and Alaska Natives, have been disproportionately impacted by environmental pollution and contamination. This includes siting and location of point sources of pollution, legacies of contamination of drinking and recreational water, and mining, military and agricultural impacts. As a result, both quantity and quality of culturally important subsistence resources are diminished, contributing to poor nutrition and obesity, and overall reductions in quality of life and life expectancy. Climate change is adding to these impacts on Native American communities, variably causing drought, increased flooding and forced relocation affecting tribal water resources, traditional foods, forests and forest resources, and tribal health. This article will highlight several extramural research projects supported by the United States Environmental Protection Agency (USEPA) Science to Achieve Results (STAR) tribal environmental research grants as a mechanism to address the environmental health inequities and disparities faced by tribal communities. The tribal research portfolio has focused on addressing tribal environmental health risks through community based participatory research. Specifically, the STAR research program was developed under the premise that tribal populations may be at an increased risk for environmentally-induced diseases as a result of unique subsistence and traditional practices of the tribes and Alaska Native villages, community activities, occupations and customs, and/or environmental releases that significantly and disproportionately impact tribal lands. Through a series of case studies, this article will demonstrate how grantees—tribal community leaders and members and academic collaborators—have been addressing these complex environmental concerns by developing capacity, expertise and tools through community-engaged research. PMID:25872019

A Community of Congruence among Secondary Social Studies Teachers: A Case Study

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Province, Rachael

2012-01-01

The purpose of this case study was to explore the community of one purposely selected department of secondary social studies teachers. I aimed to provide insight into the nature of one community of congruence amid the many constraints and systemic pressures in school systems today. Many have suggested that education is a microcosm of larger…

Community-based gang desistance

DEFF Research Database (Denmark)

Højgaard Dichmann, Kirstine; Jensen, Tobias Bo; Mørck, Line Lerche

2018-01-01

of belonging to the communities in Homeboy Industries also facilitates self-reflection and identity transformation. Homeboy Industries is furthermore an important life changing resource because it offers former gang members a legal source of income. This provides them with a new and secure base, a way...

Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials: a case study of the BeWEL trial.

Science.gov (United States)

Treweek, Shaun; Wilkie, Erna; Craigie, Angela M; Caswell, Stephen; Thompson, Joyce; Steele, Robert J C; Stead, Martine; Anderson, Annie S

2013-12-18

Recruiting participants to multicentre, community-based trials is a challenge. This case study describes how this challenge was met for the BeWEL trial, which evaluated the impact of a diet and physical activity intervention on body weight in people who had had pre-cancerous bowel polyps. The BeWEL trial was a community-based trial, involving centres linked to the Scottish National Health Service (NHS) colorectal cancer screening programme. BeWEL had a recruitment target of 316 and its primary recruitment route was the colonoscopy clinics of the Scottish Bowel Screening Programme. BeWEL exceeded its recruitment target but needed a 6-month no-cost extension from the funder to achieve this. The major causes of delay were lower consent rates (49% as opposed to 70% estimated from earlier work), the time taken for NHS research and development department approvals and the inclusion of two additional sites to increase recruitment, for which there were substantial bureaucratic delays. A range of specific interventions to increase recruitment, for example, telephone reminders and a shorter participant information leaflet, helped to increase the proportion of eligible individuals consenting and being randomized. Recruitment to multicentre trials is a challenge but can be successfully achieved with a committed team. In a UK context, NHS research and development approval can be a substantial source of delay. Investigators should be cautious when estimating consent rates. If consent rates are less than expected, qualitative analysis might be beneficial, to try and identify the reason. Finally, investigators should select trial sites on the basis of a formal assessment of a site's past performance and the likelihood of success in the trial being planned. Current Controlled Trials ISRCTN53033856.

Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

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Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

2013-01-01

This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

Engaging the Deaf American Sign Language Community: Lessons From a Community-Based Participatory Research Center

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McKee, Michael; Thew, Denise; Starr, Matthew; Kushalnagar, Poorna; Reid, John T.; Graybill, Patrick; Velasquez, Julia; Pearson, Thomas

2013-01-01

Background Numerous publications demonstrate the importance of community-based participatory research (CBPR) in community health research, but few target the Deaf community. The Deaf community is understudied and underrepresented in health research despite suspected health disparities and communication barriers. Objectives The goal of this paper is to share the lessons learned from the implementation of CBPR in an understudied community of Deaf American Sign Language (ASL) users in the greater Rochester, New York, area. Methods We review the process of CBPR in a Deaf ASL community and identify the lessons learned. Results Key CBPR lessons include the importance of engaging and educating the community about research, ensuring that research benefits the community, using peer-based recruitment strategies, and sustaining community partnerships. These lessons informed subsequent research activities. Conclusions This report focuses on the use of CBPR principles in a Deaf ASL population; lessons learned can be applied to research with other challenging-to-reach populations. PMID:22982845

Adaptive Management and Social Learning in Collaborative and Community-Based Monitoring: a Study of Five Community-Based Forestry Organizations in the western USA

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Maria E. Fernandez-Gimenez

2008-12-01

Full Text Available Collaborative and community-based monitoring are becoming more frequent, yet few studies have examined the process and outcomes of these monitoring approaches. We studied 18 collaborative or community-based ecological assessment or monitoring projects undertaken by five community-based forestry organizations (CBFs, to investigate the objectives, process, and outcomes of collaborative ecological monitoring by CBF organizations. We found that collaborative monitoring can lead to shared ecological understanding among diverse participants, build trust internally and credibility externally, foster social learning and community-building, and advance adaptive management. The CBFs experienced challenges in recruiting and sustaining community participation in monitoring, building needed technical capacity for monitoring, and communicating monitoring results back to the broader community. Our results suggest that involving diverse and sometimes adversarial interests at key points in the monitoring process can help resolve conflicts and advance social learning, while also strengthening the link between social and ecological systems by improving the information base for management and increasing collective awareness of the interdependence of human and natural forest communities.

Community Based Networks and 5G

DEFF Research Database (Denmark)

Williams, Idongesit

2016-01-01

The deployment of previous wireless standards has provided more benefits for urban dwellers than rural dwellers. 5G deployment may not be different. This paper identifies that Community Based Networks as carriers that deserve recognition as potential 5G providers may change this. The argument....... The findings indicate that 5G connectivity can be extended to rural areas by these networks, via heterogenous networks. Hence the delivery of 5G data rates delivery via Wireless WAN in rural areas can be achieved by utilizing the causal factors of the identified models for Community Based Networks....

Developing and Field Testing a Community Based Youth Initiative to Increase Tuberculosis Awareness in Remote Arctic Inuit Communities.

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Alvarez, Gonzalo G; Van Dyk, Deborah D; Colquhoun, Heather; Moreau, Katherine A; Mulpuru, Sunita; Graham, Ian D

2016-01-01

Inuit in Canada have the highest reported tuberculosis (TB) incidence rate in Canada, even higher than other Canadian Indigenous groups. The aim of this study was to increase TB awareness among Inuit youth and their communities by equipping those who can best reach this population with a community based, youth focused, education initiative built on interventions adapted from a previous TB awareness study. The Taima TB Youth Education Initiative was a field test case study of a knowledge translation (KT) strategy aimed at community members who provide health education in these communities. In the first stage of this study, interventions from a larger TB awareness campaign were adapted to focus on youth living in remote Inuit communities. During the second stage of the study, investigators field tested the initiative in two isolated Inuit communities. It was then applied by local implementation teams in two other communities. Evaluation criteria included feasibility, acceptability, knowledge uptake and health behavior change. Implementation of the adapted KT interventions resulted in participation of a total of 41 youth (19 females, 22 males) with an average age of 16 years (range 12-21 years) in four different communities in Nunavut. Community celebration events were attended by 271 community members where TB messaging were presented and discussed. All of the health care workers and community members surveyed reported that the adapted interventions were acceptable and a useful way of learning to some extent. Knowledge uptake measures indicated an average TB knowledge score of 64 out of 100. Local partners in all four communities indicated that they would use the Taima TB Youth Education Initiative again to raise awareness about TB among youth in their communities. The TB awareness interventions adapted for the Taima TB Youth Education Initiative were acceptable to the Inuit communities involved in the study. They resulted in uptake of knowledge among participants

Source Water Protection Planning for Ontario First Nations Communities: Case Studies Identifying Challenges and Outcomes

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Leslie Collins

2017-07-01

Full Text Available After the Walkerton tragedy in 2000, where drinking water contamination left seven people dead and many suffering from chronic illness, the Province of Ontario, Canada implemented policies to develop Source Water Protection (SWP plans. Under the Clean Water Act (2006, thirty-six regional Conservation Authorities were mandated to develop watershed-based SWP plans under 19 Source Protection Regions. Most First Nations in Ontario are outside of these Source Protection Regions and reserve lands are under Federal jurisdiction. This paper explores how First Nations in Ontario are attempting to address SWP to improve drinking water quality in their communities even though these communities are not part of the Ontario SWP framework. The case studies highlight the gap between the regulatory requirements of the Federal and Provincial governments and the challenges for First Nations in Ontario from lack of funding to implement solutions to address the threats identified in SWP planning. This analysis of different approaches taken by Ontario First Nations shows that the Ontario framework for SWP planning is not an option for the majority of First Nations communities, and does not adequately address threats originating on reserve lands. First Nations attempting to address on-reserve threats to drinking water are using a variety of resources and approaches to develop community SWP plans. However, a common theme of all the cases surveyed is a lack of funding to support implementing solutions for the threats identified by the SWP planning process. Federal government initiatives to address the chronic problem of boil water advisories within Indigenous communities do not recognize SWP planning as a cost-effective tool for improving drinking water quality.

Energy Information Augmented Community-Based Energy Reduction

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Mark Rembert

2012-06-01

Full Text Available More than one-half of all U.S. states have instituted energy efficiency mandates requiring utilities to reduce energy use. To achieve these goals, utilities have been permitted rate structures to help them incentivize energy reduction projects. This strategy is proving to be only modestly successful in stemming energy consumption growth. By the same token, community energy reduction programs have achieved moderate to very significant energy reduction. The research described here offers an important tool to strengthen the community energy reduction efforts—by providing such efforts energy information tailored to the energy use patterns of each building occupant. The information provided most importantly helps each individual energy customer understand their potential for energy savings and what reduction measures are most important to them. This information can be leveraged by the leading community organization to prompt greater action in its community. A number of case studies of this model are shown. Early results are promising.

Creating "communicative spaces": a case of NGO community organizing for HIV/AIDS prevention.

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de Souza, Rebecca

2009-12-01

This study uses the case study method to investigate the processes used by a local nongovernmental organization called the Society for People's Action for Development to organize sex workers in the slums of Bangalore, India, for HIV/AIDS prevention. The nongovernmental organization-facilitated HIV/AIDS program is based on the new paradigm of community organizing that encourages community participation and capacity building. Grounded in the culture-centered approach, this study documents the processes used to organize the women, while highlighting the role of communication in these processes. The study identifies 4 primary processes used to mobilize the community, namely collectivization, community awareness and sensitization, capacity building, and providing legal education and support. Each of these processes highlights the importance of attending to the economic, social, and political realities that shape the health of women. The common thread linking these processes together is the notion of "voice." More specifically, each process serves as a catalyst to produce discursive practices that enable women to provide support to each other, increase awareness in the community about the problems that they face, build self-reliance through financial skills training and communication training, and defend their legal rights. In addition, the study suggests that the primary role of nongovernmental organizations should be the creation of "communicative spaces," which are discursive and material spaces within marginalized communities and mainstream society where cultural participants can identify problems (oftentimes beyond the realm of health), manage solutions to those problems, and advocate for health and social change.

Ensemble method: Community detection based on game theory

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Zhang, Xia; Xia, Zhengyou; Xu, Shengwu; Wang, J. D.

2014-08-01

Timely and cost-effective analytics over social network has emerged as a key ingredient for success in many businesses and government endeavors. Community detection is an active research area of relevance to analyze online social network. The problem of selecting a particular community detection algorithm is crucial if the aim is to unveil the community structure of a network. The choice of a given methodology could affect the outcome of the experiments because different algorithms have different advantages and depend on tuning specific parameters. In this paper, we propose a community division model based on the notion of game theory, which can combine advantages of previous algorithms effectively to get a better community classification result. By making experiments on some standard dataset, it verifies that our community detection model based on game theory is valid and better.

Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

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Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

2013-09-01

Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

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Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

2014-01-01

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

Science.gov (United States)

Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

2015-06-18

Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

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Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

2007-09-01

In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

Community-Based Research: From Practice to Theory and Back Again.

Science.gov (United States)

Stoecker, Randy

2003-01-01

Explores the theoretical strands being combined in community-based research--charity service learning, social justice service learning, action research, and participatory research. Shows how different models of community-based research, based in different theories of society and different approaches to community work, may combine or conflict. (EV)

Community-based first aid: a program report on the intersection of community-based participatory research and first aid education in a remote Canadian Aboriginal community.

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VanderBurgh, D; Jamieson, R; Beardy, J; Ritchie, S D; Orkin, A

2014-01-01

Community-based first aid training is the collaborative development of locally relevant emergency response training. The Sachigo Lake Wilderness Emergency Response Education Initiative was developed, delivered, and evaluated through two intensive 5-day first aid courses. Sachigo Lake First Nation is a remote Aboriginal community of 450 people in northern Ontario, Canada, with no local paramedical services. These courses were developed in collaboration with the community, with a goal of building community capacity to respond to medical emergencies. Most first aid training programs rely on standardized curriculum developed for urban and rural contexts with established emergency response systems. Delivering effective community-based first aid training in a remote Aboriginal community required specific adaptations to conventional first aid educational content and pedagogy. Three key lessons emerged during this program that used collaborative principles to adapt conventional first aid concepts and curriculum: (1) standardized approaches may not be relevant nor appropriate; (2) relationships between course participants and the people they help are relevant and important; (3) curriculum must be attentive to existing informal and formal emergency response systems. These lessons may be instructive for the development of other programs in similar settings.

Enhanced Web-Based Otitis Study Case vs. Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam Performance

Directory of Open Access Journals (Sweden)

Michael H. Malloy, M.D., M.S.

2002-01-01

Full Text Available Background: Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. Objective: To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Design/Methods: Students were randomized by community site to receive either the enhanced (E or simple otitis study case (S. Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site. They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR. Scores on the two stations were compared by group. Results: There were 198 students who took the OSCE. 178 (90% responded to a survey that indicated they had opened and read the e-mailed case. There

Web-Based Case Conferencing for Preservice Teacher Education: Electronic Discourse from the Field.

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Bonk, Curtis Jay; Malikowski, Steve; Angeli, Charoula; East, Judy

1998-01-01

The purpose of this study was to foster preservice teacher learning of educational psychology by creating a Web-based learning community using actual case situations experienced during field observations. Participants (146 undergraduate students) were assigned to two electronic-conferencing groups where they generated teaching vignettes related to…

Community-Based Wildlife Management In Tanzania: The Policy ...

African Journals Online (AJOL)

Community-based wildlife management (CWM) approach – known to others as community-based conservation – was first introduced in Tanzania in 1987/88. The approach intends to reconcile wildlife conservation and rural economic development. In the 1990s Tanzanians witnessed a rush by government Ministries and ...

Community-based research in action: tales from the Ktunaxa community learning centres project.

Science.gov (United States)

Stacy, Elizabeth; Wisener, Katherine; Liman, Yolanda; Beznosova, Olga; Lauscher, Helen Novak; Ho, Kendall; Jarvis-Selinger, Sandra

2014-01-01

Rural communities, particularly Aboriginal communities, often have limited access to health information, a situation that can have significant negative consequences. To address the lack of culturally and geographically relevant health information, a community-university partnership was formed to develop, implement, and evaluate Aboriginal Community Learning Centres (CLCs). The objective of this paper is to evaluate the community-based research process used in the development of the CLCs. It focuses on the process of building relationships among partners and the CLC's value and sustainability. Semistructured interviews were conducted with key stakeholders, including principal investigators, community research leads, and supervisors. The interview transcripts were analyzed using an open-coding process to identify themes. Key challenges included enacting shared project governance, negotiating different working styles, and hiring practices based on commitment to project objectives rather than skill set. Technological access provided by the CLCs increased capacity for learning and collective community initiatives, as well as building community leads' skills, knowledge, and self-efficacy. An important lesson was to meet all partners "where they are" in building trusting relationships and adapting research methods to fit the project's context and strengths. Successful results were dependent upon persistence and patience in working through differences, and breaking the project into achievable goals, which collectively contributed to trust and capacity building. The process of building these partnerships resulted in increased capacity of communities to facilitate learning and change initiatives, and the capacity of the university to engage in successful research partnerships with Aboriginal communities in the future.

A heuristic framework for understanding the role of participatory decision making in community-based non-profits.

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Bess, Kimberly D; Perkins, Douglas D; Cooper, Daniel G; Jones, Diana L

2011-06-01

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members' input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs' capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.

Community-Based Disaster Management: A Lesson Learned From Community Emergency Response Management in Banyumas, Indonesia

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Pratama, A. Y.; Sariffuddin, S.

2018-02-01

This article aimed to review community-based disaster management in terms of its independent coordination and disaster management. Community resilience was tested during disaster emergency. While panic, the community is required to be viable and able to evacuate, manage logistic, collect data on damage and the victim, and coordinate with outsiders independently. The community in Gununglurah Village, Banyumas Regency which was hit by a landslide in 2015 provides a lesson learned about community based disaster management. This research used qualitative descriptive methodology with in-depth interview with 23 informants from the community, donor institution, village officers, and government officers. Through traditional and informal methods, the community implemented disaster management that was categorized into 3 mechanisms that were social, functional, and sequential mechanism. These mechanisms controlled different portion in which social mechanism holds the most important role in disaster management, then functional mechanism and sequential mechanism. Various community activities in the village equipped the community with organizational experience to manage logistic, human resource and other coordination. In 2007, in fact, there was vulnerability risk assessment done by the local government, which recommended efforts to be done by the community to reduce the disaster risk, yet it was not implemented. It was interesting to note that in spite of the independent disaster management there was a scientific assessment neglected. Based on this research, a new discussion on how to synchronize the endogenous knowledge with scientific modern knowledge was opened.

Local perceptions on social-ecological dynamics in Latin America in three community-based natural resource management systems

DEFF Research Database (Denmark)

Delgado-Serrano, Maria del Mar; Rozas, Elisa Oteros; Vanwildemeersch, Pieter

2015-01-01

by internal variables, particularly those linked to the governance system. The case study analysis revealed that the community-based natural resource management approach needs external support and recognition to work effectively. In the Argentine and Colombian cases, megaprojects were perceived as controllers...... prospective structural analysis to unravel stakeholders’ perceptions of each system’s functioning along with network analysis to assess resilience. We identified external variables as the most influential variables in the Colombian and Argentine cases. In the Mexican case, larger influence is exerted...

Socioeconomic effects of operating reactors on two host communities: a case study of Pilgrim and Millstone

International Nuclear Information System (INIS)

Peelle, E.

1976-01-01

This exploratory case study examines the social, economic, and political/institutional impacts of two operating nuclear power complexes on two New England communities. This work is one of a series planned to broaden knowledge of the effects of large energy generating facilities upon the social structure of local communities. Its primary objectives are to investigate and assess social and economic impacts resulting from construction and operation of nuclear power plants and to generate hypotheses about such impacts for future testing. The study concludes that construction impacts were minor due to a dispersed commuting pattern by construction workers and that the only significant construction impact that can be identified retrospectively is construction-worker traffic. The primary impact of the nuclear power plants in both communities was the massive increase in property tax payments paid to the local communities by the utilities and the option chosen by each community to maintain the existing tax rate while using the additional revenue to significantly increase and enhance the public service delivery systems and facilities within the community. Second-order consequences of the direct, first-order economic impact were: (1) changes in community land use policies, (2) increase in salience of growth issues, and (3) alteration of both inter- and intra-community relationships. The majority of residents in both communities express favorable attitudes toward the nuclear plants, primarily because of the substantial increase in the tax base of their communities

EMERGENCE OF VIRTUAL COMMUNITIES AS MEANS OF COMMUNICATION: A Case Study On Virtual Health Care Communities

Directory of Open Access Journals (Sweden)

Mehpare Tokay ARGAN

2011-07-01

Full Text Available Today, like in all areas, the Internet has had an important effect in the area of health as well. With the development of the Internet many new and different applications have developed and one of the most important of these are probably virtual communities. Virtual communities, which are used as a tool for providing information and word of mouth communication, have become a widely used marketing tool in the area of healthcare services in recent years. A virtual community is a group that does not depend on space and time to maintain ties or participation in the group whose members share the same interest and to maintain closeness, that is based on internet communications and whose membership is based on free will. In these kinds of communities whose services are provided on a membership basis, health services of various kinds are offered to the members. In virtual communities, virtual interactive communications established between the members can be an important determining factor when choosing a product, service or doctor.

Microbial Community Structure of Casing Soil During Mushroom Growth

Institute of Scientific and Technical Information of China (English)

CAI Wei-Ming; YAO Huai-Ying; FENG Wei-Lin; JIN Qun-Li; LIU Yue-Yan; LI Nan-Yi; ZHENG Zhong

2009-01-01

The culturable bacterial population and phospholipid fatty acid (PLFA)profile of casing soil were investigated at different mushroom (Agaricus bisporusI cropping stages.The change in soil bacterial PLFAs was always accompanied by a change in the soil culturable bacterial population in the first flush.Comparatively higher culturable bacterial population and bacterial PLFAs were found in the casing soil at the primordia formation stage of the first flush.There was a significant increase in the ratio of fungal to bacterial PLFAs during mushroom growth.Multivariate analysis of PLFA data demonstrated that the mushroom cropping stage could considerably affect the microbial community structure of the casing soil.The bacterial population increased significantly from casing soil application to the primordia formation stage of the first flush.Casing soil application resulted in an increase in the ratio of gram-negative bacterial PLFAs to gram-positive bacterial PLFAs,suggesting that some gram-negative bacteria might play an important role in mushroom sporophore initiation.

A method for analyzing the business case for provider participation in the National Cancer Institute's Community Clinical Oncology Program and similar federally funded, provider-based research networks.

Science.gov (United States)

Reiter, Kristin L; Song, Paula H; Minasian, Lori; Good, Marjorie; Weiner, Bryan J; McAlearney, Ann Scheck

2012-09-01

The Community Clinical Oncology Program (CCOP) plays an essential role in the efforts of the National Cancer Institute (NCI) to increase enrollment in clinical trials. Currently, there is little practical guidance in the literature to assist provider organizations in analyzing the return on investment (ROI), or business case, for establishing and operating a provider-based research network (PBRN) such as the CCOP. In this article, the authors present a conceptual model of the business case for PBRN participation, a spreadsheet-based tool and advice for evaluating the business case for provider participation in a CCOP organization. A comparative, case-study approach was used to identify key components of the business case for hospitals attempting to support a CCOP research infrastructure. Semistructured interviews were conducted with providers and administrators. Key themes were identified and used to develop the financial analysis tool. Key components of the business case included CCOP start-up costs, direct revenue from the NCI CCOP grant, direct expenses required to maintain the CCOP research infrastructure, and incidental benefits, most notably downstream revenues from CCOP patients. The authors recognized the value of incidental benefits as an important contributor to the business case for CCOP participation; however, currently, this component is not calculated. The current results indicated that providing a method for documenting the business case for CCOP or other PBRN involvement will contribute to the long-term sustainability and expansion of these programs by improving providers' understanding of the financial implications of participation. Copyright © 2011 American Cancer Society.

Assessing Payment and Community Based Distribution Issues in ...

African Journals Online (AJOL)

Methods: Questionnaire interviews were conducted with randomly selected household heads or their representatives in five malaria holo-endemic communities of Southeast Nigeria. Interviews were also held with community leaders before and after ITNs sales. The sale of ITNs was based on the communities' distribution ...

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

Directory of Open Access Journals (Sweden)

Kendra Siekmans

2017-01-01

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

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

Science.gov (United States)

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

2017-01-17

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

Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.

Science.gov (United States)

Greene, Gregory S; West, Sheila K; Mkocha, Harran; Munoz, Beatriz; Merbs, Shannath L

2015-12-01

Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT) and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs) to use during Mass Drug Administration (MDA) was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania. A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50) as those assigned to usual care (n = 9, p card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

Efficient community-based control strategies in adaptive networks

International Nuclear Information System (INIS)

Yang Hui; Tang Ming; Zhang Haifeng

2012-01-01

Most studies on adaptive networks concentrate on the properties of steady state, but neglect transient dynamics. In this study, we pay attention to the emergence of community structure in the transient process and the effects of community-based control strategies on epidemic spreading. First, by normalizing the modularity, we investigate the evolution of community structure during the transient process, and find that a strong community structure is induced by the rewiring mechanism in the early stage of epidemic dynamics, which, remarkably, delays the outbreak of disease. We then study the effects of control strategies started at different stages on the prevalence. Both immunization and quarantine strategies indicate that it is not ‘the earlier, the better’ for the implementation of control measures. And the optimal control effect is obtained if control measures can be efficiently implemented in the period of a strong community structure. For the immunization strategy, immunizing the susceptible nodes on susceptible–infected links and immunizing susceptible nodes randomly have similar control effects. However, for the quarantine strategy, quarantining the infected nodes on susceptible–infected links can yield a far better result than quarantining infected nodes randomly. More significantly, the community-based quarantine strategy performs better than the community-based immunization strategy. This study may shed new light on the forecast and the prevention of epidemics among humans. (paper)

Exploring Student Engagement and Collaborative Learning in a Community-Based Module in Fine Art

Directory of Open Access Journals (Sweden)

John McGarrigle

2013-05-01

Full Text Available This article is based on masters research1 into student and civic engagement using a case study of an innovative Community Based Module in a Fine Art degree course (McGarrigle, 2009. 2 (Flyvbjerg, 2006 notes that contrary to some common misunderstandings around case study research, it is possible to use individual case study to test theory particularly in relation to falsification. The research presented here is based on student’s repsonses to Coates’ (2007 quantitative study of student engagement and attempts to test his engagement typology which identifies the terms passive, intense, independent or collaborative to apply to students’ approaches to online and general campus learning. In a participatory action research framework, low agreement was found between students (n=13 and lecturers (n=3 in assigning these terms to student postings to online discussion fora. This presents a challenge to the validity of such a narrow typology, and discussions with this student group suggested the addition of ‘adaptive’ as a valid student approach to the varied demands of third level learning. Further evidence from the case study found greater student collaboration in discussion fora when linked to practical course activity. Qualitative analysis of discussion threads using conversation analysis provided evidence for collaboration in deeper knowledge construction when supported by lecturers’ contributions. Collaborative approaches to learning may support learning within a social constructivist paradigm, though acknowledgement must be made of the context of an individualistic society where competition may present real or imagined barriers to student collaboration. An argument is made for Pedagogies for Community Engagement to promote these ways of learning to in order to develop active and engaged citizens of the future.

Flaming Chalice of Hope: A Case Study of Suicide Prevention in a Faith Community

Directory of Open Access Journals (Sweden)

Sally Spencer-Thomas

2018-04-01

Full Text Available The integration of spiritual and emotional health is key for the development of a comprehensive public health approach to suicide prevention. Faith communities play a unique and powerful role in shaping this integration. This case study investigated one United States-based, predominantly White Unitarian Universalist faith community’s efforts in the development of promising practices for “upstream, midstream, and downstream” approaches to suicide prevention. Through a series of in-depth interviews with stakeholders (leadership, volunteers, family members with lived experience, response patterns were used to identify key strategies to promote mental health and prevent suicide. These key strategies include developing healthy social connectedness across one’s life, finding ways to make meaning by connecting with something larger than oneself, and cultivating a community that is compassionate and knowledgeable when assisting its members through emotional crises.

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

Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

Science.gov (United States)

Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

2014-01-01

This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

Moral Decision-Making among Assertive Community Treatment (ACT) Case Managers

DEFF Research Database (Denmark)

Lerbæk, Birgitte; Aagaard, Jørgen; Andersen, Mette Braendstrup

2015-01-01

The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral...... obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational...

Stability and change in forest-based communities: a selected bibliography.

Science.gov (United States)

Catherine Woods Richardson

1996-01-01

This bibliography lists literature dealing with the concept of community stability, the condition of forest-based communities, and the relations between forest management and local community conditions. Most citations are from the 1970s to the mid 1990s, though some particularly pertinent earlier works also appear. The emphasis is on forest-based communities in the...

Medicaid program; state plan home and community-based services, 5-year period for waivers, provider payment reassignment, and home and community-based setting requirements for Community First Choice and home and community-based services (HCBS) waivers. Final rule.

Science.gov (United States)

2014-01-16

This final rule amends the Medicaid regulations to define and describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations. This rule describes Medicaid coverage of the optional state plan benefit to furnish home and community based-services and draw federal matching funds. This rule also provides for a 5-year duration for certain demonstration projects or waivers at the discretion of the Secretary, when they provide medical assistance for individuals dually eligible for Medicaid and Medicare benefits, includes payment reassignment provisions because state Medicaid programs often operate as the primary or only payer for the class of practitioners that includes HCBS providers, and amends Medicaid regulations to provide home and community-based setting requirements related to the Affordable Care Act for Community First Choice State plan option. This final rule also makes several important changes to the regulations implementing Medicaid 1915(c) HCBS waivers.

Community-level moderators of a school-based childhood sexual assault prevention program.

Science.gov (United States)

Morris, Matthew C; Kouros, Chrystyna D; Janecek, Kim; Freeman, Rachel; Mielock, Alyssa; Garber, Judy

2017-01-01

Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Lastprogramcomparedtoawaitlistcontrolcondition.(*) Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d's ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children's knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

Studi Evaluasi Penerapan Community Based Tourism (CBT) Sebagai Pendukung Agrowisata Berkelanjutan

OpenAIRE

Nurhidayati, Sri Endah

2015-01-01

The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

Supporting Latino communities' natural helpers: a case study of promotoras in a research capacity building course.

Science.gov (United States)

Otiniano, Angie Denisse; Carroll-Scott, Amy; Toy, Peggy; Wallace, Steven P

2012-08-01

Promotores have unique access to underserved and hard-to-reach Latino communities facing health disparities. Although promotores are involved in community change, they rarely receive training that gives them the skills to be partners in research. We present a case study of promotoras who participated in a research capacity building course focused on assessing community health needs. Data comes from course application surveys, follow-up notes, and narratives from qualitative phone interviews of eight promotoras. Content analysis drawing from grounded theory was conducted to identify and describe emerging themes. Four themes emerged as promotoras discussed their experience learning basic research skills and teaching others: (1) challenges, (2) support, (3) building capacity, and (4) using research. Promotores play an important role in the health of Latino communities and are increasingly asked to participate in research processes; however they have few opportunities for training and professional development in this area. Capacity building opportunities for promotores need to be tailored to their needs and provide them with support. Fostering collaboration between promotores and partnering with local community-based organizations can help facilitate needed research skill-building among promotores.

Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study.

Science.gov (United States)

van der Plas, Annicka G M; Onwuteaka-Philipsen, Bregje D; Vissers, Kris C; Deliens, Luc; Jansen, Wim J J; Francke, Anneke L

2016-01-01

To investigate how general practitioners and community nurses value the support that they receive from a nurse case manager with expertise in palliative care, whether they think the case manager is helpful in realizing appropriate care and what characteristics of the patient and case management are associated with this view. For sustainable palliative care in an ageing society, basic palliative care is provided by generalists and specialist palliative care is reserved for complex situations. Acceptance of and cooperation with specialist palliative care providers by the general practitioner and community nurse is pivotal. Cross-sectional questionnaire study. Questionnaire data from 168 general practitioners and 125 community nurses were analysed using chi-square tests, univariate and multivariate logistic regression. Data were gathered between March 2011-December 2013. Of general practitioners, 46% rated the case manager as helpful in realizing care that is appropriate for the patient; for community nurses this was 49%. The case manager did not hinder the process of care and had added value for patients, according to the general practitioners and community nurses. The tasks of the case manager were associated with whether or not the case manager was helpful in realizing appropriate care, whereas patient characteristics and the number of contacts with the case manager were not. General practitioners and community nurses are moderately positive about the support from the case manager. To improve cooperation further, case managers should invest in contact with general practitioners and community nurses. © 2015 John Wiley & Sons Ltd.

Psychiatric morbidity in the community: A population based-study from Kerala.

Science.gov (United States)

Shaji, K S; Raju, D; Sathesh, V; Krishnakumar, P; Punnoose, Varghese P; Kiran, P S; Mini, B S; Kumar, Shibu; Anish, P K; Kaimal, Ganga G; Gupthan, Lekshmy; Sumesh, T P; Nikhil, U G; Cyriac, Nisha; Vinod, M D; Kumar, R Prasad; Chandran, Ramesh; Rejani, P P; Amrutha, R; Mahesh; Anand, T N

2017-01-01

Estimates of psychiatric morbidity in the community will help service development. Participation of trained nonspecialist health-care providers will facilitate scaling up of services in resource-limited settings. This study aimed to estimate the prevalence of priority mental health problems in populations served by the District Mental Health Program (DMHP). This is a population-based cross-sectional survey. We did stratified cluster sampling of households in five districts of Kerala. Trained Accredited Social Health Activists (ASHAs) identified people who had symptoms suggestive of schizophrenia or bipolar disorder. Clinicians evaluated the information collected by the ASHAs and designated individuals as probable cases of psychosis or noncases. Screening instruments such as General Health Questionnaire-12, CAGE questionnaire, and Everyday Abilities Scale for India were used for identifying common mental disorders (CMDs), clinically significant alcohol-related problems, and functional impairment. We found 12.43% of the adult population affected by mental health conditions. We found CMD as most common with a prevalence of 9%. The prevalence of psychosis was 0.71%, clinically significant alcohol-related problems was 1.46%, and dementia and other cognitive impairments was 1.26%. We found informant-based case finding to be useful in the identification of psychosis. Mental health problems are common. Nonspecialist health-care providers can be trained to identify psychiatric morbidity in the community. Their participation will help in narrowing the treatment gap. Embedding operational research to DMHP will make scaling up more efficient.

Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

Science.gov (United States)

Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

2013-01-01

As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

The Legacy Project: A Case Study of Civic Capacity Building and Transformative Educational Leadership in a Community-Based Academic Enrichment Program

Science.gov (United States)

Didlick-Davis, Celeste R.

2016-01-01

This study examines how a grassroots educational enrichment program in a small urban economically depressed area builds and uses civic capacity. Using qualitative data collected through a case study of the Legacy Academic Enrichment program in Middletown, Ohio, I identify factors that make Legacy sustainable and successful in a community that has…

Consequences of Environmental Projects on Development : Pilot Case Study of a Company-Community Partnership in Espírito Santo - Brazil

OpenAIRE

Gondar, Anelise F. P.

2008-01-01

This work aims to analyze partnerships between communities and businesses in the forestry sector in Brazil. The question to be answered is whether business-community partnerships can be considered a governance mode in the forestry sector in Brazil. Conclusions shall be drawn on the case of the “Forestry Partners” program of the firm Aracruz Cellulose, in the state of Espírito Santo. The methodology is theoretically based on studies of governance in general and environmental governance in part...

Impact of Participatory Health Research: A Test of the Community-Based Participatory Research Conceptual Model

Directory of Open Access Journals (Sweden)

John G. Oetzel

2018-01-01

Full Text Available Objectives. A key challenge in evaluating the impact of community-based participatory research (CBPR is identifying what mechanisms and pathways are critical for health equity outcomes. Our purpose is to provide an empirical test of the CBPR conceptual model to address this challenge. Methods. A three-stage quantitative survey was completed: (1 294 US CBPR projects with US federal funding were identified; (2 200 principal investigators completed a questionnaire about project-level details; and (3 450 community or academic partners and principal investigators completed a questionnaire about perceived contextual, process, and outcome variables. Seven in-depth qualitative case studies were conducted to explore elements of the model not captured in the survey; one is presented due to space limitations. Results. We demonstrated support for multiple mechanisms illustrated by the conceptual model using a latent structural equation model. Significant pathways were identified, showing the positive association of context with partnership structures and dynamics. Partnership structures and dynamics showed similar associations with partnership synergy and community involvement in research; both of these had positive associations with intermediate community changes and distal health outcomes. The case study complemented and extended understandings of the mechanisms of how partnerships can improve community conditions. Conclusions. The CBPR conceptual model is well suited to explain key relational and structural pathways for impact on health equity outcomes.

Trust of community health workers influences the acceptance of community-based maternal and child health services

Directory of Open Access Journals (Sweden)

Merridy Grant

2017-05-01

Conclusion: Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

Studi evaluasi penerapan Community Based Tourism (CBT) sebagai pendukung agrowisata berkelanjutan

OpenAIRE

Sri Endah Nurhidayati

2015-01-01

The role of government in the development of Community Based Tourism (CBT) is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1) describe the government's perception of the  Community Based Tourism (CBT) development, (2) identifying government policies to support the Community Based Tourism...

Risk Factors for Fall-Related Injuries Leading to Hospitalization Among Community-Dwelling Older Persons: A Hospital-Based Case-Control Study in Thiruvananthapuram, Kerala, India.

Science.gov (United States)

Ravindran, Rekha M; Kutty, V Raman

2016-01-01

This study intended to identify the risk factors for injurious falls that led to hospitalization of older persons living in the community. A hospital-based unmatched incident case-control study was done among 251 cases and 250 controls admitted at a tertiary care centre in Kerala. Mean age of cases was 71.6 ± 9.13 years and that of controls was 67.02 ± 6.17 years. Hip fractures were the predominant injury following falls. Falls were mostly a result of intrinsic causes. After adjusting for other variabes, the risk factors for all injuries were age above 70 years (odds ratio [OR] = 2.25; 95% confidence interval [CI] = 1.46-3.46), previous fall history (OR = 2.76; 95% CI = 1.08-7.08), impaired vision (OR = 4.49; 95% CI = 2.77-7.30), not living with spouse (OR = 1.97; 95% CI = 1.31-2.97), door thresholds (OR = 1.52; 95% CI = 1.01-2.29), and slippery floor (OR = 2.37; 95% CI = 1.31-4.32). The risk factors for hip fractures and other injuries were identified separately. Fall prevention strategies among older persons are warranted in Kerala. © 2015 APJPH.

Community based monitoring: engaging and empowering Alberta ranchers

Science.gov (United States)

Michael S. Quinn; Jennifer E. Dubois

2005-01-01

Community based monitoring (CBM), a form of citizen science, is presented as a potential contributor to ecosystem management and sustainable development. A conceptual model for CBM and lessons learned from a Canadian national pilot program, the Canadian Community Monitoring Network, are summarized along with a description of the European university-based “science shop...

The meaning of community involvement in health: the perspective of primary health care communities

Directory of Open Access Journals (Sweden)

GG Mchunu

2005-09-01

Full Text Available The goal of this study was to establish the understanding and appreciation of the essence of PHC principles in the two Primary Health Care (PHC communities. The PHC communities in this study referred to the people who were involved in the operation of the phenomenon, that is health professionals working in the health care centers and the communities served by these health care centers. It was hoped that the study would enhance the understanding of the importance of community involvement in health (CIH in health care delivery, for both community members and health professionals. A case study method was used to conduct the study. Two community health centers in the Ethekwini health district, in Kwa Zulu Natal, were studied. One health center was urban based, the other was rural based. A sample of 31 participants participated in the study. The sample comprised of 8 registered nurses, 2 enrolled nurses, 13 community members and 8 community health workers. Data was collected using individual interviews and focus groups, and was guided by the case study protocol. The findings of the study revealed that in both communities, participants had different, albeit complementary, understanding of the term ‘Community Involvement in Health’ (CIH. Essentially, for these participants, CIH meant collaboration, co-operation and involvement in decision-making.

Implementing and managing community-based education and ...

African Journals Online (AJOL)

Background. A current challenge in the training of healthcare professionals is to produce socially responsive graduates who are prepared for work in community settings. Community-based education (CBE) and service learning (SL) are teaching approaches used in the Faculty of Health Sciences at the University of the Free ...

Frontline over ivory tower: key competencies in community-based curricula

Directory of Open Access Journals (Sweden)

Adam Millar

2015-04-01

Full Text Available Background: The Royal College of Physicians and Surgeons of Canada mandates that community experiences be incorporated into medicine-based specialties.  Presently there is wide variability in community endocrine experiences across Canadian training programs.  This is complicated by the paucity of literature providing guidance on what constitutes a ‘community’ rotation. Method: A modified Delphi technique was used to determine the CanMEDS competencies best taught in a community endocrinology curriculum. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each survey round.  The experts in this study included endocrinology program directors, community endocrinologists, endocrinology residents and recent endocrinology graduates. Results: Thirty four out of 44 competencies rated by the panel were deemed suitable for a community curriculum.  The experts considered the “Manager” role best taught in the community, while they considered the community least suitable to learn the “Medical Expert” competency. Conclusions: To our knowledge, this is the first time the content of a community-based subspecialty curriculum was determined using the Delphi process in Canada.  These findings suggest that community settings have potential to fill in gaps in residency training in regards to the CanMEDS Manager role.  The results will aid program directors in designing competency-based community endocrinology rotations and competency-based community rotations in other medical subspecialty programs.

Community-Based Tourism and Peasant Differentiation: Considerations from an Andean case Turismo rural comunitario y diferenciación campesina: Consideraciones a partir de un caso andino

Directory of Open Access Journals (Sweden)

Jordi Gascón

2011-01-01

Full Text Available In the last years, Community-Based Tourism has created expectations in many latin american rural communities as an strategy to increase their income and to diversify the sources of this income. But it is an activity that is not free of risks. From a specific case (Amantaní Island, Titikaka Lake, Peru, the article studies one of these risks: the impact of tourism in the socio-economical communitarian cohesion.En los últimos años, el turismo rural comunitario se ha presentado como un instrumento adecuado para aumentar la renta de la población campesina y diversificar sus fuentes de ingresos. Pero se trata de una actividad económica que no está exenta de riesgos. A partir de un caso específico (la isla peruana de Amantaní, en el Lago Titicaca el artículo estudia uno de ellos: el impacto del turismo en la cohesión socioeconómica comunitaria.

Functional outcomes in community-based adults with borderline personality disorder.

Science.gov (United States)

Javaras, Kristin N; Zanarini, Mary C; Hudson, James I; Greenfield, Shelly F; Gunderson, John G

2017-06-01

Many individuals in clinical samples with borderline personality disorder (BPD) experience high levels of functional impairment. However, little is known about the levels of functional impairment experienced by individuals with BPD in the general community. To address this issue, we compared overall and domain-specific (educational/occupational; social; recreational) functioning in a sample of community-based individuals with BPD (n = 164); community-based individuals without BPD (n = 901); and clinically-ascertained individuals with BPD (n = 61). BPD diagnoses and functional outcomes were based on well-accepted, semi-structured interviews. Community-based individuals with BPD were significantly less likely to experience good overall functioning (steady, consistent employment and ≥1 good relationship) compared to community-based individuals without BPD (BPD: 47.4%; Non- BPD: 74.5%; risk difference -27.1%; p < 0.001), even when compared directly to their own non-BPD siblings (risk difference -35.5%; p < 0.001). Community-based individuals with BPD versus those without BPD did not differ significantly on most domain-specific outcomes, but the former group experienced poorer educational/occupational performance and lower quality relationships with parents, partners, and friends. However, community-based individuals with BPD were significantly more likely to experience good overall functioning than clinically-based individuals with BPD (risk difference -35.2%; p < 0.001), with the latter group more likely to experience reduced employment status, very poor quality relationships with partners, and social isolation. In conclusion, community-based individuals with BPD experienced marked functional impairment, especially in the social domain, but were less likely to experience the more extreme occupational and social impairments seen among patients with BPD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reflecting on the tensions faced by a community-based multicultural health navigator service.

Science.gov (United States)

Henderson, Saras; Kendall, Elizabeth

2014-11-01

The community navigator model was developed to assist four culturally and linguistically diverse communities (Sudanese, Burmese, Pacific Islander Group, Afghani) in south-east Queensland to negotiate the Australian health system and promote health. Using participatory action research, we developed the model in partnership with community leaders and members, the local health department and two non-governmental organisations. Following implementation, we evaluated the model, with the results published elsewhere. However, our evaluation revealed that although the model was accepted by the communities and was associated with positive health outcomes, the financial, social and organisational durability of the model was problematic. Ironically, this situation was inadvertently created by critical decisions made during the development process to enhance the durability and acceptability of the model. This paper explores these critical decisions, our rationale for making those decisions and the four hidden tensions that subsequently emerged. Using a reflective case study method to guide our analysis, we provide possible resolutions to these tensions that may promote the longevity and utility of similar models in the future. WHAT IS KNOWN ABOUT THE TOPIC?: The use of community navigators to assist culturally diverse communities to access health services is not new. Many benefits have been documented for communities, individuals and heath service providers following the use of such models. What is not well documented is how to maintain these models in a safe and cost-effective way within the Australian health system while respecting cultural and community practices and reducing the burden of service delivery on the navigators. WHAT DOES THIS PAPER ADD?: This paper provides a perspective on how the development of community-based service models inherently places them in a position of tension that must be resolved if they are to be long lasting. Four core tensions experienced

A comparative analysis of the costs of onshore wind energy: Is there a case for community-specific policy support?

International Nuclear Information System (INIS)

Berka, Anna L.; Harnmeijer, Jelte; Roberts, Deborah; Phimister, Euan; Msika, Joshua

2017-01-01

There is growing policy interest in increasing the share of community-owned renewable energy generation. This study explores why and how the costs of community-owned projects differ from commercially-owned projects by examining the case of onshore wind in the UK. Based on cross-sectoral literature on the challenges of community ownership, cost differences are attributed to six facets of an organisation or project: internal processes, internal knowledge and skills, perceived local legitimacy of the project, perceived external legitimacy of the organisation, investor motivation and expectations, and finally, project scale. These facets impact not only development costs but also project development times and the probability that projects pass certain critical stages in the development process. Using survey-based and secondary cost data on community and commercial projects in the UK, a model is developed to show the overall impact of cost, time and risk differences on the value of a hypothetical 500 kW onshore wind project. The results show that the main factors accounting for differences are higher pre-planning costs and additional risks born by community projects, and suggest that policy interventions may be required to place community- owned projects on a level playing field with commercial projects. - Highlights: • Policy support for community energy projects should be targeted at reducing early costs and risk factors. • Hurdle rates are critical in determining the financial viability of projects. • Shared ownership arrangements may help remove some of key challenges to community-only projects.

Community-based enterprises: The significance of partnerships and institutional linkages

Directory of Open Access Journals (Sweden)

Cristiana Simão Seixas

2009-10-01

Full Text Available Community-based institutions used to be driven by local needs, but in recent decades, some of them have been responding to national and global economic opportunities. These cases are of interest because they make it possible to investigate how local institutions can evolve in response to new challenges. A promising set of cases comes from the UNDP Equator Initiative, a program that holds biennial searches to find and reward entrepreneurship cases that seek to reduce poverty and conserve biodiversity at the same time. What can we learn from these local entrepreneurship cases that seem to be playing at the global level? Here we focus on partnerships and horizontal and vertical linkages in a sample of ten Equator Initiative projects. We find that successful projects tend to interact with a large array of support groups, typically 10 to 15 partners. Based on information from on-site research, these partners include local and national NGOs; local, regional and (less commonly national governments; international donor agencies and other organizations; and universities and research centers. These partners provide a range of services and support functions, including raising start-up funds; institution building; business networking and marketing; innovation and knowledge transfer; and technical training. These findings indicate that a diverse variety of partners are needed to help satisfy a diversity of needs, and highlight the importance of networks and support groups in the evolution of commons institutions.

Case study in designing a research fundamentals curriculum for community health workers: a university-community clinic collaboration.

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Dumbauld, Jill; Kalichman, Michael; Bell, Yvonne; Dagnino, Cynthia; Taras, Howard L

2014-01-01

Community health workers (CHWs) are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community's characteristics, may help to better integrate these health promotion personnel into research teams. An interactive training course on research fundamentals for CHWs was designed and implemented jointly by a community agency serving a primarily Latino, rural population and an academic health center. A focus group of community members and input from community leaders comprised a community-based participatory research model to create three 3-hour interactive training sessions. The resulting curriculum was interactive and successfully stimulated dialogue between trainees and academic researchers. By choosing course activities that elicited community-specific responses into each session's discussion, researchers learned about the community as much as the training course educated CHWs about research. The approach is readily adaptable, making it useful to other communities where CHWs are part of the health system.

Importance of woodlots to local communities, small scale entrepreneurs and indigenous forest conservation – A case study

CSIR Research Space (South Africa)

Ham, C

2000-01-01

Full Text Available forestry, South Africa The Importance of Woodlots to Local Communities, Small-scale Entrepreneurs and Indigenous Forest Conservation A case study Cori Ham ii The Importance of Woodlots to Local Communities, Small Scale Entrepreneurs... by the financial support of the UK Department for International Development and the European Commission iii Citation: Ham, C. 2000. The importance of woodlots to local communities, small scale entrepreneurs and indigenous forest conservation– A case study...

Local natural and cultural heritage assets and community based ...

African Journals Online (AJOL)

Community based tourism (CBT) is seen as an opportunity which mass tourism does not offer for, especially, rural communities to develop their natural and cultural assets into tourism activities for the benefit of the community. The point of CBT is that the community, collectively and individually, gains a livelihood from ...

Community-Based Control of Aedes aegypti By Using Mesocyclops in Southern Vietnam

Science.gov (United States)

Nam, Vu Sinh; Yen, Nguyen Thi; Duc, Hoang Minh; Tu, Tran Cong; Thang, Vu Trong; Le, Nguyen Hoang; San, Le Hoang; Loan, Luu Le; Huong, Vu Thi Que; Khanh, Ly Huynh Kim; Trang, Huynh Thi Thuy; Lam, Leonie Z. Y.; Kutcher, Simon C.; Aaskov, John G.; Jeffery, Jason A. L.; Ryan, Peter A.; Kay, Brian H.

2012-01-01

We previously reported a new community-based mosquito control strategy that resulted in elimination of Aedes aegypti (Linn.) in 40 of 46 communes in northern and central Vietnam, and with annual recurrent total costs (direct and indirect) of only $0.28–$0.89 international dollars per person. This control strategy was extended to four provinces in southern Vietnam in Long An and Hau Giang (2004–2007) and to Long An, Ben Tre, and Vinh Long (2005–2010). In a total of 14 communes with 124,743 residents, the mean ± SD of adult female Ae. aegypti was reduced from 0.93 ± 0.62 to 0.06 ± 0.09, and the reduction of immature Ae. aegypti averaged 98.8%. By the final survey, no adults could be collected in 6 of 14 communes, and one commune, Binh Thanh, also had no immature forms. Although the community-based programs also involved community education and clean-up campaigns, the prevalence of Mesocyclops in large water storage containers > 50 liters increased from 12.77 ± 8.39 to 75.69 ± 9.17% over periods of 15–45 months. At the conclusion of the study, no confirmed dengue cases were detected in four of the five communes for which diagnostic serologic analysis was performed. The rate of progress was faster in communes that were added in stages to the program but the reason for this finding was unclear. At the completion of the formal project, sustainability funds were set up to provide each commune with the financial means to ensure that community-based dengue control activities continued. PMID:22556087

Recommendations for scale-up of community-based misoprostol distribution programs.

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Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

2014-06-01

Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Developing a community-based flood resilience measurement standard

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Keating, Adriana; Szoenyi, Michael; Chaplowe, Scott; McQuistan, Colin; Campbell, Karen

2015-04-01

Given the increased attention to resilience-strengthening in international humanitarian and development work, there has been concurrent interest in its measurement and the overall accountability of "resilience strengthening" initiatives. The literature is reaching beyond the polemic of defining resilience to its measurement. Similarly, donors are increasingly expecting organizations to go beyond claiming resilience programing to measuring and showing it. However, key questions must be asked, in particular "Resilience of whom and to what?". There is no one-size-fits-all solution. The approach to measuring resilience is dependent on the audience and the purpose of the measurement exercise. Deriving a resilience measurement system needs to be based on the question it seeks to answer and needs to be specific. This session highlights key lessons from the Zurich Flood Resilience Alliance approach to develop a flood resilience measurement standard to measure and assess the impact of community based flood resilience interventions, and to inform decision-making to enhance the effectiveness of these interventions. We draw on experience in methodology development to-date, together with lessons from application in two case study sites in Latin America. Attention will be given to the use of a consistent measurement methodology for community resilience to floods over time and place; challenges to measuring a complex and dynamic phenomenon such as community resilience; methodological implications of measuring community resilience versus impact on and contribution to this goal; and using measurement and tools such as cost-benefit analysis to prioritize and inform strategic decision making for resilience interventions. The measurement tool follows the five categories of the Sustainable Livelihoods Framework and the 4Rs of complex adaptive systems - robustness, rapidity, redundancy and resourcefulness -5C-4R. A recent white paper by the Zurich Flood Resilience Alliance traces the

Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

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Rudel Ruthann A

2010-07-01

Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.

Case-Based FCTF Reasoning System

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Jing Lu

2015-10-01

Full Text Available Case-based reasoning uses old information to infer the answer of new problems. In case-based reasoning, a reasoner firstly records the previous cases, then searches the previous case list that is similar to the current one and uses that to solve the new case. Case-based reasoning means adapting old solving solutions to new situations. This paper proposes a reasoning system based on the case-based reasoning method. To begin, we show the theoretical structure and algorithm of from coarse to fine (FCTF reasoning system, and then demonstrate that it is possible to successfully learn and reason new information. Finally, we use our system to predict practical weather conditions based on previous ones and experiments show that the prediction accuracy increases with further learning of the FCTF reasoning system.

A University-Community Partnership in Teacher Education from the Perspectives of Community-Based Teacher Educators

Science.gov (United States)

Guillen, Lorena; Zeichner, Ken

2018-01-01

This article examines the experiences of a group of nine community-based mentors of teacher candidates who partnered for several years through a local, community-based organization with the graduate elementary and secondary teacher education programs at a research university in the Pacific Northwest. Following a brief discussion of the history of…

Scoping study into community-based renewable energy projects

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

This scoping study has been carried out by the Centre for Sustainable Energy (CSE), a charity which promotes energy efficiency and renewable energy. CSE have used their involvement in the development of the Energy Club (the first energy service company for householders in the UK) and the Bristol Environment and Energy Trust (a cross-sector organisation initiating environmental projects) as the basis of the study. This study is the first phase of a long term project to set up two small-scale renewable energy schemes to demonstrate the benefits of a community based approach. Specific objectives of the study were: to identify, quantify and cost, renewable energy resources for interested community organisations; to evaluate two routes for developing community based projects - Environment Trusts and Energy Clubs'; to organise a seminar with the objective of bringing together community interest groups with experts in renewable energy; to identify two communities with viable renewable projects for the next phase - full feasibility studies/pilot projects. (author)

Studi evaluasi penerapan Community Based Tourism (CBT sebagai pendukung agrowisata berkelanjutan

Directory of Open Access Journals (Sweden)

Sri Endah Nurhidayati

2015-01-01

Full Text Available The role of government in the development of Community Based Tourism (CBT is very important to strengthen communities around the tourism destination. Government has significant role to ensure that the community has accesses, opportunities and an important power in the development of tourism. The objectives of this research are: (1 describe the government's perception of the  Community Based Tourism (CBT development, (2 identifying government policies to support the Community Based Tourism (CBT implementation in Batu City, East Java, and (3 describe the constraints that occur in the implementation of Community based Tourism (CBT in Batu City, East Java. This study uses qualitative approach by analyzing critical reality, being constructed locally and specifically. The study was conducted in Batu City, East Java. Perceptions of government on the implementation of community-based tourism reflected the mindset of the individual. The community-based tourism development in Batu city is considered the same as rural tourism development. The Government supervise the development of tourism products, especially the tourist village. To support the existence of a tourist village Department of Tourism and Creative Economy   help develop and market promotion. Barriers to the implementation of community-based tourism development with regard to the internal aspects of the government: the quality of human resources decision makers in the Batu Government do not possess educational background of tourism, government people less creative design programs and somewhat forced, the lack of trust the government to local communities, government is not able to map the condition social community related to the system's internal decision-making in the community that are less able to intervene in all components of society, a narrow understanding of CBT, and yet solid government policy coordination between stakeholders. While the external barriers are lack of insight into the

A community-based framework for aquatic ecosystem models

DEFF Research Database (Denmark)

Trolle, Didde; Hamilton, D. P.; Hipsey, M. R.

2012-01-01

Here, we communicate a point of departure in the development of aquatic ecosystem models, namely a new community-based framework, which supports an enhanced and transparent union between the collective expertise that exists in the communities of traditional ecologists and model developers. Through...... a literature survey, we document the growing importance of numerical aquatic ecosystem models while also noting the difficulties, up until now, of the aquatic scientific community to make significant advances in these models during the past two decades. Through a common forum for aquatic ecosystem modellers we...... aim to (i) advance collaboration within the aquatic ecosystem modelling community, (ii) enable increased use of models for research, policy and ecosystem-based management, (iii) facilitate a collective framework using common (standardised) code to ensure that model development is incremental, (iv...

Community of Communities: An Electronic Link to Integrating Cultural Diversity in Nursing Curriculum.

Science.gov (United States)

Ryan, Marilyn; Ali, Nagia; Carlton, Kay Hodson

2002-01-01

The Community of Communities (COC) website contains information and case studies based on cultural assessment. Online nursing courses are linked to a cultural module in the COC. Evaluation results from 63 students showed that the COC increased awareness of the role of culture in health care and knowledge of international health practices.…

Hyperbolic mapping of complex networks based on community information

Science.gov (United States)

Wang, Zuxi; Li, Qingguang; Jin, Fengdong; Xiong, Wei; Wu, Yao

2016-08-01

To improve the hyperbolic mapping methods both in terms of accuracy and running time, a novel mapping method called Community and Hyperbolic Mapping (CHM) is proposed based on community information in this paper. Firstly, an index called Community Intimacy (CI) is presented to measure the adjacency relationship between the communities, based on which a community ordering algorithm is introduced. According to the proposed Community-Sector hypothesis, which supposes that most nodes of one community gather in a same sector in hyperbolic space, CHM maps the ordered communities into hyperbolic space, and then the angular coordinates of nodes are randomly initialized within the sector that they belong to. Therefore, all the network nodes are so far mapped to hyperbolic space, and then the initialized angular coordinates can be optimized by employing the information of all nodes, which can greatly improve the algorithm precision. By applying the proposed dual-layer angle sampling method in the optimization procedure, CHM reduces the time complexity to O(n2) . The experiments show that our algorithm outperforms the state-of-the-art methods.

Case nine. Two hospitals struggling to survive in a small rural community.

Science.gov (United States)

Gaidos, H A

1990-01-01

St. Luke's Hospital was the only hospital in town until 26 years before the time of the case. In the late 1950s St. Luke's Hospital was overcrowded and in dire need of renovation and expansion. Plans were devised and the hospital applied for Hill-Burton money to expand. At the same time, a group of local citizens decided to also apply for Hill-Burton money to build another hospital, County Memorial, in the community. The Hill-Burton money was divided and both received money. Both facilities opened within months of each other. For about 10 to 12 years, both hospitals prospered. At the time of the case, competition has heated up between the two facilities. Attempts at collaboration fail; the story is one of wasted resources and community pain because of the lack of ability of two competitors to put aside differences for mutual benefit. The case ends with there being only one hospital in town. Read alone, the case is instructive in terms of the difficulties created when organizations value survival in a known form above all else. Read and considered in concert with Case Eight, it encourages contemplation of the pros and cons of head-on competition versus collaboration.

Alzheimer's Disease Sequencing Project discovery and replication criteria for cases and controls: Data from a community-based prospective cohort study with autopsy follow-up.

Science.gov (United States)

Crane, Paul K; Foroud, Tatiana; Montine, Thomas J; Larson, Eric B

2017-12-01

The Alzheimer's Disease Sequencing Project (ADSP) used different criteria for assigning case and control status from the discovery and replication phases of the project. We considered data from a community-based prospective cohort study with autopsy follow-up where participants could be categorized as case, control, or neither by both definitions and compared the two sets of criteria. We used data from the Adult Changes in Thought (ACT) study including Diagnostic and Statistical Manual-IV criteria for dementia status, McKhann et al. criteria for clinical Alzheimer's disease, and Braak and Consortium to Establish a Registry for AD findings on neurofibrillary tangles and neuritic plaques to categorize the 621 ACT participants of European ancestry who died and came to autopsy. We applied ADSP discovery and replication definitions to identify controls, cases, and people who were neither controls nor cases. There was some agreement between the discovery and replication definitions. Major areas of discrepancy included the finding that only 40% of the discovery sample controls had sufficiently low levels of neurofibrillary tangles and neuritic plaques to be considered controls by the replication criteria and the finding that 16% of the replication phase cases were diagnosed with non-AD dementia during life and thus were excluded as cases for the discovery phase. These findings should inform interpretation of genetic association findings from the ADSP. Differences in genetic association findings between the two phases of the study may reflect these different phenotype definitions from the discovery and replication phase of the ADSP. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Volume of Home and Community Based Services and...

Data.gov (United States)

U.S. Department of Health & Human Services — Volume of Home- and Community-Based Services and Time to Nursing-Home Placement The purpose of this study was to determine whether the volume of Home and Community...

Meeting rural demand: a case for combining community-based distribution and social marketing of injectable contraceptives in Tigray, Ethiopia.

Science.gov (United States)

Prata, Ndola; Weidert, Karen; Fraser, Ashley; Gessessew, Amanuel

2013-01-01

In Sub-Saharan Africa, policy changes have begun to pave the way for community distribution of injectable contraceptives but sustaining such efforts remains challenging. Combining social marketing with community-based distribution provides an opportunity to recover some program costs and compensate workers with proceeds from contraceptive sales. This paper proposes a model for increasing access to injectable contraceptives in rural settings by using community-based distributers as social marketing agents and incorporating financing systems to improve sustainability. This intervention was implemented in three districts of the Central Zone of Tigray, Ethiopia and program data has been collected from November 2011 through October 2012. A total of 137 Community Based Reproductive Health Agents (CBRHAs) were trained to provide injectable contraceptives and were provided with a loan of 25 injectable contraceptives from a drug revolving fund, created with project funds. The price of a single dose credited to a CBRHA was 3 birr ($0.17) and they provide injections to women for 5 birr ($0.29), determined with willingness-to-pay data. Social marketing was used to create awareness and generate demand. Both quantitative and qualitative methods were used to examine important feasibility aspects of the intervention. Forty-four percent of CBRHAs were providing family planning methods at the time of the training and 96% believed providing injectable contraceptives would improve their services. By October 2012, 137 CBRHAs had successfully completed training and provided 2541 injections. Of total injections, 47% were provided to new users of injectable contraceptives. Approximately 31% of injections were given for free to the poorest women, including adolescents. Insights gained from the first year of implementation of the model provide a framework for further expansion in Tigray, Ethiopia. Our experience highlights how program planners can tailor interventions to match family

Community Based Health Insurance Knowledge and Willingness to ...

African Journals Online (AJOL)

Community Based Health Insurance Knowledge and Willingness to Pay; A Survey of a Rural Community in ... Journal Home > Vol 6, No 1 (2012) > ... and is the most appropriate insurance model for rural areas where incomes are unstable.

Enhancing community based health programs in Iran: a multi-objective location-allocation model.

Science.gov (United States)

Khodaparasti, S; Maleki, H R; Jahedi, S; Bruni, M E; Beraldi, P

2017-12-01

Community Based Organizations (CBOs) are important health system stakeholders with the mission of addressing the social and economic needs of individuals and groups in a defined geographic area, usually no larger than a county. The access and success efforts of CBOs vary, depending on the integration between health care providers and CBOs but also in relation to the community participation level. To achieve widespread results, it is important to carefully design an efficient network which can serve as a bridge between the community and the health care system. This study addresses this challenge through a location-allocation model that deals with the hierarchical nature of the system explicitly. To reflect social welfare concerns of equity, local accessibility, and efficiency, we develop the model in a multi-objective framework, capturing the ambiguity in the decision makers' aspiration levels through a fuzzy goal programming approach. This study reports the findings for the real case of Shiraz city, Fars province, Iran, obtained by a thorough analysis of the results.

Psychiatric morbidity in the community: A population based-study from Kerala

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Shaji, K. S.; Raju, D.; Sathesh, V; Krishnakumar, P.; Punnoose, Varghese P.; Kiran, P. S; Mini, B. S.; Kumar, Shibu; Anish, P. K; Kaimal, Ganga G.; Gupthan, Lekshmy; Sumesh, T. P.; Nikhil, U. G; Cyriac, Nisha; Vinod, M. D.; Kumar, R. Prasad; Chandran, Ramesh; Rejani, P. P; Amrutha, R; Mahesh; Anand, TN

2017-01-01

Background: Estimates of psychiatric morbidity in the community will help service development. Participation of trained nonspecialist health-care providers will facilitate scaling up of services in resource-limited settings. Aims: This study aimed to estimate the prevalence of priority mental health problems in populations served by the District Mental Health Program (DMHP). Settings and Design: This is a population-based cross-sectional survey. Materials and Methods: We did stratified cluster sampling of households in five districts of Kerala. Trained Accredited Social Health Activists (ASHAs) identified people who had symptoms suggestive of schizophrenia or bipolar disorder. Clinicians evaluated the information collected by the ASHAs and designated individuals as probable cases of psychosis or noncases. Screening instruments such as General Health Questionnaire-12, CAGE questionnaire, and Everyday Abilities Scale for India were used for identifying common mental disorders (CMDs), clinically significant alcohol-related problems, and functional impairment. Results: We found 12.43% of the adult population affected by mental health conditions. We found CMD as most common with a prevalence of 9%. The prevalence of psychosis was 0.71%, clinically significant alcohol-related problems was 1.46%, and dementia and other cognitive impairments was 1.26%. We found informant-based case finding to be useful in the identification of psychosis. Conclusions: Mental health problems are common. Nonspecialist health-care providers can be trained to identify psychiatric morbidity in the community. Their participation will help in narrowing the treatment gap. Embedding operational research to DMHP will make scaling up more efficient. PMID:28827860

Using Community-Based Participatory Research to Identify Environmental Justice Issues in an Inner-City Community and Inform Urban Planning.

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Mansyur, Carol Leler; Jeng, Hueiwang Anna; Holloman, Erica; DeBrew, Linwood

2016-01-01

The Southeast CARE Coalition has been using community-based participatory research to examine environmental degradation in the Southeast Community, Newport News, Virginia. A survey was developed to collect assessment data. Up to 66% of respondents were concerned about environmental problems in their community. Those with health conditions were significantly more likely to identify specific environmental problems. The top 5 environmental concerns included coal dust, air quality, crime, water quality, and trash. The community-based participatory research process is building community capacity and participation, providing community input into strategic planning, and empowering community members to take control of environmental justice issues in their community.

Social Entrepreneurship Andragogy-Based for Community Empowerment

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Hidayat Dayat

2018-01-01

Full Text Available The essence of social entrepreneurship is the ability to initiate, lead and implement problem-solving strategies, through cooperation with others in all types of social networks. The purpose of this study analyzes: 1 entrepreneurship training, 2 adult education assumptions, and 3 community empowerment. This study is discussed by using a comparative theory analysis method that related to entrepreneurship training, andragogy, and community empowerment from various literary sources. Analysis is conducted to find conclusions that can be justified scientifically. The results of the study conclude that: 1 social entrepreneurship training is an organized learning process from planning, implementation, and evaluation on non-formal education path aimed at enhancing community knowledge, attitude and skills for learning and endeavor, 2 entrepreneurship training based on andragogy conducted through a learning process that implements adults’ assumptions of self-conceptual, learning experiences, learning readiness, and learning orientation. 3 Community empowerment is a process of empowerment or strength to community to have the ability of individuals who completely agreed with the community in building social and economic empowerment of the community.

Gender Performativity in the Community College: A Case Study of Female Backline Classified Staff

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Powers, Samantha Rose

2012-01-01

This case study explored the gendered performances of five female backline classified staff members who work in non-traditional fields within a community college. More specifically, this study defined gendered behaviors at a community college, and explored how these behaviors have affected the identities of women working in non-traditional fields…

A Modularity Degree Based Heuristic Community Detection Algorithm

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Dongming Chen

2014-01-01

Full Text Available A community in a complex network can be seen as a subgroup of nodes that are densely connected. Discovery of community structures is a basic problem of research and can be used in various areas, such as biology, computer science, and sociology. Existing community detection methods usually try to expand or collapse the nodes partitions in order to optimize a given quality function. These optimization function based methods share the same drawback of inefficiency. Here we propose a heuristic algorithm (MDBH algorithm based on network structure which employs modularity degree as a measure function. Experiments on both synthetic benchmarks and real-world networks show that our algorithm gives competitive accuracy with previous modularity optimization methods, even though it has less computational complexity. Furthermore, due to the use of modularity degree, our algorithm naturally improves the resolution limit in community detection.

Exploring impacts of multi-year, community-based care programs for orphans and vulnerable children: a case study from Kenya.

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Larson, Bruce A; Wambua, Nancy; Masila, Juliana; Wangai, Susan; Rohr, Julia; Brooks, Mohamad; Bryant, Malcolm

2013-01-01

The Community-Based Care for Orphans and Vulnerable Children (CBCO) program operated in Kenya during 2006-2010. In Eastern Province, the program provided support to approximately 3000 orphans and vulnerable children (OVC) living in 1500 households. A primary focus of the program was to support savings and loan associations composed of OVC caregivers (typically elderly women) to improve household and OVC welfare. Cross-sectional data were collected in 2011 from 1500 randomly selected households from 3 populations: program participants (CBCO group, n=500), households in the same villages as program participants but not in the program (the local-community-group = Group L, n=300), and households living in nearby villages where the program did not operate (the adjacent-community-group, Group A, n=700). Primary welfare outcomes evaluated are household food security, as measured by the Household Food Insecurity Access instrument, and OVC educational attainment. We compared outcomes between the CBCO and the subset of Group L not meeting program eligibility criteria (L-N) to investigate disparities within local communities. We compared outcomes between the CBCO group and the subset of Group A meeting eligibility criteria (A-E) to consider program impact. We compared outcomes between households not eligible for the program in the local and adjacent community groups (L-N and A-N) to consider if the adjacent communities are similar to the local communities. In May-June 2011, at the end of the OVC program, the majority of CBCO households continued to be severely food insecure, with rates similar to other households living in nearby communities. Participation rates in primary school are high, reflecting free primary education. Among the 18-22 year olds who were "children" during the program years, relatively few children completed secondary school across all study groups. Although the CBCO program likely provided useful services and benefits to program participants, disparities

Recruitment strategies and costs associated with community-based research in a Mexican-origin population.

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Mendez-Luck, Carolyn A; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S; Mangione, Carol M

2011-06-01

We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic-community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study methodology to categorize recruitment methods, examine community partnerships, and calculate study costs. We employed several recruitment methods to identify and solicit 154 female caregivers for participation in qualitative interviews and quantitative surveys. Recruitment approaches included using flyers and word of mouth, attending health fairs, and partnering with nonprofit community-based organizations (CBOs) to sponsor targeted recruitment events. Face-to-face contact with community residents and partnerships with CBOs were most effective in enrolling caregivers into the studies. Almost 70% of participants attended a recruitment event sponsored or supported by CBOs. The least effective recruitment strategy was the use of flyers, which resulted in only 7 completed interviews or questionnaires. Time and costs related to carrying out the research varied by study, where personal interviews cost more on a per-participant basis ($1,081) than the questionnaires ($298). However, almost the same amount of time was spent in the community for both studies. Partnerships with CBOs were critical for reaching the target enrollment for our studies. The relationship between the University of California-Los Angeles (UCLA) Resource Center for Minority Aging Research/Center for Health Improvement for Minority Elderly and the Department of Aging provided the infrastructure for maintaining connections with academic-community partnerships. Nevertheless, building partnerships required time, effort, and resources for both researchers and local organizations.

Recruitment Strategies and Costs Associated With Community-Based Research in a Mexican-Origin Population

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Mendez-Luck, Carolyn A.; Trejo, Laura; Miranda, Jeanne; Jimenez, Elizabeth; Quiter, Elaine S.; Mangione, Carol M.

2011-01-01

Purpose: We describe the recruitment strategies and personnel and materials costs associated with two community-based research studies in a Mexican-origin population. We also highlight the role that academic–community partnerships played in the outreach and recruitment process for our studies. We reviewed study documents using case study methodology to categorize recruitment methods, examine community partnerships, and calculate study costs. Results: We employed several recruitment methods to identify and solicit 154 female caregivers for participation in qualitative interviews and quantitative surveys. Recruitment approaches included using flyers and word of mouth, attending health fairs, and partnering with nonprofit community-based organizations (CBOs) to sponsor targeted recruitment events. Face-to-face contact with community residents and partnerships with CBOs were most effective in enrolling caregivers into the studies. Almost 70% of participants attended a recruitment event sponsored or supported by CBOs. The least effective recruitment strategy was the use of flyers, which resulted in only 7 completed interviews or questionnaires. Time and costs related to carrying out the research varied by study, where personal interviews cost more on a per-participant basis ($1,081) than the questionnaires ($298). However, almost the same amount of time was spent in the community for both studies. Implications: Partnerships with CBOs were critical for reaching the target enrollment for our studies. The relationship between the University of California–Los Angeles (UCLA) Resource Center for Minority Aging Research/Center for Health Improvement for Minority Elderly and the Department of Aging provided the infrastructure for maintaining connections with academic–community partnerships. Nevertheless, building partnerships required time, effort, and resources for both researchers and local organizations. PMID:21565824

HIV testing in community based research: a case study of female ...

African Journals Online (AJOL)

Female genital schistosomiasis prevalence found was 10.3%, Trichomonas vaginalis, 2.1%, Candida albicans, 9.6%, Gardnerella vaginalis, 11.8% and HIV 6.6%. The study also showed that, the location of Voluntary Counseling and Testing (VCT) services in rural communities in the Volta Basin were unavailable. The use ...

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.

Enhancing Community Detection By Affinity-based Edge Weighting Scheme

Energy Technology Data Exchange (ETDEWEB)

Yoo, Andy [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sanders, Geoffrey [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Henson, Van [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Vassilevski, Panayot [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-10-05

Community detection refers to an important graph analytics problem of finding a set of densely-connected subgraphs in a graph and has gained a great deal of interest recently. The performance of current community detection algorithms is limited by an inherent constraint of unweighted graphs that offer very little information on their internal community structures. In this paper, we propose a new scheme to address this issue that weights the edges in a given graph based on recently proposed vertex affinity. The vertex affinity quantifies the proximity between two vertices in terms of their clustering strength, and therefore, it is ideal for graph analytics applications such as community detection. We also demonstrate that the affinity-based edge weighting scheme can improve the performance of community detection algorithms significantly.

Community based bioremediation: grassroots responses to urban soil contamination

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Scott Kellogg

2016-12-01

Full Text Available The past 150 years of industrial processes have left a legacy of toxicity in the soils of today’s urban environments. Exposure to soil based pollutants disproportionately affects low-income communities who are frequently located within formerly industrialized zones. Both gardeners, who come into direct contact with soil, as well as those who eat the products grown in the soil, are at risk to exposure from industrial contaminants. Options for low-income communities for remediating contaminated soils are limited, with most remediation work being carried out by costly engineering firms. Even more problematic is the overall lack of awareness and available information regarding safety and best practices with soils. In response to these challenges, a grassroots movement has emerged that seeks to empower urban residents with the tools and information necessary to address residual industrial toxicity in their ecosystems. Focusing on methods that are simple and affordable, this movement wishes to remove the barriers of cost and technical expertise that may be otherwise prohibitive. This paper will give an overview of this exemplar of generative justice, looking at case studies of organizations that have been successful in implementing these strategies.

Removing barriers to rehabilitation: Theory-based family intervention in community settings after brain injury.

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Stejskal, Taryn M

2012-01-01

Rehabilitation professionals have become increasingly aware that family members play a critical role in the recovery process of individuals after brain injury. In addition, researchers have begun to identify a relationship between family member caregivers' well-being and survivors' outcomes. The idea of a continuum of care or following survivors from inpatient care to community reintegration has become an important model of treatment across many hospital and community-based settings. In concert with the continuum of care, present research literature indicates that family intervention may be a key component to successful rehabilitation after brain injury. Yet, clinicians interacting with family members and survivors often feel confounded about how exactly to intervene with the broader family system beyond the individual survivor. Drawing on the systemic nature of the field of marriage and family therapy (MFT), this article provides information to assist clinicians in effectively intervening with families using theory-based interventions in community settings. First, a rationale for the utilization of systems-based, as opposed to individual-based, therapies will be uncovered. Second, historically relevant publications focusing on family psychotherapy and intervention after brain injury are reviewed and their implications discussed. Recommendations for the utilization of systemic theory-based principles and strategies, specifically cognitive behavioral therapy (CBT), narrative therapy (NT), and solution-focused therapy (SFT) will be examined. Descriptions of common challenges families and couples face will be presented along with case examples to illustrate how these theoretical frameworks might be applied to these special concerns postinjury. Finally, the article concludes with an overview of the ideas presented in this manuscript to assist practitioners and systems of care in community-based settings to more effectively intervene with the family system as a whole

Community-based native seed production for restoration in Brazil - the role of science and policy.

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Schmidt, I B; de Urzedo, D I; Piña-Rodrigues, F C M; Vieira, D L M; de Rezende, G M; Sampaio, A B; Junqueira, R G P

2018-05-20

Large-scale restoration programmes in the tropics require large volumes of high quality, genetically diverse and locally adapted seeds from a large number of species. However, scarcity of native seeds is a critical restriction to achieve restoration targets. In this paper, we analyse three successful community-based networks that supply native seeds and seedlings for Brazilian Amazon and Cerrado restoration projects. In addition, we propose directions to promote local participation, legal, technical and commercialisation issues for up-scaling the market of native seeds for restoration with high quality and social justice. We argue that effective community-based restoration arrangements should follow some principles: (i) seed production must be based on real market demand; (ii) non-governmental and governmental organisations have a key role in supporting local organisation, legal requirements and selling processes; (iii) local ecological knowledge and labour should be valued, enabling local communities to promote large-scale seed production; (iv) applied research can help develop appropriate techniques and solve technical issues. The case studies from Brazil and principles presented here can be useful for the up-scaling restoration ecology efforts in many other parts of the world and especially in tropical countries where improving rural community income is a strategy for biodiversity conservation and restoration. © 2018 German Society for Plant Sciences and The Royal Botanical Society of the Netherlands.

Building a Mien-American house: A case study in school-community relations

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Hammond, Lorie A.

2000-10-01

Researchers and policymakers agree that schools and parents must work together if they are to provide the sustenance, services, and support which children need to be successful in our increasingly complex society. (Clark, 1983; Comer, 1980, 1996; Clinton, 1995; Epstein, 1995, 1996). Unfortunately, the social and academic success of language minority students is often adversely affected by the alienation of parents from school culture and by the "deficit" view which teachers hold of language minority parents' academic and parenting skills (Boggs, 1985; Delgado-Gaitan, 1990; Heath, 1983; Lareau, 1987, 1989; Philips, 1983). This case study describes the attempts of one school site to build academic and social bridges between immigrant families from a Southeast Asian Hill Tribe, the Iu Mien, and a mainstream elementary school. This effort is facilitated by a constructivist approach to curriculum in which parents, teachers, and children create an intercultural space---a school community garden---as a context in which academic dialogue can occur. Various strategies which enable inter-cultural learning are described, including the use of students as ethnographers, of parents as expert teachers, and of teachers as cultural brokers. The study also considers the cultural conflicts and understandings which occurred when American teachers and Mien parents built a Mien field-house together: a structure which became symbolic of their blended lives. Through both a descriptive narration and interviews with various participants, the study analyzes (a) community-based curriculum development, led by practitioner reformers, as a way to enable language minority students to be academically successful within their own life worlds, as well as (b) the political and bureaucratic forces which make community-based reforms difficult to sustain. This study employs qualitative research strategies within an action-research context in which the author plays the dual role of practitioner reformer

Community action research track: Community-based participatory research and service-learning experiences for medical students.

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Gimpel, Nora; Kindratt, Tiffany; Dawson, Alvin; Pagels, Patti

2018-04-01

Community-based participatory research (CBPR) and service-learning are unique experiential approaches designed to train medical students how to provide individualized patient care from a population perspective. Medical schools in the US are required to provide support for service-learning and community projects. Despite this requirement, few medical schools offer structured service-learning. We developed the Community Action Research Track (CART) to integrate population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum through CBPR and service-learning experiences. This article provides an overview of CART and reports the program impact based on students' participation, preliminary evaluations and accomplishments. CART is an optional 4‑year service-learning experience for medical students interested in community health. The curriculum includes a coordinated longitudinal program of electives, community service-learning and lecture-based instruction. From 2009-2015, 146 CART students participated. Interests in public health (93%), community service (73%), primary care (73%), CBPR (60%) and community medicine (60%) were the top reasons for enrolment. Significant improvements in mean knowledge were found when measuring the principles of CBPR, levels of prevention, determining health literacy and patient communication strategies (all p's Projects were disseminated by at least 65 posters and four oral presentations at local, national and international professional meetings. Six manuscripts were published in peer-reviewed journals. CART is an innovative curriculum for training future physicians to be community-responsive physicians. CART can be replicated by other medical schools interested in offering a longitudinal CBPR and service-learning track in an urban metropolitan setting.

Home Based Training: Main Strategy in Community Based Rehabilitation in Iran

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Peiman Salamati

2006-10-01

Full Text Available Objective: Study of effectiveness of “home based training” in community based rehabilitation program on disabled people, under supervised of 21 pilot cities health and medical networks, who were trained and evaluated at the end of the course. Materials & Methods: In a cross-sectional study, 614 disabled people who had participated in “home based training” were selected with stratified random sampling method. They were evaluated according to function progress level variables by community based rehabilitation programme experts. Age, sex, disability groups, employment state and teacher’s relation variables were studied from their files and recording datas. Statistical analysis was performed with Chi-square test. Results: There was a relationship between age group and disability group with functional progress level (P = 0.014 & P <0.001. Low age groups, visional disabled group, epileptic patients and individuals with learning problems had the best results. High age groups, mixed disability group and individuals with verbal and hearing problems had the least results. There was a relationship between teacher’s relation with progress or nonprogress state (P = 0.038. Individuals that they were own teachers had the best results and individuals with teachers other than first or second relation or health worker had the least results. Conclusion: Home based training in community based rehabilitation programme is an effective method for improving disabled people in some selected groups.

Epidemiology of rheumatic diseases in Mixtec and Chontal indigenous communities in Mexico: a cross-sectional community-based study.

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Julián-Santiago, Flor; García-García, Conrado; García-Olivera, Imelda; Goycochea-Robles, María Victoria; Pelaez-Ballestas, Ingris

2016-07-01

This study aimed to estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Chontal and Mixtec indigenous communities in the state of Oaxaca, Mexico, using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. After cross-culturally validating the COPCORD questionnaire for these communities, we conducted a cross-sectional, analytical, community-based census study using a house-to-house method. Positive cases of MSK disorders were assessed by primary care physicians and rheumatologists. The study population included participants aged ≥18 years from the indigenous communities of San Antonio Huitepec and San Carlos Yautepec. A total of 1061 persons participated in the study. Mean age was 46.9 years (standard deviation 19.9; age range 18-97 years); 642 (60.5 %) were women; 483 participants (45.5; 42.4-48.5 %) had MSK pain in the previous 7 days. Diagnoses were back pain 170 (16.0 %; 95 % confidence interval [CI] 13.8-18.3); osteoarthritis 157 (14.7 %; 95 % CI 12.7-17.0); rheumatic regional pain syndrome 53 (4.9 %; 95 % CI 3.7-6.4); rheumatoid arthritis 4 (0.3 %; 95 % CI 0.1-0.9); dermatomyositis 1 (0.09 %; 95 % CI 0.0-0.5); ankylosing spondylitis 1 (0.09 %; 95 % CI 0.0-0.5); systemic lupus erythematosus 1 (0.09 %; 95 % CI 0.02-0.5); and gout 1 (0.09 %; 95 % CI 0.0-0.5). 53.2 % had not received medical treatment for their disease. The prevalence of MSK disorders in indigenous communities in the Mixtec and Chontal regions is very high. The most common rheumatic diseases found were back pain and osteoarthritis. A high percentage of participants had not received medical care.

Community-based Ecotourism in Tenganan Dauh Tukad: An Indigenous Conservation Perspective

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I Ketut Sardiana

2015-11-01

Full Text Available Abstract Community-based ecotourism involves conservation, business, and community development. It is a subset of nature-based tourism that are owned and managed by the community and used to improve the well-being of its community members. Research conducted in Indigenous Tenganan Dauh Tukad Village, Bali. This paper examines the linkage of community participation in ecotourism with the conservation practices and perspectives. This study revealed that there is a positive linkage between community participation to their practices and perspective of conservation. This includes conservation of biodiversity environment and cultural heritage of the local community.

Use of partnership strategies to build radiation oncology disparities research programs in five Western Pennsylvania communities: an organizational case study.

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Morgenlander, Keith H; Heron, Dwight E; Schenken, Larry L

2009-01-01

Many cancer treatment and prevention trials as well as surveillance programs suffer from a disproportionately low rate of accrual and a high rate of noncompliance or dropouts of racial minorities and the poor. One suggested strategy to help remediate this trend is to directly involve those targeted populations within the development, implementation, and evaluation of these services. The Radiation Oncology Community Outreach Group (ROCOG) and Neighborhood Cancer Care Cooperative (NCCC) are designed based upon this type of highly collaborative organizational structure, consistent with the general principles of community-based participatory research. Funded by the National Cancer Institute Cancer Disparities Research Partnership program, ROCOG/NCCC provide oncology-focused, community hospital-based initiatives intended to help close the cancer disparities gap. This article presents a descriptive case study of the organizational and political process that preceded our grant proposal submission, the potential benefits and difficulties associated with our extensive collaborative model, and an example of how highly competitive health care organizations can become partners in narrowly focused initiatives aimed at a greater social good.

Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

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Jahn Albrecht

2010-04-01

Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

A case of an immunocompetent young man obtaining community-acquired disseminated Nocardia brasiliensis.

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Li, Jinna; Cao, Jie; Wu, Yueqing; Wan, Nansheng; Pan, Li; Chen, Yuanbao

2014-01-01

Nocardiosis is a rare but severe pyogenic or granulomatous disease and caused by Nocardia that mainly infects immunocompromised patients. We report here a case of an immunocompetent 24-year-old male student with community-acquired pneumonia with asymptomatic disseminated cerebral abscess by Brasiliensis nocardiosis. The patient was fully recovered after receiving optimized antimicrobial therapy without relapse. This case suggests the health professionals such as the physicians of pulmonary, infection, neurology department and et al should always think about unusual cause of community acquired pneumonia, even in immunocompetent patients and when having pulmonary nocardiosis we should do a radiological neurological work up, even with the absence of neurological finding or symptom. Copyright © 2014 Elsevier Inc. All rights reserved.

Setting health priorities in a community: a case example

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Fábio Alexandre Melo do Rego Sousa

Full Text Available ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1 grouping by level of similarity, (2 classification according to epidemiological criteria, (3 ordering by experts, and (4 application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence. The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community.

A case-control study of support/opposition to wind turbines: Perceptions of health risk, economic benefits, and community conflict

International Nuclear Information System (INIS)

Baxter, Jamie; Morzaria, Rakhee; Hirsch, Rachel

2013-01-01

Despite considerable quantitative case study research on communities living with turbines, few have studied the roles played by the perceptions of: health risk, economic benefits/fairness, and intra-community conflict. We report the findings from a case-control survey which compares residents living with/without turbines in their community to understand the relative importance of these variables as predictors of turbine support. Ontario is the context for this study as it is a place where the pace of turbine installations is both very high and extremely politicized. As expected 69% of residents in the case community would vote in favour of local turbines yet surprisingly, only 25% would do so in the control community. Though the literature suggests that aesthetic preferences best predict turbine support the key predictors in this study are: health risk perception, community benefits, general community enhancement, and a preference for turbine-generated electricity. Concern about intra-community conflict is high in both the case (83%) and control (85%) communities as is concern about the fairness of local economic benefits (56% and 62%, respectively); yet neither is significant in the models. We discuss the implications of these findings particularly in terms of the consequences of a technocratic decide-announce-defend model of renewable facility siting. - Highlights: • We compare turbine support in a community living with turbines against a matched control. • We include health risk perception, economic benefits, and community conflict as predictors. • Turbine support is highest in the turbine community and surprisingly low in the control. • Health risk perception and economic benefits consistently predict turbine support. • Economic benefits distribution and conflict are important, but not consistent predictors

Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania

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Nyato Daniel J

2010-02-01

Full Text Available Abstract Background New malaria treatment guidelines in Tanzania have led to the large-scale deployment of artemether-lumefantrine (Coartem®, popularly known as ALu or dawa mseto. Very little is known about how people in malaria endemic areas interpret policy makers' decision to replace existing anti-malarials, such as sulphadoxine-pyrimethamine (SP with "new" treatment regimens, such as ALu or other formulations of ACT. This study was conducted to examine community level understandings and interpretations of ALu's efficacy and side-effects. The paper specifically examines the perceived efficacy of ALu as articulated by the mothers of young children diagnosed with malaria and prescribed ALu. Methods Participant observation, six focus group discussions in two large villages, followed by interviews with a random sample of 110 mothers of children less than five years of age, who were diagnosed with malaria and prescribed ALu. Additionally, observations were conducted in two village dispensaries involving interactions between mothers/caretakers and health care providers. Results While more than two-thirds of the mothers had an overall negative disposition toward SP, 97.5% of them spoke favourably about ALu, emphasizing it's ability to help their children to rapidly recover from malaria, without undesirable side-effects. 62.5% of the mothers reported that they were spending less money dealing with malaria than previously when their child was treated with SP. 88% of the mothers had waited for 48 hours or more after the onset of fever before taking their child to the dispensary. Mothers' knowledge and reporting of ALu's dosage was, in many cases, inconsistent with the recommended dosage schedule for children. Conclusion Deployment of ALu has significantly changed community level perceptions of anti-malarial treatment. However, mothers continue to delay seeking care before accessing ALu, limiting the impact of highly subsidized rollout of the drug

Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014.

Science.gov (United States)

Woodruff, Rebecca C; Coleman, Anne-Marie; Hermstad, April K; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F; Shipley, Rebecca; Kegler, Michelle C

2016-03-10

Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project's pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.

A rural, community-based suicide awareness and intervention program.

Science.gov (United States)

Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

2015-01-01

Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

Community owned solutions for fire management in tropical ecosystems: case studies from Indigenous communities of South America.

Science.gov (United States)

Mistry, Jayalaxshmi; Bilbao, Bibiana A; Berardi, Andrea

2016-06-05

Fire plays an increasingly significant role in tropical forest and savanna ecosystems, contributing to greenhouse gas emissions and impacting on biodiversity. Emerging research shows the potential role of Indigenous land-use practices for controlling deforestation and reducing CO2 emissions. Analysis of satellite imagery suggests that Indigenous lands have the lowest incidence of wildfires, significantly contributing to maintaining carbon stocks and enhancing biodiversity. Yet acknowledgement of Indigenous peoples' role in fire management and control is limited, and in many cases dismissed, especially in policy-making circles. In this paper, we review existing data on Indigenous fire management and impact, focusing on examples from tropical forest and savanna ecosystems in Venezuela, Brazil and Guyana. We highlight how the complexities of community owned solutions for fire management are being lost as well as undermined by continued efforts on fire suppression and firefighting, and emerging approaches to incorporate Indigenous fire management into market- and incentive-based mechanisms for climate change mitigation. Our aim is to build a case for supporting Indigenous fire practices within all scales of decision-making by strengthening Indigenous knowledge systems to ensure more effective and sustainable fire management.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Author(s).

Virtual Community Based Destination Marketing with YouTube

DEFF Research Database (Denmark)

Sambhanthan, Arunasalam; Thelijjagoda, Samantha; Good, Alice

2016-01-01

YouTube has now evolved into a powerful medium for social interaction. Utilizing YouTube for enhancing marketing endeavours is a strategy practiced by marketing professionals across several industries. This paper rationalizes on the different strategies of leveraging YouTube-based platforms...... for effective destination marketing by the hospitality industry (hotels) and provides insights on the critical drivers and challenges embedded within YouTube-based community interactions for destination marketing. The comments made by YouTube users have been subjected to a content analysis and the results...... are reported under the five broad clusters of virtual communities. More broadly, the typology of virtual communities is adapted to evaluate the YouTube platform for effective destination marketing....

The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

Science.gov (United States)

Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

2014-07-01

The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

Science.gov (United States)

Newman, Peter A; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as highlighting

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study.

Directory of Open Access Journals (Sweden)

Peter A Newman

Full Text Available Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations.From 2008-2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement.Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of "community"; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted.This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the GPP Blueprint, as well as

A peer evaluation of the community-based education programme for ...

African Journals Online (AJOL)

A peer evaluation of the community-based education programme for medical ... The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which ... of community-based activities and the availability of a large teaching platform, ...

The New Community Policing: Developing a Partnership-Based Theoretical Foundation

Directory of Open Access Journals (Sweden)

Adam J McKee

2016-10-01

Full Text Available This paper presents a Partnership Model of Community Policing based on Partnership concepts developed by Riane Eisler and undergirded by Cultural Transformation Theory as a guiding principle (1987, 2010, 2013. This model is more reflective of the daily lived experiences of community police officers. It is culturally relevant and based on the whole of the police officer’s relationship with the community within the context in which the interactions occur. This "New Community Policing" is an extension of Riane Eisler’s Cultural Transformation Theory and is an attempt to answer her call for a movement towards a partnership model of social organization. Ultimately, "8 Pillars of the New Community Policing" are developed to aid in defining and implementing community policing.

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

Science.gov (United States)

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

2011-09-01

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

Management of children’s acute diarrhea by community pharmacies in five towns of Ethiopia: simulated client case study

Directory of Open Access Journals (Sweden)

Abegaz TM

2016-04-01

Full Text Available Tadesse Melaku Abegaz,1 Sewunet Admasu Belachew,1 Tamrat Befekadu Abebe,1 Begashaw Melaku Gebresilassie,1 Fitsum Sebsibe Teni,2 Habtamu Gebremeskel Woldie3 1Department of Clinical Pharmacy, School of Pharmacy, Gondar University, Gondar, 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Hospital Pharmacy, Debremarkos Teaching and Referral Hospital, Debremarkos, Ethiopia Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nations. It is the second most common cause of death among children <5 years of age globally. The indispensable role of community pharmacists is clearly observed in the prevention and treatment of diarrhea. However, there is a paucity of data on how community pharmacies manage acute childhood diarrhea cases in Ethiopia. This study aimed to evaluate the experience of community pharmacies in the management of acute diarrhea in northern Ethiopia.Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance.Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69% of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90

A community-based framework for aquatic ecosystem models

NARCIS (Netherlands)

Trolle, D.; Hamilton, D.P.; Hipsey, M.R.; Bolding, K.; Bruggeman, J.; Mooij, W.M.; Janse, J.H.; Nielsen, A.; Jeppesen, E.; Elliott, J.A.; Makler-Pick, V.; Petzoldt, T.; Rinke, K.; Flindt, M.R.; Arhonditsis, G.B.; Gal, G.; Bjerring, R.; Tominaga, K.; Hoen, 't J.; Downing, A.S.; Marques, D.M.; Fragoso, C.R.; Sondergaard, M.; Hanson, P.C.

2012-01-01

Here, we communicate a point of departure in the development of aquatic ecosystem models, namely a new community-based framework, which supports an enhanced and transparent union between the collective expertise that exists in the communities of traditional ecologists and model developers. Through a

Barriers and Strategies to Engaging Our Community-Based Preceptors.

Science.gov (United States)

Graziano, Scott C; McKenzie, Margaret L; Abbott, Jodi F; Buery-Joyner, Samantha D; Craig, LaTasha B; Dalrymple, John L; Forstein, David A; Hampton, Brittany S; Page-Ramsey, Sarah M; Pradhan, Archana; Wolf, Abigail; Hopkins, Laura

2018-03-26

This article, from the "To the Point" series that is prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a review of commonly cited barriers to recruiting and retaining community-based preceptors in undergraduate medical education and potential strategies to overcome them. Community-based preceptors have traditionally served as volunteer, nonsalaried faculty, with academic institutions relying on intrinsic teaching rewards to sustain this model. However, increasing numbers of learners, the burdens of incorporating the electronic medical record in practice, and increasing demands for clinical productivity are making recruitment and retention of community-based preceptors more challenging. General challenges to engaging preceptors, as well as those unique to women's health, are discussed. Potential solutions are reviewed, including alternative recruitment strategies, faculty development to emphasize efficient teaching practices in the ambulatory setting, offers of online educational resources, and opportunities to incorporate students in value-added roles. Through examples cited in this review, clerkship directors and medical school administrators should have a solid foundation to actively engage their community-based preceptors.

Beyond vertical integration--Community based medical education.

Science.gov (United States)

Kennedy, Emma Margaret

2006-11-01

The term 'vertical integration' is used broadly in medical education, sometimes when discussing community based medical education (CBME). This article examines the relevance of the term 'vertical integration' and provides an alternative perspective on the complexities of facilitating the CBME process. The principles of learner centredness, patient centredness and flexibility are fundamental to learning in the diverse contexts of 'community'. Vertical integration as a structural concept is helpful for academic organisations but has less application to education in the community setting; a different approach illuminates the strengths and challenges of CBME that need consideration by these organisations.

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.

Energy concepts for self-supplying communities based on local and renewable energy sources

DEFF Research Database (Denmark)

Petersen, Jens-Phillip

2016-01-01

The reduction of GHG emissions in buildings is a focus area of national energy policies, because buildings are responsible for a major share of energy consumption. Policies to increase the share of renewable energies and energy efficiency measures are implemented at local scale. Municipalities......, as responsible entities for physical planning, can hold a key role in transforming energy systems towards carbon-neutrality, based on renewable energies. The implementation should be approached at community scale, which has advantages compared to only focusing on buildings or cities. But community energy...... planning can be a complex and time-consuming process. Many municipalities hesitate to initiate such a process, because of missing guidelines and uncertainty about possible energy potentials. Case studies help to understand applied methodologies and could show available energy potentials in different local...

Community resiliency as a measure of collective health status: perspectives from rural communities.

Science.gov (United States)

Kulig, Judith C; Edge, Dana; Joyce, Brenda

2008-12-01

Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.

Community Based Learning and Civic Engagement: Informal Learning among Adult Volunteers in Community Organizations

Science.gov (United States)

Mundel, Karsten; Schugurensky, Daniel

2008-01-01

Many iterations of community based learning employ models, such as consciousness raising groups, cultural circles, and participatory action research. In all of them, learning is a deliberate part of an explicit educational activity. This article explores another realm of community learning: the informal learning that results from volunteering in…

Assessment of a Novel Approach to Identify Trichiasis Cases Using Community Treatment Assistants in Tanzania.

Directory of Open Access Journals (Sweden)

Gregory S Greene

2015-12-01

Full Text Available Simple surgical intervention advocated by the World Health Organization can alleviate trachomatous trichiasis (TT and prevent subsequent blindness. A large backlog of TT cases remain unidentified and untreated. To increase identification and referral of TT cases, a novel approach using standard screening questions, a card, and simple training for Community Treatment Assistants (CTAs to use during Mass Drug Administration (MDA was developed and evaluated in Kongwa District, a trachoma-endemic area of central Tanzania.A community randomized trial was conducted in 36 communities during MDA. CTAs in intervention villages received an additional half-day of training and a TT screening card in addition to the training received by CTAs in villages assigned to usual care. All MDA participants 15 years and older were screened for TT, and senior TT graders confirmed case status by evaluating all screened-positive cases. A random sample of those screened negative for TT and those who did not present at MDA were also evaluated by the master graders. Intervention CTAs identified 5.6 times as many cases (n = 50 as those assigned to usual care (n = 9, p < 0.05. While specificity was above 90% for both groups, the sensitivity for the novel screening tool was 31.2% compared to 5.6% for the usual care group (p < 0.05.CTAs appear to be viable resources for the identification of TT cases. Additional training and use of a TT screening card significantly increased the ability of CTAs to recognize and refer TT cases during MDA; however, further efforts are needed to improve case detection and reduce the number of false positive cases.

Community natural resource management: the case of woodlots in Northern Ethiopia

NARCIS (Netherlands)

Gebremedhin, B.; Pender, J.; Tesfay Belay, Girmay

2003-01-01

This paper examines the nature of community management of woodlots and investigates the determinants of collective action and its effectiveness in managing woodlots, based on a survey of 100 villages in Tigray, northern Ethiopia. Despite limited current benefits received by community members, the

The Role of the Military in Building Political Community: The Case of the Two German States.

Science.gov (United States)

1995-01-01

community is represented primarily by three vital intervening outcomes of the political socialization process: a distinct political culture, a separate...case-study attempts to first identify any conscious political socialization processes implemented by the two militaries, and then tries to link these processes to the two distinct German political communities....rapidly engineer political change in these cases, the resurrection and maintenance of a military may especially contribute to the process of political

Harnessing the power of the grassroots to conduct public health research in sub-Saharan Africa: a case study from western Kenya in the adaptation of community-based participatory research (CBPR) approaches

Science.gov (United States)

2013-01-01

Background Community-based participatory research (CBPR) is a collaborative approach to research that involves the equitable participation of those affected by an issue. As the field of global public health grows, the potential of CBPR to build capacity and to engage communities in identification of problems and development and implementation of solutions in sub-Saharan Africa has yet to be fully tapped. The Orphaned and Separated Children’s Assessments Related to their Health and Well-Being (OSCAR) project is a longitudinal cohort of orphaned and non-orphaned children in Kenya. This paper will describe how CBPR approaches and principles can be incorporated and adapted into the study design and methods of a longitudinal epidemiological study in sub-Saharan Africa using this project as an example. Methods The CBPR framework we used involves problem identification, feasibility and planning; implementation; and evaluation and dissemination. This case study will describe how we have engaged the community and adapted CBPR methods to OSCAR’s Health and Well-being Project’s corresponding to this framework in four phases: 1) community engagement, 2) sampling and recruitment, 3) retention, validation, and follow-up, and 4) analysis, interpretation and dissemination. Results To date the study has enrolled 3130 orphaned and separated children, including children living in institutional environments, those living in extended family or other households in the community, and street-involved children and youth. Community engagement and participation was integral in refining the study design and identifying research questions that were impacting the community. Through the participation of village Chiefs and elders we were able to successfully identify eligible households and randomize the selection of participants. The on-going contribution of the community in the research process has been vital to participant retention and data validation while ensuring cultural and

Case-based pedagogy as a context for collaborative inquiry in the Philippines

Science.gov (United States)

Arellano, Elvira L.; Barcenal, Tessie L.; Bilbao, Purita P.; Castellano, Merilin A.; Nichols, Sharon; Tippins, Deborah J.

2001-05-01

The purpose of this study was to investigate the potential for using case-based pedagogy as a context for collaborative inquiry into the teaching and learning of elementary science. The context for this study was the elementary science teacher preparation program at West Visayas State University on the the island of Panay in Iloilo City, the Philippines. In this context, triple linguistic conventions involving the interactions of the local Ilonggo dialect, the national language of Philipino (predominantly Tagalog) and English create unique challenges for science teachers. Participants in the study included six elementary student teachers, their respective critic teachers and a research team composed of four Filipino and two U.S. science teacher educators. Two teacher-generated case narratives serve as the centerpiece for deliberation, around which we highlight key tensions that reflect both the struggles and positive aspects of teacher learning that took place. Theoretical perspectives drawn from assumptions underlying the use of case-based pedagogy and scholarship surrounding the community metaphor as a referent for science education curriculum inquiry influenced our understanding of tensions at the intersection of re-presentation of science, authority of knowledge, and professional practice, at the intersection of not shared language, explicit moral codes, and indigenization, and at the intersection of identity and dilemmas in science teaching. Implications of this study are discussed with respect to the building of science teacher learning communities in both local and global contexts of reform.

Promoting physical activity among youth through community-based prevention marketing.

Science.gov (United States)

Bryant, Carol A; Courtney, Anita H; McDermott, Robert J; Alfonso, Moya L; Baldwin, Julie A; Nickelson, Jen; McCormack Brown, Kelli R; Debate, Rita D; Phillips, Leah M; Thompson, Zachary; Zhu, Yiliang

2010-05-01

Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

The roles and needs of community health workers in developing countries: an exploratory case study in South Africa

CSIR Research Space (South Africa)

Khalala, G

2013-01-01

Full Text Available counseling and testing. Community Health Workers play a significant role in primary health care provision to vulnerable communities[5][6]. Although the importance of Community Health Workers in the provision of primary health care to rural... slightly urbanized (Soweto). In terms of data collection, group interviews and questionnaires were used as data collection tools. 1) Selection of case studies Case study was chosen as an appropriate approach as this study sought to explore...

Community-based conservation of critical sites: Uganda's experience

African Journals Online (AJOL)

... of natural resources, first and foremost for their own good, and then for national and global benefit. Ecotourism and adding value to locally produced materials in communities can translate into support for conservation. This paper highlights the importance of community-based conservation for important biodiversity sites.

Community-based Natural Resource Management of the Jozani ...

African Journals Online (AJOL)

Community-based Natural Resource Management (CBNRM) is an approach that has generally .... rules in use across a broad range of CPR user- communities .... identified these social clusters and vocational groupings as ..... satisfied with the agreement and the villagers .... protection measures for the red colobus monkey ...

Employing continuous quality improvement in community-based substance abuse programs.

Science.gov (United States)

Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

2012-01-01

This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners.

Science.gov (United States)

Calzo, Jerel P; Bogart, Laura M; Francis, Evelyn; Kornetsky, Susan Z; Winkler, Sabune J; Kaberry, Julie

2016-01-01

Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (eg, self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based institutional review board (IRB) in implementing a brief, community-responsive human subjects training session. A 2-hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. Local IRBs have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners.

Case-Based Fault Diagnostic System

International Nuclear Information System (INIS)

Mohamed, A.H.

2014-01-01

Nowadays, case-based fault diagnostic (CBFD) systems have become important and widely applied problem solving technologies. They are based on the assumption that “similar faults have similar diagnosis”. On the other hand, CBFD systems still suffer from some limitations. Common ones of them are: (1) failure of CBFD to have the needed diagnosis for the new faults that have no similar cases in the case library. (2) Limited memorization when increasing the number of stored cases in the library. The proposed research introduces incorporating the neural network into the case based system to enable the system to diagnose all the faults. Neural networks have proved their success in the classification and diagnosis problems. The suggested system uses the neural network to diagnose the new faults (cases) that cannot be diagnosed by the traditional CBR diagnostic system. Besides, the proposed system can use the another neural network to control adding and deleting the cases in the library to manage the size of the cases in the case library. However, the suggested system has improved the performance of the case based fault diagnostic system when applied for the motor rolling bearing as a case of study

Researching in the community: the value and contribution of nurses to community based or primary health care research.

Science.gov (United States)

Barthow, Christine; Jones, Bernadette; Macdonald, Lindsay; Vernall, Sue; Gallagher, Peter; McKinlay, Eileen

2015-05-01

To describe the role, contribution and value of research nurses in New Zealand community-based or primary health care research. Research nurses are increasingly recognised as having a key role in undertaking successful research in hospitals and clinical trial units however only limited work has been undertaken to examine their role in community-based research. Undertaking health research in the community has unique challenges particularly in relation to research design and recruitment and retention of participants. We describe four community-based research projects involving research nurses, each with particular recruitment, retention and logistical problems. Vignettes are used to illustrate the role, contribution and value of research nurses in a diverse range of community research projects. The knowledge and skills used by research nurses in these projects included familiarity with communities, cultural competence, health care systems and practice philosophies and in particular with vulnerable populations. Their research actions and activities include competence with a broad range of research methodologies, organisational efficiency, family-centred approach, along with advocacy and flexibility. These are underpinned by nursing knowledge and clinical expertise contributing to an ability to work autonomously. These four projects demonstrate that research nurses in community-based research possess specific attributes which facilitate successful study development, implementation and outcome.

Citizen Science for Post-disaster Sustainable Community Development in Ecologically Fragiel Regions - A Case from China

Science.gov (United States)

Liu, Wei; Ming, Meng; Lu, Ye; Jin, Wei

2016-04-01

The world's mountains host some of the most complex, dynamic, and diverse ecosystems and are also hotspots for natural disasters, such as earthquake, landslide and flood. One factor that limits the mountain communities to recover from disasters and pursue sustainable development is the lack of locally relevant scientific knowledge, which is hard to gain from global and regional scale observations and models. The rapid advances in ICT, computing, communication technologies and the emergence of citizen science is changing the situation. Here we report a case from Sichuan Giant Panda Sanctuary World Natural Heritage in China on the application of citizen science in a community reconstruction project. Dahe, a mountainous community (ca. 8000 ha in size) is located covering part of the World Heritage's core and buffer zones, with an elevation range of 1000-3000 meters. The community suffered from two major earthquakes of 7.9 and 6.9 Mw in 2008 and 2013 respectively. Landslides and flooding threat the community and significantly limit their livelihood options. We integrated participatory disaster risk mapping (e.g., community vulnerability and capacity assessment) and mobile assisted natural hazards and natural resources mapping (e.g., using free APP GeoODK) into more conventional community reconstruction and livelihood building activities. We showed that better decisions are made based on results from these activities and local residents have a high level of buy-in in these new knowledge. We suggest that initiatives like this, if successfully scale-up, can also help generate much needed data and knowledge in similar less-developed and data deficient regions of the world.

75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

Science.gov (United States)

2010-11-03

...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...

Options for a National Framework for Benefit Distribution and Their Relation to Community-Based and National REDD+ Monitoring

Directory of Open Access Journals (Sweden)

Margaret Skutsch

2014-07-01

Full Text Available Monitoring is a central element in the implementation of national REDD+ and may be essential in providing the data needed to support benefit distribution. We discuss the options for benefit sharing systems in terms of technical feasibility and political acceptability in respect of equity considerations, and the kind of data that would be needed for the different options. We contrast output-based distribution systems, in which rewards are distributed according to performance measured in terms of carbon impacts, with input-based systems in which performance is measured in term of compliance with prescribed REDD+ activities. Output-based systems, which would require regular community carbon inventories to produce Tier 3 data locally, face various challenges particularly for the case of assessing avoided deforestation, and they may not be perceived as equitable. Input-based systems would require data on activities undertaken rather than change in stocks; this information could come from community-acquired data. We also consider how community monitored data could support national forest monitoring systems and the further development of national REDD+.

Reflective practice: a framework for case manager development.

Science.gov (United States)

Brubakken, Karen; Grant, Sara; Johnson, Mary K; Kollauf, Cynthia

2011-01-01

The role of a nurse case manager (NCM) incorporates practice that is built upon knowledge gained in other roles as well as components unique to case management. The concept of reflective practice was used in creating a framework to recognize the developmental stages that occur within community based case management practice. The formation of this framework and its uses are described in this article. The practice setting is a community based case management department in a large midwestern metropolitan health care system with Magnet recognition. Advanced practice nurses provide care for clients with chronic health conditions. Twenty-four narratives were used to identify behaviors of community based case managers and to distinguish stages of practice. The behaviors of advanced practice found within the narratives were labeled and analyzed for similarities. Related behaviors were grouped and descriptor statements were written. These statements grouped into 3 domains of practice: relationship/partnership, coordination/collaboration, and clinical knowledge/decision making. The statements in each domain showed practice variations from competent to expert, and 3 stages were determined. Reliability and validity of the framework involved analysis of additional narratives. The reflective practice process, used for monthly case review presentations, provides opportunity for professional development and group learning focused on improving case manager practice. The framework is also being used in orientation as new case managers acclimate to the role. Reflective writing has unveiled the richness and depth of nurse case manager practice. The depth of knowledge and skills involved in community-based case management is captured within this reflective practice framework. This framework provides a format for describing community based case manager practice development over the course of time and has been used as a tool for orientation and peer review.

Case-based medical informatics

Directory of Open Access Journals (Sweden)

Arocha José F

2004-11-01

Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences

Integrated community-based dementia care: the Geriant model

Directory of Open Access Journals (Sweden)

Ludo Glimmerveen

2015-09-01

Full Text Available This article gives an in-depth description of the service delivery model of Geriant, a Dutch organization providing community-based care services for people suffering from dementia. Core to its model is the provision of clinical case management, embedded in multidisciplinary dementia care teams. As Geriant's client group includes people from the first presumption of dementia until they can no longer live at home, its care model provides valuable lessons about how different mechanisms of integration are flexibly put to use if the complexity of clients” care needs increases. It showcases how the integration of services for a specific sub-population is combined with alignment of these services with generalist network partners. After a detailed description of the programme and its results, this article builds on the work of Walter Leutz for a conceptual discussion of Geriant's approach to care integration. 

Effects of Community-Based Newborn Care Intervention on Neonate Health Status in a District of Tehran (Iran

Directory of Open Access Journals (Sweden)

Fatemeh Nayeri

2016-08-01

Full Text Available Objective: To identify the effects of community-based interventions on the Neonatal Health Index in one district of Tehran-Iran.Materials and methods: A community and healthcare center-based study was carried out from January 2011 through September 2014. The population of the study included newborns from mothers residing in the 4th district of Tehran, Iran. Demographic data of mothers and infants were recorded in questionnaires before and after intervention. Interventions were implemented in hospitals, participants' homes, and health centers. The primary outcomes were comparison of mean birth weight, weight gain during the first 3-7 days, first week visit rate, hospitalization rate between the before and after intervention groups.Results: The populations in the before and after intervention groups were 274 and 250, respectively. A significant difference was seen between the gestational ages (P value = 0.007 of the two groups. Mean birth height in the first group was 50.35 ± 3.48 and in the second group was 55 ± 5.32 cm (P value = 0.04. Neonatal complications in the second group were 6.9% lower than in the first group (P value = 0.048. In the first group 41 neonates (15% were hospitalized in the NICU while in the second group 12 cases (4.8% were hospitalized (P value = 0.018. Seven cases (2.6% in the first group and one case (0.4% in the second group were resuscitated (P value = 0.0001.Conclusion: The results of implementing community-based newborn care strategies witnessed at the first week postnatal visit included improvements inneonatal gestational growth, management of neonates with potentially serious illnesses, diagnosis of warning signs and neonatal care practices.

Service delivery, community development, and disability.

Science.gov (United States)

Murphy, John W

2010-01-01

Service delivery has traditionally been based on market forces. When this is the case, the community becomes a silent partner in this process. Services, accordingly, are directed mostly to correcting personal ills and have little to do with community uplift. Another model, based on the work of Amartya Sen, is available that conceptualizes interventions in a very different way. If understood in the context of community development, the focus of services is social change, rather than merely personal rehabilitation. This reorientation is discussed in this article.

Creating Qungasvik (a Yup'ik intervention "toolbox"): case examples from a community-developed and culturally-driven intervention.

Science.gov (United States)

Rasmus, Stacy M; Charles, Billy; Mohatt, Gerald V

2014-09-01

This paper describes the development of a Yup'ik Alaska Native approach to suicide and alcohol abuse prevention that resulted in the creation of the Qungasvik, a toolbox promoting reasons for life and sobriety among youth. The Qungasvik is made up of thirty-six modules that function as cultural scripts for creating experiences in Yup'ik communities that build strengths and protection against suicide and alcohol abuse. The Qungasvik manual represents the results of a community based participatory research intervention development process grounded in culture and local process, and nurtured through a syncretic blending of Indigenous and Western theories and practices. This paper will provide a description of the collaborative steps taken at the community-level to develop the intervention modules. This process involved university researchers and community members coming together and drawing from multiple sources of data and knowledge to inform the development of prevention activities addressing youth suicide and alcohol abuse. We will present case examples describing the development of three keystone modules; Qasgiq (The Men's House), Yup'ik Kinship Terms, and Surviving Your Feelings. These modules each are representative of the process that the community co-researcher team took to develop and implement protective experiences that: (1) create supportive community, (2) strengthen families, and (3) give individuals tools to be healthy and strong.

Community based research for an urban recreation application of benefits-based management

Science.gov (United States)

William T. Borrie; Joseph W. Roggenbuck

1995-01-01

Benefits-based management is an approach to park and recreation management that focuses on the positive outcomes of engaging in recreational experiences. Because one class of possible benefits accrue to the community, a philosophical framework is discussed suggesting that communities are themselves the primary sources, generators, and repositories of knowledge....

Cultural Capital and Innovative Pedagogy: A Case Study among Indigenous Communities in Mexico and Honduras

Science.gov (United States)

Gregorcic, Marta

2009-01-01

This article introduces case studies of innovative approaches to pedagogy among indigenous Mayan communities in Chiapas (Mexico) and Lencan communities in Intibuca (Honduras). Innovative approaches to researching alternative theories and practices of pedagogy are used by the author to develop an epistemology of critical pedagogy and its potential…

Indoor pollution as an occupational risk factor for tuberculosis among women: a population-based, gender oriented, case-control study in Southern Mexico.

Science.gov (United States)

García-Sancho, Ma Cecilia; García-García, Lourdes; Báez-Saldaña, Renata; Ponce-De-León, Alfredo; Sifuentes-Osornio, José; Bobadilla-Del-valle, Miriam; Ferreyra-Reyes, Leticia; Cano-Arellano, Bulmaro; Canizales-Quintero, Sergio; Palacios-Merino, Luz del Carmen; Juárez-Sandino, Luis; Ferreira-Guerrero, Elizabeth; Cruz-Hervert, Luis Pablo; Small, Peter M; Pérez-Padilla, José Rogelio

2009-01-01

Indoor air pollution produced by biomass cooking fuels in developing countries has been associated with acute and chronic lower respiratory diseases, but has not been identified as an occupational exposure among women. To examine the relationship between the use of biomass cooking fuels (mainly wood) and tuberculosis (TB) among women living in rural areas in Southern Mexico. We conducted a population based case-control study in the health jurisdiction of Orizaba, Mexico. Cases were all incident female pulmonary TB patients, with Mycobacterium tuberculosis in sputum, living in communities with fewer than 15,000 inhabitants, diagnosed between March 1995 and April 2003. Woodsmoke exposure was assessed by applying a standardized questionnaire (ATS-DLD-78 questionnaire). Controls were randomly selected from sex-matched neighbors. Appropriate IRB approval was obtained. 42 TB cases and 84 community controls were recruited. Multivariate assessment showed that more than 20 years of exposure to smoke from biomass fuels was three times more frequent among cases than among controls [Odds ratio (OR): 3.3, 95% confidence interval (CI):1.06-10.30, p = 0.03], after controlling for age, body mass, household crowding, years of formal education and tobacco use. We found a strong association between the use of biomass cooking fuels and tuberculosis among women in a community-based, case-control study. Results of this study are intended to provide evidence to policy makers, community leaders and the general public on the importance of implementing gender oriented interventions that decrease the use of biomass fuels in poor communities in developing countries.

Challenges for Community-Based Forest Management in the KoloAla Site Manompana

Science.gov (United States)

Urech, Zora Lea; Sorg, Jean-Pierre; Felber, Hans Rudolph

2013-03-01

Following the IUCN 5th World Congress on Protected Areas in 2003, the then-President of Madagascar decided to increase the area of Madagascar's protected areas from 1.7 to 6 million ha. To combine the aims of protection and timber production, a new concept was developed through the establishment of community-based forest management (CBFM) sites, called KoloAla. However, experience shows that similar management transfers to communities in Madagascar have only been successful in a very few cases. We aimed to explore the success to be expected of this new approach in the particular case of the Manompana corridor at Madagascar's eastern coast. In a first step, the readiness of the corridor's resource users for CBFM has been analysed according to the seven resource users' attributes developed by Ostrom that predict an effective self-organized resource management. In a second step, we explored how KoloAla addresses known challenges of Madagascar's CBFM. Analyses lead in a rather sober conclusion. Although KoloAla attempts to address the goals of poverty alleviation, biodiversity conservation and timber production under a single umbrella, it does so in a rather non-innovative way. Challenges with regard to the state's environmental governance, agricultural inefficiency and thus deforestation remain unsolved.

Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

Science.gov (United States)

Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

2011-06-01

This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

Community Partner Perspectives on Benefits, Challenges, Facilitating Factors, and Lessons Learned from Community-Based Participatory Research Partnerships in Detroit.

Science.gov (United States)

Caldwell, Wilma Brakefield; Reyes, Angela G; Rowe, Zachary; Weinert, Julia; Israel, Barbara A

2015-01-01

There is an extensive body of literature on community-based participatory research (CBPR) and the role of community-academic partnerships, much of which has involved community partners in the conceptualization and preparation of publications. However, there has been a relative dearth of solely community voices addressing these topics, given the other roles and responsibilities which community members and leaders of community-based organizations (CBOs) have. The purpose of this article is to share the perspectives of three long-time (>20 years) community partners involved in the Detroit Community-Academic Urban Research Center and its affiliated partnerships. In this article, we community partners provide our assessment of the benefits and challenges in using a CBPR approach at the personal, organizational, and community levels; the factors that facilitate effective partnerships; and our lessons learned through engagement in CBPR. We also present specific recommendations from a community perspective to researchers and institutions interested in conducting CBPR.

Community-based child health nurses: an exploration of current practice.

Science.gov (United States)

Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

2011-12-01

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in

A Bibliometric Study of Community Pharmacy-Based Research ...

African Journals Online (AJOL)

2003-01-01

Purpose: To analyze community pharmacy based research in Arab countries. Methods: Comprehensive review of the literature indexed by Scopus was conducted. Data from Jan 01, 2003 till December 31, 2013 was searched for documents with specific words pertaining to “community pharmacy” in any one of the 13 Middle ...

Mind the Gap - Building Profitable Community Based Businesses on the Internet

OpenAIRE

Krieger,Bernhard; Müller,Philipp

2001-01-01

Building Internet communities will become a strategic tool both as a stand-alone model and as a supplement to sustain competitive advantage for "normal" businesses. Community based business models aim to profit from the value, which is created when Internet communities solve problems of collective action, by controlling access, aggregating data, or realizing side-payments. The current literature on community based business models refers to rational choices by individuals to explain why member...

A Case Study of Peer Educators in a Community-Based Program to Reduce Teen Pregnancy: Selected Characteristics Prior to Training, Perceptions of Training and Work, and Perceptions of How Participation in the Program Has Affected Them

Science.gov (United States)

Beshers, Sarah C.

2007-01-01

This investigation is a case study of peer educators in a community-based teen pregnancy prevention program. Research questions focused on identifying ways in which peer educators differed from other teens and exploring the perceptions of the peer educators about their experience in the program and the ways in which it has affected them. Data were…

School-Based Caries Prevention, Tooth Decay, and the Community Environment.

Science.gov (United States)

Ruff, R R; Niederman, R

2018-04-01

The school and community context can contribute to inequity in child oral health. Whether the school and community affect the effectiveness of school-based caries prevention is unknown. The association between the school and community environment and dental caries, as well as their moderating effects with school-based caries prevention, was assessed using multilevel mixed-effects regression. Data were derived from a 6-y prospective cohort study of children participating in a school-based caries prevention program. For the school and community, living in a dental-shortage area and the proportion of children receiving free or reduced lunch were significantly related to an increased risk of dental caries at baseline. Caries prevention was associated with a significant per-visit decrease in the risk of untreated caries, but the rate of total caries experience increased over time. Caries prevention was more effective in children who had prior dental care at baseline and in schools with a higher proportion of low socioeconomic status students. There was significant variation across schools in the baseline prevalence of dental caries and the effect of prevention over time, although effects were modest. The school and community environment have a direct impact on oral health and moderate the association between school-based caries prevention and dental caries. Knowledge Transfer Statement: School-based caries prevention can be an effective means to reduce oral health inequity by embedding dental care within schools. However, the socioeconomic makeup of schools and characteristics of the surrounding community can affect the impact of school-based care.

Synthetic socioeconomic based domestic wastewater hydrographs for small arid communities

KAUST Repository

Elnakar, H.

2012-06-04

A model was developed to predict synthetic socioeconomic based domestic wastewater hydrographs for the small arid communities. The model predicts the flow hydrograph for random weekdays and weekends based on the specific socioeconomic characteristics of the community. The main socioeconomic characteristics are the composition of the community, the different user behaviours in using water appliances, and the unit discharges of such appliances. Use patterns of water appliances are assumed to vary for the various members of the community and the type of day. Each community is composed of several social categories such as the employee, working woman, stay home woman, stay home child, students etc. The use patterns account for the stochastic nature of use in terms of number of uses, duration of the use and times of use in the day. Randomly generated hydrographs are generated for weekdays and weekends along with synthetic hydrographs of non-exceedance. The model was verified for a small residential compound in Sharm El Shiekh - Egypt using 11 days of flow measurements performed in summer. The synthetic hydrographs based on assumed water use patterns of the various members of the community compared reasonably with the measured hydrographs. Synthetic hydrographs can be derived for a community under consideration to reflect its socioeconomic conditions and thus can be used to generate probability based peaking factors to be used in the design of sewerage systems pumping facilities, and treatment plants. © 201 WIT Press.

Synthetic socioeconomic based domestic wastewater hydrographs for small arid communities

KAUST Repository

Elnakar, H.; Imam, E.; Nassar, K.

2012-01-01

A model was developed to predict synthetic socioeconomic based domestic wastewater hydrographs for the small arid communities. The model predicts the flow hydrograph for random weekdays and weekends based on the specific socioeconomic characteristics of the community. The main socioeconomic characteristics are the composition of the community, the different user behaviours in using water appliances, and the unit discharges of such appliances. Use patterns of water appliances are assumed to vary for the various members of the community and the type of day. Each community is composed of several social categories such as the employee, working woman, stay home woman, stay home child, students etc. The use patterns account for the stochastic nature of use in terms of number of uses, duration of the use and times of use in the day. Randomly generated hydrographs are generated for weekdays and weekends along with synthetic hydrographs of non-exceedance. The model was verified for a small residential compound in Sharm El Shiekh - Egypt using 11 days of flow measurements performed in summer. The synthetic hydrographs based on assumed water use patterns of the various members of the community compared reasonably with the measured hydrographs. Synthetic hydrographs can be derived for a community under consideration to reflect its socioeconomic conditions and thus can be used to generate probability based peaking factors to be used in the design of sewerage systems pumping facilities, and treatment plants. © 201 WIT Press.

Community Based Nutrition Rehabilitation in Tanzania: Challenges and Lessons Learned

International Nuclear Information System (INIS)

Urio, Elisaphinate Moses; Jeje, Benedict; Ndossi, Godwin

2014-01-01

Full text: Malnutrition among children under the age of five continues to be a significant public health problem in Tanzania. Despite numerous nutritional interventions that have been implemented, the country still experiences high rates of malnutrition. According to Tanzania Demographic and Health Survey of 2010 the prevalence of underweight was estimated to be 16%, wasting 5% and stunting 42 %. Factors contributing to causes of malnutrition include immediate, underlying and basic causes. All these factors are interlinked and operate synergistically and not independently. Approaches for managing malnourished children in Tanzania evolved from facility based Nutrition Rehabilitation Units (NURU) in the late 1960s to Community Based Nutrition Rehabilitation (CBNR) in late 1980s. In the latter approach, malnourished children are rehabilitated in the same environment (village, home) that precipitated the condition, using resources and infrastructures available in the community. Mothers are taught about child feeding using family foods to make good food mixtures and of the importance of feeding frequency for the young child. Limitations for this approach include inadequate advocacy to leaders from districts down to the community level, few trained health providers and community health workers on knowledge and skills on community based nutrition rehabilitation, inadequate equipment and supplies for identification and categorization of malnutrition, low awareness of parents, care givers and community leaders on home rehabilitation of malnourished children. Nonetheless, Community Based Nutrition Rehabilitation approach has the potential to address malnutrition in children given political will and resources. (author)

Is community-based ecotourism a good use of biodiversity conservation funds?

Science.gov (United States)

Kiss, Agnes

2004-05-01

Community-based ecotourism (CBET) has become a popular tool for biodiversity conservation, based on the principle that biodiversity must pay for itself by generating economic benefits, particularly for local people. There are many examples of projects that produce revenues for local communities and improve local attitudes towards conservation, but the contribution of CBET to conservation and local economic development is limited by factors such as the small areas and few people involved, limited earnings, weak linkages between biodiversity gains and commercial success, and the competitive and specialized nature of the tourism industry. Many CBET projects cited as success stories actually involve little change in existing local land and resource-use practices, provide only a modest supplement to local livelihoods, and remain dependent on external support for long periods, if not indefinitely. Investment in CBET might be justified in cases where such small changes and benefits can yield significant conservation and social benefits, although it must still be recognized as requiring a long term funding commitment. Here, I aim to identify conditions under which CBET is, and is not, likely to be effective, efficient and sustainable compared with alternative approaches for conserving biodiversity. I also highlight the need for better data and more rigorous analysis of both conservation and economic impacts.

Getting better at chronic care in remote communities: study protocol for a pragmatic cluster randomised controlled of community based management.

Science.gov (United States)

Schmidt, Barbara; Wenitong, Mark; Esterman, Adrian; Hoy, Wendy; Segal, Leonie; Taylor, Sean; Preece, Cilla; Sticpewich, Alex; McDermott, Robyn

2012-11-21

Prevalence and incidence of diabetes and other common comorbid conditions (hypertension, coronary heart disease, renal disease and chronic lung disease) are extremely high among Indigenous Australians. Recent measures to improve quality of preventive care in Indigenous community settings, while apparently successful at increasing screening and routine check-up rates, have shown only modest or little improvements in appropriate care such as the introduction of insulin and other scaled-up drug regimens in line with evidence-based guidelines, together with support for risk factor reduction. A new strategy is required to ensure high quality integrated family-centred care is available locally, with continuity and cultural safety, by community-based care coordinators with appropriate system supports. The trial design is open parallel cluster randomised controlled trial. The objective of this pragmatic trial is to test the effectiveness of a model of health service delivery that facilitates integrated community-based, intensive chronic condition management, compared with usual care, in rural and remote Indigenous primary health care services in north Queensland. Participants are Indigenous adults (aged 18-65 years) with poorly controlled diabetes (HbA1c>=8.5) and at least one other chronic condition. The intervention is to employ an Indigenous Health Worker to case manage the care of a maximum caseload of 30 participants. The Indigenous Health Workers receive intensive clinical training initially, and throughout the study, to ensure they are competent to coordinate care for people with chronic conditions. The Indigenous Health Workers, supported by the local primary health care (PHC) team and an Indigenous Clinical Support Team, will manage care, including coordinating access to multidisciplinary team care based on best practice standards. Allocation by cluster to the intervention and control groups is by simple randomisation after participant enrolment. Participants in

Towards a Science of Community Stakeholder Engagement in Biomedical HIV Prevention Trials: An Embedded Four-Country Case Study

Science.gov (United States)

Newman, Peter A.; Rubincam, Clara; Slack, Catherine; Essack, Zaynab; Chakrapani, Venkatesan; Chuang, Deng-Min; Tepjan, Suchon; Shunmugam, Murali; Roungprakhon, Surachet; Logie, Carmen; Koen, Jennifer; Lindegger, Graham

2015-01-01

Objectives Broad international guidelines and studies in the context of individual clinical trials highlight the centrality of community stakeholder engagement in conducting ethically rigorous HIV prevention trials. We explored and identified challenges and facilitators for community stakeholder engagement in biomedical HIV prevention trials in diverse global settings. Our aim was to assess and deepen the empirical foundation for priorities included in the GPP guidelines and to highlight challenges in implementation that may merit further attention in subsequent GPP iterations. Methods From 2008–2012 we conducted an embedded, multiple case study centered in Thailand, India, South Africa and Canada. We conducted in-depth interviews and focus groups with respondents from different trial-related subsystems: civil society organization representatives, community advocates, service providers, clinical trialists/researchers, former trial participants, and key HIV risk populations. Interviews/focus groups were recorded, and coded using thematic content analysis. After intra-case analyses, we conducted cross-case analysis to contrast and synthesize themes and sub-themes across cases. Lastly, we applied the case study findings to explore and assess UNAIDS/AVAC GPP guidelines and the GPP Blueprint for Stakeholder Engagement. Results Across settings, we identified three cross-cutting themes as essential to community stakeholder engagement: trial literacy, including lexicon challenges and misconceptions that imperil sound communication; mistrust due to historical exploitation; and participatory processes: engaging early; considering the breadth of “community”; and, developing appropriate stakeholder roles. Site-specific challenges arose in resource-limited settings and settings where trials were halted. Conclusions This multiple case study revealed common themes underlying community stakeholder engagement across four country settings that largely mirror GPP goals and the

Transforming Social Regularities in a Multicomponent Community-Based Intervention: A Case Study of Professionals' Adaptability to Better Support Parents to Meet Their Children's Needs.

Science.gov (United States)

Quiroz Saavedra, Rodrigo; Brunson, Liesette; Bigras, Nathalie

2017-06-01

This paper presents an in-depth case study of the dynamic processes of mutual adjustment that occurred between two professional teams participating in a multicomponent community-based intervention (CBI). Drawing on the concept of social regularities, we focus on patterns of social interaction within and across the two microsystems involved in delivering the intervention. Two research strategies, narrative analysis and structural network analysis, were used to reveal the social regularities linking the two microsystems. Results document strategies and actions undertaken by the professionals responsible for the intervention to modify intersetting social regularities to deal with a problem situation that arose during the course of one intervention cycle. The results illustrate how key social regularities were modified in order to resolve the problem situation and allow the intervention to continue to function smoothly. We propose that these changes represent a transition to a new state of the ecological intervention system. This transformation appeared to be the result of certain key intervening mechanisms: changing key role relationships, boundary spanning, and synergy. The transformation also appeared to be linked to positive setting-level and individual-level outcomes: confidence of key team members, joint planning, decision-making and intervention activities, and the achievement of desired intervention objectives. © Society for Community Research and Action 2017.

Context-Aware Community Construction in Proximity-Based Mobile Networks

Directory of Open Access Journals (Sweden)

Na Yu

2015-01-01

Full Text Available Sensor-equipped mobile devices have allowed users to participate in various social networking services. We focus on proximity-based mobile social networking environments where users can share information obtained from different places via their mobile devices when they are in proximity. Since people are more likely to share information if they can benefit from the sharing or if they think the information is of interest to others, there might exist community structures where users who share information more often are grouped together. Communities in proximity-based mobile networks represent social groups where connections are built when people are in proximity. We consider information influence (i.e., specify who shares information with whom as the connection and the space and time related to the shared information as the contexts. To model the potential information influences, we construct an influence graph by integrating the space and time contexts into the proximity-based contacts of mobile users. Further, we propose a two-phase strategy to detect and track context-aware communities based on the influence graph and show how the context-aware community structure improves the performance of two types of mobile social applications.