Nutritional management of Eosinophilic Gastroenteropathies: Case series from the community

Directory of Open Access Journals (Sweden)

Basilious Alfred

2011-05-01

Full Text Available Abstract Eosinophilic gastroenteropathies, such as eosinophilic esophagitis and eosinophilic colitis, have classically been treated with swallowed inhaled corticosteroids or oral corticosteroids. More recent studies have found elimination and elemental diets to be effective treatment alternatives to steroids. In this case series we describe the treatment of three children using nutritional management in a community setting. Elimination diets and elemental diets based on patch testing and skin prick tests reduced the eosinophil counts to normal levels in all three children. Food items which tested positive were then reintroduced while symptoms and eosinophil counts were monitored. Nutritional management of eosinophilic esophagitis and eosinophilic colitis was found to be effective in reducing symptoms. However, obstacles facing patients who choose this type of therapy include limitations due to the cost of repeated endoscopies, palatability of elimination/elemental diets and the availability of subspecialists trained in management (e.g. Allergy, Gastroenterology, and Pathology. It may be a worthwhile endeavour to overcome these obstacles as nutritional management minimizes the potential long-term effects of chronic steroid therapy.

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...

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

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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....

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.

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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.

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

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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.

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 ...

Transaction costs and community-based natural resource management in Nepal.

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Adhikari, Bhim; Lovett, Jon C

2006-01-01

Transaction costs in community-based resource management are incurred by households attempting to enforce property right rules over common resources similar to those inherent in private property rights. Despite their importance, transaction costs of community-based management of common pool resources (CPRs) are often not incorporated into the economic analysis of participatory resource management. This paper examines the transaction costs incurred by forest users in community forestry (CF) based on a survey of 309 households belonging to eight different forest user groups (FUGs) in the mid hills of Nepal. The analysis reveals that the average 'poor' household incurred Nepalese rupees (NRS) 1265 in transaction costs annually, while wealthier 'rich' households incurred an average of NRS 2312 per year. Although richer households bear higher proportions of such costs, transaction costs for CF management as a percentage of resource appropriation costs are higher for poorer households (26%) than those of middle-wealth (24%) or rich households (14%). There are also village differences in the level of transaction costs. The results show that transaction costs are a major component of resource management costs and vary according to socio-economic status of resource users and characteristics of 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

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

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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).

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...

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

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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.

Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

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Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

2015-01-01

Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

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

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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

Participation in community based natural resource management ...

African Journals Online (AJOL)

The study was on participation in Community Based Natural Resource Management Programme (CBNRMP) and its socio-economic effect on rural families in Ikwerre Area, Rivers State Nigeria. A structured questionnaire was administered to 60 beneficiaries of the programme. Data collected were subjected to descriptive ...

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

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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.

Community-Based Solid Waste Management: A Training Facilitator's Guide.

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Peace Corps, Washington, DC. Information Collection and Exchange Div.

Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

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.

Strategies in Mobilizing Coastal Communities for Community-Based Coastal Resource Management in Bolinao, Pangasinan

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Jacquelyn Pinat

2000-12-01

Full Text Available The Marine Fishery Resources Management Project (MFRMP hopes to facilitate partnership between the local government unit and the local communities in managing the coastal resources of Bolinao. Mobilization, both at the community and municipal levels, has been very important in promoting community-based strategies in coastal resources management. The community organization process in the municipality has gone through several levels; and different organizations have been formed. In empowering individuals and organizations, strategies tend to be varied and fluid depending on the need, the reason for mobilization, and the resources at hand. The Bolinao experience showcases different strategies used in implementing the resource enhancement, coastal zoning, harvest regulation, and capability building components of the program. These have included the formation of people's organizations, the mobilization of zonal action teams for each of the four zones, the creation and orientation of fishery and aquatic resources management councils at the barangay and municipal levels, and the active collaboration with the local government unit. These strategies and approaches have provided the people and the communities a wealth of experience and lessons that provide helpful insights in undertaking different endeavors. The strategies employed in the mobilization activities have significantly contributed to the empowerment of communities and individuals who are the primary managers of their resources.

Using Analysis of Governance to Unpack Community-Based Conservation: A Case Study from Tanzania.

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Robinson, Lance W; Makupa, Enock

2015-11-01

Community-based conservation policies and programs are often hollow with little real devolution. But to pass a judgment of community-based or not community-based on such initiatives and programs obscures what is actually a suite of attributes. In this paper, we analyze governance around a specific case of what is nominally community-based conservation-Ikona Wildlife Management Area (WMA) in Tanzania-using two complementary sets of criteria. The first relates to governance "powers": planning powers, regulatory powers, spending powers, revenue-generating powers, and the power to enter into agreements. The second set of criteria derive from the understanding of governance as a set of social functions: social coordination, shaping power, setting direction, and building community. The analysis helps to detail ways in which the Tanzanian state through policy and regulations has constrained the potential for Ikona WMA to empower communities and community actors. Although it has some features of community-based conservation, community input into how the governance social functions would be carried out in the WMA was constrained from the start and is now largely out of community hands. The two governance powers that have any significant community-based flavor-spending powers and revenue-generating powers-relate to the WMA's tourism activities, but even here the picture is equivocal at best. The unpacking of governance that we have done, however, reveals that community empowerment through the processes associated with creating and recognizing indigenous and community-conserved areas is something that can be pursued through multiple channels, some of which might be more strategic than others.

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)....

Intelligent community management system based on the devicenet fieldbus

Science.gov (United States)

Wang, Yulan; Wang, Jianxiong; Liu, Jiwen

2013-03-01

With the rapid development of the national economy and the improvement of people's living standards, people are making higher demands on the living environment. And the estate management content, management efficiency and service quality have been higher required. This paper in-depth analyzes about the intelligent community of the structure and composition. According to the users' requirements and related specifications, it achieves the district management systems, which includes Basic Information Management: the management level of housing, household information management, administrator-level management, password management, etc. Service Management: standard property costs, property charges collecting, the history of arrears and other property expenses. Security Management: household gas, water, electricity and security and other security management, security management district and other public places. Systems Management: backup database, restore database, log management. This article also carries out on the Intelligent Community System analysis, proposes an architecture which is based on B / S technology system. And it has achieved a global network device management with friendly, easy to use, unified human - machine interface.

Intelligent Internet-based information system optimises diabetes mellitus management in communities.

Science.gov (United States)

Wei, Xuejuan; Wu, Hao; Cui, Shuqi; Ge, Caiying; Wang, Li; Jia, Hongyan; Liang, Wannian

2018-05-01

To evaluate the effect of an intelligent Internet-based information system upon optimising the management of patients diagnosed with type 2 diabetes mellitus (T2DM). In 2015, a T2DM information system was introduced to optimise the management of T2DM patients for 1 year in Fangzhuang community of Beijing, China. A total of 602 T2DM patients who were registered in the health service centre of Fangzhuang community were enrolled based on an isometric sampling technique. The data from 587 patients were used in the final analysis. The intervention effect was subsequently assessed by statistically comparing multiple parameters, such as the prevalence of glycaemic control, standard health management and annual outpatient consultation visits per person, before and after the implementation of the T2DM information system. In 2015, a total of 1668 T2DM patients were newly registered in Fangzhuang community. The glycaemic control rate was calculated as 37.65% in 2014 and significantly elevated up to 62.35% in 2015 ( p information system, the rate of standard health management was increased from 48.04% to 85.01% ( p information system optimised the management of T2DM patients in Fangzhuang community and decreased the outpatient numbers in both community and general hospitals, which played a positive role in assisting T2DM patients and their healthcare providers to better manage this chronic illness.

Multiple Drivers of Local (Non- Compliance in Community-Based Marine Resource Management: Case Studies from the South Pacific

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Janne R. Rohe

2017-05-01

Full Text Available The outcomes of marine conservation and related management interventions depend to a large extent on people's compliance with these rule systems. In the South Pacific, community-based marine resource management (CBMRM has gained wide recognition as a strategy for the sustainable management of marine resources. In current practice, CBMRM initiatives often build upon customary forms of marine governance, integrating scientific advice and management principles in collaboration with external partners. However, diverse socio-economic developments as well as limited legal mandates can challenge these approaches. Compliance with and effective (legally-backed enforcement of local management strategies constitute a growing challenge for communities—often resulting in considerable impact on the success or failure of CBMRM. Marine management arrangements are highly dynamic over time, and similarly compliance with rule systems tends to change depending on context. Understanding the factors contributing to (non- compliance in a given setting is key to the design and function of adaptive management approaches. Yet, few empirical studies have looked in depth into the dynamics around local (non- compliance with local marine tenure rules under the transforming management arrangements. Using two case studies from Solomon Islands and Fiji, we investigate what drives local (non- compliance with CBMRM and what hinders or supports its effective enforcement. The case studies reveal that non-compliance is mainly driven by: (1 diminishing perceived legitimacy of local rules and rule-makers; (2 increased incentives to break rules due to market access and/ or lack of alternative income; and (3 relatively weak enforcement of local rules (i.e., low perceptions of risk from sanctions for rule-breaking. These drivers do not stand alone but can act together and add up to impair effective management. We further analyze how enforcement of CBMRM is challenged through a range of

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

Software requirements management based on use cases

International Nuclear Information System (INIS)

Xiao Jin

2009-01-01

In this paper, the requirements management based on use cases is theoretically explored, and a multi-layer use-case model is introduced, which combined with three levels of use cases and a single use-case refinement model. Through the practice in a software project, the multi-layer use-case model provides a good solution on how to control the requirements scope and change, and provides the balance of work assignment between customer departments, information management departments and software development outsourcing team. (authors)

CO-CD base management model of Universitas Terbuka community service program

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Kridasakti, S. W.; Sudirah; Siregar, H.

2018-03-01

These studies were to respond whether the UT social-aid management had been executed under CO-CD principles (Ife J. 1995) and what CO-CD base community service management model can be built. The goals of these evaluational studies were UT social-aid managerial performance profile (2011-2013) and CO-CD management model development. The methods used were Survey and FGD. For data collection were involving the UT officers, the counterparts, and the documents. The analysis used combination between the Performance Analysis (Irawan P., 2003) and the CIPP (Stuffelbeam, D, L., & Shinkfield, A, J., 1985). The findings showed that the quantitative targeting in program completion was credible in achievement (85%). However, the “qulitative targeting” of the management goals was indicating far from a good-stage (≤5.0_Interval-Force: 1-10 Scale). The “Gap” was due to the absent of socialization_needs-analysis_maintenance_release factors on the UT social-service grand-policy. The trial of CO-CD Base Management Model had been imposed to the community that turned out to be very effective to self-help, and the ensuing SOP had been successfully defined. Conclusion, ‘CO-CD Principles’ were not designed in UT community service programs management. However, if efficiency and effectivity likely to be achieved, the SOP of ‘CO-CD Base Management Model has to be adopted.

Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

Science.gov (United States)

Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

2015-07-02

The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

Management initiatives in a community-based health insurance scheme.

Science.gov (United States)

Sinha, Tara; Ranson, M Kent; Chatterjee, Mirai; Mills, Anne

2007-01-01

Community-based health insurance (CBHI) schemes have developed in response to inadequacies of alternate systems for protecting the poor against health care expenditures. Some of these schemes have arisen within community-based organizations (CBOs), which have strong links with poor communities, and are therefore well situated to offer CBHI. However, the managerial capacities of many such CBOs are limited. This paper describes management initiatives undertaken in a CBHI scheme in India, in the course of an action-research project. The existing structures and systems at the CBHI had several strengths, but fell short on some counts, which became apparent in the course of planning for two interventions under the research project. Management initiatives were introduced that addressed four features of the CBHI, viz. human resources, organizational structure, implementation systems, and data management. Trained personnel were hired and given clear roles and responsibilities. Lines of reporting and accountability were spelt out, and supportive supervision was provided to team members. The data resources of the organization were strengthened for greater utilization of this information. While the changes that were introduced took some time to be accepted by team members, the commitment of the CBHI's leadership to these initiatives was critical to their success. Copyright (c) 2007 John Wiley & Sons, Ltd.

"Since I have my case manager, I am back to life" case management in Croatia.

Science.gov (United States)

Gruber, Ema N; Ivezić-Strkalj, Sladana; Agius, Mark; Martić-Biocina, Sanja

2008-03-01

The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

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...

Resource-Based Capability on Development Knowledge Management Capabilities of Coastal Community

Science.gov (United States)

Teniwut, Roberto M. K.; Hasyim, Cawalinya L.; Teniwut, Wellem A.

2017-10-01

Building sustainable knowledge management capabilities in the coastal area might face a whole new challenge since there are many intangible factors involved from openness on new knowledge, access and ability to use the latest technology to the various local wisdom that still in place. The aimed of this study was to identify and analyze the resource-based condition of coastal community in this area to have an empirical condition of tangible and intangible infrastructure on developing knowledge management capability coastal community in Southeast Maluku, Indonesia. We used qualitative and quantitative analysis by depth interview and questionnaire for collecting the data with multiple linear regression as our analysis method. The result provided the information on current state of resource-based capability of a coastal community in this Southeast Maluku to build a sustainability model of knowledge management capabilities especially on utilization marine and fisheries resources. The implication of this study can provide an empirical information for government, NGO and research institution to dictate on how they conducted their policy and program on developing coastal community region.

The Role of Perceptions for Community-Based Marine Resource Management

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Katharina Beyerl

2016-11-01

Full Text Available Every community-based marine resource management (CBMRM inherently takes place in a highly complex social-ecological environment, and stakeholder perceptions related to various aspects of the natural and social environment guide behavior in every stage of the management process. This paper provides an introduction to the psychology of perception with regard to marine resource management. In particular, it offers a typology of CBMRM relevant perceptions along with an analysis of psychological, societal, and physical factors that modulate them. Based on this analysis, we propose the introduction of specially trained local Perception Experts (PE’s, whose role will be to recognize and reflect individual perceptions of involved stakeholders, and to communicate them at community meetings where decisions are made. This empirically testable addition to current CBMRM schemes could help to increase participation, develop management measures that fit the capacities of the involved stakeholders more accurately, and hence, contribute to a faster rehabilitation of marine resources.

Community-Based Management of Diabetes in Nepal: Exploring the Potential Role of Female Community Health Volunteers

DEFF Research Database (Denmark)

Gyawali, Bishal

2016-01-01

, and this is particularly apparent in the South Asian countries, including Nepal. Despite the growing burden and chronic nature of type 2 diabetes, prevention and control of this disease is far from adequate in these settings. One possibility could be through the involvement of community health workers to prevent, diagnose...... and treat type 2 diabetes. We suggest that involving Female Community Health Volunteers (FCHVs) of Nepal offering culturally appropriate health promotion may be the blue print for community-based management programmes tackling type 2 diabetes. We aim to explore the potential role of FCHVs of Nepal...... for diabetes management at community level. It is anticipated that the study can give valuable information regarding effectiveness, acceptability, and feasibility of an innovative way to improve diabetes management in low resource settings....

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.

Development of a community based management protocol for ...

African Journals Online (AJOL)

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

Community-Based Coastal Resource Management (CB-CRM: a Case Study f Mariveles, Bataan, Philippines

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Andrew Lou L. Mungcal

2013-11-01

Full Text Available This paper addressed the issue of sustainable coastal resource management through a successful Community-Based Coastal Resource Management (CB-CRM Program in the Municipality of Mariveles, province of Bataan in the Philippines. The paper investigated how governance and institutional and legislative framework, and the concept of sustainable development complemented each other to promote good local eco-governance in the management and protection of finite local marine resources. Specifically, it analyzed how the local fisherfolk community of Mariveles utilized efficiently their finite marine resources in the context of eco-governance. It also investigated how the cooperative efforts of various stakeholders: peoples’ organizations (POs, local government unit (LGU, and a non-government organization (NGO in Mariveles, Bataan affected their coastal resources against environmental degradation and exploitation. This paper would benefit POs, LGUs, and NGOs in their quest for sustainable management and conservation of their limited coastal resources. This paper yielded the following findings. First, POs and NGOs engage when NGOs can strengthen the POs’ capacity building through the transfer of skills and technology, when NGOs can enhance the POs’ indigenous knowledge, and when NGOs are more knowledgeable of formal venues of LGU participation. Second, LGUs, NGOs and POs engage when POs and NGOs can complement each other to strengthen their capacity building, and when NGOs can help implement environmental programs that are beneficial to the POs. Third, NGOs and POs engage when POs are threatened by elite power, and when NGOs want their environmental issues on LGU’s legislative agenda. Finally, NGOs and POs engage when they see possible LGU cooperation. Participant observation through focus group discussion (FGD and key informants’ interview of different stakeholders was a primary source of information in formulating the aforementioned conclusions

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

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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

Reducing carbon transaction costs in community based forest management

NARCIS (Netherlands)

Skutsch, Margaret

The paper considers the potential for community based forest management (of existing forests) in developing countries, as a future CDM strategy, to sequester carbon and claim credits in future commitment periods. This kind of forestry is cost effective, and should bring many more benefits to local

How Case-Based Reasoning on e-Community Knowledge Can Be Improved Thanks to Knowledge Reliability

OpenAIRE

Gaillard , Emmanuelle; Lieber , Jean; Nauer , Emmanuel; Cordier , Amélie

2014-01-01

International audience; This paper shows that performing case-based reasoning (CBR) on knowledge coming from an e-community is improved by taking into account knowledge reliability. MKM (meta-knowledge model) is a model for managing reliability of the knowledge units that are used in the reasoning process. For this, MKM uses meta-knowledge such as belief, trust and reputation, about knowledge units and users. MKM is used both to select relevant knowledge to conduct the reasoning process, and ...

COMMUNITY BASED HOME ENERGY MANAGEMENT SYSTEM

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Muhammad Adnan Aziz

2017-05-01

Full Text Available In a Smart Grid (SG scenario, domestic consumers can gain cost reduction benefit by scheduling their Appliance Activation Time (AAT towards the slots of low charge. Minimization in cost is essential in Home Energy Management Systems (HEMS to induce consumers acceptance for power scheduling to accommodate for a Demand Response (DR at peak hours. Despite the fact that many algorithms address the power scheduling for HEMS, community based optimization has not been the focus. This paper presents an algorithm that targets the minimization of energy costs of whole community while keeping a low Peak to Average Ratio (PAR and smooth Power Usage Pattern (PUP. Objective of cost reduction is accomplished by finding most favorable AAT by Particle Swarm Optimization (PSO in conjunction with Inclined Block Rate (IBR approach and Circular Price Shift (CPS. Simulated numerical results demonstrate the effectiveness of CPS to assist the merger of PSO & IBR to enhance the reduction/stability of PAR and cost reduction.

Community-based management induces rapid recovery of a high-value tropical freshwater fishery

Science.gov (United States)

Campos-Silva, João Vitor; Peres, Carlos A.

2016-10-01

Tropical wetlands are highly threatened socio-ecological systems, where local communities rely heavily on aquatic animal protein, such as fish, to meet food security. Here, we quantify how a ‘win-win’ community-based resource management program induced stock recovery of the world’s largest scaled freshwater fish (Arapaima gigas), providing both food and income. We analyzed stock assessment data over eight years and examined the effects of protected areas, community-based management, and landscape and limnological variables across 83 oxbow lakes monitored along a ~500-km section of the Juruá River of Western Brazilian Amazonia. Patterns of community management explained 71.8% of the variation in arapaima population sizes. Annual population counts showed that protected lakes on average contained 304.8 (±332.5) arapaimas, compared to only 9.2 (±9.8) in open-access lakes. Protected lakes have become analogous to a high-interest savings account, ensuring an average annual revenue of US$10,601 per community and US$1046.6 per household, greatly improving socioeconomic welfare. Arapaima management is a superb window of opportunity in harmonizing the co-delivery of sustainable resource management and poverty alleviation. We show that arapaima management deserves greater attention from policy makers across Amazonian countries, and highlight the need to include local stakeholders in conservation planning of Amazonian floodplains.

Models of community care for severe mental illness: a review of research on case management.

Science.gov (United States)

Mueser, K T; Bond, G R; Drake, R E; Resnick, S G

1998-01-01

We describe different models of community care for persons with severe mental illness and review the research literature on case management, including the results of 75 studies. Most research has been conducted on the assertive community treatment (ACT) or intensive case management (ICM) models. Controlled research on ACT and ICM indicates that these models reduce time in the hospital and improve housing stability, especially among patients who are high service users. ACT and ICM appear to have moderate effects on improving symptomatology and quality of life. Most studies suggest little effect of ACT and ICM on social functioning, arrests and time spent in jail, or vocational functioning. Studies on reducing or withdrawing ACT or ICM services suggest some deterioration in gains. Research on other models of community care is inconclusive. We discuss the implications of the findings in terms of the need for specialization of ACT or ICM teams to address social and vocational functioning and substance abuse. We suggest directions for future research on models of community care, including evaluating implementation fidelity, exploring patient predictors of improvement, and evaluating the role of the helping alliance in mediating outcome.

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

NARCIS (Netherlands)

Plas, A.G.M. van der; Onwuteaka-Philipsen, B.D.; Vissers, K.C.; Deliens, L.; Jansen, W.J.J.; Francke, A.L.

2016-01-01

Aims: 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

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.

Comparison of community managed projects and conventional ...

African Journals Online (AJOL)

Comparison of community managed projects and conventional approaches in rural water supply of Ethiopia. ... African Journal of Environmental Science and Technology ... This study aimed to compare Community Managed Projects (CMP) approach with the conventional approaches (Non-CMP) in the case of Ethiopia.

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

Diabetes connect: African American men's preferences for a community-based diabetes management program.

Science.gov (United States)

Crabtree, Krysia; Sherrer, Nathan; Rushton, Tullia; Willig, Amanda; Agne, April; Shelton, Tanya; Cherrington, Andrea

2015-02-01

The purpose of the study is to explore African American men's perceptions of how community-based, community-health worker (CHW)-delivered diabetes interventions might best be implemented. Four 90-minute focus groups were guided by a trained moderator with a written guide to facilitate discussion on the topic of diabetes management and preferences for community-based programs. Participants were recruited from the diabetes education database at a safety-net health system in Jefferson County, AL. Two independent reviewers performed content analysis to identify major themes using an iterative, combined deductive and inductive approach. There were 25 male participants. Mean years living with diabetes was 9.6 (range, 1-20). Participants demonstrated knowledge of self-management strategies and identified various hardships including emotional and physical manifestations of diabetes, dietary restrictions, and institutional frustrations with the health system that contributed to self-management barriers. Their preferred CHW responsibilities were to educate, hold support groups, help track daily activities, and help find resources. Potential concerns included the need for confidentiality and fears of being stereotyped. Participants identified critical self-management strategies but endure hardships that present barriers to daily diabetes management. Preferences for community-based programs and suggested CHW responsibilities could help to overcome many of those barriers by increasing access and providing support. © 2014 The Author(s).

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Community-Based Coastal Resource Management (CB-CRM: a Case Study f Mariveles, Bataan, Philippines

Directory of Open Access Journals (Sweden)

Andrew L.L Munchal

2016-06-01

Full Text Available This paper addressed the issue of sustainable coastal resource management through a successful Community-Based Coastal Resource Management (CB-CRM Program in the Municipality of Mariveles, province of Bataan in the Philippines. The paper investigated how governance and institutional and legislative framework, and the concept of sustainable development complemented  each  other  to  promote  good  local  eco-governance in  the management and protection of finite local marine resources. Specifically, it analyzed how the local fisherfolk community of Mariveles utilized efficiently their finite marine resources in the context of eco-governance. It also investigated how the cooperative efforts of various stakeholders: peoples’ organizations (POs,  local  government unit  (LGU,  and  a  non- government organization (NGO  in  Mariveles, Bataan  affected  their  coastal  resources against environmental degradation and exploitation. This paper would benefit POs, LGUs, and NGOs in their quest for sustainable management and conservation of their limited coastal resources. This paper yielded the following findings. First, POs and NGOs engage when NGOs can strengthen the POs’ capacity building through the transfer of skills and technology, when NGOs can enhance the POs’ indigenous knowledge, and when NGOs are more knowledgeable of formal venues of LGU participation. Second, LGUs, NGOs and POs engage when POs and NGOs can complement each other to strengthen their capacity building, and when NGOs can help implement environmental programs that are beneficial to the POs. Third, NGOs and POs engage when POs are threatened by elite power, and when NGOs want their environmental issues on LGU’s legislative agenda. Finally, NGOs and POs engage when they see possible LGU cooperation. Participant observation through focus group discussion (FGD and key informants’ interview of different stakeholders was a  primary  source  of �

Developing a rural transitional care community case management program using clinical nurse specialists.

Science.gov (United States)

Baldwin, Kathleen M; Black, Denice; Hammond, Sheri

2014-01-01

This quality improvement project developed a community nursing case management program to decrease preventable readmissions to the hospital and emergency department by providing telephonic case management and, if needed, onsite assessment and treatment by a clinical nurse specialist (CNS) with prescriptive authority. As more people reach Medicare age, the number of individuals with worsening chronic diseases with dramatically increases unless appropriate disease management programs are developed. Care transitions can result in breakdown in continuity of care, resulting in increased preventable readmissions, particularly for indigent patients. The CNS is uniquely educated to managing care transitions and coordination of community resources to prevent readmissions. After a thorough SWOT (strengths, weaknesses, opportunities, and threats) analysis, we developed and implemented a cost-avoidance model to prevent readmissions in our uninsured and underinsured patients. The project CNS used a wide array of interventions to decrease readmissions. In the last 2 years, there have been a total of 22 less than 30-day readmissions to the emergency department or hospital in 13 patients, a significant decrease from readmissions in these patients prior to the program. Three of them required transfer to a larger hospital for a higher level of care. Using advanced practice nurses in transitional care can prevent readmissions, resulting in cost avoidance. The coordination of community resources during transition from hospital to home is a job best suited to CNSs, because they are educated to work within organizations/systems. The money we saved with this project more than justified the cost of hiring a CNS to lead it. More research is needed into this technology. Guidelines for this intervention need to be developed. Replicating our cost-avoidance transitional care model can help other facilities limit that loss.

The intersection of software and strengths: Using internet technology and case management software to assist Strength-Based Practice.

Science.gov (United States)

Clark, Michael D; Brien, Dale W

2016-01-01

The focus of this investigation is the helping professionals working within American Indian and Alaska Native (AI/AN) communities. This article looks at how innovative technology-in the form of automated case management software and Internet connectivity-can assist effective implementation of Strength-based Practice and agency services within tribal courts and the many other helping agencies that serve AI/AN populations. We seek to expand practice knowledge by reviewing the benefits that this software and Internet connectivity can offer to agency operations and exploring how they can assist case management services.

Effectiveness of community-based mangrove management for sustainable resource use and livelihood support

NARCIS (Netherlands)

Damastuti, Ekaningrum; Groot, de Dolf

2017-01-01

Community-Based Mangrove Management (CBMM) is implemented with different approaches and outcomes. This study examined the effectiveness of various CBMM practices to achieve sustainable management of mangrove resources. We analyzed local mangrove resource management strategies in four coastal

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.

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

Science.gov (United States)

Prendergast, Michael; Cartier, Jerome J

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

A Model of Solid Waste Management Based Multilateral Co-Operation in Semi-Urban Community

Science.gov (United States)

Kanchanabhandhu, Chanchai; Woraphong, Seree

2016-01-01

The purpose of this research was to construct a model of solid waste management based on multilateral cooperation in semi-urban community. Its specific objectives were to 1) study the solid waste situation and involvement of community in the solid waste management in Wangtaku Sub-district, Muang District, Nakhon Pathom Province; 2) construct a…

Getting better at chronic care in remote communities: study protocol for a pragmatic cluster randomised controlled of community based management

Directory of Open Access Journals (Sweden)

Schmidt Barbara

2012-11-01

Full Text Available Abstract Background 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. Methods/design 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

Case management: developing practice through action research.

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Smith, Annetta; Mackay, Seonaid; McCulloch, Kathleen

2013-09-01

This article is a report of an action research study carried out with community nurses to help develop case management within their practice. Using action research principles, nurses reviewed and analysed their current practice and developed recommendations for further embedding case management as a means of supporting patients with complex care needs in their own homes. Findings indicate that a number of factors can influence the community nurse's ability to implement case management. These factors include approaches to case finding, availability of resources and interprofessional working. Important considerations for nurses were the influence of the context of care, the geographical location and the health needs of the local patient population, which meant that case management may need to be adapted to meet local circumstances.

Case Management Directors

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Bankston White, Cheri; Birmingham, Jackie

2015-01-01

Purpose and Objectives: Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the “moving parts” of such a complex role. This is Part 2 of a two-part article written for case management directors, particularly new ones. Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes. This article attempts to answer the following questions: Are case management directors prepared for an expanded role that affects departments and organizations outside of their own?How does a case management director manage the transition of care of patients while managing required relationships outside the department?How does the director manage program outcomes in such a complex department? Primary Practice Setting: The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Findings/Conclusions: Part 1 found that case management directors would benefit from further research and documentation of “best practices” related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations

Emerging issues on the sustainability of the community based rural water resources management approach in Zimbabwe: A case study of Gwanda District

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Thulani Dube

2012-12-01

Full Text Available Although there is considerable on-going debate about the suitability and sustainability of community based water resources management (CBWRM in Africa as a water provision strategy, evidence shows that this approach has gone a long way in promoting access to clean water amongst rural African communities. CBWRM provides an alternative approach to water provision for rural communities. This paper examines how the strategy has been operationalised in Gwanda District in Zimbabwe. The paper examines the experiences of rural communities in using CBWRM. Data was collected using focus group discussions, key informant in-depth interviews and a survey of 685 households in Gwanda district across five wards. The findings of this study are that 67% of the surveyed rural communities in Gwanda depended on community managed water resources mostly in the form of boreholes and protected wells. High rates of nun-functional sources were reported at 60-70% in most wards. Several system weaknesses were noted in the current CBWRM set-up including a depletion of committee memberships, inadequate community resources, limited agency and government support. This paper makes several recommendations on strengthening the capacity of CBWRM in Zimbabwe and Africa.

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

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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...

Enhancing voluntary participation in community collaborative forest management: a case of Central Java, Indonesia.

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Lestari, Sri; Kotani, Koji; Kakinaka, Makoto

2015-03-01

This paper examines voluntary participation in community forest management, and characterizes how more participation may be induced. We implemented a survey of 571 respondents and conducted a case study in Central Java, Indonesia. The study's novelty lies in categorizing the degrees of participation into three levels and in identifying how socio-economic factors affect people's participation at each level. The analysis finds that voluntary participation responds to key determinants, such as education and income, in a different direction, depending on each of the three levels. However, the publicly organized programs, such as information provision of benefit sharing, are effective, irrespective of the levels of participation. Overall, the results suggest a possibility of further success and corrective measures to enhance the participation in community forest management. Copyright © 2014 Elsevier Ltd. All rights reserved.

Organizing and delivering case management services: lessons from the National Long Term Care Channeling Demonstration.

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Christianson, J B; Applebaum, R; Carcagno, G; Phillips, B

1988-01-01

This article discusses issues relating to the design and internal administration of a case-management agency for community based home care for the elderly. Included in the article are issues relating to screening procedures, assessment and case management activities, cost controls, automated management information systems, and personnel matters. The analysis is based on the experience of the National Long Term Care Demonstration ("Channeling") which established and evaluated ten case management projects nationwide under federal funding.

Building Trust in Natural Resource Management Within Local Communities: A Case Study of the Midewin National Tallgrass Prairie

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Davenport, Mae A.; Leahy, Jessica E.; Anderson, Dorothy H.; Jakes, Pamela J.

2007-03-01

Communities neighboring federally protected natural areas regularly weigh the costs and benefits of the administering agency’s programs and policies. While most agencies integrate public opinion into decision making, efforts to standardize and formalize public involvement have left many local communities feeling marginalized, spurring acrimony and opposition. A significant body of research has examined barriers to effective public participation as well as strategies for relationship building in planning processes; many of which point to trust as a key factor. Trust is especially tenuous in local communities. This paper explores perceptions of trust, expectations for management, as well as constraints to building trust. In-depth interviews were conducted with 21 community members and USDA Forest Service personnel at the Midewin National Tallgrass Prairie in northeastern Illinois. The interviews revealed that trust is perceived as important to effective management. Distinct expectations for management outcomes and processes emerged, including the values, knowledge, and capacity demonstrated in management decisions and actions and opportunities provided for communication, collaboration, and cooperation within the agency-community relationship. The case study identified several constraints to building trust, including competing values, knowledge gaps, limited community engagement, and staff turnover.

Health worker perceptions of integrating mobile phones into community case management of malaria in Saraya, Senegal.

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Blanas, Demetri A; Ndiaye, Youssoupha; MacFarlane, Matthew; Manga, Isaac; Siddiqui, Ammar; Velez, Olivia; Kanter, Andrew S; Nichols, Kim; Hennig, Nils

2015-05-01

Although community case management of malaria increases access to life-saving care in isolated settings, it contends with many logistical challenges. Mobile phone health information technology may present an opportunity to address a number of these barriers. Using the wireless adaptation of the technology acceptance model, this study assessed availability, ease of use, usefulness, and job relevance of mobile phones by health workers in Saraya, Senegal. This study conducted seven key informant interviews with government health workers, and three focus groups and 76 surveys with lay health workers. Principal findings included that mobile phones are already widely available and used, and that participants valued using phones to address training, stock management, programme reporting, and transportation challenges. By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Lack of cross-scale linkages reduces robustness of community-based fisheries management.

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Richard Cudney-Bueno

Full Text Available Community-based management and the establishment of marine reserves have been advocated worldwide as means to overcome overexploitation of fisheries. Yet, researchers and managers are divided regarding the effectiveness of these measures. The "tragedy of the commons" model is often accepted as a universal paradigm, which assumes that unless managed by the State or privatized, common-pool resources are inevitably overexploited due to conflicts between the self-interest of individuals and the goals of a group as a whole. Under this paradigm, the emergence and maintenance of effective community-based efforts that include cooperative risky decisions as the establishment of marine reserves could not occur. In this paper, we question these assumptions and show that outcomes of commons dilemmas can be complex and scale-dependent. We studied the evolution and effectiveness of a community-based management effort to establish, monitor, and enforce a marine reserve network in the Gulf of California, Mexico. Our findings build on social and ecological research before (1997-2001, during (2002 and after (2003-2004 the establishment of marine reserves, which included participant observation in >100 fishing trips and meetings, interviews, as well as fishery dependent and independent monitoring. We found that locally crafted and enforced harvesting rules led to a rapid increase in resource abundance. Nevertheless, news about this increase spread quickly at a regional scale, resulting in poaching from outsiders and a subsequent rapid cascading effect on fishing resources and locally-designed rule compliance. We show that cooperation for management of common-pool fisheries, in which marine reserves form a core component of the system, can emerge, evolve rapidly, and be effective at a local scale even in recently organized fisheries. Stakeholder participation in monitoring, where there is a rapid feedback of the systems response, can play a key role in reinforcing

[Case management process identified from experience of nurse case managers].

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Park, Eun-Jun; Kim, Chunmi

2008-12-01

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

Costing commodity and human resource needs for integrated community case management in thie differing community health strategies of Ethiopia, Kenya and Zambia.

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Nefdt, Rory; Ribaira, Eric; Diallo, Khassoum

2014-10-01

To ensure correct and appropriate funding is available, there is a need to estimate resource needs for improved planning and implementation of integrated Community Case Management (iCCM). To compare and estimate costs for commodity and human resource needs for iCCM, based on treatment coverage rates, bottlenecks and national targets in Ethiopia, Kenya and Zambia from 2014 to 2016. Resource needs were estimated using Ministry of Health (MoH) targets fronm 2014 to 2016 for implementation of case management of pneumonia, diarrhea and malaria through iCCM based on epidemiological, demographic, economic, intervention coverage and other health system parameters. Bottleneck analysis adjusted cost estimates against system barriers. Ethiopia, Kenya and Zambia were chosen to compare differences in iCCM costs in different programmatic implementation landscapes. Coverage treatment rates through iCCM are lowest in Ethiopia, followed by Kenya and Zambia, but Ethiopia had the greatest increases between 2009 and 2012. Deployment of health extension workers (HEWs) in Ethiopia is more advanced compared to Kenya and Zambia, which have fewer equivalent cadres (called commu- nity health workers (CHWs)) covering a smaller proportion of the population. Between 2014 and 2016, the propor- tion of treatments through iCCM compared to health centres are set to increase from 30% to 81% in Ethiopia, 1% to 18% in Kenya and 3% to 22% in Zambia. The total estimated cost of iCCM for these three years are USD 75,531,376 for Ethiopia, USD 19,839,780 for Kenya and USD 33,667,742 for Zambia. Projected per capita expen- diture for 2016 is USD 0.28 for Ethiopia, USD 0.20 in Kenya and USD 0.98 in Zambia. Commodity costs for pneumonia and diarrhea were a small fraction of the total iCCM budget for all three countries (less than 3%), while around 80% of the costs related to human resources. Analysis of coverage, demography and epidemiology data improves estimates of fimding requirements for iCCM. Bottleneck

Patients' experiences of a multidisciplinary team-led community case management programme: a qualitative study.

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Gowing, Alice; Dickinson, Claire; Gorman, Tom; Robinson, Louise; Duncan, Rachel

2016-09-09

To explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patients through care planning and regular reviews using primary, community, secondary and social care professionals. A qualitative study using semistructured interviews, which were digitally recorded, transcribed and subject to thematic analysis. Community patients receiving primary care in the county of Northumberland, England. 23 participants took part, of which 16 were patients enrolled on the NHRPP, and 7 carers. GP practices were selected purposively by size, deprivation and location, and patients identified and invited by General Practitioners to participate. 4 main themes emerged from the data: awareness and understanding of the NHRPP, confidence in the primary healthcare team, limitations of home care and the active role of being a patient. Despite having a low level of awareness of the details of the NHRPP, participants did think that its broad aim made sense. Participants discussed their high level of satisfaction with their care and access to team members. However, some limitations of alternatives to hospital care were identified, including the need to consider psychological as well as medical needs, the importance of overnight care and the needs of those without informal carers. Finally, participants discussed the active nature of being a patient under the NHRPP if they were to contribute fully to planning and managing their own care. This study has identified that a programme of MDT-led case management was generally very well received by patients and their families. However, a number of factors were identified that could improve the implementation of the programme and further research needs to be undertaken to address these. Published by the BMJ

Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

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King, Robert

2009-05-01

In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

Occupational therapy consultation for case managers in community mental health: exploring strategies to improve job satisfaction and self-efficacy.

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Chapleau, Ann; Seroczynski, A D; Meyers, Susan; Lamb, Kristen; Haynes, Susan

2011-01-01

The purpose of this study was 2-fold: (1) to examine to what extent case managers' job satisfaction and self-efficacy were impacted by the addition of an occupational therapy consultation model and (2) to identify factors that both positively and negatively impacted the occupational therapy consultation services. The study was conducted at a mental health community support program in a local homeless center. In a 2-year study, a mixed-methods design was used to study changes over time in job satisfaction and perceived self-efficacy among 14 case managers who received ongoing occupational therapy consultation. Job satisfaction and self-efficacy data were obtained using standardized questionnaires. Qualitative data related to factors impacting the consultation program were obtained using open-ended written questions, focus groups, and individual interviews. Statistically significant differences in job satisfaction and perceptions of self-efficacy were found 18 months into the study, when case managers were more actively seeking occupational therapy consultation services and were reporting improved client outcomes from occupational therapy intervention. In addition, themes related to both positive and negative factors impacting the occupational therapy consultation program were identified and provided useful data for development of future consultation services. IMPLICATION FOR CASE MANAGEMENT PRACTICE: Results suggest that ongoing training and professional support for case managers who are paraprofessionals and/or new to mental health practice may improve job satisfaction and efficacy. Occupational therapy consultation may be helpful in developing services for health promotion, including self-care management, cognitive assessments, activity-based programming, and home safety evaluation and modification. In addition, new graduates and paraprofessional case managers working with clients who are high utilizers of services may benefit from smaller caseloads and support

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

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

2013-11-01

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

The Place of Community-Based Learning in Higher Education: A Case Study of Interchange

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Hardwick, Louise

2013-01-01

This article focuses on one strand of community engagement: community-based learning for students. It considers in particular Interchange as a case study. Interchange is a registered charity based in, but independent of, a department in a Higher Education Institution. It brokers between undergraduate research/work projects and Voluntary Community…

Policy challenges facing integrated community case management in Sub-Saharan Africa.

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Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

2014-07-01

To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Invited spaces and informal practices in participatory community forest management in India

NARCIS (Netherlands)

Nandigama, S.

2013-01-01

This chapter shows how the formal participation of men and women in a community-based forest management project shapes and is shaped by informal practices. The gender analysis is based on an ethnographic case study of a village in Andhra Pradesh, India. It aims to contribute to a better

Evaluation of mangrove management through community-based silvofishery in North Sumatra, Indonesia

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Basyuni, M.; Yani, P.; Hartini, K. S.

2018-02-01

Aquaculture expansion has been reported as the primary driver of mangrove loss and a significant cause of mangrove deforestation in North Sumatra, Indonesia. Development of silvofishery based on creating balance condition between conserving mangrove forest and offering better livelihood for local communities surrounding mangrove. The present study evaluates of mangrove management through community-based silvofishery in three villages, namely Paluh Manan, Paluh Kurau, and Lama, Hamparan Perak of Deli Serdang Regency, North Sumatra, Indonesia. Three communities used the same ecological type-silvofishery, characterized by planted mangrove surrounded aquaculture. Results showed that in the Paluh Manan village, planted mangrove and aquaculture in the ratio of 75:25 with planting distance of mangrove 50x50 cm, containing 2,500 trees/ha, resulted in US 36.2/month/ha of fish and shrimp farming. In the Paluh Kurau village, a mixture mangrove and aquaculture in an 84:16 ratio, planting distance of 1x1 m, consists of 1,600 trees/ha, US 23.8 of generating revenue from crab farming. Furthermore, in the third village, Lama village, consists of mangrove and aquaculture in the proportions 90:10, with planting spacing 2x2 m, composing 1,000 trees/ha, led to US 45.8/month/ha from fish, shrimp and crab farming. The present study suggested the mangrove management through community-based mangrove-friendly aquaculture.

Community involvement works where enforcement fails: conservation success through community-based management of Amazon river turtle nests

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Darren Norris

2018-06-01

Full Text Available Law enforcement is widely regarded as a cornerstone to effective natural resource management. Practical guidelines for the optimal use of enforcement measures are lacking particularly in areas protected under sustainable and/or mixed use management regimes and where legal institution are weak. Focusing on the yellow-spotted river turtles (Podocnemis unifilis along 33 km of river that runs between two sustainable–use reserves in the Brazilian Amazon as an illustrative example, we show that two years of patrols to enforce lawful protection regulations had no effect on nest harvesting. In contrast, during one year when community-based management approaches were enacted harvest levels dropped nearly threefold to a rate (26% that is likely sufficient for river turtle population recovery. Our findings support previous studies that show how community participation, if appropriately implemented, can facilitate effective natural resource management where law enforcement is limited or ineffective.

Community-based peer-led diabetes self-management: a randomized trial.

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Lorig, Kate; Ritter, Philip L; Villa, Frank J; Armas, Jean

2009-01-01

The purpose of this study is to determine the effectiveness of a community-based diabetes self-management program comparing treatment participants to a randomized usual-care control group at 6 months. A total of 345 adults with type 2 diabetes but no criteria for high A1C were randomized to a usual-care control group or 6-week community-based, peer-led diabetes self-management program (DSMP). Randomized participants were compared at 6 months. The DSMP intervention participants were followed for an additional 6 months (12 months total). A1C and body mass index were measured at baseline, 6 months, and 12 months. All other data were collected by self-administered questionnaires. At 6 months, DSMP participants did not demonstrate improvements in A1C as compared with controls. Baseline A1C was much lower than in similar trials. Participants did have significant improvements in depression, symptoms of hypoglycemia, communication with physicians, healthy eating, and reading food labels (P < .01). They also had significant improvements in patient activation and self-efficacy. At 12 months, DSMP intervention participants continued to demonstrate improvements in depression, communication with physicians, healthy eating, patient activation, and self-efficacy (P < .01). There were no significant changes in utilization measures. These findings suggest that people with diabetes without elevated A1C can benefit from a community-based, peer-led diabetes program. Given the large number of people with diabetes and lack of low-cost diabetes education, the DSMP deserves consideration for implementation.

Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

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Ogwang Simon

2012-03-01

sensitization by empowered community based resource persons rather than health workers and improvement in quality of health care can contribute towards effective management of obstetric complications.

Local knowledge: Empirical Fact to Develop Community Based Disaster Risk Management Concept for Community Resilience at Mangkang Kulon Village, Semarang City

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Kapiarsa, A. B.; Sariffuddin, S.

2018-02-01

Local knowledge in disaster management should not be neglected in developing community resilience. The circular relation between humans and their living habitat and community social relation have developed the local knowledge namely specialized knowledge, shared knowledge, and common knowledge. Its correlation with community-based disaster management has become an important discussion specially to answer can local knowledge underlie community-based disaster risk reduction concept development? To answer this question, this research used mix-method. Interview and crosstab method for 73 respondents with 90% trust rate were used to determine the correlation between local knowledge and community characteristics. This research found out that shared knowledge dominated community local knowledge (77%). While common knowledge and specialized knowledge were sequentially 8% and 15%. The high score of shared value (77%) indicated that local knowledge was occurred in household level and not yet indicated in community level. Shared knowledge was found in 3 phases of the resilient community in dealing with disaster, namely mitigation, emergency response, and recovery phase. This research, therefore, has opened a new scientific discussion on the self-help concept in community-help concept in CBDRM concept development in Indonesia.

A framework of lessons learned from community-based marine reserves and its effectiveness in guiding a new coastal management initiative in the Philippines.

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Beger, Maria; Harborne, Alastair R; Dacles, Terence P; Solandt, Jean-Luc; Ledesma, Gerardo L

2004-12-01

Community-based coastal resource management has been widely applied within the Philippines. However, small-scale community-based reserves are often inefficient owing to management inadequacies arising because of a lack of local support or enforcement or poor design. Because there are many potential pitfalls during the establishment of even small community-based reserves, it is important for coastal managers, communities, and facilitating institutions to have access to a summary of the key factors for success. Reviewing relevant literature, we present a framework of "lessons learned" during the establishment of protected areas, mainly in the Philippines. The framework contains summary guidance on the importance of (1) an island location, (2) small community population size, (3) minimal effect of land-based development, (4) application of a bottom-up approach, (5) an external facilitating institution, (6) acquisition of title, (7) use of a scientific information database, (8) stakeholder involvement, (9) the establishment of legislation, (10) community empowerment, (11) alternative livelihood schemes, (12) surveillance, (13) tangible management results, (14) continued involvement of external groups after reserve establishment, and (15) small-scale project expansion.These framework components guided the establishment of a community-based protected area at Danjugan Island, Negros Occidental, Philippines. This case study showed that the framework was a useful guide that led to establishing and implementing a community-based marine reserve. Evaluation of the reserve using standard criteria developed for the Philippines shows that the Danjugan Island protected area can be considered successful and sustainable. At Danjugan Island, all of the lessons synthesized in the framework were important and should be considered elsewhere, even for relatively small projects. As shown in previous projects in the Philippines, local involvement and stewardship of the protected area

Case-based Influence in Conflict Management

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2014-10-31

AFRL-OSR-VA-TR-2014-0337 CASE-BASED INFLUENCE IN CONFLICT MANAGEMENT Robert Axelrod ARTIS RESEARCH & RISK MODELING Final Report 10/31/2014...FA9550-10-1-0373 Dr. Robert Axelrod - PI Dr. Richard Davis- PD ARTIS Research & Risk Modeling ARTIS 5741 Canyon Ridge North Cave Creek, AZ 85331-9318...analysis of the timing of cyber conflict that quickly received attention from over 30 countries. 3 1 Axelrod , Final Report and Publications Final

Planning for Community Based Tourism in a Remote Location

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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.

Community-Based Tourism - Option for Forest-Dependent Communities in 1A IUCN Protected Areas? Cameroon Case Study

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Burgin Shelley

2014-01-01

Full Text Available In developing countries, ‘exponential’ growth in IUCN protected lands has occurred in the last 25 years. Approximately 6% of protected areas are ‘Strict Nature Reserve[s]’ (1A with emphasis on conservation and strict restrictions on human access. Before Bakossi Forest Reserve (Cameroon had 1A protection, 95% of local families used the Reserve for their livelihood. They farmed cash crops, collected fire wood, timber, and food with incomes equivalent to US$35,000/annually/family. Post-protection, the Reserve’s local communities lacked support to develop alternative livelihoods, and 75% reported being intercepted illegally trespassing by Reserve guards. Without illegal activity economic impacts would have been substantially greater. Protection has also meant foregone national income from timber and coffee exports. We used Bakossi Forest Reserve as a case study to identify issues facing local communities excluded from the Reserve that traditionally provided their livelihood. We also investigated potential alternative family livelihoods based on critical evaluation of the literature. We identified ‘exceptional’ community-based tourism potential. We also found that Cameroon was the first African country to develop community-based forestry with the dual roles of conservation and poverty alleviation. Using this model, community-based tourism could be a cost-effectively initiative to deliver the same dual roles as community-based forestry.

An evaluation of a community pharmacy-based rural asthma management service.

Science.gov (United States)

Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

2008-04-01

To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.

The Imposition of Participation? The Case of Participatory Water Management in Coastal Bangladesh

Directory of Open Access Journals (Sweden)

Camelia Dewan

2014-06-01

Full Text Available Community-based Natural Resources Management (CBNRM has been promoted as part of the development discourse on sustainable natural resources management since the mid-1980s. It has influenced recent water policy in Bangladesh through the Guidelines for Participatory Water Management (GPWM where community-based organisations are to participate in the management of water resources. This paper reviews the extent of success of such participatory water management. It does so by first discussing the changing discourses of participation in Bangladesh’s water policy from social mobilisation to decentralised CBNRM. Second, Bangladesh is used as a case study to draw attention to how the creation of separate water management organisations has been unable to promote inclusive participation. It argues that the current form of decentralisation through a CBNRM framework has not resulted in its stated aims of equitable, efficient, and sustainable management of natural resources; rather it has duplicated existing local government institutions. Finally, it questions the current investments into community-based organisations and recommends that the role of local government in water management be formally recognised.

Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers.

Science.gov (United States)

Sellars, Marcus; Detering, Karen M; Silvester, William

2015-04-23

Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers. An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample. 120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service. This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.

Development of a validated clinical case definition of generalized tonic-clonic seizures for use by community-based health care providers.

Science.gov (United States)

Anand, Krishnan; Jain, Satish; Paul, Eldho; Srivastava, Achal; Sahariah, Sirazul A; Kapoor, Suresh K

2005-05-01

and 26 new non-GTCS patients recruited from hospitals from select SEAR Member Countries, in phase III, the sensitivity of this clinical case definition was 72% and specificity, 100%. A stratified analysis by gender in all the three phases did not show any differences between the sexes. Based on these criteria, we recommend that all patients with a history of two or more episodes of jerking or rigidity of limbs, having a score of > or =4 in the case definition, be identified as having GTCSs and started on antiepileptic medications. This clinical case definition can be very useful for community-based health care providers to identify and manage cases of GTCSs in the community. This should play a major role in the reduction of treatment gap for epilepsy in developing countries.

Community based physiotherapeutic exercise in COPD self-management: a randomised controlled trial.

NARCIS (Netherlands)

Effing, T.; Zielhuis, G.A.; Kerstjens, H.; Valk, P. van der; Palen, J.A.M. van der

2011-01-01

Little is known about effects of community-based physiotherapeutic exercise programmes incorporated in COPD self-management programmes. In a randomised trial, the effect of such a programme (COPE-active) on exercise capacity and various secondary outcomes including daily activity as a marker of

Community based psysiotherapeutic exercise in COPD self-management: A randomised controlled trial

NARCIS (Netherlands)

Effing, T.W.; Zielhuis, Gerhard; Kerstjens, Huib; van der Valk, Paul; van der Palen, Jacobus Adrianus Maria

2011-01-01

Little is known about effects of community-based physiotherapeutic exercise programmes incorporated in COPD self-management programmes. In a randomised trial, the effect of such a programme (COPE-active) on exercise capacity and various secondary outcomes including daily activity as a marker of

Two-year outcome of team-based intensive case management for patients with schizophrenia.

Science.gov (United States)

Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

1995-12-01

Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

Using Fishers Knowledge in Community Based Fisheries Management in the River Nun Estuary, Niger Delta

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Ngodigha Sabina

2018-02-01

Full Text Available A study of fishers’ knowledge in community based fisheries management practices in the Nun River estuary were conducted to assess the contribution of fishers’ knowledge to fisheries resources conservation. The total number of fishers that operated in the area were 390, and 221 fishers were interviewed based on a minimum of 10 years fishing experience using the socio-ecological approach. The laws introduced are banned on the use of mesh size less than five cm and banned on chemical fishing. Fishers caught using chemicals to fish were arrested and handed over to the police for prosecution. The management method has enhanced conservation of fisheries’ resources, which is a major source of livelihood for the people. It is therefore pertinent to introduce community based laws to check over exploitation of fisheries’ resources in fishing communities in the Niger Delta.

Community-based management of water supply services

CSIR Research Space (South Africa)

Mogane-Ramahotswa, B

1992-01-01

Full Text Available One of the most important aspects of suitability of water supply is the ability of the community to manage its own scheme. Unlike in urban settlement institutional arrangements for rural water supply are rudimentary. Over the past decade...

Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management

OpenAIRE

Prendergast, Michael; Cartier, Jerome J.

2008-01-01

In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post...

Adapting cognitive behavioral therapy for psychosis for case managers: increasing access to services in a community mental health agency.

Science.gov (United States)

Montesano, Vicki L; Sivec, Harry J; Munetz, Mark R; Pelton, Jeremy R; Turkington, Douglas

2014-03-01

The purpose of this article is twofold: (a) to describe the adaptation of an evidence-based practice and, (b) using a dissemination framework, to describe the process of implementing the practice at a community mental health agency. The authors describe the training concept and dissemination framework of implementing an emerging practice: high-yield cognitive behavioral techniques for psychosis, which is rooted in cognitive behavioral therapy. Thirteen case managers who represented teams from across the agency delivered the adapted practice at a community mental health agency. Implementation required buy in from all stakeholders, communication across disciplines, persistence, and flexibility. It appears that the use of a dissemination framework that is grounded in the literature, yet flexible, eases the process of implementing an adapted practice. Further research focusing on the effectiveness of this approach, along with the impact of implementing a full spectrum of cognitive behavioral therapy services for individuals with persistent psychotic symptoms, based on cognitive behavioral therapy principles, is indicated.

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

Restricted grouper reproductive migrations support community-based management

KAUST Repository

Waldie, Peter A.

2016-03-09

Conservation commonly requires trade-offs between social and ecological goals. For tropical small-scale fisheries, spatial scales of socially appropriate management are generally small—the median no-take locally managed marine area (LMMA) area throughout the Pacific is less than 1 km2. This is of particular concern for large coral reef fishes, such as many species of grouper, which migrate to aggregations to spawn. Current data suggest that the catchment areas (i.e. total area from which individuals are drawn) of such aggregations are at spatial scales that preclude effective community-based management with no-take LMMAs. We used acoustic telemetry and tag-returns to examine reproductive migrations and catchment areas of the grouper Epinephelus fuscoguttatus at a spawning aggregation in Papua New Guinea. Protection of the resultant catchment area of approximately 16 km2 using a no-take LMMA is socially untenable here and throughout much of the Pacific region. However, we found that spawning migrations were skewed towards shorter distances. Consequently, expanding the current 0.2 km2 no-take LMMA to 1–2 km2 would protect approximately 30–50% of the spawning population throughout the non-spawning season. Contrasting with current knowledge, our results demonstrate that species with moderate reproductive migrations can be managed at scales congruous with spatially restricted management tools.

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.

Building Virtual Collaborative Research Community Using Knowledge Management Approach

Directory of Open Access Journals (Sweden)

Ju-Ling Shih

2010-09-01

Full Text Available Many online communities nowadays are emphasized more on peer interactions and information sharing among members; very few online communities are built with knowledge management in nature supported by knowledge management system (KMS. This study aims to present a community of practice on how to effectively adopt a knowledge management system (KMS to neutralize a cyber collaborative learning community for a research lab in a higher education setting. A longitudinal case for 7 years was used to analyze the retention and extension of participants‟ community of practice experiences. Interviews were conducted for the comparison between experiences and theories. It was found that the transformations of tacit and explicit knowledge are in accordance with the framework of Nonaka‟s model of knowledge management from which we elicit the strategies and suggestions to the adoption and implementation of virtual collaborative research community supported by KMS.

The role of communities in sustainable land and forest management: The case of Nyanga, Zvimba and Guruve districts of Zimbabwe

Directory of Open Access Journals (Sweden)

Diego Matsvange

2016-05-01

Full Text Available Forest benefit analysis is vital in ensuring sustainable community-based natural resources management. Forest depletion and degradation are key issues in rural Zimbabwe and strategies to enhance sustainable forest management are continually sought. This study was carried out to assess the impact of forests on communities from Nyanga, Guruve and Zvimba districts of Zimbabwe. It is based on a Big Lottery Fund project implemented by Progressio-UK and Environment Africa. Itfocuses on identifying replicable community forest and landmanagement strategies and the level of benefits accruing to the community. Analysis of change was based on the Income and Food Security and Forest benefits, which also constitutes the tools used during the research. The study confirms the high rate of deforestation and the increased realisation by communities to initiate practical measures aimed at protecting and sustaining forest and land resources from which they derive economic and social benefits. The results highlight the value of community structures (Farmer Field Schools and Environmental Action Groups as conduits for natural resource management. The interconnectivity among forests, agricultural systems and the integral role of people are recognised as key to climate change adaptation. Keywords: Forest benefits; sustainability,;livelihoods; farmer field schools

Diversity in case management modalities: the Summit model.

Science.gov (United States)

Peterson, G A; Drone, I D; Munetz, M R

1997-06-01

Though ubiquitous in community mental health agencies, case management suffers from a lack of consensus regarding its definition, essential components, and appropriate application. Meaningful comparisons of various case management models await such a consensus. Global assessments of case management must be replaced by empirical studies of specific interventions with respect to the needs of specific populations. The authors describe a highly differentiated and prescriptive system of case management involving the application of more than one model of service delivery. Such a diversified and targeted system offers an opportunity to study the technology of case management in a more meaningful manner.

Environmental entitlements: Dynamics and institutions in community-based natural resource management

OpenAIRE

Leach, M.; Mearns, R.; Scoones, I.

1999-01-01

Metadata only record While community-based natural resource management (CBNRM) now attracts widespread international attention, its practical implementation frequently falls short of expectations. This paper contributes to emerging critiques by focusing on the implications of intracommunity dynamics and ecological heterogeneity. It builds a conceptual framework highlighting the central role of institutions - regularized patterns of behavior between individuals and groups in society - in me...

Stakeholders' perceptions of integrated community case management by community health workers: a post-intervention qualitative study.

Directory of Open Access Journals (Sweden)

Denise L Buchner

Full Text Available Integrated community case management (iCCM involves delivery of simple medicines to children with pneumonia, diarrhea and/or malaria by community health workers (CHWs. Between 2010 and 2012, an iCCM intervention trial was implemented by Healthy Child Uganda. This study used qualitative tools to assess whether project stakeholders perceived that iCCM improved access to care for children under five years of age.The intervention involved training and equipping 196 CHWs in 98 study villages in one sub-county in Uganda in iCCM. During the eight-month intervention, CHWs assessed sick children, provided antimalarials (coartem for fever, antibiotics (amoxicillin for cough and fast breathing, oral rehydration salts/zinc for diarrhea, and referred very sick children to health facilities. In order to examine community perceptions and acceptability of iCCM, post-intervention focus groups and key respondent interviews involving caregivers, health workers, CHWs and local leaders were carried out by experienced facilitators using semi-structured interview guides. Data were analyzed using thematic analysis techniques.Respondents reported increased access to health care for children as a result of iCCM. Access was reportedly closer to home, available more hours in a day, and the availability of CHWs was perceived as more reliable. CHW care was reported to be trustworthy and caring. Families reported saving money especially due to reduced transportation costs, and less time away from home. Respondents also perceived better health outcomes. Linkages between health facilities and communities were reportedly improved by the iCCM intervention due to the presence of trained CHWs in the community.iCCM delivered by CHWs may improve access to health care and is acceptable to families. Policymakers should continue to seek opportunities to implement and support iCCM, particularly in remote communities where there are health worker shortages.

Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study.

Science.gov (United States)

Greenhalgh, Trisha; Jackson, Claire; Shaw, Sara; Janamian, Tina

2016-06-01

Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-is an increasingly popular approach to aligning research and service development. It has potential for "moving beyond the ivory towers" to deliver significant societal impact via dynamic, locally adaptive community-academic partnerships. Principles of successful co-creation include a systems perspective, a creative approach to research focused on improving human experience, and careful attention to governance and process. If these principles are not followed, co-creation efforts may fail. Co-creation-collaborative knowledge generation by academics working alongside other stakeholders-reflects a "Mode 2" relationship (knowledge production rather than knowledge translation) between universities and society. Co-creation is widely believed to increase research impact. We undertook a narrative review of different models of co-creation relevant to community-based health services. We contrasted their diverse disciplinary roots and highlighted their common philosophical assumptions, principles of success, and explanations for failures. We applied these to an empirical case study of a community-based research-service partnership led by the Centre of Research Excellence in Quality and Safety in Integrated Primary-Secondary Care at the University of Queensland, Australia. Co-creation emerged independently in several fields, including business studies ("value co-creation"), design science ("experience-based co-design"), computer science ("technology co-design"), and community development ("participatory research"). These diverse models share some common features, which were also evident in the case study. Key success principles included (1) a systems perspective (assuming emergence, local adaptation, and nonlinearity); (2) the framing of research as a creative enterprise with human experience at its core; and (3) an emphasis on process (the framing of the program, the nature of

Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

Science.gov (United States)

Gao, Xing; He, Yao; Hu, Hongpu

2017-01-01

Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

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.

Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps.

Science.gov (United States)

Awor, Phyllis; Miller, Jane; Peterson, Stefan

2014-12-01

Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community-acquired malaria, pneumonia or diarrhoea. We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were "malaria", "pneumonia", "diarrhoea", "private sector" and "community case management". A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM-related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM-related studies in the public sector directly reported on community case management of 2 or more of the illnesses. While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non-malaria-associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs.

Quality and safety of integrated community case management of malaria using rapid diagnostic tests and pneumonia by community health workers.

Science.gov (United States)

Hamer, Davidson H; Brooks, Erin Twohig; Semrau, Katherine; Pilingana, Portipher; MacLeod, William B; Siazeele, Kazungu; Sabin, Lora L; Thea, Donald M; Yeboah-Antwi, Kojo

2012-03-01

To assess the quality and safety of having community health workers (CHWs) in rural Zambia use rapid diagnostic tests (RDTs) and provide integrated management of malaria and pneumonia. In the context of a cluster-randomized controlled trial of two models for community-based management of malaria and/or non-severe pneumonia in children under 5 years old, CHWs in the intervention arm were trained to use RDTs, follow a simple algorithm for classification and treat malaria with artemether-lumefantrine (AL) and pneumonia with amoxicillin. CHW records were reviewed to assess the ability of the CHWs to appropriately classify and treat malaria and pneumonia, and account for supplies. Patients were also followed up to assess treatment safety. During the 12-month study, the CHWs evaluated 1017 children with fever and/or fast/difficult breathing and performed 975 RDTs. Malaria and/or pneumonia were appropriately classified 94-100% of the time. Treatment based on disease classification was correct in 94-100% of episodes. Supply management was excellent with over 98% of RDTs, amoxicillin, and AL properly accounted for. The use of RDTs, amoxicillin, and AL was associated with few minor adverse events. Most febrile children (90%) with negative RDT results recovered after being treated with an antipyretic alone. Volunteer CHWs in rural Zambia are capable of providing integrated management of malaria and pneumonia to children safely and at high quality.

Data management for community research projects: A JGOFS case study

Science.gov (United States)

Lowry, Roy K.

1992-01-01

Since the mid 1980s, much of the marine science research effort in the United Kingdom has been focused into large scale collaborative projects involving public sector laboratories and university departments, termed Community Research Projects. Two of these, the Biogeochemical Ocean Flux Study (BOFS) and the North Sea Project incorporated large scale data collection to underpin multidisciplinary modeling efforts. The challenge of providing project data sets to support the science was met by a small team within the British Oceanographic Data Centre (BODC) operating as a topical data center. The role of the data center was to both work up the data from the ship's sensors and to combine these data with sample measurements into online databases. The working up of the data was achieved by a unique symbiosis between data center staff and project scientists. The project management, programming and data processing skills of the data center were combined with the oceanographic experience of the project communities to develop a system which has produced quality controlled, calibrated data sets from 49 research cruises in 3.5 years of operation. The data center resources required to achieve this were modest and far outweighed by the time liberated in the scientific community by the removal of the data processing burden. Two online project databases have been assembled containing a very high proportion of the data collected. As these are under the control of BODC their long term availability as part of the UK national data archive is assured. The success of the topical data center model for UK Community Research Project data management has been founded upon the strong working relationships forged between the data center and project scientists. These can only be established by frequent personal contact and hence the relatively small size of the UK has been a critical factor. However, projects covering a larger, even international scale could be successfully supported by a

Towards eliminating malaria in high endemic countries: the roles of community health workers and related cadres and their challenges in integrated community case management for malaria: a systematic review.

Science.gov (United States)

Sunguya, Bruno F; Mlunde, Linda B; Ayer, Rakesh; Jimba, Masamine

2017-01-03

Human resource for health crisis has impaired global efforts against malaria in highly endemic countries. To address this, the World Health Organization (WHO) recommended scaling-up of community health workers (CHWs) and related cadres owing to their documented success in malaria and other disease prevention and management. Evidence is inconsistent on the roles and challenges they encounter in malaria interventions. This systematic review aims to summarize evidence on roles and challenges of CHWs and related cadres in integrated community case management for malaria (iCCM). This systematic review retrieved evidence from PubMed, CINAHL, ISI Web of Knowledge, and WHO regional databases. Terms extracted from the Boolean phrase used for PubMed were also used in other databases. The review included studies with Randomized Control Trial, Quasi-experimental, Pre-post interventional, Longitudinal and cohort, Cross-sectional, Case study, and Secondary data analysis. Because of heterogeneity, only narrative synthesis was conducted for this review. A total of 66 articles were eligible for analysis out of 1380 studies retrieved. CHWs and related cadre roles in malaria interventions included: malaria case management, prevention including health surveillance and health promotion specific to malaria. Despite their documented success, CHWs and related cadres succumb to health system challenges. These are poor and unsustainable finance for iCCM, workforce related challenges, lack of and unsustainable supply of medicines and diagnostics, lack of information and research, service delivery and leadership challenges. Community health workers and related cadres had important preventive, case management and promotive roles in malaria interventions. To enable their effective integration into the health systems, the identified challenges should be addressed. They include: introducing sustainable financing on iCCM programmes, tailoring their training to address the identified gaps

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 ...

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

Science.gov (United States)

Jelly, Isaya; Peters, Micah D J

2017-12-01

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

Community-based home-care program for the management of pre-eclampsia: an alternative.

OpenAIRE

Helewa, M; Heaman, M; Robinson, M A; Thompson, L

1993-01-01

OBJECTIVE: To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia. DESIGN: A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989. SETTING: St. Boniface General Hospital, Winnipeg. PATIENTS: Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program. INTERVENTION...

Leveraging Small-Scale Sport Events: Challenges of Organising, Delivering and Managing Sustainable Outcomes in Rural Communities, the Case of Gorski kotar, Croatia

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Marko Perić

2016-12-01

Full Text Available Sports and events play an important role in local identity building and creating a sense of community that encourages participation and increases social capital. Rural communities are specific areas with special needs and can face challenges and restraints when it comes to event organisation. The purpose of this paper is to identify organisational challenges and analyse the potential to achieving long-term sustainable social and economic outcomes linked to small-scale sports events in rural communities. Organisational challenges of rural communities in terms of organising sport events are examined and discussed using the framework of event leveraging developed by O’Brien and Chalip. This methodology is applied and discussed to a case study focusing on small-scale winter sport events in rural Croatia. Semi-structured interviews with local organisers were conducted in order to collect data on the overall event organisation and management, local coordination, role of community stakeholders and challenges facing strategic planning, with the intent to identify objectives for future events. Results were discussed independently and in the context of the leverage framework, with reflection on its applicability to rural communities as the event organisers. Recommendations are provided based on critical insight from the literature and are oriented on how to streamline the process of organising, delivering and managing of events in remote rural communities. Finally, the idea of inter-community organisation is proposed to ensure long-term social and economic benefits and to address the existing issues of overlapping of stakeholder categories, mixed objectives, distrust among stakeholders and inefficiently used local resources.

Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality: An application of Equitable Impact Sensitive Tool (EQUIST) in five low- and middle-income countries.

Science.gov (United States)

Waters, Donald; Theodoratou, Evropi; Campbell, Harry; Rudan, Igor; Chopra, Mickey

2012-12-01

The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost-effectiveness of community case management of childhood pneumonia in 5 low- and middle-income countries with relation to equity impact. Wealth quintile-specific data were gathered or modelled for all contributory determinants of the EQUIST framework, namely: under-five mortality rate, cost of intervention, intervention effectiveness, current coverage of intervention and relative disease distribution. These were then combined statistically to calculate the final outcome of the EQUIST model for community case management of childhood pneumonia: US$ per life saved, in several different approaches to scaling-up. The current 'mainstream' approach to scaling-up of interventions is never the most cost-effective. Community-case management appears to strongly support an 'equity-promoting' approach to scaling-up, displaying the highest levels of cost-effectiveness in interventions targeted at the poorest quintile of each study country, although absolute cost differences vary by context. The relationship between cost-effectiveness and equity impact is complex, with many determinants to consider. One important way to increase intervention cost-effectiveness in poorer quintiles is to improve the efficiency and quality of delivery. More data are needed in all areas to increase the accuracy of EQUIST-based estimates.

Community-Based Progressive Aquatic Exercise for the Management of Knee Osteoarthritis

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Dayle Maryanna Masslon

2016-10-01

Full Text Available Background We examined the feasibility and effectiveness of a community-based progressive aquatic exercise program for community dwelling older adults, with moderate to severe knee osteoarthritis (OA. Objectives The purposes of this study were to 1, assess the effects of a progressive aquatic exercise program on the walking ability, stair climbing ability, quadriceps muscle strength, as well as self-reported symptoms, function, and quality of life in community dwelling adults with moderate to severe knee OA and; 2, assess the feasibility of a community-based aquatic program for community dwelling adults with knee OA. Methods Seventeen volunteers (12 women (x = 61.1 years and 5 men (x = 69.0 years participated in a progressive 8 - 10 week aquatic exercise program, consisting of 20 - 24, 1-hour sessions. Outcome measures, acquired twice before beginning the exercise protocol as well as after 4 and 8 weeks of exercise, included the Knee Injury and Osteoarthritis outcome score (KOOS instrument, a 2 minute walk test (2MWT, a 10 step stair climb for time, and an isometric knee extension strength assessment. Results Significant improvements were detected in 2 MWT, 10 step stair climb, right quadriceps isometric force development, and the KOOS symptoms and stiffness subscale. Significant improvement was found on KOOS function subscales between baseline testing sessions and maintained at follow-up. Non-significant improvements were identified in left quadriceps isometric force development, KOOS pain, and KOOS quality of life. Conclusions These data suggest that a community-based, progressive aquatic exercise program is feasible and results in measurable improvements in function without worsening symptoms. Further study is warranted to investigate the impact of a longer program and the role of aquatic exercise in the long-term management of patients with knee OA.

Optimizing community-level surveillance data for pediatric asthma management

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Wande O. Benka-Coker

2018-06-01

Full Text Available Community-level approaches for pediatric asthma management rely on locally collected information derived primarily from two sources: claims records and school-based surveys. We combined claims and school-based surveillance data, and examined the asthma-related risk patterns among adolescent students.Symptom data collected from school-based asthma surveys conducted in Oakland, CA were used for case identification and determination of severity levels for students (high and low. Survey data were matched to Medicaid claims data for all asthma-related health care encounters for the year prior to the survey. We then employed recursive partitioning to develop classification trees that identified patterns of demographics and healthcare utilization associated with severity.A total of 561 students had complete matched data; 86.1% were classified as high-severity, and 13.9% as low-severity asthma. The classification tree consisted of eight subsets: three indicating high severity and five indicating low severity. The risk subsets highlighted varying combinations of non-specific demographic and socioeconomic predictors of asthma prevalence, morbidity and severity. For example, the subset with the highest class-prior probability (92.1% predicted high-severity asthma and consisted of students without prescribed rescue medication, but with at least one in-clinic nebulizer treatment. The predictive accuracy of the tree-based model was approximately 66.7%, with an estimated 91.1% of high-severity cases and 42.3% of low-severity cases correctly predicted.Our analysis draws on the strengths of two complementary datasets to provide community-level information on children with asthma, and demonstrates the utility of recursive partitioning methods to explore a combination of features that convey asthma severity. Keywords: Asthma, Classification, Risk stratification, Statistical data analysis, Disease management

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

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

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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.

Traditions and Management Perspectives of Community and Non-Profit Organizations in Lithuania

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Andrius Stasiukynas

2015-02-01

Full Text Available Purpose – To overview the traditions and management perspectives of community and non-profit organizations in Lithuania.Methodology – For the purpose of this research a literature analysis on community and non-profit organization case studies was conducted. The case studies describing stories of success were singled out and leaders of these organizations were interviewed.Findings – The research has showed the growth of the number of community and nonprofit organizations during the last twenty years and the difficulties of collecting the statistical data. This study presupposes the possibility to identify the tendencies of management in community and non-profit organizations, including the following: increasing use of the social networks for communication; proliferation of strategic planning; greater emphasis on educating and empowering new generation of leaders.Research implications – Prior studies in this area in Lithuania have not exhaustively analyzed the components of human resource management of non-profit organizations. An important follow up on this study would be to analyze the human resource management in community organizations.Practical implications – This study covered the management aspects important for the improvement of how community and non-profit organizations work.Originality/Value – This study expands the knowledge on Lithuanian community and non-profit organization development and management.Research type – literature review, research paper.

Effectiveness of community-based mangrove management for sustainable resource use and livelihood support: A case study of four villages in Central Java, Indonesia.

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Damastuti, Ekaningrum; de Groot, Rudolf

2017-12-01

Community-Based Mangrove Management (CBMM) is implemented with different approaches and outcomes. This study examined the effectiveness of various CBMM practices to achieve sustainable management of mangrove resources. We analyzed local mangrove resource management strategies in four coastal villages (e.g. Sriwulan, Bedono, Timbulsloko, and Surodadi) on Central Java, Indonesia. Local data on institutions, socio-economic conditions and mangrove resources utilization was collected through participatory resource mapping and interviews with 16 key actors and 500 households. The main differences in CBMM-practices that affect the outcomes in each village were the type of community participation, the level of organizational and economic assistance from external institutions, the magnitude of the rehabilitation project, the time selected for rehabilitation and the maintenance strategies applied in each village. Surodadi achieved most in terms of both efficient resource utilization and local livelihood improvement. Bedono's management strategy was most effective in extending and maintaining the rehabilitated mangrove areas but less in terms of livelihood support while the strategy applied in Timbulsloko resulted in higher resource utilization compared to Surodadi. Sriwulan failed on most criteria. This study suggests that combining the management strategies practiced in Bedono and Surodadi and adding external scientific and technological assistance, income diversification, institutional reinforcement and continuous monitoring of the functioning of local institutions can improve the CBMM performance to sustainably manage mangrove resources and improve livelihoods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Community-based asthma care: trial of a "credit card" asthma self-management plan.

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D'Souza, W; Crane, J; Burgess, C; Te Karu, H; Fox, C; Harper, M; Robson, B; Howden-Chapman, P; Crossland, L; Woodman, K

1994-07-01

Although asthma self-management plans are widely recommended as essential in the long-term treatment of adult asthma, there have been few studies examining their use. Our objective was to assess the effect of a "credit card" adult asthma self-management plan in a community experiencing major health problems from asthma, by means of a before and after intervention trial of the efficacy of the "credit card" plan, when introduced through community-based asthma clinics. The participants were 69 Maori people with asthma. The "credit card" plan consisted of written guidelines for the self-management of asthma, based on self-assessment of asthma severity, printed on a plastic card. On one side, management guidelines were based on the interpretation of peak expiratory flow rate (PEFR) recordings, whilst the reverse side was based on symptoms. The outcome measures used were before and after comparison of markers of asthma morbidity and requirement for acute medical treatment; and a structured questionnaire assessing the acceptability and use of the credit card plan. Following the introduction of the plan, the mean PEFR increased from 347 to 389 l.min-1, the percentage of nights woken fell from 30.4 to 16.9%, and the number of days "out of action" fell from 3.8 to 1.7%. The requirements for acute medical treatment also fell during the intervention period. Most participants commented favourably on the content and usefulness of the plan. In the situation of worsening asthma, 28% of subjects found the peak flow side of the card most helpful, 7% the symptoms side, and 48% found both sides equally helpful.(ABSTRACT TRUNCATED AT 250 WORDS)

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 ...

Population-based worksite obesity management interventions: a qualitative case study.

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Romney, Martha C; Thomson, Erin; Kash, Kathryn

2011-06-01

Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

Policy Change and Its Effect on Australian Community-Based Natural Resource Management Practices

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Cooke, Penelope R.; Hemmings, Brian C.

2016-01-01

The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…

Immortality of Prejudice in Striving Ubuntu: Case Studies of Community Managed Schools in Nepal

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Rajbhandari, Mani Man Singh; Rajbhandari, Smriti

2016-01-01

The immortality of prejudice after the school management transfer has not been judged. This makes communities to take responsibility for schools further by compelling the government to mandate amendments of Community Managed Schools (CMS) Directives. The purpose was to explore the CMS enduring Ubuntu against immorality of prejudice, through…

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

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Jacobs, Sally; Johnson, Sheena; Hassell, Karen

2018-02-01

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

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

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Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Examining Preservice Teachers' Classroom Management Decisions in Three Case-Based Teaching Approaches

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Cevik, Yasemin Demiraslan; Andre, Thomas

2013-01-01

This study was aimed at comparing the impact of three types of case-based approaches (worked example, faded work example, and case-based reasoning) on preservice teachers' decision making and reasoning skills related to realistic classroom management situations. Participants in this study received a short-term implementation of one of these three…

Community based assessment on household management of waste ...

African Journals Online (AJOL)

Bernt Lindtjorn

Conclusion: in the study community household management of waste is in poor condition. Health-workers and local authorities must pay special emphasis to improve these conditions. Further in-depth studies should also be encouraged to look for improved interventions. [Ethiop. J. Health Dev. 2010;24(2):103-109].

National scale-up of integrated community case management in rural Ethiopia: implementation and early lessons learned.

Science.gov (United States)

2014-10-01

Although under-five mortality in Ethiopia has decreased 67% in the past two decades, many, children still die from preventable or treatable conditions, mainly pneumonia, newborn problems, diarrhea, malaria and malnutrition. Most of these deaths can be avoided with timely and appropriate care, but access to and use of treatment remains inadequate. Community health workers, appropriately trained, supervised, and supplied with essen- tial equipment and medicines, can deliver case management or referral to most sick children. In 2010, Ethiopia added pneumonia to diarrhea, malaria and severe acute malnutrition, targeted for treatment in the integrated community case management (iCCM) strategy. This article describes the national scale-up of iCCM implementation and early lessons learned. We reviewed data related to iCCM program inputs and processes from reports, minutes, and related documents from January 2010 through July 2013. We describe introduction and scale-up through eight health system components. The government and partners trained and supplied 27,116 of the total 32,000 Health Extension Workers and mentored 80% of them to deliver iCCM services to over one million children. The government led a strong-iCCM partnership that attracted development partners in implementation, monitoring, evaluation, and research. Service utilization and weak supply chain remain-major challenges. Strong MOH leadership, policy support, and national partnerships helped successful national iCCM scale-up and should help settle remaining challenges.

Public health program planning logic model for community engaged type 2 diabetes management and prevention.

Science.gov (United States)

West, Joseph F

2014-02-01

Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Community referral in home management of malaria in western Uganda: A case series study

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Nsungwa-Sabiiti Jesca

2006-03-01

Full Text Available Abstract Background Home Based Management of fever (HBM was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed free of charge to febrile children Methods A case-series study was performed during 20 weeks in a West-Ugandan sub-county with an under-five population of 3,600. Community drug distributors (DDs were visited fortnightly and recording forms collected. Referred children were located and primary caretaker interviewed in the household. Referral health facility records were studied for those stating having completed referral. Results Overall referral rate was 8% (117/1454. Fever was the main reason for mothers to seek DD care and for DDs to refer. Twenty-six of the 28 (93% "urgent referrals" accessed referral care but 8 (31% delayed >24 hours. Waiting for antimalarial drugs to finish caused most delays. Of 32 possible pneumonias only 16 (50% were urgently referred; most delayed ≥ 2 days before accessing referral care. Conclusion The HBM has high referral compliance and extends primary health care to the communities by maintaining linkages with formal health services. Referral non-completion was not a major issue but failure to recognise pneumonia symptoms and delays in referral care access for respiratory illnesses may pose hazards for children with acute respiratory infections. Extending HBM to also include pneumonia may increase prompt and effective care of the sick child in sub-Saharan Africa.

The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

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Chao Jianqian

2012-12-01

Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

Scaling-up Community-Based Program for Management of Child Malnutrition in Rural Thailand

International Nuclear Information System (INIS)

Winichagoon, Pattanee

2014-01-01

Full text: Despite efforts to address child malnutrition at scale since 1970s, management of child illnesses focused on treatment of common infections. In the fifth National Economic and Social Development Plan (NESDP) (1982-1987), effective scaled-up child nutrition policy and program was implemented, through Primary Health Care (PHC) and Poverty Alleviation Plan (PAP). The PAP provided the mechanism to streamline government resources to poverty stricken areas. Almost 300 districts were identified and sectoral programs implemented in the same priority areas. Provincial planning is the key to allocate the government budget, while the district level implemented and supervised actions at the community level. PHC was implemented with the principle of self-help care and nutrition was one of the PHC elements. Community participation was strengthened through manpower mobilization and capacity building, village financing and organization. As a result, there is an alignment of national resource allocations and micro-level actions. Scaling-up of community-based nutrition program was implemented by adopting the PHC principle, using community participation strategy, namely, mobilization and capacity building of village health volunteers, financing and organization. Growth monitoring, promotion of infant and young child feeding and joint financing via a ‘nutrition fund’ was implemented in rural areas, particularly in the poorest areas of the northeast and north. Child malnutrition was strategically managed at the community level, whereby differential actions were taken according to the severity of malnutrition. Management of severe and moderate malnutrition was by monitoring growth monthly, with support of basic health services to manage infections and other curative needs. Food assistance for complementary feeding using appropriate technology for village level processing was an integral part of child malnutrition management. Children with mild malnutrition or normal were

Implementation of a Contingency Management-Based Intervention in a Community Supervision Setting: Clinical Issues and Recommendations

Science.gov (United States)

Trotman, Adria J.; Taxman, Faye S.

2011-01-01

A cognitive-behaviorally based substance abuse treatment program was implemented within a community supervision setting. This program included a goals group that used a contingency management component and included the probation agent as a part of the treatment. In this article, the authors describe the contingency management component of the…

Integrating Medication Therapy Management (MTM Services Provided by Community Pharmacists into a Community-Based Accountable Care Organization (ACO

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Brian Isetts

2017-10-01

Full Text Available (1 Background: As the U.S. healthcare system evolves from fee-for-service financing to global population-based payments designed to be accountable for both quality and total cost of care, the effective and safe use of medications is gaining increased importance. The purpose of this project was to determine the feasibility of integrating medication therapy management (MTM services provided by community pharmacists into the clinical care teams and the health information technology (HIT infrastructure for Minnesota Medicaid recipients of a 12-county community-based accountable care organization (ACO. (2 Methods: The continuous quality improvement evaluation methodology employed in this project was the context + mechanism = outcome (CMO model to account for the fact that programs only work insofar as they introduce promising ideas, solutions and opportunities in the appropriate social and cultural contexts. Collaborations between a 12-county ACO and 15 community pharmacies in Southwest Minnesota served as the social context for this feasibility study of MTM referrals to community pharmacists. (3 Results: All 15 community pharmacy sites were integrated into the HIT infrastructure through Direct Secure Messaging, and there were 32 recipients who received MTM services subsequent to referrals from the ACO at 5 of the 15 community pharmacies over a 1-year implementation phase. (4 Conclusion: At the conclusion of this project, an effective electronic communication and MTM referral system was activated, and consideration was given to community pharmacists providing MTM in future ACO shared savings agreements.

Community energy auditing: experience with the comprehensive community energy management program

Energy Technology Data Exchange (ETDEWEB)

Moore, J.L.; Berger, D.A.; Rubin, C.B.; Hutchinson, P.A. Sr.; Griggs, H.M.

1980-09-01

The report provides local officials and staff with information on lessons from the audit, projection, and general planning experiences of the Comprehensive Community Energy Management Program (CCEMP) communities and provides ANL and US DOE with information useful to the further development of local energy management planning methods. In keeping with the objectives, the report is organized into the following sections: Section II presents the evaluation issues and key findings based on the communities' experiences from Spring of 1979 to approximately March of 1980; Section III gives an organized review of experience of communities in applying the detailed audit methodology for estimating current community energy consumption and projecting future consumption and supply; Section IV provides a preliminary assessment of how audit information is being used in other CCEMP tasks; Section V presents an organized review of preliminary lessons from development of the community planning processes; and Section VI provides preliminary conclusions on the audit and planning methodology. (MCW)

Renewal Strategy and Community Based Organisations in Community

African Journals Online (AJOL)

FBL

organisations in the study areas and Community-Based Poverty Reduction. Programme ... regions or areas. In Nigeria, for ... industries in the growing and developing urban areas. ..... Security network is also provided by the community. To ..... Development Efforts in Nigeria: Case Study of Anambra and Oyo State, NISER.

Assessing diabetes practices in clinical settings: precursor to building community partnerships around disease management.

Science.gov (United States)

Prochaska, John D; Mier, Nelda; Bolin, Jane N; Hora, Kerrie L; Clark, Heather R; Ory, Marcia G

2009-12-01

Many recommended best practices exist for clinical and community diabetes management and prevention. However, in many cases, these recommendations are not being fully utilized. It is useful to gain a sense of currently utilized and needed practices when beginning a partnership building effort to ameliorate such practice problems. The purpose of this study was to assess current practices in clinical settings within the Brazos Valley in preparation for beginning a community-based participatory research project on improving diabetes prevention and management in this region. Fifty-seven physicians with admission privileges to a regional health system were faxed a survey related to current diabetes patient loads, knowledge and implementation of diabetes-related best practices, and related topics. Both qualitative and quantitative examination of the data was conducted. Fifteen percent of responding providers indicated they implemented diabetes prevention best practices, with significant differences between primary-care physicians and specialists. Respondents indicated a need for educational and counseling resources, as well as an increased health-care workforce in the region. The utilization of a faxed-based survey proved an effective means for assessing baseline data as well as serving as a catalyst for further discussion around coalition development. Results indicated a strong need for both clinical and community-based services regarding diabetes prevention and management, and provided information and insight to begin focused community dialogue around diabetes prevention and management needs across the region. Other sites seeking to begin similar projects may benefit from a similar process.

[Evaluation on programs regarding the community-based management of hypertension and type 2 diabetes mellitus patients in eight provinces, China].

Science.gov (United States)

Li, Yuan; Ren, Duofu; Ding, Pingfei; Zhang, Qin; Zhang, Juan; Shi, Wenhui; Wu, Jing; Shi, Xiaoming; Liang, Xiaofeng

2014-01-01

To understand the situation and efficacy of community-based management programs on hypertension and type 2 diabetes mellitus patients in primary health service centers. In eight provinces being selected, a stratified multistage random sampling method was used to survey 5 116 cases of hypertension patients and 3 586 cases of type 2 diabetes mellitus patients aged over 35 years who had been under the management program for over 1 year. Face-to-face questionnaire interview and physical and biochemical examination were applied to collect related information, blood pressure and situation of glucose control. The rates of management on hypertension patients and type 2 diabetes mellitus patients were 23.6% (urban:17.1%, rural:28.1%, χ² = 27 195.33, P hypertension patients and the rate on fasting glucose control on type 2 diabetes mellitus patients were 50.3% (urban:62.0%, rural:36.6%, χ² = 329.31, P hypertension patients and type 2 diabetes mellitus patients were 83.0% (urban:84.7% , rural: 80.7% , χ² = 13.42, P hypertension and type 2 diabetes mellitus patients in primary health service centers. Further improvement was expected on rates regarding management, standardized management and control on both blood pressure and glucose.

Introduction of mobile phones for use by volunteer community health workers in support of integrated community case management in Bushenyi District, Uganda: development and implementation process.

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Tumusiime, David Katuruba; Agaba, Gad; Kyomuhangi, Teddy; Finch, Jan; Kabakyenga, Jerome; MacLeod, Stuart

2014-01-01

A substantial literature suggests that mobile phones have great potential to improve management and survival of acutely ill children in rural Africa. The national strategy of the Ugandan Ministry of Health calls for employment of volunteer community health workers (CHWs) in implementation of Integrated Community Case Management (iCCM) of common illnesses (diarrhea, acute respiratory infection, pneumonia, fever/malaria) affecting children under five years of age. A mobile phone enabled system was developed within iCCM aiming to improve access by CHWs to medical advice and to strengthen reporting of data on danger signs and symptoms for acutely ill children under five years of age. Herein critical steps in development, implementation, and integration of mobile phone technology within iCCM are described. Mechanisms to improve diagnosis, treatment and referral of sick children under five were defined. Treatment algorithms were developed by the project technical team and mounted and piloted on the mobile phones, using an iterative process involving technical support personnel, health care providers, and academic support. Using a purposefully developed mobile phone training manual, CHWs were trained over an intensive five-day course to make timely diagnoses, recognize clinical danger signs, communicate about referrals and initiate treatment with appropriate essential drugs. Performance by CHWs and the accuracy and completeness of their submitted data was closely monitored post training test period and during the subsequent nine month community trial. In the full trial, the number of referrals and correctly treated children, based on the agreed treatment algorithms, was recorded. Births, deaths, and medication stocks were also tracked. Seven distinct phases were required to develop a robust mobile phone enabled system in support of the iCCM program. Over a nine month period, 96 CHWs were trained to use mobile phones and their competence to initiate a community trial was

Description and outcomes of a Medicare case management program by nurses.

Science.gov (United States)

Allen, S A

1999-01-01

During the current environment of cost-cutting and restructuring, case management is viewed as a means of providing comprehensive, coordinated care while reducing costs. Studies of community-based case management have been disappointing. This study evaluates a Medicare service, Management and Evaluation of the Care Plan (MAE), as a model of nurses providing case management in the home. Three groups were compared: MAE (N = 176), non-MAE (N = 187) and newly discharged (N = 93). Utilization data was collected over one year. Overall, subjects were unmarried older women with three functional limitations, four medical diagnoses and averaged 43 home care visits and one hospitalization. MAE patients were older, had more functional and environmental limitations, less ADL independence, and a worse prognosis, yet used significantly less health care than non-MAE recipients did. Regression analysis was performed using group membership and hospital and home care utilization as dependent variables. Although the project was conducted at one site, overall the sample was similar to the national Medicare population.

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

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Doreen Nkiru Eugene-Ezebilo

2015-07-01

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

The potential of, and threat to, the transfer of ecological knowledge in urban areas: the case of community-based woodland management in Tokyo, Japan

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Kazuaki Tsuchiya

2014-06-01

Full Text Available Urban dwellers often have little knowledge of local ecosystems, but community groups that actively manage local ecosystems can acquire a rich ecological knowledge. Understanding the knowledge transfer process within community groups contributes to the continuous improvement of urban ecosystem management. In this paper, we address three main questions: (1 How is ecological knowledge acquisition linked to boundary and intra-group interactions? (2 Does holding knowledge mean the involvement in actual management activities? (3 Does the aging of community group members threaten the continuity of activities? We selected satoyama woodlands (seminatural woodlands in peri-urban Tokyo, Japan as a study site. We used a mixed method approach that combined a qualitative interview with a quantitative questionnaire. We found that boundary interactions were particularly important at the start of an urban ecological management process, to obtain basic knowledge relating to management activities. Intra-group interaction contributed to knowledge transfer after the starting period. We found that participants possessing considerable ecological knowledge do not necessarily participate in management activities. Findings also indicated that the aging of group members in groups established for more than 10 years was an area of concern for the continuity of group activities. New members did not necessarily solve this aging issue. We conclude that further measures and actions are needed to ensure long-term knowledge transfer among the participants of community groups in urban ecosystem management.

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

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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.

Leadership in school-based management: a case study in selected ...

African Journals Online (AJOL)

This article, derived from a qualitative case study undertaken among a number of divergent secondary schools in Gauteng province, is an attempt to conceptualise the important and pivotal leadership role of the school principal in ensuring school improvement via effective school-based management in South African ...

Community-based management: under what conditions do Sami pastoralists manage pastures sustainably?

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Vera H Hausner

Full Text Available Community-based management (CBM has been implemented in socio-ecological systems (SES worldwide. CBM has also been the prevailing policy in Sámi pastoral SES in Norway, but the outcomes tend to vary extensively among resource groups ("siidas". We asked why do some siidas self-organize to manage common pool resources sustainably and others do not? To answer this question we used a mixed methods approach. First, in the statistical analyses we analyzed the relationship between sustainability indicators and structural variables. We found that small winter pastures that are shared by few siidas were managed more sustainably than larger pastures. Seasonal siida stability, i.e., a low turnover of pastoralists working together throughout the year, and equality among herders, also contributed to more sustainable outcomes. Second, interviews were conducted in the five largest pastures to explain the relationships between the structural variables and sustainability. The pastoralists expressed a high level of agreement with respect to sustainable policies, but reported a low level of trust and cooperation among the siidas. The pastoralists requested siida tenures or clear rules and sanctioning mechanisms by an impartial authority rather than flexible organization or more autonomy for the siidas. The lack of nestedness in self-organization for managing pastures on larger scales, combined with the past economic policies, could explain why CBM is less sustainable on the largest winter pastures. We conclude that the scale mis-match between self-organization and the formal governance is a key condition for sustainability.

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

Leadership development and succession planning in case management.

Science.gov (United States)

Miodonski, Kathleen; Hines, Patricia

2013-01-01

The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

The role local initiatives in community based disaster risk management in Kemijen, Semarang City

Science.gov (United States)

Fauzie, W. Z.; Sariffudin, S.

2017-06-01

Community-based disaster risk reduction is one of the homegrown initiatives efforts and community empowerment oriented in disaster management. This approach is very important because no one can understand the conditions in a region better than the local communities. Therefore, the implementation of CBDRM always emphasize local initiatives in decision making. The existence of local initiative is necessary specially to anticipate the impact of climate change which is increasingly affecting towns in coastal areas, including settlements in Semarang. Kemijen Urban Village is one of the informal settlements in Semarang, which has the highest intensity of flood that is 12 times during 5 years (2011-2015). The research question is how the level of local initiatives in flood disaster management in Kemijen, Semarang? This study aims to assess the level of local initiatives in Kemijen as the community adaptive capacity of flood prevention in pre-disaster, emergency response, and post-disaster. Local initiatives assessed on water supply, sanitation, food, shelter, health, drainage maintenance and waste management. This study shows the level of local initiatives in pre-disaster and post-disaster is almost same and bigger than the response phase. Scoring results showed that pre-disaster is 35.002, 27.9577 for emergency response, and post-disaster is 34.9862 with each category that is independent, empowered, and independent. This study also shows that local initiatives in Kemijen largely formed by individual initiative and only a few were formed by a collective initiative.

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

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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.

Community-based management versus traditional hospitalization in treatment of drug-resistant tuberculosis: a systematic review and meta-analysis.

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Williams, Abimbola Onigbanjo; Makinde, Olusesan Ayodeji; Ojo, Mojisola

2016-01-01

Multidrug drug resistant Tuberculosis (MDR-TB) and extensively drug resistant Tuberculosis (XDR-TB) have emerged as significant public health threats worldwide. This systematic review and meta-analysis aimed to investigate the effects of community-based treatment to traditional hospitalization in improving treatment success rates among MDR-TB and XDR-TB patients in the 27 MDR-TB High burden countries (HBC). We searched PubMed, Cochrane, Lancet, Web of Science, International Journal of Tuberculosis and Lung Disease, and Centre for Reviews and Dissemination (CRD) for studies on community-based treatment and traditional hospitalization and MDR-TB and XDR-TB from the 27 MDR-TB HBC. Data on treatment success and failure rates were extracted from retrospective and prospective cohort studies, and a case control study. Sensitivity analysis, subgroup analyses, and meta-regression analysis were used to explore bias and potential sources of heterogeneity. The final sample included 16 studies involving 3344 patients from nine countries; Bangladesh, China, Ethiopia, Kenya, India, South Africa, Philippines, Russia, and Uzbekistan. Based on a random-effects model, we observed a higher treatment success rate in community-based treatment (Point estimate = 0.68, 95 % CI: 0.59 to 0.76, p   18 months, and regimen with drugs >5 reported higher treatment success rate. In the meta-regression model, age of patients, adverse events, treatment duration, and lost to follow up explains some of the heterogeneity of treatment effects between studies. Community-based management improved treatment outcomes. A mix of interventions with DOTS-Plus throughout therapy and treatment duration > 18 months as well as strategies in place for lost to follow up and adverse events should be considered in MDR-TB and XDR-TB interventions, as they influenced positively, treatment success.

M-Health for Improving Screening Accuracy of Acute Malnutrition in a Community-Based Management of Acute Malnutrition Program in Mumbai Informal Settlements.

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Chanani, Sheila; Wacksman, Jeremy; Deshmukh, Devika; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2016-12-01

Acute malnutrition is linked to child mortality and morbidity. Community-Based Management of Acute Malnutrition (CMAM) programs can be instrumental in large-scale detection and treatment of undernutrition. The World Health Organization (WHO) 2006 weight-for-height/length tables are diagnostic tools available to screen for acute malnutrition. Frontline workers (FWs) in a CMAM program in Dharavi, Mumbai, were using CommCare, a mobile application, for monitoring and case management of children in combination with the paper-based WHO simplified tables. A strategy was undertaken to digitize the WHO tables into the CommCare application. To measure differences in diagnostic accuracy in community-based screening for acute malnutrition, by FWs, using a mobile-based solution. Twenty-seven FWs initially used the paper-based tables and then switched to an updated mobile application that included a nutritional grade calculator. Human error rates specifically associated with grade classification were calculated by comparison of the grade assigned by the FW to the grade each child should have received based on the same WHO tables. Cohen kappa coefficient, sensitivity and specificity rates were also calculated and compared for paper-based grade assignments and calculator grade assignments. Comparing FWs (N = 14) who completed at least 40 screenings without and 40 with the calculator, the error rates were 5.5% and 0.7%, respectively (p .90), from .79 to .97, after switching to the mobile calculator. Sensitivity and specificity also improved significantly. The mobile calculator significantly reduces an important component of human error in using the WHO tables to assess acute malnutrition at the community level. © The Author(s) 2016.

Behavioural Comorbidity in Tanzanian Children with Epilepsy: A Community-Based Case-Control Study

Science.gov (United States)

Burton, Kathryn; Rogathe, Jane; Hunter, Ewan; Burton, Matthew; Swai, Mark; Todd, Jim; Neville, Brian; Walker, Richard; Newton, Charles

2011-01-01

Aim: The aim of this study was to define the prevalence of and risk factors for behavioural disorders in children with epilepsy from a rural district of Tanzania by conducting a community-based case-control study. Method: One hundred and twelve children aged 6 to 14 years (55 males, 57 females; median age 12y) with active epilepsy (at least two…

The development of an acute care case manager orientation.

Science.gov (United States)

Strzelecki, S; Brobst, R

1997-01-01

The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

Energy Management for Community Energy Network with CHP Based on Cooperative Game

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Xiaofeng Liu

2018-04-01

Full Text Available Integrated energy system (IES has received increasing attention in micro grid due to the high energy efficiency and low emission of carbon dioxide. Based on the technology of combined heat and power (CHP, this paper develops a novel operation mechanism with community micro turbine and shared energy storage system (ESS for energy management of prosumers. In the proposed framework, micro-grid operator (MGO equipped with micro turbine and ESS provides energy selling business and ESS leasing business for prosumers. Prosumers can make energy trading with public grid and MGO, and ESS will be shared among prosumers when they pay for the rent to MGO. Based on such framework, we adopt a cooperative game for prosumers to determine optimal energy trading strategies from MGO and public grid for the next day. Concretely, a cooperative game model is formulated to search the optimal strategies aiming at minimizing the daily cost of coalition, and then a bilateral Shapley value (BSV is proposed to solve the allocation problem of coalition’s cost among prosumers. To verify the effectiveness of proposed energy management framework, a practical example is conducted with a community energy network containing MGO and 10 residential buildings. Simulation results show that the proposed scheme is able to provide financial benefits to all prosumers, while providing peak load leveling for the grid.

Hospital‑based case management for migrant patients

DEFF Research Database (Denmark)

Ølholm, Anne Mette; Christensen, Janne B; Kamionka, Stine Lundstrøm

2016-01-01

management programme might include reducing inequality and improving clinical outcomes. No studies supporting the argument that specialized hospital care is stigmatizing or reduces quality of care were identified. Conclusion: The review highlights a fundamental lack of evidence against specialized care...... to patients with a refugee or immigrant background. Provision of specialized services for migrant patients, including case management with multidisciplinary physical, cognitive and social interventions, has been suggested as a way to tackle inequalities in response to a growing recognition of the complexity...... - b ased case management for ethnic minority patients. Methods: This review used a health technology assessment model, including a systematic search of literature in the PubMed, Embase, the Cochrane Library, Sociological Abstracts, the Cumulative Index to Nursing and Allied Health Literature databases...

Managing Communities – Mining MNEs’ Community Risk Management Practices

DEFF Research Database (Denmark)

Taarup Esbensen, Jacob

This PhD reflects the effort to close a gap in the multinational enterprise (MNE) risk management literature on the identification and mitigation of risk arising from local communities. Small villages and towns that are situated geographically close to the MNEs’ place of operation have increasingly......-to-date information about mining MNE operations. This improved outreach has meant that mines have been closed due to conflicts with local communities and therefor a need had arisen for MNEs to implement management practices that can effectively mitigate these types of risks....... been identified as a source of risk (BSR, 2003; ICMM, 2015). The mining industry is one of the most exposed to risks from local communities, where there historically have been many conflicts between mine owners on one side and the people living close to the mine on the other (Godoy, 1985; Hoskin, 1912...

Case management.

Science.gov (United States)

Woodward, Judy; Rice, Eve

2015-03-01

Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

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...

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

Science.gov (United States)

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

2018-01-01

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

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.

Case management directors: how to manage in a transition-focused world: part 2.

Science.gov (United States)

Bankston White, Cheri; Birmingham, Jackie

2015-01-01

Case management directors are in a dynamic position to affect the transition of care of patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role.This is Part 2 of a two-part article written for case management directors, particularly new ones.Part 1 covered the first 4 of 7 tracks: (1) Staffing and Human Resources, (2) Compliance and Accreditation, (3) Discharge Planning and (4) Utilization Review and Revenue Cycle. Part 2 addresses (5) Internal Departmental Relationships (Organizational), (6) External Relationships (Community Agency), and (7) Quality and Program Outcomes.This article attempts to answer the following questions: : The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems and have frontline case managers (CMs) reporting to them. Part 1 found that case management directors would benefit from further research and documentation of "best practices" related to their role, particularly in the areas of leadership and management. The same conclusion applies to Part 2, which addresses the director's responsibilities outside her immediate department. Leadership and management skills apply as well to building strong, productive relationships across a broad spectrum of external organizations that include payer, provider, and regulatory agencies. At the same time, they must also develop the skills to positively influence the revenue cycle and financial health of both the organization for which they work and those to whom they transition patients. A director of case management with responsibility for transitions of care has more power and influence over patient safety than is commonly known. Few of the

Community-Based Management of Acute Malnutrition to Reduce Wasting in Urban Informal Settlements of Mumbai, India: A Mixed-Methods Evaluation.

Science.gov (United States)

Shah More, Neena; Waingankar, Anagha; Ramani, Sudha; Chanani, Sheila; D'Souza, Vanessa; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2018-03-21

We evaluated an adaptation of a large-scale community-based management of acute malnutrition program run by an NGO with government partnerships, in informal settlements of Mumbai, India. The program aimed to reduce the prevalence of wasting among children under age 3 and covered a population of approximately 300,000. This study used a mixed-methods approach including a quasi-experimental design to compare prevalence estimates of wasting in intervention areas with neighboring informal settlements. Cross-sectional data were collected from March through November 2014 for the baseline and October through December 2015 for the endline. Endline data were analyzed using mixed-effects logistic regression models, adjusting for child, maternal, and household characteristics. In addition, we conducted in-depth interviews with 37 stakeholders (13 staff and 24 mothers) who reported on salient features that contributed to successful implementation of the program. We interviewed 2,578 caregivers at baseline and 3,455 at endline in intervention areas. In comparison areas, we interviewed 2,082 caregivers at baseline and 2,122 at endline. At endline, the prevalence of wasting decreased by 28% (18% to 13%) in intervention areas and by 5% (16.9% to 16%) in comparison areas. Analysis of the endline data indicated that children in intervention areas were significantly less likely to be malnourished (adjusted odds ratio, 0.81; confidence interval, 0.67 to 0.99). Stakeholders identified 4 main features as contributing to the success of the program: (1) tailoring and reinforcement of information provided to caregivers in informal settings, (2) constant field presence of staff, (3) holistic case management of issues beyond immediate malnourishment, and (4) persistence of field staff in persuading reluctant families. Staff capabilities were enhanced through training, stringent monitoring mechanisms, and support from senior staff in tackling difficult cases. NGO-government partnerships can

The Multiple Use of Tropical Forests by Indigenous Peoples in Mexico: a Case of Adaptive Management

Directory of Open Access Journals (Sweden)

Víctor M. Toledo

2003-12-01

Full Text Available The quest for an appropriate system of management for tropical ecosystems necessitates that ecologists consider the accumulated experiences of indigenous peoples in their long-term management of local resources, a subject of current ethnoecology. This paper provides data and empirical evidence of an indigenous multiple-use strategy (MUS of tropical forest management existing in Mexico, that can be considered a case of adaptive management. This conclusion is based on the observation that some indigenous communities avoid common modernization routes toward specialized, unsustainable, and ecologically disruptive systems of production, and yet probably achieve the most successful tropical forest utilization design, in terms of biodiversity conservation, resilience, and sustainability. This analysis relies on an exhaustive review of the literature and the authors' field research. Apparently, this MUS represents an endogenous reaction of indigenous communities to the intensification of natural resource use, responding to technological, demographic, cultural, and economic changes in the contemporary world. This transforms traditional shifting cultivators into multiple-use strategists. Based on a case study, three main features (biodiversity, resilience, and permanence considered relevant to achieving adaptive and sustainable management of tropical ecosystems are discussed.

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

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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.

Adolescent testicular microlithiasis: A case-based, multinational survey of clinical management practices.

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Brodie, Katie E; Saltzman, Amanda F; Cost, Nicholas G

2018-04-01

Testicular microlithiasis (TM) is a condition characterized by calcium deposits within the testis, usually detected incidentally during ultrasonography of the scrotum. TM has been associated with the presence of, and possibly the development of, testicular malignancy. Our aim was to document international clinical management practices for TM and to analyze what factors and perception of risk influence conservative versus active management and follow-up. European Society for Paediatric Urology (ESPU) and Society for Pediatric Urology (SPU) members were invited to complete an online case-based survey of clinical management practices of TM. Eight cases had a single variable changed each time (classic versus limited TM, unilateral versus bilateral, prior cryptorchidism versus no cryptorchidism) to ascertain the provider's perception of risk. The respondents completed multiple choice questions on initial management, follow-up plan, length and interval of follow-up. Multivariate logistic regression was performed to determine factors associated with decisions on management and follow-up. There were 265 respondents to the survey from 35 countries (Table). Median time in practice was 13 years. Factors that were significantly associated with more aggressive initial management (more than counseling on self-examination) included: not yet in independent practice, low volume TM cases per year, those practicing pediatric and adult urology, classic appearance of TM and cryptorchidism. Factors that were significantly associated with urologist follow-up and active investigation included: European practitioners, low TM case volume per year, those practicing both pediatric urology and pediatric surgery, classic TM appearance and a case history of cryptorchidism. Interval and length of follow-up was wide-ranging, with most respondents favoring annual follow-up. Management of TM varies and a mix of surgeon and case factors significantly influences management strategies. This baseline

Estimating the cost of referral and willingness to pay for referral to higher-level health facilities: a case series study from an integrated community case management programme in Uganda.

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Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin

2015-08-28

Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing

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

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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.…

Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists.

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Fary, Robyn E; Slater, Helen; Chua, Jason; Briggs, Andrew M

2012-01-01

Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA). This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD) needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA). Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7-58.2%) and need for PD was high (45.1-95.2%). Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.

Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists

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Robyn E. Fary

2012-01-01

Full Text Available Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA. This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA. Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7–58.2% and need for PD was high (45.1–95.2%. Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.

Integrated community case management for childhood illnesses: explaining policy resistance in Kenya.

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Juma, Pamela A; Owuor, Karen; Bennett, Sara

2015-12-01

There has been a re-emphasis recently on community health workers to provide child health care services including integrated community case management for childhood illness (iCCM). This research analysed iCCM policy development in Kenya and in particular the types of decision-making criteria used by Kenyan policy-makers in considering whether to advance iCCM policy. Data were collected through document reviews (n = 41) and semi-structured interviews (n = 19) with key stakeholders in iCCM policy including government officials, development partners, bilateral donors, and civil society organizations. Initial analysis was guided by the policy triangle with further analysis of factors affecting policy decision-making drawing upon a simple framework developed by Grindle and Thomas (Policy makers, policy choices and policy outcomes: the political economy of reform in developing countries. 1989; Policy Sci 22: :213-48.). Policy development for iCCM has been slow in Kenya, compared with other Sub-Saharan African countries. At the time of the study, the Government had just completed the Community Health Training Manual which incorporated iCCM as a module, but this was the only formal expression of iCCM in Kenya. We found technical considerations, notably concerns about community health workers dispensing antibiotics to be a key factor slowing iCCM policy development, but this also overlapped with bureaucratic considerations, such as how the development of community health worker cadres may affect clinicians, as well as initial concerns about how an integrated approach might affect vertically oriented programs. International actors through agreements such as the Millennium Development Goals helped to get child survival onto the national policy agenda and such actors were active promoters of iCCM policy change. However international funders had not committed funding to scale-up iCCM policy, and this probably constrained their influence over iCCM policy debate. Kenyan actors

The Dynamics of Social Capital and Conflict Management in Multiple Resource Regimes: A Case of the Southwestern Highlands of Uganda

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Pascal C. Sanginga

2007-06-01

Full Text Available Increasingly, social capital, defined as shared norms, trust, and the horizontal and vertical social networks that facilitate coordination and cooperation for mutually beneficial collective action, is seen as an important asset upon which people rely to manage natural resources and resolve conflicts. This paper uses empirical data from households and community surveys and case studies, to examine the role, strengths, and limits of social capital in managing conflicts over the use and management of natural resources. We inventoried over 700 cases ranging from conflicts between multiple resource users to supra-community conflicts between local communities concerns for better livelihoods and national/international concerns for environment conservation. Results show how different types of social capital are used in preventing and managing conflicts. Endowment in certain dimensions of social capital significantly decreased the occurrence of conflicts and played a significant role in managing them. However, social capital mechanisms have some limits, and are not always effective in resolving some types of conflicts. For such conflicts, people rely on formal mechanisms for arbitration and adjudication. In many cases, these have resulted in exclusion, coercion, and violence. Results show that policies or social capital alone do not possess the resources needed to promote broad-based and sustainable conflict resolution strategies. Rather, people use a range of conflict management strategies of different types and combinations of social capital and local polices. This synergy between social capital and local policy is based on complementarity and embededness: mutually supportive relations between local government and local communities, and the nature and extent of the ties connecting people and communities and public institutions. Better understanding of how this synergy between social capital and local policy can be strengthened is crucial to minimize

Natural hazards in a changing world: a case for ecosystem-based management.

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Jeanne L Nel

Full Text Available Communities worldwide are increasingly affected by natural hazards such as floods, droughts, wildfires and storm-waves. However, the causes of these increases remain underexplored, often attributed to climate changes or changes in the patterns of human exposure. This paper aims to quantify the effect of climate change, as well as land cover change, on a suite of natural hazards. Changes to four natural hazards (floods, droughts, wildfires and storm-waves were investigated through scenario-based models using land cover and climate change drivers as inputs. Findings showed that human-induced land cover changes are likely to increase natural hazards, in some cases quite substantially. Of the drivers explored, the uncontrolled spread of invasive alien trees was estimated to halve the monthly flows experienced during extremely dry periods, and also to double fire intensities. Changes to plantation forestry management shifted the 1:100 year flood event to a 1:80 year return period in the most extreme scenario. Severe 1:100 year storm-waves were estimated to occur on an annual basis with only modest human-induced coastal hardening, predominantly from removal of coastal foredunes and infrastructure development. This study suggests that through appropriate land use management (e.g. clearing invasive alien trees, re-vegetating clear-felled forests, and restoring coastal foredunes, it would be possible to reduce the impacts of natural hazards to a large degree. It also highlights the value of intact and well-managed landscapes and their role in reducing the probabilities and impacts of extreme climate events.

Emergency department case management: the dyad team of nurse case manager and social worker improve discharge planning and patient and staff satisfaction while decreasing inappropriate admissions and costs: a literature review.

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Bristow, Darlene P; Herrick, Charlotte A

2002-01-01

A model of emergency department (ED) case management consisting of a social worker and a nurse case manager can prevent inappropriate admissions, improve discharge planning, decrease cost, and enhance patient satisfaction. The individual and combined roles of the dyad team of social worker and nurse case manager are discussed. A literature review includes how a case management dyad team of social worker and nurse case manager in the ED can decrease utilization of the ED for nonemergent visits, promote the use of community resources, and improve discharge planning to avoid excessive costs. The importance of the dyad team working with the interdisciplinary team in the ED, the primary care physician (PCP), and other community health care providers in order to provide a holistic approach to care is addressed. A discussion about the improvement of both patient and staff satisfaction demonstrates the results of case management strategies that support and advocate for patients to receive quality, cost-effective care across the health care continuum, while decreasing the use of the ED for nonemergent care.

Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

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Mohamed, Somaia

2013-03-01

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

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

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Zhang YJ

2018-05-01

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

Improving village poultry's survival rate through community-based poultry health management

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Sodjinou, Epiphane; Henningsen, Arne; Koudande, Olorounto Delphin

2012-01-01

Community-based poultry health management (CBM) is a strategy for village poultry improvement based on the installment of “poultry interest groups” in experimental villages. These groups serve as a channel for the dissemination of village poultry improvement technologies. The use of CBM is due...... to the fact that village poultry farming is practiced in a total or partial scavenging system which gives the impression that all the birds in the village belong to the same flock. Accordingly, actions that target all farmers of the same village may have a larger impact on the village poultry's survival rate...... than actions that target individual producers. The objective of this study is to assess the impact of CBM on the survival rate of village poultry. Based on data collected on 353 poultry keepers, the study shows that CBM significantly improves the survival rate of village poultry. The adoption...

Real-world use of the risk-need-responsivity model and the level of service/case management inventory with community-supervised offenders.

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Dyck, Heather L; Campbell, Mary Ann; Wershler, Julie L

2018-06-01

The risk-need-responsivity model (RNR; Bonta & Andrews, 2017) has become a leading approach for effective offender case management, but field tests of this model are still required. The present study first assessed the predictive validity of the RNR-informed Level of Service/Case Management Inventory (LS/CMI; Andrews, Bonta, & Wormith, 2004) with a sample of Atlantic Canadian male and female community-supervised provincial offenders (N = 136). Next, the case management plans prepared from these LS/CMI results were analyzed for adherence to the principles of risk, need, and responsivity. As expected, the LS/CMI was a strong predictor of general recidivism for both males (area under the curve = .75, 95% confidence interval [.66, .85]), and especially females (area under the curve = .94, 95% confidence interval [.84, 1.00]), over an average 3.42-year follow-up period. The LS/CMI was predictive of time to recidivism, with lower risk cases taking longer to reoffend than higher risk cases. Despite the robust predictive validity of the LS/CMI, case management plans developed by probation officers generally reflected poor adherence to the RNR principles. These findings highlight the need for better training on how to transfer risk appraisal information from valid risk tools to case plans to better meet the best-practice principles of risk, need, and responsivity for criminal behavior risk reduction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A CASE-BASED ROADMAP FOR LATERAL TRANSSHIPMENT IN SUPPLY CHAIN INVENTORY MANAGEMENT

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Henry Lau

2016-04-01

Full Text Available Manufacturers and wholesalers are increasingly cost conscious in response to today’s hyper-competitive environment. Lateral transshipment (LT has been proposed as a viable solution to drive total inventory costs down whilst increasing customer service level. Our study proposes five LT decision rules with a case-based roadmap to guide professional inventory management. Results of this large fast moving consumer goods case study company demonstrate superior inventory management performance with implementing a combined reactive and proactive LT strategy to determine whether to transship emergency stock from other warehouse or to backorder from suppliers, size of transshipment, favorite wholesaler, preferred supplier, and extra quantity for preventive LT, which are the key LT decision points among the professional supply chain management practitioners.

Best management practices for creating a community wildfire protection plan

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Pamela J. Jakes; Christine Esposito; Sam Burns; Antony S. Cheng; Kristen C. Nelson; Victoria E. Sturtevant; Daniel R. Williams

2012-01-01

A community wildfire protection plan (CWPP) is a means of bringing local solutions to wildland fire management. In developing and implementing CWPPs, communities assume a leadership role in reducing wildfi re risk on federal and nonfederal land. In this publication, we identify best management practices for CWPP development and implementation based on the experiences...

Evaluation of a Telephone-Delivered, Community-Based Collaborative Care Management Program for Caregivers of Older Adults with Dementia.

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Mavandadi, Shahrzad; Wray, Laura O; DiFilippo, Suzanne; Streim, Joel; Oslin, David

2017-09-01

To evaluate whether a community-based, telephone-delivered, brief patient/caregiver-centered collaborative dementia care management intervention is associated with improved caregiver and care recipient (CR) outcomes. Longitudinal program evaluation of a clinical intervention; assessments at baseline and 3- and 6-month follow-up. General community. Caregivers (N = 440) of older, community-dwelling, low-income CRs prescribed a psychotropic medication by a primary care provider who met criteria for dementia and were enrolled in the SUpporting Seniors Receiving Treatment And INtervention (SUSTAIN) program for older adults. Dementia care management versus clinical evaluation only. Perceived caregiving burden and caregiver general health (primary outcomes); CR neuropsychiatric symptoms and caregiver distress in response to CRs' challenging dementia-related behaviors (secondary outcomes). Caregivers were, on average, 64.0 (SD: 11.8) years old and 62.6% provided care for the CR for 20 or more hours per week. The majority of the sample was female (73.2%), non-Hispanic White (90.2%), and spousal caregivers (72.5%). Adjusted longitudinal models of baseline and 3- and 6-month data suggest that compared with caregivers receiving clinical evaluation only, caregivers receiving care management reported greater reductions in burden over time. Subgroup analyses also showed statistically significant reductions in caregiver-reported frequency of CR dementia-related behaviors and caregiver distress in response to those symptoms at 3-month follow-up. A community-based, telephone-delivered care management program for caregivers of individuals with dementia is associated with favorable caregiver and CR-related outcomes. Findings support replication and further research in the impact of tailored, collaborative dementia care management programs that address barriers to access and engagement. Published by Elsevier Inc.

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

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Fathima M

2017-09-01

Full Text Available Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. Methods: A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT, invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ] and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV1/forced expiratory volume in 6 seconds (FEV6 ratio <0.75 to their general practitioner (GP for further assessment and diagnosis. Results: In all, 91 of 167 (54% patients had an ISQ score >3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39% had an FEV1/FEV6 ratio of <0.75 and were referred to their GP. Patients with high ISQ symptoms scores (>3 were at a significantly higher risk of an FEV1/FEV6 ratio of <0.75, compared to patients with fewer COPD symptoms. A total of 15 (10% patients were diagnosed with COPD by their GP. Another eight (5% patients were diagnosed with other medical conditions and 87% of these were initiated on treatment. Although only half of all screened patients lived in regional areas, 93

Increasing physical activity for veterans in the Mental Health Intensive Case Management Program: A community-based intervention.

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Harrold, S Akeya; Libet, Julian; Pope, Charlene; Lauerer, Joy A; Johnson, Emily; Edlund, Barbara J

2018-04-01

Individuals with severe mental illness (SMI), experience increased mortality-20 years greater disparity for men and 15 years greater disparity for women-compared to the general population (Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442). Numerous factors contribute to premature mortality in persons with SMI, including suicide and accidental death (Richardson RC, Faulkner G, McDevitt J, Skrinar GS, Hutchinson D, Piette JD. Integrating physical activity into mental health services for persons with serious mental illness. Psychiatr Serv. 2005;56(3):324-331; Thornicroft G. Physical health disparities and mental illness: The scandal of premature mortality. Br J Psychiatr. 2011;199:441-442), but research has shown that adverse health behaviors-including smoking, low rate of physical activity, poor diet, and high alcohol consumption-also significantly contribute to premature deaths (Jones J. Life expectancy in mental illness. Psychiatry Services. 2010. Retrieved from http://psychcentral.com/news/2010/07/13/life-expectancy-in-mental-illness). This quality improvement (QI) project sought to improve health and wellness for veterans in the Mental Health Intensive Case Management Program (MHICM), which is a community-based intensive program for veterans with SMI at risk for decompensation and frequent hospitalizations. At the time of this QI project, the program had 69 veterans who were assessed and treated weekly in their homes. The project introduced a pedometer steps intervention adapted from the VA MOVE! Program-a physical activity and weight management program-with the addition of personalized assistance from trained mental health professionals in the veteran's home environment. Because a large percentage of the veterans in the MHICM program had high blood pressure and increased weight, these outcomes were the focus of this project. Through mental health case management involvement and

The use and usefulness of inventory-based management planning to forest management

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Toft, Maja Nastasia Juul; Adeyeye, Yemi; Lund, Jens Friis

2015-01-01

-structured interviews, participatory rural appraisal exercises and analyses of aerial photographs. First, we find that the operational plans supposed to guide community-level management are based on sub-standard forest inventories, which limits their potential role in practical forest management. Second, we find...... of their forests in the sense that their impressions of past and current forest condition are mirrored in what we can observe from analysis of change in forest condition based on aerial photographs. Based on these results we question the usefulness of inventory-based management planning in the context of community...

An assessment of patient education and self-management in diabetes disease management--two case studies.

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Fitzner, Karen; Greenwood, Deborah; Payne, Hildegarde; Thomson, John; Vukovljak, Lana; McCulloch, Amber; Specker, James E

2008-12-01

Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs.

Impacts of community-based natural resource management on wealth, food security and child health in Tanzania

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Pailler, Sharon; Naidoo, Robin; Burgess, Neil David

2015-01-01

Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates socioecono......Community-based natural resource management (CBNRM) is a major global strategy for enhancing conservation outcomes while also seeking to improve rural livelihoods; however, little evidence of socioeconomic outcomes exists. We present a national-level analysis that empirically estimates...... socioeconomic impacts of CBNRM across Tanzania, while systematically controlling for potential sources of bias. Specifically, we apply a difference-indifferences model to national-scale, cross-sectional data to estimate the impact of three different CBNRM governance regimes on wealth, food security and child...... health, considering differential impacts of CBNRM on wealthy and poor populations. We also explore whether or not longer-standing CBNRM efforts provide more benefits than recently-established CBNRM areas. Our results show significant improvements in household food security in CBNRM areas compared...

Demand generation and social mobilisation for integrated community case management (iCCM) and child health: Lessons learned from successful programmes in Niger and Mozambique.

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Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio

2014-12-01

We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care-seeking within 24 hours and care-seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers' ability to assess and treat illnesses can lead to improved care-seeking and utilisation, and community ownership for iCCM.

Demand generation and social mobilisation for integrated community case management (iCCM and child health: Lessons learned from successful programmes in Niger and Mozambique

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Alyssa B Sharkey

2014-11-01

Full Text Available We present the approaches used in and outcomes resulting from integrated community case management (iCCM programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM.

Case management redesign in an urban facility.

Science.gov (United States)

Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.

A case-based reasoning tool for breast cancer knowledge management with data mining concepts and techniques

Science.gov (United States)

Demigha, Souâd.

2016-03-01

The paper presents a Case-Based Reasoning Tool for Breast Cancer Knowledge Management to improve breast cancer screening. To develop this tool, we combine both concepts and techniques of Case-Based Reasoning (CBR) and Data Mining (DM). Physicians and radiologists ground their diagnosis on their expertise (past experience) based on clinical cases. Case-Based Reasoning is the process of solving new problems based on the solutions of similar past problems and structured as cases. CBR is suitable for medical use. On the other hand, existing traditional hospital information systems (HIS), Radiological Information Systems (RIS) and Picture Archiving Information Systems (PACS) don't allow managing efficiently medical information because of its complexity and heterogeneity. Data Mining is the process of mining information from a data set and transform it into an understandable structure for further use. Combining CBR to Data Mining techniques will facilitate diagnosis and decision-making of medical experts.

An evidence-based approach to case management model selection for an acute care facility: is there really a preferred model?

Science.gov (United States)

Terra, Sandra M

2007-01-01

This research seeks to determine whether there is adequate evidence-based justification for selection of one acute care case management model over another. Acute Inpatient Hospital. This article presents a systematic review of published case management literature, resulting in classification specific to terms of level of evidence. This review examines the best available evidence in an effort to select an acute care case management model. Although no single case management model can be identified as preferred, it is clear that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and to form a foundation for the efficacy of hospital case management practice. Although no single case management model can be identified as preferred, this systematic review demonstrates that adequate evidence-based literature exists to acknowledge key factors driving the acute care model and forming a foundation for the efficacy of hospital case management practice. Distinctive aspects of case management frameworks can be used to guide the development of an acute care case management model. The study illustrates: * The effectiveness of case management when there is direct patient contact by the case manager regardless of disease condition: not only does the quality of care increase but also length of stay (LOS) decreases, care is defragmented, and both patient and physician satisfaction can increase. * The preferred case management models result in measurable outcomes that can directly relate to, and demonstrate alignment with, organizational strategy. * Acute care management programs reduce cost and LOS, and improve outcomes. * An integrated case management program that includes social workers, as well as nursing, is the most effective acute care management model. * The successful case management model will recognize physicians, as well as patients, as valued customers with whom partnership can positively affect financial outcomes in terms of

Community Forest Management: An Assessment and Explanation of its Performance Through QCA

NARCIS (Netherlands)

Arts, B.J.M.; Koning, de J.

2017-01-01

Community Forest Management (CFM)—ranging from community-based to co-management regimes—has become an influential approach in the management of forests around the world in the last couple of decades. In response to some of the adverse effects of state forestry and commercial timber production, CFM

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

Science.gov (United States)

Sultana, Parvin; Abeyasekera, Savitri

2008-01-01

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

Development of the Andalusian Registry of Patients Receiving Community Case Management, for the follow-up of people with complex chronic diseases.

Science.gov (United States)

Morales-Asencio, Jose M; Kaknani-Uttumchandani, Shakira; Cuevas-Fernández-Gallego, Magdalena; Palacios-Gómez, Leopoldo; Gutiérrez-Sequera, José L; Silvano-Arranz, Agustina; Batres-Sicilia, Juan Pedro; Delgado-Romero, Ascensión; Cejudo-Lopez, Ángela; Trabado-Herrera, Manuel; García-Lara, Esteban L; Martin-Santos, Francisco J; Morilla-Herrera, Juan C

2015-10-01

Complex chronic diseases are a challenge for the current configuration of health services. Case management is a service frequently provided for people with chronic conditions, and despite its effectiveness in many outcomes, such as mortality or readmissions, uncertainty remains about the most effective form of team organization, structures and the nature of the interventions. Many processes and outcomes of case management for people with complex chronic conditions cannot be addressed with the information provided by electronic clinical records. Registries are frequently used to deal with this weakness. The aim of this study was to generate a registry-based information system of patients receiving case management to identify their clinical characteristics, their context of care, events identified during their follow-up, interventions developed by case managers and services used. The study was divided into three phases, covering the detection of information needs, the design and its implementation in the health care system, using literature review and expert consensus methods to select variables that would be included in the registry. A total of 102 variables representing structure, processes and outcomes of case management were selected for their inclusion in the registry after the consensus phase. A web-based registry with modular and layered architecture was designed. The framework follows a pattern based on the model-view-controller approach. In its first 6 months after the implementation, 102 case managers have introduced an average number of 6.49 patients each one. The registry permits a complete and in-depth analysis of the characteristics of the patients who receive case management, the interventions delivered and some major outcomes as mortality, readmissions or adverse events. © 2015 John Wiley & Sons, Ltd.

Preventive home care of frail older people: a review of recent case management studies.

Science.gov (United States)

Hallberg, Ingalill Rahm; Kristensson, Jimmie

2004-09-01

Preventive actions targeting community-dwelling frail older people will be increasingly important with the growing number of very old and thereby also frail older people. This study aimed to explore and summarize the empirical literature on recent studies of case/care management interventions for community-dwelling frail older people and especially with regard to the content of the interventions and the nurse's role and outcome of it. Very few of the interventions took either a preventive or a rehabilitative approach using psycho-educative interventions focusing, for instance, on self-care activities, risk prevention, health complaints management or how to preserve or strengthen social activities, community involvement and functional ability. Moreover, it was striking that very few included a family-oriented approach also including support and education for informal caregivers. Thus it seems that the content of case/care management needs to be expanded and more influenced by a salutogenic health care perspective. Targeting frail older people seemed to benefit from a standardized two-stage strategy for inclusion and for planning the interventions. A comprehensive geriatric assessment seemed useful as a base. Nurses, preferably trained in gerontological practice, have a key role in case/care management for frail older people. This approach calls for developing the content of case/care management so that it involves a more salutogenic, rehabilitative and family-oriented approach. To this end it may be useful for nurses to strengthen their psychosocial skills or develop close collaboration with social workers. The outcome measures examined in this study represented one of three perspectives: the consumer's perspective, the perspective of health care consumption or the recipient's health and functional ability. Perhaps effects would be expected in all three areas and thus these should be included in evaluative studies in addition to measures for family and/or informal

The economics of reducing emissions from community managed forests in Nepal Himalaya

NARCIS (Netherlands)

Karky, B.S.

2008-01-01

The climate change agenda is more important in global politics today than ever before. This research set out to examine whether community forest management (CFM) can play a signifi cant role in reducing global emissions, by taking Nepal’s community forestry sector as a case. The thesis selects three

Role of Knowledge Based Communities in Knowledge Process

Directory of Open Access Journals (Sweden)

Sebastian Ion CEPTUREANU

2015-12-01

Full Text Available In the new economy, knowledge is an essential component of economic and social systems. The organizational focus has to be on building knowledge-based management, development of human resource and building intellectual capital capabilities. Knowledge-based management is defined, at company level, by economic processes that emphasize creation, selling, buying, learning, storing, developing, sharing and protection of knowledge as a decisive condition for profit and long-term sustainability of the company. Hence, knowledge is, concurently, according to a majoritiy of specialists, raw material, capital, product and an essential input. Knowledge-based communities are one of the main constituent elements of a framework for knowledge based management. These are peer networks consisting of practitioners within an organization, supporting each other to perform better through the exchange and sharing of knowledge. Some large companies have contributed or supported the establishment of numerous communities of practice, some of which may have several thousand members. They operate in different ways, are of different sizes, have different areas of interest and addresses knowledge at different levels of its maturity. This article examines the role of knowledge-based communities from the perspective of knowledge based management, given that the arrangements for organizational learning, creating, sharing, use of knowledge within organizations become more heterogeneous and take forms more difficult to predict by managers and specialists.

Examining End-of-Life Case Management: Systematic Review

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Roger E. Thomas

2014-01-01

Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

Collaborative leadership and the implementation of community-based fall prevention initiatives: a multiple case study of public health practice within community groups.

Science.gov (United States)

Markle-Reid, Maureen; Dykeman, Cathy; Ploeg, Jenny; Kelly Stradiotto, Caralyn; Andrews, Angela; Bonomo, Susan; Orr-Shaw, Sarah; Salker, Niyati

2017-02-16

Falls among community-dwelling older adults are a serious public health concern. While evidence-based fall prevention strategies are available, their effective implementation requires broad cross-sector coordination that is beyond the capacity of any single institution or organization. Community groups comprised of diverse stakeholders that include public health, care providers from the public and private sectors and citizen volunteers are working to deliver locally-based fall prevention. These groups are examples of collective impact and are important venues for public health professionals (PHPs) to deliver their mandate to work collaboratively towards achieving improved health outcomes. This study explores the process of community-based group work directed towards fall prevention, and it focuses particular attention on the collaborative leadership practices of PHPs, in order to advance understanding of the competencies required for collective impact. Four community groups, located in Ontario, Canada, were studied using an exploratory, retrospective, multiple case study design. The criteria for inclusion were presence of a PHP, a diverse membership and the completion of an initiative that fit within the scope of the World Health Organization Fall Prevention Model. Data were collected using interviews (n = 26), focus groups (n = 4), and documents. Cross-case synthesis was conducted by a collaborative team of researchers. The community groups differed by membership, the role of the PHP and the type of fall prevention initiatives. Seven practice themes emerged: (1) tailoring to address context; (2) making connections; (3) enabling communication; (4) shaping a vision; (5) skill-building to mobilize and take action; (6) orchestrating people and projects; and (7) contributing information and experience. The value of recognized leadership competencies was underscored and the vital role of institutional supports was highlighted. To align stakeholders working

Endurance and Adaptation of Community Forest Management in Quintana Roo, Mexico

Directory of Open Access Journals (Sweden)

Edward A. Ellis

2015-11-01

Full Text Available Despite regional deforestation threats, the state of Quintana Roo has maintained over 80% of its territory in forests. Community forest management (CFM has played a pivotal role in forest cover and biodiversity conservation in the region. In this article, we present the institutional, socioeconomic and environmental conditions under which community-based forest management has been consolidated in the tropical state of Quintana Roo, which occupies the eastern half of Mexico’s Yucatan Peninsula. With a focus on management for timber and other market-based development strategies, we then examine the institutional and socioeconomic factors, as well as biophysical shocks, that have constrained community forestry development in the past 25 years, challenging its persistence. Following, we discuss how forest communities and institutions have responded and adapted to changing forest policies and markets as well as major environmental shocks from hurricanes and fires. CFM in Quintana Roo has shown resiliency since its institutionalization 30 years ago. Future challenges and opportunities include biodiversity conservation, carbon management through Reducing Emissions from Deforestation and Forest Degradation (REDD+ initiatives, market strengthening, business management training as well as the implementation of alternative silvicultural systems, particularly to manage sustainable populations of commercial timber species.

[Evaluation by case managers dementia : An explorative practice based study on types and content].

Science.gov (United States)

Ketelaar, Nicole A B M; Jukema, Jan S; van Bemmel, Marlies; Adriaansen, Marian J M; Smits, Carolien H M

2017-06-01

This practice based explorative study aims to provide insight into the ways in which case managers shape and fill up the evaluation phase of their support of the informal care network of persons with dementia. A combination of quantitative and qualitative research methods were used. A group of 57 case managers of persons with dementia in three different organisational networks took part in this study. Results from the quantitative and qualitative data are organized into four themes: (1) attitude towards evaluation, (2) forms of evaluation, (3) implementation of evaluation and (4) content of evaluation. There are different ways in shaping evaluation and the content of it. The importance of interim and final evaluation is recognized, but is difficult to realize in a methodical way. Barriers experienced by the case managers include various factors associated both with clients as professionals. Case managers evaluate continuously and in an informal way to assess whether the extent of their assistance is meeting the needs of the client and informal network. Case managers do not use systematic evaluation to measure the quality of care they offer to persons with dementia and their caregivers. The findings demand a discussion on the level of clients, as well as on the professional and societal level about the way case managers should evaluate their support.

Aspects and Intensity of Pediatric Palliative Case Management Provided by a Hospital-Based Case Management Team: A Comparative Study Between Children With Malignant and Nonmalignant Disease.

Science.gov (United States)

Jagt-van Kampen, Charissa T; Colenbrander, Derk A; Bosman, Diederik K; Grootenhuis, Martha A; Kars, Marijke C; Schouten-van Meeteren, Antoinette Yn

2018-01-01

Anticipating case management is considered crucial in pediatric palliative care. In 2012, our children's university hospital initiated a specialized pediatric palliative care team (PPCT) to deliver inbound and outbound case management for children with life-shortening disease. The aim of this report is to gain insight in the first 9 months of this PPCT. Aspects of care during the first 9 months of the PPCT are presented, and comparison is made between patients with malignant disease (MD) and nonmalignant disease (NMD) in a retrospective study design. Insight in the aspects of care of all patients with a life-shortening disease was retrieved from web-based files and the hour registrations from the PPCT. Forty-three children were supported by the PPCT during the first 9 months: 22 with MD with a median of 50 (1-267) days and 29 minutes (4-615) of case management per patient per day and 21 patients with NMD with a median of 79.5 (5-211) days and 16 minutes of case management per day (6-64). Our data show significantly more interprofessional contacts for patients with MD and more in-hospital contacts for patients with NMD. The median number of admission days per patient was 11 (0-22) for MD (44% for anticancer therapy) and 44 (0-303) for NMD (36% for infectious diseases). This overview of aspects of pediatric palliative case management shows shorter but more intensive case management for MD in comparison with NMD. This insight in palliative case management guides the design of a PPCT.

Who Manages Space? Eco-DRR and the Local Community

Directory of Open Access Journals (Sweden)

Syarifah Aini Dalimunthe

2018-05-01

Full Text Available The notion of ecosystem-based disaster risk reduction (DRR has only recently emerged in Indonesia. The Indonesian central government now adopts some policies related to ecosystem-based DRR with formal commitments from local administrations. At the implementation level, various activities have taken place, such as mangrove planting and restoration along the coastline to address the rising sea level and the “one billion trees” program to address the urgent issue of deforestation. These governmental activities have involved local communities that reside in the high-risk area, while nonlocal actors, particularly from the private and the nongovernmental sectors, have contributed as a third element to development. This paper examines space management in the context of Eco-DRR, paying special attention to uncertainty and anxiety in the local communities as the government and private sectors engage in development activities that have significant impacts on their present and future lives. The present study pursues this purpose by means of in-depth interview and focus group discussions (FGD with local leaders in mangrove planting and restoration programs. The study took place in a small island community in a part of the Jakarta Megapolitan Region, Indonesia. The results point out that the community feels left behind due to lack of trust in managing the conservation space. Another issue to be addressed is how to improve the democratization of environment management and livelihood base of the local community. Therefore, building confidence and ameliorating relationships between actors within/without the local community should lead to a better Eco-DRR initiative.

Utilising Planning and Financing Strategies in the Management of Community Development Projects in Enugu State, Nigeria

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Obetta, Chukwuemeka K.; Oreh, Catherine I.

2017-01-01

Utilisation of community management strategies is an approach to governance that is based on community and organisational involvement. Communities with development projects have formed community projects management committees (CPMCs) that are encouraged to adopt the community management strategy in the planning and financing of community…

Economic Community of West African States Conflict Management and Resolution: A Case Study

National Research Council Canada - National Science Library

Umaru, Kayode

2003-01-01

.... The prevalence of conflicts has risen since the last decade and though the Economic Community of West African States has been involved in the management of these conflicts, the efforts were marred...

Making it local: Beacon Communities use health information technology to optimize care management.

Science.gov (United States)

Allen, Amy; Des Jardins, Terrisca R; Heider, Arvela; Kanger, Chatrian R; Lobach, David F; McWilliams, Lee; Polello, Jennifer M; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Tulikangas, Megan C; Turske, Scott A

2014-06-01

Care management aims to provide cost-effective, coordinated, non-duplicative care to improve care quality, population health, and reduce costs. The 17 communities receiving funding from the Office of the National Coordinator for Health Information Technology through the Beacon Community Cooperative Agreement Program are leaders in building and strengthening their health information technology (health IT) infrastructure to provide more effective and efficient care management. This article profiles 6 Beacon Communities' health IT-enabled care management programs, highlighting the influence of local context on program strategy and design, and describing challenges, lessons learned, and policy implications for care delivery and payment reform. The unique needs (eg, disease burden, demographics), community partnerships, and existing resources and infrastructure all exerted significant influence on the overall priorities and design of each community's care management program. Though each Beacon Community needed to engage in a similar set of care management tasks--including patient identification, stratification, and prioritization; intervention; patient engagement; and evaluation--the contextual factors helped shape the specific strategies and tools used to carry out these tasks and achieve their objectives. Although providers across the country are striving to deliver standardized, high-quality care, the diverse contexts in which this care is delivered significantly influence the priorities, strategies, and design of community-based care management interventions. Gaps and challenges in implementing effective community-based care management programs include: optimizing allocation of care management services; lack of available technology tailored to care management needs; lack of standards and interoperability; integrating care management into care settings; evaluating impact; and funding and sustainability.

Restoring Myanmar’s mangrove forests and coastal communities’ socioeconomic stability with community based mangrove management

OpenAIRE

Lindholt, Jonathan Grevstad

2016-01-01

Mangrove forests have a significant capacity to provide ecosystem services. However, deforestation from land use changes has led to widespread degradation of these services and consequently jeopardizes coastal populations. Reforestation projects and attempts to develop sustainable management procedures are widely attempted worldwide. However, these projects often have sustainable rural livelihood improvements as a complementary goal. Integrated approaches such as Community Based Mangrove Mana...

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective.

Science.gov (United States)

Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

2017-01-01

Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV 1 )/forced expiratory volume in 6 seconds (FEV 6 ) ratio 3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV 1 /FEV 6 ratio of 3) were at a significantly higher risk of an FEV 1 /FEV 6 ratio of strategy for reducing the burden of COPD, particularly for those living in rural locations.

Case Management Promotion of Social Media for the Elderly Who Live Alone.

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Hashi, Ilham

2016-01-01

Professional case managers advocate patient access to necessary and appropriate services, while educating the patient and family and/or caregiver about resource availability within practice settings. The purpose of this article is to explain the role case managers can have to promote the use of social media by the elderly, as a means to decrease their loneliness and isolation. The promotion of the use of social media will take place in the community setting, involving willing and competent elderly patients who live alone. It is framed as one strategy to help combat loneliness. The primary target audiences for this initiative are case managers who work in the community, as they are the ones who have contact with this population. However, hospital case managers could also benefit, as they need to be aware of ways to help discharged elderly patients feel more connected to their community; the use of social media is one way to achieve this outcome. The elderly population experience changes brought on by their longer life. One of those changes or undesirable effects is an increase in social isolation and experiencing loneliness. There are many factors that contribute to loneliness and social isolation in the elderly such as a change in financial situations, death, divorce, or migration. Utilizing the capabilities of the internet, coupled with the use of social media (e.g., Facebook), can facilitate opening up a virtual world where the elderly can communicate with family and friends, make new friends, or occupy their time with the many interactive games that are available online. Case managers should increase their awareness to identify patients who are socially isolated; the outcome is to decrease the risk of developing a major depressive disorder. Community case managers might at times be the only professional health care givers who are visiting patients in their home; therefore, they should also be aware of the signs and symptoms of depression so they can encourage

Exploring Weight Management Recommendations across Australian Community Pharmacies Using Case Vignettes

Science.gov (United States)

Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.

2014-01-01

With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…

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

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.

Managing the Social Determinants of Health: Part I: Fundamental Knowledge for Professional Case Management.

Science.gov (United States)

Fink-Samnick, Ellen

PRIMARY PRACTICE SETTING(S):: Applicable to health and behavioral health settings, wherever case management is practiced. The SDH pose major challenges to the health care workforce in terms of effective resource provision, health and behavioral health treatment planning plus adherence, and overall coordination of care. Obstacles and variances to needed interventions easily lead to less than optimal outcomes for case managers and their health care organizations. Possessing sound knowledge and clear understanding of each SDH, the historical perspectives, main theories, and integral dynamics, as well as creative resource solutions, all support a higher level of intentional and effective professional case management practice. Those persons and communities impacted most by the SDH comprise every case management practice setting. These clients can be among the most vulnerable and disenfranchised members of society, which can easily engender biases on the part of the interprofessional workforce. They are also among the costliest to care for with 50% of costs for only 5% of the population. Critical attention to knowledge about managing the SDH leverages and informs case management practice, evolves more effective programming, and enhances operational outcomes across practice settings.

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

OpenAIRE

Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The h...

Effectiveness of Case Management for Homeless Persons: A Systematic Review

Science.gov (United States)

de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

2013-01-01

We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

Case mix management education in a Canadian hospital.

Science.gov (United States)

Moffat, M; Prociw, M

1992-01-01

The Sunnybrook Health Science Centre's matrix organization model includes a traditional departmental structure, a strategic program-based structure and a case management-based structure--the Clinical Unit structure. The Clinical Unit structure allows the centre to give responsibility for the management of case mix and volume to decentralized Clinical Unit teams, each of which manages its own budget. To train physicians and nurses in their respective roles of Medical Unit directors and Nursing Unit directors, Sunnybrook designed unique short courses on financial management and budgeting, and case-costing and case mix management. This paper discusses how these courses were organized, details their contents and explains how they fit into Sunnybrook's program of decentralized management.

COLLABORATE©: a universal competency-based paradigm for professional case management, part i: introduction, historical validation, and competency presentation.

Science.gov (United States)

Treiger, Teresa M; Fink-Samnick, Ellen

2013-01-01

The purpose of this first of a three-article series is to provide context and justification for a new paradigm of case management built upon a value-driven foundation that Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is there will be constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby or Pokey. This is exactly why the definition of a competency-based case management model's time has come, one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than by the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. While there is inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

Community impact management

International Nuclear Information System (INIS)

Baril, R.G.

1983-01-01

Industrial expansion, whether for resource extraction, refining, production or distribution and particularly the construction of energy facilities, usually has many effects on communities. In the early 1970s, as more experience was gained with large projects and as communities became more sensitive to their needs and rights, the negative effects of projects gained some prominence. Communities questioned whether it was in their best interest to accept changes that large corporations would impose on them. It is in this context that Ontario Hydro, in 1977, set up the first of four community impact agreements for the construction of generating stations. This paper discusses these community impact agreements and how they have become the framework for the management of community impacts. Also, the paper discusses a model for compensating social impacts

ICT Design for Collaborative and Community Driven Disaster Management.

Science.gov (United States)

Kuziemsky, Craig E

2017-01-01

Information and communication technologies (ICT) have the potential to greatly enhance our ability to develop community reliance and sustainability to support disaster management. However, developing community resilience requires the sharing of numerous resources and the development of collaborative capacity, both of which make ICT design a challenge. This paper presents a framework that integrates community based participatory research (CBPR) and participatory design (PD). We discuss how the framework provides bounding to support community driven ICT design and evaluation.

[Case managers experience improved trajectories for cancer patients after implementation of the case manager function].

Science.gov (United States)

Axelsen, Karina Rahbek; Nafei, Hanne; Jakobsen, Stine Finne; Gandrup, Per; Knudsen, Janne Lehmann

2015-06-08

Case managers are increasingly used to optimize trajectories for patients. This study is based on a questionnaire among case managers in cancer care, aiming at the clarification of the func­tion and its impact on especially patient safety, when handing over the responsibility. The results show a major variation in how the function is organized, the level of competence and the task to be handled. The responsibility has in general been nar­rowed to department level. Overall, the case managers believe that the function has optimized pathways for cancer patients and improved safety, but barriers persist.

[Intervention of Schizophrenia From the Community Model].

Science.gov (United States)

Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

The RF spectrum: managing community health concerns

International Nuclear Information System (INIS)

Maclean, I.

2001-01-01

In this presentation I would like to share with you the way in which the Australian Communications Authority (ACA) goes about 'managing' community issues relating to the RF spectrum. In particular, I would like to refer to community issues associated with concerns about health. I will refer only briefly to the siting of mobile phone base stations as that will be covered elsewhere. Before getting into the community issues, I would like to provide some context about the ACA and the arrangements it has for regulating radiofrequency electromagnetic radiation (RF EMR). Copyright (2001) Australasian Radiation Protection Society Inc

Improving village poultry’s survival rate through community-based poultry health management

DEFF Research Database (Denmark)

Sodjinou, Epiphane; Henningsen, Arne; Koudande, Olorounto D.

Community-based poultry health management (CBM) is a strategy for village poultry improvement based on the installment of “poultry interest groups” in experimental villages. These groups serve as a channel for the dissemination of village poultry improvement technologies. The use of CBM is due...... to the fact that village poultry farming is practiced in a total or partial scavenging system which gives the impression that all the birds in the village belong to the same flock. Accordingly, actions that target all farmers of the same village may have a larger impact on the village poultry’s survival rate...... than actions that target individual producers. The objective of this study is to assess the impact of CBM on the survival rate of village poultry. Based on data collected on 353 poultry keepers, the study shows that CBM significantly improves the survival rate of village poultry. The adoption...

Community-Based Disaster Risk Management in the Philippines: Achievements and Challenges of the Purok System

Directory of Open Access Journals (Sweden)

Angelina Matthies

2017-06-01

Full Text Available The purok system in the Philippines is promoted as a voluntary self-organization at the sub-village level which strengthens community resilience to natural hazards. In 2011, the system received the UN Sasakawa Award and gained prominence among the practitioner community. Based on a qualitative study in the municipality of San Francisco (Cebu province from December 2014 to March 2015, the article elaborates on the achievements and challenges of the purok system. Striking merits encompass efficient and effective information dissemination and evacuation measurements between all levels of political administration that stem from the system’s remarkable enforcement of human and social capital. This is underpinned by a clear determination of roles and responsibility that is subsumed under the concept of accountability. However, the purok system faces internal challenges of maintenance and implies profound conceptual ambiguities regarding the notion of voluntarism and capabilities that favor clientelism. Nevertheless, the purok system clearly distinguishes itself from conventional community-based disaster risk management practices and implies potentials that are highly beneficial for strengthening resilience in disaster prone areas.

Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

Science.gov (United States)

Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

2009-11-01

We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

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...

Rural electrification for isolated consumers: Sustainable management model based on residue biomass

International Nuclear Information System (INIS)

Pinheiro, Giorgiana; Rendeiro, Goncalo; Pinho, Joao; Macedo, Emanuel

2011-01-01

This paper presents a case study of the electrification of a riparian community in the State of Para, Brazil, within the scope of the Program for Electric Power Service Universalization in Brazil. The community is located in a remote area; approximately 100 km from the municipal district, there is no regular transport to access the community, and adequate communication service. The community is provided with electrification facilities through a small biomass-based power plant, directly firing residues produced by the local economic activity. The objective of the paper is to propose a sustainable management model that is suitable for community's isolation conditions, considering the high costs with operation and maintenance related to the supply of isolated consumers in small locations. A simulation is conducted for the operation of the small biomass-based power plant, the generation costs are determined, the legal aspects are analyzed, and a suggestion for the management model is presented. - Highlights: → Electrification of isolated consumers is a great challenge for utilities. → Using local labor and resources allows lower energy costs for electrification. → Creation of a specific legislation for utilities is required. → Should also be implemented social activities together with electrification.

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.

Management Conflicts in Cameroonian Community Forests

Directory of Open Access Journals (Sweden)

Driss Ezzine de Blas

2011-03-01

Full Text Available Cameroonian community forests were designed and implemented to meet the general objectives of forest management decentralization for democratic and community management. The spread of management conflicts all over the country has shown that these broad expectations have not been met. We describe conflicts occurring in 20 community forests by types of actors and processes involved. We argue that a number of external (community vs. external actors and internal (intra-community conflicts are part of the causes blocking the expected outcome of Cameroonian community forests, fostering bad governance and loss of confidence. Rent appropriation and control of forest resources appear as systemic or generalized conflicts. While community forest support projects have tended to focus on capacity building activities, less direct attention has been given to these systemic problems. We conclude that some factors like appropriate leadership, and spending of logging receipts on collective benefits (direct and indirect are needed to minimize conflicts. Government and development agencies should concentrate efforts on designing concrete tools for improving financial transparency while privileging communities with credible leaders.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India.

Science.gov (United States)

Srivastava, P K; Kulshreshtha, K; Mohanty, C S; Pushpangadan, P; Singh, A

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible "threats" into "opportunities" and changing the "weaknesses" into "strengths" regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow.

Stakeholder-based SWOT analysis for successful municipal solid waste management in Lucknow, India

International Nuclear Information System (INIS)

Srivastava, P.K.; Kulshreshtha, K.; Mohanty, C.S.; Pushpangadan, P.; Singh, A.

2005-01-01

The present investigation is a case study of Lucknow, the main metropolis in Northern India, which succumbs to a major problem of municipal solid waste and its management. A qualitative investigation using strengths, weaknesses, opportunities and threats analysis (SWOT) has been successfully implemented through this community participation study. This qualitative investigation emphasizes the limited capabilities of the municipal corporation's resources to provide proper facilitation of the municipal solid waste management (MSWM) services without community participation in Lucknow city. The SWOT analysis was performed to formulate strategic action plans for MSWM in order to mobilize and utilize the community resources on the one hand and municipal corporation's resources on the other. It has allowed the introduction of a participatory approach for better collaboration between the community and municipal corporation in Lucknow (India). With this stakeholder-based SWOT analysis, efforts were made to explore the ways and means of converting the possible 'threats' into 'opportunities' and changing the 'weaknesses' into 'strengths' regarding a community-based MSWM programme. By this investigation, concrete strategic action plans were developed for both the community and municipal corporation to improve MSWM in Lucknow

Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

OpenAIRE

Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

2017-01-01

Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case fin...

Veterans Affairs Intensive Case Management for older veterans.

Science.gov (United States)

Mohamed, Somaia; Neale, Michael S; Rosenheck, Robert

2009-08-01

There is a growing need for information on evidence-based practices that may potentially address needs of elderly people with severe mental illness (SMI), and more specifically on community-based services such as assertive community treatment (ACT). This study examines national evaluation data from fiscal year 2001-2005 from Veterans Affairs Mental Health Intensive Case Management (MHICM) program (N = 5,222), an ACT-based service model, to characterize the age distribution of participants and the distinctive needs, patterns of service delivery, and treatment outcomes for elderly veterans. Altogether, 24.8% of participants were 55-64 years; 7.4% 65-74 years; and 2.8% were older than 75. Veterans over 75 formed a distinct subgroup that had a later age of onset of primarily nonpsychotic illnesses without comorbid substance abuse and had experienced more limited lifetime hospital treatment than younger participants. Older veterans were less symptomatic and more satisfied with their social relationships than younger clients. They mostly live independently or in minimally restrictive housing, but they received less recovery-focused services and more crisis intervention and medical services. They thus do not appear to be young patients with SMI who have aged but rather constitute a distinct group with serious late-onset problems. It is possible that MHICM services keep them in the community and avoid costly nursing home placement while providing a respite service that reduces family burden. These data highlight the unique characteristics of older veterans receiving ACT-like services and the need to focus greater attention on recovery-oriented services as well as community support for this subgroup.

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...

Perceived Benefits and Barriers of a Community-Based Diabetes Prevention and Management Program.

Science.gov (United States)

Shawley-Brzoska, Samantha; Misra, Ranjita

2018-03-13

This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants' perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% females; 62% diabetic; 77% had adequate health literacy); 79% of participants completed the benefits and barriers survey. Principal component analysis indicated two components representing benefits (Cronbach's α = 0.83) and barriers (α = 0.65). The majority perceived high benefits and low barriers to program participation; benefits included helpful interaction with health coach or program leader (73%), improved lifestyle modification (65%) due to the program, and satisfaction with the program (75%). Open-ended questions confirmed themes related to benefits of program participation, suggestion for programmatic improvements as well as barriers to participation. Participant feedback could be used to guide interventions and tailor future program implementation.

Using the critical incident technique in community-based participatory research: a case study.

Science.gov (United States)

Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

2011-01-01

Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

Community Based Networks and 5G Wi-Fi

DEFF Research Database (Denmark)

Williams, Idongesit

2018-01-01

This paper argues on why Community Based Networks should be recognized as potential 5G providers using 5G Wi-Fi. The argument is hinged on findings in a research to understand why Community Based Networks deploy telecom and Broadband infrastructure. The study was a qualitative study carried out...... inductively using Grounded Theory. Six cases were investigated. Two Community Based Network Mobilization Models were identified. The findings indicate that 5G Wi-Fi deployment by Community Based Networks is possible if policy initiatives and the 5G Wi-Fi standards are developed to facilitate the causal...

Is the contribution of community forest users financially efficient? A household level benefit-cost analysis of community forest management in Nepal

Directory of Open Access Journals (Sweden)

Rajesh Kumar Rai

2016-02-01

Full Text Available Community forestry in Nepal is considered an exemplary forest management regime. However, the economics behind managing a community forest is not fully studied. This study examines whether the benefits generated from community forest management justify the contributions of forest users. The study is based on a survey of community forest users in Chitwan, Nepal. A household level benefit-cost analysis was performed to quantify and compare the costs and benefits from community forest management. Only direct benefits were included in the analysis. The study shows that older forest user groups derive more benefits to households compared to more recently established ones. The extent of timber harvesting also substantially influences the size of the household benefits. In addition, redistribution of benefits at the household level, in terms of income generating activities and payment for involvement in forest management activities, also enhances household benefits. Sensitivity analysis suggests that the current practice of community forest management enhances the welfare of rural households in this subsistence community. However, this finding is sensitive to assumptions regarding the opportunity cost of time. The study also found that the household costs of community forest management depend upon two factors – the area of community forest and the size of the forest area relative to the number of households.

Risk assessment and model for community-based construction ...

African Journals Online (AJOL)

It, therefore, becomes necessary to systematically manage uncertainty in community-based construction in order to increase the likelihood of meeting project objectives using necessary risk management strategies. Risk management, which is an iterative process due to the dynamic nature of many risks, follows three main ...

Information needs of case managers caring for persons living with HIV.

Science.gov (United States)

Schnall, Rebecca; Cimino, James J; Currie, Leanne M; Bakken, Suzanne

2011-05-01

The goals of this study were to explore the information needs of case managers who provide services to persons living with HIV (PLWH) and to assess the applicability of the Information Needs Event Taxonomy in a new population. The study design was observational with data collection via an online survey. Responses to open-ended survey questions about the information needs of case managers (n=94) related to PLWH of three levels of care complexity were categorized using the Information Needs Event Taxonomy. The most frequently identified needs were related to patient education resources (33%), patient data (23%), and referral resources (22%) accounting for 79% of all (N=282) information needs. Study limitations include selection bias, recall bias, and a relatively narrow focus of the study on case-manager information needs in the context of caring for PLWH. The study findings contribute to the evidence base regarding information needs in the context of patient interactions by: (1) supporting the applicability of the Information Needs Event Taxonomy and extending it through addition of a new generic question; (2) providing a foundation for the addition of context-specific links to external information resources within information systems; (3) applying a new approach for elicitation of information needs; and (4) expanding the literature regarding addressing information needs in community-based settings for HIV services.

Using the "Seven A's" assessment tool for developing competency in case management.

Science.gov (United States)

Gallagher, Louise P; Truglio-Londrigan, Marie

2004-01-01

In the latter part of the 20th century, healthcare reform sparked a transition in the nursing curriculum from acute care to primary and secondary care. Faculty responded to this challenge by redesigning curricula in creative ways. The transitional curriculum introduced community clinical experiences designed to challenge students to practice in diverse, nontraditional sites and in more independent ways. Such practice requires the nurse to function as designer, coordinator, and manager of patient care in addition to the traditional provider role. Additionally, the transitional curricula emphasized the roles of communicator, educator, facilitator, listener, and advocate to a greater degree. For students to achieve competence in the above roles, the curriculum must include learning activities that allow them to practice as case managers in the community. This paper presents the "Seven A's" as a framework for students to gain an understanding of and engage in the role and process of case management in the community.

Effective support for community resource management

NARCIS (Netherlands)

Ansink, E.; Bouma, J.A.

2013-01-01

A popular alternative to state-led resource management is community resource management. This decentralised approach is potentially more efficient, but is not necessarily stable. We study this issue using coalition theory, arguing that some of the conditions for effective community resource

Design and application of a theory-based case/care management model for home care: advanced practice for nurses as care managers.

Science.gov (United States)

Sears, Nancy A

2002-01-01

Case management has developed in a variety of health care, social service, and insurance industries. Its historical pattern of development has resulted in practices that are generally administrative and technical in nature as well as being relatively generic and often undifferentiated between being a role and process. Research over the last decade has resulted in the opportunity to move case management practice for home care into a structured theory-based model and practice. Design and implementation of a specialized advanced practice care management model reflective of care management research and theory design by British researchers is beginning to show clinical and systemic results that should be replicable in other regions.

Management Information Systems Students' Perception of Skills and Competencies - Towards Knowledge Based Community

Directory of Open Access Journals (Sweden)

Alev ELÇİ

2016-12-01

Full Text Available The increasing usage of Information and Communication Technologies in official borders of our business lives, starting from e-government and e-commerce applications, spreading towards our daily personal lives has made it difficult to ignore the importance of Management Information Systems (MIS. MIS, initially taught as a course in different disciplines, has now started to develop as a standalone interdisciplinary academic program in higher education. Besides curriculum standards suggestions and necessary skills and competencies for MIS education identified by academic and professional organizations, students' perceptions in these topics are also important. Thus while developing towards knowledge based community, the aim of this research is to identify MIS students' perceptions of essential skills and competencies in their educational, proffesional and personal lives. The sample group of this study are the students that are a member of social media MIS groups. The gathered quantitative data has been analyzed by an online survey. As a result, it has been evident that students find that information technical skills and competencies are crucial. The skills required for transition to knowledge based community; global working, multicultural, social responsibility, civic awareness, equal opportunity, gender and environmental awareness comes later.

Social Relation between Businessman and Community in Management of Intensive Shrimp Pond

Science.gov (United States)

Gumay Febryano, Indra; Sinurat, James; Lovinia Salampessy, Messalina

2017-02-01

Expansion of aquaculture, especially shrimp culture, is the primary cause of deforestation of mangrove along coastal zone. This phenomenon is pretty much related to social relation between businessman of intensive shrimp pond and community around coastal zone. The objective of this research is to explain social relation between businessman and community in managing intensive shrimp pond. This research is a kind of qualitative research and the method used is a case study. The result of this research shows that the behaviour of the majority of businessman of intensive shrimp pond is not accordingly with environmental concerns as they compelled conversion of mangrove and they disposed waste of shrimp pond into the sea. Such kind of behaviour caused degradation of water ecosystem and marginalizing local community. Corporate Social Responsibility (CSR) which was implemented by businessman of intensive shrimp pond in the area of social, religion, and education can downgrade the coming up of social turbulence. Otherwise, CSR in enabling economic community and environmental management was not conducted yet. CSR in environmental management can be conducted by businessman of intensive shrimp pond by considering the existence of mangrove and pond management and waste in a better way, so that environment around ponds is not polluted and the sustainability of shrimp pond business as well as income of community can be guaranteed. Accordingly with the result of this research, CSR is not only involving businessman of intensive shrimp pond and community, but also involving local government in terms of right and responsibility of citizen as well as management and development of community.

Community-based tourism in Cape Verde - a case study

OpenAIRE

Tomas Lopez-Guzman; Osvaldo Borges; Ana Maria Castillo-Canalejo

2011-01-01

Community-based tourism is taking its place in the world as an alternative to traditional tourist destinations, especially in developing countries. This form of tourism allows for greater contact with the local community and for the tourist to experience new sensations while enabling the economic and social development of the geographic area. In this paper, the results of fieldwork carried out in the island of Fogo (Cape Verde) are presented, assessing the opinion and perception tourists visi...

The levels of Community Involvement in Health (CIH: a case of rural and urban communities in KwaZulu-Natal

Directory of Open Access Journals (Sweden)

G.G. Mchunu

2009-09-01

Full Text Available The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969 Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.

Knowledge and pharmacological management of Alzheimer's disease by managing community pharmacists: a nationwide study.

Science.gov (United States)

Zerafa, Natalie; Scerri, Charles

2016-12-01

Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer's disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer's disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer's Disease Knowledge Scale and the Alzheimer's Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer's disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.

Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

Directory of Open Access Journals (Sweden)

Zethu Nkosi

2013-11-01

Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via a case-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking.Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method.Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age, working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years.Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services.Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

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.

Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

Directory of Open Access Journals (Sweden)

Zethu Nkosi

2013-11-01

Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via acase-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking. Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method. Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age,working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years. Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services. Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa.

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Arnaud Setondji Amoussouhoui

2018-03-01

Full Text Available Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU, is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care.We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds.This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.

Building a community-based culture of evaluation.

Science.gov (United States)

Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

2017-12-01

In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Keep Talking & Monitoring: the importance of longitudinal research & community-based monitoring to support sustainable land management in southern Africa

Science.gov (United States)

Dougill, Andrew; Stringer, Lindsay

2015-04-01

drought events linked to climate change. Returning to communities (even if irregularly) after project completion enables identification of local-level knowledge and institutional problems that are often the underlying cause of the post-project failings. In many cases, such failings have led to a lack of sustained benefits as significant community-level goodwill and knowledge is developed during projects, but limited input and guidance through remaining institutional channels means that any strong grounding for success is not harnessed or sustained. It is vital that researchers work pro-actively with formal state institutions (notably agricultural extension services) to ensure that research and development project outputs are understood and used in the post-project phase. Continued engagement with local and institutional actors through longitudinal research assessing multi-stakeholder partnerships and local management practices can realise significant additional benefits far beyond the small time and cost implications of such continued engagement. Shifts to trans-disciplinary, multi-stakeholder working need to address the need for such longer-term, longitudinal research processes to ensure that benefits are not immediately lost and that new forms of sustainable land management can indeed be sustained.

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.

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.

Understanding the scale of Marine protection in Hawai'i: from community-based management to the remote Northwestern Hawaiian Islands.

Science.gov (United States)

Friedlander, Alan M; Stamoulis, Kostantinos A; Kittinger, John N; Drazen, Jeffrey C; Tissot, Brian N

2014-01-01

Ancient Hawaiians developed a sophisticated natural resource management system that included various forms of spatial management. Today there exists in Hawai'i a variety of spatial marine management strategies along a range of scales, with varying degrees of effectiveness. State-managed no-take areas make up less than 0.4% of nearshore waters, resulting in limited ecological and social benefits. There is increasing interest among communities and coastal stakeholders in integrating aspects of customary Hawaiian knowledge into contemporary co-management. A network of no-take reserves for aquarium fish on Hawai'i Island is a stakeholder-driven, adaptive management strategy that has been successful in achieving ecological objectives and economic benefits. A network of large-scale no-take areas for deepwater (100-400m) bottomfishes suffered from a lack of adequate data during their initiation; however, better technology, more ecological data, and stakeholder input have resulted in improvements and the ecological benefits are becoming clear. Finally, the Papahānaumokuākea Marine National Monument (PMNM) is currently the single largest conservation area in the United States, and one of the largest in the world. It is considered an unqualified success and is managed under a new model of collaborative governance. These case studies allow an examination of the effects of scale on spatial marine management in Hawai'i and beyond that illustrate the advantages and shortcomings of different management strategies. Ultimately a marine spatial planning framework should be applied that incorporates existing marine managed areas to create a holistic, regional, multi-use zoning plan engaging stakeholders at all levels in order to maximize resilience of ecosystems and communities.

A Case Study of Student Engagement in Collaborative Group Learning in a Blended Community Based (Service) Learning Module

OpenAIRE

McGarrigle, John G.

2009-01-01

Abstract: A participatory action research case study employed mixed methods to examine student collaboration and engagement in a Community Based (Service) learning module. A quasi experimental testing of Coates (2007) typology of student engagement found low agreement between students and lecturers in assigning the terms, passive, intense, independent or collaborative to student postings to discussion fora. Evidence from this case study found greater student collaboration in discussion fora w...

Chapter 11. Community analysis-based methods

Energy Technology Data Exchange (ETDEWEB)

Cao, Y.; Wu, C.H.; Andersen, G.L.; Holden, P.A.

2010-05-01

Microbial communities are each a composite of populations whose presence and relative abundance in water or other environmental samples are a direct manifestation of environmental conditions, including the introduction of microbe-rich fecal material and factors promoting persistence of the microbes therein. As shown by culture-independent methods, different animal-host fecal microbial communities appear distinctive, suggesting that their community profiles can be used to differentiate fecal samples and to potentially reveal the presence of host fecal material in environmental waters. Cross-comparisons of microbial communities from different hosts also reveal relative abundances of genetic groups that can be used to distinguish sources. In increasing order of their information richness, several community analysis methods hold promise for MST applications: phospholipid fatty acid (PLFA) analysis, denaturing gradient gel electrophoresis (DGGE), terminal restriction fragment length polymorphism (TRFLP), cloning/sequencing, and PhyloChip. Specific case studies involving TRFLP and PhyloChip approaches demonstrate the ability of community-based analyses of contaminated waters to confirm a diagnosis of water quality based on host-specific marker(s). The success of community-based MST for comprehensively confirming fecal sources relies extensively upon using appropriate multivariate statistical approaches. While community-based MST is still under evaluation and development as a primary diagnostic tool, results presented herein demonstrate its promise. Coupled with its inherently comprehensive ability to capture an unprecedented amount of microbiological data that is relevant to water quality, the tools for microbial community analysis are increasingly accessible, and community-based approaches have unparalleled potential for translation into rapid, perhaps real-time, monitoring platforms.

The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

Science.gov (United States)

Hogan, Tierney D

2005-01-01

A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

Powerless Spectators, Coping Actors, and Adaptive Co-managers: a Synthesis of the Role of Communities in Ecosystem Management

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Christo Fabricius

2007-06-01

Full Text Available We provide a synthesis of the papers in the Special Issue, the Communities Ecosystems and Livelihoods component of the Millennium Ecosystem Assessment (MA, and other recent publications on the adaptive capacity of communities and their role in ecosystem management. Communities adapt because they face enormous challenges due to policies, conflicts, demographic factors, ecological change, and changes in their livelihood options, but the appropriateness of their responses varies. Based on our synthesis, three broad categories of adaptive communities are identified. "Powerless spectator" communities have a low adaptive capacity and weak capacity to govern, do not have financial or technological options, and lack natural resources, skills, institutions, and networks. "Coping actor" communities have the capacity to adapt, but are not managing social-ecological systems. They lack the capacity for governance because of lack of leadership, of vision, and of motivation, and their responses are typically short term. "Adaptive manager" communities have both adaptive capacity and governance capacity to sustain and internalize this adaptation. They invest in the long-term management of ecosystem services. Such communities are not only aware of the threats, but also take appropriate action for long-term sustainability. Adaptive co-management becomes possible through leadership and vision, the formation of knowledge networks, the existence or development of polycentric institutions, the establishment and maintenance of links between culture and management, the existence of enabling policies, and high levels of motivation in all role players. Adaptive co-managers are empowered, but empowerment is a consequence of the capacity for governance and the capacity to adapt, rather than a starting point. Communities that are able to enhance their adaptive capacity can deal with challenges such as conflicts, make difficult trade-offs between their short- and long

Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso

Science.gov (United States)

2015-01-01

Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and political capital. Policy entrepreneurs have received little study in low- and middle-income country policy research despite observations of individualized decision-making, informal institutions and the unequal distribution and exercise of power in policymaking. This article aims to identify whether policy entrepreneurs were present in the policy process around integrated community case management (iCCM) in Burkina Faso, whether they were successful in achieving policy change, and whether success or failure can be explained using existing policy entrepreneur frameworks from high-income polities. This mixed methods policy study collected data from in-depth qualitative interviews and social network surveys of actors involved in iCCM policymaking [known locally as C-integrated management of childhood illness (IMCI)]; data were analysed based on the framework categories. Interview data pointed to one key individual who played a significant role in the inclusion of pneumonia treatment into the country’s iCCM policy, an issue that had been a point of contention between government policy elites and development partners. Social network data confirmed that this actor was strategically located in the policy network to be able to reach the most other actors and to be able to control the flow of information. Although some development partner actors were as strategically located, none had the same level of authority or trust as was imbued by being a member of the government civil service. The entrepreneur’s mid-level rank in the health ministry may have encouraged him/her to invest political capital and take risks that would not have been feasible or attractive to

Calibration of Community-based Coral Reef Monitoring Protocols ...

African Journals Online (AJOL)

Coral reef monitoring (CRM) has been recognised as an important management tool and has consequently been incorporated in Integrated Coastal Area Management (ICAM) programmes in the Western Indian Ocean (WIO). Community-based coral reef monitoring (CB-CRM), which uses simplified procedures suitable for ...

Health Care Leadership: Managing Knowledge Bases as Stakeholders.

Science.gov (United States)

Rotarius, Timothy

Communities are composed of many organizations. These organizations naturally form clusters based on common patterns of knowledge, skills, and abilities of the individual organizations. Each of these spontaneous clusters represents a distinct knowledge base. The health care knowledge base is shown to be the natural leader of any community. Using the Central Florida region's 5 knowledge bases as an example, each knowledge base is categorized as a distinct type of stakeholder, and then a specific stakeholder management strategy is discussed to facilitate managing both the cooperative potential and the threatening potential of each "knowledge base" stakeholder.

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

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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.

Community Involvement in School Management in Portugal

Science.gov (United States)

Veloso, Luísa; Craveiro, Daniela; Rufino, Isabel

2013-01-01

This article discusses the ways in which the community is involved in Portuguese school management. It is based on an analysis of the external evaluation reports of 298 Portuguese schools for the academic years 2006-07, 2007-08 and 2008-09. The corpus analysed allowed the identification of two main aspects of the participation processes: (1) local…

Beacon communities' public health initiatives: a case study analysis.

Science.gov (United States)

Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

2014-01-01

The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach

Project management case studies

CERN Document Server

Kerzner, Harold R

2013-01-01

A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

Promoting weight management services in community pharmacy: perspectives of the pharmacy team in Scotland.

Science.gov (United States)

Weidmann, Anita Elaine; MacLure, Katie; Marshall, Sarah; Gray, Gwen; Stewart, Derek

2015-08-01

Obesity has reached pandemic levels with more than 1.4 billion adults affected worldwide. While there is a need to systematically develop and evaluate community pharmacy based models of weight management, it is imperative to describe and understand the perspectives of pharmacy staff. In the UK, trained and accredited community pharmacy medicines counter assistants (MCAs) are commonly the front line staff involved in patient consultations and sale of over-the-counter medicines. To explore the beliefs and experiences of pharmacists and MCAs in the North-East of Scotland on community pharmacy weight management. All 135 community pharmacies in the North-East of Scotland. A qualitative approach of semi-structured telephone interviews with 31 pharmacists and 20 MCAs in the North-East of Scotland. The semi-structured interview schedule was developed with reference to key domains describing professional practice (i.e. awareness and knowledge, skills, practicalities, motivation, acceptance and beliefs) and contextualised with policy documents and published research on community pharmacy based weight management. Interviews were audio-recorded, transcribed and analysed thematically. Pharmacists' and MCAs' beliefs and experiences with delivering weight management services in community pharmacy. There were mixed responses from pharmacists and MCAs around pharmacy based weight management services from positive views of providing the service in community pharmacy to those more reticent who would always favour patients visiting their physician. While all described similar services e.g. measurement of weight, healthy eating advice, supply of products, they acknowledged that support was often opportunistic at the request of customers, with little integration of other providers. Roles described varied from pharmacist only functions to any staff member. While pharmacists generally felt comfortable and confident, MCAs gave more diverse responses. Both Pharmacist and MCAs highlighted

Terrestrial Species in Protected Areas and Community-Managed Lands in Arunachal Pradesh, Northeast India

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Nandini Velho

2016-10-01

Full Text Available Protected areas (including areas that are nominally fully protected and those managed for multiple uses encompass about a quarter of the total tropical forest estate. Despite growing interest in the relative value of community-managed lands and protected areas, knowledge about the biodiversity value that each sustains remains scarce in the biodiversity-rich tropics. We investigated the species occurrence of a suite of mammal and pheasant species across four protected areas and nearby community-managed lands in a biodiversity hotspot in northeast India. Over 2.5 years we walked 98 transects (half of which were resampled on a second occasion across the four paired sites. In addition, we interviewed 84 key informants to understand their perceptions of species trends in these two management regimes. We found that protected areas had higher overall species richness and were important for species that were apparently declining in occurrence. On a site-specific basis, community-managed lands had species richness and occurrences comparable to those of a protected area, and in one case their relative abundances of mammals were higher. Interviewees indicated declines in the abundances of larger-bodied species in community-managed lands. Their observations agreed with our field surveys for certain key, large-bodied species, such as gaur and sambar, which generally occurred less in community-managed lands. Hence, the degree to which protected areas and community-managed lands protect wildlife species depends upon the species in question, with larger-bodied species usually faring better within protected areas.

Can scenario-planning support community-based natural resource management? Experiences from three countries in Latin America

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Kerry A. Waylen

2015-12-01

Full Text Available Community-based natural resource management (CBNRM is a concept critical to managing social-ecological systems but whose implementation needs strengthening. Scenario planning is one approach that may offer benefits relevant to CBNRM but whose potential is not yet well understood. Therefore, we designed, trialed, and evaluated a scenario-planning method intended to support CBNRM in three cases, located in Colombia, Mexico, and Argentina. Implementing scenario planning was judged as worthwhile in all three cases, although aspects of it were challenging to facilitate. The benefits generated were relevant to strengthening CBNRM: encouraging the participation of local people and using their knowledge, enhanced consideration of and adaptation to future change, and supporting the development of systems thinking. Tracing exactly when and how these benefits arose was challenging, but two elements of the method seemed particularly useful. First, using a systematic approach to discuss how drivers of change may affect local social-ecological systems helped to foster systems thinking and identify connections between issues. Second, explicitly focusing on how to use and respond to scenarios helped identify specific practical activities, or "response options," that would support CBNRM despite the pressures of future change. Discussions about response options also highlighted the need for support by other actors, e.g., policy groups: this raised the question of when and how other actors and other sources of knowledge should be involved in scenario planning, so as to encourage their buy-in to actions identified by the process. We suggest that other CBNRM initiatives may benefit from adapting and applying scenario planning. However, these initiatives should be carefully monitored because further research is required to understand how and when scenario-planning methods may produce benefits, as well as their strengths and weaknesses versus other methods.

Clinical waste management in the context of the Kanye community ...

African Journals Online (AJOL)

Clinical waste management in the context of the Kanye community home-based care programme, Botswana. ... or clinics; poor storage of the healthcare waste at clinics; lack of incinerators for burning clinical waste; and a high risk of contagion to individuals and the environment at all stages of managing the clinical waste.

Increased Difficulties in Managing Stairs in Visually Impaired Older Adults: A Community-Based Survey.

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Chen-Wei Pan

Full Text Available Managing stairs is a challenging aspect of daily activities of living for older people. We assessed whether older adults with visual impairment (VI have greater difficulties of managing stairs in daily lives.The study was designed as a community-based cross-sectional study based on a Chinese cohort aged 60 years and older in rural China. Visual acuity (VA was measured in both eyes using a retro-illuminated Snellen chart with tumbling-E optotypes. VI (including blindness was defined as presenting VA of worse than 20/60 in either eye. Having any difficulties in managing stairs was self-reported based on a question drawn from the Barthel Index. Information on participants' socioeconomic status, lifestyle-related factors, diseases histories and medication intake was collected using a questionnaire.The Barthel Index, Activities of Daily Living questionnaire was completed by 4597 (99.7% participants including 2218 men and 2379 women. The age of the participants ranged from 60 to 93 years with a mean of 67.6 ± 6.3 years. In age and gender adjusted models, adults with VI had a higher likelihood of having difficulties in managing stairs (odds ratio [OR] = 2.7; 95% confidence interval [CI] 2.0, 3.7 compared with those without. The association of VI with the likelihood of having difficulties in managing stairs was stronger in older adults who lived alone (OR = 3.2; 95%CI 1.8, 4.5 compared with those who lived with other family members (OR = 2.0; 95%CI 1.3, 4.3. Compared with hypertension, diabetes, obesity and cognitive dysfunction, VI had the greatest impact on people's abilities of managing stairs.VI was associated with an increased likelihood of having difficulties in managing stairs, especially in those who lived alone. However, whether the finding could be extrapolated to other populations warrants further studies as different environmental exposures such as illumination and types of stairs may alter the association observed in this study.

Community-based post-stroke service provision and challenges: a national survey of managers and inter-disciplinary healthcare staff in Ireland

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Hickey Anne

2012-05-01

Full Text Available Abstract Background The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC, a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. Methods The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7 and disciplinary allied health professional and public health nurse managers (N = 25 were interviewed (94% response rate. Results Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years. The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. Conclusions This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care

Community-based post-stroke service provision and challenges: a national survey of managers and inter-disciplinary healthcare staff in Ireland

Science.gov (United States)

2012-01-01

Background The extent of stroke-related disability typically becomes most apparent after patient discharge to the community. As part of the Irish National Audit of Stroke Care (INASC), a national survey of community-based allied health professionals and public health nurses was conducted. The aim was to document the challenges to service availability for patients with stroke in the community and to identify priorities for service improvement. Methods The study was a cross-sectional tailored interview survey with key managerial and service delivery staff. As comprehensive listings of community-based health professionals involved in stroke care were not available, a cascade approach to information gathering was adopted. Representative regional managers for services incorporating stroke care (N = 7) and disciplinary allied health professional and public health nurse managers (N = 25) were interviewed (94% response rate). Results Results indicated a lack of formal, structured community-based services for stroke, with no designated clinical posts for stroke care across disciplines nationally. There was significant regional variation in availability of allied health professionals. Considerable inequity was identified in patient access to stroke services, with greater access, where available, for older patients (≥ 65 years). The absence of a stroke strategy and stroke prevalence statistics were identified as significant impediments to service planning, alongside organisational barriers limiting the recruitment of additional allied health professional staff, and lack of sharing of discipline-specific information on patients. Conclusions This study highlighted major gaps in the provision of inter-disciplinary team community-based services for people with stroke in one country. Where services existed, they were generic in nature, rarely inter-disciplinary in function and deficient in input from salient disciplines. Challenges to optimal care included the need for

Whose forests, whose voices? Mining and community- based nature ...

African Journals Online (AJOL)

This paper explores local experiences of private - sector led community - based nature conservation near Fort Dauphin, southeastern Madagascar through the analysis of a conservation zone managed in partnership between the Rio Tinto mining corporation, local government and local communities. The article assesses ...

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).

A knowledge management and need-capacity matching approach for community-based disaster management and recovery

NARCIS (Netherlands)

Palomares, I.; Galway, L.; Haran, M.; Neef, M.; Woods, C.; Wang, H.

2015-01-01

Post-crisis response and recovery necessitates the identification and prioritization of the needs and capacities of the affected community in order to provide efficient and wellcoordinated humanitarian assistance. The Community Based Comprehensive Recovery platform aims to facilitate enhanced

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.

Assessing potential for community-based management of peccaries through common pool resource theory in the rural area of the Argentine Chaco.

Science.gov (United States)

Altrichter, Mariana

2008-03-01

Community-based management (CBM) has been recognized as an appropriate approach to conservation, assuming that local communities have higher stakes than the state in their natural resources and have better knowledge of local resources and, therefore, can manage them more efficiently. However, the implementation of CBM has not always been successful. The objective of this research was to assess the potential for the implementation of a governmental proposal for community-based management of peccaries (Tayassuidae) in the Impenetrable northern Argentine, through the examination of the reasons why arrangements to avoid overexploitation have not evolved in this region. I used the theory of common pool resources (CPRs) as a framework for this analysis. CPRs theory explains the conditions under which appropriators of a resource are likely to engage in devising and altering governing arrangements and the conditions under which such arrangements are likely to succeed. Fieldwork was conducted between June 2000 and August 2003 using a mixed methods approach. It was found that most of the condition of the resource and users identified by the CPR theory as associated with an increased likelihood of successful management of natural resources are absent or scarcely developed in the Impenetrable. Thus, the situation in the Impenetrable does not seem appropriate for the implementation of CBM of peccaries. It is first necessary to invest in training and development of local institutions' capacities and social capital. It is also important to increase the flow of relevant information, which will enable institutions to be effective, responsible, and accountable to the community. For the moment, a more appropriate approach will have to include a mixture of protectionism and comanagement of collared peccaries while the propitious conditions for a complete local management of the resource are developed.

Iowa Case Management for Rural Drug Abuse

Science.gov (United States)

Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

2009-01-01

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

Community-based Monitoring of Water Resources in Remote Mountain Regions

Science.gov (United States)

Buytaert, W.; Hannah, D. M.; Dewulf, A.; Clark, J.; Zulkafli, Z. D.; Karpouzoglou, T.; Mao, F.; Ochoa-Tocachi, B. F.

2016-12-01

Remote mountain regions are often represented by pockets of poverty combined with accelerated environmental change. The combination of harsh climatic and topographical conditions with limited infrastructure puts severe pressures on local livelihoods, many of which rely strongly on local ecosystem services (ESS) such as agricultural production and water supply. It is therefore paramount to optimise the management of ESS for the benefit of local people. This is hindered by a scarcity of quantitative data about physical processes such as precipitation and river flow as well as qualitative data concerning the management of water and land. National and conventional scientific monitoring networks tend to be insufficient to cover adequately the spatial and temporal gradients. Additionally, the data that are being collected often fail to be converted into locally relevant and actionable knowledge for ESS management. In such conditions, community-based monitoring of natural resources may be an effective way to reduce this knowledge gap. The participatory nature of such monitoring also enhances knowledge co-production and integration in locally-based decision-making processes. Here, we present the results of a 4-year consortium project on the use of citizen science technologies for ecosystem services management (Mountain-EVO). The project analyzed ecosystem service dynamics and decision-making processes and implemented a comparative analysis of experiments with community-based monitoring of water resources in 4 remote mountain regions, i.e. Peru, Nepal, Kyrgyzstan, and Ethiopia. We find that community-based monitoring can have a transformative impact on local ESS management, because of its potential to be more inclusive, polycentric, and context-driven as compared to conventional monitoring. However, the results and effectiveness of community-based approaches depend strongly on the natural and socio-economic boundary conditions. As such, this requires a tailored and bottom

Challenges and opportunities of integration of community based Management of Acute Malnutrition into the government health system in Bangladesh: a qualitative study.

Science.gov (United States)

Ireen, Santhia; Raihan, Mohammad Jyoti; Choudhury, Nuzhat; Islam, M Munirul; Hossain, Md Iqbal; Islam, Ziaul; Rahman, S M Mustafizur; Ahmed, Tahmeed

2018-04-10

Severe acute malnutrition (SAM) in children is the most serious form of malnutrition and is associated with very high rates of morbidity and mortality. For sustainable SAM management, United Nations recommends integration of community based management of acute malnutrition (CMAM) into the health system. The objective of the study was to assess the preparedness of the health system to implement CMAM in Bangladesh. The assessment was undertaken during January to May 2014 by conducting document review, key informant interviews, and direct observation. A total of 38 key informant interviews were conducted among government policy makers and program managers (n = 4), nutrition experts (n = 2), health and nutrition implementing partners (n = 2), development partner (n = 1), government health system staff (n = 5), government front line field workers (n = 22), and community members (n = 2). The assessment was based on: workforce, service delivery, financing, governance, information system, medical supplies, and the broad socio-political context. The government of Bangladesh has developed inpatient and outpatient guidelines for the management of SAM. There are cadres of community health workers of government and non-government actors who can be adequately trained to conduct CMAM. Inpatient management of SAM is available in 288 facilities across the country. However, only 2.7% doctors and 3.3% auxiliary staff are trained on facility based management of SAM. In functional facilities, uninterrupted supply of medicines and therapeutic diet are not available. There is resistance and disagreement among nutrition stakeholders regarding import or local production of ready-to-use therapeutic food (RUTF). Nutrition coordination is fragile and there is no functional supra-ministerial coordination platform for multi-sectoral and multi-stakeholder nutrition. There is an enabling environment for CMAM intervention in Bangladesh although health system

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.

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea

Directory of Open Access Journals (Sweden)

Jinjoo Oh, Ph.D., RN, GNP

2017-12-01

Full Text Available Purpose: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Methods: Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Results: Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. Conclusion: The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Keywords: case management, focus groups, hospitalization, qualitative research, vulnerable populations

Case management directors: how to manage in a transition-focused world: part 1.

Science.gov (United States)

Bankston-White, Cheri; Birmingham, Jackie

2015-01-01

Case management directors are in a dynamic position to affect the transition of care for patients across the continuum, work with all levels of providers, and support the financial well-being of a hospital. Most importantly, they can drive good patient outcomes. Although the position is critical on many different levels, there is little to help guide a new director in attending to all the "moving parts" of such a complex role. The purpose of this two-part article is to provide case management directors, particularly new ones, with a framework for understanding and fulfilling their role.We have divided the guide into seven tracks of responsibility. Part 1 discusses the first four tracks: (1) staffing and human resources, (2) compliance and accreditation, (3) discharge planning, and (4) utilization review and revenue cycle. Part 2 addresses (5) internal departmental relationships (organizational), (6) external relationships (Community agency), and (7) quality and program outcomes. The information is most meaningful to those case management directors who work in either stand-alone hospitals or integrated health systems, and have frontline case managers reporting to them. Case management directors would benefit from further research and documentation of "best practices" related to their role, particularly in the areas of leadership and management. New directors would benefit from mentoring and networking with one another. As new regulations and models of care bring increased emphasis and focus to transitions of care, the role of the case management director continues to evolve, growing in importance and complexity. The growing financial impact of readmissions also brings added scrutiny and increased pressure to get the transitions of care right the first time.To operate most effectively, case management directors must understand the full range of their responsibilities and impact. They must find opportunities for themselves and their departments to learn and stay

A randomized controlled trial to examine the effectiveness of case management model for community dwelling older persons with mild dementia in Hong Kong.

Science.gov (United States)

Lam, Linda C W; Lee, Jenny S W; Chung, Jenny C C; Lau, Anna; Woo, Jean; Kwok, Timothy C Y

2010-04-01

To evaluate a case management (CM) model for people with mild dementia, whereby resources within the family and in the community were mobilized and optimally used. Community dwelling psychiatric and geriatrics outpatients with mild dementia were randomized to receive CM by a trained occupational therapist for 4 months (CM group, N = 59) or usual care only (control group, N = 43). Primary outcome indicators included the Zarit Burden Scale (ZBI), General Health Questionnaire (GHQ), and Personal Well-Being Index for Adult (PWI-A) of the family caregivers. Secondary outcome indicators included the Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Cornell Scale for Depression in Dementia (CSDD), and Personal Well-Being Index for Intellectually Disabled (PWI-ID) of the demented subjects as measured at fourth and twelfth months. CSDDis reduced in the CM group at fourth month, but not at twelfth month. The changes in outcome variables of persons with dementia did not differ between the groups (Mann-Whitney U-test, p > 0.05). At follow-up, CM group used more day care and domestic helpers than control group (chi (2), p > 0.05). Case management for Chinese persons with mild dementia outpatients did not show significant effects in reducing caregiver burden, but encouraged family caregivers to seek external support.

The effect of community-based health education intervention on management of menstrual hygiene among rural Indian adolescent girls.

Science.gov (United States)

Dongre, A R; Deshmukh, P R; Garg, B S

2007-01-01

To study the effect of a community-based health education intervention on awareness and behaviour change of rural adolescent girls regarding their management of menstrual hygiene. A participatory-action study was undertaken in Primary Health Centres in 23 villages in Anji, in the Wardha district of Maharashtra state. Study subjects were unmarried rural adolescent girls (12-19 years). We conducted a needs assessment for health messages with this target audience, using a triangulated research design of quantitative (survey) and qualitative (focus group discussions) methods. Program for Appropriate Technology for Health (PATH) guidelines were used to develop a pre-tested, handmade flip book containing needs-based key messages about the management of menstrual hygiene. The messages were delivered at monthly meetings of village-based groups of adolescent girls, called Kishori Panchayat. After 3 years, the effect of the messages was assessed using a combination of quantitative (survey) and qualitative (trend analysis) methods. After 3 years, significantly more adolescent girls (55%) were aware of menstruation before its initiation compared with baseline (35%). The practice of using ready-made pads increased significantly from 5% to 25% and reuse of cloth declined from 85% to 57%. The trend analysis showed that adolescent girls perceived a positive change in their behaviour and level of awareness. The present community health education intervention strategy could bring significant changes in the awareness and behaviour of rural adolescent girls regarding management of their menstrual hygiene.

A case management agency and bank create a service innovation.

Science.gov (United States)

Katz, K S; Stowe, A W

1992-01-01

Connecticut Community Care, Inc. (CCCI), a statewide, nonprofit case management agency, in collaboration with Connecticut National Bank (CNB), developed a unique model of delivering case management services to bank trust clients. No reports of such a collaborative model have been found in the published literature in the United States. The article presents a historical overview of this innovative initiative; the identification of the target population; the delivery of the assessment, coordination, and monitoring services; and the marketing techniques. Utilization statistics, a synopsis of the model outcomes as viewed by the trust officers, and suggestions for replication are also presented.

A Randomized Controlled Trial of Hospital-based Case Management in Cancer Care

DEFF Research Database (Denmark)

Wulff, Christian N; Vedsted, Peter; Søndergaard, Jens

2012-01-01

BACKGROUND: Case management (CM) models based on experienced nurses are increasingly used to improve coordination and continuity of care for patients with complex health care needs. Anyway, little is known about the effects of hospital-based CM in cancer care.Aim.To analyse the effects of hospital...... and out of hours were collected 9 months after recruitment and the data from the two groups were compared quarterly. RESULTS: CM was associated with an overall tendency towards more positive GP evaluations, which for 3 of 20 items reached statistical significance. Statistically significantly fewer GPs...

Quality improvement initiatives in a case management service: case study.

Science.gov (United States)

Davies, Deborah J

2015-01-01

This article explores the importance of quality practices in underpinning the person-centred approach at a Community Options Program (COP) case management service in northern NSW. The NSW community care sector does not have a statutory excellence body to identify, promote and support improved practices and quality and safety across community services, and therefore the COP provider decided to establish a dedicated role to focus on the quality improvement of its service. The subsequent quality improvement initiatives have included mapping the clients' journey through the service, identifying areas to standardise practice, and creating service pathways. The clients' journey was used as the framework to identify where standardised practice was required, and a robust process was implemented to develop over 25 good practice guidelines and tools that addressed the variations in practice and enabled the service pathways to be developed. Prior to trialling the guidelines and tools, staff received education sessions on the anticipated changes to practice, and the practicality and applicability of the guidelines were evaluated at the end of the trials. This information was reviewed and the guidelines were amended accordingly before being rolled out. The guidelines have been in use for over 12 months and have provided the benchmark against which to audit practice, and have resulted in key performance improvements such as an increase in client review rates and a rise in the feedback response rate from clients, with a noticeable shift in the comments about the brokered support worker to acknowledging the role of their case manager. Formalising informal supports for those clients that lived alone also increased, which means these people are less reliant on services and there is a reduced risk of social isolation.

Community Based Fisheries Management (CBFM) in Sunamganj district of Bangladesh: the nature of cooperation and conflicts

OpenAIRE

Alam, M.F.; Das, T.K.; Kazal, M.M.H.

2007-01-01

There are altogether 411 haors comprising an area of about 8000 square kilometer, covering 25% of entire region dispersed in the districts of Sunamgonj, Sylhet, Moulvibazar, Hobigonj, Netrokona and Kishoreganj. Sunamganj district is particularly known as a district of haors and baors where a large number of people depend on fishing for their livelihood. Some people are basically fishermen and fish all the year round. Community Based Fisheries Management (CBFM) project has been initiated in th...

Changes in soil microbial community structure influenced by agricultural management practices in a mediterranean agro-ecosystem.

Science.gov (United States)

García-Orenes, Fuensanta; Morugán-Coronado, Alicia; Zornoza, Raul; Cerdà, Artemi; Scow, Kate

2013-01-01

Agricultural practices have proven to be unsuitable in many cases, causing considerable reductions in soil quality. Land management practices can provide solutions to this problem and contribute to get a sustainable agriculture model. The main objective of this work was to assess the effect of different agricultural management practices on soil microbial community structure (evaluated as abundance of phospholipid fatty acids, PLFA). Five different treatments were selected, based on the most common practices used by farmers in the study area (eastern Spain): residual herbicides, tillage, tillage with oats and oats straw mulching; these agricultural practices were evaluated against an abandoned land after farming and an adjacent long term wild forest coverage. The results showed a substantial level of differentiation in the microbial community structure, in terms of management practices, which was highly associated with soil organic matter content. Addition of oats straw led to a microbial community structure closer to wild forest coverage soil, associated with increases in organic carbon, microbial biomass and fungal abundances. The microbial community composition of the abandoned agricultural soil was characterised by increases in both fungal abundances and the metabolic quotient (soil respiration per unit of microbial biomass), suggesting an increase in the stability of organic carbon. The ratio of bacteria:fungi was higher in wild forest coverage and land abandoned systems, as well as in the soil treated with oat straw. The most intensively managed soils showed higher abundances of bacteria and actinobacteria. Thus, the application of organic matter, such as oats straw, appears to be a sustainable management practice that enhances organic carbon, microbial biomass and activity and fungal abundances, thereby changing the microbial community structure to one more similar to those observed in soils under wild forest coverage.

Empowering European communities to improve natural resource management for human well-being: the OPPLA web portal & communities of practice

Science.gov (United States)

Metzger, M.; Brown, C.; Pérez-Soba, M.; Rounsevell, M.; Verweij, P.; Delbaere, B.; Cojocaru, G.; Saarikoski, H.; Harrison, P.; Zellmer, K.

2014-12-01

The ecosystem services concept is seen by many as a useful paradigm to support decision-making at the complex interface between science, policy and practice. However, to be successful, it requires a strong willingness for collaboration and joint understanding. In support of this aspiration, OPPLA is being developed as a web portal to enable European communities to better manage ecosystems for human well-being and livelihoods. OPPLA will provide access to a variety of online resources such as tools, case studies, lessons learned, videos, manuals and training and educational materials. It will also provide expert forums and spaces for discussions between researchers, practitioners and decision makers. Hence a critical aspect of the success of OPPLA is the co-evolution of communities of practice. An example of a community of practice is the recently launched Ecosystem Services Community - Scotland (ESCom-Scotland; escomscotland.wordpress.com). ESCom-Scotland aims to support better management of Scotland's natural resources by helping to establish a community of practice between individuals and groups involved in the science, policy and practice behind sustainable ecosystem management. It aspires to encourage the sharing of ideas, increase collaboration and to initiate a support network for those engaging with the ecosystem services concept and it will use the OPPLA resources to support these activities. OPPLA is currently at the developmental stage and was instigated by two large European Commission funded research projects: OPERAs (www.operas-project.eu) and OpenNESS (www.openness-project.eu), with a combined budget of ca. €24m. These projects aim to improve understanding of how ecosystem services contribute to human well-being in different social-ecological systems. Research will establish whether, how and under what conditions the ecosystem services concept can move beyond the academic domain towards practical implementation in support of sustainable ecosystem

Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

Science.gov (United States)

Oh, Jinjoo; Oh, Seieun

2017-12-01

The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

A typology for campus-based alcohol prevention: moving toward environmental management strategies.

Science.gov (United States)

DeJong, William; Langford, Linda M

2002-03-01

This article outlines a typology of programs and policies for preventing and treating campus-based alcohol-related problems, reviews recent case studies showing the promise of campus-based environmental management strategies and reports findings from a national survey of U.S. colleges and universities about available resources for pursuing environmentally focused prevention. The typology is grounded in a social ecological framework, which recognizes that health-related behaviors are affected through multiple levels of influence: intrapersonal (individual) factors, interpersonal (group) processes, institutional factors, community factors and public policy. The survey on prevention resources and activities was mailed to senior administrators responsible for their school's institutional response to substance use problems. The study sample was an equal probability sample of 365 2- and 4-year U.S. campuses. The response rate was 76.9%. Recent case studies suggest the value of environmentally focused alcohol prevention approaches on campus, but more rigorous research is needed to establish their effectiveness. The administrators' survey showed that most U.S. colleges have not yet installed the basic infrastructure required for developing, implementing and evaluating environmental management strategies. The typology of campus-based prevention options can be used to categorize current efforts and to inform strategic planning of multilevel interventions. Additional colleges and universities should establish a permanent campus task force that reports directly to the president, participate actively in a campus-community coalition that seeks to change the availability of alcohol in the local community and join a state-level association that speaks out on state and federal policy issues.

An ontological case base engineering methodology for diabetes management.

Science.gov (United States)

El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

2014-08-01

Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

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

Science.gov (United States)

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

2009-04-08

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

Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?

Science.gov (United States)

George, Asha; Young, Mark; Nefdt, Rory; Basu, Roshni; Sylla, Mariame; Clarysse, Guy; Bannicq, Marika Yip; de Sousa, Alexandra; Binkin, Nancy; Diaz, Theresa

2012-11-01

We describe community health workers (CHWs) in government community case management (CCM) programs for child survival across sub-Saharan Africa. In sub-Saharan Africa, 91% of 44 United Nations Children's Fund (UNICEF) offices responded to a cross-sectional survey in 2010. Frequencies describe CHW profiles and activities in government CCM programs (N = 29). Although a few programs paid CHWs a salary or conversely, rewarded CHWs purely on a non-financial basis, most programs combined financial and non-financial incentives and had training for 1 week. Not all programs allowed CHWs to provide zinc, use timers, dispense antibiotics, or use rapid diagnostic tests. Many CHWs undertake health promotion, but fewer CHWs provide soap, water treatment products, indoor residual spraying, or ready-to-use therapeutic foods. For newborn care, very few promote kangaroo care, and they do not provide antibiotics or resuscitation. Even if CHWs are as varied as the health systems in which they work, more work must be done in terms of the design and implementation of the CHW programs for them to realize their potential.

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

Science.gov (United States)

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…

The participation of community-based organizations on waste management in the city municipal of Medan

Science.gov (United States)

Trimurni, Februati; Dayana

2018-03-01

Waste is currently main problem experienced by cities all over the world. The waste has brought negative impacts on public health, environment, development and social of the cities. However, there must be solutions to overcome the piles of waste in case the individual citizens or community-based organization wisely deal with the problem. In the municipal area of Medan in the Province of North Sumatra, there is sort of organization established by community-based organization (CBO) so-called Bank Sampah or Waste Bank which is placed as a flatform for the member to do business of waste materials by collecting them from households around, sorting the materials into waste categories and ended up by purchasing and selling them to make some money. The organization is not merely a flatform for doing a business of waste materials yet the media for other social activities and efforts of reaching social and family welfare. The study is conducted in some sites of such organization activities in the city, and there are some observations of how the community run the business and in the same time arranging other social activities. The study tries to portray the activities and analyzes the means and the significancy of the CBO on reducing waste problems in the city.

Strategies used by case managers supporting frail, community-dwelling older persons, to engage primary care physicians in interprofessional collaboration

OpenAIRE

Van Durme, Thérèse; Cès, Sophie; Karam, Marlène; Macq, Jean; RCN 2014 Annual International Nursing Research Conference

2014-01-01

Background and aim Although it is known that case management for frail older persons (FOP) is more likely to foster positive outcomes when the case manager works closely with the primary care physicians (PCP) [1], engaging PCPs to collaborate is often a difficult process, especially when the case management function is new [2]. The aim of this study was to provide insight on how newly implemented case management projects managed to engage FOPs’ PCP in the case management process, (to what ext...

Recovery-oriented services for individuals with mental illness and case managers' experience of professional burnout.

Science.gov (United States)

Kraus, Shane W; Stein, Catherine H

2013-02-01

Present cross-sectional study examined perceptions of recovery-oriented services and reports of professional burnout and job satisfaction in a sample of 114 case managers working in community mental health centers across Ohio. The research examined the relative contribution of demographic characteristics, the structure of case management services, and case managers' beliefs about recovery-oriented services in describing their reports of professional burnout and job satisfaction. Regardless of individual characteristics of case managers and reports of the structure of their jobs, case managers who perceived their agency to offer higher levels of recovery-oriented services also reported lower levels of depersonalization and emotional exhaustion at work, and higher levels of professional accomplishment and job satisfaction. Directions for future research in the area are discussed.

Health care waste management in community-based care: experiences of community health workers in low resource communities in South Africa

Directory of Open Access Journals (Sweden)

Lydia Hangulu

2017-05-01

Full Text Available Abstract Background In South Africa, community health workers (CHWs working in community-based care (CBC programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB. Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW, there is limited information about the experiences of CHWs on health care waste management (HCWM in CBC. This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs. Methods We used three ethnographic approaches to collect data: focus group discussions, participant observations and informal discussions. Data was collected from 85 CHWs working in 29 communities in the Durban metropolis, South Africa. Data collection took place from July 2013 to August 2014. Results CHWs provided nursing care activities to patients many of whom were incontinent or bedridden. Some the patients were living with HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood pressure. These caregiving activities generate sharps and infectious waste but CHWs and family members did not segregate HCW according to the risk posed as stipulated by the HCWM policy. In addition, HCW was left with domestic waste. Major barriers to proper HCWM identified by CHWs include, lack of assistance from family members in assisting patients to use the toilet or change diapers and removing HCW from homes, irregular waste collection by waste collectors, inadequate water for practicing hygiene and sanitation, long distance between the house and the toilets and poor conditions of communal toilets and pit latrines. As a result of these barriers, HCW was illegally dumped along roads or in the bush, burnt openly and buried within the yards. Liquid HCW such as vomit, urine and sputum were disposed in open spaces near the homes. Conclusion Current policies on primary health care (PHC and HCWM in South Africa have not paid attention to HCWM. Findings suggest the

A prototype case-based reasoning human assistant for space crew assessment and mission management

Science.gov (United States)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

Case management approaches to home support for people with dementia.

Science.gov (United States)

Reilly, Siobhan; Miranda-Castillo, Claudia; Malouf, Reem; Hoe, Juanita; Toot, Sandeep; Challis, David; Orrell, Martin

2015-01-05

Over 35 million people are estimated to be living with dementia in the world and the societal costs are very high. Case management is a widely used and strongly promoted complex intervention for organising and co-ordinating care at the level of the individual, with the aim of providing long-term care for people with dementia in the community as an alternative to early admission to a care home or hospital. To evaluate the effectiveness of case management approaches to home support for people with dementia, from the perspective of the different people involved (patients, carers, and staff) compared with other forms of treatment, including 'treatment as usual', standard community treatment and other non-case management interventions. We searched the following databases up to 31 December 2013: ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group,The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS, Web of Science (including Science Citation Index Expanded (SCI-EXPANDED) and Social Science Citation Index), Campbell Collaboration/SORO database and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group. We updated this search in March 2014 but results have not yet been incorporated. We include randomised controlled trials (RCTs) of case management interventions for people with dementia living in the community and their carers. We screened interventions to ensure that they focused on planning and co-ordination of care. We used standard methodological procedures as required by The Cochrane Collaboration. Two review authors independently extracted data and made 'Risk of bias' assessments using Cochrane criteria. For continuous outcomes, we used the mean difference (MD) or standardised mean difference (SMD) between groups along with its confidence interval (95% CI). We applied a fixed- or random-effects model as appropriate. For binary or dichotomous data, we generated the corresponding odds

Evaluation of Probation Case Management (PCM) for Drug-Involved Women Offenders

Science.gov (United States)

Chan, Monica; Guydish, Joseph; Prem, Rosemary; Jessup, Martha A.; Cervantes, Armando; Bostrom, Alan

2005-01-01

Based on availability of case management services, drug-involved women offenders entered either a probation case management (PCM) intervention(n = 65) or standard probation(n = 44). Participants were placed in the case management condition until all slots were filled, then placed in standard probation until case management slots opened.…

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

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

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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

Case management helps prevent criminal justice recidivism for people with serious mental illness.

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Leutwyler, Heather; Hubbard, Erin; Zahnd, Elaine

2017-09-11

Purpose The purpose of this paper is to discuss how case management can decrease recidivism for people with serious mental illness (SMI) because people with SMI are at high risk for incarceration and recidivism. Design/methodology/approach Examples of successful case management models for formerly incarcerated individuals with SMI found through a secondary analysis of qualitative data and an analysis of the literature are presented. Findings Currently, no international, national, or statewide guidelines exist to ensure that formerly incarcerated individuals with SMI receive case management upon community reentry despite evidence that such services can prevent further criminal justice involvement. Recommendations include establishment of and evaluation of best practices for case management. In addition, the authors recommend additional funding for case management with the goal of greatly increasing the number of individuals with SMI leaving the criminal justice system in their ability to access adequate case management. Originality/value Providing effective case management tailored to the needs of formerly incarcerated people with SMI improves their quality of life and reduces their involvement in the criminal justice system with clear positive outcomes for public safety and public health.

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.

Do Community-based Institutions Build Resilience to Climate Change in Mongolia?

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Fernandez-Gimenez, M.

2012-12-01

Climate change impacts are inherently local, yet relatively little is known about the role of local people and institutions in adapting to climate change. Mongolia has experienced one of the strongest warming trends on Earth over the past 40 years, associated declines in streamflow, and increases in the frequency of extreme winter weather events. Environmental changes are compounded by rapid political, economic and social transformations beginning in 1990. We investigate the complex interactions of social, ecological and climate changes across multiple levels from local to regional to national. We hypothesize that community-based institutions increase resilience by strengthening self-regulating feedbacks between social and ecological systems through development and enforcement of formal management rules, implementation of innovative management practices, strengthening of social networks and information exchange within and across levels of social organization, and enhanced monitoring. These result in better ecological and socio-economic conditions and greater adaptive capacity in areas under formal community-based management compared to adjacent areas without formal community management institutions. Evaluation of this hypothesis involves integrated collection and analysis of quantitative and qualitative ecological, social and hydro-climatic data at household, community and regional levels of spatial and social organization. Here, we present preliminary results evaluating these hypotheses from 10 counties (soum) in 3 provinces (aimag) in the Gobi desert-steppe of southern Mongolia based on household-level social data and plot-level ecological data representing. Our initial findings support the hypothesis that community-based institutions are associated with greater household adaptive capacity and healthier pasture ecological conditions, characterized by greater perennial vegetation cover and biomass, especially in the functional group most important for livestock

Factors Associated With Weight Change in Online Weight Management Communities: A Case Study in the LoseIt Reddit Community.

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Pappa, Gisele Lobo; Cunha, Tiago Oliveira; Bicalho, Paulo Viana; Ribeiro, Antonio; Couto Silva, Ana Paula; Meira, Wagner; Beleigoli, Alline Maria Rezende

2017-01-16

Recent research has shown that of the 72% of American Internet users who have looked for health information online, 22% have searched for help to lose or control weight. This demand for information has given rise to many online weight management communities, where users support one another throughout their weight loss process. Whether and how user engagement in online communities relates to weight change is not totally understood. We investigated the activity behavior and analyze the semantic content of the messages of active users in LoseIt (r/loseit), a weight management community of the online social network Reddit. We then explored whether these features are associated with weight loss in this online social network. A data collection tool was used to collect English posts, comments, and other public metadata of active users (ie, users with at least one post or comment) on LoseIt from August 2010 to November 2014. Analyses of frequency and intensity of user interaction in the community were performed together with a semantic analysis of the messages, done by a latent Dirichlet allocation method. The association between weight loss and online user activity patterns, the semantics of the messages, and real-world variables was found by a linear regression model using 30-day weight change as the dependent variable. We collected posts and comments of 107,886 unique users. Among these, 101,003 (93.62%) wrote at least one comment and 38,981 (36.13%) wrote at least one post. Median percentage of days online was 3.81 (IQR 9.51). The 10 most-discussed semantic topics on posts were related to healthy food, clothing, calorie counting, workouts, looks, habits, support, and unhealthy food. In the subset of 754 users who had gender, age, and 30-day weight change data available, women were predominant and 92.9% (701/754) lost weight. Female gender, body mass index (BMI) at baseline, high levels of online activity, the number of upvotes received per post, and topics discussed

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

Science.gov (United States)

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.

Using communities of practice towards the next level of knowledge-management maturity

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Lameshnee Chetty

2012-07-01

Objectives: The research was conducted to analyse the impact of communities of practice on building a learning organisation. The organisational system, culture and people offer the key towards leveraging knowledge as a strategic resource in a learning organisation. The awareness of the organisation concerning knowledge management was measured on a replicated knowledge management maturity model. Method: The organisational knowledge base was analysed prior to the implementation of the communities of practice and was compared to the situation three years later. The research was based on experiential learning cycles that consisted of five consequential but perpetual stages,namely reflect, plan, act, observe and reflect again. Results: The results indicated that communities of practice were instrumental in leveraging the organisation to the next level in the knowledge-management maturity model. A collaboration framework was developed for each business unit to work towards a common goal by harnessing the knowledge that was shared. Conclusion: Although a positive impact by communities of practice is visible, an instrument for the measurement of intellectual capital is necessary. It is recommended that the monetary value of knowledge as an asset is determined so that the value of the potential intellectual capital can be measured.

Untangling outcomes of de jure and de facto community-based management of natural resources.

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Agarwala, Meghna; Ginsberg, Joshua R

2017-12-01

We systematically reviewed the literature on the tragedy of the commons and common-property resources. We segregated studies by legal management regimes (de jure regimes) and management that develops in practice (de facto regimes) to understand how the structure of regime formation affects the outcome of community management on sustainability of resource use. De facto regimes, developed within the community, are more likely to have positive impacts on the resource. However, de facto regimes are fragile and not resilient in the face of increased population pressure and unregulated markets, and de facto management regimes are less successful where physical exclusion of external agents from resources is more difficult. Yet, formalization or imposition of de jure management regimes can have complicated impacts on sustainability. The imposition of de jure regimes usually has a negative outcome when existing de facto regimes operate at larger scales than the imposed de jure regime. In contrast, de jure regimes have largely positive impacts when the de facto regimes operate at scales smaller than the overlying de jure regimes. Formalization may also be counterproductive because of elite capture and the resulting de facto privatization (that allows elites to effectively exclude others) or de facto open access (where the disenfranchised may resort to theft and elites cannot effectively exclude them). This underscores that although the global movement to formalize community-management regimes may address some forms of inequity and may produce better outcomes, it does not ensure resource sustainability and may lead to greater marginalization of users. Comparison of governance systems that differentiate between initiatives that legitimize existing de facto regimes and systems that create new de facto regimes, investigations of new top-down de jure regimes, and studies that further examine different approaches to changing de jure regimes to de facto regimes are avenues for

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.

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.

Project management in practice : Evaluating a case project through project management theories

OpenAIRE

Uusitalo, Jenni

2013-01-01

The purpose of this thesis was to evaluate a case project and to study whether it was carried out in a correct manner; meaning that did the case project follow the project management models. In addition, part of the study was to determine what could have been improved in the management of the case project. The case project was about creating and launching a communication channel based on a social media service, on a blog platform called Tumblr, for Team Finland in Spain network. The network p...

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

Science.gov (United States)

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

Facilities Management and Value Adding - The LEGO case

DEFF Research Database (Denmark)

Jensen, Per Anker; Katchamart, Akarapong

on the management model for FM included in the European FM standards, recent theories on added value of FM and real estate and the related concept of Value Management from building projects. The paper outlines a preliminary theoretical based management concept, which is investigated, tested and discussed based...... on a case study of LEGO. Results: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms the relevance of the basic concept and provides an important...... example of how Value Adding Management can be implemented and added value measured. Practical Implications: The concept of Value Adding Management is expected to increase the awareness of the impacts and strategic importance of FM for organisations and can be a practical tool for facilities managers...

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

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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

Contemplating case mix: A primer on case mix classification and management.

Science.gov (United States)

Costa, Andrew P; Poss, Jeffery W; McKillop, Ian

2015-01-01

Case mix classifications are the frameworks that underlie many healthcare funding schemes, including the so-called activity-based funding. Now more than ever, Canadian healthcare administrators are evaluating case mix-based funding and deciphering how they will influence their organization. Case mix is a topic fraught with technical jargon and largely relegated to government agencies or private industries. This article provides an abridged review of case mix classification as well as its implications for management in healthcare. © 2015 The Canadian College of Health Leaders.

Financial Management: Cash Management Practices in Florida Community Colleges.

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Spiwak, Rand S.

A study was conducted to identify those variables appearing to affect cash management practices in Florida community colleges, and recommend prescriptive measures concerning these practices. The study methodology included informal discussions with the chief fiscal officers of each Florida community college and appropriate state board staff,…

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

Science.gov (United States)

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…

Capacity development for community health nurses in Pakistan: the assistant manager role.

Science.gov (United States)

Gulzar, S A; Mistry, R; Upvall, M J

2011-09-01

Community health nurses (CHNs), as leaders in developing countries, can promote successful outcomes in meeting the targets of the Millennium Development Goals. A community-based organization in Pakistan is striving to achieve the goals of maternal and child health through the development of the assistant manager role for community health nursing. The purpose of this study was to assess the perception of the role of the CHN assistant manager, with the goal of strengthening that role. This interpretive, qualitative study included 13 participants already familiar with CHNs in Pakistan. Interviewing was utilized to explore perceptions of the assistant manager role and to uncover challenges currently existing within this new role. Content analysis revealed the following themes: 'role perceptions', 'expectations of the role' and 'collaboration with other community healthcare providers'. Changes to the role are necessary including increased education of the assistant manager CHNs and preparing administration to work with the assistant mangers for effective leadership. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

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.

Policy entrepreneurs and structural influence in integrated community case management policymaking in Burkina Faso.

Science.gov (United States)

Shearer, Jessica C

2015-12-01

Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and political capital. Policy entrepreneurs have received little study in low- and middle-income country policy research despite observations of individualized decision-making, informal institutions and the unequal distribution and exercise of power in policymaking. This article aims to identify whether policy entrepreneurs were present in the policy process around integrated community case management (iCCM) in Burkina Faso, whether they were successful in achieving policy change, and whether success or failure can be explained using existing policy entrepreneur frameworks from high-income polities. This mixed methods policy study collected data from in-depth qualitative interviews and social network surveys of actors involved in iCCM policymaking [known locally as C-integrated management of childhood illness (IMCI)]; data were analysed based on the framework categories. Interview data pointed to one key individual who played a significant role in the inclusion of pneumonia treatment into the country's iCCM policy, an issue that had been a point of contention between government policy elites and development partners. Social network data confirmed that this actor was strategically located in the policy network to be able to reach the most other actors and to be able to control the flow of information. Although some development partner actors were as strategically located, none had the same level of authority or trust as was imbued by being a member of the government civil service. The entrepreneur's mid-level rank in the health ministry may have encouraged him/her to invest political capital and take risks that would not have been feasible or attractive to a

[Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

Science.gov (United States)

Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

2010-04-01

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

Constructing an Evaluation Framework for Eco-Museum Operations-Management Performance, Based on the Case of Jhushan, Taiwan

Directory of Open Access Journals (Sweden)

Kuo-Wei Hsu

2018-06-01

Full Text Available The bamboo-art industry in Taiwan’s Jhushan Township is inseparable from local life. In the face of local industrial-development difficulties in smaller towns, the Taiwan government aimed to achieve a range of (redevelopment goals using eco-museums as collaboration platforms and required such museums to combine their operations management with cultural preservation, local industrial development, and local residents’ goals. As such, the likely future performance of such operations management has emerged as a crucially important factor in decision-making about whether such museums should be constructed. This study, therefore, reviews the relevant literature on the operations-management performance of museums, with special attention to eco-museums, and proposes an operations-management performance measurement framework for eco-museums based on that review and a two-stage questionnaire administered to experts. The first stage utilized the Fuzzy Delphi Method, which focuses on impact factors, and the second, the Analytica Network Process Method, deals with performance factors. The results indicate that the key impacts on the performance of eco-museums and their operations management were, in order of importance, (1 community symbiosis, (2 cultural inheritance, and (3 regional revitalization. The preservation of cultural heritage, local identity, and community participation are the most important criteria in the operations management of eco-museums, and Jhushan Town can promote such museums through these guidelines.

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.

Modern Wildlife Monitoring Technologies: Conservationists versus Communities? A Case Study: The Terai-Arc Landscape, Nepal

Directory of Open Access Journals (Sweden)

Yashaswi Shrestha

2018-01-01

Full Text Available The use of new and advanced wildlife monitoring technologies is shifting the paradigm of wildlife conservation and management. These digital technologies are helping wildlife conservationists and researchers around the world to monitor and manage wildlife with more precision and efficiency. However, this research study highlights some of the key drawbacks of using such modern technologies for wildlife conservation and management especially in developing countries, where the digital divide often clearly separates well-endowed conservation organisations and rural communities. It provides an insight into how the extensive use of such digital wildlife monitoring technologies can often marginalise the role of local and indigenous communities in wildlife management. Our case study, which was conducted in the Terai Arc Landscape (TAL in southern Nepal, includes interviews with several wildlife experts, biologists, and members of local and indigenous communities. Findings indicate that the increasing militarisation and centralisation of protected area management, and the lack of universal access to the information gathered using modern monitoring technologies, have notably led to the marginalisation of local and indigenous communities in the region. These developments not only undermine the benefits of using such technologies but have also caused a rift between conservation organisations and local communities. As a result, this research study recommends that conservation organisations who advocate for the use of such technologies need to hold consultations and dialogues between conservationists and local and indigenous community members in order to be more inclusive and allow for a cross cultural and an interdisciplinary understanding of the best practices for the conservation and management of wildlife.

Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study