Community Development and Divergent Forces in Philippine State Universities and Colleges: Developing a Protocol in Evaluating Extension Projects Towards Community Empowerment

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Dexter S. Ontoy

2016-11-01

Full Text Available Divergent paradigms operate in State Universities and Colleges SUCs, which influence the performance of extension projects towards attainment of full empowerment as the ultimate goal implied by the universally-accepted definition of community development. In particular, a livelihood and environment project of Cebu Normal University (CNU implemented in Caputatan Norte, Medillin, Cebu, Philippines was assessed based on five (5 primary parameters and two (2 secondary parameters. A novel protocol using Delphi Method shows was developed and used for this particular study, which could be adapted in evaluating the performance of community extension projects. In this particular case, the performance of CNU livelihood and environment project falls between ―demonstration‖ and ―community organizing‖. The evaluation shows that there is still a need to reinforce activities to the ultimate goal. However, it is also implied that the secondary parameters are more robust indicators in assessing the outcomes of the project implementation towards full community empowerment.

Evaluating quality indicators for patients with community-acquired pneumonia.

Science.gov (United States)

Rhew, D C; Goetz, M B; Shekelle, P G

2001-11-01

Several organizations have published evidence-based quality indicators for community-acquired pneumonia (CAP). However, there is variability in the types of indicators presented between organizations and the level of supporting evidence for each of the indicators. A systematic review of the literature and relevant Internet Web sites was performed to identify quality indicators for CAP that have been proposed or recommended by organizations, and each of the indicators was then critically appraised, using a well-defined set of criteria. The MEDLINE, EMBASE, Best Evidence, and Cochrane Systematic Review databases and Internet Web sites were searched for articles and guidelines published between January 1980 and May 2001 to identify quality indicators for CAP and relevant evidence. Experts in the area of health services research were contacted to identify additional sources. A well-defined set of criteria was applied to evaluate each of the quality indicators. The systematic review of the literature and Internet Web sites yielded 44 CAP-specific quality indicators. The critical appraisal of these indicators yielded 16 indicators that were supported by a study that identified an association between quality of care and the process of care or outcome measure, were applied to enough patients to be able to detect clinically meaningful differences, were clinically and/or economically relevant, were measurable in a clinical practice setting, and were precise in their specifications. Many organizations recommend indicators for CAP. Indicators may serve as measures of clinical performance for clinicians and hospitals, may help in benchmarking, and may ultimately facilitate improvements in quality of care and cost reductions. However, CAP indicators often vary in their meaningfulness, scientific soundness, and interpretability of results. A set of five critical appraisal questions may assist in the evaluation of which quality indicators are most valid.

Hospital management of community-acquired pneumonia in Malta

OpenAIRE

Callus, Roberta; Micallef, Josef; Mamo, Jonathan; Montefort, Stephen

2012-01-01

Community-acquired pneumonia (CAP) remains a common diagnosis requiring hospital admission and a leading cause of death worldwide. No local guideline is currently available for the management of CAP. Our aim was to evaluate current practices in the management of CAP at Mater Dei Hospital, Malta. In this prospective study we looked at all adult patients admitted with CAP in winter and summer (105 consecutive days for both seasons). Data collected and analysed included: basic patient demographi...

A post hoc assessment of duration of protection in CAPiTA (Community Acquired Pneumonia immunization Trial in Adults)

NARCIS (Netherlands)

Patterson, Scott; Webber, Chris; Patton, Michael; Drews, Wayne; Huijts, Susanne M.; Bolkenbaas, Marieke; Gruber, William C.; Scott, Daniel A.; Bonten, Marc J M

2016-01-01

Background: The Community Acquired Pneumonia immunization Trial in Adults (CAPiTA) was conducted to evaluate 13-valent pneumococcal conjugate vaccine (PCV13) for the prevention of vaccine-type community-acquired pneumonia (VT-CAP) and vaccine-type invasive pneumococcal disease (VT-IPD) in adults

Community-acquired Clostridium difficile infection in children: A retrospective study.

Science.gov (United States)

Borali, Elena; Ortisi, Giuseppe; Moretti, Chiara; Stacul, Elisabetta Francesca; Lipreri, Rita; Gesu, Giovanni Pietro; De Giacomo, Costantino

2015-10-01

Community acquired-Clostridium difficile infection (CDI) has increased also in children in the last years. To determine the incidence of community-acquired CDI and to understand whether Clostridium difficile could be considered a symptom-triggering pathogen in infants. A five-year retrospective analysis (January 2007-December 2011) of faecal specimens from 124 children hospitalized in the Niguarda Ca' Granda Hospital for prolonged or muco-haemorrhagic diarrhoea was carried out. Stool samples were evaluated for common infective causes of diarrhoea and for Clostridium difficile toxins. Patients with and without CDI were compared for clinical characteristics and known risk factors for infection. Twenty-two children with CDI were identified in 5 years. An increased incidence of community-acquired CDI was observed, ranging from 0.75 per 1000 hospitalizations in 2007 to 9.8 per 1000 hospitalizations in 2011. Antimicrobial treatment was successful in all 19 children in whom it was administered; 8/22 CDI-positive children were younger than 2 years. No statistically significant differences in clinical presentation were observed between patients with and without CDI, nor in patients with and without risk factors for CDI. Our study shows that Clostridium difficile infection is increasing and suggests a possible pathogenic role in the first 2 years of life. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Arthritis in adults with community-acquired bacterial meningitis: a prospective cohort study

NARCIS (Netherlands)

Weisfelt, M.; van de Beek, D.; Spanjaard, L.; de Gans, J.

2006-01-01

Background: Although the coexistence of bacterial meningitis and arthritis has been noted in several studies, it remains unclear how often both conditions occur simultaneously. Methods: We evaluated the presence of arthritis in a prospective nationwide cohort of 696 episodes of community-acquired

Problems with Reporting and Evaluating Mining Industry Community Development Projects: A Case Study from Tanzania

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Esther Wangari

2012-02-01

Full Text Available Reporting on contributions to community development is one way gold mining companies communicate the expanse and depth of their commitment to social responsibility. These projects are intended to provide the mine-proximate communities with some of the wealth and other benefits generated by mine development in their locales. We raise questions about reporting and evaluation of community development projects undertaken by AngloGold Ashanti in the two communities of Nyakabale and Nyamalembo, near its Geita mining projects in the Lake Victoria goldfields of Tanzania. We use archival data and data obtained from field research conducted during different periods throughout 2005, 2007 and 2010 to compare what the company reports to have done with what is found on the ground. Our findings revealed that the corporate reporting is misleading, ambiguous, and omissive. Much of the effort labeled “community development” benefited the companies directly via infrastructure development, food supplies to the mine cafeteria, and worker health. We argue that, if Corporate Social Responsibility (CSR projects are to be the primary way local people directly benefit from mine development, the relationship between the value of those projects and the wealth taken from the location should be considered, community projects should be well defined and differentiated from company-oriented projects, and community representatives should participate in monitoring the success and impact of community development projects.

Sequential Therapy of Community-Acquired Pneumonia in Children

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I.A. Karimdzhanov

2014-04-01

Full Text Available Aim of the study — to examine the effectiveness of sequential therapy of injectable and oral forms cephalosporins of II generation, cefuroxime sodium and cefprozil, in children with acute community-acquired pneumonia. We examined 53 child patients aged 6 months — 14 years with acute community-acquired pneumonia. Patients were divided into 2 groups: 1st group — 26 patients who treated with cefuroxime sodium intramuscularly, and 2nd — 27 patients who treated with cefuroxime sodium in first 3 days and then from the 4th day — with cefprozil suspension orally. Both groups of patients were comparable by forms and course of pneumonia. In the clinic to all patients were conducted conventional clinical and laboratory investigations. Complex therapy was not different in both groups. Efficacy of treatment was assessed in dynamics. When comparing the effectiveness of two antibiotic regimens (cefuroxime sodium parenterally and sequential regimen with replacement by cefprozil orally there were no differences in the dynamics of clinical course, laboratory and radiological data. Finding of the conducted investigations before treatment showed that majority of patients had clinical and radiological evidence of pneumonia: fever, cough, shortness of breath, tachycardia, physical and radiological changes in the lungs. Evaluation of treatment efficacy showed that by the end of treatment in both groups of patients there was a positive clinical and radiological dynamics of the disease, the body temperature returned to normal, symptoms of intoxication, physical changes in the lungs disappeared, focal and infiltrative changes disappeared completely. Thus, sequential therapy with cephalosporins of II generation, cefuroxime and cefprozil, in the treatment of acute community-acquired pneumonia in children is a quite effective and safe method with good tolerability and no side effects.

Diagnosis and Treatment of Community-Acquired Pneumonia in Children

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I.A. Karymdzhanov

2016-02-01

The initial antibiotic therapy of community-acquired pneumonia is carried out empirically. In the treatment of severe community-acquired pneumonia in children from 2 months to 5 years, the drug of choice is amoxicillin orally. Macrolides are the drugs of choice for children aged 5 to 16 years. In severe pneumonia, drugs of choice are amoxicillin clavulanate, 2nd–4th generation cephalosporins. In general, the duration of antibiotic therapy in the community-acquired pneumonia caused by typical bacteria is 7–10 days, by atypical bacteria — 10–14 days. In the real clinical practice, the errors associated with the choice of drug, route of administration, dosage, regimen of application, length of treatment are frequent during antibacterial therapy.

The DLESE Evaluation Toolkit Project

Science.gov (United States)

Buhr, S. M.; Barker, L. J.; Marlino, M.

2002-12-01

The Evaluation Toolkit and Community project is a new Digital Library for Earth System Education (DLESE) collection designed to raise awareness of project evaluation within the geoscience education community, and to enable principal investigators, teachers, and evaluators to implement project evaluation more readily. This new resource is grounded in the needs of geoscience educators, and will provide a virtual home for a geoscience education evaluation community. The goals of the project are to 1) provide a robust collection of evaluation resources useful for Earth systems educators, 2) establish a forum and community for evaluation dialogue within DLESE, and 3) disseminate the resources through the DLESE infrastructure and through professional society workshops and proceedings. Collaboration and expertise in education, geoscience and evaluation are necessary if we are to conduct the best possible geoscience education. The Toolkit allows users to engage in evaluation at whichever level best suits their needs, get more evaluation professional development if desired, and access the expertise of other segments of the community. To date, a test web site has been built and populated, initial community feedback from the DLESE and broader community is being garnered, and we have begun to heighten awareness of geoscience education evaluation within our community. The web site contains features that allow users to access professional development about evaluation, search and find evaluation resources, submit resources, find or offer evaluation services, sign up for upcoming workshops, take the user survey, and submit calendar items. The evaluation resource matrix currently contains resources that have met our initial review. The resources are currently organized by type; they will become searchable on multiple dimensions of project type, audience, objectives and evaluation resource type as efforts to develop a collection-specific search engine mature. The peer review

Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.

Science.gov (United States)

Wang, Yafang; Wang, Jinwei; Su, Tao; Qu, Zhen; Zhao, Minghui; Yang, Li

2017-05-01

This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. Cross-sectional and retrospective study. A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted. All-cause in-hospital mortality and recovery of kidney function at hospital discharge. 4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor. Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine. The features of community-acquired AKI varied substantially in different regions of China and were closely

[Community-acquired Acinetobacter pneumonia].

Science.gov (United States)

Bernasconi, E; Wüst, J; Speich, R; Flury, G; Krause, M

1993-08-21

We report the history of a 38-year-old male native of Sri Lanka admitted to the emergency ward because of chest pain and shortness of breath. On physical and radiographic examination a bilateral predominantly right-sided pneumonia was found. The patient was admitted to the medical ICU and an antibiotic regimen with amoxicillin/clavulanic acid and erythromycin was initiated. Shortly afterwards septic shock developed. The patient was intubated and received high doses of catecholamines. He died 30 hours after admission to the hospital. Cultures from sputum, tracheal aspirate and blood grew Acinetobacter baumanni. Acinetobacter is an ubiquitous gram-negative rod with coccobacillary appearance in clinical specimens, that may appear gram-positive due to poor discoloration on Gram-stain. It is a well known causative agent of nosocomial infections, particularly in intensive care units. Community-acquired pneumonias, however, are quite rare. Sporadic cases have been reported from the US, Papua-New Guinea and Australia. Interestingly, these pneumonias are fulminant and have a high mortality. Chronic obstructive lung disease, diabetes, and tobacco and alcohol consumption appear to be predisposing factors. Due to the rapid course and poor prognosis, prompt diagnosis and adequate antibiotic treatment are indicated. Antibiotics use for community-acquired pneumonias, such as amoxicillin/clavulanic acid or macrolides, are not sufficient. Appropriate antibiotics for the initial treatment of suspected Acinetobacter infections include imipenem and carboxy- and ureidopenicillins combined with an aminoglycoside.

Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differences, in a public healthcare system

DEFF Research Database (Denmark)

Hedegaard Klausen, Henrik; Petersen, J; Lindhardt, T

2012-01-01

OBJECTIVES: To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients. METHODS: National registry study on elderly Danish citizens with an acute admission in 2009 owing to community....... RESULTS: A total of 11,332 elderly citizens were admitted with community-acquired pneumonia. Mortality during admission and 30-days from discharge were 11.6% and 16.2%, respectively. Readmission rates within 30 days of discharge were 12.3%. There were significantly differences between hospitals in length...

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark

DEFF Research Database (Denmark)

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang

2017-01-01

BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin......-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines....

Emergency Medicine Evaluation of Community-Acquired Pneumonia: History, Examination, Imaging and Laboratory Assessment, and Risk Scores.

Science.gov (United States)

Long, Brit; Long, Drew; Koyfman, Alex

2017-11-01

Pneumonia is a common infection, accounting for approximately one million hospitalizations in the United States annually. This potentially life-threatening disease is commonly diagnosed based on history, physical examination, and chest radiograph. To investigate emergency medicine evaluation of community-acquired pneumonia including history, physical examination, imaging, and the use of risk scores in patient assessment. Pneumonia is the number one cause of death from infectious disease. The condition is broken into several categories, the most common being community-acquired pneumonia. Diagnosis centers on history, physical examination, and chest radiograph. However, all are unreliable when used alone, and misdiagnosis occurs in up to one-third of patients. Chest radiograph has a sensitivity of 46-77%, and biomarkers including white blood cell count, procalcitonin, and C-reactive protein provide little benefit in diagnosis. Biomarkers may assist admitting teams, but require further study for use in the emergency department. Ultrasound has shown utility in correctly identifying pneumonia. Clinical gestalt demonstrates greater ability to diagnose pneumonia. Clinical scores including Pneumonia Severity Index (PSI); Confusion, blood Urea nitrogen, Respiratory rate, Blood pressure, age 65 score (CURB-65); and several others may be helpful for disposition, but should supplement, not replace, clinical judgment. Patient socioeconomic status must be considered in disposition decisions. The diagnosis of pneumonia requires clinical gestalt using a combination of history and physical examination. Chest radiograph may be negative, particularly in patients presenting early in disease course and elderly patients. Clinical scores can supplement clinical gestalt and assist in disposition when used appropriately. Published by Elsevier Inc.

[Cross-cultural adaptation of the community-acquired pneumonia score questionnaire in patients with mild-to-moderate pneumonia in Colombia].

Science.gov (United States)

Bernal-Vargas, Mónica Alejandra; Cortés, Jorge Alberto; Sánchez, Ricardo

2017-01-24

One of the strategies for the rational use of antibiotics is the use of the score for community-acquired pneumonia (CAP Score). This instrument clinically evaluates patients with community-acquired pneumonia, thereby facilitating decision making regarding the early and safe withdrawal of antibiotics. To generate a translation and cross-cultural adaptation of the Community-Acquired Pneumonia (CAP) Score questionnaire in Spanish. Authorization for cross-cultural adaptation of the Community-Acquired Pneumonia (CAP) Score questionnaire was obtained; the recommendations of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the European Organisation for Research and Treatment of Cancer (EORTC) were carried out through the following stages: forward translation, reconciliation, backward translation, harmonization, obtaining a provisional questionnaire, and applying the questionnaire in a pilot test. The pilot test was conducted at a second-level public hospital in Bogotá after the study was approved by the ethics and research institutional boards. The changes suggested by the forward translators were applied. There were no discrepancies between the backward and forward translations, consequently, no revisions were necessary. Five items had modifications based on suggestions made by eleven patients hospitalized with a diagnosis of community-acquired pneumonia during the pilot test. A Spanish version of the Community-Acquired Pneumonia (CAP) Score was crossculturally adapted and is now available.

Process evaluation of a community-based adolescent obesity prevention project in Tonga.

Science.gov (United States)

Fotu, Kalesita F; Moodie, Marj M; Mavoa, Helen M; Pomana, Siosifa; Schultz, Jimaima T; Swinburn, Boyd A

2011-05-09

The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP) conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents) to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider than the target group), but the dose and frequency of activities were

Community-acquired pneumonia; Ambulant erworbene Pneumonien

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Poetter-Lang, S.; Herold, C.J. [Medizinische Universitaet Wien, Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Wien (Austria)

2017-01-15

The diagnosis of community-acquired pneumonia (CAP) is often not possible based only on the clinical symptoms and biochemical parameters. For every patient with the suspicion of CAP, a chest radiograph in two planes should be carried out. Additionally, a risk stratification for the decision between outpatient therapy or hospitalization is recommended. Based on the evaluation of the different radiological patterns as well as their extent and distribution, a rough allocation to so-called pathogen groups as well as a differentiation between viral and bacterial infections are possible; however, because different pathogens cause different patterns an accurate correlation is not feasible by relying purely on imaging. The radiological findings serve as proof or exclusion of pneumonia and can also be used to evaluate the extent of the disease (e.g. monolobular, multilobular, unilateral or bilateral). In cases of prolonged disease, suspicion of complications (e.g. pleural effusion or empyema, necrotizing pneumonia or abscess) or comorbid conditions (e.g. underlying pulmonary or mediastinal diseases) computed tomography is an important diagnostic tool in addition to chest radiography. Ultrasound is often used to diagnose pleural processes (e.g. parapneumonic effusion or pleural empyema). (orig.) [German] Anhand der klinischen Symptome und laborchemischen Befundkonstellation alleine ist es oft nicht moeglich, die Diagnose einer ambulant erworbenen Pneumonie (''community-acquired pneumonia'', CAP) zu stellen. Bei jedem Patienten mit Verdacht auf CAP sollte eine Roentgenthoraxaufnahme in 2 Ebenen angefertigt werden. Weiter muss eine Risikostratifizierung im Sinne der Entscheidung ambulante Therapie vs. Hospitalisierung erfolgen. Anhand der Analyse radiologischer Muster sowie deren Verteilung und Ausdehnung koennen eine grobe Zuordnung zu sogenannten Erregergruppen sowie eine Differenzierung zwischen viralen und bakteriellen Infektionen gelingen. Da

Comparative antimicrobial susceptibility of aerobic and facultative bacteria from community-acquired bacteremia to ertapenem in Taiwan

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Fung Chang-Phone

2007-07-01

Full Text Available Abstract Background Ertapenem is a once-a-day carbapenem and has excellent activity against many gram-positive and gram-negative aerobic, facultative, and anaerobic bacteria. The susceptibility of isolates of community-acquired bacteremia to ertapenem has not been reported yet. The present study assesses the in vitro activity of ertapenem against aerobic and facultative bacterial pathogens isolated from patients with community-acquired bacteremia by determining and comparing the MICs of cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin. The prevalence of extended broad spectrum β-lactamases (ESBL producing strains of community-acquired bacteremia and their susceptibility to these antibiotics are investigated. Methods Aerobic and facultative bacteria isolated from blood obtained from hospitalized patients with community-acquired bacteremia within 48 hours of admission between August 1, 2004 and September 30, 2004 in Chang Gung Memorial Hospital at Keelung, Taiwan, were identified using standard procedures. Antimicrobial susceptibility was evaluated by Etest according to the standard guidelines provided by the manufacturer and document M100-S16 Performance Standards of the Clinical Laboratory of Standard Institute. Antimicrobial agents including cefepime, cefoxitin, ceftazidime, ceftriaxone, ertapenem, piperacillin, piperacillin-tazobactam, ciprofloxacin, amikacin and gentamicin were used against the bacterial isolates to test their MICs as determined by Etest. For Staphylococcus aureus isolates, MICs of oxacillin were also tested by Etest to differentiate oxacillin-sensitive and oxacillin-resistant S. aureus. Results Ertapenem was highly active in vitro against many aerobic and facultative bacterial pathogens commonly recovered from patients with community-acquired bacteremia (128/159, 80.5 %. Ertapenem had more potent activity than ceftriaxone, piperacillin

The role of haloaerosolotherapy in immunorehabilitation of convalescents after community acquired pneumonia

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Olha Lemko

2015-02-01

Full Text Available Aim: Investigation of the peculiarities of different haloaerosoltherapy regimes influence (treatment with different intensity of haloaerosol load upon non-specific defense and cellular immunity at convalescents after community acquired pneumonia. Objectives: patients with community acquired pneumonia in the early convalescence period (after completing antibiotic therapy, who received treatment in conditions of artificial rock salt aerosol medium (haloaerosoltherapy. Material and Methods. 42 patients with non-severe community acquired pneumonia were examined in the early convalescence period before and after the course of haloaerosoltherapy, which was prescribed after antibacterial therapy. Immunological studies included: evaluation of phagocytic activity of neutrophils (PhAN - the percentage of phagocytic neutrophils, phagocytic number (PhN - average number of latex particles absorbed by a neutrophil; metabolism of neutrophils in the test with nitroblue tetrasolium (NBT-test spontaneous and induced, which allowed to assess the functional reserve of neutrophils (FR; calculation of cytochemical coefficient (CCC for lysosomal cationic proteins (LCP and for myeloperoxidase (MPO of neutrophils; number of T- and B-lymphocytes and their subpopulations (CD3+ -, CD4+ -, CD8+ -, CD22+ - lymphocytes, calculation the number of 0- lymphocytes and the ratio of CD4+ /CD8+ lymphocytes. Laboratory examinations were also conducted in 21 practically healthy individuals (control group. Two regimes of haloaerosoltherapy were used in recovery treatment of patients with community acquired pneumonia: treating complex №1 (TC-1 with standard haloaerosol load and with increased haloaerosol load (TC-2. Results. After completion the antibiotic therapy at patients with community acquired pneumonia the moderate inhibition of phagocytic activity of neutrophils (47,6±0,58% to 55,5±1,14% in control group remained and was accompanied with a decrease in neutrophil bactericidal

Prognostic value of lactate clearance in severe community acquired pneumonia

OpenAIRE

Mohamed, Kamel Abd Elaziz; Ahmed, Dief Abd Elgalil

2014-01-01

Introduction: Severe community acquired pneumonia (SCAP) occurs in approximately 18–36% of all CAP and the mortality rate could be as high as 67% in patients with SCAP. Several studies have described a correlation between baseline lactate concentration and mortality of ICU patients. Aim of the work: To follow lactate clearance after admission for 24 h which could be an indicator of outcome in severe community acquired pneumonia. Patients and methods: Forty-six consecutively admitted adu...

Community-Acquired Pneumonia: a Comparison between elderly and nonelderly patients

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S. Jafari

2006-08-01

Full Text Available Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias. Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed; and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist. Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years and 38 young (group II, age<65years subjects. Delirium was seen more in elderly group (p=0.05. The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02. Smoking (29.1%, neurological disturbances (19%, congestive heart failure (15.2%, chronic obstructive pulmonary disease and diabetes mellitus (13.9% were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients. Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.

Pseudomona pseudomallei community acquired pneumonia

International Nuclear Information System (INIS)

Severiche, Diego

1998-01-01

This is the first published case report en Colombia about pseudomona pseudomallei community acquired pneumonia. This uncommon pathogen is from the epidemiological standpoint a very important one and medical community should be aware to look after it in those patients where no other etiological pathogen is recovered. A brief summary about epidemiology is showed, emphasizing those regions where it can be found. Likewise, comments about the differential diagnosis are important since it should be considered in those patients where tuberculosis is suspected. This is particularly representative for countries with high tuberculosis rates. Furthermore, a microbiological review is shown, emphasizing on isolation techniques, descriptions about therapeutics and other regarding treatment issues according international standards. Finally; a description about the clinical picture, laboratory findings, treatment and evolution of the case reported are shown for discussion

Predicting pneumococcal community-acquired pneumonia in the emergency department: evaluation of clinical parameters.

Science.gov (United States)

Huijts, S M; Boersma, W G; Grobbee, D E; Gruber, W C; Jansen, K U; Kluytmans, J A J W; Kuipers, B A F; Palmen, F; Pride, M W; Webber, C; Bonten, M J M

2014-12-01

The aim of this study was to quantify the value of clinical predictors available in the emergency department (ED) in predicting Streptococcus pneumoniae as the cause of community-acquired pneumonia (CAP). A prospective, observational, cohort study of patients with CAP presenting in the ED was performed. Pneumococcal aetiology of CAP was based on either bacteraemia, or S. pneumoniae being cultured from sputum, or urinary immunochromatographic assay positivity, or positivity of a novel serotype-specific urinary antigen detection test. Multivariate logistic regression was used to identify independent predictors and various cut-off values of probability scores were used to evaluate the usefulness of the model. Three hundred and twenty-eight (31.0%) of 1057 patients with CAP had pneumococcal CAP. Nine independent predictors for pneumococcal pneumonia were identified, but the clinical utility of this prediction model was disappointing, because of low positive predictive values or a small yield. Clinical criteria have insufficient diagnostic capacity to predict pneumococcal CAP. Rapid antigen detection tests are needed to diagnose S. pneumoniae at the time of hospital admission. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

Community-acquired Pneumonia in Hospitalized Urban Young ...

African Journals Online (AJOL)

As part of a comprehensive hospital-based study of acute lower respiratory infections (ALRI) in under-five urban Nigerian children, we sought to identify the possible clinical and investigative correlates of lobar versus bronchopneumonia, and the possible determinants of mortality in community-acquired pneumonia. Over a ...

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA in community-acquired primary pyoderma

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Patil Rahul

2006-01-01

Full Text Available Background: Although prevalence of MRSA strains is reported to be increasing, there are no studies of their prevalence in community-acquired primary pyodermas in western India. Aims: This study aimed at determining the prevalence of MRSA infection in community-acquired primary pyodermas. Methods: Open, prospective survey carried out in a tertiary care hospital in Mumbai. Materials and Methods: Eighty-six patients with primary pyoderma, visiting the dermatology outpatient, were studied clinically and microbiologically. Sensitivity testing was done for vancomycin, sisomycin, gentamicin, framycetin, erythromycin, methicillin, cefazolin, cefuroxime, penicillin G and ciprofloxacin. Phage typing was done for MRSA positive strains. Results : The culture positivity rate was 83.7%. Staphylococcus aureus was isolated in all cases except two. Barring one, all strains of Staphylococcus were sensitive to methicillin. Conclusions: Methicillin resistance is uncommon in community-acquired primary pyodermas in Mumbai. Treatment with antibacterials active against MRSA is probably unwarranted for community-acquired primary pyodermas.

The impact of community-acquired pneumonia on the health-related quality-of-life in elderly.

Science.gov (United States)

Mangen, Marie-Josée J; Huijts, Susanne M; Bonten, Marc J M; de Wit, G Ardine

2017-03-14

The sustained health-related quality-of-life of patients surviving community-acquired pneumonia has not been accurately quantified. The aim of the current study was to quantify differences in health-related quality-of-life of community-dwelling elderly with and without community-acquired pneumonia during a 12-month follow-up period. In a matched cohort study design, nested in a prospective randomized double-blind placebo-controlled trial on the efficacy of the 13-valent pneumococcal vaccine in community-dwelling persons of ≥65 years, health-related quality-of-life was assessed in 562 subjects hospitalized with suspected community-acquired pneumonia (i.e. diseased cohort) and 1145 unaffected persons (i.e. non-diseased cohort) matched to pneumonia cases on age, sex, and health status (EQ-5D-3L-index). Health-related quality-of-life was determined 1-2 weeks after hospital discharge/inclusion and 1, 6 and 12 months thereafter, using Euroqol EQ-5D-3L and Short Form-36 Health survey questionnaires. One-year quality-adjusted life years (QALY) were estimated for both diseased and non-diseased cohorts. Separate analyses were performed for pneumonia cases with and without radiologically confirmed community-acquired pneumonia. The one-year excess QALY loss attributed to community-acquired pneumonia was 0.13. Mortality in the post-discharge follow-up year was 8.4% in community-acquired pneumonia patients and 1.2% in non-diseased persons (p pneumonia patients, compared to non-diseased persons, but differences in health-related quality-of-life between radiologically confirmed and non-confirmed community-acquired pneumonia cases were not statistically significant. Community-acquired pneumonia was associated with a six-fold increased mortality and 16% lower quality-of-life in the post-discharge year among patients surviving hospitalization for community-acquired pneumonia, compared to non-diseased persons. ClinicalTrials.gov, NCT00812084 .

Some Characteristics of Patients with Community Acquired ...

African Journals Online (AJOL)

There is a dearth of studies relating the information from the history of patients with community-acquired pneumonia to the mortality of the disease. The relationship between age, sex, occupation, marital status, smoking history, alcohol use, concomitant COPD / bronchial asthma, source of referral and the mortality of patients ...

Process evaluation of a community-based adolescent obesity prevention project in Tonga

Directory of Open Access Journals (Sweden)

Pomana Siosifa

2011-05-01

Full Text Available Abstract Background The rising burden of obesity in Tonga is alarming. The promotion of healthy behaviours and environments requires immediate urgent action and a multi-sectoral approach. A three-year community based study titled the Ma'alahi Youth Project (MYP conducted in Tonga from 2005-2008 aimed to increase the capacity of the whole community (schools, churches, parents and adolescents to promote healthy eating and regular physical activity and to reduce the prevalence of overweight and obesity amongst youth and their families. This paper reflects on the process evaluation for MYP, against a set of Best Practice Principles for community-based obesity prevention. Methods MYP was managed by the Fiji School of Medicine. A team of five staff in Tonga were committed to planning, implementation and evaluation of a strategic plan, the key planks of which were developed during a two day community workshop. Intervention activities were delivered in villages, churches and schools, on the main island of Tongatapu. Process evaluation data covering the resource utilisation associated with all intervention activities were collected, and analysed by dose, frequency and reach for specific strategies. The action plan included three standard objectives around capacity building, social marketing and evaluation; four nutrition; two physical activity objectives; and one around championing key people as role models. Results While the interventions included a wide mix of activities straddling across all of these objectives and in both school and village settings, there was a major focus on the social marketing and physical activity objectives. The intervention reach, frequency and dose varied widely across all activities, and showed no consistent patterns. Conclusions The adolescent obesity interventions implemented as part of the MYP program comprised a wide range of activities conducted in multiple settings, touched a broad spectrum of the population (wider

Antibiotic resistance in community-acquired urinary tract infections

African Journals Online (AJOL)

of community-acquired UTI organisms to amoxycillin and co-trimoxazole was .... Treatment of uncomplicated urinary tract infection in non-pregnant women. Postgrad ... Single-dose antibiotic treatment for symptomatic uri- nary tract infections in ...

Community-acquired pneumonia: 2012 history, mythology, and science.

Science.gov (United States)

Donowitz, Gerald R

2013-01-01

Pneumonia remains one of the major disease entities practicing physicians must manage. It is a leading cause of infection-related morbidity and mortality in all age groups, and a leading cause of death in those older than 65 years of age. Despite its frequency and importance, clinical questions have remained in the therapy of community-acquired pneumonia including when to start antibiotics, when to stop them, who to treat, and what agents to use. Answers to these questions have involved historical practice, mythology, and science-sometimes good science, and sometimes better science. How clinical decisions are made for patients with community-acquired pneumonia serves as an illustrative model for other problem areas of medicine and allows for insight as to how clinical decisions have been made and clinical practice established.

[Probiotics as an items of increasing the effectiveness of treatment of community-acquired pneumonia in adolescents].

Science.gov (United States)

Gonchar, N V; Kassner, L N; Korenev, P B; Il'kovich, Iu M; Mogilina, S V; Petrov, L N

2011-01-01

The aim of the work was to evaluate the efficiency of microbial probiotics Vitaflor and metabolic probiotic Aktoflor-C in complex treatment of community-acquired pneumonia in adolescents in a hospital. The observation involved 38 children aged 11 to 18 years with radiologically verified community-acquired pneumonia, including 23 boys and 15 girls. Patients were divided in 3 groups. Patients in group 1 (n = 13) simultaneously with the antibiotic therapy received per os Vitaflor probiotic containing symbiotic strains of Lactobacillus acidophilus; patients in group 2 (n = 10) along with antibiotic therapy received per os metabolic probiotic Aktoflor-C, containing low molecular weight exometabolites bacteria; patient of the comparison group (n = 15) received antibiotic therapy only. The effectiveness of the used treatment schemes was assessed on the dynamics of the gut state microbiot acoarding to an extended bacteriological examination of faecal flora, level of saliva IgA secretory (before and after treatment), the dynamics of SF-36 quality of life 1 month after discharge from hospital. Was conducted a study of economic efficiency of different modes of therapy. Results showed that adolescents with community-acquired pneumonia during standard antibiotic therapy indicated development of dysbiotic bowel disturbances in the form of reliable oppression of the bifidobacteria and laktoflora. Dysbiosis of the microbial associations are not conducive to proper implementation of immune and nutritional functions of the intestine that shows the imperfection of rehabilitation of patients with pneumonia according to the evaluation of SF-36 quality of life. Pharmacoeconomic analysis revealed the benefits of probiotic metabolic type "Aktoflor" used in addition to standard therapy of community-acquired pneumonia in adolescents.

Point-of-care lung ultrasound in children with community acquired pneumonia.

Science.gov (United States)

Yilmaz, Hayri Levent; Özkaya, Ahmet Kağan; Sarı Gökay, Sinem; Tolu Kendir, Özlem; Şenol, Hande

2017-07-01

To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings. Community acquired pneumonia was established as a final diagnosis by two clinicians based on the recommendations in the British Thoracic Society guideline. One hundred sixty children with a mean age of 3.3±4years and a median age of 1.4years (min-max 0.08-17.5years) were investigated. Final diagnosis in 149 children was community-acquired pneumonia. Lung ultrasound findings were compatible with pneumonia in 142 (95.3%) of these 149 children, while chest X-ray findings were compatible with pneumonia in 132 (88.5%). Pneumonia was confirmed with lung ultrasound in 15 of the 17 patients (11.4%) not evaluated as compatible with pneumonia at chest X-ray. While pneumonia could not be confirmed with lung ultrasound in seven (4.6%) patients, findings compatible with pneumonia were not determined at chest X-ray in two of these patients. When lung ultrasound and chest X-ray were compared as diagnostic tools, a significant difference was observed between them (p=0.041). This study shows that lung ultrasound is at least as useful as chest X-ray in diagnosing children with community-acquired pneumonia. Copyright © 2017 Elsevier Inc. All rights reserved.

Principles of Antibiotic Management of Community-Acquired Pneumonia.

Science.gov (United States)

Bender, Michael T; Niederman, Michael S

2016-12-01

Community-acquired pneumonia (CAP) encompasses a broad spectrum of disease severity and may require outpatient, inpatient, or intensive care management. Successful treatment hinges on expedient delivery of appropriate antibiotic therapy tailored to both the likely offending pathogens and the severity of disease. This review summarizes key principles in starting treatment and provides recommended empiric therapy regimens for each site of care. In addition, we discuss the antimicrobial and anti-inflammatory role macrolides play in CAP, as well as specific information for managing individual CAP pathogens such as community-acquired methicillin-resistant Staphylococcus aureus and drug-resistant Streptococcus pneumoniae . We also examine several novel antibiotics being developed for CAP and review the evidence guiding duration of therapy and current best practices for the transition of hospitalized patients from intravenous antibiotics to oral therapy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Economic Development Impacts of Community Wind Projects. A Review and Empirical Evaluation

Energy Technology Data Exchange (ETDEWEB)

Lantz, E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Tegen, S. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2009-04-01

"Community wind" refers to a class of wind energy ownership structures. The extent of local ownership may range from a small minority share to full ownership by persons in the immediate area surrounding the wind project site. Potential project owners include local farmers, businesses, Native American tribes, universities, cooperatives, or any other local entity seeking to invest in wind energy. The opposite of community wind is an "absentee" project, in which ownership is completely removed from the state and community surrounding the facility. Thus, there is little or no ongoing direct financial benefit to state and local populations aside from salaries for local repair technicians, local property tax payments, and land lease payments. In recent years, the community wind sector has been inhibited by manufacturers' preference for larger turbine orders. This often puts smaller community wind developers and projects at a competitive disadvantage. However, state policies specifically supporting community wind may become a more influential market factor as turbines are now more readily available given manufacturer ramp-ups and the slow-down in the industry that has accompanied the recent economic and financial crises. This report examines existing literature to provide an overview of economic impacts resulting from community wind projects, compares results, and explains variability.

Value of intensive diagnostic microbiological investigation in low- and high-risk patients with community-acquired pneumonia

NARCIS (Netherlands)

van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Jansen, H. M.; Boersma, W. G.

2005-01-01

In a prospective study to evaluate the diagnostic yield of different microbiological tests in hospitalised patients with community-acquired pneumonia, material for microbiological investigation was obtained from 262 patients. Clinical samples consisted of the following: sputum for Gram staining,

Community-acquired pneumonia - a clinical approach to ...

African Journals Online (AJOL)

to pneumonia acquired within the general community. CAP remains a common and ... patients.2 The exact incidence of atypical pathogens as a cause of CAP in South Africa is ... nor specific enough to use in clinical practice. There is a ..... resolve within 14 days but non-respiratory symptoms such as fatigue may persist for ...

Severe Community-acquired Pneumonia Due to Legionella pneumophila Serogroup 6

Directory of Open Access Journals (Sweden)

Chung-Yu Chen

2006-01-01

Full Text Available Legionella pneumophila is a common cause of sporadic community-acquired pneumonia, but culture-proven legionellosis is rarely diagnosed. There is no laboratory test for Legionnaires' disease that can detect all patients with the disease. Culture is the standard diagnostic method and should be initiated as soon as possible in suspected cases. We describe a rare case of community-acquired pneumonia caused by L. pneumophila serogroup 6. A 77-year-old man was admitted to a tertiary care hospital because of high fever, productive cough, and progressive dyspnea. Chest radiography showed bilateral pneumonia, which led to respiratory failure necessitating mechanical ventilatory support. Despite antibiotic therapy, his condition continued to deteriorate and acute renal failure also developed. Urine was negative for L. pneumophila. Culture of the sputum yielded L. pneumophila serogroup 6, although there was no elevation of the serum antibody titer. Pneumonia resolved gradually and he was extubated after treatment with levofloxacin followed by erythromycin. L. pneumophila other than serogroup 1 should be included in the differential diagnosis of patients with suspected atypical community-acquired pneumonia.

Lung ultrasound for the diagnosis of community-acquired pneumonia in children.

Science.gov (United States)

Stadler, Jacob A M; Andronikou, Savvas; Zar, Heather J

2017-10-01

Ultrasound (US) has been proposed as an alternative first-line imaging modality to diagnose community-acquired pneumonia in children. Lung US has the potential benefits over chest radiography of being radiation free, subject to fewer regulatory requirements, relatively lower cost and with immediate bedside availability of results. However, the uptake of lung US into clinical practice has been slow and it is not yet included in clinical guidelines for community-acquired pneumonia in children. The aim of this review is to give an overview of the equipment and techniques used to perform lung US in children with suspected pneumonia and the interpretation of relevant sonographic findings. We also summarise the current evidence of diagnostic accuracy and reliability of lung US compared to alternative imaging modalities in children and critically consider the strengths and limitations of lung US for use in children presenting with suspected community-acquired pneumonia.

Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia

OpenAIRE

Murdoch, David R.; Anderson, Trevor P.; Beynon, Kirsten A.; Chua, Alvin; Fleming, Angela M.; Laing, Richard T. R.; Town, G. Ian; Mills, Graham D.; Chambers, Stephen T.; Jennings, Lance C.

2003-01-01

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia. Plasma or buffy coat samples were PCR positive in only 6 of the 21 patients with positive blood cultures for S. pneumoniae and in 12 other patients (4 of whom h...

Atypical pathogens and challenges in community-acquired pneumonia

African Journals Online (AJOL)

Atypical organisms such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are implicated in up to 40 percent of cases of community-acquired pneumonia. Antibiotic treatment is empiric and includes coverage for both typical and atypical organisms. Doxycycline, a fluoroquinolone with ...

Bacterial Isolates andAntibiotic Sensitivity in Community Acquired ...

African Journals Online (AJOL)

Objective: The objective of the studywas to determine bacterial causes of community acquired pneumonia and their antibiotic sensitivity pattern amongst patients admitted intomedicalwards inAminu Kano Teaching Hospital, Kano, Nigeria Methods: The study incorporated patients aged fifteen years and above admitted into ...

Sensitivity, Specificity, and Positivity Predictors of the Pneumococcal Urinary Antigen Test in Community-Acquired Pneumonia.

Science.gov (United States)

Molinos, Luis; Zalacain, Rafael; Menéndez, Rosario; Reyes, Soledad; Capelastegui, Alberto; Cillóniz, Catia; Rajas, Olga; Borderías, Luis; Martín-Villasclaras, Juan J; Bello, Salvador; Alfageme, Inmaculada; Rodríguez de Castro, Felipe; Rello, Jordi; Ruiz-Manzano, Juan; Gabarrús, Albert; Musher, Daniel M; Torres, Antoni

2015-10-01

Detection of the C-polysaccharide of Streptococcus pneumoniae in urine by an immune-chromatographic test is increasingly used to evaluate patients with community-acquired pneumonia. We assessed the sensitivity and specificity of this test in the largest series of cases to date and used logistic regression models to determine predictors of positivity in patients hospitalized with community-acquired pneumonia. We performed a multicenter, prospective, observational study of 4,374 patients hospitalized with community-acquired pneumonia. The urinary antigen test was done in 3,874 cases. Pneumococcal infection was diagnosed in 916 cases (21%); 653 (71%) of these cases were diagnosed exclusively by the urinary antigen test. Sensitivity and specificity were 60 and 99.7%, respectively. Predictors of urinary antigen positivity were female sex; heart rate≥125 bpm, systolic blood pressureantibiotic treatment; pleuritic chest pain; chills; pleural effusion; and blood urea nitrogen≥30 mg/dl. With at least six of all these predictors present, the probability of positivity was 52%. With only one factor present, the probability was only 12%. The urinary antigen test is a method with good sensitivity and excellent specificity in diagnosing pneumococcal pneumonia, and its use greatly increased the recognition of community-acquired pneumonia due to S. pneumoniae. With a specificity of 99.7%, this test could be used to direct simplified antibiotic therapy, thereby avoiding excess costs and risk for bacterial resistance that result from broad-spectrum antibiotics. We also identified predictors of positivity that could increase suspicion for pneumococcal infection or avoid the unnecessary use of this test.

Тhe features of severe community acquired pneumonia

Directory of Open Access Journals (Sweden)

Avramenko I.V.

2015-06-01

Full Text Available Based on data from a prospective analysis for the year of observation, the article presents information about the features of severe community acquired pneumonia in patients who were hospitalized at the department of pulmonology (or therapy, as well as department of the intensive care from three teaching hospitals in Dnepropetrovsk, namely "Dnipropetrovsk City Hospital №6», "Dnipropetrovsk City Hospital №2», "Dnipropetrovsk City Hospital №16», which are the clinical ones of "Dnepropetrovsk Medical Academy of the Ministry of Health Ukraine". Dependence of the severity of the condition shown on duration of illness before admission, features of season character of disease. The effect of breathing exercises on the course of the disease. The results can be the basis for a more personal approach to the development of diagnostic and therapeutic programs for patients with severe community-acquired pneumonia.

The obesity paradox in community-acquired bacterial pneumonia.

Science.gov (United States)

Corrales-Medina, Vicente F; Valayam, Josemon; Serpa, Jose A; Rueda, Adriana M; Musher, Daniel M

2011-01-01

The impact of obesity on the outcome of pneumonia is uncertain. We retrospectively identified 266 hospitalized patients with proven pneumococcal or Haemophilus community-acquired pneumonia who had at least one body mass index (BMI, kg/m²) value documented in the 3 months before admission. Patients were classified as underweight (BMI values and BMI categories with the mortality at 30 days after admission for pneumonia was investigated. Increasing BMI values were associated with reduced 30-day mortality, even after adjustment for significant covariates (odds ratio 0.88, confidence interval 0.81-0.96; p<0.01). There was a significant trend towards lower mortality in the overweight and obese (non-parametric trend, p=0.02). Our data suggest that obesity may exert a protective effect against 30-day mortality from community-acquired bacterial pneumonia. Copyright © 2010 International Society for Infectious Diseases. All rights reserved.

Clinical and Diagnostic Peculiarities of Immunological Adaptation in Children of the First Year of Life Suffering from Community-Acquired Pneumonia

Directory of Open Access Journals (Sweden)

V.S. Oleynik

2013-04-01

Full Text Available The aim of the study was to evaluate the immunological parameters in community-acquired pneumonia in infants born with very low birth weight. A comprehensive clinical, laboratory and instrumental examination had been carried out in children of the first year of life suffering from community-acquired pneumonia who were born with very low birth weight. In the vast majority of children the clinical pattern of community-acquired pneumonia manifested with respiratory syndrome, the symptoms of respiratory distress I–II degree, intoxication and the lack of temperature response. Due to immunological examination of infants born with very low birth weight disorders in cellular and humoral immune system, as well as reduced functional capacity of phagocytes had been detected.

The Community Publishing Project: assisting writers to self-publish ...

African Journals Online (AJOL)

This article examines the need for a small project such as the Community Publishing Project in South Africa and explores its aims. The method of involving writers and community groups in the publication process is described and two completed projects are evaluated. Lessons learnt by the Centre for the Book in managing ...

[PECULIARITIES OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN WITH NEUROLOGICAL PATHOLOGY].

Science.gov (United States)

Zubarenko, O; Kopiyka, G; Kravchenko, T; Koval, L; Gurienko, K

2017-06-01

Neurological disorders in children highly affect the course of pneumonia, its outcome and the development of possible complications. The aim of the study was to reveal clinical and paraclinical features of community-acquired pneumonia in younger children with neurologic pathology infantile cerebral palsy. Under observation were 37 children with community-acquired pneumonia aged 1 to 3 years that suffered from spastic forms of infantile cerebral palsy. The comparison group consisted of 30 children with community-acquired pneumonia without any concomitant neurological pathology. The age of the children in the comparison and study groups was the same. The results of the study show that the presence of infantile cerebral palsy allow to relate the child to the risk group of respiratory pathology development. The course of community-acquired pneumonia in children affected by infantile cerebral palsy is characterized by rapid progression of symptoms and severity of the condition, and the clinical picture also has a number of characteristic features. Thus, cough, local physical data, classical laboratory signs of inflammation in the form of leukocytosis with neutrophil shift were noticed significantly less often in children with infantile cerebral palsy. The debut of the disease was often accompanied by bronchial obstruction, the inflammatory process was localized in the lower parts of the lungs and often matched the side of the neurologically affected part of the body. Children with cerebral palsy required a longer hospital-stay and a prolonged course of antibiotic therapy. Therefore, the risk of pneumonia in children with infantile cerebral palsy should be taken into account at the primary stage of medical care for the creation of preventive programs.

The sensitivity status of community-acquired Staphylococcus aureus ...

African Journals Online (AJOL)

Community acquired Staphylococcus aureus was isolated from various infectious sites in two private laboratories in Kano-city, Nigeria. A total of 247 (11%) Staphylococcu aureus isolates were recovered from all infectious sites except cerebro-spinal fluid. The least Staphylococcus aureus isolates were found in urine ...

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

Science.gov (United States)

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

2014-01-01

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

Scoping study into community-based renewable energy projects

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-07-01

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

Hydrocephalus is a rare outcome in community-acquired bacterial meningitis in adults

DEFF Research Database (Denmark)

Bodilsen, Jacob; Schønheyder, Henrik Carl; Nielsen, Henrik I

2013-01-01

BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid in this ......BACKGROUND: Community-acquired bacterial meningitis (CABM) continues to have a high mortality rate and often results in severe sequelae among survivors. Lately, an increased effort has been focused on describing the neurological complications of meningitis including hydrocephalus. To aid...... in this field of research we set out to ascertain the risk and outcome of hydrocephalus in patients with community-acquired bacterial meningitis (CABM) in North Denmark Region. METHODS: We conducted a retrospective population-based cohort study of CABM cases above 14 years of age. Cases diagnosed during a 13......-year period, 1998 through 2010, were identified in a laboratory register and data were acquired through patient records. Cases not confirmed by culture met other strict inclusion criteria. The diagnosis of hydrocephalus relied upon the radiologists' reports on cranial imaging. Outcome was graded...

Community-acquired respiratory infections are common in patients with non-Hodgkin lymphoma and multiple myeloma.

Science.gov (United States)

Lavi, Noa; Avivi, Irit; Kra-Oz, Zipora; Oren, Ilana; Hardak, Emilia

2018-07-01

Available data suggest that respiratory infections are associated with increased morbidity and mortality in patients hospitalized due to acute leukemia and allogeneic stem cell transplantation (allo-SCT). However, the precise incidence, risk factors, and severity of respiratory infection, mainly community-acquired, in patients with lymphoma and multiple myeloma (MM) are not fully determined. The current study aimed to investigate risk factors for respiratory infections and their clinical significance in patients with B cell non-Hodgkin lymphoma (NHL) and multiple myeloma (MM) in the first year of diagnosis. Data of consecutive patients diagnosed with NHL or MM and treated at the Rambam Hematology Inpatient and Outpatient Units between 01/2011 and 03/2012 were evaluated. Information regarding anticancer treatment, incidence and course of respiratory infections, and infection-related outcomes was analyzed. One hundred and sixty episodes of respiratory infections were recorded in 103 (49%) of 211 (73-MM, 138-NHL) patients; 126 (79%) episodes were community-acquired, 47 (29%) of them required hospitalization. In univariate analysis, age respiratory infection risk (P = 0.058, 0.038, and 0.001, respectively). Ninety episodes (56% of all respiratory episodes) were examined for viral pathogens. Viral infections were documented in 25/90 (28%) episodes, 21 (84%) of them were community-acquired, requiring hospitalization in 5 (24%) cases. Anti-flu vaccination was performed in 119 (56%) patients. Two of the six patients diagnosed with influenza were vaccinated. Respiratory infections, including viral ones, are common in NHL and MM. Most infections are community-acquired and have a favorable outcome. Rapid identification of viral pathogens allows avoiding antibiotic overuse in this patient population.

Etiology and antibiotic susceptibility pattern of community-acquired ...

African Journals Online (AJOL)

Community-acquired urinary tract infections occur in individuals not admitted in hospital prior to development of the symptoms of the infection. It occurs mostly in women and caused by Escherichia coli. The aim of this study was to determine the prevalence of urinary tract infection among individuals residing within Jos ...

Economic Development Impacts of Community Wind Projects: A Review and Empirical Evaluation; Preprint

Energy Technology Data Exchange (ETDEWEB)

Lantz, E.; Tegen, S.

2009-04-01

'Community wind' refers to a class of wind energy ownership structures. The extent of local ownership may range from a small minority share to full ownership by persons in the immediate area surrounding the wind project site. Potential project owners include local farmers, businesses, Native American tribes, universities, cooperatives, or any other local entity seeking to invest in wind energy. The opposite of community wind is an 'absentee' project, in which ownership is completely removed from the state and community surrounding the facility. Thus, there is little or no ongoing direct financial benefit to state and local populations aside from salaries for local repair technicians, local property tax payments, and land lease payments. In recent years, the community wind sector has been inhibited by manufacturers' preference for larger turbine orders. This often puts smaller community wind developers and projects at a competitive disadvantage. However, state policies specifically supporting community wind may become a more influential market factor as turbines are now more readily available given manufacturer ramp-ups and the slow-down in the industry that has accompanied the recent economic and financial crises. This report examines existing literature to provide an overview of economic impacts resulting from community wind projects, compares results, and explains variability.

Etiology and outcome of community-acquired lung abscess.

Science.gov (United States)

Takayanagi, Noboru; Kagiyama, Naho; Ishiguro, Takashi; Tokunaga, Daidou; Sugita, Yutaka

2010-01-01

Anaerobes are the first and Streptococcus species the second most common cause of community-acquired lung abscess (CALA) in the West. The etiologic pathogens of this disease have changed in Taiwan, with Klebsiella pneumoniae being reported as the most common cause of CALA. To determine the etiologies of community-acquired lung abscess. We retrospectively reviewed the records of 205 Japanese adult patients with CALA to evaluate etiologies and outcomes. We used not only traditional microbiological investigations but also percutaneous ultrasonography-guided transthoracic needle aspiration and protected specimen brushes. Of these 205 patients, 122 had documented bacteriological results, with 189 bacterial species isolated. Pure aerobic, mixed aerobic and anaerobic, and pure anaerobic bacteria were isolated in 90 (73.8%), 17 (13.9%), and 15 (12.3%) patients, respectively. The four most common etiologic pathogens were Streptococcus species (59.8%), anaerobes (26.2%), Gemella species (9.8%), and K. pneumoniae (8.2%). Streptococcus mitis was the most common among the Streptococcus species. Mean duration of antibiotic administration was 26 days. Six patients (2.9%, 3 with actinomycosis and 3 with nocardiosis) were treated with antibiotics for 76-189 days. Two patients with anaerobic lung abscess died. The first and second most common etiologic pathogens of CALA in our hospital were Streptococcus species and anaerobes, respectively. The etiologies in our study differ from those in Taiwan and are similar to those in the West with the exception that Streptococcus species were the most common etiologic pathogens in our study whereas anaerobes are the most frequent etiologic pathogens in Western countries. S. mitis and Gemella species are important etiologic pathogens as well. The identification of Actinomyces and Nocardia is important in order to define the adequate duration of antibiotic administration. Copyright 2010 S. Karger AG, Basel.

The changing face of community-acquired methicillin-resistant Staphylococcus aureus

Directory of Open Access Journals (Sweden)

P Kale

2016-01-01

Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is an important cause of infection, both in hospitalised patients with significant healthcare exposure and in patients without healthcare risk factors. Community-acquired methicillin-resistant S. aureus (CA-MRSA are known for their rapid community transmission and propensity to cause aggressive skin and soft tissue infections and community-acquired pneumonia. The distinction between the healthcare-associated (HA-MRSA and CA-MRSA is gradually fading owing to the acquisition of multiple virulence factors and genetic elements. The movement of CA-MRSA strains into the nosocomial setting limits the utility of using clinical risk factors alone to designate community or HA status. Identification of unique genetic characteristics and genotyping are valuable tools for MRSA epidemiological studies. Although the optimum pharmacotherapy for CA-MRSA infections has not been determined, many CA-MRSA strains remain broadly susceptible to several non-β-lactam antibacterial agents. This review aimed at illuminating the characteristic features of CA-MRSA, virulence factors, changing clinical settings and molecular epidemiology, insurgence into the hospital settings and therapy with drug resistance.

An unusual cause of community-acquired pneumonia

Directory of Open Access Journals (Sweden)

Jaimie Mittal

2018-01-01

Full Text Available We present a case of fatal community-acquired pneumonia (CAP due to Acinetobacter baumannii, which is rarely reported in the northeastern United States. Previously reported cases originate from tropical and subtropical climates, and infection tends to have an aggressive course with a poor outcome. Appropriate antimicrobial therapy is crucial; however, the associated systemic inflammatory response may overwhelm host defenses, especially in patients with certain co-morbidities.

Guiding therapy and adjunctive treatment in community-acquired pneumonia

NARCIS (Netherlands)

Spoorenberg, S.M.C.

2018-01-01

Background: Despite the availability of effective antibiotics and vaccines, community-acquired pneumonia (CAP) remains the cause of significant morbidity and mortality worldwide.A major problem is that in absence of full spectrum rapid microbiology diagnostics, the antibiotic treatment at start is

The order of administration of macrolides and beta-lactams may impact the outcomes of hospitalized patients with community-acquired pneumonia: results from the community-acquired pneumonia organization.

Science.gov (United States)

Peyrani, Paula; Wiemken, Timothy L; Metersky, Mark L; Arnold, Forest W; Mattingly, William A; Feldman, Charles; Cavallazzi, Rodrigo; Fernandez-Botran, Rafael; Bordon, Jose; Ramirez, Julio A

2018-01-01

The beneficial effect of macrolides for the treatment of community-acquired pneumonia (CAP) in combination with beta-lactams may be due to their anti-inflammatory activity. In patients with pneumococcal meningitis, the use of steroids improves outcomes only if they are administered before beta-lactams. The objective of this study was to compare outcomes in hospitalized patients with CAP when macrolides were administered before, simultaneously with, or after beta-lactams. Secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) International Cohort Study database. Study groups were defined based on the sequence of administration of macrolides and beta-lactams. The study outcomes were time to clinical stability (TCS), length of stay (LOS) and in-hospital mortality. Accelerated failure time models were used to evaluate the adjusted impact of sequential antibiotic administration and time-to-event outcomes, while a logistic regression model was used to evaluate their adjusted impact on mortality. A total of 99 patients were included in the macrolide before group and 305 in the macrolide after group. Administration of a macrolide before a beta-lactam compared to after a beta-lactam reduced TCS (3 vs. 4 days, p = .011), LOS (6 vs. 7 days, p = .002) and mortality (3 vs. 7.2%, p = .228). The administration of macrolides before beta-lactams was associated with a statistically significant decrease in TCS and LOS and a non-statistically significant decrease in mortality. The beneficial effect of macrolides in hospitalized patient with CAP may occur only if administered before beta-lactams.

Prevalence of Methicillin Resistant Staphylococcus aureus in pyogenic community and hospital acquired skin and soft tissues infections

International Nuclear Information System (INIS)

Ahmad, M. K.; Asrar, A.

2014-01-01

Objective: To determine the percentage and frequency of Methicillin Resistant Staphylococcus aureus in community and hospital-acquired pyogenic skin and soft tissue infections. Methods: The descriptive cross-sectional study was conducted at the Dermatology Department of Combined Military Hospital, Abbottabad, from June 2009 to March 2010, and comprised 144 community-acquired and 54 hospital-acquired skin and soft tissue infections. Pus swabs from the infected lesions one from each individual were sent to laboratory for culture and sensitivity tests. Methicillin resistance was detected by 1 (mu) g oxacillin disk. Organisms were labelled methicillin-resistant once the inhibition zone for oxocillin was less than 10 mm. Data analysis was done by using SPSS 20. Results: Of the 198 patients in the study, 98(49.5%) were males and 100(50.5%) were females, with an overall mean age of 33.7+-14.8144 years. There were 144(72.72%) community-acquired infections and 54(27.27%) had hospital-acquired infections. Community-acquired Methicillin Resistant Staphylococcus aureus numbered 40(27.8%) and hospital-acquired ones numbered 26(48.1%). Conclusion: Prevalence of Methicillin Resistant Staphylococcus aureus in community and hospital-acquired pyogenic skin and soft tissue infections was high. (author)

Retrospective evaluation of Project Envision: A community mobilization pilot program to prevent sexual violence in New York City.

Science.gov (United States)

Glenn, Lily; Fidler, Laura; O'Connor, Meghan; Haviland, Mary; Fry, Deborah; Pollak, Tamara; Frye, Victoria

2018-02-01

Sexual violence is a public health problem associated with short- and long-term physical and mental health consequences. Most interventions that aim to prevent sexual violence before it occurs target individual-level change or promote bystander training. Community-level interventions, while increasingly recommended in the sexual violence prevention field, are rarely documented in peer-reviewed literature. This paper is a targeted process evaluation of Project Envision, a 6-year pilot initiative to address social norms at the root of sexual violence through coalition building and community mobilization in three New York City neighborhoods, and reflects the perspectives of those charged with designing and implementing the program. Evaluation methods included a systematic literature review, archival source document review, and key informant interviews. Three themes emerged from the results: community identity and implications for engagement; capacity and readiness for community mobilization and consequences for implementation; and impacts on participants. Lessons learned include the limitations of using geographic boundaries to structure community interventions in urban settings; carefully considering whether communities should be mobilized around an externally-identified issue; translating theoretical frameworks into concrete tasks; assessing all coalition partners and organizations for readiness; critically evaluating available resources; and recognizing that community organizing is a skill that requires investment from funders. We conclude that Project Envision showed promise for shifting institutional norms towards addressing root causes of sexual violence in addition to providing victim services. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

Directory of Open Access Journals (Sweden)

David Eisenman

2014-08-01

Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

Strategies to improve clinical management of community-acquired pneumonia

NARCIS (Netherlands)

Meijvis, S.C.A.

2012-01-01

Despite advances during the last few decades in the prevention, diagnosis and treatment of community-acquired pneumonia (CAP), its incidence remains high. In this thesis, strategies are described for improvement of the quality of clinical management in patients with pneumonia and for the reduction

The impact of blood glucose on community-acquired pneumonia

DEFF Research Database (Denmark)

Jensen, Andreas Vestergaard; Egelund, Gertrud Baunbæk; Andersen, Stine Bang

2017-01-01

Hyperglycaemia is common in patients with community-acquired pneumonia (CAP) and is a predictor of severe outcomes. Data are scarce regarding whether this association is affected by diabetes mellitus (DM) and also regarding its importance for severe outcomes in hospital. We determined the impact...

'Atypical' bacteria are a common cause of community-acquired ...

African Journals Online (AJOL)

Objectives. To assess the proportion of cases of community· acquired pneumonia caused by 'atypical' bacteria, inclUding the recently discovered Chlamydia pneumoniae, and to compare the clinical, radiographic and laboratory features of patients with and without 'atypical' bacteria. Methods. A prospective serological ...

The Pacific Obesity Prevention in Communities project

DEFF Research Database (Denmark)

Swinburn, B A; Millar, L; Utter, J

2011-01-01

, Tonga, New Zealand and Australia) designed to prevent adolescent obesity. This paper overviews the project and the methods common to the four countries. Each country implemented a community-based intervention programme promoting healthy eating, physical activity and healthy weight in adolescents......Obesity is increasing worldwide with the Pacific region having the highest prevalence among adults. The most common precursor of adult obesity is adolescent obesity making this a critical period for prevention. The Pacific Obesity Prevention in Communities project was a four-country project (Fiji....... The evaluation tools common to each are described. Additional analytical studies included economic, socio-cultural and policy studies. The project pioneered many areas of obesity prevention research: using multi-country collaboration to build research capacity; testing a capacity-building approach in ethnic...

Evaluation of antimicrobial susceptibilities and virulence factors of Staphylococcus aureus strains isolated from community-acquired and health-care associated pediatric infections.

Science.gov (United States)

Karbuz, Adem; Karahan, Zeynep Ceren; Aldemir-Kocabaş, Bilge; Tekeli, Alper; Özdemir, Halil; Güriz, Haluk; Gökdemir, Refik; İnce, Erdal; Çiftçi, Ergin

2017-01-01

Karbuz A, Karahan ZC, Aldemir-Kocabaş B, Tekeli A, Özdemir H, Güriz H, Gökdemir R, İnce E, Çiftçi E. Evaluation of antimicrobial susceptibilities and virulence factors of Staphylococcus aureus strains isolated from community-acquired and health-care associated pediatric infections. Turk J Pediatr 2017; 59: 395-403. The aim of this study was to investigate the enterotoxins and Panton-Valentine leukocidin (PVL) gene as virulence factor, identification if antimicrobial sensitivity patterns, agr (accessory gene regulator) types and sequence types and in resistant cases to obtain SCCmec (staphylococcal cassette chromosome mec) gene types which will be helpful to decide empirical therapy and future health politics for S. aureus species. Total of 150 isolates of S. aureus were isolated from the cultures of the child patients in January 2011 and December 2012. In this study, the penicillin resistance was observed as 93.8%. PVL and mecA was detected positive in 8.7% and in 6% of all S. aureus strains, respectively. Two MRSA (methicillin resistant S.aureus) strains were detected as SCCmec type III and SCCmec type V and five MRSA strains were detected as SCCmec type IV. SET-I and SET-G were the most common detected enterotoxins. In both community-associated and healthcare-associated MRSA strains, agr type 1 was detected most commonly. The most common sequence types were ST737 in 13 patients than ST22 in eight patients and ST121 in six patients. This study highlights a necessity to review the cause of small changes in the structural genes in order to determine whether it is a cause or outcome; community-acquired and healthcare associated strains overlap.

Assessing Community Informatics: A Review of Methodological Approaches for Evaluating Community Networks and Community Technology Centers.

Science.gov (United States)

O'Neil, Dara

2002-01-01

Analyzes the emerging community informatics evaluation literature to develop an understanding of the indicators used to gauge project impacts in community networks and community technology centers. The study finds that community networks and community technology center assessments fall into five key areas: strong democracy; social capital;…

Community acquired urinary tract infection: etiology and bacterial susceptibility

Directory of Open Access Journals (Sweden)

Dias Neto José Anastácio

2003-01-01

Full Text Available PURPOSE: Urinary tract infections (UTI are one of the most common infectious diseases diagnosed. UTI account for a large proportion of antibacterial drug consumption and have large socio-economic impacts. Since the majority of the treatments begins or is done completely empirically, the knowledge of the organisms, their epidemiological characteristics and their antibacterial susceptibility that may vary with time is mandatory. OBJECTIVE: The aim of this study was to report the prevalence of uropathogens and their antibiotic susceptibility of the community acquired UTI diagnosed in our institution and to provide a national data. METHODS: We analyzed retrospectively the results of urine cultures of 402 patients that had community acquired urinary tract infection in the year of 2003. RESULTS: The mean age of the patients in this study was 45.34 ± 23.56 (SD years. There were 242 (60.2% females and 160 (39.8% males. The most commonly isolated organism was Escherichia coli (58%. Klebsiella sp. (8.4% and Enterococcus sp.(7.9% were reported as the next most common organisms. Of all bacteria isolated from community acquired UTI, only 37% were sensitive to ampicillin, 51% to cefalothin and 52% to trimethoprim/sulfamethoxazole. The highest levels of susceptibility were to imipenem (96%, ceftriaxone (90%, amikacin (90%, gentamicin (88%, levofloxacin (86%, ciprofloxacin (73%, nitrofurantoin (77% and norfloxacin (75%. CONCLUSION: Gram-negative agents are the most common cause of UTI. Fluoroquinolones remains the choice among the orally administered antibiotics, followed by nitrofurantoin, second and third generation cephalosporins. For severe disease that require parenteral antibiotics the choice should be aminoglycosides, third generation cephalosporins, fluoroquinolones or imipenem, which were the most effective.

Does C-reactive protein independently predict mortality in adult community-acquired bacteremia patients with known sepsis severity?

DEFF Research Database (Denmark)

Gradel, Kim O; Jensen, Thøger G; Kolmos, Hans J

2013-01-01

We evaluated whether sepsis severity and C-reactive protein (CRP) level on admission prognostically corroborated or annulled each other in adult patients with incident community-acquired bacteremia (Funen, Denmark, 2000-2008). We used logistic regression and area under the receiver operating.......06), thus CRP contributed as much as sepsis severity to prognosis....

Valuing and Evaluating Community-Engaged Scholarship

Science.gov (United States)

Shephard, Kerry; Brown, Kim; Guiney, Tess; Deaker, Lynley

2018-01-01

This article examines the nature of, and need for, evaluation of community-engaged university teaching and research. The research was conducted as part of a larger project aimed at improving institutional understanding of how to best support community-engaged university people. We interviewed 25 community-engaged colleagues, and used a general…

DOE Heat Pump Centered Integrated Community Energy Systems Project

Energy Technology Data Exchange (ETDEWEB)

Calm, J. M.

1979-01-01

The Heat Pump Centered Integrated Community Energy Systems (HP-ICES) Project is a multiphase undertaking seeking to demonstrate one or more operational HP-ICES by the end of 1983. The seven phases include System Development, Demonstration Design, Design Completion, HP-ICES Construction, Operation and Data Acquisition, HP-ICES Evaluation, and Upgraded Continuation. This project is sponsored by the Community Systems Branch, Office of Buildings and Community Systems, Assistant Secretary for Conservation and Solar Applicaions, U.S. Department of Energy (DOE). It is part of the Community Systems Program and is managed by the Energy and Environmental Systems Division of Argonne Natinal Laboratory.

Alpena Community College Workplace Partnership Project.

Science.gov (United States)

Alpena Community Coll., MI.

These materials include a report, evaluation, and book written about a workplace literacy project involving education (Alpena Community College), business and industry (Besser Company and Alpena Power Company), and labor (Thunder Bay Labor Council). The report specifies objectives; accomplishments, including development of eight courses in math,…

Health related quality of life in patients with community-acquired pneumococcal pneumonia in France

OpenAIRE

Andrade, Luiz Flavio; Saba, Grèce; Ricard, Jean-Damien; Messika, Jonathan; Gaillat, Jacques; Bonnin, Pierre; Chidiac, Christian; Illes, Hajnal-Gabriela; Laurichesse, Henri; Detournay, Bruno; Petitpretz, Patrick; de Pouvourville, Gérard

2018-01-01

Background Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. Methods A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae ...

The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia

DEFF Research Database (Denmark)

Kristiansen, Dorte Melgaard; Baandrup, Ulrik; Bøgsted, Martin

2017-01-01

Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome was mort......Community-acquired pneumonia (CAP) and oropharyngeal dysphagia (OD) are prevalent conditions in the elderly. The aim of this study was to explore the relationship between CAP, OD, and frailty in patients admitted to a department of respiratory medicine at a regional hospital. The outcome...

Design of two molecular methodologies for the rapid identification of Colombian community-acquired methicillin-resistant Staphylococcus aureus isolates

OpenAIRE

Escobar, Javier Antonio; Gómez, Ingrid Tatiana; Murillo, Martha Johanna; Castro, Betsy Esperanza; Chavarro, Bibiana; Márquez, Ricaurte Alejandro; Vanegas, Natasha

2012-01-01

Introduction. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are found with increasing the frequency, both in healthy individuals in the community and in hospitalized patients. In Colombia and the Andean region, CA-MRSA isolates have a genetic background that is related to the pandemic USA300 clone. Objective. Two molecular methods are designed and standardized for the rapid differentiation of Colombian community-acquired and hospital-acquired methicillin-...

Evaluation of an algorithm for switching from IV to PO therapy in clinical practice in patients with community-acquired pneumonia

NARCIS (Netherlands)

van der Eerden, Menno M.; de Graaff, Casper S.; Vlaspolder, Fer; Bronsveld, Willem; Jansen, Henk M.; Boersma, Wim G.

2004-01-01

Background: in patients with community-acquired pneumonia (CAP), switching from IV to PO antibiotics offers advantages over IV therapy alone, including improved cost-effectiveness through reductions in the length of hospital stay and treatment costs. Objective: The aim of this study was to determine

[Increasing incidence of community-acquired pneumonia caused by atypical microorganisms].

Science.gov (United States)

Tazón-Varela, M A; Alonso-Valle, H; Muñoz-Cacho, P; Gallo-Terán, J; Piris-García, X; Pérez-Mier, L A

2017-09-01

Knowing the most common microorganisms in our environment can help us to make proper empirical treatment decisions. The aim is to identify those microorganisms causing community-acquired pneumonia. An observational, descriptive and prospective study was conducted, including patients over 14 years with a clinical and radiographic diagnosis of community-acquired pneumonia during a 383 consecutive day period. A record was made of sociodemographic variables, personal history, prognostic severity scales, progress, and pathogenic agents. The aetiological diagnosis was made using blood cultures, detection of Streptococcus pneumoniae and Legionella pneumophila urinary antigens, sputum culture, influenza virus and Streptococcus pyogenes detection. Categorical variables are presented as absolute values and percentages, and continuous variables as their means and standard deviations. Of the 287 patients included in the study (42% women, mean age 66±22 years), 10.45% died and 70% required hospital admission. An aetiological diagnosis was achieved in 43 patients (14.98%), with 16 microorganisms found in 59 positive samples. The most frequently isolated pathogen was Streptococcus pneumonia (24/59, 41%), followed by gram-negative enteric bacilli, Klebsiella pneumonia, Escherichia coli, Serratia marcescens and Enterobacter cloacae isolated in 20% of the samples (12/59), influenza virus (5/59, 9%), methicillin-resistant Staphylococcus aureus (3/59, 5%), Pseudomonas aeruginosa (2/59, 3%), Moraxella catarrhalis (2/59, 3%), Legionella pneumophila (2/59, 3%), and Haemophilus influenza (2/59, 3%). Polymicrobial infections accounted for 14% (8/59). A high percentage of atypical microorganisms causing community-acquired pneumonia were found. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Community-acquired methicillin-resistant Staphylococcus aureus: community transmission, pathogenesis, and drug resistance.

Science.gov (United States)

Yamamoto, Tatsuo; Nishiyama, Akihito; Takano, Tomomi; Yabe, Shizuka; Higuchi, Wataru; Razvina, Olga; Shi, Da

2010-08-01

Methicillin-resistant Staphylococcus aureus (MRSA) is able to persist not only in hospitals (with a high level of antimicrobial agent use) but also in the community (with a low level of antimicrobial agent use). The former is called hospital-acquired MRSA (HA-MRSA) and the latter community-acquired MRSA (CA-MRSA). It is believed MRSA clones are generated from S. aureus through insertion of the staphylococcal cassette chromosome mec (SCCmec), and outbreaks occur as they spread. Several worldwide and regional clones have been identified, and their epidemiological, clinical, and genetic characteristics have been described. CA-MRSA is likely able to survive in the community because of suitable SCCmec types (type IV or V), a clone-specific colonization/infection nature, toxin profiles (including Pantone-Valentine leucocidin, PVL), and narrow drug resistance patterns. CA-MRSA infections are generally seen in healthy children or young athletes, with unexpected cases of diseases, and also in elderly inpatients, occasionally surprising clinicians used to HA-MRSA infections. CA-MRSA spreads within families and close-contact groups or even through public transport, demonstrating transmission cores. Re-infection (including multifocal infection) frequently occurs, if the cores are not sought out and properly eradicated. Recently, attention has been given to CA-MRSA (USA300), which originated in the US, and is growing as HA-MRSA and also as a worldwide clone. CA-MRSA infection in influenza season has increasingly been noted as well. MRSA is also found in farm and companion animals, and has occasionally transferred to humans. As such, the epidemiological, clinical, and genetic behavior of CA-MRSA, a growing threat, is focused on in this study.

[Ceftaroline fosamil in community-acquired and nosocomial pneumonia].

Science.gov (United States)

Calbo, Esther; Zaragoza, Rafael

2014-03-01

Community-acquired pneumonia (CAP) is a common infection in developed countries and causes a large number of hospital admissions and deaths. In recent years, the incidence of this disease has increased, caused by progressive population aging. Following the introduction of the conjugate vaccine against Streptococcus pneumoniae, there have been significant epidemiological changes that require close monitoring because of the possible emergence of new patterns of resistance. This article aims to review the role of ceftaroline fosamil, a new parenteral cephalosporin with antibacterial activity against Gram-negative and Gram-positive pathogens, in the treatment of pneumonia. Several in vitro and in vivo studies have shown the efficacy of ceftaroline fosamil against penicillin-resistant S. pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA). Additionally, ceftaroline has shown similar efficacy and safety to ceftriaxone in the treatment of community-acquired pneumonia with severe prognosis (prognostic severity index III and IV) in two phase III clinical trials. Although a non-inferiority design was used for these clinical trials, some data suggest a superior efficacy of ceftaroline, with earlier clinical response and higher cure rate in infections caused by S. pneumoniae, making this drug particularly interesting for critically-ill patients admitted to the intensive care unit. Ceftaroline may also be considered for empirical and directed treatment of MRSA pneumonia. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark

DEFF Research Database (Denmark)

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang

2017-01-01

BACKGROUND: Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin...... penicillin-G/V using logistic regression analysis. RESULTS: We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated...... with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). CONCLUSION: The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin...

Time-based distribution of Staphylococcus saprophyticus pulsed field gel-electrophoresis clusters in community-acquired urinary tract infections

Directory of Open Access Journals (Sweden)

Viviane Santos de Sousa

2013-02-01

Full Text Available The epidemiology of urinary tract infections (UTI by Staphylococcus saprophyticus has not been fully characterised and strain typing methods have not been validated for this agent. To evaluate whether epidemiological relationships exist between clusters of pulsed field gel-electrophoresis (PFGE genotypes of S. saprophyticus from community-acquired UTI, a cross-sectional surveillance study was conducted in the city of Rio de Janeiro, Brazil. In total, 32 (16% female patients attending two walk-in clinics were culture-positive for S. saprophyticus. Five PFGE clusters were defined and evaluated against epidemiological data. The PFGE clusters were grouped in time, suggesting the existence of community point sources of S. saprophyticus. From these point sources, S. saprophyticus strains may spread among individuals.

In-hospital mortality risk factors in community acquired pneumonia: evaluation of immunocompetent adult patients without comorbidities

Directory of Open Access Journals (Sweden)

Miguel Hernan Vicco

2015-04-01

Full Text Available Summary Objective: several scores were developed in order to improve the determination of community acquired pneumonia (CAP severity and its management, mainly CURB-65 and SACP score. However, none of them were evaluated for risk assessment of in-hospital mortality, particularly in individuals who were non-immunosuppressed and/or without any comorbidity. In this regard, the present study was carried out. Methods: we performed a cross-sectional study in 272 immunocompetent patients without comorbidities and with a diagnosis of CAP. Performance of CURB- 65 and SCAP scores in predicting in-hospital mortality was evaluated. Also, variables related to death were assessed. Furthermore, in order to design a model of in-hospital mortality prediction, sampled individuals were randomly divided in two groups. The association of the variables with mortality was weighed and, by multiple binary regression, a model was constructed in one of the subgroups. Then, it was validated in the other subgroup. Results: both scores yielded a fair strength of agreement, and CURB-65 showed a better performance in predicting in-hospital mortality. In our casuistry, age, white blood cell counts, serum urea and diastolic blood pressure were related to death. The model constructed with these variables showed a good performance in predicting in-hospital mortality; moreover, only one patient with fatal outcome was not correctly classified in the group where the model was constructed and in the group where it was validated. Conclusion: our findings suggest that a simple model that uses only 4 variables, which are easily accessible and interpretable, can identify seriously ill patients with CAP

The burden and epidemiology of community-acquired central nervous system infections

DEFF Research Database (Denmark)

Erdem, H; Inan, A; Guven, E

2017-01-01

Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012...

Community participation in primary health care projects of the Muldersdrift Health and Development Programme

Directory of Open Access Journals (Sweden)

M. Barker

2007-09-01

Full Text Available After numerous teething problems (1974-1994, the Department of Nursing Education of WITS University took responsibility for the Muldersdrift Health and Development Programme (MHDP. The nursing science students explored and implemented an empowerment approach to community participation. The students worked with MHDP health workers to improve health through community participation, in combination with primary health care (PHC activities and the involvement of a variety of community groups. As the PHC projects evolved overtime, the need arose to evaluate the level of community participation and how much community ownership was present over decision-making and resources. This led to the question “What was the level of community participation in PHC projects of the MHDP?” Based on the question the following objectives were set, i.e. i to evaluate the community participation in PHC initiatives; ii to provide the project partners with motivational affirmation on the level of community participation criteria thus far achieved; iii to indicate to participants the mechanisms that should still be implemented if they wanted to advance to higher levels of community participation; iv to evaluate the MHDP’s implementation of a people-centred approach to community participation in PHC; and v the evaluation of the level of community participation in PHC projects in the MHDP. An evaluative, descriptive, contextual and quantitative research design was used. Ethical standards were adhered to throughout the study. The MHDP had a study population of twentythree (N=23 PHC projects. A purposive sample of seven PHC initiatives was chosen according to specific selection criteria and evaluated according to the “Criteria to evaluate community participation in PHC projects” instrument (a quantitative tool. Structured group interviews were done with PHC projects’ executive committee members. The Joint Management Committee’s data was collected through mailed

The Complete Genome and Phenome of a Community-Acquired Acinetobacter baumannii

Science.gov (United States)

Farrugia, Daniel N.; Elbourne, Liam D. H.; Hassan, Karl A.; Eijkelkamp, Bart A.; Tetu, Sasha G.; Brown, Melissa H.; Shah, Bhumika S.; Peleg, Anton Y.; Mabbutt, Bridget C.; Paulsen, Ian T.

2013-01-01

Many sequenced strains of Acinetobacter baumannii are established nosocomial pathogens capable of resistance to multiple antimicrobials. Community-acquired A. baumannii in contrast, comprise a minor proportion of all A. baumannii infections and are highly susceptible to antimicrobial treatment. However, these infections also present acute clinical manifestations associated with high reported rates of mortality. We report the complete 3.70 Mbp genome of A. baumannii D1279779, previously isolated from the bacteraemic infection of an Indigenous Australian; this strain represents the first community-acquired A. baumannii to be sequenced. Comparative analysis of currently published A. baumannii genomes identified twenty-four accessory gene clusters present in D1279779. These accessory elements were predicted to encode a range of functions including polysaccharide biosynthesis, type I DNA restriction-modification, and the metabolism of novel carbonaceous and nitrogenous compounds. Conversely, twenty genomic regions present in previously sequenced A. baumannii strains were absent in D1279779, including gene clusters involved in the catabolism of 4-hydroxybenzoate and glucarate, and the A. baumannii antibiotic resistance island, known to bestow resistance to multiple antimicrobials in nosocomial strains. Phenomic analysis utilising the Biolog Phenotype Microarray system indicated that A. baumannii D1279779 can utilise a broader range of carbon and nitrogen sources than international clone I and clone II nosocomial isolates. However, D1279779 was more sensitive to antimicrobial compounds, particularly beta-lactams, tetracyclines and sulphonamides. The combined genomic and phenomic analyses have provided insight into the features distinguishing A. baumannii isolated from community-acquired and nosocomial infections. PMID:23527001

Adherence with national guidelines in hospitalized patients with community-acquired pneumonia: results from the CAPO study in Venezuela.

Science.gov (United States)

Levy, Gur; Perez, Mario; Rodríguez, Benito; Hernández Voth, Ana; Perez, Jorge; Gnoni, Martin; Kelley, Robert; Wiemken, Timothy; Ramirez, Julio

2015-04-01

The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP. In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Community-acquired meningitis due to Staphylococcus capitis in the absence of neurologic trauma, surgery, or implants.

Science.gov (United States)

Oud, Lavi

2011-01-01

Community-acquired meningitis due to coagulase-negative staphylococci in adults has been rarely reported and generally develops in patients with ventricular shunts or after neurosurgery or neurotrauma. Staphylococcus capitis is a rare cause of adult meningitis. We describe a patient with community-acquired meningitis due to S. capitis, in the absence of traditional risk factors, with atypical presentation. Copyright © 2011 Elsevier Inc. All rights reserved.

Community Project Funding in Malawi under the Malawi Social ...

African Journals Online (AJOL)

This paper gives an overview of the kind of community development projects that the Malawi Social Action Fund (MASAF) has supported since its inception in July 1996. The MASAF has tended to subscribe to a demand-driven approach in its evaluation of projects, thereby introducing an element of competition in commu ...

The syphilis elimination project: targeting the Hispanic community of Baltimore city.

Science.gov (United States)

Endyke-Doran, Cara; Gonzalez, Rosa Maria; Trujillo, Marangellie; Solera, Angelo; Vigilance, Pierre N; Edwards, Lori A; Groves, Sara L

2007-01-01

The objective of the Syphilis Elimination Project was to decrease the incidence of syphilis in the Hispanic community of Baltimore City through a culturally appropriate health initiative. Both qualitative and quantitative methods were used in the study design. Surveillance data were used to collect testing information. Comparisons at the start and end of the project measured change in individual knowledge about syphilis. Cross-sectional data from interviews with business owners and qualitative comments from outreach workers evaluated perception of program effectiveness. The local health department collected surveillance data. A convenience sample of 63 Hispanic community members, 12 business owners/managers, and 8 outreach workers was utilized throughout the evaluation process. The project was a culturally appropriate approach to health promotion with street and business outreach. Post intervention there was a statistically significant increase in knowledge about syphilis within the Hispanic community and an increase in testing behaviors. The Syphilis Elimination Project was created in response to a marked increase in syphilis in Baltimore among the Hispanic population and a health disparity that existed within the city. It increased community members' knowledge of syphilis and positively influenced testing behaviors.

Extracorporeal Membrane Oxygenation for Adult Community-Acquired Pneumonia: Outcomes and Predictors of Mortality.

Science.gov (United States)

Ramanathan, Kollengode; Tan, Chuen Seng; Rycus, Peter; MacLaren, Graeme

2017-05-01

Extracorporeal membrane oxygenation is a rescue therapy used to support severe cardiorespiratory failure. Data on outcomes from severe community-acquired pneumonia in adults receiving rescue extracorporeal membrane oxygenation are mainly confined to single-center experiences or specific pathogens. We examined data from the Extracorporeal Life Support Organisation registry to identify risk factors for poor outcomes in adult patients with community-acquired pneumonia. Retrospective data analysis. Extracorporeal Life Support Organization Registry database. We collected deidentified data on adult patients (> 18 yr) receiving extracorporeal membrane oxygenation for community-acquired pneumonia between 2002 and 2012. Patients with incomplete data or brain death were excluded. The primary outcome measure was in-hospital mortality. Other measurements included demographic information, pre-extracorporeal membrane oxygenation mechanical ventilation and biochemical variables, inotrope requirements, extracorporeal membrane oxygenation mode, duration, and complications. Initial univariate analysis assessed potential associations between survival and various pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation factors. Variables with p values of less than 0.1 were considered for logistic regression analysis to identify predictors of mortality. None. One thousand fifty-five patients, who satisfied inclusion criteria, were included in the final analysis. There was an increase in the number of patients cannulated per annum over the 10-year period studied. Univariate analysis identified pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation variables associated with high mortality. Further multiple regression analysis identified certain pre-extracorporeal membrane oxygenation factors as predictors of mortality, including duration of mechanical ventilation prior to extracorporeal membrane oxygenation, lower arterial pressure, fungal

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

Science.gov (United States)

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

2014-01-01

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

Project Aprendizaje. Final Evaluation Report 1992-93.

Science.gov (United States)

Clark, Andrew

This report provides evaluative information regarding the effectiveness of Project Aprendizaje, a New York City program that served 269 Spanish-speaking students of limited English proficiency (LEP). The project promoted parent and community involvement by sponsoring cultural events, such as a large Latin American festival. Students developed…

Aetiology of community-acquired neonatal sepsis in low- and middle-income countries

Directory of Open Access Journals (Sweden)

Donald Waters

2011-12-01

Full Text Available 99% of the approximate 1 million annual neonatal deaths from life-threatening invasive bacterial infections occur in developing countries, at least 50% of which are from home births or community settings. Data concerning aetiology of sepsis in these settings are necessary to inform targeted therapy and devise management guidelines. This review describes and analyses the bacterial aetiology of community-acquired neonatal sepsis in developing countries.

Development of quality indicators to evaluate antibiotic treatment of patients with community-acquired pneumonia in Indonesia.

Science.gov (United States)

Farida, Helmia; Rondags, Angelique; Gasem, M Hussein; Leong, Katharina; Adityana, A; van den Broek, Peterhans J; Keuter, Monique; Natsch, Stephanie

2015-04-01

To develop an instrument for evaluating the quality of antibiotic management of patients with community-acquired pneumonia (CAP) applicable in a middle-income developing country. A previous study and Indonesian guidelines were reviewed to derive potential quality of care indicators (QIs). An expert panel performed a two-round Delphi consensus procedure on the QI's relevance to patient recovery, reduction of antimicrobial resistance and cost containment. Applicability in practice, including reliability, feasibility and opportunity for improvement, was determined in a data set of 128 patients hospitalised with CAP in Semarang, Indonesia. Fifteen QIs were selected by the consensus procedure. Five QIs did not pass feasibility criteria, because of inappropriate documentation, inefficient laboratory services or patient factors. Three QIs provided minor opportunity for improvement. Two QIs contradicted each other; one of these was considered not valid and excluded. A final set of six QIs was defined for use in the Indonesian setting. Using the Delphi method, we defined a list of QIs for assessing the quality of care, in particular antibiotic treatment, for CAP in Indonesia. For further improvement, a modified Delphi method that includes discussion, a sound medical documentation system, improvement of microbiology laboratory services, and multi-center applicability tests are needed to develop a valid and applicable QI list for the Indonesian setting. © 2014 John Wiley & Sons Ltd.

Possibilities of predicting of the non-severe community-acquired pneumonia outcomes in patients with type 2 diabetes mellitus or chronic heart failure

Directory of Open Access Journals (Sweden)

O. S. Makharynska

2014-06-01

Full Text Available Aim. Сommunity-acquired pneumonia is life-threatening disease with level of fatal events in hospitals within 12-36 %. In turn, presence of congestive heart failure or type 2 diabetes increases the risk of adverse outcomes in patients with community-acquired pneumonia. Methods and results. In the modern world’s literature there are many models predicting clinical outcomes of community-acquired pneumonia, but none of them includes questionnaires data for such patients. In our study, we used two questionnaires: "The scale of assessment community-acquired pneumonia" R. el Moussaoui and CapSym-12. C Сonclusion. Using logistic regression, we have found statistically significant indices sample questionnaires prognostic opportunities which were used in this study to assess the health and dynamics of symptoms of community-acquired pneumonia and that allows us to predict the outcome community-acquired pneumonia.

Prognostic value of severity indicators of nursing-home-acquired pneumonia versus community-acquired pneumonia in elderly patients

Directory of Open Access Journals (Sweden)

Ugajin M

2014-02-01

Full Text Available Motoi Ugajin, Kenichi Yamaki, Natsuko Hirasawa, Takanori Kobayashi, Takeo Yagi Department of Respiratory Medicine, Ichinomiya-Nishi Hospital, Ichinomiya City, Japan Background: The credibility of prognostic indicators in nursing-home-acquired pneumonia (NHAP is not clear. We previously reported a simple prognostic indicator in community-acquired pneumonia (CAP: blood urea nitrogen to serum albumin (B/A ratio. This retrospective study investigated the prognostic value of severity indicators in NHAP versus CAP in elderly patients. Methods: Patients aged ≥65 years and hospitalized because of NHAP or CAP within the previous 3 years were enrolled. Demographics, coexisting illnesses, laboratory and microbiological findings, and severity scores (confusion, urea, respiratory rate, blood pressure, and age ≥65 [CURB-65] scale; age, dehydration, respiratory failure, orientation disturbance, and pressure [A-DROP] scale; and pneumonia severity index [PSI] were retrieved from medical records. The primary outcome was mortality within 28 days of admission. Results: In total, 138 NHAP and 307 CAP patients were enrolled. Mortality was higher in NHAP (18.1% than in CAP (4.6% (P<0.001. Patients with NHAP were older and had lower functional status and a higher rate of do-not-resuscitate orders, heart failure, and cerebrovascular diseases. The NHAP patients more frequently had typical bacterial pathogens. Using the receiver-operating characteristics curve for predicting mortality, the area under the curve in NHAP was 0.70 for the A-DROP scale, 0.69 for the CURB-65 scale, 0.67 for the PSI class, and 0.65 for the B/A ratio. The area under the curve in CAP was 0.73 for the A-DROP scale, 0.76 for the CURB-65 scale, 0.81 for the PSI class, and 0.83 for the B/A ratio. Conclusion: Patient mortality was greater in NHAP than in CAP. Patient characteristics, coexisting illnesses, and detected pathogens differed greatly between NHAP and CAP. The existing severity indicators

Process evaluation of a community-based intervention program: Healthy Youth Healthy Communities, an adolescent obesity prevention project in Fiji.

Science.gov (United States)

Waqa, Gade; Moodie, Marj; Schultz, Jimaima; Swinburn, Boyd

2013-12-01

Nearly one-half of the adult population in Fiji between the ages of 15-64 years is either overweight or obese; and rates amongst school children have, on average, doubled during the last decade. There is an urgent need to scale up the promotion of healthy behaviors and environments using a multi-sectoral approach. The Healthy Youth Healthy Community (HYHC) project in Fiji used a settings approach in secondary schools and faith-based organizations to increase the capacity of the whole community, including churches, mosques and temples, to promote healthy eating and regular physical activity, and to prevent unhealthy weight gain in adolescents aged 13-18 years. The team consisted of a study manager, project coordinator and four research assistants (RAs) committed to planning, designing and facilitating the implementation of intervention programs in collaboration with other stakeholders, such as the wider school communities, government and non-governmental organizations and business partners. Process data were collected on all intervention activities and analyzed by dose, frequency and reach for each specific strategy. The Fiji Action Plan included nine objectives for the school settings; four were based on nutrition and two on physical activity in schools, plus three general objectives, namely capacity building, social marketing and evaluation. Long-term change in nutritional behavior was difficult to achieve; a key contributor to this was the unhealthy food served in the school canteens. Whilst capacity-building proved to be one of the best mechanisms for intervening, it is important to consider the cultural and social factors influencing health behaviors and affecting specific groups.

The Heartfile Lodhran CVD prevention project--end of project evaluation.

Science.gov (United States)

Nishtar, Sania; Badar, Asma; Kamal, Mohammad Umer; Iqbal, Azhar; Bajwa, Rashid; Shah, Tauqeer; Larik, Zahid; Karim, Fazle; Mehmood, Mahmood ul Hassan; Jehangir, Haroon; Azam, Syed Iqbal; Mirza, Yasir Abbas; Khan, Shahzad Ali; Qayyum, Aamra; Aqeel, Fauzia; Bakir, Abdul; Rahim, Ejaz

2007-01-01

Mainstream preventive interventions often fail to reach poor populations with a high risk of cardiovascular diseases (CVDs) in Pakistan. A community-based CVD primary prevention project aimed at developing approaches to reduce risk factors in such populations was established by Heartfile in collaboration with the National Rural Support Program in the district of Lodhran. The project implemented a range of activities integrated with existing social and health service mechanisms during a three year intervention period 2000/01-03/04. These were targeted in 4 key settings: community health education, mass media interventions, training of health professionals and health education through Lady Health Workers. The project received support from the Department for International Development, U.K. At the community level, a pre-test-post-test quasi-experimental design was used for examining project outcomes related to the community component of the intervention. Pre and post-intervention (training) evaluations were conducted involving all health care providers in randomly selected workshops in order to determine baseline levels of knowledge and the impact of training on knowledge level. In order to assess practices of physician and non-physician health care providers patient interviews, with control comparisons were conducted at each health care facility. Significant positive changes were observed in knowledge levels at a community level in the district of intervention compared with baseline knowledge levels particularly in relation to a heart healthy diet, beneficial level of physical activity, the causes of high blood pressure and heart attack and the effects of high blood pressure and active and passive smoking on health. Significant changes in behaviors at a practice level were not shown in the district of intervention. However the project played a critical role in spurring national action for the prevention and control of non-communicable diseases and introducing

Systolic blood pressure is superior to other haemodynamic predictors of outcome in community acquired pneumonia.

Science.gov (United States)

Chalmers, J D; Singanayagam, A; Hill, A T

2008-08-01

Admission blood pressure (BP) assessment is a central component of severity assessment for community acquired pneumonia. The aim of this study was to establish which readily available haemodynamic measure on admission is most useful for predicting severity in patients admitted with community acquired pneumonia. A prospective observational study of patients admitted with community acquired pneumonia was conducted in Edinburgh, UK. The measurements compared were systolic and diastolic BP, mean arterial pressure and pulse pressure. The outcomes of interest were 30 day mortality and the requirement for mechanical ventilation and/or inotropic support. Admission systolic BP pressure pressure AUC values for each predictor of 30 day mortality were as follows: systolic BP pressure pressure AUC values for each predictor of need for mechanical ventilation and/or inotropic support were as follows: systolic BP pressure pressure blood pressure AUC 0.76 vs 0.74) and to the standard CURB65 score (0.76 vs 0.76) for the prediction of 30 day mortality. The simplified CRB65 score was equivalent for prediction of mechanical ventilation and/or inotropic support to standard CRB65 (0.77 vs 0.77) and to CURB65 (0.77 vs 0.78). Systolic BP is superior to other haemodynamic predictors of 30 day mortality and need for mechanical ventilation and/or inotropic support in community acquired pneumonia. The CURB65 score can be simplified to a modified CRB65 score by omission of the diastolic BP criterion without compromising its accuracy.

Community-acquired acute kidney injury in adults in Africa.

Science.gov (United States)

Adu, Dwomoa; Okyere, Perditer; Boima, Vincent; Matekole, Michael; Osafo, Charlotte

We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa. A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015. The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired. Most patients with AKI are young with a weighted mean age of 41.3 standard deviation (SD) 9.3 years, and a male to female ratio of 1.2 : 1.0. Medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 - 27% of cases and surgical causes in 2 - 24% of cases. In the reported studies, between 17 and 94% of patients who needed dialysis received this. The mortality of AKI in adults in Africa ranged from 11.5 to 43.5%. Most reported cases of AKI in Africa originate in the community. The low incidence of hospital-acquired AKI is likely to be due to under ascertainment. Most patients with AKI in Africa are young and have a single precipitating cause. Prominent among these are infection, pregnancy complications and nephrotoxins. Early treatment can improve clinical outcomes.

Androgen deprivation therapy for prostate cancer and the risk of hospitalisation for community-acquired pneumonia.

Science.gov (United States)

Hicks, Blánaid M; Yin, Hui; Bladou, Franck; Ernst, Pierre; Azoulay, Laurent

2017-07-01

Androgens have been shown to influence both the immune system and lung tissue, raising the hypothesis that androgen deprivation therapy (ADT) for prostate cancer may increase the risk of pneumonia. Thus, the aim of this study was to determine whether ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in patients with prostate cancer. This was a population-based cohort study using the United Kingdom Clinical Practice Research Datalink linked to the Hospital Episode Statistics repository. The cohort consisted of 20 310 men newly diagnosed with non-metastatic prostate cancer between 1 April 1998 and 31 March 2015. Time-dependent Cox proportional hazards models were used to estimate adjusted HRs and 95% CIs for hospitalisation for community-acquired pneumonia associated with current and past use of ADT compared with non-use. During a mean follow-up of 4.3 years, there were 621 incident hospitalisations for community-acquired pneumonia (incidence rate: 7.2/1000 person-years). Current ADT use was associated with an 81% increased risk of hospitalisation for community-acquired pneumonia (12.1 vs 3.8 per 1000 person-years, respectively; HR 1.81, 95% CI 1.47 to 2.23). The association was observed within the first six months of use (HR 1.73, 95% CI 1.23 to 2.42) and remained elevated with increasing durations of use (≥25 months; HR 1.79, 95% CI 1.39 to 2.30). In contrast, past ADT use was not associated with an increased risk (HR 1.23, 95% CI 0.95 to 1.60). The use of ADT is associated with an increased risk of hospitalisation for community-acquired pneumonia in men with prostate cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Talking About The Smokes: a large-scale, community-based participatory research project.

Science.gov (United States)

Couzos, Sophia; Nicholson, Anna K; Hunt, Jennifer M; Davey, Maureen E; May, Josephine K; Bennet, Pele T; Westphal, Darren W; Thomas, David P

2015-06-01

To describe the Talking About The Smokes (TATS) project according to the World Health Organization guiding principles for conducting community-based participatory research (PR) involving indigenous peoples, to assist others planning large-scale PR projects. The TATS project was initiated in Australia in 2010 as part of the International Tobacco Control Policy Evaluation Project, and surveyed a representative sample of 2522 Aboriginal and Torres Strait Islander adults to assess the impact of tobacco control policies. The PR process of the TATS project, which aimed to build partnerships to create equitable conditions for knowledge production, was mapped and summarised onto a framework adapted from the WHO principles. Processes describing consultation and approval, partnerships and research agreements, communication, funding, ethics and consent, data and benefits of the research. The TATS project involved baseline and follow-up surveys conducted in 34 Aboriginal community-controlled health services and one Torres Strait community. Consistent with the WHO PR principles, the TATS project built on community priorities and strengths through strategic partnerships from project inception, and demonstrated the value of research agreements and trusting relationships to foster shared decision making, capacity building and a commitment to Indigenous data ownership. Community-based PR methodology, by definition, needs adaptation to local settings and priorities. The TATS project demonstrates that large-scale research can be participatory, with strong Indigenous community engagement and benefits.

Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan.

Science.gov (United States)

Sada, Ryuichi; Fukuda, Saori; Ishimaru, Hiroyasu

2017-01-01

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis due to a cleft narrowing associated with vulvar lichen sclerosus. Both patients were admitted to our hospital with septic shock and severe acute kidney injury and subsequently recovered with appropriate antibiotic treatment. In our review of the literature, 8 cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus were reported in Japan. In these 8 cases, the main portals of entry were the skin and respiratory tract; however, the portal of entry of Community-acquired methicillin-resistant Staphylococcus aureus from a vaginal lesion has not been reported in Japan previously.

Perceptions of community participation and health gain in a community project for the South Asian population: a qualitative study.

Science.gov (United States)

Bandesha, G; Litva, A

2005-09-01

The new public health rejects old individualist attempts at improving health and embraces community-based approaches in reducing health inequalities. Primary Care Trusts in England face the challenge of converting community participation in health into reality. This study explores differences in perception of participation between lay and professional stakeholders of a community health project for a South Asian population in Greater Manchester. In-depth interviews and focus groups were used to explore the views of professional and lay stakeholders. All data were audio-taped, transcribed and analysed for emerging themes using a qualitative framework. Professionals talked of working in partnership with the community but lay stakeholders did not feel that they had control over the project. There were problems in engaging the community and local health professionals in the project. Lack of cultural awareness hampered participation in the project. There was agreement that the project improved the self-confidence of participants and created a more informed population. However, there was little support for claims of improvements in social cohesion and changes in lifestyle directly as a result of the project. Converting the rhetoric of community participation in health into reality is a greater challenge than was envisaged by policy makers. Marginalized communities may not be willing participants and issues of language and cultural sensitivity are important. Project outcomes need to be agreed to ensure projects are evaluated appropriately. Projects with South Asian communities should not be seen to be dealing with all 'ethnic health' issues without addressing changes in statutory organizations and other wider social determinants of health.

Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treatment of community acquired pneumonia in children

International Nuclear Information System (INIS)

Aurangzeb, B.; Hameed, A.

2003-01-01

Objective: To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment. Subjects and Methods: Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups 1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvements at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared. Results: There was no statistical difference in the clinical response at 48 hours of initiating treatment and discharge (p>0.01 each). The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively (p>0.01). Ninety-seven percent patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs. 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively. Conclusion: Amoxicillin was found in the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia. (author)

Community-acquired pneumonia among smokers.

Science.gov (United States)

Almirall, Jordi; Blanquer, José; Bello, Salvador

2014-06-01

Recent studies have left absolutely no doubt that tobacco increases susceptibility to bacterial lung infection, even in passive smokers. This relationship also shows a dose-response effect, since the risk reduces spectacularly 10 years after giving up smoking, returning to the level of non-smokers. Streptococcus pneumoniae is the causative microorganism responsible for community-acquired pneumonia (CAP) most frequently associated with smoking, particularly in invasive pneumococcal disease and septic shock. It is not clear how it acts on the progress of pneumonia, but there is evidence to suggest that the prognosis for pneumococcal pneumonia is worse. In CAP caused by Legionella pneumophila, it has also been observed that smoking is the most important risk factor, with the risk rising 121% for each pack of cigarettes smoked a day. Tobacco use may also favor diseases that are also known risk factors for CAP, such as periodontal disease and upper respiratory viral infections. By way of prevention, while giving up smoking should always be proposed, the use of the pneumococcal vaccine is also recommended, regardless of the presence of other comorbidities. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan

OpenAIRE

Sada, Ryuichi; Fukuda, Saori; Ishimaru, Hiroyasu

2017-01-01

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis ...

Evaluation of Embedded System Component Utilized in Delivery Integrated Design Project Course

Science.gov (United States)

Junid, Syed Abdul Mutalib Al; Hussaini, Yusnira; Nazmie Osman, Fairul; Razak, Abdul Hadi Abdul; Idros, Mohd Faizul Md; Karimi Halim, Abdul

2018-03-01

This paper reports the evaluation of the embedded system component utilized in delivering the integrated electronic engineering design project course. The evaluation is conducted based on the report project submitted as to fulfil the assessment criteria for the integrated electronic engineering design project course named; engineering system design. Six projects were assessed in this evaluation. The evaluation covers the type of controller, programming language and the number of embedded component utilization as well. From the evaluation, the C-programming based language is the best solution preferred by the students which provide them flexibility in the programming. Moreover, the Analog to Digital converter is intensively used in the projects which include sensors in their proposed design. As a conclusion, in delivering the integrated design project course, the knowledge over the embedded system solution is very important since the high density of the knowledge acquired in accomplishing the project assigned.

[Usefulness of sputum Gram staining in community-acquired pneumonia].

Science.gov (United States)

Sato, Tadashi; Aoshima, Masahiro; Ohmagari, Norio; Tada, Hiroshi; Chohnabayashi, Naohiko

2002-07-01

To evaluate the usefulness of sputum gram staining in community-acquired pneumonia (CAP), we reviewed 144 cases requiring hospitalization in the last 4 years. The sensitivity was 75.5%, specificity 68.2%, positive predictive value 74.1%, negative predictive value 69.8%, positive likelihood ratio 2.37, negative likelihood ratio 0.36 and accuracy 72.2% in 97 cases. Both sputum gram staining and culture were performed. Concerning bacterial pneumonia (65 cases), we compared the Gram staining group (n = 33), which received initial antibiotic treatment, based on sputum gram staining with the Empiric group (n = 32) that received antibiotics empirically. The success rates of the initial antibiotic treatment were 87.9% vs. 78.1% (P = 0.473); mean hospitalization periods were 9.67 vs. 11.75 days (P = 0.053); and periods of intravenous therapy were 6.73 vs. 7.91 days (P = 0.044), respectively. As for initial treatment, penicillins were used in the Gram staining group more frequently (P gram staining is useful for the shortening of the treatment period and the appropriate selection of initial antibiotics in bacterial pneumonia. We believe, therefore, that sputum gram staining is indispensable as a diagnostic tool CAP.

Acquiring Data by Mining the Past: Pairing Communities with Environmental Monitoring Methods through Open Online Collaborative Replication

Science.gov (United States)

Lippincott, M.; Lewis, E. S.; Gehrke, G. E.; Wise, A.; Pyle, S.; Sinatra, V.; Bland, G.; Bydlowski, D.; Henry, A.; Gilberts, P. A.

2016-12-01

Community groups are interested in low-cost sensors to monitor their environment. However, many new commercial sensors are unknown devices without peer-reviewed evaluations of data quality or pathways to regulatory acceptance, and the time to achieve these outcomes may be beyond a community's patience and attention. Rather than developing a device from scratch or validating a new commercial product, a workflow is presented whereby existing technologies, especially those that are out of patent, are replicated through open online collaboration between communities affected by environmental pollution, volunteers, academic institutions, and existing open hardware and open source software projects. Technology case studies will be presented, focusing primarily on a passive PM monitor based on the UNC Passive Monitor. Stages of the project will be detailed moving from identifying community needs, reviewing existing technology, partnership development, technology replication, IP review and licensing, data quality assurance (in process), and field evaluation with community partners (in process), with special attention to partnership development and technology review. We have leveraged open hardware and open source software to lower the cost and access barriers of existing technologies for PM10-2.5 and other atmospheric measures that have already been validated through peer review. Existing validation of and regulatory familiarity with a technology enables a rapid pathway towards collecting data, shortening the time it takes for communities to leverage data in environmental management decisions. Online collaboration requires rigorous documentation that aids in spreading research methods and promoting deep engagement by interested community researchers outside academia. At the same time, careful choice of technology and the use of small-scale fabrication through laser cutting, 3D printing, and open, shared repositories of plans and software enables educational engagement that

Failure of CRP decline within three days of hospitalization is associated with poor prognosis of Community-acquired Pneumonia

DEFF Research Database (Denmark)

Andersen, Stine Bang; Baunbæk Egelund, Gertrud Louise; Jensen, Andreas Vestergaard

2017-01-01

BACKGROUND: C-reactive protein (CRP) is a well-known acute phase protein used to monitor the patient's response during treatment in infectious diseases. Mortality from Community-acquired Pneumonia (CAP) remains high, particularly in hospitalized patients. Better risk prediction during hospitaliza......BACKGROUND: C-reactive protein (CRP) is a well-known acute phase protein used to monitor the patient's response during treatment in infectious diseases. Mortality from Community-acquired Pneumonia (CAP) remains high, particularly in hospitalized patients. Better risk prediction during...... hospitalization could improve management and ultimately reduce mortality levels. The aim of this study was to evaluate CRP on the 3rd day (CRP3) of hospitalization as a predictor for 30 days mortality. METHODS: A retrospective multicentre cohort study of adult patients admitted with CAP at three Danish hospitals....... Predictive associations of CRP3 (absolute levels and relative decline) and 30 days mortality were analysed using receiver operating characteristics and logistic regression. RESULTS: Eight hundred and fourteen patients were included and 90 (11%) died within 30 days. The area under the curve for CRP3 level...

Impact of Community Driven Development Project: A Case of ...

African Journals Online (AJOL)

This paper evaluates impact of Community Driven Development programme on infrastructure under National Fadama II Project in Oyo State Nigeria. Data were collected from two hundred and sixty-four farmers using multistage sampling procedures. Data were analyzed using descriptive statistics and infrastructure index.

Metastatic Spreading of Community Acquired Staphylococcus aureus Bacteraemia

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Giovanna Fabio

2011-01-01

Full Text Available A 29-year-old woman presented to the Fondazione IRCCS “Cà Granda” Ospedale Maggiore, a tertiary care university hospital in Milan (Italy, with skin lesions, fever, myalgia, joint pain and swelling, and a one-week history of low back pain. The diagnosis was Staphylococcus aureus (S. aureus bacteraemia spreading to skin, bones, and joints and a lumbosacral epidural abscess L5-S2. Neither initial focus nor predisposing conditions were apparent. The antibiotic therapy was prolonged for six-weeks with the resolution of fever, skin lesions, articular inflammation, and the epidural abscess. Community-acquired S. aureus infections can affect patients without traditional healthcare-associated risk factors, and community acquisition is a risk-factor for the development of complications. Raised awareness of S. aureus bacteraemia, also in patients without healthcare-associated risk factors, is important in the diagnosis, management, and control of this infection, because failure to recognise patients with serious infection and lack of understanding of empirical antimicrobial selection are associated with a high mortality rate in otherwise healthy people.

The Healthy Skin Project: changing nursing practice to prevent and treat hospital-acquired pressure ulcers.

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Armour-Burton, Teri; Fields, Willa; Outlaw, Lanie; Deleon, Elvira

2013-06-01

Hospital-acquired pressure ulcers are serious clinical complications that can lead to increased length of stay, pain, infection, and, potentially, death. The surgical progressive care unit at Sharp Grossmont Hospital, San Diego, California, developed the multidisciplinary Healthy Skin Project to decrease the prevalence of hospital-acquired pressure ulcers. The previous treatment plan was reviewed and modified according to current evidence-based practice. The project consisted of 3 components: creation of a position for a unit-based wound liaison nurse, staff education, and involvement of the nursing assistants. The wound liaison nurse developed and conducted bimonthly skin audits, which revealed inconsistencies in clinical practice and documentation. Education for the staff was accomplished via a self-learning module, case presentations, and 1-on-1 training. In addition, a pressure ulcer algorithm tool was developed to demonstrate step-by-step wound management and documentation. From Spring 2003 through Summer 2006, the prevalence of hospital-acquired pressure ulcers ranged from 0.0% to 18.92%, with a mean of 4.85%. After implementation of the project, the prevalence decreased to 0.0% for 17 of 20 quarters, through 2011. Prevention and a multidisciplinary approach are effective in reducing the occurrence of hospital-acquired pressure ulcers.

Clinical study of serum interleukin-6 in children with community-acquired pneumonia

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Ahmed A. Khattab

2018-06-01

Full Text Available Background: Community-acquired pneumonia (CAP is an important childhood killer. Excessive production of cytokines, including interleukin-6 (IL-6, might be associated with severe disease course but pediatric data is limited. Aim: To assess value of IL-6 in predicting CAP severity in children. Methods: A prospective study conducted on 73 children hospitalized for CAP and 15 healthy controls. Pneumonia severity was evaluated according to World Health Organization (WHO classification, Respiratory Index of Severity Score (RISC, Predisposition, Insult, Response, Organ dysfunction modified (PIROm score, and Pediatric Respiratory Severity Score (PRESS. Serum IL-6 was measured within 24 h of admission. The primary outcome was occurrence of any pneumonia complications or death within 30 days. Results: IL-6 was significantly higher among patients compared with controls. Unlike CRP, IL-6 was significantly higher among children with severe pneumonia as determined by WHO, PRESS, and RISC (p = 0.001 for all. IL-6 was significantly higher among children with PICU admission, mechanical ventilation, shock (p = 0.001 for all, hypoxia (p < 0.001, and lobar consolidation (p = 0.042. IL-6 had positive correlations with PRESS (rs=0.8, P < 0.001, RISC (rs=0.6, p < 0.001, and PIROm (rs=0.59, p < 0.001 while a negative correlation was found with Oxygen saturation [r = −0.61, p = 0.001]. IL-6 was not significantly correlated with CRP. Receiver Operating Characteristic curve (ROC analysis revealed large area under the curve (AUC of IL-6 for prediction of severe pneumonia as classified by WHO, PRESS, and RISC (AUC = 0.95, 0.94, and 0.89 respectively. Conclusion: IL-6 appears to be valuable for assessment of CAP severity in children compared with conventional biomarkers. Keywords: Interleukin-6, Community acquired pneumonia, C-reactive protein, Prognosis, Pediatric

Plausible role for CHW peer support groups in increasing care-seeking in an integrated community case management project in Rwanda: a mixed methods evaluation

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Langston, Anne; Weiss, Jennifer; Landegger, Justine; Pullum, Thomas; Morrow, Melanie; Kabadege, Melene; Mugeni, Catherine; Sarriot, Eric

2014-01-01

ABSTRACT Background: The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda's 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In project districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. Methods: The 2005 and 2010 Demographic and Health Surveys were re-analyzed to evaluate how project and non-project districts differed in terms of care-seeking for fever, diarrhea, and acute respiratory infection symptoms and related indicators. We developed a logit regression model, controlling for the timing of the first CHW training, with the district included as a fixed categorical effect. We also analyzed qualitative data from the final evaluation to examine factors that may have contributed to improved outcomes. Results: While there was notable improvement in care-seeking across all districts, care-seeking from any provider for each of the 3 conditions, and for all 3 combined, increased significantly more in the project districts. CHWs contributed a larger percentage of consultations in project districts (27%) than in non-project districts (12%). Qualitative data suggested that the PSG model was a valuable sub-level of CHW organization associated with improved CHW performance, supervision, and social capital. Conclusions: The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of i

Acute versus subacute community-acquired meningitis: Analysis of 611 patients.

Science.gov (United States)

Sulaiman, Tarek; Salazar, Lucrecia; Hasbun, Rodrigo

2017-09-01

Community-acquired meningitis can be classified into acute and subacute presentations by the duration of illness of ≤ or >5 days, respectively. There are currently no studies comparing the clinical features, management decisions, etiologies, and outcomes between acute and subacute presentations.It is a retrospective study of adults with community-acquired meningitis hospitalized in Houston, TX between January 2005 and January 2010. An adverse clinical outcome was defined as a Glasgow Outcome Scale score of ≤4.A total of 611 patients were identified, of which 458 (75%) were acute and 153 subacute (25%). The most common etiologies were unknown in 418 (68.4%), viral in 94 (15.4%), bacterial in 47 (7.7%), fungal in 42 patients (6.9%), and other noninfectious etiologies in 6 (1%). Patients with subacute meningitis were more likely to be immunosuppressed or have comorbidities, had fungal etiologies, and had higher rates of hypoglycorrachia and abnormal neurological findings (P 65 years and abnormal neurological findings were predictive of an adverse clinical outcome in both acute and subacute meningitis, whereas fever was also a significant prognostic factor in acute meningitis. (P meningitis differ in regards to clinical presentations, etiologies, laboratory findings, and management decisions, but did not differ in rates of adverse clinical outcomes. Future studies including thoroughly investigated patients with new diagnostic molecular methods may show different results and outcomes.

New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study.

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Ranzani, Otavio T; Prina, Elena; Menéndez, Rosario; Ceccato, Adrian; Cilloniz, Catia; Méndez, Raul; Gabarrus, Albert; Barbeta, Enric; Bassi, Gianluigi Li; Ferrer, Miquel; Torres, Antoni

2017-11-15

The Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia. This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals. SIRS, qSOFA, the Confusion, Respiratory Rate and Blood Pressure (CRB) score, modified SOFA (mSOFA), the Confusion, Urea, Respiratory Rate, Blood Pressure and Age (CURB-65) score, and Pneumonia Severity Index (PSI) were calculated with data from the emergency department. We used decision-curve analysis to evaluate the clinical usefulness of each score and the primary outcome was in-hospital mortality. Of 6,874 patients, 442 (6.4%) died in-hospital. SIRS presented the worst discrimination, followed by qSOFA, CRB, mSOFA, CURB-65, and PSI. Overall, overestimation of in-hospital mortality and miscalibration was more evident for qSOFA and mSOFA. SIRS had lower net benefit than qSOFA and CRB, significantly increasing the risk of over-treatment and being comparable with the "treat-all" strategy. PSI had higher net benefit than mSOFA and CURB-65 for mortality, whereas mSOFA seemed more applicable when considering mortality/intensive care unit admission. Sepsis-3 flowchart resulted in better identification of patients at high risk of mortality. qSOFA and CRB outperformed SIRS and presented better clinical usefulness as prompt tools for patients with community-acquired pneumonia in the emergency department. Among the tools for a comprehensive patient assessment, PSI had the best decision-aid tool profile.

Bacteriological and clinical profile of Community acquired pneumonia in hospitalized patients

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Shah Bashir

2010-01-01

Full Text Available The aim of our study was to obtain comprehensive insight into the bacteriological and clinical profile of community-acquired pneumonia requiring hospitalization. The patient population consisted of 100 patients admitted with the diagnosis of community-acquired pneumonia (CAP, as defined by British Thoracic society, from December 1998 to Dec 2000, at the Sher- i-Kashmir institute of Medical Sciences Soura, Srinagar, India. Gram negative organisms were the commonest cause (19/29, followed by gram positive (10/29. In 71 cases no etiological cause was obtained. Pseudomonas aeruginosa was the commonest pathogen (10/29, followed by Staphylococcus aureus (7/29, Escherichia coli (6/29, Klebsiella spp. (3/29, Streptococcus pyogenes (1/29, Streptococcus pneumoniae (1/29 and Acinetobacter spp. (1/29. Sputum was the most common etiological source of organism isolation (26 followed by blood (6, pleural fluid (3, and pus culture (1. Maximum number of patients presented with cough (99%, fever (95%, tachycardia (92%, pleuritic chest pain (75%, sputum production (65% and leucocytosis (43%. The commonest predisposing factors were smoking (65%, COPD (57%, structural lung disease (21%, diabetes mellitus (13%, and decreased level of consciousness following seizure (eight per cent and chronic alcoholism (one per cent. Fourteen patients, of whom, nine were males and five females, died. Staphylococcus aureus was the causative organism in four, Pseudomonas in two, Klebsiella in one, and no organism was isolated in seven cases. The factors predicting mortality at admission were - age over 62 years, history of COPD or smoking, hypotension, altered sensorium, respiratory failure, leucocytosis, and s0 taphylococcus pneumonia and undetermined etiology. The overall rate of identification of microbial etiology of community-acquired pneumonia was 29%, which is very low, and if serological tests for legionella, mycoplasma and viruses are performed the diagnostic yield would

Transforming community members into diabetes cultural health brokers: the Neighborhood Health Talker project.

Science.gov (United States)

Cadzow, Renee B; Craig, Mary; Rowe, Jimmy; Kahn, Linda S

2013-01-01

The purpose of this study was to evaluate a community-based diabetes education pilot project. The Neighborhood Health Talker project aimed to train and implement cultural health brokers primarily targeting communities of color to improve community members' diabetes knowledge and diabetes self-management skills. A secondary aim was to establish diabetes resource libraries accessible to communities that normally experience barriers to these resources. Recruited community members completed 1 week of formal training developed by a multidisciplinary team in Buffalo, NY. The effect of training was evaluated through the use of baseline surveys, a pretest/posttest covering all training content, and daily quizzes evaluating knowledge relevant to each of the five training modules. Trained NHTs then held at least five community conversations in various locations and administered anonymous postconversation surveys to participants. Descriptive statistics and qualitative analysis techniques were used to summarize test, quiz, and survey results. Twelve women and 1 man completed the training program. Working alone as well as in pairs, each held at least five community conversations reaching over 700 community members of all ages over 3 months and established 8 diabetes resource libraries in the community. All trainees increased their diabetes knowledge and confidence as well as their abilities to perform the tasks of a cultural health broker. Trainees also indicated that the goals they set at training initiation were met. The training was successful in increasing trainee knowledge and confidence about diabetes prevention and self-management. Participants not only developed proficiency in discussing diabetes, they also made important lifestyle changes that demonstrated their commitment to the cause and the project. Low-cost initiatives like this are easily reproducible in other communities of color and could be modified to meet the needs of other communities as well.

The Fort McMurray Demonstration Project in Social Marketing: theory, design, and evaluation.

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Guidotti, T L; Ford, L; Wheeler, M

2000-02-01

The Fort McMurray Demonstration Project in Social Marketing is a multifaceted program that applies the techniques of social marketing to health and safety. This paper describes the origins of the project and the principles on which it was based. VENUE: Fort McMurray, in the province of Alberta, Canada, was selected because the community had several community initiatives already underway and the project had the opportunity to demonstrate "value added." The project is distinguished from others by a model that attempts to achieve mutually reinforcing effects from social marketing in the community as a whole and from workplace safety promotion in particular. Specific interventions sponsored by the project include a media campaign on cable television, public activities in local schools, a community safety audit, and media appearance by a mascot that provides visual identity to the project, a dinosaur named "Safetysaurus." The project integrated its activities with other community initiatives. The evaluation component emphasizes outcome measures. A final evaluation based on injury rates and attitudinal surveys is underway. Baseline data from the first round of surveys have been compiled and published. In 1995, Fort McMurray became the first city in North America to be given membership in the World Health Organization's Safe Community Network.

[Community-based health promotion--a challenge for the evaluation].

Science.gov (United States)

Loss, J; Eichhorn, C; Gehlert, J; Donhauser, J; Wise, M; Nagel, E

2007-02-01

Community-based health promotion (CBHP) aims at mobilising citizens for health-related issues in their environment, and at implementing health-promoting projects on the community level. Whereas recent political decisions support this approach, scientific studies dealing with theories and consequences of CBHP are scarce in Germany. Evaluation of CBHP could help identify (in)effective factors and elements of community programmes and thus improve future planning. In Germany, however, there is a deficit in systematic concepts and recommendations for the evaluation of CBHP. This work outlines basic ideas and core principles of CBHP and deduces implications for the assessment of health-promoting community projects. Based on different international models and studies and on discussions with health promotion professionals, we developed a framework for the evaluation of CBHP. The proposed framework includes a guideline for CBHP programme planning. Its strategic and operational criteria can serve as a basis for a strategy evaluation. In terms of process evaluation, indicators for the dimensions (1) programme implementation and service delivery, (2) capacity building, and (3) reach of and acceptability in the target group were developed. In addition, we present different areas of OUTCOME EVALUATION; it is advisable to distinguish between measurement on the individual and on the community level. The framework further proposes strategies for the evaluation of the core principles empowerment and participation. The presented framework can serve as a basis for the development of flexible and individual instruments for the evaluation of CBHP, which should not ignore the perspective of the citizens, or complex aspects like changes on the community level. Some aspects, e.g., the potential evaluation of further targets of CBHP (improvement of quality of life, reduction of social and health inequalities), the responsibility of evaluation or the effects of financial constraints, are

[Community-acquired pneumonia due to Legionella pneumophila serogroup 1. Study of 97 cases].

Science.gov (United States)

Benito, José Ramón; Montejo, José Miguel; Cancelo, Laura; Zalacaín, Rafael; López, Leyre; Fernández Gil de Pareja, Joaquín; Alonso, Eva; Oñate, Javier

2003-10-01

Legionella pneumophila is the causal agent of 5% to 12% of sporadic community-acquired pneumonia cases, though rates are changing with the use of new diagnostic methods. This is a retrospective study of all patients admitted to our hospital with community-acquired pneumonia due to Legionella pneumophila between 1997 and 2001. Diagnostic criteria included either a positive Legionella serogroup 1 urinary antigen test or seroconversion and a chest radiograph consistent with pneumonia. A total of 97 patients were studied. Ninety cases (92.8%) were community-acquired and 7 (7.2%) were associated with travelling. In 82 cases (84.5%) the presentation was sporadic. Seventy-five patients were smokers (77.3%). The most common symptoms were fever in 91 patients (93.8%) and cough in 67 (68.1%). In five patients (5.2%) creatine phosphokinase concentrations were over 5 times their baseline values (in two over 100 times); four of these patients presented acute renal failure. Seroconversion was observed in 23/42 patients (54.8%). There were no statistically significant differences between the administration of erythromycin or clarithromycin in monotherapy, or in combination with rifampin. Nineteen patients (19.6%) presented acute renal failure and mechanical ventilation was necessary in 22 (22.7%). Twelve patients died (12.5%). Independent prognostic factors associated with death included respiratory rate > 30 breaths/min, urea > 60 mg/dL and PaO2 scale scores and the presence of complications or mortality. The Legionella urinary antigen test permits early diagnosis and treatment of this disease. The severity scale is an indicator of complications or death.

INTEGRAL BENCHMARKS AVAILABLE THROUGH THE INTERNATIONAL REACTOR PHYSICS EXPERIMENT EVALUATION PROJECT AND THE INTERNATIONAL CRITICALITY SAFETY BENCHMARK EVALUATION PROJECT

Energy Technology Data Exchange (ETDEWEB)

J. Blair Briggs; Lori Scott; Enrico Sartori; Yolanda Rugama

2008-09-01

Interest in high-quality integral benchmark data is increasing as efforts to quantify and reduce calculational uncertainties accelerate to meet the demands of next generation reactor and advanced fuel cycle concepts. The International Reactor Physics Experiment Evaluation Project (IRPhEP) and the International Criticality Safety Benchmark Evaluation Project (ICSBEP) continue to expand their efforts and broaden their scope to identify, evaluate, and provide integral benchmark data for method and data validation. Benchmark model specifications provided by these two projects are used heavily by the international reactor physics, nuclear data, and criticality safety communities. Thus far, 14 countries have contributed to the IRPhEP, and 20 have contributed to the ICSBEP. The status of the IRPhEP and ICSBEP is discussed in this paper, and the future of the two projects is outlined and discussed. Selected benchmarks that have been added to the IRPhEP and ICSBEP handbooks since PHYSOR’06 are highlighted, and the future of the two projects is discussed.

INTEGRAL BENCHMARKS AVAILABLE THROUGH THE INTERNATIONAL REACTOR PHYSICS EXPERIMENT EVALUATION PROJECT AND THE INTERNATIONAL CRITICALITY SAFETY BENCHMARK EVALUATION PROJECT

International Nuclear Information System (INIS)

J. Blair Briggs; Lori Scott; Enrico Sartori; Yolanda Rugama

2008-01-01

Interest in high-quality integral benchmark data is increasing as efforts to quantify and reduce calculational uncertainties accelerate to meet the demands of next generation reactor and advanced fuel cycle concepts. The International Reactor Physics Experiment Evaluation Project (IRPhEP) and the International Criticality Safety Benchmark Evaluation Project (ICSBEP) continue to expand their efforts and broaden their scope to identify, evaluate, and provide integral benchmark data for method and data validation. Benchmark model specifications provided by these two projects are used heavily by the international reactor physics, nuclear data, and criticality safety communities. Thus far, 14 countries have contributed to the IRPhEP, and 20 have contributed to the ICSBEP. The status of the IRPhEP and ICSBEP is discussed in this paper, and the future of the two projects is outlined and discussed. Selected benchmarks that have been added to the IRPhEP and ICSBEP handbooks since PHYSOR-06 are highlighted, and the future of the two projects is discussed

Elderly patients with community-acquired pneumonia are not treated according to current guidelines

DEFF Research Database (Denmark)

Lindhardt Damsgaard, Tove; Klausen, Henrik Hedegaard; Christiansen, Christina

2013-01-01

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigated in-hospital compliance...

Community-Acquired Pneumonia in Children: A Multidisciplinary Consensus Review

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Donald E Low

2003-01-01

Full Text Available Community-acquired pneumonia (CAP is common among children and may have viral, bacterial or, occasionally, other causes. The etiology is complex, with age-related trends, and differs from that in adult CAP, necessitating different management guidelines. There is an absence of current guidelines for the management of pediatric CAP (PCAP that take into account changing etiologies, antimicrobial-resistance issues and the use of newly licensed antimicrobials. The present review does not provide specific guidelines, but it reviews the literature and presents currrent approaches to the treatment of PCAP. To compile the review, an expert panel was convened to provide a consensus. The review discusses the etiology, diagnosis and antimicrobial treatment of PCAP as well as indications for referral to a hospital emergency department. The goal of the review is to provide those involved with treatment of PCAP in the community setting with information that can be used to make effective treatment choices.

STEM-related, Student-led Service Learning / Community Engagement Projects: Examples and Benefits

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Swap, R. J.; Wayland, K.

2015-12-01

Field-based, STEM-related service learning / community engagement projects present an opportunity for undergraduate students to demonstrate proficiencies related to the process of inquiry. These proficiencies include: appreciation of the larger project context, articulation of an informed question/hypothesis, project proposal development, interdisciplinary collaboration, project management (including planning, implementation reconfiguration and synthesis) and lastly the generation and handing off of acquired knowledge. Calls for these types of proficiencies have been expressed by governmental, non-governmental as well as the private sector. Accordingly, institutions of higher learning have viewed such activities as opportunities for enriching the learning experience for undergraduate students and for making such students more marketable, especially those from STEM-related fields. This institutional interest has provided an opportunity to support and expand field-based learning. Here we present examples of student-led/faculty-mentored international service learning and community engagement projects along the arc of preparation, implementation and post-field process. Representative examples that draw upon environmental science and engineering knowledge have been selected from more than 20 international undergraduate student projects over past decade and include: slow-sand water filtration, rainwater harvesting, methane biodigesters, water reticulation schemes and development and implementation of rocket stoves for communal cooking. We discuss these efforts in terms of the development of the aforementioned proficiencies, the utility of such proficiencies to the larger enterprise of STEM and the potential for transformative student learning outcomes. We share these experiences and lessons learned with the hope that others may intelligently borrow from our approach in a manner appropriate for their particular context.

The process evaluation of It's Your Move!, an Australian adolescent community-based obesity prevention project

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Simmons Annie M

2010-07-01

Full Text Available Abstract Background Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008 project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region. Methods The project was supported by Deakin University (training and evaluation, a Reference Committee (strategic direction, budgetary approval and monitoring and a Project Management Committee (project delivery. A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities. Results The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as

The process evaluation of It's Your Move!, an Australian adolescent community-based obesity prevention project.

Science.gov (United States)

Mathews, Louise B; Moodie, Marj M; Simmons, Annie M; Swinburn, Boyd A

2010-07-30

Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008) project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region. The project was supported by Deakin University (training and evaluation), a Reference Committee (strategic direction, budgetary approval and monitoring) and a Project Management Committee (project delivery). A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week) and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities. The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as physical activity practices were seen by the teachers as

Building evaluative culture in community services: Caring for evidence.

Science.gov (United States)

Mayne, John

2017-05-25

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

Renewable based hydrogen energy projects in remote and island communities

International Nuclear Information System (INIS)

Miles, S.; Gillie, M.

2009-01-01

Task 18 working group of the International Energy Agency's Hydrogen Implementing Agreement has been evaluating and documenting experiences with renewable based hydrogen energy projects in remote and island communities in the United Kingdom, Canada, Norway, Iceland, Gran Canaria, Spain and New Zealand. The objective was to examine the lessons learned from existing projects and provide recommendations regarding the effective development of hydrogen systems. In order to accomplish this task, some of the drivers behind the niche markets where hydrogen systems have already been developed, or are in the development stages, were studied in order to determine how these could be expanded and modified to reach new markets. Renewable based hydrogen energy projects for remote and island communities are currently a key niche market. This paper compared various aspects of these projects and discussed the benefits, objectives and barriers facing the development of a hydrogen-based economy

Prevalence and resistance pattern of Moraxella catarrhalis in community-acquired lower respiratory tract infections

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Shaikh SBU

2015-07-01

Full Text Available Safia Bader Uddin Shaikh, Zafar Ahmed, Syed Ali Arsalan, Sana Shafiq Department of Pulmonology, Liaquat National Hospital, Karachi, Pakistan Introduction: Moraxella catarrhalis previously considered as commensal of upper respiratory tract has gained importance as a pathogen responsible for respiratory tract infections. Its beta-lactamase-producing ability draws even more attention toward its varying patterns of resistance. Methods: This was an observational study conducted to evaluate the prevalence and resistance pattern of M. catarrhalis. Patients aged 20–80 years admitted in the Department of Chest Medicine of Liaquat National Hospital from March 2012 to December 2012 were included in the study. Respiratory samples of sputum, tracheal secretions, and bronchoalveolar lavage were included, and their cultures were followed. Results: Out of 110 respiratory samples, 22 showed positive cultures for M. catarrhalis in which 14 were males and eight were females. Ten samples out of 22 showed resistance to clarithromycin, and 13 samples out of 22 displayed resistance to erythromycin, whereas 13 showed resistance to levofloxacin. Hence, 45% of the cultures showed resistance to macrolides so far and 59% showed resistance to quinolones. Conclusion: Our study shows that in our environment, M. catarrhalis may be resistant to macrolides and quinolones; hence, these should not be recommended as an alternative treatment in community-acquired lower respiratory tract infections caused by M. catarrhalis. However, a study of larger sample size should be conducted to determine if the recommendations are required to be changed. Keywords: community-acquired lower respiratory tract infections or pneumonia, M. catarrhalis, antibiotic resistance, gram-negative diplococcic, Pakistan

Role of community acceptance in sustainable bioenergy projects in India

International Nuclear Information System (INIS)

Eswarlal, Vimal Kumar; Vasudevan, Geoffrey; Dey, Prasanta Kumar; Vasudevan, Padma

2014-01-01

Community acceptance has been identified as one of the key requirements for a sustainable bioenergy project. However less attention has been paid to this aspect from developing nations and small projects perspective. Therefore this research examines the role of community acceptance for sustainable small scale bioenergy projects in India. While addressing the aim, this work identifies influence of community over bioenergy projects, major concerns of communities regarding bioenergy projects and factors influencing perceptions of communities about bioenergy projects. The empirical research was carried out on four bioenergy companies in India as case studies. It has been identified that communities have significant influence over bioenergy projects in India. Local air pollution, inappropriate storage of by-products and credibility of developer are identified as some of the important concerns. Local energy needs, benefits to community from bioenergy companies, level of trust on company and relationship between company and the community are some of the prime factors which influence community's perception on bioenergy projects. This research sheds light on important aspects related to community acceptance of bioenergy projects, and this information would help practitioners in understanding the community perceptions and take appropriate actions to satisfy them

7 CFR 1709.109 - Eligible projects.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Eligible projects. 1709.109 Section 1709.109... projects. Eligible projects are those that acquire, construct, extend, repair, upgrade or otherwise improve... are eligible. Projects providing or improving service to communities with extremely high energy costs...

UNAVCO's Education and Community Engagement Program: Evaluating Five years of Geoscience Education and Community Outreach

Science.gov (United States)

Charlevoix, D. J.; Dutilly, E.

2017-12-01

In 2013, UNAVCO, a facility co-sponsored by the NSF and NASA, received a five-year award from the NSF: Geodesy Advancing Geosciences and EarthScope (GAGE). Under GAGE, UNAVCO's Education and Community Engagement (ECE) program conducts outreach and education activities, in essence broader impacts for the scientific community and public. One major challenge of this evaluation was the breadth and depth of the dozens of projects conducted by the ECE program under the GAGE award. To efficiently solve this problem of a large-scale program evaluation, we adopted a deliberative democratic (DD) approach that afforded UNAVCO ECE staff a prominent voice in the process. The evaluator directed staff members to chose the projects they wished to highlight as case studies of their finest broader impacts work. The DD approach prizes inclusion, dialogue, and deliberation. The evaluator invited ECE staff to articulate qualities of great programs and develop a case study of their most valuable broader impacts work. To anchor the staff's opinion in more objectivity than opinion, the evaluator asked each staff member to articulate exemplary qualities of their chosen project, discuss how these qualities fit their case study, and helped staff to develop data collection systems that lead to an evidence-based argument in support of their project's unique value. The results of this evaluation show that the individual ECE work areas specialized in certain kinds of projects. However, when viewed at the aggregate level, ECE projects spanned almost the entire gamut of NSF broader impacts categories. Longitudinal analyses show that since the beginning of the GAGE award, many projects grew in impact from year 1 to year 5. While roughly half of the ECE projects were prior work projects, by year five at least 33% of projects were newly developed under GAGE. All selected case studies exemplified how education and outreach work can be productively tied to UNAVCO's core mission of promoting geodesy.

The effectiveness of community-based cycling promotion: findings from the Cycling Connecting Communities project in Sydney, Australia

Directory of Open Access Journals (Sweden)

Merom Dafna

2010-01-01

Full Text Available Abstract Background Encouraging cycling is an important way to increase physical activity in the community. The Cycling Connecting Communities (CCC Project is a community-based cycling promotion program that included a range of community engagement and social marketing activities, such as organised bike rides and events, cycling skills courses, the distribution of cycling maps of the area and coverage in the local press. The aim of the study was to assess the effectiveness of this program designed to encourage the use of newly completed off-road cycle paths through south west Sydney, Australia. Methods The evaluation used a quasi-experimental design that consisted of a pre- and post-intervention telephone survey (24 months apart of a cohort of residents (n = 909 in the intervention area (n = 520 (Fairfield and Liverpool and a socio-demographically similar comparison area (n = 389 (Bankstown. Both areas had similar bicycle infrastructure. Four bicycle counters were placed on the main bicycle paths in the intervention and comparison areas to monitor daily bicycle use before and after the intervention. Results The telephone survey results showed significantly greater awareness of the Cycling Connecting Communities project (13.5% vs 8.0%, p Conclusion Despite relatively modest resources, the Cycling Connecting Communities project achieved significant increases in bicycle path use, and increased cycling in some sub-groups. However, this community based intervention with limited funding had very limited reach into the community and did not increase population cycling levels.

Building Ecological and Community Resilience and Measuring Success of the Department of Interior Hurricane Sandy Resilience Projects

Science.gov (United States)

Taylor, S. M.; Worman, S. L.; Bennett, R.; Bassow, A.

2017-12-01

The Department of the Interior (DOI) partnered with the National Fish and Wildlife Foundation (NFWF) to administer an external funding competition to support coastal resilience projects in the region affected by Hurricane Sandy. The projects complement the DOI Bureau-led projects, but are led by state and local governments, universities, non-profits, community groups, tribes, and other non-Federal entities. In total, the Hurricane Sandy Resilience Program invested over $750 million in approximately 180 projects to repair damage and improve the resilience of habitats, communities and infrastructure to future storms and sea level rise. Project activities include waterway connection and opening, living shoreline, marsh restoration, community resilience planning, data/mapping/modeling, and beach and dune restoration. DOI and NFWF initiated a resilience assessment in 2015 to evaluate the impact of this investment. The assessment began by clarifying the program's resilience goals and the development of ecological and socio-economic metrics across the project activities. Using these metrics, the evaluation is assessing the ecological and community outcomes, cost effectiveness of activities, improved scientific understanding, and temporal and spatial scaling of benefits across resilience activities. Recognizing the unique opportunity afforded by the scale and distribution of projects, NFWF and DOI have invested in monitoring through 2024 to better understand how these projects perform over time. This presentation will describe the evaluation questions, approach, long-term monitoring, online metrics portal, and findings to date.

Importance of Q Fever in Community Acquired Pneumonia

Directory of Open Access Journals (Sweden)

Monique Goyette

1996-01-01

Full Text Available Coxiella burnetii appears to be endemic in animals in the Mauricie region of Quebec, and causes some human cases of Q fever annually. Unlike in other rural areas, patients in this study experienced few respiratory symptoms. To determine whether C burnetii pneumonia is underdiagnosed, adults admitted to hospital for community acquired pneumonia were included in a one-year serological study. Significant immunofluorescent antibody (IFA titres in four of 118 patients with pneumonia (fewer than 4% were studied. Clinical presentation, standard laboratory tests and epidemiological data did not allow identification of these cases; however, Q fever increased during the warm months. There were no detectable complement fixing (CF antibodies in these four cases. C burnetii causes few cases of pneumonia in Mauricie. IFA seems to be a more sensitive test than CF.

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.

Antibiotic stewardship in community-acquired pneumonia.

Science.gov (United States)

Viasus, Diego; Vecino-Moreno, Milly; De La Hoz, Juan M; Carratalà, Jordi

2017-04-01

Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Areas covered: Several elements can be applied to antibiotic stewardship strategies for CAP in order to maintain or improve patient outcomes. In this regard, antibiotic de-escalation, duration of antibiotic treatment, adherence to CAP guidelines recommendations about empirical treatment, and switching from intravenous to oral antibiotic therapy may each be relevant in this context. Antimicrobial stewardship strategies, such as prospective audit with intervention and feedback, clinical pathways, and dedicated multidisciplinary teams, that have included some of these elements have demonstrated improvements in antimicrobial use for CAP without negatively affecting clinical outcomes. Expert commentary: Although there are a limited number of randomized clinical studies addressing antimicrobial stewardship strategies in CAP, there is evidence that antibiotic stewardship initiatives can be securely applied, providing benefits to both healthcare systems and patients.

Advances in the causes and management of community acquired pneumonia in adults.

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Wunderink, Richard G; Waterer, Grant

2017-07-10

Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Experiences from three community health promotion projects in Greenland

DEFF Research Database (Denmark)

Curtis, Tine; Olesen, Ingelise; Kjeldsen, Ann B

2005-01-01

OBJECTIVES AND METHODS: Three community health promotion projects have been implemented in Greenland in the municipalities of Upernavik, Ittoqqortoormiit and Qasigiannguit. Based on project reports and other written material, this paper describes experiences from the three projects and discusses...... with strong leadership and a central organisation, whereas the Qasigiannguit project was designed as a community project with population participation in all phases of the project. The two former projects have probably had a greater direct change impact on the community, whereas the latter has strengthened...

Evaluation of a PCR Assay for Detection of Streptococcus pneumoniae in Respiratory and Nonrespiratory Samples from Adults with Community-Acquired Pneumonia

Science.gov (United States)

Murdoch, David R.; Anderson, Trevor P.; Beynon, Kirsten A.; Chua, Alvin; Fleming, Angela M.; Laing, Richard T. R.; Town, G. Ian; Mills, Graham D.; Chambers, Stephen T.; Jennings, Lance C.

2003-01-01

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia. Plasma or buffy coat samples were PCR positive in only 6 of the 21 patients with positive blood cultures for S. pneumoniae and in 12 other patients (4 of whom had no other laboratory evidence of S. pneumoniae infection). Buffy coat samples from two control patients (neither having evidence of S. pneumoniae infection), but no control plasma samples, were PCR positive. Although pneumococcal antigen was detected in the urine from 120 of 420 (29%) patients, only 4 of 227 (2%) urine samples tested were PCR positive. Overall, 256 of 318 (81%) patients had PCR-positive sputum samples, including 58 of 59 samples from which S. pneumoniae was cultured. Throat swab samples from 229 of 417 (55%) patients were PCR positive and, in those who produced sputum, 96% also had positive PCR results from sputum. Throat swabs from 73 of 126 (58%) control patients were also PCR positive. We conclude that the pneumolysin PCR assay adds little to existing diagnostic tests for S. pneumoniae and is unable to distinguish colonization from infection when respiratory samples are tested. PMID:12517826

Exact fan-beam image reconstruction algorithm for truncated projection data acquired from an asymmetric half-size detector

International Nuclear Information System (INIS)

Leng Shuai; Zhuang Tingliang; Nett, Brian E; Chen Guanghong

2005-01-01

In this paper, we present a new algorithm designed for a specific data truncation problem in fan-beam CT. We consider a scanning configuration in which the fan-beam projection data are acquired from an asymmetrically positioned half-sized detector. Namely, the asymmetric detector only covers one half of the scanning field of view. Thus, the acquired fan-beam projection data are truncated at every view angle. If an explicit data rebinning process is not invoked, this data acquisition configuration will reek havoc on many known fan-beam image reconstruction schemes including the standard filtered backprojection (FBP) algorithm and the super-short-scan FBP reconstruction algorithms. However, we demonstrate that a recently developed fan-beam image reconstruction algorithm which reconstructs an image via filtering a backprojection image of differentiated projection data (FBPD) survives the above fan-beam data truncation problem. Namely, we may exactly reconstruct the whole image object using the truncated data acquired in a full scan mode (2π angular range). We may also exactly reconstruct a small region of interest (ROI) using the truncated projection data acquired in a short-scan mode (less than 2π angular range). The most important characteristic of the proposed reconstruction scheme is that an explicit data rebinning process is not introduced. Numerical simulations were conducted to validate the new reconstruction algorithm

Evaluating public participation in environmental decision-making: EPA's superfund community involvement program.

Science.gov (United States)

Susan Charnley; Bruce. Engelbert

2005-01-01

This article discusses an 8-year, ongoing project that evaluates the Environmental Protection Agency's Superfund community involvement program. The project originated as a response to the Government Performance and Results Act, which requires federal agencies to articulate program goals, and evaluate and report their progress in meeting those goals. The evaluation...

RAPID DETECTION OF PNEUMOCOCCAL ANTIGEN IN PLEURAL FLUID OF PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA

NARCIS (Netherlands)

BOERSMA, WG; LOWENBERG, A; HOLLOWAY, Y; KUTTSCHRUTTER, H; SNIJDER, JAM; KOETER, GH

Background Detection of pneumococcal antigen may help to increase the rate of diagnosis of pneumococcal pneumonia. This study was designed to determine the value of rapid detection of pneumococcal antigen in pleural fluid from patients with community acquired pneumonia. Methods Thoracentesis was

Macroinvertebrate communities evaluated prior to and following a channel restoration project in Silver Creek, Blaine County, Idaho, 2001-16

Science.gov (United States)

MacCoy, Dorene E.; Short, Terry M.

2017-11-22

The U.S. Geological Survey, in cooperation with Blaine County and The Nature Conservancy, evaluated the status of macroinvertebrate communities prior to and following a channel restoration project in Silver Creek, Blaine County, Idaho. The objective of the evaluation was to determine whether 2014 remediation efforts to restore natural channel conditions in an impounded area of Silver Creek caused declines in local macroinvertebrate communities. Starting in 2001 and ending in 2016, macroinvertebrates were sampled every 3 years at two long-term trend sites and sampled seasonally (spring, summer, and autumn) in 2013, 2015, and 2016 at seven synoptic sites. Trend-site communities were collected from natural stream-bottom substrates to represent locally established macroinvertebrate assemblages. Synoptic site communities were sampled using artificial (multi-plate) substrates to represent recently colonized (4–6 weeks) assemblages. Statistical summaries of spatial and temporal patterns in macroinvertebrate taxonomic composition at both trend and synoptic sites were completed.The potential effect of the restoration project on resident macroinvertebrate populations was determined by comparing the following community assemblage metrics:Total taxonomic richness (taxa richness);Total macroinvertebrate abundance (total abundance);Ephemeroptera, Plecoptera, Trichoptera (EPT) richness;EPT abundance;Simpson’s diversity; andSimpson’s evenness for periods prior to and following restoration.A significant decrease in one or more metric values in the period following stream channel restoration was the basis for determining impairment to the macroinvertebrate communities in Silver Creek.Comparison of pre-restoration (2001–13) and post‑restoration (2016) macroinvertebrate community composition at trend sites determined that no significant decreases occurred in any metric parameter for communities sampled in 2016. Taxa and EPT richness of colonized assemblages at synoptic sites

A Comprehensive Program to Reduce Rates of Hospital-Acquired Pressure Ulcers in a System of Community Hospitals.

Science.gov (United States)

Englebright, Jane; Westcott, Ruth; McManus, Kathryn; Kleja, Kacie; Helm, Colleen; Korwek, Kimberly M; Perlin, Jonathan B

2018-03-01

The prevention of hospital-acquired pressure ulcers (PrUs) has significant consequences for patient outcomes and the cost of care. Providers are challenged with evaluating available evidence and best practices, then implementing programs and motivating change in various facility environments. In a large system of community hospitals, the Reducing Hospital Acquired-PrUs Program was developed to provide a toolkit of best practices, timely and appropriate data for focusing efforts, and continuous implementation support. Baseline data on PrU rates helped focus efforts on the most vulnerable patients and care situations. Facilities were empowered to use and adapt available resources to meet local needs and to share best practices for implementation across the system. Outcomes were measured by the rate of hospital-acquired PrUs, as gathered from patient discharge records. The rate of hospital-acquired stage III and IV PrUs decreased 66.3% between 2011 and 2013. Of the 149 participating facilities, 40 (27%) had zero hospital-acquired stage III and IV PrUs and 77 (52%) had a reduction in their PrU rate. Rates of all PrUs documented as present on admission did not change during this period. A comparison of different strategies used by the most successful facilities illustrated the necessity of facility-level flexibility and recognition of local workflows and patient demographics. Driven by the combination of a repository of evidence-based tools and best practices, readily available data on PrU rates, and local flexibility with processes, the Reducing Hospital Acquired-PrUs Program represents the successful operationalization of improvement in a wide variety of facilities.

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

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Maja Ogielska

2015-08-01

Conclusions: CDI can cause community-acquired diarrhoea, and CA-CDI may be more severe than HCA-CDI. Prospective studies of CDI involving people from the general community without risk factors are required to confirm this observation.

Designs for Evaluating the Community-Level Impact of Comprehensive Prevention Programs: Examples from the CDC Centers of Excellence in Youth Violence Prevention.

Science.gov (United States)

Farrell, Albert D; Henry, David; Bradshaw, Catherine; Reischl, Thomas

2016-04-01

This article discusses the opportunities and challenges of developing research designs to evaluate the impact of community-level prevention efforts. To illustrate examples of evaluation designs, we describe six projects funded by the Centers for Disease Control and Prevention to evaluate multifaceted approaches to reduce youth violence in high-risk communities. Each of these projects was designed to evaluate the community-level impact of multiple intervention strategies to address individual and contextual factors that place youth at risk for violent behavior. Communities differed across projects in their setting, size, and how their boundaries were defined. Each project is using multiple approaches to compare outcomes in one or more intervention communities to those in comparison communities. Five of the projects are using comparative interrupted time-series designs to compare outcomes in an intervention community to matched comparison communities. A sixth project is using a multiple baseline design in which the order and timing of intervention activities is randomized across three communities. All six projects are also using regression point displacement designs to compare outcomes within intervention communities to those within broader sets of similar communities. Projects are using a variety of approaches to assess outcomes including archival records, surveys, and direct observations. We discuss the strengths and weaknesses of the designs of these projects and illustrate the challenges of designing high-quality evaluations of comprehensive prevention approaches implemented at the community level.

CONSORT to community: translation of an RCT to a large-scale community intervention and learnings from evaluation of the upscaled program.

Science.gov (United States)

Moores, Carly Jane; Miller, Jacqueline; Perry, Rebecca Anne; Chan, Lily Lai Hang; Daniels, Lynne Allison; Vidgen, Helen Anna; Magarey, Anthea Margaret

2017-11-29

Translation encompasses the continuum from clinical efficacy to widespread adoption within the healthcare service and ultimately routine clinical practice. The Parenting, Eating and Activity for Child Health (PEACH™) program has previously demonstrated clinical effectiveness in the management of child obesity, and has been recently implemented as a large-scale community intervention in Queensland, Australia. This paper aims to describe the translation of the evaluation framework from a randomised controlled trial (RCT) to large-scale community intervention (PEACH™ QLD). Tensions between RCT paradigm and implementation research will be discussed along with lived evaluation challenges, responses to overcome these, and key learnings for future evaluation conducted at scale. The translation of evaluation from PEACH™ RCT to the large-scale community intervention PEACH™ QLD is described. While the CONSORT Statement was used to report findings from two previous RCTs, the REAIM framework was more suitable for the evaluation of upscaled delivery of the PEACH™ program. Evaluation of PEACH™ QLD was undertaken during the project delivery period from 2013 to 2016. Experiential learnings from conducting the evaluation of PEACH™ QLD to the described evaluation framework are presented for the purposes of informing the future evaluation of upscaled programs. Evaluation changes in response to real-time changes in the delivery of the PEACH™ QLD Project were necessary at stages during the project term. Key evaluation challenges encountered included the collection of complete evaluation data from a diverse and geographically dispersed workforce and the systematic collection of process evaluation data in real time to support program changes during the project. Evaluation of large-scale community interventions in the real world is challenging and divergent from RCTs which are rigourously evaluated within a more tightly-controlled clinical research setting. Constructs

Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up

Science.gov (United States)

Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

2017-01-01

Abstract Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection. Design Cohort study. Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02. Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060). Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses. Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients. Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes

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

Functional status and mortality prediction in community-acquired pneumonia.

Science.gov (United States)

Jeon, Kyeongman; Yoo, Hongseok; Jeong, Byeong-Ho; Park, Hye Yun; Koh, Won-Jung; Suh, Gee Young; Guallar, Eliseo

2017-10-01

Poor functional status (FS) has been suggested as a poor prognostic factor in both pneumonia and severe pneumonia in elderly patients. However, it is still unclear whether FS is associated with outcomes and improves survival prediction in community-acquired pneumonia (CAP) in the general population. Data on hospitalized patients with CAP and FS, assessed by the Eastern Cooperative Oncology Group (ECOG) scale were prospectively collected between January 2008 and December 2012. The independent association of FS with 30-day mortality in CAP patients was evaluated using multivariable logistic regression. Improvement in mortality prediction when FS was added to the CRB-65 (confusion, respiratory rate, blood pressure and age 65) score was evaluated for discrimination, reclassification and calibration. The 30-day mortality of study participants (n = 1526) was 10%. Mortality significantly increased with higher ECOG score (P for trend <0.001). In multivariable analysis, ECOG ≥3 was strongly associated with 30-day mortality (adjusted OR: 5.70; 95% CI: 3.82-8.50). Adding ECOG ≥3 significantly improved the discriminatory power of CRB-65. Reclassification indices also confirmed the improvement in discrimination ability when FS was combined with the CRB-65, with a categorized net reclassification index (NRI) of 0.561 (0.437-0.686), a continuous NRI of 0.858 (0.696-1.019) and a relative integrated discrimination improvement in the discrimination slope of 139.8 % (110.8-154.6). FS predicted 30-day mortality and improved discrimination and reclassification in consecutive CAP patients. Assessment of premorbid FS should be considered in mortality prediction in patients with CAP. © 2017 Asian Pacific Society of Respirology.

Diagnostic and prognostic accuracy of clinical and laboratory parameters in community-acquired pneumonia

Directory of Open Access Journals (Sweden)

Nusbaumer Charly

2007-03-01

Full Text Available Abstract Background Community-acquired pneumonia (CAP is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP. Methods 545 patients with suspected lower respiratory tract infection, admitted to the emergency department of a university hospital were included in a pre-planned post-hoc analysis of two controlled intervention trials. Baseline assessment included history, clinical examination, radiography and measurements of procalcitonin (PCT, highly sensitive C-reactive protein (hsCRP and leukocyte count. Results Of the 545 patients, 373 had CAP, 132 other respiratory tract infections, and 40 other final diagnoses. The AUC of a clinical model including standard clinical signs and symptoms (i.e. fever, cough, sputum production, abnormal chest auscultation and dyspnea to diagnose CAP was 0.79 [95% CI, 0.75–0.83]. This AUC was significantly improved by including PCT and hsCRP (0.92 [0.89–0.94]; p Conclusion PCT, and to a lesser degree hsCRP, improve the accuracy of currently recommended approaches for the diagnosis of CAP, thereby complementing clinical signs and symptoms. PCT is useful in the severity assessment of CAP.

Project H.O.P.E.: Effective University Engagement with Community Afterschool Programs

Directory of Open Access Journals (Sweden)

Barbara C. Jentleson

2009-09-01

Full Text Available Implemented in 2002 by the Duke-Durham Neighborhood Partnership, Project H.O.P.E. has improved the quantity and quality of afterschool programs for the youth of Durham, NC. Project H.O.P.E. provides tutoring programs, enrichment resources, and evaluation support to non-profit community partner organizations located in the low income Durham neighborhoods surrounding Duke University. Duke University undergraduates who provide tutoring services to the Durham youth in the afterschool programs gain from valuable reciprocal service learning experiences. Project H.O.P.E. is an effective model of the mutual benefits that can be gained from effective university and community engagement in the service of at-risk students.

Reaching Residents of Green Communities: Evaluation of a Unique Environmental Education Program

Science.gov (United States)

Hostetler, Mark; Swiman, Elizabeth; Prizzia, Anna; Noiseux, Krystal

2008-01-01

Often in green communities, homeowner understanding is left out of the project. We evaluated the impact of a new environmental education program installed in a green community, Town of Harmony, Florida. Consisting of educational kiosks, website, and brochure, we evaluated whether Harmony residents' environmental knowledge, attitudes, and behaviors…

Computed tomography in children with community-acquired pneumonia.

Science.gov (United States)

Andronikou, Savvas; Goussard, Pierre; Sorantin, Erich

2017-10-01

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns.

Computed tomography in children with community-acquired pneumonia

Energy Technology Data Exchange (ETDEWEB)

Andronikou, Savvas [Bristol Royal Hospital for Children and the University of Bristol, Department of Paediatric Radiology, Bristol (United Kingdom); University of Cape Town, Department of Radiology, Cape Town (South Africa); Goussard, Pierre [Tygerberg Hospital, Stellenbosch University, Department of Paediatrics and Child Health, Cape Town (South Africa); Sorantin, Erich [Medical University Graz, Department of Radiology, Graz (Austria)

2017-10-15

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns. (orig.)

Severe community-acquired pneumonia caused by Mycoplasma pneumoniae in young female patient

Directory of Open Access Journals (Sweden)

Milačić Nena

2015-07-01

Full Text Available Mycoplasma pneumonia is common agent causing community acquired pneumonia in younger population. However, the course of illness is usually benign and is rarely associated with pulmonary complications. We report a 27 years old female patient with unilateral pneumonia followed by pleural effusion and adhesions on the same side. This potential source of infection should be considered in young patients where resolution of symptoms from pneumonia is delayed.

Detection of IgM and IgG antibodies to Chlamydophila pneumoniae in pediatric community-acquired lower respiratory tract infections

Directory of Open Access Journals (Sweden)

Surinder Kumar

2011-01-01

Full Text Available Context: Chlamydophila pneumoniae (C. pneumoniae is an emerging infectious agent with a spectrum of clinical manifestations including lower and upper respiratory tract infections. Aims: To investigate the role of C. pneumoniae in community-acquired lower respiratory tract infections (LRTIs in children using serological tests. Settings and Design: Two hundred children, age 2 months to 12 years, hospitalized for community-acquired LRTIs were investigated for C. pneumoniae etiology. Materials and Methods: We investigated 200 children hospitalized for community-acquired LRTIs, using ELISA for detecting anti-C. pneumoniae IgM and IgG antibodies. The demographic, clinical and radiological findings for C. pneumoniae antibody positive and C. pneumoniae antibody negative cases were compared. Statistical Analysis Used: Data analysis was performed by Chi-square test and Fisher′s exact tests using Epi Info (2002. Results: Clinical and radiological findings in both the groups were comparable. Serological evidence of C. pneumoniae infection was observed in 12 (6% patients; specific IgM antibodies were detected in 11 (91.67%; specific IgG antibodies in 1 (8.33% patients, while 4-fold rise in C. pneumoniae IgG antibody titers were noted in none of the patients. Conclusions: C. pneumoniae has a role in community-acquired LRTIs, even in children aged < 5 years. Serological detection using ELISA would enable pediatricians in better management of C. pneumoniae infections.

Detection of CTX-M-15 beta-lactamases in Enterobacteriaceae causing hospital- and community-acquired urinary tract infections as early as 2004, in Dar es Salaam, Tanzania.

Science.gov (United States)

Manyahi, Joel; Moyo, Sabrina J; Tellevik, Marit Gjerde; Ndugulile, Faustine; Urassa, Willy; Blomberg, Bjørn; Langeland, Nina

2017-04-17

The spread of Extended Spectrum β-lactamases (ESBLs) among Enterobacteriaceae and other Gram-Negative pathogens in the community and hospitals represents a major challenge to combat infections. We conducted a study to assess the prevalence and genetic makeup of ESBL-type resistance in bacterial isolates causing community- and hospital-acquired urinary tract infections. A total of 172 isolates of Enterobacteriaceae were collected in Dar es Salaam, Tanzania, from patients who met criteria of community and hospital-acquired urinary tract infections. We used E-test ESBL strips to test for ESBL-phenotype and PCR and sequencing for detection of ESBL genes. Overall 23.8% (41/172) of all isolates were ESBL-producers. ESBL-producers were more frequently isolated from hospital-acquired infections (32%, 27/84 than from community-acquired infections (16%, 14/88, p Enterobacteriaceae causing both hospital- and community-acquired infections in Tanzania.

Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers.

Science.gov (United States)

Leerlooijer, Joanne N; Bos, Arjan E R; Ruiter, Robert A C; van Reeuwijk, Miranda A J; Rijsdijk, Liesbeth E; Nshakira, Nathan; Kok, Gerjo

2013-09-08

A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda empowers unmarried teenage mothers to cope with the consequences of early pregnancy and motherhood. Since 2000, 1036 unmarried teenage mothers, their parents, and community leaders participated in economic and social empowerment interventions. The present study explored the changes resulting from the TMP as well as factors that either enabled or inhibited these changes. Semi-structured interviews (N = 23) were conducted with former teenage mothers , community leaders, and project implementers, and lifeline histories were obtained from former teenage mothers (N = 9). Quantitative monitoring data regarding demographic and social characteristics of teenage mother participants (N = 1036) were analysed. The findings suggest that, overall, the TMP seems to have contributed to the well-being of unmarried teenage mothers and to a supportive social environment. It appears that the project contributed to supportive community norms towards teenage mothers' position and future opportunities, increased agency, improved coping with early motherhood and stigma, continued education, and increased income generation by teenage mothers. The study findings also suggest limited change in disapproving community norms regarding out-of-wedlock sex and pregnancy, late active enrolment of teenage mothers in the project (i.e., ten months after delivery of the child), and differences in the extent to which parents provided support. It is concluded that strengths of the community-based TMP seem to be its socio-ecological approach, the participatory planning with community leaders and other stakeholders, counselling of parents and unmarried teenage mothers, and the emphasis on education and income

Exploring Community Stakeholders' Perceptions of the Enhancing Family Well-being Project in Hong Kong: A Qualitative Study.

Science.gov (United States)

Chu, Joanna T W; Chan, Sophia S; Stewart, Sunita M; Zhou, Qianling; Leung, Charles Sai-Cheong; Wan, Alice; Lam, Tai Hing

2017-01-01

Community engagement is a powerful tool in bringing about positive social and community change. Community stakeholders possess critical experience and knowledge that are needed to inform the development of community-based projects. However, limited literature is available on the practical experience involved with planning and implementing community-based family programs. Even less has been published documenting efforts in Chinese communities. This paper explores community stakeholders' experiences with the enhancing family well-being project-part of a citywide project entitled the "FAMILY Project," aimed at promoting family health, happiness, and harmony in Hong Kong. This qualitative evaluation examined the perspectives of community stakeholders. Four focus groups with social workers ( n  = 24) and six in-depth interviews with steering committee members were conducted from December 2012 to May 2013 in Hong Kong. Focus groups and in-depths interview were audiotaped, transcribed, and analyzed using thematic analysis techniques. Rich accounts were given by our respondents on various aspects of the project. Main themes and subthemes were identified and grouped into four categories (project conception, project implementation, project consolidation, and the overall impact of the project). Respondents described the practical challenges associated with the project (e.g., recruitment, balancing scientific research, and lack of resources) and identified the elements that are important to the success of the project. These included the commitment to a shared goal, multi-agency collaboration, and a platform for knowledge exchange. Finally, respondents perceived benefits of the project at both the individual and community level. Our project sheds light on many of the practical considerations and challenges associated with a designing and implementing a community-based family intervention project. Community stakeholders input provided important information on their perceived

Evaluation of Patients with Community-Acquired Pneumonia Caused by Zoonotic Pathogens in an Area with a High Density of Animal Farms.

Science.gov (United States)

Huijskens, E G W; Smit, L A M; Rossen, J W A; Heederik, D; Koopmans, M

2016-03-01

Intensive animal farming could potentially lead to outbreaks of infectious diseases. Clinicians are at the forefront of detecting unusual diseases, but the lack of specificity of zoonotic disease symptoms makes this a challenging task. We evaluated patients with community-acquired pneumonia (CAP) with known and unknown aetiology in an area with a high livestock density and a potential association with animal farms in the proximity. Between 2008 and 2009, a period coinciding with a large Q fever outbreak in the Netherlands, patients with CAP were tested for the presence of possible respiratory pathogens. The presence and number of farm animals within 1 km of the patients' home address were assessed using geographic information system (GIS) and were compared between cases and age-matched control subjects. Of 408 patients with CAP, pathogens were detected in 275 (67.4%) patients. The presence of sheep and the number of goats were associated with CAP caused by Coxiella burnetii in a multiple logistic regression model (P 0.10). The use of GIS in combination with aetiology of CAP could be potentially used to target diagnostics and to identify outbreaks of rare zoonotic disease. © 2015 Blackwell Verlag GmbH.

Long-Term Cognitive Impairment after Hospitalization for Community-Acquired Pneumonia: a Prospective Cohort Study.

Science.gov (United States)

Girard, Timothy D; Self, Wesley H; Edwards, Kathryn M; Grijalva, Carlos G; Zhu, Yuwei; Williams, Derek J; Jain, Seema; Jackson, James C

2018-06-01

Recent studies suggest older patients hospitalized for community-acquired pneumonia are at risk for new-onset cognitive impairment. The characteristics of long-term cognitive impairment after pneumonia, however, have not been elucidated. To characterize long-term cognitive impairment among adults of all ages hospitalized for community-acquired pneumonia. Prospective cohort study. Adults without severe preexisting cognitive impairment who were hospitalized with community-acquired pneumonia. At enrollment, we estimated baseline cognitive function with the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). At 2- and 12-month follow-up, we assessed cognition using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and tests of executive function, diagnosing cognitive impairment when results were ≥ 1.5 standard deviations below published age-adjusted means for the general population. We also identified subtypes of mild cognitive impairment using standard definitions. We assessed 58 (73%) of 80 patients who survived to 2-month follow-up and 57 (77%) of 74 who survived to 12-month follow-up. The median [range] age of survivors tested was 57 [19-97] years. Only 8 (12%) had evidence of mild cognitive impairment at baseline according to the Short IQCODE, but 21 (38%) at 2 months and 17 (30%) at 12 months had mild cognitive impairment per the RBANS. Moderate-to-severe cognitive impairment was common among adults ≥ 65 years [4/13 (31%) and 5/13 (38%) at 2 and 12 months, respectively] but also affected many of those cognitive domains affected one-third of patients ≥ 65 years old and 20% of younger patients, and another third of survivors had mild cognitive impairment.

Formative Evaluation of a Nutritional Marketing Project in City-Center Restaurants.

Science.gov (United States)

Demers, Andree; Renaud, Lise

1992-01-01

Formative evaluation of a community health project providing and promoting low-fat foods in five restaurants in Montreal (Canada) shows that restaurateurs are willing to collaborate in project implementation but not in training waiters and that the project did not cause an increase in market demand for low-fat menu offerings. (SLD)

Collaborating with consumer and community representatives in health and medical research in Australia: results from an evaluation

Directory of Open Access Journals (Sweden)

Bartu Anne E

2011-05-01

Full Text Available Abstract Objective To collaborate with consumer and community representatives in the Alcohol and Pregnancy Project from 2006-2008 http://www.ichr.uwa.edu.au/alcoholandpregnancy and evaluate researchers' and consumer and community representatives' perceptions of the process, context and impact of consumer and community participation in the project. Methods We formed two reference groups and sought consumer and community representatives' perspectives on all aspects of the project over a three year period. We developed an evaluation framework and asked consumer and community representatives and researchers to complete a self-administered questionnaire at the end of the project. Results Fifteen researchers (93.8% and seven (53.8% consumer and community representatives completed a questionnaire. Most consumer and community representatives agreed that the process and context measures of their participation had been achieved. Both researchers and consumer and community representatives identified areas for improvement and offered suggestions how these could be improved for future research. Researchers thought consumer and community participation contributed to project outputs and outcomes by enhancing scientific and ethical standards, providing legitimacy and authority, and increasing the project's credibility and participation. They saw it was fundamental to the research process and acknowledged consumer and community representatives for their excellent contribution. Consumer and community representatives were able to directly influence decisions about the research. They thought that consumer and community participation had significant influence on the success of project outputs and outcomes. Conclusions Consumer and community participation is an essential component of good research practice and contributed to the Alcohol and Pregnancy Project by enhancing research processes, outputs and outcomes, and this participation was valued by community and

Collaborating with consumer and community representatives in health and medical research in Australia: results from an evaluation.

Science.gov (United States)

Payne, Janet M; D'Antoine, Heather A; France, Kathryn E; McKenzie, Anne E; Henley, Nadine; Bartu, Anne E; Elliott, Elizabeth J; Bower, Carol

2011-05-14

To collaborate with consumer and community representatives in the Alcohol and Pregnancy Project from 2006-2008 http://www.ichr.uwa.edu.au/alcoholandpregnancy and evaluate researchers' and consumer and community representatives' perceptions of the process, context and impact of consumer and community participation in the project. We formed two reference groups and sought consumer and community representatives' perspectives on all aspects of the project over a three year period. We developed an evaluation framework and asked consumer and community representatives and researchers to complete a self-administered questionnaire at the end of the project. Fifteen researchers (93.8%) and seven (53.8%) consumer and community representatives completed a questionnaire. Most consumer and community representatives agreed that the process and context measures of their participation had been achieved. Both researchers and consumer and community representatives identified areas for improvement and offered suggestions how these could be improved for future research. Researchers thought consumer and community participation contributed to project outputs and outcomes by enhancing scientific and ethical standards, providing legitimacy and authority, and increasing the project's credibility and participation. They saw it was fundamental to the research process and acknowledged consumer and community representatives for their excellent contribution. Consumer and community representatives were able to directly influence decisions about the research. They thought that consumer and community participation had significant influence on the success of project outputs and outcomes. Consumer and community participation is an essential component of good research practice and contributed to the Alcohol and Pregnancy Project by enhancing research processes, outputs and outcomes, and this participation was valued by community and consumer representatives and researchers. The National Health and

Community-acquired bacterial meningitis in elderly patients: experience over 30 years.

Science.gov (United States)

Cabellos, Carmen; Verdaguer, Ricard; Olmo, Montse; Fernández-Sabé, Nuria; Cisnal, Maria; Ariza, Javier; Gudiol, Francesc; Viladrich, Pedro F

2009-03-01

Clinical characteristics, etiologies, evolution, and prognostic factors of community-acquired bacterial meningitis in elderly patients are not well known. To improve this knowledge, all episodes of community-acquired bacterial meningitis were prospectively recorded and cases occurring in patients >or=65 years old were selected. During the period 1977-2006, 675 episodes in adults (aged >or=18 yr) were recorded, with 185 (27%) in patients aged >or=65 years old; 76 were male and 109 were female, with a mean age of 73 +/- 6 years (range, 65-93 yr). Causative microorganisms were Streptococcus pneumoniae 74, Neisseria meningitidis 49, Listeria monocytogenes 17, other streptococcal 9, Escherichia coli 6, Haemophilus influenzae 4, Klebsiella pneumoniae and Staphylococcus aureus 2 each, Capnocytophaga canimorsus and Enterococcus faecalis 1 each, and unknown in 20. On admission 91% had had fever, 32% were in a coma (Glasgow Coma Scale or=65 yr), who showed a higher frequency of diabetes and malignancy as underlying disease; pneumonia, otitis, and pericranial fistula as predisposing factors; and S. pneumoniae and L. monocytogenes as etiology. There were also differences in clinical presentation, complications, sequelae, and mortality. Factors independently related with mortality were age, pneumonia as a predisposing factor, coma on admission, and heart failure and seizures after therapy. Dexamethasone therapy was a protective factor. In conclusion, bacterial meningitis in elderly patients is associated with greater diagnostic difficulties and neurologic severity and more complications, as well as with increased mortality. Antiseizure prophylaxis might be useful in these patients.

Iterative reconstruction with attenuation compensation from cone-beam projections acquired via nonplanar orbits

International Nuclear Information System (INIS)

Zeng, G.L.; Weng, Y.; Gullberg, G.T.

1997-01-01

Single photon emission computed tomography (SPECT) imaging with cone-beam collimators provides improved sensitivity and spatial resolution for imaging small objects with large field-of-view detectors. It is known that Tuy's cone-beam data sufficiency condition must be met to obtain artifact-free reconstructions. Even though Tuy's condition was derived for an attenuation-free situation, the authors hypothesize that an artifact-free reconstruction can be obtained even if the cone-beam data are attenuated, provided the imaging orbit satisfies Tuy's condition and the exact attenuation map is known. In the authors' studies, emission data are acquired using nonplanar circle-and-line orbits to acquire cone-beam data for tomographic reconstructions. An extended iterative ML-EM (maximum likelihood-expectation maximization) reconstruction algorithm is derived and used to reconstruct projection data with either a pre-acquired or assumed attenuation map. Quantitative accuracy of the attenuation corrected emission reconstruction is significantly improved

Mitigation of socio-economic impacts due to the construction of energy projects in rural communities: an evaluation of the Hartsville nuclear power plant transportation-mitigation program

International Nuclear Information System (INIS)

Whitney, T.C.

1982-01-01

This study analyzes the effects of a commuter ride-sharing program in mitigating the harmful socio-economic impacts of a short-term, labor-intensive nuclear-power-plant construction project. The major hypothesis is that transportation-mitigation programs are more cost-effective in reducing the undesirable socio-economic impacts of large-scale construction projects than programs designed to mitigate impacts through the provision of public services for migrating workers. The dissertation begins by delineating the socio-economic effects of large-scale construction projects in rural areas. It proceeds to show how some of the deleterious impacts were mitigated using a commuter ride-sharing program. After the range of potential socio-economic impacts was established, a framework was developed to evaluate the effects of the transportation-mitigation program in mediating the harmful impacts. The framework involved the integration of the cost-benefit technique with social-impact assessment. The evaluation was grounded in a comparative framework whereby the Hartsville project community was compared with a similar community undergoing the construction of a nuclear power plant but without a commuter ride-sharing program, and a community not experiencing a major construction project. The research findings indicated that the transportation-mitigation program substantially reduced the in-migration of construction workers into the Hartsville-Trousdale County area. Further, the program was cost effective, with a benefit-cost ratio of 2.5 and net benefits totalling 28 million dollars

A case of community-acquired Acinetobacter baumannii meningitis - has the threat moved beyond the hospital?

NARCIS (Netherlands)

Lowman, Warren; Kalk, Thomas; Menezes, Colin N.; John, Melanie A.; Grobusch, Martin P.

2008-01-01

Acinetobacter baumannii is a prolific nosocomial pathogen renowned for its multidrug-resistant nature. We report a case of community-acquired meningitis due to A. baumannii. The case highlights the potential pathogenicity of this organism and raises concerns that this highly adaptable organism may

CHLAMYDIA PNEUMONIAE – THE PREVALENCE OF ANTIBODIES IN HEALTHY POPULATION AND IN PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA

Directory of Open Access Journals (Sweden)

Darja Keše

2001-06-01

Full Text Available Background. To determinate the prevalence rates of Chlamydia pneumoniae infections in Slovenia and to evaluate the importance of C. pneumoniae infections at patients with community acquired pneumonia (CAP.Materials and methods. With the microimmunofluorescence test (micro-IF we evaluated the presence of C. pneumoniae specific antibodies in 1036 healthy subjects, in two periods of time, in 1991–93 and 1997–1998. We also tested the pair sera collected from 2118 patients with CAP between 1993–1999.Results. We demonstrated that C. pneumoniae infections are common in our population, as we detected IgG antibodies in 43.1% of healthy population. The prevalence rate of C. pneumoniae infections statistically significant increased in two periods of time. Acute C. pneumoniae infections were proved in 15.9% of all patients with CAP.Conclusions. C. pneumoniae is important respiratory pathogen also in our community. The infections are more common in older patients. Because C. pneumoniae like other Chlamydia species has tendency to cause chronic disease, it is reasonable to diagnose this bacterium in respiratory patients. It is also recommended to test convalescent sera at serologic laboratory diagnosis.

Undergraduate nursing students' perceptions of service-learning through a school-based community project.

Science.gov (United States)

Bassi, Sherry

2011-01-01

Service-learning (SL) is an experiential teaching method that combines instruction with community service, with the aim of enriching students' academic learning, interpersonal skills and sense of responsibility while making meaningful contributions to the community. However, measuring outcomes of service-learning projects is difficult. This article reports on the perceptions of 18 third-year undergraduate nursing students who took part in a pilot service-learning project targeting tobacco use in a local elementary school. Faculty members evaluated the program's outcomes by engaging students in structured reflection on the program about its relevance to their future careers as practicing professionals, especially in community-based settings. The students' perceptions were elicited through three sets of reflective assignments following the project. Findings from the reflective assignments suggest that the pilot program was successful in enhancing the students' academic, social, and personal development while building a partnership between the school of nursing and key players in the community, including school-based nurses, teachers, administrators, families, and community leaders. The author suggests that service-learning projects can help nursing students accomplish key developmental tasks of the college years (such as building their competence, autonomy, and integrity), while helping impart the skills and values they will need as they graduate and seek professional nursing roles.

On Community Education and Community Development

Directory of Open Access Journals (Sweden)

Dušana Findeisen

1996-12-01

Full Text Available In this paper Dušana Findeisen introduces community education and development. She particularly insists upon the fact that in the future our life will not be organised around a paid full time job and that we will be forced into searching other ways of getting involved into society and to acquire our social identity. Community education is one of the ways we could eventually choose. Since community development education in Slovenia has not developed yet the author begins by describing some basic concepts like community and history of community education and community development movement. Further on, she introduces the Andragogical Summer School based in a small Slovenian town, its aim being to encourage Slovenian adult educators to encourage community development projects.

Prospective evaluation of biomarkers for prediction of quality of life in community-acquired pneumonia.

Science.gov (United States)

Nickler, Manuela; Schaffner, Daniela; Christ-Crain, Mirjam; Ottiger, Manuel; Thomann, Robert; Hoess, Claus; Henzen, Christoph; Mueller, Beat; Schuetz, Philipp

2016-11-01

Most clinical research investigated prognostic biomarkers for their ability to predict cardiovascular events or mortality. It is unknown whether biomarkers allow prediction of quality of life (QoL) after survival of the acute event. Herein, we investigated the prognostic potential of well-established inflammatory/cardiovascular blood biomarkers including white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), pro-adrenomedullin (proADM) and pro-atrial natriuretic peptide (proANP) in regard to a decline in QoL in a well-defined cohort of patients with community-acquired pneumonia (CAP). Within this secondary analysis including 753 patients with a final inpatient diagnosis of CAP from a multicenter trial, we investigated associations between admission biomarker levels and decline in QoL assessed by the EQ-5D health questionnaire from admission to day 30 and after 6 years. Admission proADM and proANP levels significantly predicted decline of the weighted EQ-5D index after 30 days (n=753) with adjusted odds ratios (ORs) of 2.0 ([95% CI 1.1-3.8]; p=0.027) and 3.7 ([95% CI 2.2-6.0]; pscale (VAS). Initial WBC, PCT and CRP values did not well predict QoL at any time point. ProADM and proANP accurately predict short- and long-term decline in QoL across most dimensions in CAP patients. It will be interesting to reveal underlying physiopathology in future studies.

Community Solar Value Project

Energy Technology Data Exchange (ETDEWEB)

Powers, John T [Extensible Energy; Cliburn, Jill [Cliburn and Associates

2017-11-30

The Community Solar Value Project (CSVP) is designed to assist electric utilities in designing better community solar programs. Better programs seek new sources of value to promote “win-win” solutions between utilities and their customers. The CSVP focused on five “challenge areas” in identifying new sources of value: - Strategic solar design for community solar projects (including technology choices, siting, orientation, and related issues) - Market research and targeted marketing approaches (for program design and for customer recruitment) - Procurement and financing (for establishing best practices that can bring economies of scale and economies of expertise) - Integration of “companion measures” (such as storage and demand-response options that can benefit customer and utility net load shapes) - Pricing in program design (including best practices for integration of identified value in program prices or credits) The CSVP directly engaged the Sacramento Municipal Utility District (SMUD), the Public Service Company of New Mexico (PNM), and more than a dozen other utilities to develop improved community solar program designs. The outcomes include a plan at SMUD for over 100 MW or more of community and shared solar and support for new or expanded programs at 15 other utilities so far. Resulting best-practice solutions have not only informed program applications, but also have generated discussion among experts and industry associations about the new opportunities and challenges CSVP has brought forth. In these ways, the CSVP has impacted community solar programs and DER plans, competitive innovations and policies nationwide. The CSVP team has been led by Extensible Energy under John Powers, President and CEO. Jill Cliburn, of Santa Fe, NM-based Cliburn and Associates, has served as Principal Investigator. The team also benefitted from expertise from Navigant, Olivine Inc. and Millennium Energy, LLC, in addition to the collaborative and cost

Early versus late diagnosis in community-acquired bacterial meningitis

DEFF Research Database (Denmark)

Bodilsen, J; Brandt, C T; Sharew, A

2018-01-01

OBJECTIVES: To examine clinical characteristics and outcome of patients with late diagnosis of community-acquired bacterial meningitis (CABM). METHODS: We conducted a chart review of all adults with proven CABM in three centres in Denmark from 1998 through to 2014. Patients were categorized...... as early diagnosis of CABM immediately on admission, or late diagnosis if CABM was not listed in referral or admission records and neither lumbar puncture nor antibiotic therapy for meningitis was considered immediately on admission. We used modified Poisson regression analysis to compute adjusted relative...... differences (p 65 years (56/113, 50% versus 67/245, 27%), neck stiffness (35/97, 36% versus 183/234, 78%), concomitant pneumonia (26/113, 23% versus 26/245, 11%), and meningococcal meningitis (6/113, 5% versus 52/245, 21%). These variables...

An evaluation of University of Cape Town medical students’ community placements in South Africa

Directory of Open Access Journals (Sweden)

Claudia S. Naidu

2012-11-01

Objectives: This study evaluated the placements as a learning experience from the perspectives of past students and community stakeholders. Methods: A total of 32 projects were randomly selected out of 232 projects undertaken during 2006, 2008 and 2009. Two students and a stakeholder involved with each project were sampled. A standardised survey was emailed to students and in-depth interviews were held with stakeholders. Results: Fifty two per cent of 64 students and 57% of 25 stakeholders responded. Most students felt that the placements enhanced their academic experience and confidence in research skills, and were an effective form of learning. Perceived challenges included time constraints and, for a minority, inadequately prepared settings and stakeholders. Stakeholders felt that the placements empowered the communities and prepared students for the realities of working as a medical professional. They viewed students as a valuable resource and believed that student projects addressed important community myths and health problems. Recommendations from students and stakeholders included more time for the Public Health block, followup interventions for greater continuity, and better alignment of projects with stakeholder programmes. Conclusion: The evaluation reveals both the importance and challenges of community placements and identifies areas of improvement. Despite the limited duration of the placements, they offered valuable community-based learning experiences for the students and worthwhile benefits for the communities.

Perceptions of community-based field workers on the effect of a longitudinal biomedical research project on their sustainable livelihoods

Directory of Open Access Journals (Sweden)

Christabelle S. Moyo

2017-03-01

, biomedical research project, had positive effects on tangible and intangible assets that compose the sustainable livelihoods of community-based fieldworkers. However, the field workers expressed the need to acquire social skills to enable them carry out their duties more efficiently.

Energy Efficient Community Development in California: Chula Vista Research Project

Energy Technology Data Exchange (ETDEWEB)

Gas Technology Institute

2009-03-31

energy utility networks; (d) Alternative land-use design and development options and their impact on energy efficiency and urban runoff, emissions and the heat island effect; and (e) Alternative transportation and mobility options and their impact on local emissions. (2) Creating Energy-Efficient Communities in California: A Reference Guide to Barriers, Solutions and Resources report provides the results of an effort to identify the most innovative existing and emerging public policy, incentive and market mechanisms that encourage investment in advanced energy technologies and enabling community design options in the State of California and the nation. The report evaluates each of these mechanisms in light of the preceding research and concludes with a set of recommended mechanisms designed for consideration by relevant California State agencies, development and finance industry associations, and municipal governments. (3) Creating Energy-Efficient Communities in California: A Technical Reference Guide to Building and Site Design report contains a set of selected commercially viable energy technology and community design options for high-efficiency, low-impact community development in California. It includes a summary of the research findings referenced above and recommendations for energy technology applications and energy-efficient development strategies for residential, commercial and institutional structures and supporting municipal infrastructure for planned communities. The document also identifies design options, technology applications and development strategies that are applicable to urban infill projects.

Phenotypic and molecular characterization of Klebsiella spp. isolates causing community-acquired infections

Directory of Open Access Journals (Sweden)

U. Garza-Ramos

2018-05-01

Full Text Available Klebsiella spp. isolates from community-acquired infections were characterized. A total of 39 Klebsiella spp. isolates were obtained from outpatients at four rural hospitals in Mexico (2013–2014. The biochemical tests identified all as being K. pneumoniae. The molecular multiplex-PCR test identified 36 (92.4% K. pneumoniae isolates and one (2.5% K. variicola isolate, and phylogenetic analysis of the rpoB gene identified two isolates (5.1% belonging to K. quasipneumoniae subsp. quasipneumoniae and K. quasivariicola. The last one was confirmed by phylogenetic analysis of six-loci concatenated genes. Mostly the isolates were multidrug resistant; however, a minority were extended-spectrum β-lactamase producing (10.2%. The extended-spectrum β-lactamase CTX-M-15 gene was identified in these isolates. Analysis of biofilm production and the hypermucoviscosity phenotype showed a total of 35 (92.3% and seven (17.9% of the isolates were positive for these phenotypes respectively. The K2 (4/39, 10.2%, K5 (2/39, 5.1% and K54 (1/39, 2.5% serotypes were identified in seven (17.9% of the isolates, and only 28.5% (2/7 hypermucoviscous isolates were positive for the K2 and K5 serotypes. In general, the sequence type (ST analysis and phylogenetic analysis of seven multilocus sequence typing loci were heterogeneous; however, ST29 was the most prevalent ST in the analysed isolates, accounting for 19% (4/21 of the total isolates. Two of the four ST29 isolates had the hypermucoviscosity phenotype. The virulence factors for fimbriae were the most prevalent, followed by siderophores. Community-acquired infections are caused by various species from Klebsiella genus, with different profiles of antibiotic resistance and heterogeneous virulence factors. Keywords: Antimicrobial susceptibility, Bacterial resistance, Cephalosporin resistance, Community infection, ESBL, Hypermucoviscosity

Hospital Resource Utilisation by Patients with Community-Acquired Pneumonia

LENUS (Irish Health Repository)

McCarthy, S

2017-09-01

Little data is available on the resource utilisation of patients admitted with Community-Acquired Pneumonia (CAP) in Ireland. A retrospective review of 50 randomly-selected patients admitted to Beaumont Hospital with CAP was undertaken. The mean length of stay of patients with CAP was 12 days (+\\/- 16 days). All patients were emergency admissions, all had a chest x-ray, a C-reactive protein blood test, and occupied a public bed at some point during admission. Common antimicrobial therapies were intravenous (IV) amoxicillin\\/clavulanic acid and oral clarithromycin; 60% received physiotherapy. The estimated mean cost of CAP per patient was €14,802.17. Costs arising from admission to hospital with CAP are substantial, but efforts can be undertaken to ensure that resources are used efficiently to improve patient care such as discharge planning and fewer in-hospital ward transfers

The Childhood Obesity Declines Project: Implications for Research and Evaluation Approaches.

Science.gov (United States)

Young-Hyman, Deborah; Morris, Kathryn; Kettel Khan, Laura; Dawkins-Lyn, Nicola; Dooyema, Carrie; Harris, Carole; Jernigan, Jan; Ottley, Phyllis; Kauh, Tina

2018-03-01

Childhood obesity remains prevalent and is increasing in some disadvantaged populations. Numerous research, policy and community initiatives are undertaken to impact this pandemic. Understudied are natural experiments. The need to learn from these efforts is paramount. Resulting evidence may not be readily available to inform future research, community initiatives, and policy development/implementation. We discuss the implications of using an adaptation of the Systematic Screening and Assessment (SSA) method to evaluate the Childhood Obesity Declines (COBD) project. The project examined successful initiatives, programs and policies in four diverse communities which were concurrent with significant declines in child obesity. In the context of other research designs and evaluation schemas, rationale for use of SSA is presented. Evidence generated by this method is highlighted and guidance suggested for evaluation of future studies of community-based childhood obesity prevention initiatives. Support for the role of stakeholder collaboratives, in particular the National Collaborative on Childhood Obesity Research, as a synergistic vehicle to accelerate research on childhood obesity is discussed. SSA mapped active processes and provided contextual understanding of multi-level/component simultaneous efforts to reduce rates of childhood obesity in community settings. Initiatives, programs and policies were not necessarily coordinated. And although direct attribution of intervention/initiative/policy components could not be made, the what, by who, how, to whom was temporally associated with statistically significant reductions in childhood obesity. SSA provides evidence for context and processes which are not often evaluated in other data analytic methods. SSA provides an additional tool to layer with other evaluation approaches.

A case of newborn with community acquired pneumonia caused by Cupriavidus pauculus.

Science.gov (United States)

Aydın, Banu; Dilli, Dilek; Zenciroğlu, Ayşegül; Okumuş, Nurullah; Ozkan, Sengül; Tanır, Gönül

2012-01-01

Cupriavidus pauculus is a gram-negative, aerobic, non-spore forming, non-fermentative motile bacillus. The bacillus can be isolated from water, bottled mineral water, and water from ultrafiltration systems in hospital setting. C. pauculus rarely causes human infections, however it may be an infectious agent especially in immunocompromised individuals. In this report, we present the first case of community acquired pneumonia caused by C. pauculus in a previously healthy newborn who was hospitalized in neonatal intensive care unit on postnatal day 16 because of respiratory distress.

Short- and long-term mortality in patients with community-acquired severe sepsis and septic shock

DEFF Research Database (Denmark)

Storgaard, Merete; Hallas, Jesper; Gahrn-Hansen, Bente

2013-01-01

Background: Severe sepsis and septic shock have a high 30-day mortality (10-50%), but the long-term mortality is not well described. The purpose of this study was to describe long-term mortality among patients with community-acquired severe sepsis or septic shock compared to a population-based re......Background: Severe sepsis and septic shock have a high 30-day mortality (10-50%), but the long-term mortality is not well described. The purpose of this study was to describe long-term mortality among patients with community-acquired severe sepsis or septic shock compared to a population...... extracted from the National Danish Patient Registry. We analyzed the hazard ratio for mortality at predefined intervals. Results: Absolute mortality within the first 30 days was 69/211 (33%, 95% confidence interval (CI) 25-41%), with a cumulative mortality of 121/211 (57%, 95% CI 48-69%) for the entire...... follow-up. Among septic patients who survived the first 30 days, the mortality hazard ratio was 2.7 (95% CI 1.7-4.3) until day 365, and among septic patients who survived the first year, the 1-4 y mortality hazard ratio was 2.3 (95% CI 1.7-3.3), compared to the community-based reference persons...

Developing a comprehensive framework of community integration for people with acquired brain injury: a conceptual analysis.

Science.gov (United States)

Shaikh, Nusratnaaz M; Kersten, Paula; Siegert, Richard J; Theadom, Alice

2018-03-06

Despite increasing emphasis on the importance of community integration as an outcome for acquired brain injury (ABI), there is still no consensus on the definition of community integration. The aim of this study was to complete a concept analysis of community integration in people with ABI. The method of concept clarification was used to guide concept analysis of community integration based on a literature review. Articles were included if they explored community integration in people with ABI. Data extraction was performed by the initial coding of (1) the definition of community integration used in the articles, (2) attributes of community integration recognized in the articles' findings, and (3) the process of community integration. This information was synthesized to develop a model of community integration. Thirty-three articles were identified that met the inclusion criteria. The construct of community integration was found to be a non-linear process reflecting recovery over time, sequential goals, and transitions. Community integration was found to encompass six components including: independence, sense of belonging, adjustment, having a place to live, involved in a meaningful occupational activity, and being socially connected into the community. Antecedents to community integration included individual, injury-related, environmental, and societal factors. The findings of this concept analysis suggest that the concept of community integration is more diverse than previously recognized. New measures and rehabilitation plans capturing all attributes of community integration are needed in clinical practice. Implications for rehabilitation Understanding of perceptions and lived experiences of people with acquired brain injury through this analysis provides basis to ensure rehabilitation meets patients' needs. This model highlights the need for clinicians to be aware and assess the role of antecedents as well as the attributes of community integration itself to

The Health and Sport Engagement (HASE) Intervention and Evaluation Project: protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity.

Science.gov (United States)

Mansfield, Louise; Anokye, Nana; Fox-Rushby, Julia; Kay, Tess

2015-10-26

Sport is being promoted to raise population levels of physical activity for health. National sport participation policy focuses on complex community provision tailored to diverse local users. Few quality research studies exist that examine the role of community sport interventions in raising physical activity levels and no research to date has examined the costs and cost-effectiveness of such provision. This study is a protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity, the Health and Sport Engagement (HASE) project part of the national Get Healthy Get Active programme led by Sport England. The HASE study is a collaborative partnership between local community sport deliverers and sport and public health researchers. It involves designing, delivering and evaluating community sport interventions. The aim is to engage previously inactive people in sustained sporting activity for 1×30 min a week and to examine associated health and well-being outcomes. The study uses mixed methods. Outcomes (physical activity, health, well-being costs to individuals) will be measured by a series of self-report questionnaires and attendance data and evaluated using interrupted time series analysis controlling for a range of sociodemographic factors. Resource use will be identified and measured using diaries, interviews and records and presented alongside effectiveness data as incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. A longitudinal process evaluation (focus groups, structured observations, in-depth interview methods) will examine the efficacy of the project for achieving its aim using the principles of thematic analysis. The results of this study will be disseminated through peer-reviewed publications, academic conference presentations, Sport England and national public health organisation policy conferences, and practice-based case studies

Impact of amoxicillin therapy on resistance selection in patients with community-acquired lower respiratory tract infections

DEFF Research Database (Denmark)

Malhotra-Kumar, Surbhi; Van Heirstraeten, Liesbet; Coenen, Samuel

2016-01-01

OBJECTIVES: To determine the effect of amoxicillin treatment on resistance selection in patients with community-acquired lower respiratory tract infections in a randomized, placebo-controlled trial. METHODS: Patients were prescribed amoxicillin 1 g, three times daily (n = 52) or placebo (n = 50) ...

Are Pathogenic Leptospira Species Agents of Community-Acquired Pneumonia? Case Reports of Leptospirosis Presenting as Pneumonia

NARCIS (Netherlands)

Gasem, M. Hussein; Farida, Helmia; Ahmed, Ahmed; Severin, Juliţte A.; Suryanto, Agus; Isbandrio, Bambang; Verbrugh, Henri A.; Hartskeerl, Rudy A.; van den Broek, Peterhans J.

2016-01-01

We report four Indonesian cases meeting the clinical and radiological criteria for community-acquired pneumonia and other findings suggestive of leptospirosis. Quantitative PCR (qPCR) analyses of serum and urine samples and serology confirmed the diagnosis of leptospirosis in each. Results of qPCR

Association between Obstructive Sleep Apnea and Community-Acquired Pneumonia.

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Eusebi Chiner

Full Text Available We hypothesized that obstructive sleep apnea (OSA can predispose individuals to lower airway infections and community-acquired pneumonia (CAP due to upper airway microaspiration. This study evaluated the association between OSA and CAP.We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group. The controls were matched according to age, sex and body mass index (BMI. A respiratory polygraph (RP was performed upon admission for patients in both groups. The severity of pneumonia was assessed according to the Pneumonia Severity Index (PSI. The associations between CAP and the Epworth Sleepiness Scale (ESS, OSA, OSA severity and other sleep-related variables were evaluated using logistic regression models. The associations between OSA, OSA severity with CAP severity were evaluated with linear regression models and non-parametric tests.No significant differences were found between CAP and control patients regarding anthropometric variables, toxic habits and risk factors for CAP. Patients with OSA, defined as individuals with an Apnea-Hypopnea Index (AHI ≥10, showed an increased risk of CAP (OR = 2·86, 95%CI 1·29-6·44, p = 0·01. Patients with severe OSA (AHI≥30 also had a higher risk of CAP (OR = 3·18, 95%CI 1·11-11·56, p = 0·047. In addition, OSA severity, defined according to the AHI quartile, was also significantly associated with CAP (p = 0·007. Furthermore, OSA was significantly associated with CAP severity (p = 0·0002, and OSA severity was also associated with CAP severity (p = 0·0006.OSA and OSA severity are associated with CAP when compared to patients admitted to the hospital for non-respiratory infections. In addition, OSA and OSA severity are associated with CAP severity. These results support the potential role of OSA in the pathogenesis of CAP and could have clinical implications. This link between OSA and infection risk should be explored to investigate the

The Charlotte Action Research Project: A Model for Direct and Mutually Beneficial Community-University Engagement

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Morrell, Elizabeth; Sorensen, Janni; Howarth, Joe

2015-01-01

This article describes the evolution of the Charlotte Action Research Project (CHARP), a community-university partnership founded in 2008 at the University of North Carolina at Charlotte, and focuses particularly on the program's unique organizational structure. Research findings of a project evaluation suggest that the CHARP model's unique…

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

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Danielle Fastring

2018-02-01

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

Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections

Science.gov (United States)

Ha, U-Syn; Lee, Seung-Ju; Yeo, Jeong Kyun; Min, Seung Ki; Lee, Heeyoung

2018-01-01

Urinary tract infections (UTIs) are infectious diseases that commonly occur in communities. Although several international guidelines for the management of UTIs have been available, clinical characteristics, etiology and antimicrobial susceptibility patterns may differ from country to country. This work represents an update of the 2011 Korean guideline for UTIs. The current guideline was developed by the update and adaptation method. This clinical practice guideline provides recommendations for the diagnosis and management of UTIs, including asymptomatic bacteriuria, acute uncomplicated cystitis, acute uncomplicated pyelonephritis, complicated pyelonephritis related to urinary tract obstruction, and acute bacterial prostatitis. This guideline targets community-acquired UTIs occurring among adult patients. Healthcare-associated UTIs, catheter-associated UTIs, and infections in immunocompromised patients were not included in this guideline. PMID:29637759

An FDK-like cone-beam SPECT reconstruction algorithm for non-uniform attenuated projections acquired using a circular trajectory

International Nuclear Information System (INIS)

Huang, Q; Zeng, G L; You, J; Gullberg, G T

2005-01-01

In this paper, Novikov's inversion formula of the attenuated two-dimensional (2D) Radon transform is applied to the reconstruction of attenuated fan-beam projections acquired with equal detector spacing and of attenuated cone-beam projections acquired with a flat planar detector and circular trajectory. The derivation of the fan-beam algorithm is obtained by transformation from parallel-beam coordinates to fan-beam coordinates. The cone-beam reconstruction algorithm is an extension of the fan-beam reconstruction algorithm using Feldkamp-Davis-Kress's (FDK) method. Computer simulations indicate that the algorithm is efficient and is accurate in reconstructing slices close to the central slice of the cone-beam orbit plane. When the attenuation map is set to zero the implementation is equivalent to the FDK method. Reconstructed images are also shown for noise corrupted projections

Evaluation of transversal competencies: pilot project in a maths course for first-year business

OpenAIRE

Bosch Príncep, Manuela; Morillo, Isabel

2013-01-01

The aim of this communication is to describe the results of a pilot project for the assessment of the transversal competency "the capacity for learning and responsibility". This competency is centred on the capacity for the analysis, synthesis, overview, and practical application of newly acquired knowledge. It is proposed by the University of Barcelona in its undergraduate degree courses, through multidisciplinary teaching teams. The goal of the pilot project is to evaluate this competenc...

Service Learning in Medical Education: Project Description and Evaluation

Science.gov (United States)

Borges, Nicole J.; Hartung, Paul J.

2007-01-01

Although medical education has long recognized the importance of community service, most medical schools have not formally nor fully incorporated service learning into their curricula. To address this problem, we describe the initial design, development, implementation, and evaluation of a service-learning project within a first-year medical…

Antibiotic resistance patterns of pediatric community-acquired urinary infections

Directory of Open Access Journals (Sweden)

Eliana Biondi Medeiros Guidoni

Full Text Available Knowledge about antimicrobial resistance patterns of the etiological agents of urinary tract infections (UTIs is essential for appropriate therapy. Urinary isolates from symptomatic UTI cases attended at Santa Casa University Hospital of São Paulo from August 1986 to December 1989 and August 2004 to December 2005 were identified by conventional methods. Antimicrobial resistance testing was performed by Kirby Bauer's disc diffusion method. Among the 257 children, E. coli was found in 77%. A high prevalence of resistance was observed against ampicillin and TMP/SMX (55% and 51%. The antibiotic resistance rates for E. coli were: nitrofurantoin (6%, nalidixic acid (14%, 1st generation cephalosporin (13%, 3rd generation cephalosporins (5%, aminoglycosides (2%, norfloxacin (9% and ciprofloxacin (4%. We found that E. coli was the predominant bacterial pathogen of community-acquired UTIs. We also detected increasing resistance to TMP/SMX among UTI pathogens in this population.

Community acquired Pseudomonas aeruginosa pneumonia in a young athlete man: a case report and literature review.

Science.gov (United States)

Rahdar, Hossein Ali; Kazemian, Hossein; Bimanand, Lida; Zahedani, Shahram Shahraki; Feyisa, Seifu Gizaw; Taki, Elahe; Havaei, Seyed Asghar; Karami-Zarandi, Morteza

2018-04-10

Pseudomonas aeruginosa is commonly known as nosocomial infection agent but rarely previously healthy peoples infected by P. aeruginosa. Here we report community acquired pneumonia in a 27 years old athleteman. 15 published P. aeruginosa CAP case reports are reviewed.1 53.3% of patients was female and 46.67% was male. The mean age was 44 years old (SD: ±13.54). In 8 report it is mentioned that the patient was smoker. Fatality rate was 46.6% and death rate was not significantly different between selected antibiotic regimen, sex and smoking in patient's outcome. Chest strike can be a risk factor for P. aeruginosa CAP in athlete people. Our reported patient treated by ciprofloxacin 400 mg per day and healed without any Secondary complication. Fast and timelymanner diagnosis and treatment is critical in Community acquired P. aeruginosapneumonia outcome. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Usefulness of time-resolved projection MRA on evaluation of hemodynamics in cerebral occlusive diseases

International Nuclear Information System (INIS)

Oka, Yoshihisa; Kusunoki, Katsusuke; Nochide, Ichiro; Igase, Keiji; Harada, Hironobu; Sadamoto, Kazuhiko; Nagasawa, Kiyoshi

2001-01-01

The usefulness for evaluation of cerebral hemodynamics using time-resolved projection MRA was studied in normal volunteers and patients of cerebrovascular diseases. Six normal volunteers and ten patients with cerebrovascular occlusive diseases including 6 of IC occlusion and 4 of post EC/IC bypass surgery underwent time-resolved projection MRA on a 1.5 T clinical MRI system. Projection angiograms are acquired with 2D-fast SPGR sequence with a time resolution of approximately one image per second, 40 images being acquired consecutively before and after bolus injection Gd-DTPA. And all images were calculated by complex subtraction from the background mask in a work station. In normal volunteers, the quality of images of time-resolved projection MRA was satisfactory. The arteries from internal carotid artery through M2 segment of middle cerebral artery and all major venous systems were well portrayed. In 4 cases of IC occlusion who were assessed the collateral flow through the anterior communicating artery and posterior communicating artery, there were delayed to demonstrate the ipsilateral MCA. However, in 2 cases of IC occlusion that were assessed the collateral flow through leptomeningeal anastomosis, ipsilateral MCA and collateral circulation were not demonstrated. In all patients of post EC/IC bypass surgery, the patency of EC/IC bypass could be evaluated as properly with time-resolved projection MRA as 3D-TOF MRA. Although the temporal and spatial resolutions are insufficient, time-resolved projection MRA was power-full non-invasive method to evaluate the cerebral hemodynamics vis the basal communicating arteries in IC occlusion and identify the patency of EC/IC bypass. (author)

Determine small and medium enterprise social media activities: A community engagement project in the Tshwane community

OpenAIRE

Louise van Scheers; Jacques van Scheers

2015-01-01

The aim of this paper is to determine small and medium enterprise (SME) social media activities and promote CE scholarship engagement. It is a community engagement project conducted in the Tshwane community. Community engagement (CE) as a planned process with the specific purpose of working with identified groups of people in the community to address issues affecting their well-being. The CE project SME skills transfer workshops are aimed at expanding involvement with the community. The benef...

Building Capacity in the Sikh Asian Indian Community to Lead Participatory Oral Health Projects.

Science.gov (United States)

Kavathe, Rucha; Islam, Nadia; Zanowiak, Jennifer; Wyatt, Laura; Singh, Hardayal; Northridge, Mary E

2018-01-01

Lack of access to oral health care is a significant burden for disadvantaged populations, yet rarely draws the attention of policymakers or community leaders. To understand how UNITED SIKHS identified oral health care as a priority need through its involvement in community-based participatory research (CBPR) initiatives and local data collection, thereby building its capacity to lead participatory oral health projects. The foundation for the partnership between UNITED SIKHS and the New York University (NYU) Prevention Research Center (PRC) was the joint implementation of a CBPR project to prevent diabetes in the Sikh Asian Indian community. Project partners also included a community coalition composed of religious leaders, health providers, members of the media, and dental students and faculty at the NYU College of Dentistry (NYU Dentistry). A community needs and resources assessment survey was jointly developed and conducted in 2010 to better understand health needs in the Sikh community. Fewer than one-half of the Sikh participants (43.0%) reported ever receiving a check-up or screening by a dentist, and of those who did, only one-half (50.0%) reported that it occurred in the past 12 months. Upon clinical assessment, more than one-half of Sikh adults (58.2%) had untreated dental decay. The collection and analysis of local data motivated UNITED SIKHS to develop new priorities based upon the findings. UNITED SIKHS applied for and received external funding to lead a CBPR project that developed, implemented, evaluated, and disseminated a culturally tailored oral health and healthy living curriculum for the Sikh Asian Indian community.

A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers.

Science.gov (United States)

Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela

2016-01-01

The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.

A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI).

Science.gov (United States)

Jones, Taryn M; Dean, Catherine M; Hush, Julia M; Dear, Blake F; Titov, Nickolai

2015-04-19

Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined. A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data. Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion

Prognostic value of severity indicators of nursing-home-acquired pneumonia versus community-acquired pneumonia in elderly patients.

Science.gov (United States)

Ugajin, Motoi; Yamaki, Kenichi; Hirasawa, Natsuko; Kobayashi, Takanori; Yagi, Takeo

2014-01-01

The credibility of prognostic indicators in nursing-home-acquired pneumonia (NHAP) is not clear. We previously reported a simple prognostic indicator in community-acquired pneumonia (CAP): blood urea nitrogen to serum albumin (B/A) ratio. This retrospective study investigated the prognostic value of severity indicators in NHAP versus CAP in elderly patients. Patients aged ≥65 years and hospitalized because of NHAP or CAP within the previous 3 years were enrolled. Demographics, coexisting illnesses, laboratory and microbiological findings, and severity scores (confusion, urea, respiratory rate, blood pressure, and age ≥65 [CURB-65] scale; age, dehydration, respiratory failure, orientation disturbance, and pressure [A-DROP] scale; and pneumonia severity index [PSI]) were retrieved from medical records. The primary outcome was mortality within 28 days of admission. In total, 138 NHAP and 307 CAP patients were enrolled. Mortality was higher in NHAP (18.1%) than in CAP (4.6%) (Pscale, 0.69 for the CURB-65 scale, 0.67 for the PSI class, and 0.65 for the B/A ratio. The area under the curve in CAP was 0.73 for the A-DROP scale, 0.76 for the CURB-65 scale, 0.81 for the PSI class, and 0.83 for the B/A ratio. Patient mortality was greater in NHAP than in CAP. Patient characteristics, coexisting illnesses, and detected pathogens differed greatly between NHAP and CAP. The existing severity indicators had less prognostic value for NHAP than for CAP.

Teachers' Experiences and Perceptions of a Community Music Project: Impacts on Community and New Ways of Working

Science.gov (United States)

Ansio, Hei; Seppälä, Piia; Houni, Pia

2017-01-01

This qualitative research discusses a Finnish community music project aimed at school pupils with disabilities. The practices of this project define community music as community-driven, goal-oriented participatory music-making with a musician as a facilitator. Instead of the effects on pupils, this research investigates the project's impacts on…

Impact evaluation of productive use—An implementation guideline for electrification projects

International Nuclear Information System (INIS)

Bensch, Gunther; Peters, Jörg; Schmidt, Christoph M.

2012-01-01

There is a consensus in the international community that rural electrification and, in particular, the productive use of electricity contributes to poverty alleviation. At the same time, efforts to evaluate the impacts of development projects have increased substantially. This paper provides a hands-on guide for designing evaluation studies regarding the impacts of productive electricity usage. Complementary to the existing literature on evaluation methods, this guide familiarizes project managers with the concrete steps that have to be undertaken to plan and implement an evaluation. The guide comprises three modules based on enterprise surveys and on anecdotal case studies. For each module, the implementation is described on a step-by-step basis including conceptual issues as well as logistics and methodological questions. - Highlights: ► Hands-on evaluation guideline for development project managers. ► Step-by-step procedure on how to implement evaluation. ► Impacts of productive electricity use.

Using logic models in a community-based agricultural injury prevention project.

Science.gov (United States)

Helitzer, Deborah; Willging, Cathleen; Hathorn, Gary; Benally, Jeannie

2009-01-01

The National Institute for Occupational Safety and Health has long promoted the logic model as a useful tool in an evaluator's portfolio. Because a logic model supports a systematic approach to designing interventions, it is equally useful for program planners. Undertaken with community stakeholders, a logic model process articulates the underlying foundations of a particular programmatic effort and enhances program design and evaluation. Most often presented as sequenced diagrams or flow charts, logic models demonstrate relationships among the following components: statement of a problem, various causal and mitigating factors related to that problem, available resources to address the problem, theoretical foundations of the selected intervention, intervention goals and planned activities, and anticipated short- and long-term outcomes. This article describes a case example of how a logic model process was used to help community stakeholders on the Navajo Nation conceive, design, implement, and evaluate agricultural injury prevention projects.

Detection of immunoglobulin M and immunoglobulin G antibodies to Mycoplasma pneumoniae in children with community-acquired lower respiratory tract infections

Directory of Open Access Journals (Sweden)

Surinder Kumar

2018-01-01

Full Text Available Context: Mycoplasma pneumoniae (M. pneumoniae causes up to 40% of community-acquired pneumonia in children. It is impossible to identify M. pneumoniae infection on the basis of clinical signs, symptoms, and radiological features. Therefore, correct etiological diagnosis strongly depends on laboratory diagnosis. Aims: This study aims to investigate the role of M. pneumonia e in pediatric lower respiratory tract infections (LRTIs employing enzyme-linked immunosorbent assays (ELISA and particle agglutination (PA test. Settings and Design: Two hundred and eighty children, age 6 months to 12 years with community-acquired LRTIs were investigated for M. pneumoniae etiology. Materials and Methods: We investigated 280 children hospitalized for community-acquired LRTIs, using ELISA and PA test for detecting M. pneumoniae immunoglobulin M (IgM and immunoglobulin G antibodies. Statistical Analysis Used: The difference of proportion between the qualitative variables was tested using the Chi-square test and Fischer exact test. P ≤ 0.05 was considered as statistically significant. Kappa value was used to assess agreement between ELISA and PA test. Results: M. pneumoniae was positive in 51 (23.2% 5 years of age.

Health Advocacy Project: Evaluating the Benefits of Service Learning to Nursing Students and Low Income Individuals Involved in a Community-Based Mental Health Promotion Project.

Science.gov (United States)

Samuels-Dennis, Joan; Xia, Liudi; Secord, Sandra; Raiger, Amelia

2016-10-08

Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study.

Science.gov (United States)

Egelund, Gertrud Baunbæk; Jensen, Andreas Vestergaard; Andersen, Stine Bang; Petersen, Pelle Trier; Lindhardt, Bjarne Ørskov; von Plessen, Christian; Rohde, Gernot; Ravn, Pernille

2017-04-20

Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy. Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis. We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G/V as empiric monotherapy and they did not have a higher mortality compared to patients treated with broader-spectrum antibiotics (OR 0.92, CI 95% 0.55-1.53). The duration of treatment exceeded recommendations in European guidelines. Empiric monotherapy with penicillin-G/V was commonly used and not associated with increased mortality in patients with mild to moderate pneumonia. Our results are in agreement with current conservative antibiotic strategy as outlined in the Danish guidelines.

Development, Implementation and Evaluation of an M3 Community Health Curriculum.

Science.gov (United States)

Beck, Barbra; Wolff, Marie; Bates, Tovah; Beverdorf, Sarah; Young, Staci; Ahmed, Syed

2004-12-01

This paper describes the development, implementation and evaluation of an M3 community health curriculum that responds to recent changes within the health care finance and delivery system. The new curriculum was developed based on AAMC recommendations, LCME requirements, a national review of undergraduate community health curricula, and an internal review of the integration of community health concepts in M3 clerkships. The M3 curriculum teaches: 1) the importance of being a community responsive physician; 2) SES factors that influence health; 3) cultural competency; and 4) the role of physicians as health educators. Student evaluations for the first twelve months of implementation indicate that students are most satisfied with presentations and less satisfied with required readings and a patient interview project. Most students agree that at the completion of the course they understand what it means to be a community-responsive physician, and they have developed skills to help them become more community responsive. Evaluation tools need to be developed to assess if students' behavior has changed due to course participation.

Development, Implementation and Evaluation of an M3 Community Health Curriculum

Directory of Open Access Journals (Sweden)

Staci Young, MS

2004-03-01

Full Text Available Objectives: This paper describes the development, implementation and evaluation of an M3 community health curriculum that responds to recent changes within the health care finance and delivery system. Methods: The new curriculum was developed based on AAMC recommendations, LCME requirements, a national review of undergraduate community health curricula, and an internal review of the integration of community health concepts in M3 clerkships. Results: The M3 curriculum teaches: 1 the importance of being a community responsive physician; 2 SES factors that influence health; 3 cultural competency; and 4 the role of physicians as health educators. Student evaluations for the first twelve months of implementation indicate that students are most satisfied with presentations and less satisfied with required readings and a patient interview project. Discussion: Most students agree that at the completion of the course they understand what it means to be a community-responsive physician, and they have developed skills to help them become more community responsive. Evaluation tools need to be developed to assess if students’ behavior has changed due to course participation.

An Overview of the International Reactor Physics Experiment Evaluation Project

International Nuclear Information System (INIS)

Briggs, J. Blair; Gulliford, Jim

2014-01-01

Interest in high-quality integral benchmark data is increasing as efforts to quantify and reduce calculational uncertainties associated with advanced modeling and simulation accelerate to meet the demands of next generation reactor and advanced fuel cycle concepts. Two Organization for Economic Cooperation and Development (OECD) Nuclear Energy Agency (NEA) activities, the International Criticality Safety Benchmark Evaluation Project (ICSBEP), initiated in 1992, and the International Reactor Physics Experiment Evaluation Project (IRPhEP), initiated in 2003, have been identifying existing integral experiment data, evaluating those data, and providing integral benchmark specifications for methods and data validation for nearly two decades. Data provided by those two projects will be of use to the international reactor physics, criticality safety, and nuclear data communities for future decades. An overview of the IRPhEP and a brief update of the ICSBEP are provided in this paper.

Public perceptions of opportunities for community-based renewable energy projects

International Nuclear Information System (INIS)

Rogers, J.C.; Simmons, E.A.; Convery, I.; Weatherall, A.

2008-01-01

It now widely acknowledged that the UK needs to increase renewable energy capacity and it has been claimed that community-based renewable energy projects, with high levels of public participation, are more likely to be accepted by the public than top-down development of large-scale schemes and may bring additional benefits such as increased engagement with sustainable energy issues. However, little research has investigated public expectations of how people would like to participate in such projects and why. The aim of this study was to explore one rural community's response to a proposed sustainable energy project. A questionnaire survey and semi-structured interviews provided quantitative and qualitative data. There was widespread support for local generation and use of renewable energy, with respondents expecting benefits from a project in terms of increased community spirit and conservation of natural resources. However, desire for active involvement was lower and residents viewed themselves participating as consultees, rather than project leaders. We suggest community renewable energy projects are likely to gain public acceptance but are unlikely to become widespread without greater institutional support

Community-acquired Klebsiella pneumoniae liver abscess: an emerging infection in Ireland and Europe.

LENUS (Irish Health Repository)

Moore, R

2013-02-05

INTRODUCTION: Klebsiella pneumoniae has emerged as a predominant cause of community-acquired mono-microbial pyogenic liver abscess. This was first described in Taiwan and has been widely reported in Asia. This infectious entity has been described in Europe, with single case reports predominating. METHODS: We present three cases in one year from our institution in Ireland and review the European literature to date. RESULTS\\/CONCLUSION: Klebsiella pneumoniae invasive liver abscess syndrome is now emerging in Europe and notably is not restricted to individuals of Asian descent.

Improving Pain Care with Project ECHO in Community Health Centers.

Science.gov (United States)

Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

2017-10-01

Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

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

Science.gov (United States)

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

2017-03-01

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

Lessons learnt from comprehensive evaluation of community-based education in Uganda: a proposal for an ideal model community-based education for health professional training institutions

Directory of Open Access Journals (Sweden)

Atuyambe Lynn

2011-03-01

Full Text Available Abstract Background Community-based education (CBE can provide contextual learning that addresses manpower scarcity by enabling trainees acquire requisite experiences, competence, confidence and values. In Uganda, many health professional training institutions conduct some form of community-based education (CBE. However, there is scanty information on the nature of the training: whether a curriculum exists (objectives, intended outcomes, content, implementation strategy, administration and constraints faced. The objective was to make a comprehensive assessment of CBE as implemented by Ugandan health professional training institutions to document the nature of CBE conducted and propose an ideal model with minimum requirements for health professional training institutions in Uganda. Methods We employed several methods: documentary review of curricula of 22 institutions, so as to assess the nature, purpose, outcomes, and methods of instruction and assessment; site visits to these institutions and their CBE sites, to assess the learning environment (infrastructure and resources; in-depth interviews with key people involved in running CBE at the institutions and community, to evaluate CBE implementation, challenges experienced and perceived solutions. Results CBE was perceived differently ranging from a subject, a course, a program or a project. Despite having similar curricula, institutions differ in the administration, implementation and assessment of CBE. Objectives of CBE, the curricula content and implementation strategies differ in similar institutions. On collaborative and social learning, most trainees do not reside in the community, though they work on group projects and write group reports. Lectures and skills demonstrations were the main instruction methods. Assessment involved mainly continuous assessment, oral or written reports and summative examination. Conclusion This assessment identified deficiencies in the design and implementation

Evaluating the impact of a community developed collaborative project for the prevention of early childhood caries: the Healthy Smile Happy Child project.

Science.gov (United States)

Schroth, Robert J; Edwards, Jeanette M; Brothwell, Douglas J; Yakiwchuk, Carol A; Bertone, Mary F; Mellon, Bernadette; Ward, Jennifer; Ellis, Marion; Hai-Santiago, Khalida; Lawrence, Herenia P; Moffatt, Michael E

2015-01-01

To determine the effectiveness of the Healthy Smile Happy Child (HSHC) project, a community-developed initiative promoting early childhood oral health in Manitoba, Canada. Specific aims were to assess improvements in caregiver knowledge, attitudes, and behaviours relating to early childhood oral health, and the burden of early childhood caries (ECC) and severe ECC (S-ECC). A serial cross-sectional study design was selected to contrast findings following the Healthy Smile Happy Child (HSHC) campaign in four communities with the previous baseline data. One community was a remote First Nation in northern Manitoba and another was a rural First Nation in southern Manitoba. The other two communities were urban centres, one of which was located in northern Manitoba. A community-development approach was adopted for the project to foster community solutions to address ECC. Goals of the HSHC program were to promote the project in each community, use existing community-based programs and services to deliver the oral health promotion and ECC prevention activities, and recruit and train natural leaders to assist in program development and to deliver the ECC prevention program. The HSHC coordinator worked with communities to develop a comprehensive list of potential strategies to address ECC. Numerous activities occurred in each community to engage members and increase their knowledge of early childhood oral health and ultimately lead them to adopt preventive oral health practices for their young children. Children under 71 months of age and their primary caregivers participated in this follow-up study. A -value ≤0.05 was statistically significant. 319 children (mean age 38.2±18.6 months) and their primary caregivers participated. Significant improvements in caregiver knowledge and attitudes were observed following the HSHC campaign, including that baby teeth are important (98.8%), that decay involving primary teeth can impact on health (94.3%), and the importance of a dental

Determinants for hospitalization in " low-risk" community acquired pneumonia

Directory of Open Access Journals (Sweden)

Aliyu Muktar H

2003-06-01

Full Text Available Abstract Background A variable decision in managing community acquired pneumonia (CAP is the initial site of care; in-patient versus outpatient. These variations persist despite comprehensive practice guidelines. Patients with a Pneumonia Severity Index (PSI score lower than seventy have low risk for complications and outpatient antibiotic management is recommended in this group. These patients are generally below the age of fifty years, non-nursing home residents, HIV negative and have no major cardiac, hepatic, renal or malignant diseases. Methods A retrospective analysis of 296 low-risk CAP patients evaluated within a year one period at St. Agnes Hospital, Baltimore, Maryland was undertaken. All patients were assigned a PSI score. 208 (70% were evaluated and discharged from the emergency department (E.D. to complete outpatient antibiotic therapy, while 88 (30% were hospitalized. Patients were sub-stratified into classes I-V according to PSI. A comparison of demographic, clinical, social and financial parameters was made between the E.D. discharged and hospitalized groups. Results Statistically significant differences in favor of the hospitalized group were noted for female gender (CI: 1.46-5.89, p= 0.0018, African Americans (CI: 0.31-0.73, p= 0.004, insurance coverage (CI: 0.19-0.63, p= 0.0034, temperature (CI: 0.04-0.09, p= 0.0001 and pulse rate (CI: 0.03-0.14, p= 0.0001. No statistically significant differences were observed between the two groups for altered mental status, hypotension, tachypnea, laboratory/radiological parameters and social indicators (p>0.05. The average length of stay for in-patients was 3.5 days at about eight time's higher cost than outpatient management. There was no difference in mortality or treatment failures between the two groups. The documentation rate and justifications for hospitalizing low risk CAP patients by admitting physicians was less than optimal. Conclusions High fever, tachycardia, female gender

Is H3N2 Pneumonia Different from Other Community-Acquired Pneumonia?

Directory of Open Access Journals (Sweden)

Coşkun Doğan

2016-04-01

Full Text Available Objective: To evaluate the clinical, laboratory, radiological, and demographic data of H3N2 pneumonia cases hospitalized to the Pulmonology Department during H3N2 pandemics and compare them with non-H3N2 community-acquired pneumonia (CAP cases. Methods: The study population consisted of all CAP cases hospitalized to our Pulmonology Department between December 2013 and February 2014 during the influenza outbreak. The patient files were evaluated for physical findings, laboratory data, radiological findings, and treatment and outcome of cases. H3N2 was diagnosed using polymerase chain reaction (PCR analysis of throat swabs. The clinical, radiological, and laboratory findings of H3N2 pneumonia cases were compared with those of non-H3N2 pneumonia cases. Mann–Whitney U test, Chi-square test, Fisher’s exact test, and logistic regression analysis by the forward step wise method were used for statistical analyses. P value0.05. The rates of treatment failure and/or transport to the intensive care unit with the need of invasive mechanical ventilation and mortality rates were also similar in both groups (p>0.05. Conclusion: H3N2 pneumonia/viral pneumonia is a member of CAP. Although the number of H3N2 cases are extremely small to draw a conclusion, the results of this study highlight that the clinical, radiological, and laboratory findings of H3N2 pneumonia cases are not different from those of non-H3N2 CAP cases.

Pharmacotherapy and the risk for community-acquired pneumonia

Directory of Open Access Journals (Sweden)

Mody Lona

2010-07-01

Full Text Available Abstract Background Some forms of pharmacotherapy are shown to increase the risk of community-acquired pneumonia (CAP. The purpose of this study is to investigate whether pharmacotherapy with proton pump inhibitors (PPI, inhaled corticosteroids, and atypical antipsychotics was associated with the increased risk for CAP in hospitalized older adults with the adjustment of known risk factors (such as smoking status and serum albumin levels. Methods A retrospective case-control study of adults aged 65 years or older at a rural community hospital during 2004 and 2006 was conducted. Cases (N = 194 were those with radiographic evidence of pneumonia on admission. The controls were patients without the discharge diagnosis of pneumonia or acute exacerbation of chronic obstructive pulmonary disease (COPD (N = 952. Patients with gastric tube feeding, ventilator support, requiring hemodialysis, metastatic diseases or active lung cancers were excluded. Results Multiple logistic regression analysis revealed that the current use of inhaled corticosteroids (adjusted odds ratio [AOR] = 2.89, 95% confidence interval [CI] = 1.56-5.35 and atypical antipsychotics (AOR = 2.26, 95% CI = 1.23-4.15 was an independent risk factor for CAP after adjusting for confounders, including age, serum albumin levels, sex, smoking status, a history of congestive heart failure, coronary artery disease, and COPD, the current use of PPI, β2 agonist and anticholinergic bronchodilators, antibiotic(s, iron supplement, narcotics, and non-steroidal anti-inflammatory drugs. The crude OR and the AOR of PPI use for CAP was 1.41 [95% CI = 1.03 - 1.93] and 1.18 [95% CI = 0.80 - 1.74] after adjusting for the above confounders, respectively. Lower serum albumin levels independently increased the risk of CAP 1.89- fold by decreasing a gram per deciliter (AOR = 2.89, 95% CI = 2.01 - 4.16. Conclusion Our study reaffirmed that the use of inhaled corticosteroids and atypical antipsychotics was both

Rationale, Design, and Methods for Process Evaluation in the Childhood Obesity Research Demonstration Project.

Science.gov (United States)

Joseph, Sitara; Stevens, Andria M; Ledoux, Tracey; O'Connor, Teresia M; O'Connor, Daniel P; Thompson, Debbe

2015-01-01

The cross-site process evaluation plan for the Childhood Obesity Research Demonstration (CORD) project is described here. The CORD project comprises 3 unique demonstration projects designed to integrate multi-level, multi-setting health care and public health interventions over a 4-year funding period. Three different communities in California, Massachusetts, and Texas. All CORD demonstration projects targeted 2-12-year-old children whose families are eligible for benefits under Title XXI (CHIP) or Title XIX (Medicaid). The CORD projects were developed independently and consisted of evidence-based interventions that aim to prevent childhood obesity. The interventions promote healthy behaviors in children by applying strategies in 4 key settings (primary care clinics, early care and education centers, public schools, and community institutions). The CORD process evaluation outlined 3 main outcome measures: reach, dose, and fidelity, on 2 levels (researcher to provider, and provider to participant). The plan described here provides insight into the complex nature of process evaluation for consortia of independently designed multi-level, multi-setting intervention studies. The process evaluation results will provide contextual information about intervention implementation and delivery with which to interpret other aspects of the program. Copyright © 2015 Society for Nutrition Education and Behavior. All rights reserved.

Causes of non-adherence to therapeutic guidelines in severe community-acquired pneumonia

Science.gov (United States)

Gattarello, Simone; Ramírez, Sergio; Almarales, José Rafael; Borgatta, Bárbara; Lagunes, Leonel; Encina, Belén; Rello, Jordi

2015-01-01

Objective To assess the adherence to Infectious Disease Society of America/American Thoracic Society guidelines and the causes of lack of adherence during empirical antibiotic prescription in severe pneumonia in Latin America. Methods A clinical questionnaire was submitted to 36 physicians from Latin America; they were asked to indicate the empirical treatment in two fictitious cases of severe respiratory infection: community-acquired pneumonia and nosocomial pneumonia. Results In the case of communityacquired pneumonia, 11 prescriptions of 36 (30.6%) were compliant with international guidelines. The causes for non-compliant treatment were monotherapy (16.0%), the unnecessary prescription of broad-spectrum antibiotics (40.0%) and the use of non-recommended antibiotics (44.0%). In the case of nosocomial pneumonia, the rate of adherence to the Infectious Disease Society of America/American Thoracic Society guidelines was 2.8% (1 patient of 36). The reasons for lack of compliance were monotherapy (14.3%) and a lack of dual antibiotic coverage against Pseudomonas aeruginosa (85.7%). If monotherapy with an antipseudomonal antibiotic was considered adequate, the antibiotic treatment would be adequate in 100% of the total prescriptions. Conclusion The compliance rate with the Infectious Disease Society of America/American Thoracic Society guidelines in the community-acquired pneumonia scenario was 30.6%; the most frequent cause of lack of compliance was the indication of monotherapy. In the case of nosocomial pneumonia, the compliance rate with the guidelines was 2.8%, and the most important cause of non-adherence was lack of combined antipseudomonal therapy. If the use of monotherapy with an antipseudomonal antibiotic was considered the correct option, the treatment would be adequate in 100% of the prescriptions. PMID:25909312

Evaluating Community Partnerships Addressing Community Resilience in Los Angeles, California

Directory of Open Access Journals (Sweden)

Malcolm V. Williams

2018-03-01

Full Text Available Community resilience has grown in importance in national disaster response and recovery efforts. However, measurement of community resilience, particularly the content and quality of relationships aimed at improving resilience, is lacking. To address this gap, we used a social network survey to measure the number, type, and quality of relationships among organizations participating in 16 coalitions brought together to address community resilience in the Los Angeles Community Disaster Resilience project. These coalitions were randomized to one of two approaches (community resilience or preparedness. Resilience coalitions received training and support to develop these partnerships and implement new activities. Both coalition types received expert facilitation by a public health nurse or community educator. We also measured the activities each coalition engaged in and the extent to which partners participated in these activities at two time points. We found that the community resilience coalitions were initially larger and had lower trust among members than the preparedness communities. Over time, these trust differences dissipated. While both coalitions grew, the resilience community coalitions maintained their size difference throughout the project. We also found differences in the types of activities implemented by the resilience communities; these differences were directly related to the trainings provided. This information is useful to organizations seeking guidance on expanding the network of community-based organizations that participate in community resilience activities.

Evaluation of the AccessIT Project and the Distance LearningProgramme on Digitization

Directory of Open Access Journals (Sweden)

Bülent Yılmaz

2013-11-01

Full Text Available AccessIT is an EU-funded project under EU’s Education and Culture Program aiming to digitize a certain amount of sources that are part of the cultural heritage, to transfer them to Europeana, and to sustain the education infrastructure to achieve this goal in the partner countries of Greece, Poland, Serbia, Turkey and UK. In this study, in addition to the general evaluation of the AccessIT Project, it is aimed to investigate the awareness of participants in thefield on digitization and digital content management, their self-efficiency perceptions, and to evaluate the education program based on the data acquired from the survey of544participants who were enrolled in the distance education program offered within the scope of the project.It was found out in the study that the AccessIT Project has had an important function in Turkey and the distance education program significantly contributed to participants ’ self-efficiency perceptions about digitization.

Recommendations for the diagnosis, treatment and prevention of the pneumonia acquired in the community in adults

International Nuclear Information System (INIS)

2003-01-01

The pneumonia acquired in the community in adults, is the acute infection of the pulmonary parenchyma that is developed away from the hospital environment, it is manifested in the first 48 hours from the entrance to the hospital or after seven days of having left. The supplement includes clinical square, epidemiology, etiology classification, diagnostic, treatment and prevention among others

Four Approaches to Project Evaluation

DEFF Research Database (Denmark)

Laursen, Markus; Svejvig, Per; Rode, Anna Le Gerstrøm

. Each of the framework’s four approaches provides a distinct evaluation that sheds light on some issues while leaving others unattended. Following these lines, the paper calls for more multi-faceted project evaluations. Introducing a framework that can help analyze existing evaluations and structure......There are many theoretical and practical reasons for evaluating projects – including explorative arguments focusing on expanding descriptive knowledge on project work as well as normative arguments focusing on improving prescriptive models of project performance. Despite the need for project...... management methodologies that work and combat project failure, and research methods that can assess effective project management and methodologies, as well as empirical research on the actuality of projects as practice, evaluation research on projects including project management and methodologies is scarce...

In Reply - Statin Use and Risk of Community-Acquired Staphylococcus aureus Bacteremia

DEFF Research Database (Denmark)

Smit, Jesper; Schønheyder, Henrik C; Nielsen, Henrik

2018-01-01

OBJECTIVE: To ascertain whether persons treated with statins experience a decreased risk of community-acquired Staphylococcus aureus bacteremia (CA-SAB) as compared with nonusers. PATIENTS AND METHODS: Using population-based medical registries, we conducted a case-control study including all adults...... with first-time CA-SAB and population controls matched on age, sex, and residence in Northern Denmark from January 1, 2000, through December 31, 2011. Statin users were categorized as current users (new or long-term use), former users, and nonusers. We used conditional logistic regression to compute odds...... ratios (ORs) for CA-SAB according to statin exposure, overall and stratified by intensity (statin...

Trend and seasonality of community-acquired Escherichia coli antimicrobial resistance and its dynamic relationship with antimicrobial use assessed by ARIMA models.

Science.gov (United States)

Asencio Egea, María Ángeles; Huertas Vaquero, María; Carranza González, Rafael; Herráez Carrera, Óscar; Redondo González, Olga; Arias Arias, Ángel

2017-12-04

We studied the trend and seasonality of community-acquired Escherichia coli resistance and quantified its correlation with the previous use of certain antibiotics. A time series study of resistant community-acquired E. coli isolates and their association with antibiotic use was conducted in a Primary Health Care Area from 2008 to 2012. A Poisson regression model was constructed to estimate the trend and seasonality of E. coli resistance. A significant increasing trend in mean E. coli resistance to cephalosporins, aminoglycosides and nitrofurantoin was observed. Seasonal resistance to ciprofloxacin and amoxicillin-clavulanic acid was significantly higher in autumn-winter. There was a delay of 7, 10 and 12 months between the use of cotrimoxazole (P<0.038), fosfomycin (P<0.024) and amoxicillin-clavulanic acid (P<0.015), respectively, and the occurrence of E. coli resistance. An average delay of 10 months between the previous use of amoxicillin-clavulanic acid, cotrimoxazole and fosfomycin and the appearance of resistant community-acquired E. coli strains was detected. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Research Project Evaluation-Learnings from the PATHWAYS Project Experience.

Science.gov (United States)

Galas, Aleksander; Pilat, Aleksandra; Leonardi, Matilde; Tobiasz-Adamczyk, Beata

2018-05-25

Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project's evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. A methodology for longitudinal EU projects' evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects.

[Prognostic factors in community acquired pneumonia. Prospective multicenter study in internal medical departments].

Science.gov (United States)

Apolinario Hidalgo, R; Suárez Cabrera, M; Geijo Martínez, M P; Bernabéu-Wittel, M; Falguera Sacrest, M; Limiñana Cañal, J M

2007-10-01

the aims of the present study were to evaluate the clinical and microbiological characteristics of patients suffering from community-acquired pneumonia attended in the Internal Medical Departments of several Spanish institutions and to analyze those prognostic factors predicting thirty-day mortality in such patients. Past medical history, symptoms and signs, radiological pattern and blood parameters including albumin and C Reactive Protein, were recorded for each patient. Time from admission to starting antibiotics (in hours) and follow-up (in days) were also recorded. Patients were stratified by the Pneumonia Severity Index in five risk classes. 389 patients were included in the study, most of them in Fine categories III to V. Mortality rate for all patients was 12.1% (48 patients), increasing up to 40% in Fine Class V. Neither age, sex nor time from admission to the start of antibiotic treatment predicted survival rates. Plasmatic levels of PCR or microbiologic diagnosis were not related to clinical outcome. In the Cox regression analysis, oriented patients (OR 0.138, IC95% 0.055-0.324), and those with normal albuminemia (OR 0.207, IC95% 0.103-0.417) showed better survival rates. On the contrary, those with active carcinoma (OR 3.2, IC95% 1.181-8.947) significantly showed a reduced life expectancy. Besides the fully accepted Fine scale criteria, albumin measurements should be included in routine evaluation in order to improve patient s prognostic classification.

Reaching out: medical students leading in local communities.

Science.gov (United States)

Bannon, Aidan; O'Hare, Niamh; Corr, Michael; Sterling, Margaret; Gormley, Gerard J

2015-06-01

Queen's University Red Cross is a medical student-led volunteer group with a key aim of promoting social change within local communities and empowering young people to aspire to higher education. We describe 'The Personal Development Certificate', a 12-week community development programme devised by third-year medical students at Queen's University Belfast to target young people who are lacking educational motivation, are disengaged at home or are marginalised through social circumstances. Community-based education is of increasing importance within undergraduate and postgraduate medical education in the UK, and further afield. We evaluated the perceived improvements in key skills such as teamwork, leadership, communication, and problem solving in students following participation in this programme, and the extent to which their attitude and appreciation of community-based medicine changed. [Students] appreciated the opportunity to translate a series of classroom-learned skills to real-life environments Following facilitation of this community-based initiative, all students reported a perceived improvement in the acquired skill sets. Students made strong links from this programme to previous clinical experiences and appreciated the opportunity to translate a series of classroom-learned skills to real-life environments and interactions. The students' appreciation and understanding of community-based medicine was the single most improved area of our evaluation. We have demonstrated that medical students possess the skills to develop and facilitate their own educational projects. Non-clinical, student-led community projects have the potential to be reproduced using recognised frameworks and guidelines to complement the current undergraduate medical curriculum. © 2015 John Wiley & Sons Ltd.

NIMH Project Accept (HPTN 043): results from in-depth interviews with a longitudinal cohort of community members.

Science.gov (United States)

Maman, Suzanne; van Rooyen, Heidi; Stankard, Petra; Chingono, Alfred; Muravha, Tshifhiwa; Ntogwisangu, Jacob; Phakathi, Zipho; Srirak, Namtip; F Morin, Stephen

2014-01-01

NIMH Project Accept (HPTN 043) is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evaluation design included a longitudinal study with community members to assess attitudinal and behavioral changes in study outcomes including HIV testing norms, HIV-related discussions, and HIV-related stigma. A cohort of 657 individuals across all sites was selected to participate in a qualitative study that involved 4 interviews during the study period. Baseline and 30-month data were summarized according to each outcome, and a qualitative assessment of changes was made at the community level over time. Members from intervention communities described fewer barriers and greater motivation for testing than those from comparison communities. HIV-related discussions in intervention communities were more grounded in personal testing experiences. A change in HIV-related stigma over time was most pronounced in Tanzania and Zimbabwe. Participants in the intervention communities from these two sites attributed community-level changes in attitudes to project specific activities. The Project Accept intervention was associated with more favorable social norms regarding HIV testing, more personal content in HIV discussions in all study sites, and qualitative changes in HIV-related stigma in two of five sites.

[Community acquired pneumonia in children: Outpatient treatment and prevention].

Science.gov (United States)

Moreno-Pérez, D; Andrés Martín, A; Tagarro García, A; Escribano Montaner, A; Figuerola Mulet, J; García García, J J; Moreno-Galdó, A; Rodrigo Gonzalo de Lliria, C; Ruiz Contreras, J; Saavedra Lozano, J

2015-12-01

There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Clinical evaluation of the need for carbapenems to treat community-acquired and healthcare-associated pneumonia.

Science.gov (United States)

Kamata, Kazuhiro; Suzuki, Hiromichi; Kanemoto, Koji; Tokuda, Yasuharu; Shiotani, Seiji; Hirose, Yumi; Suzuki, Masatsune; Ishikawa, Hiroichi

2015-08-01

Carbapenems have an overall broad antibacterial spectrum and should be protected against from the acquisition of drug resistance. The clinical advantages of carbapenem in cases of pneumonia have not been certified and the need for antipseudomonal antimicrobial agents to treat healthcare-associated pneumonia (HCAP) remains controversial. We introduced an antimicrobial stewardship program for carbapenem and tazobactam/piperacillin use and investigated the effects of this program on the clinical outcomes of 591 pneumonia cases that did not require intensive care unit management, mechanical ventilation or treatment with vasopressor agents [221 patients with community-acquired pneumonia (CAP) and 370 patients with HCAP]. Compared with the pre-intervention period, age, comorbidities and the severity and etiology of pneumonia did not differ during the intervention period. Carbapenems were rarely used during the intervention period in cases of pneumonia (CAP: 12% vs. 1%, HCAP: 13% vs. 1%), while antipseudomonal beta-lactam use was reduced from 33% to 8% among cases with HCAP. This reduction in the rate of carbapenem administration did not have an impact on the prognosis in the cases of CAP, and the in-hospital mortality was lower among the patients with HCAP during the intervention period (15% vs. 5%, p = 0.013). The causes of death in the cases of HCAP were not directly related to pneumonia during the intervention period. The current study shows that carbapenem use can be avoided in cases of CAP or HCAP that are not in a critical condition. The frequent use of antipseudomonal beta-lactams does not improve the clinical outcomes of HCAP. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Community-acquired urinary tract infections in children: pathogens, antibiotic susceptibility and seasonal changes.

Science.gov (United States)

Yolbaş, I; Tekin, R; Kelekci, S; Tekin, A; Okur, M H; Ece, A; Gunes, A; Sen, V

2013-04-01

Urinary tract infections (UTIs) are common infections affecting children. The aim of our study is to determine microorganisms that cause community-acquired urinary tract infections and their antibiotic susceptibility in children. Our investigation includes 150 cases which has positive urine culture. The cases are detected at Pediatric Polyclinics of Dicle University between June 2010 and June 2011. The study included 118 (78.7%) female and 32 (21.3%) male children. Urinary tract infections were seen in autumn 10.7% (n = 16), summer 35.3% (n = 53), winter 30.7% (n = 46) and spring 23.3% (n = 35). The culture results indicated 75.3% (n = 113) Escherichia coli; 20.7% (n = 31) Klebsiella; 2.7% (n = 4) Proteus and % 1.3 (n = 2) Pseudomonas. The antibiotic resistance against Escherichia coli was found out is amikacin (3%), ertapenem (7%), imipenem (0%), meropenem (0%), nitrofurantoin (9%), trimethoprim/sulfamethoxazole (58%), piperacillin (83%), amoxicillin/clavulanate (50%), ampicillin/sulbactam (65%), cefazolin (54%), cefotaxime (51%), cefuroxime sodium (51% ) and tetracycline (68%). The resistance ratios of Klebsiella are amikacin (0%), imipenem (0%), levofloxacin (0%), meropenem (0%), amoxicillin/clavulanate (57%), ampicillin/sulbactam (79%), ceftriaxone (68%), cefuroxime sodium (74%) and trimethoprim/sulfamethoxazole (61%). The results represent the increasing antibiotic resistance against microorganisms among the community-acquired UTI patients in a developing country such as Turkey. So, the physicians should consider resistance status of the infectious agent and choose effective antibiotics which are nitrofurantoin and cefoxitin for their empirical antibiotic treatment. Furthermore, they should be trained about selection of more effective antibiotics and check the regional studies regularly.

Evaluating the perspectives for hydrogen energy uptake in communities: Success criteria and their application

International Nuclear Information System (INIS)

Shaw, Suzanne; Mazzucchelli, Paola

2010-01-01

In recent years, a number of initiatives have been supported in Europe in the hydrogen energy sector. Communities can play an important role in the adoption process of these emerging technologies: supporting pre-commercial deployment, building public acceptance, and promoting innovation clusters, all of which lay the foundations for more widespread and sustained technology deployment. Participation by communities is hinged on the perceived contribution of technology adoption to community socio-economic and energy related goals, such as, climate change mitigation, air quality improvement, creation of new industries and businesses, exploitation of abundant renewable resources, and meeting growing energy needs. Hydrogen uptake in communities therefore stands to benefit development of the hydrogen energy sector and the communities themselves. This paper presents a methodology for evaluating the potential for successful large-scale hydrogen and fuel cell technology adoption-beyond demonstration projects-within defined community frameworks. This methodology can be a valuable tool, for community decision-makers and industry stakeholders alike, to evaluate and identify opportunities for large-scale hydrogen technology adoption. Results of applying the methodology are presented for three community types: islands, cities and regions. The work in this paper reflects work done within the frame of the European Commission-funded 'Roads2HyCom' project, Work Package 3.

Local cytokine profile and cytological status in children with community-acquired pneumonia arising on the background of the reduced resistance of the organism

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T. G. Malanicheva

2017-01-01

Full Text Available Research objective: to study the features of the cytokine profile and cytological status in children with community-acquired pneumonia, proceeding against a background of reduced resistance of the organism for improving treatment methods. 53 children aged 3 to 7 years were examined. The main group consisted of 30 children with community-acquired pneumonia, which ran against a background of reduced resistance of the body. The comparison group consisted of 23 children with community-acquired pneumonia who had good resistance. Local immunity was studied on the basis of  valuation of cytokine status parameters (tumor necrotic factor-α, interleukin-8, and interferon-γ and cellular composition with an estimate of destructive changes in neutrophils in induced sputum. It was revealed that in the main group of children there is a depression of the neutrophils’ release into the bronchial secretion and a marked increase in the number of neutrophils with maximum signs of destruction of the nucleus and cytoplasm against the background of cytokine status imbalance, manifested in an increase in the content of the tumor necrotic factor-α and a decrease in interleukin-8 and interferon- γ. Inclusion in the traditional therapy of community-acquired pneumonia in children who have a reduced resistance, anti-inflammatory drug fenspiride, eliminates the imbalance of proinflammatory cytokines and increases the release of functionally complete neutrophils in the bronchial secret.

Community-Acquired Serratia Marcescens Spinal Epidural Abscess in a Patient Without Risk Factors: Case Report and Review

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Michael D Parkins

2008-01-01

Full Text Available Serratia marcescens has rarely been reported as an agent of invasive disease in patients presenting from the community. Furthermore, S marcescens is frequently opportunistic, affecting individuals with serious medical comorbidities including immune suppression and diabetes. A case of a community-acquired S marcescens spontaneous lumbar epidural abscess presenting as cauda equina syndrome is reported in a previously well 36-year-old man with no identifiable risk factors. To the authors’ knowledge, this is the first report of invasive S marcescens causing disease in a patient with no medical comorbidities.

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

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Xavier Úcar Martínez

2014-06-01

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

On the Sense of Ownership of a Community Integration Project ...

African Journals Online (AJOL)

On the Sense of Ownership of a Community Integration Project: Phenomenology as Praxis in the Transfer of Project Ownership from Third-Party Facilitators to a Community after Conflict Resolution. ... Alternatively, you can download the PDF file directly to your computer, from where it can be opened using a PDF reader.

Project-Based Community Participatory Action Research Using Geographic Information Technologies

Science.gov (United States)

Kim, Minsung

2018-01-01

The paper investigates the effects of a project-based community participation course in which students chose research topics relevant to a local community. Specifically, the students undertook the following projects: (1) creating a virtual 3D model of a local government office, (2) creating interactive digitized versions of mountain trails using…

Soboba Community Energy Solar Project - Phase 2

Energy Technology Data Exchange (ETDEWEB)

Estrada, Steven [Soboba Band of Luiseno Indians, San Jacinto, CA (United States)

2017-12-31

This is the final technical report for the Soboba Band of Luiseno Indians' second community solar project. Since time immemorial the descendants of the Soboba people are those whom have lived on and occupied the land that is presently known as the cities of San Jacinto, Hemet, Valle Vista and Winchester. On June 19, 1883, President Chester Arthur by Executive Order established the Soboba Indian Reservation, a 3,172-acre tract which included the Soboba village and the adjacent hills. The President had limited authority as he was only able to set aside public land for the establishment of a reservation and had no authority to take private land. Thus the Soboba village; cultivated lands and major springs were part of Rancho San Jacinto Viejo and belonged to Matthew Byrne. Today the Soboba Indian Reservation lies in the lower reaches of the San Jacinto Mountains, across the San Jacinto River from the city of San Jacinto. The Soboba Band of Luiseño Indians was awarded a community solar grant through the U.S. Department of Energy. The incorporated cities of San Jacinto and Hemet, and the unincorporated community of Valle Vista border the Reservation. All three of these surrounding communities have experienced tremendous population growth over the past two decades, with slower growth during the recent economic downturn. The Tribal community that benefits from under this grant includes 1,161 enrolled members, the majority of which live on the reservation. Nearly 41% of the enrolled members are youth, age 18 and under. The elders and community leaders value preserving and maintaining the Luiseño and Cahuilla cultures and Tribal structure for future generations. The proposed project was administered from the Tribal Administration offices located on the reservation. The Soboba Tribal Government consists of five Tribal Members who are elected by the general membership to Tribal Council for a staggered two year term. The Chairman/Chairwoman is elected by a majority vote

A review of the role of Haemophilus influenzae in community-acquired pneumonia

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Mary PE Slack

2015-06-01

Full Text Available In an era when Haemophilus influenzae type b (Hib conjugate vaccine is widely used, the incidence of Hib as a cause of community-acquired pneumonia (CAP has dramatically declined. Non-typeable H. influenzae (NTHi strains and, occasionally, other encapsulated serotypes of H. influenzae are now the cause of the majority of invasive H. influenzae infections, including bacteraemic CAP. NTHi have long been recognised as an important cause of lower respiratory tract infection, including pneumonia, in adults, especially those with underlying diseases. The role of NTHi as a cause of non-bacteraemic CAP in children is less clear. In this review the evidence for the role of NTHi and capsulated strains of H. influenzae will be examined.

The Elwha Science Education Project (ESEP): Engaging an Entire Community in Geoscience Education

Science.gov (United States)

Young, R. S.; Kinner, F.

2008-12-01

Native Americans are poorly represented in all science, technology and engineering fields. This under- representation results from numerous cultural, economic, and historical factors. The Elwha Science Education Project (ESEP), initiated in 2007, strives to construct a culturally-integrated, geoscience education program for Native American young people through engagement of the entire tribal community. The ESEP has developed a unique approach to informal geoscience education, using environmental restoration as a centerpiece. Environmental restoration is an increasingly important goal for tribes. By integrating geoscience activities with community tradition and history, project stakeholders hope to show students the relevance of science to their day-to-day lives. The ESEP's strength lies in its participatory structure and unique network of partners, which include Olympic National Park; the non-profit, educational center Olympic Park Institute (OPI); a geologist providing oversight and technical expertise; and the Lower Elwha Tribe. Lower Elwha tribal elders and educators share in all phases of the project, from planning and implementation to recruitment of students and discipline. The project works collaboratively with tribal scientists and cultural educators, along with science educators to develop curriculum and best practices for this group of students. Use of hands-on, place-based outdoor activities engage students and connect them with the science outside their back doors. Preliminary results from this summer's middle school program indicate that most (75% or more) students were highly engaged approximately 90% of the time during science instruction. Recruitment of students has been particularly successful, due to a high degree of community involvement. Preliminary evaluations of the ESEP's outcomes indicate success in improving the outlook of the tribe's youth towards the geosciences and science, in general. Future evaluation will be likewise participatory

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

Science.gov (United States)

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

2007-11-01

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

Computed tomography findings of community-acquired Stenotrophomonas Maltophilia pneumonia in an immunocompetent patient: A case report

Energy Technology Data Exchange (ETDEWEB)

Cha, Yoon Ki; Kim, Jeung Sook; Park, Seong Yeon; Oh, Jin Young; Kwon, Jae Hyun [Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of)

2016-11-15

Stenotrophomonas maltophilia (S. maltophilia) is a rare, but globally emerging gram-negative multiple-drug-resistant organism usually found in a nosocomial setting in immunocompromised patients. To our best knowledge, computed tomography (CT) features of community-acquired S. maltophilia pneumonia have not been previously reported in an immunocompetent patient. Herein, we presented the CT findings of a previous healthy 56-year-old male with S. maltophilia pneumonia.

What Goes Around: the process of building a community-based harm reduction research project.

Science.gov (United States)

Jalloh, Chelsea; Illsley, Shohan; Wylie, John; Migliardi, Paula; West, Ethan; Stewart, Debbie; Mignone, Javier

2017-11-16

Often, research takes place on underserved populations rather than with underserved populations. This approach can further isolate and stigmatize groups that are already made marginalized. What Goes Around is a community-based research project that was led by community members themselves (Peers). This research aimed to implement a community-based research methodology grounded in the leadership and growing research capacity of community researchers and to investigate a topic which community members identified as important and meaningful. Chosen by community members, this project explored how safer sex and safer drug use information is shared informally among Peers. Seventeen community members actively engaged as both community researchers and research participants throughout all facets of the project: inception, implementation, analysis, and dissemination of results. Effective collaboration between community researchers, a community organization, and academics facilitated a research process in which community members actively guided the project from beginning to end. The methods used in What Goes Around demonstrated that it is not only possible, but advantageous, to draw from community members' involvement and direction in all stages of a community-based research project. This is particularly important when working with a historically underserved population. Purposeful and regular communication among collaborators, ongoing capacity building, and a commitment to respect the experience and expertise of community members were essential to the project's success. This project demonstrated that community members are highly invested in both informally sharing information about safer sex and safer drug use and taking leadership roles in directing research that prioritizes harm reduction in their communities.

Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study

International Nuclear Information System (INIS)

Katchanov, Juri; Siebert, Eberhard; Klingebiel, Randolf; Endres, Matthias

2009-01-01

Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study

Energy Technology Data Exchange (ETDEWEB)

Katchanov, Juri [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); University Hospital Charite, Campus Benjamin Franklin, Department of Neurology, Berlin (Germany); Siebert, Eberhard; Klingebiel, Randolf [Campus Charite Mitte, Charite, Department of Neuroradiology, Berlin (Germany); Endres, Matthias [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); Charite-Universitaetsmedizin Berlin, Center for Stroke Research Berlin, Berlin (Germany)

2009-11-15

Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

NIMH Project Accept (HPTN 043: results from in-depth interviews with a longitudinal cohort of community members.

Directory of Open Access Journals (Sweden)

Suzanne Maman

Full Text Available NIMH Project Accept (HPTN 043 is a community- randomized trial to test the safety and efficacy of a community-level intervention designed to increase testing and lower HIV incidence in Tanzania, Zimbabwe, South Africa and Thailand. The evaluation design included a longitudinal study with community members to assess attitudinal and behavioral changes in study outcomes including HIV testing norms, HIV-related discussions, and HIV-related stigma.A cohort of 657 individuals across all sites was selected to participate in a qualitative study that involved 4 interviews during the study period. Baseline and 30-month data were summarized according to each outcome, and a qualitative assessment of changes was made at the community level over time.Members from intervention communities described fewer barriers and greater motivation for testing than those from comparison communities. HIV-related discussions in intervention communities were more grounded in personal testing experiences. A change in HIV-related stigma over time was most pronounced in Tanzania and Zimbabwe. Participants in the intervention communities from these two sites attributed community-level changes in attitudes to project specific activities.The Project Accept intervention was associated with more favorable social norms regarding HIV testing, more personal content in HIV discussions in all study sites, and qualitative changes in HIV-related stigma in two of five sites.

Joining the Global Community.

Science.gov (United States)

Cawley, John; Knoester, Jocelyn

2002-01-01

Canada World Youth enables young Canadians to live in another part of Canada with youths from a developing country for several months while volunteering in community projects. Then they move as a group to the partner country for several months where the program structure is the same. Participants acquire the skills and values necessary to…

Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus ST30-SCCmecIVc-spat019-PVL positive in San Antonio de Areco, Argentina

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Silvina Fernández

2015-03-01

Full Text Available Community-acquired methicillin-resistant Staphylococcus aureus is the first cause of skin and soft tissue infections, but can also produce severe diseases such as bacteremia, osteomyelitis and necrotizing pneumonia. Some S. aureus lineages have been described in cases of necrotizing pneumonia worldwide, usually in young, previously healthy patients. In this work, we describe a fatal case of necrotizing pneumonia due to community-acquired methicillin-resistant S. aureus clone ST30-SCCmecIVc-spat019-PVL positive in an immunocompetent adult patient.

Project Chrysalis: The Evolution of a Community School.

Science.gov (United States)

Garrett, K.

1996-01-01

Describes the creation and operation of Project Chrysalis, a community, service-learning school transformed from row houses, where children can learn, work, and gain inspiration from artists and social entrepreneurs involved with Houston's Project Row Houses. Personal narratives of two teachers highlight the school's and students' accomplishments…

Predictors for individual patient antibiotic treatment effect in hospitalized community-acquired pneumonia patients.

Science.gov (United States)

Simonetti, A F; van Werkhoven, C H; Schweitzer, V A; Viasus, D; Carratalà, J; Postma, D F; Oosterheert, J J; Bonten, M J M

2017-10-01

Our objective was to identify clinical predictors of antibiotic treatment effects in hospitalized patients with community-acquired pneumonia (CAP) who were not in the intensive care unit (ICU). Post-hoc analysis of three prospective cohorts (from the Netherlands and Spain) of adult patients with CAP admitted to a non-ICU ward having received either β-lactam monotherapy, β-lactam + macrolide, or a fluoroquinolone-based therapy as empirical antibiotic treatment. We evaluated candidate clinical predictors of treatment effects in multiple mixed-effects models by including interactions of the predictors with empirical antibiotic choice and using 30-day mortality, ICU admission and length of hospital stay as outcomes. Among 8562 patients, empirical treatment was β-lactam in 4399 (51.4%), fluoroquinolone in 3373 (39.4%), and β-lactam + macrolide in 790 (9.2%). Older age (interaction OR 1.67, 95% CI 1.23-2.29, p 0.034) and current smoking (interaction OR 2.36, 95% CI 1.34-4.17, p 0.046) were associated with lower effectiveness of fluoroquinolone on 30-day mortality. Older age was also associated with lower effectiveness of β-lactam + macrolide on length of hospital stay (interaction effect ratio 1.14, 95% CI 1.06-1.22, p 0.008). Older age and smoking could influence the response to specific antibiotic regimens. The effect modification of age and smoking should be considered hypothesis generating to be evaluated in future trials. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Evaluating Stream Restoration Projects: What Do We Learn from Monitoring?

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Zan Rubin

2017-02-01

Full Text Available Two decades since calls for stream restoration projects to be scientifically assessed, most projects are still unevaluated, and conducted evaluations yield ambiguous results. Even after these decades of investigation, do we know how to define and measure success? We systematically reviewed 26 studies of stream restoration projects that used macroinvertebrate indicators to assess the success of habitat heterogeneity restoration projects. All 26 studies were previously included in two meta-analyses that sought to assess whether restoration programs were succeeding. By contrast, our review focuses on the evaluations themselves, and asks what exactly we are measuring and learning from these evaluations. All 26 studies used taxonomic diversity, richness, or abundance of invertebrates as biological measures of success, but none presented explicit arguments why those metrics were relevant measures of success for the restoration projects. Although changes in biodiversity may reflect overall ecological condition at the regional or global scale, in the context of reach-scale habitat restoration, more abundance and diversity may not necessarily be better. While all 26 studies sought to evaluate the biotic response to habitat heterogeneity enhancement projects, about half of the studies (46% explicitly measured habitat alteration, and 31% used visual estimates of grain size or subjectively judged ‘habitat quality’ from protocols ill-suited for the purpose. Although the goal of all 26 projects was to increase habitat heterogeneity, 31% of the studies either sampled only riffles or did not specify the habitats sampled. One-third of the studies (35% used reference ecosystems to define target conditions. After 20 years of stream restoration evaluation, more work remains for the restoration community to identify appropriate measures of success and to coordinate monitoring so that evaluations are at a scale capable of detecting ecosystem change.

Influence of socioeconomic status on community-acquired pneumonia outcomes in elderly patients requiring hospitalization: a multicenter observational study

Directory of Open Access Journals (Sweden)

Carratalà Jordi

2010-07-01

Full Text Available Abstract Background The associations between socioeconomic status and community-acquired pneumonia outcomes in adults have been studied although studies did not always document a relationship. The aim of this multicenter observational study was to determine the association between socioeconomic status and community-acquired pneumonia outcomes in the elderly, in the context of a public health system providing universal free care to the whole population. Methods A total of 651 patients aged ≥65 years hospitalized due to community-acquired pneumonia through the emergency departments of five Spanish public hospitals were recruited and followed up between May 2005 and January 2007. The primary outcomes studied were: length of stay, intensive care unit admission, overall mortality and readmission. Socioeconomic status was measured using both individual and community data: occupation [categorized in six social groups (I, II, III, IVa, IVb and V], educational level (≤ primary level or ≥ secondary level and disposable family income of the municipality or district of residence [>12,500 € (high municipality family income and ≤12,500 € (low municipality family income]. The six social groups were further categorized as upper/middle social class (groups I-IVb and lower class (group V. Bivariate and multivariate analyses were performed. OR and their 95% confidence intervals were calculated. All statistical tests were two tailed and statistical significance was established as p Results 17.7% of patients lived in a municipality or district with a high municipality family income and 63.6% were upper/middle social class (I-IVb. Only 15.7% of patients had a secondary education. The adjusted analysis showed no association between pneumonia outcomes and social class, educational level or municipality family income. However, length of stay increased significantly in patients in whom the factors, living alone and being a smoker or ex-smoker coincided (p

Alpena Community College Workplace Partnership Project. Final Report.

Science.gov (United States)

Alpena Community Coll., MI.

This document consists of materials produced during the Workplace Partnership Project (WPP), a National Workplace Literacy Program-funded workplace literacy partnership between Alpena Community College (ACC) in Alpena, Michigan, and area businesses. Presented first is a personal reflection in which the project director shares some of the lessons…

Etiology of childhood community acquired pneumonia and its implications for vaccination

Directory of Open Access Journals (Sweden)

Nascimento-Carvalho Cristiana M.C.

2001-01-01

Full Text Available Pneumonia is an important cause of morbidity and mortality among children throughout the world. Vaccines are available for some organisms, but they are underutilized and/or still in development. To evaluate the potential impact of vaccines, we review studies in which the etiology of childhood community-acquired pneumonia was recorded. In North America and Europe (9 studies, the etiology of pneumonia was established in 62% of studied children (range 43%-88% by use of noninvasive specific methods for microbiologic diagnosis. The most often identified agents were S. pneumoniae (22%, respiratory syncytial virus (RSV (20%, Haemophilus influenzae (7%, and Mycoplasma pneumoniae (15%. In Africa and South America (8 studies, bacteria were recovered from 56% (range 32%-68% of severely ill children studied by lung aspirate. The most often isolated bacteria were Streptococcus pneumoniae (33% and Haemophilus influenzae (21%. A high percentage of H. influenzae strains were not serotype b. Throughout the world, children requiring hospitalization were most likely to have infection caused by pneumococcus H. influenzae or RSV. Out patients also had Mycoplasma pneumoniae. Countries in Africa and Asia recorded 2 to 10 times more children with pneumonia (7 to 40/100 annually than in the USA. Widespread use of pneumococcal and H. influenzae type b conjugate vaccines could reduce the frequency of childhood pneumonia by one-third. Further reduction will require development of non-type b H. influenzae, RSV and M. pneumoniae vaccines. This could result in a > 50% reduction of pneumonia in children. This goal should be sought and achieved as soon as possible.

[Risk scores for community acquired pneumonia in elderly and geriatric patients].

Science.gov (United States)

Pflug, M A; Wesemann, T; Heppner, H J; Thiem, U

2015-10-01

Community-acquired pneumonia (CAP) is still an important and serious disease for elderly and geriatric patients. For epidemiological and clinical reasons it is important to collate the frequencies of the various degrees of severity of CAP and to obtain information on the spread and degree of the threat to the various risk groups by CAP. In outpatient treatment a simple to execute prognosis score can be used to objectify the assessment of the clinical status of a patient and to support therapeutic decision-making. For this purpose knowledge of the appropriate instruments should be available to potential users. Since the 1990s a variety of risk scores for stratification of CAP have been developed and evaluated. This article presents the content and value of the available risk scores whereby the advantages and disadvantages of the individual scores are critically compared. Special emphasis is placed on the importance of the risk scores for geriatric patients. At present the decision about outpatient or inpatient treatment is primarily based on the risk score CRB-65. Criteria for intensive care unit admissions are provided by the modified American Thoracic Society (ATS) set of criteria. Overall, risk scores are less reliable for elderly patients than for younger adults. For treatment decisions for the elderly, functional aspects should also be considered in addition to the aspects of risk scores discussed here. In particular, the decision about inpatient admission for elderly, geriatric CAP patients should be made on an individual basis taking the benefit-risk relationship into consideration.

Community Wind: Once Again Pushing the Envelope of Project Finance

Energy Technology Data Exchange (ETDEWEB)

bolinger, Mark A.

2011-01-18

In the United States, the 'community wind' sector - loosely defined here as consisting of relatively small utility-scale wind power projects that sell power on the wholesale market and that are developed and owned primarily by local investors - has historically served as a 'test bed' or 'proving grounds' for up-and-coming wind turbine manufacturers that are trying to break into the U.S. wind power market. For example, community wind projects - and primarily those located in the state of Minnesota - have deployed the first U.S. installations of wind turbines from Suzlon (in 2003), DeWind (2008), Americas Wind Energy (2008) and later Emergya Wind Technologies (2010), Goldwind (2009), AAER/Pioneer (2009), Nordic Windpower (2010), Unison (2010), and Alstom (2011). Thus far, one of these turbine manufacturers - Suzlon - has subsequently achieved some success in the broader U.S. wind market as well. Just as it has provided a proving grounds for new turbines, so too has the community wind sector served as a laboratory for experimentation with innovative new financing structures. For example, a variation of one of the most common financing arrangements in the U.S. wind market today - the special allocation partnership flip structure (see Figure 1 in Section 2.1) - was first developed by community wind projects in Minnesota more than a decade ago (and is therefore sometimes referred to as the 'Minnesota flip' model) before being adopted by the broader wind market. More recently, a handful of community wind projects built over the past year have been financed via new and creative structures that push the envelope of wind project finance in the U.S. - in many cases, moving beyond the now-standard partnership flip structures involving strategic tax equity investors. These include: (1) a 4.5 MW project in Maine that combines low-cost government debt with local tax equity, (2) a 25.3 MW project in Minnesota using a sale/leaseback structure

Project evaluation: one framework - four approaches

DEFF Research Database (Denmark)

Rode, Anna Le Gerstrøm; Svejvig, Per

. Introducing a framework that can help structure such evaluations, the aim of this paper is to contribute to project theory and practice by inspiring project researchers and aiding project workers in their efforts to open up the black box of projects and deliver relevant and valuable results......There are many theoretical and practical reasons for evaluating projects – including explorative arguments focusing on expanding descriptive knowledge on projects as well as normative arguments focusing on developing prescriptive knowledge of project management. Despite the need for effective...... project management and research methods that can assess effective project management methodologies, extant literature on evaluation procedures or guidelines on how to evaluate projects and/or project management is scarce. To address this challenge, this paper introduces an evaluation framework consisting...

Value of Lung Ultrasonography in the Diagnosis and Outcome Prediction of Pediatric Community-Acquired Pneumonia with Necrotizing Change.

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Shen-Hao Lai

Full Text Available Lung ultrasonography has been advocated in diagnosing pediatric community-acquired pneumonia. However, its function in identifying necrotizing pneumonia, a complication, has not been explored. This study investigated the value of lung ultrasonography in diagnosing pediatric necrotizing pneumonia and its role in predicting clinical outcomes.We retrospectively reviewed 236 children with community-acquired pneumonia who were evaluated using lung ultrasonography within 2-3 days after admission. The ultrasonographic features assessed included lung perfusion, the presence of hypoechoic lesions, and the amount of pleural effusion. Chest computed tomography was also performed in 96 patients as clinically indicated. Detailed records of clinical information were obtained.Our results showed a high correlation between the degree of impaired perfusion in ultrasonography and the severity of necrosis in computed tomography (r = 0.704. The degree of impaired perfusion can favorably be used to predict massive necrosis in computed tomography (area under the receiver operating characteristic curve, 0.908. The characteristics of impaired perfusion and hypoechoic lesions in ultrasonography were associated with an increased risk of pneumatocele formation (odds ratio (OR, 10.11; 95% CI, 2.95-34.64 and the subsequent requirement for surgical lung resection (OR, 8.28; 95% CI, 1.86-36.93. Furthermore, a longer hospital stay would be expected if moderate-to-massive pleural effusion was observed in addition to impaired perfusion in ultrasonography (OR, 3.08; 95% CI, 1.15-8.29.Lung ultrasonography is favorably correlated with chest computed tomography in the diagnosis of necrotizing pneumonia, especially regarding massive necrosis of the lung. Because it is a simple and reliable imaging tool that is valuable in predicting clinical outcomes, we suggest that ultrasonography be applied as a surrogate for computed tomography for the early detection of severe necrotizing

Community-researcher liaisons: the Pathways to Resilience Project ...

African Journals Online (AJOL)

The Pathways to Resilience Project is an ongoing, community-based participatory research (CBPR) project. Its express focus is the exploration of how at-risk youths use formal services and/or informal, naturally occurring resources to beat the odds that have been stacked against them, with the intent of partnering with ...

Assessing community-based conservation projects: A systematic review and multilevel analysis of attitudinal, behavioral, ecological, and economic outcomes

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Brooks Jeremy

2013-01-01

Full Text Available Abstract Background Community-based conservation (CBC promotes the idea that long-term conservation success requires engaging with, and providing benefits for local communities. Though widespread, CBC projects are not always successful or free of controversy. With criticisms on all sides of the conservation debates, it is critical to have a better understanding of (1 whether CBC is an effective conservation tool, and (2 of the factors associated with the success or failure of CBC projects, and the scale at which these factors operate. Recent CBC reviews have typically examined only a single resource domain, have limited geographic scope, consider only one outcome, or ignore the nested nature of socioecological systems. To remedy these issues, we use a newly coded global comparative database of CBC projects identified by systematic review to evaluate success in four outcome domains (attitudes, behaviors, ecological, economic and explore synergies and tradeoffs among these outcomes. We test hypotheses about how features of the national context (H-NC, project design (H-PD, and local community characteristics (H-CC affect these four measures of success. Methods To add to a sample of 62 projects that we used from previous systematic reviews, we systematically searched the conservation literature using six terms in four online databases. To increase the number of projects for each country in order to conduct a multilevel analysis, we also conducted a secondary search using the Advancing Conservation in a Social Context online library. We coded projects for 65 pieces of information. We conducted bivariate analyses using two-dimensional contingency tables and proportional odds logistic regression and conducted multivariate analyses by fitting reduced form proportional odds logistic regression models that were selected using a forward stepwise AIC approach. Results The primary and secondary searches produced 74 new projects to go along with the 62

Local embeddedness in community energy projects. A social entrepreneurship perspective

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Mihaela Vancea

2017-12-01

Full Text Available An increasing number of community energy projects have emerged recently, reflecting diverse sociotechnical configurations in the energy sector. This article is based on an empirical study examining different types of community energy projects such as energy cooperatives, public service utilities and other entrepreneurially oriented initiatives across the European Union. Based on an in-depth analysis of three case studies, the article aims to introduce a social entrepreneurship perspective when discussing the relationship between local embeddedness and different forms of organisation and ownership in community energy. The results indicate that community energy projects can expand beyond the local scale without losing their collective and democratic form of functioning and ownership. Moreover, social movements can act as catalysts for this expansion beyond the local, in a quest for wider social transformation. Social entrepreneurship may provide a suitable analytical lens to avoid the ‘local trap’ when examining different forms of organisation and ownership in renewable energy, and further explore the question of scaling.

Data management for community research projects: A JGOFS case study

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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

The Biodiversity Community Action Project: An STS Investigation

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Aidin, Amirshokoohi; Mahsa, Kazempour

2010-01-01

The Biodiversity Community Action Project is a stimulating and vigorous project that allows students to gain an in-depth understanding of the interconnection between organisms and their environments as well as the connection of science to their lives and society. It addresses key content standards in the National Science Education Standards and…

Multilevel perspectives on community intervention: an example from an Indo-US HIV prevention project in Mumbai, India.

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Schensul, Stephen L; Saggurti, Niranjan; Singh, Rajendra; Verma, Ravi K; Nastasi, Bonnie K; Mazumder, Papiya Guha

2009-06-01

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.

Safe Routes to School Local School Project: A health evaluation at 10 low-income schools

OpenAIRE

Cooper, Jill F MSW; McMillan, Tracy MPH, PHD

2010-01-01

fe Routes to School National Partnership (Partnership) founded the Local School Project (Project) in 2008 to assist ten schools in lowincome communities to: 1) develop and evaluate a school-based SRTS program, 2) build local capacity to apply for state or federal SRTS funding, and 3) increase safe walking and bicycling to and from the school and in the community. The Centers for Disease Control and Prevention, Kaiser Permanente, and the Robert Wood Johnson Foundation provided funding for the ...

[Nursing Research Project on Management Training (IN.FOR.MA): evaluation of the competencies acquired during Phase 1].

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Rega, Maria Luisa; Ghera, Patrizia; Dessy, Orietta; Di Lullo, Massimiliano; Galletti, Caterina

2012-01-01

The aim of the present study is to define the state of the art in nursing management training in Italy and to assess the effectiveness of training in a working context. The first phase of the IN.FOR.MA project consisted of creating a data collection tool, a questionnaire, based on paradigmatic pedagogic methodology. This was followed by a pilot study to test its effectiveness. Reliability was tested using the Cronbach's alpha test and the values obtained were between 0.79 and 0.82 for the overall scale and between 0.71 and 0.90 for the subscales. The maximum expression of the competencies perceived using the Likert scale was 4 (Fair), with a maximum value of 5 obtained in 53,06% of the total sample in the "Management" area and a minimum value between 3 (discreet) and 4 (fair) in 33.6% of the total in the area "Training and Research". Perception of the working value of the training experience reached 5 (very) , with an average value of 54,08% of the overall sample. The IN.FOR.MA questionnaire made it possible to assess the training course by focusing on the perception of the competencies acquired, with medium to high levels according to the Likert scale. The level of usefulness of these competencies in daily activities was highest in "Management" followed by "Programming and organization" and "Integration".

Mycoplasma Pneumoniae among Children Hospitalized with Community-acquired Pneumonia.

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Kutty, Preeta K; Jain, Seema; Taylor, Thomas H; Bramley, Anna M; Diaz, Maureen H; Ampofo, Krow; Arnold, Sandra R; Williams, Derek J; Edwards, Kathryn M; McCullers, Jonathan A; Pavia, Andrew T; Winchell, Jonas M; Schrag, Stephanie J; Hicks, Lauri A

2018-05-17

The burden and epidemiology of Mycoplasma pneumoniae (Mp) among U.S. children (<18 years) hospitalized with community-acquired pneumonia (CAP) are poorly understood. In the Etiology of Pneumonia in the Community (EPIC) study, we prospectively enrolled 2254 children hospitalized with radiographically-confirmed pneumonia from January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp using real-time polymerase chain reaction (PCR). Clinical and epidemiological features of Mp-PCR-positive and -negative children were compared using logistic regression. Macrolide susceptibility was assessed by genotyping isolates. In the EPIC study, 182(8%) children were Mp-PCR-positive (median age: 7 years); 12% required intensive care and 26% had pleural effusion. No in-hospital deaths occurred. Macrolide resistance was found in 6/169(4%) isolates. Of 178(98%) Mp-PCR-positive children tested for co-pathogens, 50(28%) had ≥1 co-pathogen detected. Variables significantly associated with higher odds of Mp detection included age {10-17 years [adjusted odds ratio (aOR): 7.9 (95% confidence interval (CI): 4.5-13.6)] and 5-9 years [aOR: 4.8 (CI: 2.9-7.8)] vs. 2-4 years}, outpatient antibiotics ≤5 days pre-admission [aOR: 2.3 (CI: 1.5-3.4)], and co-pathogen detection [aOR: 2.1 (CI: 1.3-3.1)]. Clinical characteristics often seen included hilar lymphadenopathy, rales, headache, sore throat, and decreased breath sounds. Usually considered as a mild respiratory infection, M. pneumoniae was the most commonly detected bacteria among children ≥5 years hospitalized with CAP; one-quarter of whom had co-detections. Although associated with clinically non-specific symptoms, there was a need for intensive care support in some cases. M. pneumoniae should be included in the differential diagnosis for school-aged children hospitalized with CAP.

The Seropositivity Rate of Atypical Agents in Patients with Community-Acquired Pneumonia

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Ruhan Karakoc Gunes

2007-08-01

Full Text Available The aim of this study was to investigate the IgM antibody positivities of atypical pneumonia agents in patients with community-acquired pneumonia (CAP, and to compare the results with controls. The serum samples which were collected from 87 adult patients and 21 healthy controls have been investigated by a commercial ELISA (Pneumobact ELISA IgM, Vircell, Spain in which four different atypical pneumonia agents were fixed onto a slide. In the patients group, IgM positivity rates for the agents were as follows, respectively; 2.3% for Legionella pneumophila, 56.3% Chlamydia pneumoniae, 33.3% for Mycoplasma pneumoniae, 9.2% for Coxiella burnetii. The rates of IgM positivities in the control group varied 7% for all of the agents except M. Pneumoniae and C. Pneumoniae and 2 of these controls were positive for L. Pneumophila IgM, one was positive for C. Burnetii IgM. According to the statistical evaluation, there were significant differences for IgM seropositivities to Mycoplasma pneumoniae and Chlamydia Pneumoniae,between the patient and the control groups (p0.05. We showed that the seropositivity rate of atypical agents in patients with CAP was significantly higher when compared to healthy control group. This result suggests us, atypical agents might be responsible in CAP patients in a great amount. Furthermore, our study also suggests that clinical and radiological findings are not useful for discriminating atypical from typical pneumonia. [TAF Prev Med Bull 2007; 6(4.000: 279-284

Acquired pneumonias in the community in adults: An etiologic prospective study with emphasis in the diagnosis

International Nuclear Information System (INIS)

Robledo, J; Sierra, P; Bedoya, F; Londono, A; Porras, A; Lujan, M; Correa, N; Mejia, GI; Realpe, T; Trujillo, H

2003-01-01

Is defined prospectively in adults the etiology of acquired pneumonia in the community (NAC) in three hospitals of the city of Medellin. The etiology of NAC in the studied group does not vary of the one reported in other countries, the pneumococo frequency and M. pneumoniae, suggests that the empiric therapies should contemplate these two pathologies, the resource toasted by the microbiology laboratory allows to define the etiology and the specific treatment

The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

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Elder, W G; Amundson, B A

1991-01-01

The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

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

Science.gov (United States)

2009-05-14

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

MATCHING CONFIGURATIONS PROJECTS OF COOPERATIVE MILK COLLECTION PROJECT ENVIRONMENT

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Анатолій Миколайович ТРИГУБА

2017-03-01

Full Text Available The condition analysis of dairy farming is done and the reasons for its degradation are revealed. The need of technologically integrated production systems projects, harvesting, and processing of milk are substantiated. A scientific methodology and the method of project design of milk provision cooperative coordination in the community of the project environment, which are based on systematic-evaluative approach and simulation are proposed. The criterion for the definition of rational parameters of objects configuration for milk provision cooperative projects in the community system is the maximum value of their product. The monetary functioning assessment of the configuration object of cooperative milk provision projects in the community is done. On the basis of the proposed method, we performed the coordination of project configuration of milk provision cooperative with the project environment of territory Zabolotsi community in Brody district of Lviv region.

Community Psychology, Evaluation, and Social Critique

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Miller, Robin Lin

2015-01-01

Community psychology blends psychological science, a community-level perspective on social issues, and a social justice orientation. Despite important difference between community psychology and program evaluation, program evaluation is a key component of many community psychologists' practice and holds a central place in my own. In this…

Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries.

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Ocampo, Wrechelle; Cheung, Amanda; Baylis, Barry; Clayden, Nancy; Conly, John M; Ghali, William A; Ho, Chester H; Kaufman, Jaime; Stelfox, Henry T; Hogan, David B

2017-07-01

To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review

Treatment with macrolides and glucocorticosteroids in severe community-acquired pneumonia: A post-hoc exploratory analysis of a randomized controlled trial.

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Adrian Ceccato

Full Text Available Systemic corticosteroids have anti-inflammatory effects, whereas macrolides also have immunomodulatory activity in addition to their primary antimicrobial actions. We aimed to evaluate the potential interaction effect between corticosteroids and macrolides on the systemic inflammatory response in patients with severe community-acquired pneumonia to determine if combining these two immunomodulating agents was harmful, or possibly beneficial.We performed a post-hoc exploratory analysis of a randomized clinical trial conducted in three tertiary hospitals in Spain. This trial included patients with severe community-acquired pneumonia with high inflammatory response (C-reactive protein [CRP] >15 mg/dL who were randomized to receive methylprednisolone 0.5 mg/kg/tpd or placebo. The choice of antibiotic treatment was at the physician's discretion. One hundred and six patients were classified into four groups according to antimicrobial therapy combination (β-lactam plus macrolide or β-lactam plus fluoroquinolone and corticosteroid arm (placebo or corticosteroids. The primary outcome was treatment failure (composite outcome of early treatment failure, or of late treatment failure, or of both early and late treatment failure.The methylprednisolone with β-lactam plus macrolide group had more elderly patients, with comorbidities, and higher pneumonia severity index (PSI risk class V, but a lower proportion of intensive care unit admission, compared to the other groups. We found non differences in treatment failure between groups (overall p = 0.374; however, a significant difference in late treatment failure was observed (4 patients in the placebo with β-lactam plus macrolide group (31% vs. 9 patients in the placebo with β-lactam plus fluoroquinolone group (24% vs. 0 patients in the methylprednisolone with β-lactam plus macrolide group (0% vs. 2 patients [5%] in the methylprednisolone with β-lactam plus fluoroquinolone group overall p = 0.009. We found

Update on the prevention and control of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA).

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Skov, Robert; Christiansen, Keryn; Dancer, Stephanie J; Daum, Robert S; Dryden, Matthew; Huang, Yhu-Chering; Lowy, Franklin D

2012-03-01

The rapid dissemination of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) since the early 2000s and the appearance of new successful lineages is a matter of concern. The burden of these infections varies widely between different groups of individuals and in different regions of the world. Estimating the total burden of disease is therefore problematic. Skin and soft-tissue infections, often in otherwise healthy young individuals, are the most common clinical manifestation of these infections. The antibiotic susceptibilities of these strains also vary, although they are often more susceptible to 'traditional' antibiotics than related hospital-acquired strains. Preventing the dissemination of these organisms throughout the general population requires a multifaceted approach, including screening and decolonisation, general hygiene and cleaning measures, antibiotic stewardship programmes and, in the future, vaccination. The current evidence on the prevention and control of CA-MRSA is appraised and summarised in this review. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Qualitative evaluation of the Teenage Mothers Project in Uganda: a community-based empowerment intervention for unmarried teenage mothers

NARCIS (Netherlands)

Leerlooijer, J.N.; Bos, A.E.R.; Ruiter, R.A.C.; Reeuwijk, van M.A.J.; Rijsdijk, E.; Nshakira, N.; Kok, G.

2013-01-01

Background A large proportion of unmarried teenage mothers in Uganda face physical, psychological, and social problems after pregnancy and childbirth, such as obstetric complications, lack of education, and stigmatisation in their communities. The Teenage Mothers Project (TMP) in Eastern Uganda

Service-learning and learning communities: two innovative school projects that are mutually enriched

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Carmen ÁLVAREZ ÁLVAREZ

2015-12-01

Full Text Available This article reflects on the interrelationships that exist between two educational projects of today: service-learning (ApS and learning communities (CdA. The ApS is an educational methodology applied worldwide where a single project combines a learning based on experience with the implementation of a service to the community. CdA is a school transformation project to achieve that the information society does not exclude any person, constituting a reality in more than one hundred and ninety schools in Spain and Latin America. Between the two, it is possible to show differences, especially in what refers to its theoretical substrates, but in actual teaching practice in schools there is some harmony, particularly in the so closely that they cultivate both projects with the school community. Therefore, we conclude that service-learning and learning communities can occur as two innovative and relevant today projects which can be mutually enriching: because for both the approach school-community-environment and volunteering is essential.

Building a community-based culture of evaluation.

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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.

Community-Acquired Pneumonia and Empyema Caused by Citrobacter koseri in an Immunocompetent Patient

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Miguel Angel Ariza-Prota

2015-01-01

Full Text Available Citrobacter species, belonging to the family Enterobacteriaceae, are environmental organisms commonly found in soil, water, and the intestinal tracts of animals and humans. Citrobacter koseri is known to be an uncommon but serious cause of both sporadic and epidemic septicemia and meningitis in neonates and young infants. Most cases reported have occurred in immunocompromised hosts. The infections caused by Citrobacter are difficult to treat with usual broad spectrum antibiotics owing to rapid generation of mutants and have been associated with high death rates in the past. We believe this is the first case described in the literature of a community-acquired pneumonia and empyema caused by Citrobacter koseri in an immunocompetent adult patient.

The impact of a community mobilization project on health-related knowledge and practices in Cameroon.

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Babalola, S; Sakolsky, N; Vondrasek, C; Mounlom, D; Brown, J; Tchupo, J P

2001-12-01

The analyses presented in this paper document the impact of a community mobilization effort in Cameroon. Between 1997 and 1998, a local non-governmental organization worked with community associations, Njangi, in one urban and one rural location to promote knowledge and positive practices concerning family planning, sexually transmitted diseases, and treatment of common childhood diseases. Based on a multi-tiered structure, the project involved selecting and training two prominent and influential members of each community as "relais" or middlemen. The "relais" then trained mobilizers from participating Njangis to provide relevant information and help to mobilize their fellow members in favor of the positive attitudes and practices promoted by the project. The project was evaluated using baseline and follow-up measurement of pertinent indicators, and service statistics. Results suggest that the intervention had significant influence in the rural location with noticeable positive effects on knowledge and practices of family planning, knowledge and attitudes about HIV/AIDS and STIs, and use of health services. In the urban location, for programmatic and extraneous factors, the intervention was not effective. The paper discusses the lessons learnt from the intervention and offers pertinent suggestions for replicating the intervention in rural settings.

A review of community-based solar home system projects in the Philippines

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Macabebe Erees Queen B.

2016-01-01

Full Text Available Solar Home Systems (SHS are easy to deploy in island and in remote communities where grid connection is costly. However, issues related to maintenance of these systems emerge after they are deployed because of the remoteness and inaccessibility of the communities. This study looked into community-based programs in the Philippines and investigated the following: (1 social preparation, (2 role of the community in the project, and (3 sustainability of the program. In this paper, three communities under two government programs offering SHS are presented. These programs are the Solar Power Technology Support (SPOTS program of the Department of Agrarian Reform (DAR and the Household Electrification Program (HEP of the Department of Energy (DOE. A focused group discussion and key informant interviews were conducted in two communities in Bukidnon province and in a community in Kalinga to obtain information from the project beneficiaries and SHS users on the preparation, implementation and maintenance of the projects. The results revealed that emphasis on the economic value of the technology, proper training of the locals on the technical and management aspects of the project, as well as the establishment of a supply chain for replacement parts are crucial factors for the sustainability of the programs.

Failure to Thrive? The Community Literacy Strand of the Additive Bilingual Project at an Eastern Cape Community School, South Africa

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Hunt, George

2007-01-01

This paper discusses an attempt to establish community literacy procedures in an Eastern Cape community school. The school hosts the Additive Bilingual Education (ABLE) project, a cooperation between UK and South African universities and the school trust. The community literacy strand of the project encourages family members to contribute oral…

Prospective study of a community reintegration programme for patients with acquired chronic brain injury: effects on caregivers' emotional burden and family functioning.

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Geurtsen, Gert J; van Heugten, Caroline M; Meijer, Ron; Martina, Juan D; Geurts, Alexander C H

2011-01-01

To examine the effects of a residential community reintegration programme for patients with psychosocial problems due to acquired chronic brain injury on caregivers' emotional burden and family functioning. A prospective cohort study with waiting list control and 1-year follow-up. Forty-one caregivers of which 28 female. Mean age was 48 ± 8.3 years and 33 caregivers were parents. A structured residential treatment programme was offered to the patients directed at domestic life, work, leisure time and social interactions. The Involvement Evaluation Questionnaire for Brain Injury (IEQ-BI) for emotional burden, the General Health Questionnaire (GHQ) for psychological health and the Family Assessment Device (FAD) for family functioning were used. There was an overall significant effect of Time for all outcome measures (MANOVA T(2 )= 9.1, F(15,317) = 64.1, p = 0.000). The effect sizes were moderate for three IEQ-BI sub-scales (partial η(2 )= 0.12-0.17) and small for two sub-scales (partial η(2 )= 0.05-0.09). The effect size for GHQ was moderate (partial η(2 )= 0.11). As for FAD no significant time effects were present (partial η(2 )= 0.00-0.04). Emotional burden and psychological health of the caregivers improved significantly when patients with acquired brain injury and psychosocial problems followed a residential community reintegration programme. Family dynamics remained stable.

Drug resistance in community-acquired respiratory tract infections: role for an emerging antibacterial

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Lorenzo Aguilar

2010-06-01

Full Text Available Lorenzo Aguilar1, María-José Giménez1, José Barberán21Microbiology Department, School of Medicine, University Complutense, Madrid; 2Infectious Diseases Department, Hospital Central de la Defensa Gomez Ulla, Madrid, SpainAbstract: The nasopharynx is the ecological niche where evolution towards resistance occurs in respiratory tract isolates. Dynamics of different bacterial populations in antibiotic-free multibacterial niches are the baseline that antibiotic treatments can alter by shifting the competitive balance in favor of resistant populations. For this reason, antibiotic resistance is increasingly being considered to be an ecological problem. Traditionally, resistance has implied the need for development of new antibiotics for which basic efficacy and safety data are required prior to licensing. Antibiotic development is mainly focused on demonstrating clinical efficacy and setting susceptibility breakpoints for efficacy prediction. However, additional information on pharmacodynamic data predicting absence of selection of resistance and of resistant subpopulations, and specific surveillance on resistance to core antibiotics (to detect emerging resistances and its link with antibiotic consumption in the community are valuable data in defining the role of a new antibiotic, not only from the perspective of its therapeutic potential but also from the ecologic perspective (countering resistances to core antibiotics in the community. The documented information on cefditoren gleaned from published studies in recent years is an example of the role for an emerging oral antibacterial facing current antibiotic resistance in community-acquired respiratory tract infections.Keywords: respiratory tract infection, antibiotic resistance, cefditoren, community

Usefulness of Plasma YKL-40 in Management of Community-Acquired Pneumonia Severity in Patients

Directory of Open Access Journals (Sweden)

Hsiang-Ling Wang

2013-11-01

Full Text Available Plasma YKL-40 level has been reported as playing a significant role in community-acquired pneumonia (CAP. However, the correlation between plasma level of YKL-40 and the severity of CAP has not been reported. This study identifies the relationship between plasma level changes of the YKL-40 gene in adult patients hospitalized with CAP. The ELISA was used to measure the plasma YKL-40 level from 61 adult CAP patients before and after antibiotic treatment and from 60 healthy controls. The plasma YKL-40 levels were significantly increased in patients with CAP compared to normal controls. Moreover, the plasma concentration of YKL-40 correlated with the severity of CAP based on the pneumonia severity index (PSI score (r = 0.630, p < 0.001, the CURB-65 (confusion, uremia, respiratory rate, BP, age 65 years score (r = 0.640, p < 0.001, the Acute Physiology And Chronic Health Evaluation II (APACHE II score (r = 0.539, p < 0.001 and length of hospital stay (r = 0.321, p = 0.011, respectively. In conclusion, plasma YKL-40 may play a role in the diagnosis and clinical assessment of CAP severity, which could potentially guide the development of treatment strategies.

Youths as partners in a community participatory project for substance use prevention.

Science.gov (United States)

Kulbok, Pamela A; Meszaros, Peggy S; Bond, Donna C; Thatcher, Esther; Park, Eunhee; Kimbrell, Monica; Smith-Gregory, Tracey

2015-01-01

This community-based participatory research project aimed to develop strategies to prevent youth substance use in a rural county. This article (1) describes the project phases, (2) examines unique contributions and considerations of youth involvement, and (3) explores the youths' perspective. Twelve youths, aged 16 to 18 years, joined parents, community leaders, and research specialists on the community-based participatory research team. The youths were integrally involved in all phases including the community assessment, community leader interviews, selection of a substance use prevention program, and program implementation. Youths reported sustained enthusiasm, experiences of authentic leadership, development of research skills, and greater awareness of their community.

Ecological green belt project; Projeto ecologico cinturao verde

Energy Technology Data Exchange (ETDEWEB)

Timmermann, Mario Cesar [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil); Berte, Rodrigo [Universidade Livre de Protecao a Biodiversidade (UNIBIO), Fazenda Rio Grande, PR (Brazil)

2005-07-01

With the objective to increase the safety conditions of the Marine Terminal of Sao Francisco do Sul, in Santa Catarina State, TRANSPETRO, the transportation branch of PETROBRAS, acquired, in the year of 2002, an area of 70.000 m{sup 2} adjacent to the terminal, with 56 houses and 174 plots. Knowing the characteristics of the region and the conditions of life of the community resident in the neighborhood, TRANSPETRO decided for the development of a project which could comprise the recovery of the acquired land and the protection of a remaining area of the Atlantic forest, taking into consideration the environmental education of the population and that it could supply some necessities of the local community. Among other installations, part of the area was planted with the original forest vegetation, a museum and a reception house were built to receive visitors and some vegetable gardens were made to be used by the community. In one year of accomplishment, nearly two thousand people had already participated in activities related to environmental education and interpretation. Currently eight institutions participate in the community vegetable gardens and more than a thousand people already had been benefited with their products. By means of this project, TRANSPETRO hopes to contribute in the dissemination of educative values, to extend its relations with the community and, so that, to improve social and environmental conditions of the community. (author)

Professions and Working Conditions Associated With Community-Acquired Pneumonia.

Science.gov (United States)

Almirall, Jordi; Serra-Prat, Mateu; Bolíbar, Ignasi; Palomera, Elisabet; Roig, Jordi; Boixeda, Ramon; Bartolomé, Maria; de la Torre, Mari; Parra, Olga; Torres, Antoni

2015-12-01

Community-acquired pneumonia (CAP) is not considered a professional disease, and the effect of different occupations and working conditions on susceptibility to CAP is unknown. The aim of this study is to determine whether different jobs and certain working conditions are risk factors for CAP. Over a 1-year period, all radiologically confirmed cases of CAP (n=1,336) and age- and sex-matched controls (n=1,326) were enrolled in a population-based case-control study. A questionnaire on CAP risk factors, including work-related questions, was administered to all participants during an in-person interview. The bivariate analysis showed that office work is a protective factor against CAP, while building work, contact with dust and sudden changes of temperature in the workplace were risk factors for CAP. The occupational factor disappeared when the multivariate analysis was adjusted for working conditions. Contact with dust (previous month) and sudden changes of temperature (previous 3 months) were risk factors for CAP, irrespective of the number of years spent working in these conditions, suggesting reversibility. Some recent working conditions such as exposure to dust and sudden changes of temperature in the workplace are risk factors for CAP. Both factors are reversible and preventable. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Specific issues, exact locations: case study of a community mapping project to improve safety in a disadvantaged community.

Science.gov (United States)

Qummouh, Rana; Rose, Vanessa; Hall, Pat

2012-12-01

Safety is a health issue and a significant concern in disadvantaged communities. This paper describes an example of community-initiated action to address perceptions of fear and safety in a suburb in south-west Sydney which led to the development of a local, community-driven research project. As a first step in developing community capacity to take action on issues of safety, a joint resident-agency group implemented a community safety mapping project to identify the extent of safety issues in the community and their exact geographical location. Two aerial maps of the suburb, measuring one metre by two metres, were placed on display at different locations for four months. Residents used coloured stickers to identify specific issues and exact locations where crime and safety were a concern. Residents identified 294 specific safety issues in the suburb, 41.9% (n=123) associated with public infrastructure, such as poor lighting and pathways, and 31.9% (n=94) associated with drug-related issues such as drug activity and discarded syringes. Good health promotion practice reflects community need. In a very practical sense, this project responded to community calls for action by mapping resident knowledge on specific safety issues and exact locations and presenting these maps to local decision makers for further action.

[Formative evaluation: experience of the Catalonian family and community medicine teaching units].

Science.gov (United States)

Ezquerra Lezcano, Matilde; Bundo Vidiella, Magda; Descarrega Queralt, Ramón; Martín Zurro, Amando; Fores García, Dolores; Fornells Vallès, Josep Maria

2010-04-01

The purpose of this article is to report on the experience in formative evaluation that was carried out in the Catalonian family and community medicine teaching units during the years 2001-2007. This formative evaluation project included the use of several evaluation tools such as, self-listening, video-recording, structured observation of clinical practice, cases by computer and simulated patients. Different resident intakes have participated in the development of the project, as well as their teaching unit tutors and coordinators. This accumulated experience has allowed it to progress into the field of formative evaluation, and to adapt and integrate the activities that were being carried out in a resident portfolio, which in our opinion is the best tool for the formative evaluation of the family medicine resident. Copyright 2009 Elsevier España, S.L. All rights reserved.

Impact evaluation in multicultural educational projects : case: ADAPTYKES project

OpenAIRE

Kuusisto, Miika

2014-01-01

The objective of this thesis was to examine the common evaluation concepts of the European Union’s funded projects. Such concepts inter alia are effectiveness, impacts and sustainability. The aim was to study how these are realized in multicultural educational case–project in a context, where the project is funded by the European Commission’s Leonardo DaVinci Programme. Thesis introduces two evaluation approaches, which are Logical Framework Approach and Realistic evaluation model. The fi...

Quantitative Evaluation of the Community Research Fellows Training Program

Directory of Open Access Journals (Sweden)

Lucy eD'Agostino McGowan

2015-07-01

Full Text Available Context: The Community Research Fellows Training (CRFT program is a community-based participatory research (CBPR initiative for the St. Louis area. This fifteen week program, based on a Master in Public Health curriculum, was implemented by the Division of Public Health Sciences at Washington University School of Medicine in partnership with the Siteman Cancer Center. Objectives: We measure the knowledge gained by participants and evaluate participant and faculty satisfaction of the CRFT program both in terms of meeting learning objectives and actively engaging the community in the research process.Participants: We conducted analyses on 44 community members who participated in the CRFT program and completed the baseline and follow-up knowledge assessments.Main Outcome Measures: Knowledge gain is measured by a baseline and follow-up assessment given at the first and final session. Additionally, pre- and post-tests are given after the first 12 sessions. To measure satisfaction, program evaluations are completed by both the participants and faculty after each topic. Mid-way through the program, a mid-term assessment was administered to assess the program’s community engagement. We analyzed the results from the assessments, pre- and post-tests, and evaluations.Results: The CRFT participants’ knowledge increased at follow-up as compared with baseline on average by a 16.5 point difference (p<0.0001. Post-test scores were higher than pre-test scores for 11 of the 12 sessions. Both participants and faculty enjoyed the training and rated all session well.Conclusions: The CRFT program was successful in increasing community knowledge, in participant satisfaction, and in faculty satisfaction. This success has enhanced the infrastructure for CBPR as well as led to CBPR pilot projects that address health disparities in the St. Louis Greater Metropolitan Area.

Attractiveness Evaluation of Investment in Wind Energy Projects

Directory of Open Access Journals (Sweden)

Paulius Rudzkis

2012-07-01

Full Text Available Last decade as prices of fossil energy resources were almost constantly going upwards, increasing flow of investments is directed to renewable energy resources. Development and application of green energy became one of priority objectives in many countries. While in the context of wind energy production Lithuania lags behind the EU average, its potential of wind energy usage has great perspective. In this article using random processes, cost-benefit and financial analysis, attractiveness of investment in wind energy projects is examined. Given the stochastic nature of wind energy and by looking into investment profitableness and risk factors, effectiveness of wind turbine is evaluated. Analysis showed that wind energy projects could be considered as having high profit-to-risk factor and should generate significant interest of investment community.

Addressing host community issues through enhancing community well-being: a practical framework for siting major nuclear projects in Canada

Energy Technology Data Exchange (ETDEWEB)

Stemeroff, M.; Richardson, D.; Wlodarczyk, T.L. [AECOM Canada Limited, Markham, ON (Canada)

2011-07-01

Any major project development, including those related to nuclear activities in Canada, will certainly impose a wide range of effects and consequences for a host community and region. These wide ranging effects can be positive as well as negative and last for varying time periods. However, the challenge is not to simply identify effects of a project and then mitigate and/or compensate for them. Rather, we have witnessed a transition in recent years that gaining community social acceptance for projects has taken on new meaning. Specifically, communities have taken a 'longer view' of themselves and are more interested in how the project will enhance their long-term well-being. There is considerable evidence to suggest that assessing and demonstrating effects on community well-being has become the focal point for community understanding and decision-making about how to proceed with any new development. This paper will examine what the term 'community well-being' is and how it applies to gaining social acceptance for major nuclear projects in Canada. Insights and examples will be gathered from a range of cases in Canada and elsewhere to demonstrate its diverse meaning and application. A discussion of its application to gaining social acceptance for nuclear projects will be generic in nature and provide a useful framework that can be adapted to the meet the needs in unique situations. There is extensive literature with a cornucopia of subject headers including: community well-being, sustainable development, sustainability, social capital, social well-being, participatory development, and so on. In many cases, these and other terms are used interchangeably or applied as a sub-set to another term. There is no distinct rule or collective wisdom regarding which term to use under different circumstances or situations. Suffice it to say that the notion of community well-being, sustainable development and the like are not new terms or concepts, even in

Addressing host community issues through enhancing community well-being: a practical framework for siting major nuclear projects in Canada

International Nuclear Information System (INIS)

Stemeroff, M.; Richardson, D.; Wlodarczyk, T.L.

2011-01-01

Any major project development, including those related to nuclear activities in Canada, will certainly impose a wide range of effects and consequences for a host community and region. These wide ranging effects can be positive as well as negative and last for varying time periods. However, the challenge is not to simply identify effects of a project and then mitigate and/or compensate for them. Rather, we have witnessed a transition in recent years that gaining community social acceptance for projects has taken on new meaning. Specifically, communities have taken a 'longer view' of themselves and are more interested in how the project will enhance their long-term well-being. There is considerable evidence to suggest that assessing and demonstrating effects on community well-being has become the focal point for community understanding and decision-making about how to proceed with any new development. This paper will examine what the term 'community well-being' is and how it applies to gaining social acceptance for major nuclear projects in Canada. Insights and examples will be gathered from a range of cases in Canada and elsewhere to demonstrate its diverse meaning and application. A discussion of its application to gaining social acceptance for nuclear projects will be generic in nature and provide a useful framework that can be adapted to the meet the needs in unique situations. There is extensive literature with a cornucopia of subject headers including: community well-being, sustainable development, sustainability, social capital, social well-being, participatory development, and so on. In many cases, these and other terms are used interchangeably or applied as a sub-set to another term. There is no distinct rule or collective wisdom regarding which term to use under different circumstances or situations. Suffice it to say that the notion of community well-being, sustainable development and the like are not new terms or concepts, even in

Addressing host community issues through enhancing community well-being: a practical framework for siting major nuclear projects in Canada

Energy Technology Data Exchange (ETDEWEB)

Stemeroff, M.; Richardson, D.; Wlodarczyk, T. L. [AECOM Canada Limited, Markham, ON (Canada)

2011-07-01

Any major project development, including those related to nuclear activities in Canada, will certainly impose a wide range of effects and consequences for a host community and region. These wide ranging effects can be positive as well as negative and last for varying time periods. However, the challenge is not to simply identify effects of a project and then mitigate and/or compensate for them. Rather, we have witnessed a transition in recent years that gaining community social acceptance for projects has taken on new meaning. Specifically, communities have taken a 'longer view' of themselves and are more interested in how the project will enhance their long-term well-being. There is considerable evidence to suggest that assessing and demonstrating effects on community well-being has become the focal point for community understanding and decision-making about how to proceed with any new development. This paper will examine what the term 'community well-being' is and how it applies to gaining social acceptance for major nuclear projects in Canada. Insights and examples will be gathered from a range of cases in Canada and elsewhere to demonstrate its diverse meaning and application. A discussion of its application to gaining social acceptance for nuclear projects will be generic in nature and provide a useful framework that can be adapted to the meet the needs in unique situations. There is extensive literature with a cornucopia of subject headers including: community well-being, sustainable development, sustainability, social capital, social well-being, participatory development, and so on. In many cases, these and other terms are used interchangeably or applied as a sub-set to another term. There is no distinct rule or collective wisdom regarding which term to use under different circumstances or situations. Suffice it to say that the notion of community well-being, sustainable development and the like are not new terms or concepts, even in Canada. Despite the wide

A systematic review of studies evaluating Australian indigenous community development projects

NARCIS (Netherlands)

Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

2015-01-01

Background: Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community

Building a Community of Scholars in Educational Research: A Case Study for Success

Directory of Open Access Journals (Sweden)

Michelle M. Lamb, PharmD

2011-01-01

Full Text Available Objective: To present the model of the Education Research/Scholarship of Teaching Community of Scholarship (EdCOS as one Community of Scholars (COS within a department of pharmacy.Case Study: A case study describing the Education Research/Scholarship of Teaching Community of Scholars (EdCOS. Faculty members were self-selected into one or more of eight COS. The EdCOS was comprised of 14 members. The EdCOS developed a vision statement to “foster and support a learning culture that enables faculty to capture and evaluate teaching and learning experiences.” The process by which the EdCOS set out to initiate this COS will be discussed. Since its inception all members of the EdCOS have become IRB Certified. Through a combined project, members had the opportunity to develop, learn, and acquire experience in areas of conducting research from the conception of a project through final submission of the manuscript. Departmental publications and grant funding increased over the years after the implementation of the COS.Conclusion: Although cause and effect cannot be explicitly determined, the EdCOS has had a positive impact on its members building confidence, experience, and ideas for future projects.

Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus ST30-SCCmecIVc-spat019-PVL positive in San Antonio de Areco, Argentina.

Science.gov (United States)

Fernandez, Silvina; Murzicato, Sofía; Sandoval, Orlando; Fernández-Canigia, Liliana; Mollerach, Marta

2015-01-01

Community-acquired methicillin-resistant Staphylococcus aureus is the first cause of skin and soft tissue infections, but can also produce severe diseases such as bacteremia, osteomyelitis and necrotizing pneumonia. Some S. aureus lineages have been described in cases of necrotizing pneumonia worldwide, usually in young, previously healthy patients. In this work, we describe a fatal case of necrotizing pneumonia due to community-acquired methicillin-resistant S. aureus clone ST30-SCCmecIVc-spat019-PVL positive in an immunocompetent adult patient. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

Prospects for local community wind energy projects in the UK

International Nuclear Information System (INIS)

Taylor, Derek; Open Univ., Milton Keynes

1993-01-01

This paper examines the prospects for local community wind energy projects in the UK. After explaining the advantages of such projects compared to purely commercial developments, the scale and funding for the projects are discussed. It is argued that such projects are beneficial both financially to individual members and also to the local rural economies particularly in deprived regions. (UK)

Design reality gap issues within an ICT4D project:an assessment of Jigawa State Community Computer Center

OpenAIRE

Kanya, Rislana Abdulazeez; Good, Alice

2013-01-01

This paper evaluates the Jigawa State Government Community Computer centre project using the design reality gap framework. The purpose of this was to analyse the shortfall between design expectations and implementation realities, in order to find out the current situation of the project. Furthermore to analyse whether it would meet the key stakeholder’s expectation. The Majority of Government ICT Projects is classified as either failure or partial failure. Our research will underpin a case st...

Community-acquired pneumonia management and outcomes in the era of health information technology.

Science.gov (United States)

Mecham, Ian D; Vines, Caroline; Dean, Nathan C

2017-11-01

Pneumonia continues to be a leading cause of hospitalization and mortality. Implementation of health information technology (HIT) can lead to cost savings and improved care. In this review, we examine the literature on the use of HIT in the management of community-acquired pneumonia. We also discuss barriers to adoption of technology in managing pneumonia, the reliability and quality of electronic health data in pneumonia research, how technology has assisted pneumonia diagnosis and outcomes research. The goal of using HIT is to develop and deploy generalizable, real-time, computerized clinical decision support integrated into usual pneumonia care. A friendly user interface that does not disrupt efficiency and demonstrates improved clinical outcomes should result in widespread adoption. © 2017 Asian Pacific Society of Respirology.

Comparison of community managed projects and conventional ...

African Journals Online (AJOL)

Ejiro O. Taghwo

This study aimed to compare Community Managed Projects (CMP) approach with the ... Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution ... attention to repair and upgrade failed systems in ... In addition to low success in improving coverage, non-.

Antimicrobial susceptibility, risk factors and prevalence of bla cefotaximase, temoneira, and sulfhydryl variable genes among Escherichia coli in community-acquired pediatric urinary tract infection

Directory of Open Access Journals (Sweden)

Kallyadan V Nisha

2017-01-01

Conclusion: ESBL-producing E. coli from community-acquired pediatric UTI carries more than one type of beta-lactamase coding genes correlating their increased antibiotic resistance. Aggressive infection control policy, routine screening for detecting ESBL isolates in clinical samples, and antimicrobial stewardship are the keys to prevent their dissemination in community settings.

Community College Economics Instruction: Results from a National Science Foundation Project

Science.gov (United States)

Maier, Mark; Chi, W. Edward

2016-01-01

The principal investigator of a National Science Foundation project, "Economics at Community Colleges," surveyed community college economics faculty and organized workshops, webinars, and regional meetings to address community college faculty isolation from new ideas in economics and economics instruction. Survey results, combined with…

Open Crowdsourcing: Leveraging Community Software Developers for IT Projects

Science.gov (United States)

Phair, Derek

2012-01-01

This qualitative exploratory single-case study was designed to examine and understand the use of volunteer community participants as software developers and other project related roles, such as testers, in completing a web-based application project by a non-profit organization. This study analyzed the strategic decision to engage crowd…

Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis

OpenAIRE

Komiya, Kosaku; Rubin, Bruce K.; Kadota, Jun-ichi; Mukae, Hiroshi; Akaba, Tomohiro; Moro, Hiroshi; Aoki, Nobumasa; Tsukada, Hiroki; Noguchi, Shingo; Shime, Nobuaki; Takahashi, Osamu; Kohno, Shigeru

2016-01-01

Aspiration pneumonia is thought to be associated with a poor outcome in patients with community acquired pneumonia (CAP). However, there has been no systematic review regarding the impact of aspiration pneumonia on the outcomes in patients with CAP. This review was conducted using the MOOSE guidelines: Patients: patients defined CAP. Exposure: aspiration pneumonia defined as pneumonia in patients who have aspiration risk. Comparison: confirmed pneumonia in patients who were not considered to ...

Nurturing social responsibility through community service-learning: Lessons learned from a pilot project.

Science.gov (United States)

Dharamsi, Shafik; Espinoza, Nancy; Cramer, Carl; Amin, Maryam; Bainbridge, Lesley; Poole, Gary

2010-01-01

Community service-learning (CSL) has been proposed as one way to enrich medical and dental students' sense of social responsibility toward people who are marginalized in society. We developed and implemented a new CSL option in the integrated medical/dental curriculum and assessed its educational impact. Focus groups, individual open-ended interviews, and a survey were used to assess dental students', faculty tutors' and community partners' experiences with CSL. CSL enabled a deeper appreciation for the vulnerabilities that people who are marginalized experience; students gained a greater insight into the social determinants of health and the related importance of community engagement; and they developed useful skills in health promotion project planning, implementation and evaluation. Community partners and faculty tutors indicated that equal partnership, greater collaboration, and a participatory approach to course development are essential to sustainability in CSL. CSL can play an important role in nurturing a purposeful sense of social responsibility among future practitioners. Our study enabled the implementation of an innovative longitudinal course (professionalism and community service) in all 4 years of the dental curriculum.

The Community Psychology Evaluation Nexus

Science.gov (United States)

Sheldon, Jeffrey A.; Wolfe, Susan M.

2015-01-01

In 2012, the American Evaluation Association (AEA) added community psychology (CP) to its roster of topical interests groups (TIG). One of the highlights of the CP TIG program at the 2012 AEA Conference and the genesis of this "American Journal of Evaluation" Forum was a panel of accomplished community psychologists and evaluation…

Community-acquired urinary tract infection: age and gender-dependent etiology.

Science.gov (United States)

Lo, Denise Swei; Shieh, Huei Hsin; Ragazzi, Selma Lopes Betta; Koch, Vera Hermina Kalika; Martinez, Marina Baquerizo; Gilio, Alfredo Elias

2013-01-01

Choosing the antimicrobial agent for initial therapy of urinary tract infection (UTI) is usually empirical and should consider the prevalence of uropathogens in different age groups and gender. To establish prevalence rates of uropathogens in community-acquired UTI in relation to age and gender. Cross-sectional study conducted in the emergency department (ED) of a general hospital, from January to December, 2010, in patients younger than 15 years old who had clinical suspicion of UTI and collected quantitative urine culture. UTI was defined as urine culture with growth of a single agent > 100.000 colony forming units (cfu)/mL in a midstream collection or ≥ 50.000 cfu/mL in urethral catheterization. There were 63.464 visits to ED. 2577 urine cultures were obtained, of whom 291 were positive for UTI (prevalence = 11.3% of clinical suspicion and 0.46% of visits), 212 cases (72.8%) in females, median age = 2.6 years. The predominant uropathogen was E. coli (76.6%), followed by Proteus mirabilis (10.3%) and Staphylococcus saprophyticus (4.1%). Among infants 10 years (24.4% vs 0.4%; OR = 79.265; p 10 years and Proteus mirabilis in males.

Exploring the dynamics of ownership in community-oriented design projects

DEFF Research Database (Denmark)

Light, Ann; Hansen, Nicolai Brodersen; Halskov, Kim

2013-01-01

This paper contributes an exploration of ownership as a dynamic process in community-oriented projects. We use case study accounts of two design projects to consider participation in contexts where social structure is relevant to design outcomes. In studying these dynamics, we consider four aspec...... community groups in making internet radio podcasts to share insight. We examine the complexity of the social process involved and trace patterns of change, before concluding with pragmatic and ethical reasons for technology design to pay attention to ownership issues....

The shifting dynamics of social roles and project ownership over the lifecycle of a community-based participatory research project.

Science.gov (United States)

Salsberg, Jon; Macridis, Soultana; Garcia Bengoechea, Enrique; Macaulay, Ann C; Moore, Spencer

2017-06-01

. Community based participatory research (CBPR) is often initiated by academic researchers, yet relies on meaningful community engagement and ownership to have lasting impact. Little is understood about how ownership shifts from academic to community partners. . We examined a CBPR project over its life course and asked: what does the evolution of ownership look like from project initiation by an academic (non-community) champion (T1); to maturation-when the intervention is ready to be deployed (T2); to independence-the time when the original champion steps aside (T3); and finally, to its maintenance-when the community has had an opportunity to function independently of the original academic champion (T4)? . Using sociometric (whole network) social network analysis, knowledge leadership was measured using 'in-degree centrality'. Stakeholder network structure was measured using 'centralisation' and 'core-periphery analysis'. Friedman rank sum test was used to measure change in actor roles over time from T1 to T4. . Project stakeholder roles were observed to shift significantly (P project maintenance (T4). Community stakeholders emerged into positions of knowledge leadership, while the roles of academic partners diminished in importance. The overall stakeholder network demonstrated a structural shift towards a core of densely interacting community stakeholders. . This was the first study to use Social network analysis to document a shift in ownership from academic to community partners, indicating community self-determination over the research process. Further analysis of qualitative data will determine which participatory actions or strategies were responsible for this observed change. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Constraints To Effective Community Development Projects Among ...

African Journals Online (AJOL)

The study focused on the perceived constraints to effective community development projects among rural households in Calabar agricultural zone of Cross River State, Nigeria. Data were collected with the aid of structured questionnaire from 104 randomly selected respondents in the study area. Data analysis was by the ...

[Community pneumonia - fundamentals of diagnosing and treatment].

Science.gov (United States)

Kolek, Vítězslav

Pneumonia is the most serious respiratory disease which causes more than 3 000 deaths per year in the Czech Republic. Community-acquired pneumonia is contracted in the ordinary life environment outside of hospitals, its development is caused by known infectious agents which mostly exhibit satisfactory sensitivity to antibiotics. Diagnosing, prevention and treatment of the disease are described including considerations of individual evaluation of the risk of complications and possible death. The strategy of administering antibiotics is discussed.Key words: antibiotics - community-acquired pneumonias - diagnosing - treatment.

Energy Evaluation of a New Construction Pilot Community: Fresno, California

Energy Technology Data Exchange (ETDEWEB)

Burdick, A.; Poerschke, A.; Rapport, A.; Wayne, M.

2014-06-01

A new construction pilot community was constructed by builder-partner Wathen-Castanos Hybrid Homes (WCHH) based on a single occupied test house that was designed to achieve greater than 30% energy savings with respect to the House Simulation Protocols (Hendron, Robert; Engebrecht, Cheryn (2010). Building America House Simulation Protocols. Golden, CO: National Renewable Energy Laboratory). Builders face several key problems when implementing a whole-house systems integrated measures package (SIMP) from a single test house into multiple houses. Although a technical solution already may have been evaluated and validated in an individual test house, the potential exists for constructability failures at the community scale. This report addresses factors of implementation and scalability at the community scale and proposes methodologies by which community-scale energy evaluations can be performed based on results at the occupied test house level. Research focused on the builder and trade implementation of a SIMP and the actual utility usage in the houses at the community scale of production. Five occupants participated in this community-scale research by providing utility bills and information on occupancy and miscellaneous gas and electric appliance use for their houses. IBACOS used these utility data and background information to analyze the actual energy performance of the houses. Verification with measured data is an important component in predictive energy modeling. The actual utility bill readings were compared to projected energy consumption using BEopt with actual weather and thermostat set points for normalization.

Give Water a Hand. Community Site Action Guide. Organizing Water Conservation and Pollution Prevention Service Projects in Your Community.

Science.gov (United States)

Wisconsin Univ., Madison. Coll. of Agricultural and Life Sciences.

Students grades 4-8 can use this guide to explore the topics of water, and water conservation within a community, while conducting an environmental community service project. Youth groups, led by a group leader, work with local experts from business, government, or environmental organizations to complete the project. Nine activity sections involve…

A Process Towards Societal Value within a Community-Based Regional Development Project

Directory of Open Access Journals (Sweden)

Anna Åslund

2012-12-01

Full Text Available Processes, activities and tasks of a community-based area development project are described. The main process has been used three times and a model is presented. An earlier developed process map has been verified. The description of the project can help other communities to plan development projects. The illustration can be valuable for entrepreneurs who are planning a societal value initiative and for decision-makers and stakeholders who can contribute to, are concerned with, or may be affected by societal entrepreneurship. Observation, participating studies, dokumentations and an interview with the project leader has been carried out. Data have been analyzed and compared with the previously developed process map to achieve a deeper understanding of the processes within societal entrepreneurship. The purpose was to study and describe the processes of a community-based area development project and to compare it with a previously developed process map and to verify the process map.

The Sagebrush Steppe Treatment Evaluation Project (SageSTEP): a test of state-and-transition theory

Science.gov (United States)

James D. McIver; Mark Brunson; Steve C. Bunting; Jeanne Chambers; Nora Devoe; Paul Doescher; James Grace; Dale Johnson; Steve Knick; Richard Miller; Mike Pellant; Fred Pierson; David Pyke; Kim Rollins; Bruce Roundy; Eugene Schupp; Robin Tausch; David Turner

2010-01-01

The Sagebrush Steppe Treatment Evaluation Project (SageSTEP) is a comprehensive, integrated, long-term study that evaluates the ecological effects of fire and fire surrogate treatments designed to reduce fuel and to restore sagebrush (Artemisia spp.) communities of the Great Basin and surrounding areas. SageSTEP has several features that make it ideal for testing...

On the contribution of labelled Certified Emission Reductions to sustainable development: A multi-criteria evaluation of CDM projects

International Nuclear Information System (INIS)

Nussbaumer, Patrick

2009-01-01

The Clean Development Mechanism (CDM) has a twofold objective, to offset greenhouse gas emissions and to contribute to sustainable development in the host country. The contribution to the latter objective seems marginal in most CDM activities. Also, CDM activities are unevenly spread among developing countries. In response to these concerns, initiatives with the objective of promoting CDM projects with broad local sustainable development dividends have been launched, such as the Gold Standard and the Community Development Carbon Fund. The Gold Standard label rewards best-practice CDM projects while the Community Development Carbon Fund focuses on promoting CDM activities in underprivileged communities. Using a multi-criteria method, the potential contribution to local sustainable development of those CDM projects with particular attributes is compared with ordinary ones. This evaluation suggests that labelled CDM activities tend to slightly outperform comparable projects, although not unequivocally

Communication and quality of life outcomes in people with acquired brain injury following project-based treatment

OpenAIRE

Behn, N.

2016-01-01

Communication impairments are common following acquired brain injury (ABI) and have a significant impact on a person’s quality of life (QOL) post-injury. While some treatments have improved communication skills, few have measured QOL, and even fewer have shown improved QOL for people with ABI following communication-based treatments. Project-based treatment is an alternative treatment approach that could have an impact on communication skills and QOL for people with ABI who are long-term post...

The power of community : the role of ownership in social marketing of wind projects

Energy Technology Data Exchange (ETDEWEB)

Roscoe, D. [Scotian Windfields, Dartmouth, NS (Canada)

2008-07-01

This paper discussed the benefits of community ownership for wind power projects in Nova Scotia. The community economic development investment fund (CEDIF) is a pool of capital funds formed by selling shares to people within a defined community. CEDIFs are created to operate or invest in local business as part of a government initiative to provide incentives for local business development. Those eligible for CEDIFs include incorporated organizations with a minimum of 25 investors, and when 6 of the maximum 12 directors are from the local community. No investors may own more than 20 per cent. CEDIF incentives include pre-approved holdings for registered savings plans; a 30 per cent non-refundable equity tax credit against Nova Scotia taxes, and additional credits for maintaining investment. Local WindFields investors have invested in the Scotian WindFields in order to develop renewable energy projects. Community ownership of wind power projects can result in greater acceptance of wind power as well as increased economic prosperity and employment. Community ownership can also lead to improved land lease opportunities and relationships between contractors, local businesses, and federal and provincial governments. Details of wind power projects in Nova Scotia were provided. It was concluded that wind power developers should consider community ownership of wind projects. tabs., figs.

Rationale and design of the CAPAMIS study: Effectiveness of pneumococcal vaccination against community-acquired pneumonia, acute myocardial infarction and stroke

Directory of Open Access Journals (Sweden)

Salsench Elisabet

2010-01-01

Full Text Available Abstract Background The 23-valent polysaccharide pneumococcal vaccine (PPV-23 is recommended for elderly and high-risk people, although its effectiveness is controversial. Some studies have reported an increasing risk of acute vascular events among patients with pneumonia, and a recent case-control study has reported a reduction in the risk of myocardial infarction among patients vaccinated with PPV-23. Given that animal experiments have shown that pneumococcal vaccination reduces the extent of atherosclerotic lesions, it has been hypothesized that PPV-23 could protect against acute vascular events by an indirect effect preventing pneumonia or by a direct effect on oxidized low-density lipoproteins. The main objective of this study is to evaluate the clinical effectiveness of PPV-23 in reducing the risk of pneumonia and acute vascular events (related or nonrelated with prior pneumonia in the general population over 60 years. Methods/Design Cohort study including 27,000 individuals 60 years or older assigned to nine Primary Care Centers in the region of Tarragona, Spain. According to the reception of PPV-23 before the start of the study, the study population will be divided into vaccinated and nonvaccinated groups, which will be followed during a consecutive 30-month period. Primary Care and Hospitals discharge databases will initially be used to identify study events (community-acquired pneumonia, hospitalisation for acute myocardial infarction and stroke, but all cases will be further validated by checking clinical records. Multivariable Cox regression analyses estimating hazard ratios (adjusted for age, sex and comorbidities will be used to estimate vaccine effectiveness. Discussion The results of the study will contribute to clarify the controversial effect of the PPV-23 in preventing community-acquired pneumonia and they will be critical in determining the posible role of pneumococcal vaccination in cardiovascular prevention.

Increasing trend of community-acquired methicillin-resistant: Staphylococcal carriers: An alarming bell for urgent measures

Directory of Open Access Journals (Sweden)

Poongodi Lakshmi Santhana Kumarasamy

2015-01-01

Full Text Available Background: An increase in the incidence of infections caused by community-associated-methicillin resistant Staphylococcus aureus (MRSA has been reported. Hence, the knowledge of resistance pattern of these isolates is a precondition for alleviating emerging antibiotic resistance and devising better treatment strategies Aim: To find out the prevalence of community-acquired methicillin-resistant staphylococcal strains from nasal carriers. Materials and Methods: A total of 352 nasal swabs collected during routine health checkup were analyzed. Results: Of the 58 (16% staphylococci isolated, 32 (55% were S. aureus and 26 (45% were coagulase-negative staphylococci (CoNS. Methicillin resistance was observed in 7 (22% of staphylococci aureus and 11 (42% of CoNS. "D test" was positive in 1 (14% MRSA, 2 (8% methicillin-susceptible S. aureus and 2 (8% methicillin resistant-CoNS. Conclusion: Effective implementation of the antibiotic policy along with measures like hand wash, isolation of patients will reduce the incidence of resistance.

Outcome mapping as methodology to monitor and evaluate community informatics projects: A case study

CSIR Research Space (South Africa)

Herselman, M

2010-10-01

Full Text Available The purpose of this paper is to indicate how Outcome Mapping (OM) can be used as a methodology to monitor and evaluate a specific developmental informatics project currently under way in the Meraka Institute. OM was applied in the Broadband for All...

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.

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

Science.gov (United States)

Crowley, Max; Jones, Damon

2017-12-01

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

The ASEAN Economic Community Project

DEFF Research Database (Denmark)

Juego, Bonn

2014-01-01

In this paper, I attempt to unpack the ASEAN Economic Community (AEC) Blueprint to reveal the project’s neoliberal capitalist strategy of ‘accumulation by dispossession’ whereby the drive for the acquisition of more wealth and power by the economically wealthy and politically powerful necessitated...... the deprivation of the peoples’ collective rights and access to the economic, political, social, and ecological commons. I therefore offer a critical reading of the AEC project in the analysis, specifically its agenda for the establishment of a competitive single market, and conclude with some notes...

Community-acquired pneumonia due to Staphylococcus cohnii in an HIV-infected patient: case report and review.

Science.gov (United States)

Mastroianni, A; Coronado, O; Nanetti, A; Manfredi, R; Chiodo, F

1995-10-01

Coagulase-negative staphylococci recently have been implicated as a cause of serious infections in immunocompromised individuals. An unusual case of community-acquired pneumonia due to Staphylococcus cohnii in an HIV-infected drug user is described. Results of a study conducted to examine the prevalence of infection due to Staphylococcus cohnii strains and their antibiotic-sensitivity patterns show a low frequency but a high morbidity. These results and a brief review of the literature emphasize the importance of these organisms and other staphylococcal species as emerging opportunistic pathogens in patients with AIDS.

Piloting a community-based micro-hydro power generation project

International Nuclear Information System (INIS)

Buenafe, Menandro B.; Eponio, Melchor P.

1998-01-01

A community based microhydro power generation project was successfully piloted in Dulao, Malibcong, Abra. The project started with the identification and evaluation of five potential creeks flowing near villages in the Cordillera hinterlands. All the sites showed comparative hydrologic features except for one factor that decided the project's implementation: the willingness of the people to invest by providing their labor- counterpart. On this account, only the residents of Dulao put their full trust in the implementing institutions, the main reason for the project's success. The micro-hydro power project consisted of an earthen diversion canal that conveyed part of the streamflow unto a forebay located above the powerhouse. The forebay was built of riprap and concrete, equipped with a desilting chamber, trashrack, a spillway, and an overflow canal that directed water to the ricefields downstream. A polyethylenevinyl penstock was laid underground along the slope,from the forebay to the powerhouse. The penstock assumed a Y-configuration inside the powerhouse where the two crossflow turbines were separately mounted on each arms. Two butterfly valves were positioned just before each turbine so that flow can be alternately controlled for the two machines. A tailrace drained the discharge from the turbines back to the same creek. Originally, the setup could only operate the 3kw turbine that ran the ricemill by means of a flat belt drive. Upon further hydrologic study, an 8kw crossflow turbine was installed to a drive a 7.5kva, two-pole, single phase alternator. The 8kw turbine can operate under three design flows, namely: 20,40, and 60 liters per second. The turbine-alternator setup was achieved by a pulley and belt drive arrangement. Typically, the AC generator was provided with monitoring instruments like a volt meter, frequency meter, and ampere meter. An electronic load controller (ELC) was observed to effectively protect the alternator from runaway speeds, over

Community-acquired methicillin-resistant Staphylococcus aureus: an emerging pathogen in orthopaedics.

Science.gov (United States)

Marcotte, Anthony L; Trzeciak, Marc A

2008-02-01

Staphylococcus aureus (S aureus) remains one of the most common pathogens for skin and soft-tissue infections encountered by the orthopaedic surgeon. Community-acquired methicillin-resistant S aureus (CA-MRSA) has become increasingly prevalent, particularly among athletes, children in day care, homeless persons, intravenous drug users, men who have sex with men, military recruits, certain minorities (ie, Alaskan Natives, Native Americans, Pacific Islanders), and prison inmates. Risk factors include antibiotic use within the preceding year, crowded living conditions, compromised skin integrity, contaminated surfaces, frequent skin-to-skin contact, shared items, and suboptimal cleanliness. When a patient presents with a skin or soft-tissue infection, the clinician should determine whether an abscess or other infection needs to be surgically incised and drained. Cultures should be performed. When the patient is a member of an at-risk group or has any of the risk factors for CA-MRSA, beta-lactam antibiotics (eg, methicillin) are no longer a reasonable choice for treatment. Empiric treatment should consist of non-beta-lactam antibiotics active against CA-MRSA.

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

Science.gov (United States)

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…

Knowledge and Perceptions About Community-acquired Staphylococcal Infections Among Health Care Workers in Hawai‘i

Science.gov (United States)

Tice, Alan D; Hurwitz, Eric L; Katz, Alan R

2013-01-01

Since the early 1990s, national rates of methicillin-resistant Staphylococcus aureus (MRSA) infections have increased dramatically.1,2 Initially identified in health care settings, community-acquired MRSA is now a major public health concern. With Hawai‘i's expanding S. aureus and MRSA epidemic closely approximating the national trend in inpatient and outpatient settings,7,8 a high level of knowledge and awareness among health care workers is essential to successfully control this evolving epidemic. Health care and related workers were surveyed to assess their knowledge and perceptions about staphylococcal and MRSA infections. Knowledge was estimated by demonstrated ability to correctly identify risk factors including diabetes and obesity, as well as to demonstrate awareness of a growing staphylococcal and MRSA epidemic.9,10 Perceptions were estimated by level of concern of antibiotic resistance as well as of the severity of the staphylococcal and MRSA epidemic. Variations in knowledge and perception concerning basic principles associated with S. aureus infections as well as characteristics of the evolving S. aureus and MRSA epidemic were observed among various occupations (advance clinical practitioners, nurses, public health professionals, athletic trainers, and non-medical workers) as well as work locations (hospital, community, and non-clinical community). Overall, health care and related workers in community settings demonstrated disparities in knowledge regarding S. aureus and MRSA infections. They were also more likely to misperceive this growing threat. These findings provide support for focused educational interventions targeting community health care and related workers to improve awareness of staphylococcal infections in order to successfully address and combat this evolving epidemic. PMID:24069572

Knowledge and perceptions about community-acquired staphylococcal infections among health care workers in Hawai'i.

Science.gov (United States)

Dunn, Brandyn S; Tice, Alan D; Hurwitz, Eric L; Katz, Alan R

2013-09-01

Since the early 1990s, national rates of methicillin-resistant Staphylococcus aureus (MRSA) infections have increased dramatically.1,2 Initially identified in health care settings, community-acquired MRSA is now a major public health concern. With Hawai'i's expanding S. aureus and MRSA epidemic closely approximating the national trend in inpatient and outpatient settings,7,8 a high level of knowledge and awareness among health care workers is essential to successfully control this evolving epidemic. Health care and related workers were surveyed to assess their knowledge and perceptions about staphylococcal and MRSA infections. Knowledge was estimated by demonstrated ability to correctly identify risk factors including diabetes and obesity, as well as to demonstrate awareness of a growing staphylococcal and MRSA epidemic.9,10 Perceptions were estimated by level of concern of antibiotic resistance as well as of the severity of the staphylococcal and MRSA epidemic. Variations in knowledge and perception concerning basic principles associated with S. aureus infections as well as characteristics of the evolving S. aureus and MRSA epidemic were observed among various occupations (advance clinical practitioners, nurses, public health professionals, athletic trainers, and non-medical workers) as well as work locations (hospital, community, and non-clinical community). Overall, health care and related workers in community settings demonstrated disparities in knowledge regarding S. aureus and MRSA infections. They were also more likely to misperceive this growing threat. These findings provide support for focused educational interventions targeting community health care and related workers to improve awareness of staphylococcal infections in order to successfully address and combat this evolving epidemic.

Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study

NARCIS (Netherlands)

van der Eerden, M. M.; Vlaspolder, F.; de Graaff, C. S.; Groot, T.; Bronsveld, W.; Jansen, H. M.; Boersma, W. G.

2005-01-01

Background: There is much controversy about the ideal approach to the management of community acquired pneumonia ( CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics. Methods: In a prospective randomised open study performed

Transport Project Evaluation

DEFF Research Database (Denmark)

Leleur, Steen

1996-01-01

Two main project evaluation approaches exist: cost-benefit analysis (CBA) and multi-criteria analysis (MCA). Related to a European road evaluation method (EURET 1.1) and the MCA-method, WARP, the paper proposes a set of so-called segregated investment return rates (SIRR) to integrate advantages...

Setting up local community wind energy projects

International Nuclear Information System (INIS)

Larke, Charmian.

1993-01-01

A report is given on progress to establish a company in the UK which involves local people at an early stage in the development of wind farms. Particular attention is paid to obtaining local finance for the projects. Because rural communities tend to be relatively poor, larger investors will need to be involved. (UK)

Acquired neuropathies.

Science.gov (United States)

Lozeron, Pierre; Trocello, Jean-Marc; Kubis, Nathalie

2013-09-01

Acquired neuropathies represent most of the neuropathies encountered in clinical practice. Hundreds of causes have been identified even though up to 41% of patients are still classified as idiopathic (Rajabally and Shah in J Neurol 258:1431-1436, 1). Routine evaluation relies on comprehensive medical history taking, clinical examination, nerve conduction studies and laboratory tests. Other investigations such as nerve biopsy or nerve or muscle imaging are performed in specific settings. This review focuses on recent advances in acquired neuropathies.

A portable low-cost 3D point cloud acquiring method based on structure light

Science.gov (United States)

Gui, Li; Zheng, Shunyi; Huang, Xia; Zhao, Like; Ma, Hao; Ge, Chao; Tang, Qiuxia

2018-03-01

A fast and low-cost method of acquiring 3D point cloud data is proposed in this paper, which can solve the problems of lack of texture information and low efficiency of acquiring point cloud data with only one pair of cheap cameras and projector. Firstly, we put forward a scene adaptive design method of random encoding pattern, that is, a coding pattern is projected onto the target surface in order to form texture information, which is favorable for image matching. Subsequently, we design an efficient dense matching algorithm that fits the projected texture. After the optimization of global algorithm and multi-kernel parallel development with the fusion of hardware and software, a fast acquisition system of point-cloud data is accomplished. Through the evaluation of point cloud accuracy, the results show that point cloud acquired by the method proposed in this paper has higher precision. What`s more, the scanning speed meets the demand of dynamic occasion and has better practical application value.

Community-acquired carbapenem-resistant Acinetobacter baumannii urinary tract infection just after marriage in a renal transplant recipient.

Science.gov (United States)

Solak, Y; Atalay, H; Turkmen, K; Biyik, Z; Genc, N; Yeksan, M

2011-12-01

Urinary tract infection (UTI) is common in renal transplant recipients and may worsen allograft and patient survival. Many risk factors such as age, female gender, immunosuppression, comorbidity, deceased-donor kidney transplantation, and uretheral catheterization are involved in development of UTI. Acinetobacter baumannii has rarely been reported as a causative agent for development of UTI. Here, we present an unusual case of a renal transplant recipient who developed community-acquired carbapenem-resistent A. baumannii UTI. © 2011 John Wiley & Sons A/S.

Learning With E-books and Project-based Strategy in a Community Health Nursing Course.

Science.gov (United States)

Sung, Tien-Wen; Wu, Ting-Ting

2018-03-01

With advances in information technology, "information-assisted instruction" has been gradually introduced to nursing education curricula. Specifically, the integration of an e-book system can effectively enhance nursing students' attention and interest. Most studies on nursing education that incorporated e-books have focused on the advantages of convenience and assistance provided by e-books. Few studies have addressed community health nursing and off-campus practice activities in relation to suitable teaching strategies for learning activities. This study involved designing and planning a multimedia e-book learning system with a project-based learning activity that conforms to the curriculum and practical requirements of a community health nursing course. The purpose was to reduce the gap between theory and practice and realize an effective learning process. For learning evaluations, a final examination analysis with an independent sample t test; a scoring scheme with intrateam, interteam, and expert ratings; and Bloom's taxonomy-based analysis were conducted. The evaluation results indicated that the comprehension and learning abilities of the experimental group using the e-book system with a mobile device were effectively improved. In addition, the exploratory process involved in project-based learning can develop multiple cognitive skills and problem-solving ability, thereby realizing effective learning.

Soboba Community Energy Solar Project – Phase 1

Energy Technology Data Exchange (ETDEWEB)

Castello, Michael [Soboba Band of Luiseno Indians, San Jacinto, CA (United States); DeForge, Deborah [Soboba Band of Luiseno Indians, San Jacinto, CA (United States); Estrada, Steven [Soboba Band of Luiseno Indians, San Jacinto, CA (United States)

2017-03-29

Since time immemorial the descendants of the Soboba people are those whom have lived on and occupied the land that is presently known as the cities of San Jacinto, Hemet, Valle Vista and Winchester. On June 19, 1883, President Chester Arthur by Executive Order established the Soboba Indian Reservation, a 3,172-acre tract which included the Soboba village and the adjacent hills. The President had limited authority as he was only able to set aside public land for the establishment of a reservation and had no authority to take private land. Thus the Soboba village; cultivated lands and major springs were part of Rancho San Jacinto Viejo and belonged to Matthew Byrne. Today the Soboba Indian Reservation lies in the lower reaches of the San Jacinto Mountains, across the San Jacinto River from the city of San Jacinto. The Soboba Band of Luiseño Indians was awarded a community solar grant through the U.S. Department of Energy. The incorporated cities of San Jacinto and Hemet, and the unincorporated community of Valle Vista border the Reservation. All three of these surrounding communities have experienced tremendous population growth over the past two decades, with slower growth during the recent economic downturn. The Tribal community that benefits from under this grant includes 1,161 enrolled members, the majority of which live on the reservation. Nearly 41% of the enrolled members are youth, age 18 and under. The elders and community leaders value preserving and maintaining the Luiseño and Cahuilla cultures and Tribal structure for future generations. The proposed project was administered from the Tribal Administration offices located on the reservation. The Soboba Tribal Government consists of five Tribal Members who are elected by the general membership to Tribal Council for a staggered two year term. The Chairman/Chairwoman is elected by a majority vote of the general membership but the positions for Vice-Chair, Tribal Secretary, Tribal Treasurer and Sergeant at

Project evaluation: main characteristics

OpenAIRE

Moutinho, Nuno

2010-01-01

— The evaluation process of real investment projects must consider not only the traditional financial approach, but also non-financial aspects. Non financial analysis can provide additional relevant information about projects. We investigate financial and non-financial areas most relevant in project appraisal. We present main critical success factors and areas of analysis that lead to the perception of project success. Finally, companies are segmented to verify its financial and non-financial...

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

Science.gov (United States)

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

2014-05-01

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

Prospective study of a community reintegration programme for patients with acquired chronic brain injury: effects on caregivers' emotional burden and family functioning

NARCIS (Netherlands)

Geurtsen, Gert J.; van Heugten, Caroline M.; Meijer, Ron; Martina, Juan D.; Geurts, Alexander C. H.

2011-01-01

Objective: To examine the effects of a residential community reintegration programme for patients with psychosocial problems due to acquired chronic brain injury on caregivers' emotional burden and family functioning. Design: A prospective cohort study with waiting list control and 1-year follow-up.

Intervention and societal costs of residential community reintegration for patients with acquired brain injury: a cost-analysis of the Brain Integration Programme

NARCIS (Netherlands)

Heugten, C.M. van; Geurtsen, G.J.; Derksen, R.E.; Martina, J.D.; Geurts, A.C.H.; Evers, S.M.

2011-01-01

OBJECTIVE: The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment. METHODS: A cost-analysis was performed identifying costs of

The Climate Impacts Research Consortium: Lessons Learned from the Evaluation of Co-production projects

Science.gov (United States)

Sokolovska, I.; Andrepont, J. A.; Lach, D.

2017-12-01

The Pacific Northwest Climate Impacts Research Consortium (CIRC) is a climate-science-to-climate-action team funded by the National Oceanic and Atmospheric Administration (NOAA), member of NOAA's Regional Integrated Sciences and Assessments (RISA) program. The internal evaluation of the last 6 years of CIRC's work focused on the co-production of knowledge process. The evaluation was based on CIRC's Reflection and Logic model and used a mixed methods design. During regular monthly meetings in 2014/15, all CIRC PIs reflected on the co-production process and presented their evaluation of the projects they worked on. Additionally, we conducted semi-structured interviews with CIRC participants, purposefully targeting key informants. The Climate Impacts Research Consortium teams also administered surveys to assess participants' experiences of the coproduction process as they were engaging in it. Identifying and cultivating an informant from the local stakeholder group with deep, accessible roots within the target community can lead to better coproduction results than having to build those relationships from naught. Across projects, most participants agreed that the project increased their understanding of their area's hazards and by the end of the project most participants were confident the project would produce useful results for themselves. Finally, most participants intended to share what they had learned from this experience with their colleagues and we found that co-production built capacities necessary for communities to incorporate climate change in discussions even after the end of CIRC's participation. During the projects, the involvement of non-traditional participants along with experts was critical to success and a lot of work and preparation needs to be put into the planning of any co-production meeting to overcome various barriers to communication and build trust.

Improved management of community-acquired pneumonia in the emergency department.

Science.gov (United States)

Julián-Jiménez, Agustín; Palomo de los Reyes, María José; Parejo Miguez, Raquel; Laín-Terés, Natividad; Cuena-Boy, Rafael; Lozano-Ancín, Agustín

2013-06-01

To determine the impact of implementing clinical practice guidelines (CPGs) in the treatment of community-acquired pneumonia (CAP) in the emergency department (ED) by analyzing case management decisions (admission or discharge, appropriateness and timeliness of antibiotic therapy, complementary tests) and the consequent results (clinical stabilization time, length of hospital stay, re-admission to ED and mortality). A prospective, observational, descriptive, comparative study carried out from 1st January 2008 to 1st August 2009 in two phases: before and after the implementation of the "Management of CAP in ED" SEMES-SEPAR (Spanish Society of Emergency Medicine - Spanish Society of Pneumology and Thoracic Surgery) clinical practice guidelines from 2008. Two hundred adult patients treated in the ED with a diagnosis of CAP were included in the study, both in the pre-intervention and post-intervention groups. The application of the guidelines increased the administration of early and appropriate antibiotic therapy (Pimplementation of the SEMES-SEPAR 2008 guidelines, along with the use of PSI and biomarkers, significantly improved the entire treatment process of CAP. This benefitted both patients and the system by reducing mortality and improving the results of other patient management factors. Copyright © 2012 SEPAR. Published by Elsevier España, S.L. All rights reserved.

Community Tenure Rights and REDD+: A Review of the Oddar Meanchey Community Forestry REDD+ Project in Cambodia

Directory of Open Access Journals (Sweden)

Donal Yeang

2012-01-01

Full Text Available Tenure rights over land, forest, and carbon have become a contentious issue within REDD+ implementation across the tropics because local communities could be excluded from REDD+ benefits if land tenure or use and access rights are not clear. This study aims to understand and assess tenure arrangements under the first REDD+ demonstration project in Cambodia, the Oddar Meanchey Com- munity Forestry REDD+ Project. In particular, the study explores the following questions: (1 How are tenure rights arranged in the Oddar Meanchey REDD+ Project? (2 Does the tenure regime recognise the rights of local communities to their land and its associated resources? (3 What kind of institu- tions are put in place to support tenure rights of local communities in the project? The author conducted in-depth semi-structured interviews with key stakeholders and complemented the analysis by participant observation and a review of policy documents and secondary literature. The major finding of this study is that the local communities in the project are still given rights to use and access forest resources, although carbon rights belong to the government. While the government retains ownership over carbon credits, it agreed that at least 50 percent of the net revenue from the sale of carbon credits will flow to participating communities. ------ Besitzrechte an Land, Wald und CO2 sind zu einer umkämpften Angelegenheit in der REDD+ Implementierung in den Tropen geworden. Diese Studie versucht die Besitzregelungen im ersten REDD+ Demons- trationsprojekt in Kambodscha, dem Oddar Meanchey Community Forestry REDD+ Project, zu verstehen und zu bewerten. Die Untersuchung analysiert dabei insbesondere folgende Fragen: (1 Wie sind Besitzrechte im Oddar Meanchey REDD+ Projekt geregelt? (2 Erkennt das Besitzsystem die Rechte von lokalen Gemeinschaften an ihrem Land und den dazugehörigen Ressourcen an? (3 Welche Institutionen werden geschaffen, um die Besitzrechte von lokalen

A Study of Four Library Programs for Disadvantaged Persons. Part II, Appendices B: Brooklyn Public Library Community Coordinator Project, the New York Public Library North Manhattan Project.

Science.gov (United States)

Winsor, Charlotte B.; Burrows, Lodema

This document contains observations of library staff and interviews with community members about the Brooklyn Public Library Community Coordinator Project and the New York Public Library North Manhattan Project. The Community Coordinator Project employs four professional librarians to take an active part in community institutions and organizations…

Antimicrobial susceptibility, risk factors and prevalence of bla cefotaximase, temoneira, and sulfhydryl variable genes among Escherichia coli in community-acquired pediatric urinary tract infection.

Science.gov (United States)

Nisha, Kallyadan V; Veena, Shetty A; Rathika, Shenoy D; Vijaya, Shenoy M; Avinash, Shetty K

2017-01-01

The emergence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli has become an important challenge among pediatric patients with community-acquired urinary tract infection (UTI). The aim of this study was to assess the antimicrobial susceptibility patterns, associated risk factors and to survey the frequency of bla cefotaximase (CTX-M), bla temoneira (TEM), and bla sulfhydryl variable (SHV) genotypes in ESBL-producing E. coli isolated from children with community-acquired UTI. This was a prospective study conducted from November 2012 to March 2016 in a tertiary care center. E. coli isolated in urine cultures from children aged ≤18 years was identified and confirmed for ESBL production. ESBL-positive strains were screened for ESBL encoding genes. Chi-square test and Fisher's exact test were used to compare the difference in antibiotic susceptibility with respect to ESBL positive and negative, and binary logistic regression was used to identify the risk factors associated with ESBL production. Among 523 E. coli isolates, 196 (37.5%) were ESBL positive, >90% were resistant to cephalosporins, and 56% were resistant to fluoroquinolones. Least resistance was observed for imipenem, netilmicin, and nitrofurantoin (2%, 8.6%, 15.3%). Association between ESBL production and drug resistance was significant for ceftazidime ( P antibiotics were the common risk factors. ESBL-producing E. coli from community-acquired pediatric UTI carries more than one type of beta-lactamase coding genes correlating their increased antibiotic resistance. Aggressive infection control policy, routine screening for detecting ESBL isolates in clinical samples, and antimicrobial stewardship are the keys to prevent their dissemination in community settings.

A Community-University Exchange Project Modeled after Europe's Science Shops

Science.gov (United States)

Tryon, Elizabeth; Ross, J. Ashleigh

2012-01-01

This article describes a pilot project of the Morgridge Center for Public Service at the University of Wisconsin-Madison for a new structure for community-based learning and research. It is based on the European-derived science shop model for democratizing campus-community partnerships using shared values of mutual respect and validation of…

Decoding Skills Acquired by Low Readers Taught in Regular Classrooms Using Clinical Techniques. Research Report No. 35.

Science.gov (United States)

Gallistel, Elizabeth; Fischer, Phyllis

This study evaluated the decoding skills acquired by low readers in an experimental project that taught low readers in regular class through the use of clinical procedures based on a synthetic phonic, multisensory approach. An evaluation instrument which permitted the tabulation of specific decoding skills was administered as a pretest and…

Research Planning and Evaluation Project

International Nuclear Information System (INIS)

Song, Seunghyun; Kim, Doyang; Ryu, Byunghoon; Lim, Chaeyoung; Song, Leeyoung; Lee, Youngchul; Han, Changsun; Kim, Hackchoon

2011-12-01

- To activate R and D through a systematic and impartial evaluation by using information on efficient distribution of research resource, setting project priorities, and measuring achievement against goals produced after research on planning and evaluation system for the government-funded project for KAERI was conducted. - Nuclear R and D project is the representative national R and D project which has been implemented in Korea. For the sustainable development of nuclear energy which supplies about 40% of total electricity generation and the enhancement of it innovative ability in the future, a systematic and efficient strategy in the planning stage is required

Healthy End of Life Project (HELP): a progress report on implementing community guidance on public health palliative care initiatives in Australia.

Science.gov (United States)

Grindrod, Andrea; Rumbold, Bruce

2018-04-01

Contemporary end of life care policies propose increasing community capacity by developing sustainable skills, policies, structures, and resources to support members of a community in caring for each other at the end of life. Public health approaches to palliative care provide strategies to bring this about. Practical implementation can however be ineffective, principally due to failures to grasp the systemic nature of public health interventions, or to ensure that programs are managed and owned by community members, not the professionals who may have introduced them. This article outlines a comprehensive community development project that identifies local end of life needs and meets them through the efficient use of community resources. The project is the product of a three-phase enquiry. The first phase, carried out in a local community, examined carers' experiences of home-based dying, the networks that supported them during care, and broader community networks with the potential to extend care. Data were collected through in-depth research interviews, focus groups and consultation with a community research reference group. Findings were key issues to be targeted by a local community development strategy. In the second phase, these local findings were compared with other practice accounts to identify themes common to many contexts. A public health palliative care framework was then used to produce an evidence-informed community development model for end of life care. The third phase involves implementing and evaluating this model in different Australian contexts. A major theme emerging in phase one of the enquiry was the reluctance of carers to ask for, or even accept, offers of help from family, friends and community networks despite their evident need for support while providing end of life care at home. Others' willingness to provide support was thus hindered by uncertainty about what to offer, and concern about infringing on people's privacy. To develop

Project Management Personnel Competencies Evaluation

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Paul POCATILU

2006-01-01

Full Text Available An important factor for the success management of IT projects is the human resource. People involved in the project management process have to be evaluated. In order to do that, same criteria has to be specified. This paper describes some aspects regarding the personnel evaluation.

IT Project Evaluation and Investment Decision

Institute of Scientific and Technical Information of China (English)

黄东兵; 张世英

2004-01-01

There are many kinds of real options,which are valuable,in each phase of the lifetime of an information technology(IT)project.However,in the current IT investment decision theory,real options that embedded in IT projects are not considered. In this paper, the process of IT project decision and implementation is fully analyzed, the real options that may be embedded in an IT project are identified, and a real option analysis (ROA) method is proposed for evaluation of an IT project under uncertain business environment. ROA employs Black-Scholes expansion model and cancels the assumption that the cost of project is certain. The numerical example manifests that the ROA can better evaluate IT project and select the IT investment alternative. Finally, a road map is provided to help selecting the suitable evaluation method to make IT investment decision.

A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia : a controlled before-and-after study

NARCIS (Netherlands)

Engel, M. F.; Bruns, A. H. W.; Hulscher, M. E. J. L.; Gaillard, C. A. J. M.; Sankatsing, S. U. C.; van Berkhout, F. Teding; Emmelot-Vonk, M. H.; Kuck, E. M.; Steeghs, M. H. M.; den Breeijen, J. H.; Stellato, R. K.; Hoepelman, A. I. M.; Oosterheert, J.J.

2014-01-01

We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia: a controlled before-and-after study

NARCIS (Netherlands)

Engel, M.F.; Bruns, A.H.; Hulscher, M.E.; Gaillard, C.A.; Sankatsing, S.U.; Berkhout, F. Teding van; Emmelot-Vonk, M.H.; Kuck, E.M.; Steeghs, M.H.; Breeijen, J.H. den; Stellato, R.K.; Hoepelman, A.I.; Oosterheert, J.J.

2014-01-01

We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

Intervention and societal costs of residential community reintegration for patients with acquired brain injury: a cost-analysis of the Brain Integration Programme

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van Heugten, Caroline M.; Geurtsen, Gert J.; Derksen, R. Elze; Martina, Juan D.; Geurts, Alexander C. H.; Evers, Silvia M. A. A.

2011-01-01

The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment. A cost-analysis was performed identifying costs of healthcare, informal care, and

Formative evaluation of the telecare fall prevention project for older veterans.

Science.gov (United States)

Miake-Lye, Isomi M; Amulis, Angel; Saliba, Debra; Shekelle, Paul G; Volkman, Linda K; Ganz, David A

2011-05-23

Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. To evaluate the intervention we: 1) interviewed patient and employee stakeholders, 2) reviewed participating patients' electronic health record data and 3) abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. The project appeared feasible at its outset but could not be sustained past the first cycle of evaluation due to insufficient resources and a waning of local

Formative evaluation of the telecare fall prevention project for older veterans

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Saliba Debra

2011-05-01

Full Text Available Abstract Background Fall prevention interventions for community-dwelling older adults have been found to reduce falls in some research studies. However, wider implementation of fall prevention activities in routine care has yielded mixed results. We implemented a theory-driven program to improve care for falls at our Veterans Affairs healthcare facility. The first project arising from this program used a nurse advice telephone line to identify patients' risk factors for falls and to triage patients to appropriate services. Here we report the formative evaluation of this project. Methods To evaluate the intervention we: 1 interviewed patient and employee stakeholders, 2 reviewed participating patients' electronic health record data and 3 abstracted information from meeting minutes. We describe the implementation process, including whether the project was implemented according to plan; identify barriers and facilitators to implementation; and assess the incremental benefit to the quality of health care for fall prevention received by patients in the project. We also estimate the cost of developing the pilot project. Results The project underwent multiple changes over its life span, including the addition of an option to mail patients educational materials about falls. During the project's lifespan, 113 patients were considered for inclusion and 35 participated. Patient and employee interviews suggested support for the project, but revealed that transportation to medical care was a major barrier in following up on fall risks identified by nurse telephone triage. Medical record review showed that the project enhanced usual medical care with respect to home safety counseling. We discontinued the program after 18 months due to staffing limitations and competing priorities. We estimated a cost of $9194 for meeting time to develop the project. Conclusions The project appeared feasible at its outset but could not be sustained past the first cycle of

Virtual communities, research groups and projects on IMS Learning Design. State of the art, key factors and forthcoming challenges

NARCIS (Netherlands)

Burgos, Daniel; Koper, Rob

2005-01-01

Burgos, D., Koper, R. (2005) Virtual communities, research groups and projects on IMS Learning Design. State of the art, key factors and forthcoming challenges. In E-Journal of Educational Research, Assessment and Evaluation, vol. 11, issue 2 [www.uv.es/RELIEVE]. Available at

The James Webb STEM Innovation Project: Bringing JWST to the Education Community

Science.gov (United States)

Eisenhamer, Bonnie; Harris, J.; Ryer, H.; Taylor, J.; Bishop, M.

2012-01-01

Building awareness of a NASA mission prior to launch and connecting that mission to the education community can be challenging. In order to address this challenge, the Space Telescope Science Institute's Office of Public Outreach has developed the James Webb STEM innovation Project (SIP) - an interdisciplinary project that focuses on the engineering aspects and potential scientific discoveries of JWST, while incorporating elements of project-based learning. Students in participating schools will use skills from multiple subject areas to research an aspect of the JWST's design or potential science and create models, illustrated essays, or technology-based projects to demonstrate their learning. Student projects will be showcased during special events at select venues in the project states - thus allowing parents and community members to also be benefactors of the project. Currently, the SIP is being piloted in New York, California, and Maryland. In addition, we will be implementing the SIP in partnership with NASA Explorer Schools in the states of New Mexico, Michigan, Texas, Tennessee, and Iowa.

Community Awareness on Rabies Prevention and Control in Bicol, Philippines: Pre- and Post-Project Implementation

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Toni Rose M. Barroga

2018-02-01

Full Text Available Rabies is endemic in the Philippines. To support the rabies campaign in the Bicol region at the southeastern part of Luzon, the BAI-OIE Stop Transboundary Animal Diseases and Zoonoses (STANDZ Rabies project was implemented in the pilot provinces of Camarines Norte, Camarines Sur, Albay, and Masbate. A community awareness survey was conducted with the residents of these provinces to determine their knowledge, attitude, and practices (KAP on rabies during the start and end of the project. Qualitative, descriptive research was done with a structured KAP questionnaire. Pet owners in the pilot provinces were chosen as respondents. Results showed that respondents know that they can acquire rabies in animals through the bite of a rabid dog (pre-project implementation (PRI: 19.6%, post-project implementation (POI: 38.0%. Vaccination was the top rabies preventive measure (PRI: 61.8%, POI: 92.8%. Biting incidents were noted in some respondents, and observing the dog and killing it immediately were some of the actions taken by bite victims. If a supposed rabid dog was seen, respondents would either: immediately kill the dog (PRI: 20.3%, POI: 13.7%, report it to authorities (PRI: 26.3%, POI: 63.1%, and capture and observe the dog concerned (PRI: 13.5%, POI: 6.0%. Pet owners increased their KAP about rabies prevention and control as compared to the pre-implementation study. However, certain gaps in their KAP need to be given attention; thus continuous education of pet owners must be done.

Reflections from a Creative Community-Based Participatory Research Project Exploring Health and Body Image with First Nations Girls

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Jennifer M. Shea PhD

2013-02-01

Full Text Available In Canada, Aboriginal peoples often experience a multitude of inequalities when compared with the general population, particularly in relation to health (e.g., increased incidence of diabetes. These inequalities are rooted in a negative history of colonization. Decolonizing methodologies recognize these realities and aim to shift the focus from communities being researched to being collaborative partners in the research process. This article describes a qualitative community-based participatory research project focused on health and body image with First Nations girls in a Tribal Council region in Western Canada. We discuss our project design and the incorporation of creative methods (e.g., photovoice to foster integration and collaboration as related to decolonizing methodology principles. This article is both descriptive and reflective as it summarizes our project and discusses lessons learned from the process, integrating evaluations from the participating girls as well as our reflections as researchers.

Governance Factors Affecting Community Participation In Public Development Projects In Meru District In Arusha In Tanzania

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Jackson Estomih Muro

2015-06-01

Full Text Available ABSTRACT The purpose of this study was to have a fresh look at the local governance status through exploring governance factors affecting community participation in public development projects. The study also has investigated the actors and factors shaping participation as well as causes for non-participation. For the purpose of the study six wards within two divisions of Poli and Mbuguni and Meru district headquarters were selected. In the wards a total of 80 respondents from among the community members were interviewed through a structured questionnaire. Others were Village chairman Village Executive Officers Ward Executive Officers and Councilors were also interviewed and involved in the FGD. Data were analyzed using SPSS. Simple descriptive statistics and cross tabulation and figures were used in the analysis. The analysis showed that the communities were participated in the public development projects and people were participating through financial material and labor contribution to the public development projects. The analysis also showed that the government supported the ongoing public development projects including through provision of fund and expertise. The study showed the benefit of community participation in the development projects or programs like ownership of the projects and enjoying the benefits accrued from the projects. The study also indicated that there is significant change in terms of governance as influencers of community participation in public development projects. Despite the fortunes study showed some challenges found in wards and villages being the incidence of corruptions and misuse of public resources which were mentioned to slow community participation in public development projects. It was therefore concluded that adhering to the good governance principles contribute positively towards community participation in public development projects.

Creating Robust Evaluation of ATE Projects

Science.gov (United States)

Eddy, Pamela L.

2017-01-01

Funded grant projects all involve some form of evaluation, and Advanced Technological Education (ATE) grants are no exception. Program evaluation serves as a critical component not only for evaluating if a project has met its intended and desired outcomes, but the evaluation process is also a central feature of the grant application itself.…

Clinical and Laboratory Characteristics of Acute Community-Acquired Urinary Tract Infections in Adult Hospitalised Patients

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Dilista Piljić

2010-02-01

Full Text Available Urinary tract infections (UTI cause a great number of morbidity and mortality. These infections are serious complications in pregnancy, patients with diabetes, polycystic kidneys disease, sickle cell anaemia, kidney transplant and in patients with functional or structural anomalies of the urinary tract. The aim of this investigation was to determine a dominant causative agents of UTI and some of the clinical and laboratory characteristics of acute community-acquired UTI in adult hospitalised patients. We studied 200 adult patients with acute community-acquired UTI hospitalised in the Clinic for Infectious Diseases Tuzla from January 2006 to December 2007. The patients were divided into two groups: a group of patients with E. coli UTI (147 and a group of patients with non-E. coli UTI (53. In these two groups, the symptoms and signs of illness, blood test and urine analysis results were analysed. Our results have shown that the patients with E. coli UTI frequently had fever higher than 38,5 degrees C (p<0,0001, chills (p=0,0349, headache (p=0,0499, cloudy urine (p<0,0001, proteinuria (p=0,0011 and positive nitrite-test (p=0,0002. The patients with non-E. coli UTI frequently had fever lower than 38,5 degrees C (p<0,0001 and urine specific gravity <1015 (p=0,0012. There was no significant difference in blood test results between patients with E. coli and non-E. coli UTI. These clinical and laboratory findings can lead us to early etiological diagnosis of these UTI before urine culture detection of causative agents, which takes several days. Early etiological diagnosis of the E. coli and non-E. coli UTI is necessary for an urgent administration of appropriate empirical antibiotic treatment. This is very important in prevention of irreversible kidney damage, prolonged treatment, complications, as well as recidives and chronicity of the illness.

Virtual Communities of Collaborative Learning for Higher Education

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Gilda E. Sotomayor

2014-11-01

Full Text Available This article aims to outline and project three new learning scenarios for Higher Education that, after the emergence of ICT and communication through the Network-lnternet, have come under the generic name of virtual communities. To that end, we start from a previous conceptual analysis on collaborative learning, cooperative learning and related concepts taking place in these communities and serving as a basis for sorting them into three types in particular: communities of educational work of professional practice and scientific knowledge. Virtual communities where the activities undertaken and skills acquired are set as important parts of our personal learning development, wich are necessary to build the Knowledge Society.

Nasopharyngeal bacterial carriage and antimicrobial resistance in underfive children with community acquired pneumonia

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Cissy B. Kartasasmita

2001-12-01

Full Text Available Lung puncture is the best way to determine the etiology of pneumonia since it yields the highest rate of positive cultures. However, this procedure is difficult, especially for a study in the community. According to WHO, isolates to be tested for antimicrobial resistance in the community should be obtained from nasopharyngeal (NP swabs. Previous studies support the use of NP isolates to determine antimicrobial resistance patterns of isolates from children with pneumonia. The aim of our study was to know the bacterial patterns of the nasopharynx in underfive children with community acquired pneumonia and their antimicrobial resistance. The study was carried out in 4 Primary Health Clinics in Majalaya sub-district, Bandung, Indonesia. All underfives with cough or difficult breathing and classified as having non-severe pneumonia (WHO guidelines, were included in the study. Nasopharyngeal swabs (CDC/WHO Manual were obtained by the doctor, the swabs were placed in Amies transport medium and stored in a sterile jar before taken to the laboratory in the same day. All children were treated with co-trimoxazole. During the nine month study, 698 children with clinical signs of non-severe pneumonia were enrolled. About 25% of the nasopharyngeal specimens yielded bacterial isolates; the two most frequently found were S. pneumoniae and S. epidermidis. The antimicrobial resistance test to co-trimoxazole showed 48.2% S. pneumoniae strain had full resistance and 32.7% showed intermediate resistance to co-trimoxazole. This result is almost similar to other studies from Asian countries. It seems that H. influenzae is not a problem in the study area; however, further studies are needed.

Sandy Lake Health and Diabetes Project: A Community-Based Intervention Targeting Type 2 Diabetes and Its Risk Factors in a First Nations Community

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Kakekagumick, Kara E.; Naqshbandi Hayward, Mariam; Harris, Stewart B.; Saksvig, Brit; Gittelsohn, Joel; Manokeesic, Gary; Goodman, Starsky; Hanley, Anthony J.

2013-01-01

The Sandy Lake Health and Diabetes Project (SLHDP) was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM) in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the 22 year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation, and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners. PMID:24302919

Sandy Lake Health and Diabetes Project: A community-based intervention targeting type 2 diabetes and its risk factors in a First Nations community

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Kara Elizabeth Kakekagumick

2013-11-01

Full Text Available The Sandy Lake Health and Diabetes Project (SLHDP was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the twenty-two year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners.

High creatinine clearance in critically ill patients with community-acquired acute infectious meningitis.

Science.gov (United States)

Lautrette, Alexandre; Phan, Thuy-Nga; Ouchchane, Lemlih; Aithssain, Ali; Tixier, Vincent; Heng, Anne-Elisabeth; Souweine, Bertrand

2012-09-27

A high dose of anti-infective agents is recommended when treating infectious meningitis. High creatinine clearance (CrCl) may affect the pharmacokinetic / pharmacodynamic relationships of anti-infective drugs eliminated by the kidneys. We recorded the incidence of high CrCl in intensive care unit (ICU) patients admitted with meningitis and assessed the diagnostic accuracy of two common methods used to identify high CrCl. Observational study performed in consecutive patients admitted with community-acquired acute infectious meningitis (defined by >7 white blood cells/mm3 in cerebral spinal fluid) between January 2006 and December 2009 to one medical ICU. During the first 7 days following ICU admission, CrCl was measured from 24-hr urine samples (24-hr-UV/P creatinine) and estimated according to Cockcroft-Gault formula and the simplified Modification of Diet in Renal Disease (MDRD) equation. High CrCl was defined as CrCl >140 ml/min/1.73 m2 by 24-hr-UV/P creatinine. Diagnostic accuracy was performed with ROC curves analysis. Thirty two patients were included. High CrCl was present in 8 patients (25%) on ICU admission and in 15 patients (47%) during the first 7 ICU days for a median duration of 3 (1-4) days. For the Cockcroft-Gault formula, the best threshold to predict high CrCl was 101 ml/min/1.73 m2 (sensitivity: 0.96, specificity: 0.75, AUC = 0.90 ± 0.03) with a negative likelihood ratio of 0.06. For the simplified MDRD equation, the best threshold to predict high CrCl was 108 ml/min/1.73 m2 (sensitivity: 0.91, specificity: 0.80, AUC = 0.88 ± 0.03) with a negative likelihood ratio of 0.11. There was no difference between the estimated methods in the diagnostic accuracy of identifying high CrCl (p = 0.30). High CrCl is frequently observed in ICU patients admitted with community-acquired acute infectious meningitis. The estimated methods of CrCl could be used as a screening tool to identify high CrCl.

Prognostic significance of platelet count changes during hospitalization for community-acquired pneumonia.

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Gorelik, Oleg; Izhakian, Shimon; Barchel, Dana; Almoznino-Sarafian, Dorit; Tzur, Irma; Swarka, Muhareb; Beberashvili, Ilia; Feldman, Leonid; Cohen, Natan; Shteinshnaider, Miriam

2017-06-01

The prognostic significance of platelet count (PC) changes during hospitalization for community-acquired pneumonia (CAP) has not been investigated. For 976 adults, clinical data during hospitalization for CAP and all-cause mortality following discharge were compared according to ΔPC (PC on discharge minus PC on admission): groups A (declining PC, ΔPC 50 × 10 9 /l), and according to the presence of thrombocytopenia, normal PC, and thrombocytosis on admission/discharge. Groups A, B, and C comprised 7.9%, 46.5%, and 45.6% of patients, respectively. On hospital admission/discharge, thrombocytopenia, normal PC, and thrombocytosis were observed in 12.8%/6.4%, 84.1%/84.4%, and 3.1%/9.2% of patients, respectively. The respective 90-day, 3-year, and total (median follow-up of 54 months) mortality rates were significantly higher: in group A (40.3%, 63.6%, and 72.7%), compared to groups B (12.3%, 31.5%, and 39.0%) and C (4.9%, 17.3%, and 25.4%), p < 0.001; and in patients with thrombocytopenia at discharge (27.4%, 48.4%, and 51.6%), compared to those with normal PC (10.2%, 26.9%, and 35.4%) and thrombocytosis (8.9%, 17.8%, and 24.4%) at discharge (p < 0.001). Mortality rates were comparable among groups with thrombocytopenia, normal PC, and thrombocytosis at admission (p = 0.6). In the entire sample, each 100 × 10 9 /l increment of ΔPC strongly predicted lower mortality (p < 0.001, relative risk 0.73, 95% confidence interval 0.64-0.83). In conclusion, PC changes are common among CAP inpatients. Rising PC throughout hospitalization is a powerful predictor of better survival, while declining PC predicts poor outcome. Evaluation of PC changes during hospitalization for CAP may provide useful prognostic information.

Determine small and medium enterprise social media activities: A community engagement project in the Tshwane community

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Louise van Scheers

2015-09-01

Full Text Available The aim of this paper is to determine small and medium enterprise (SME social media activities and promote CE scholarship engagement. It is a community engagement project conducted in the Tshwane community. Community engagement (CE as a planned process with the specific purpose of working with identified groups of people in the community to address issues affecting their well-being. The CE project SME skills transfer workshops are aimed at expanding involvement with the community. The benefits of social media seem to be ignored by most SMEs however; challenges prevent SME owners from using the tool effectively. A survey study method of research design has been selected for the research. The sample for the study comprised 200 SME owners who currently manage small businesses in the Tshwane area. The conducted research recommends that social media can be cost effective if the SMEs make use of their social networks and use best practises that enable them to get their adverts or posts shared across social networks. The conducted research also recommends that SMEs with limited resources start with social media and YouTube as a marketing tool, as the learning curve is low and cost involved is almost nil.

Evaluation of microfinance projects.

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Johnson, S

1999-08-01

This paper criticizes the quick system proposed by Henk Moll for evaluating microfinance projects in the article ¿How to Pre-Evaluate Credit Projects in Ten Minutes¿. The author contended that there is a need to emphasize the objectives of the project. The procedure used by Moll, he contended, is applicable only to projects that have only two key objectives, such as credit operations, and the provision of services. Arguments are presented on the three specific questions proposed by Moll, ranging from the availability of externally audited financial reports, the performance of interest rate on loans vis-a-vis the inflation rate, and the provision of loans according to the individual requirements of the borrowers. Lastly, the author emphasizes that the overall approach is not useful and suggests that careful considerations should be observed in the use or abuse of a simple scoring system or checklist such as the one proposed by Moll.

Fatores de risco e medidas profiláticas nas pneumonias adquiridas na comunidade Risk factors and prophylaxis of community-acquired pneumonias

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LUCY GOMES

2001-03-01

Full Text Available Este artigo revisa os efeitos do envelhecimento, tabagismo, DPOC, insuficiência cardíaca, colonização da orofaringe, aspiração (micro e macro, alcoolismo, cirrose hepática, deficiência nutricional, imunossupressão e fatores ambientais sobre o risco de adquirir pneumonia na comunidade e sua gravidade. Na segunda parte, é feita revisão sobre a ação profilática das vacinas antiinfluenza e antipneumococo, assim como a ação das drogas antivirais, na profilaxia e tratamento das pneumonias adquiridas na comunidade.This article reviews the effects of aging, tobacco-smoking, chronic bronchitis and emphysema, heart failure, oropharyngeal colonization, aspiration (micro and macro, alcoholism, hepatic cirrhosis, nutritional deficiency, immunosuppression, and environmental factors on the risk of community-acquired pneumonia and its severity. In the second part, the authors review the prophylactic action of anti-influenza and anti-pneumococcus vaccines as well as the role of prevention and treatment of antiviral agents in community-acquired pneumonia.

Neutrophil-to-lymphocyte ratio in predicting prognosis and course of community community-acquired pneumonia in hospitalized patients.

Directory of Open Access Journals (Sweden)

T. O. Pertseva

2018-04-01

Full Text Available Currently, a marker which could be used both to assess the severity of community acquired pneumonia (CAP and determine the risk of complications is being searched. According to some authors, Neutrophil-to-Lymphocyte Ratio (NLR could be such a marker. Therefore, the aim of our research was to determine the diagnostic significance of NLR in patients with CAP and to establish the relationship of NLR with other clinical and laboratory parameters. We conducted a retrospective analysis of 171 case histories of patients with CAP of 3 and 4 clinical groups, with the calculation of NLR (according to the common blood count. In the course of the work, it was found that NLR reflects a balance between the response of neutrophils and lymphocytes and this parameter is associated with the severity of systemic inflammation in patients with CAP. NLR has good diagnostic value in determining the mortality risk in patients with CAP, specially an increase in the level of NLR (more than 10 is associated with a high risk of life-threatening complications.

Building the base: two active living projects that inspired community participation.

Science.gov (United States)

Hamamoto, Mark H; Derauf, David D; Yoshimura, Sheryl R

2009-12-01

Kalihi Valley is a densely populated, low-income community (28,958 residents in approximately 6 square miles) with insufficient sidewalks, bike lanes, and public green space to support regular physical activity for its residents. Kokua Kalihi Valley (KKV), a community health center formed in 1972, sought to improve Kalihi Valley's built environment based on its history of community- and partnership-based preventive health initiatives that have focused on the social determinants of health. Kokua Kalihi Valley used a flexible partnership model and a focus on direct community action to develop an unused 100-acre state park (the Kalihi Valley Nature Park) and establish a bicycle repair and recycling program that mobilized thousands of community volunteers, attracted widespread media coverage, and established a number of innovative programs for active living. Kokua Kalihi Valley and its partners also contributed to the successful passage of a city charter amendment to prioritize Honolulu as a bicycle- and pedestrian-friendly city. This initiative was successful in reclaiming a substantial amount of land for active living and in stimulating both public governmental support and widespread private community involvement in programs and activities. Projects that engaged community members in activities with tangible accomplishment were shown to be most successful. This initiative showed that community health centers may be uniquely positioned to provide leadership and assume responsibility for cross-sectoral active-living health projects.

Community-based health care for indigenous women in Mexico: a qualitative evaluation.

Science.gov (United States)

Pelcastre-Villafuerte, Blanca; Ruiz, Myriam; Meneses, Sergio; Amaya, Claudia; Márquez, Margarita; Taboada, Arianna; Careaga, Katherine

2014-01-06

Indigenous women in Mexico represent a vulnerable population in which three kinds of discrimination converge (ethnicity, gender and class), having direct repercussions on health status. The discrimination and inequity in health care settings brought this population to the fore as a priority group for institutional action. The objective of this study was to evaluate the processes and performance of the "Casa de la Mujer Indígena", a community based project for culturally and linguistically appropriate service delivery for indigenous women. The evaluation summarizes perspectives from diverse stakeholders involved in the implementation of the model, including users, local authorities, and institutional representatives. The study covered five Casas implementation sites located in four Mexican states. A qualitative process evaluation focused on systematically analyzing the Casas project processes and performance was conducted using archival information and semi-structured interviews. Sixty-two interviews were conducted, and grounded theory approach was applied for data analysis. Few similarities were observed between the proposed model of service delivery and its implementation in diverse locations, signaling discordant operating processes. Evidence gathered from Casas personnel highlighted their ability to detect obstetric emergencies and domestic violence cases, as well as contribute to the empowerment of women in the indigenous communities served by the project. These themes directly translated to increases in the reporting of abuse and referrals for obstetric emergencies. The model's cultural and linguistic competency, and contributions to increased referrals for obstetric emergencies and abuse are notable successes. The flexibility and community-based nature of the model has allowed it to be adapted to the particularities of diverse indigenous contexts. Local, culturally appropriate implementation has been facilitated by the fact that the Casas have been

Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

Energy Technology Data Exchange (ETDEWEB)

Krivonogov, Nikolay G., E-mail: kng@cardio-tomsk.ru [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Efimova, Nataliya Y., E-mail: efimova@cardio-tomsk.ru; Zavadovsky, Konstantin W.; Lishmanov, Yuri B. [Research Institute of Cardiology, Kievskaya Street 111a, Tomsk, 634012 (Russian Federation); Tomsk Polytechnic University, Lenin Avenue 30, Tomsk, 634050 (Russian Federation)

2016-08-02

Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia

Science.gov (United States)

Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.

2016-08-01

Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

Adherence to Therapeutic Guidelines for Patients with Community-Acquired Pneumonia in Australian Hospitals

Directory of Open Access Journals (Sweden)

N.R. Adler

2014-01-01

Full Text Available Community-acquired pneumonia (CAP is a significant cause of morbidity and mortality, particularly in elderly patients, and is associated with a considerable economic burden on the healthcare system. The combination of high incidence and substantial financial costs necessitate accurate diagnosis and appropriate management of patients admitted with CAP. This article will discuss the rates of adherence to clinical guidelines, the use of severity scoring tools and the appropriateness of antimicrobial prescribing for patients diagnosed with CAP. The authors maintain that awareness of national and hospital guidelines is imperative to complement the physicians’ clinical judgment with evidence-based recommendations. Increased use of pneumonia severity assessment tools and greater adherence to therapeutic guidelines will enhance concordant antimicrobial prescribing for patients with CAP. A robust and multifaceted educational intervention, in combination with antimicrobial stewardship programs, may enhance compliance of CAP guidelines in clinical practice in Australia.

Habitat Evaluation Procedures (HEP) Report; Iskuulpa Wildlife Mitigation and Watershed Project, Technical Report 1998-2003.

Energy Technology Data Exchange (ETDEWEB)

Quaempts, Eric

2003-01-01

U.S. Fish and Wildlife Service (USFWS) Habitat Evaluation Procedures (HEP) were used to determine the number of habitat units credited to evaluate lands acquired and leased in Eskuulpa Watershed, a Confederated Tribes of the Umatilla Indian Reservation watershed and wildlife mitigation project. The project is designed to partially credit habitat losses incurred by BPA for the construction of the John Day and McNary hydroelectric facilities on the Columbia River. Upland and riparian forest, upland and riparian shrub, and grasslands cover types were included in the evaluation. Indicator species included downy woodpecker (Picuides puhescens), black-capped chickadee (Pams atricopillus), blue grouse (Beadragapus obscurus), great blue heron (Ardea herodias), yellow warbler (Dendroica petschia), mink (Mustela vison), and Western meadowlark (Sturnello neglects). Habitat surveys were conducted in 1998 and 1999 in accordance with published HEP protocols and included 55,500 feet of transects, 678 m2 plots, and 243 one-tenth-acre plots. Between 123.9 and f 0,794.4 acres were evaluated for each indicator species. Derived habitat suitability indices were multiplied by corresponding cover-type acreages to determine the number of habitat units for each species. The total habitat units credited to BPA for the Iskuulpa Watershed Project and its seven indicator species is 4,567.8 habitat units. Factors limiting habitat suitability are related to the direct, indirect, and cumulative effects of past livestock grazing, road construction, and timber harvest, which have simplified the structure, composition, and diversity of native plant communities. Alternatives for protecting and improving habitat suitability include exclusion of livestock grazing or implementation of restoration grazing schemes, road de-commissioning, reforestation, large woody debris additions to floodplains, control of competing and unwanted vegetation, reestablishing displaced or reduced native vegetation species

Diabetes and Risk of Community-Acquired Respiratory Tract Infections, Urinary Tract Infections, and Bacteremia

DEFF Research Database (Denmark)

Thomsen, Reimar W.; Mor, Anil

2013-01-01

This review provides an update on the risk of several important community-acquired infections seen in patients with diabetes: respiratory tract infections, urinary tract infections, and bacteremia. Respiratory tract infections: Recent epidemiological evidence shows a modest (1.25 to 1.75-fold) risk...... increase for hospitalization with pneumonia associated with diabetes. The increase of risk for tuberculosis is of similar magnitude in highly developed countries, and possibly higher in low-income countries. Poor glycemic control and long diabetes duration predict higher risk for both pneumonia...... and tuberculosis. Limited data is available for diabetes and influenza, yet both influenza and pneumococcal vaccination is recommended in patients with diabetes. Urinary tract infections: The risk of asymptomatic bacteriuria and cystitis is 1.5 to 2 times increased in diabetes patients, while their risk...

[Cytokine changes in community-acquired pneumonia in elderly and intervention of traditional Chinese medicine].

Science.gov (United States)

Ye, Shanghe; Gong, Guolang; Zheng, Haiwen; Hu, Guohua; Xia, Tao

2010-06-01

To make a study of the cytokine changes in community-acquired pneumonia (CAP) in the elderly and the intervention of traditional Chinese medicine that can clear away the lung-heat and dissipate blood stasis (Qingfeihuayu soup). The 82 cases with CAP in the elderly were divided at random into two treatment group and control group. Based on heteropathy, the treatment group was given Qingfeihuayu soup two times a day. The control group was given Rocephin 2 g once daily for 7 days. The clinical effect and the changes in TNF-alpha, IL-6 and IL-10 were observed before and after the treatment. A healthy group was also set up. Before treatment, IL-6 and TNF-alpha in both groups were higher than the healthy group (P soup has obviously have regulating and clinical effect.

Projected range contractions of European protected oceanic montane plant communities: focus on climate change impacts is essential for their future conservation.

Science.gov (United States)

Hodd, Rory L; Bourke, David; Skeffington, Micheline Sheehy

2014-01-01

Global climate is rapidly changing and while many studies have investigated the potential impacts of this on the distribution of montane plant species and communities, few have focused on those with oceanic montane affinities. In Europe, highly sensitive bryophyte species reach their optimum occurrence, highest diversity and abundance in the north-west hyperoceanic regions, while a number of montane vascular plant species occur here at the edge of their range. This study evaluates the potential impact of climate change on the distribution of these species and assesses the implications for EU Habitats Directive-protected oceanic montane plant communities. We applied an ensemble of species distribution modelling techniques, using atlas data of 30 vascular plant and bryophyte species, to calculate range changes under projected future climate change. The future effectiveness of the protected area network to conserve these species was evaluated using gap analysis. We found that the majority of these montane species are projected to lose suitable climate space, primarily at lower altitudes, or that areas of suitable climate will principally shift northwards. In particular, rare oceanic montane bryophytes have poor dispersal capacity and are likely to be especially vulnerable to contractions in their current climate space. Significantly different projected range change responses were found between 1) oceanic montane bryophytes and vascular plants; 2) species belonging to different montane plant communities; 3) species categorised according to different biomes and eastern limit classifications. The inclusion of topographical variables in addition to climate, significantly improved the statistical and spatial performance of models. The current protected area network is projected to become less effective, especially for specialised arctic-montane species, posing a challenge to conserving oceanic montane plant communities. Conservation management plans need significantly

Projected range contractions of European protected oceanic montane plant communities: focus on climate change impacts is essential for their future conservation.

Directory of Open Access Journals (Sweden)

Rory L Hodd

Full Text Available Global climate is rapidly changing and while many studies have investigated the potential impacts of this on the distribution of montane plant species and communities, few have focused on those with oceanic montane affinities. In Europe, highly sensitive bryophyte species reach their optimum occurrence, highest diversity and abundance in the north-west hyperoceanic regions, while a number of montane vascular plant species occur here at the edge of their range. This study evaluates the potential impact of climate change on the distribution of these species and assesses the implications for EU Habitats Directive-protected oceanic montane plant communities. We applied an ensemble of species distribution modelling techniques, using atlas data of 30 vascular plant and bryophyte species, to calculate range changes under projected future climate change. The future effectiveness of the protected area network to conserve these species was evaluated using gap analysis. We found that the majority of these montane species are projected to lose suitable climate space, primarily at lower altitudes, or that areas of suitable climate will principally shift northwards. In particular, rare oceanic montane bryophytes have poor dispersal capacity and are likely to be especially vulnerable to contractions in their current climate space. Significantly different projected range change responses were found between 1 oceanic montane bryophytes and vascular plants; 2 species belonging to different montane plant communities; 3 species categorised according to different biomes and eastern limit classifications. The inclusion of topographical variables in addition to climate, significantly improved the statistical and spatial performance of models. The current protected area network is projected to become less effective, especially for specialised arctic-montane species, posing a challenge to conserving oceanic montane plant communities. Conservation management plans need

"Sitting in different chairs:" roles of the community health workers in the Poder es Salud/Power for Health Project.

Science.gov (United States)

Farquhar, S A; Wiggins, N; Michael, Y L; Luhr, G; Jordan, J; Lopez, A

2008-07-01

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs also discuss their own personal and professional development. The analysis of the interviews suggests that CHWs valued their multiple roles with Poder es Salud/Power for Health and their participation on the project's Steering Committee. Based on CHWs' descriptions of their work, this type of involvement appears to build the CHWs' leadership skills and sense of efficacy to create change in their communities. By serving as community organizers and participating as producers of research, rather than acting merely as a deliverer of the intervention activities, the CHWs were able to build skills that make them more successful as CHWs.

Antibacterial resistance patterns of pediatric community-acquired urinary infection: Overview.

Science.gov (United States)

Konca, Capan; Tekin, Mehmet; Uckardes, Fatih; Akgun, Sadik; Almis, Habip; Bucak, Ibrahim Hakan; Genc, Yeliz; Turgut, Mehmet

2017-03-01

Urinary tract infection (UTI) is common in children. The aim of this study was therefor to construct a guide for the empirical antibiotic treatment of community-acquired UTI by investigating the etiology and antimicrobial resistance patterns of uropathogens and analyzing the epidemiological and clinical patient characteristics. A total of 158 children with positive urine culture were included in the study. Antibiotic susceptibility testing was performed with Vitek 2 Compact for 28 commonly used antimicrobials. Mean age was 3.36 ± 3.38 years (range, 45 days-15 years). Escherichia coli (60.1%), and Klebsiella spp. (16.5%) were the most common uropathogens. For all Gram-negative isolates, a high level of resistance was found against ampicillin/sulbactam (60.1%), trimethoprim/sulfamethoxazole (44.2%), cefazolin (36.2%), cefuroxime sodium (33.5%), and amoxicillin/clavulanate (31.5%). A low level of resistance was noted against cefepime (8.7%), ertapenem (4.6%), norfloxacin (1.3%), and meropenem (0.7%). There was no resistance against amikacin. There is high antibiotic resistance in children with UTI. The patterns of uropathogen antimicrobial resistance vary in susceptibility to antimicrobials depending on region and time. Thus, the trends of antibiotic susceptibility patterns should be analyzed periodically to select the appropriate regimen for UTI treatment. © 2016 Japan Pediatric Society.

Etiology of community-acquired pneumonia in hospitalized patients in Jordan

International Nuclear Information System (INIS)

Al-Ali, Musa K.; Batchoun, R. G.; Al-Nour, Tariq M.

2006-01-01

To ascertain the causative organisms of community acquired pneumonia (Cap) in Jordanian patients requiring hospital admission. A prospective study of both adults and children admitted to Princess Basma and Princess Rahma Teaching Hospitals in Irbid, Jordan with a diagnosis of CAP over a 6-month period from April to October 2002. A total of 35 adult patients were admitted with a mean age of 47 years, and 63 children with a mean age of 3 years. A pathogen was isolated from 25 (71%) adults, and from 17 (27%) children, and sputum cultures gave the best diagnostic yield. In adults Streptococcus pneumoniae was the most common isolate (26%), followed by Chlamydia pneumoniae (23%), Haemophilus influenzae (17%), Mycoplasma pneumoniae (9%), and Legionella pneumophila and Klebsiella pneumoniae (6%) each. Seven of the 9 gram negative isolates were from patients with some co morbid illness. While in children, Chlamydia pneumoniae was the most common (14%), followed by Mycoplasma pneumoniae (6%), and Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa (3%) each. Streptococcus pneumoniae and atypical microorganisms are the most common cause of CAP in previously healthy adults; while in those with associated co morbid illness, gram negative organisms are the likely cause. In children, the overall detection rate of causative organisms was low with atypical microorganisms being the most common. (author)

Outcome results for the Ma'alahi Youth Project, a Tongan community-based obesity prevention programme for adolescents.

Science.gov (United States)

Fotu, K F; Millar, L; Mavoa, H; Kremer, P; Moodie, M; Snowdon, W; Utter, J; Vivili, P; Schultz, J T; Malakellis, M; McCabe, M P; Roberts, G; Swinburn, B A

2011-11-01

Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3-year, quasi-experimental study of community-based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow-up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n = 815; 12.6% points, n = 897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (-1.5%, P Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community-based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio-cultural barriers to achieving a healthy weight. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Knowledge and Perceptions Regarding Community-Acquired Staphylococcal Infections Among Health Care Workers in Hawai‘i

Science.gov (United States)

Katz, Alan; Hurwitz, Eric; Tice, Alan

2013-01-01

Introduction Since the early 1990s, national rates of methicillin-resistant Staphylococcus aureus (MRSA) infections have increased dramatically. Initially identified in health care settings, community-acquired MRSA is now a major public health concern. With Hawai‘i's strikingly high incidence and prevalence of MRSA infections, a high level of knowledge and awareness among health care workers is essential to successfully controlling this evolving epidemic. Methods Health care and related workers were surveyed to assess their knowledge and perceptions about staphylococcal and MRSA infections. Knowledge was estimated by demonstrated ability to correctly identify risk factors including diabetes, obesity, pets, and seawater exposure as well as understanding the seriousness of antibiotic resistance. Perceptions were estimated by demonstrated awareness of the severity and elevated incidence and prevalence of S. aureus and MRSA infections. Results This study identified that occupation (advance clinical practitioner, nurse, public health professional, athletic trainers, and non-medical workers) as well as work location (community vs hospital) influence knowledge and perceptions regarding the epidemiology, severity, and risk factors of S. aureus and MRSA infections. Additionally, despite a well-documented global crisis with antibiotic resistance, Hawai‘i's community health care workers were less inclined to correctly identify the threat of antibiotic resistance as compared to their hospital-based colleagues. Conclusion Trends were observed in knowledge and perceptions with level of medical education. Differences were also noted according to work location. Overall, health care and related workers in the community were less likely to understand basic principles associated with S. aureus infections as well as misperceive this imminent threat. These findings provide compelling evidence for focused educational interventions targeting community health care and related workers