Sample records for health centres communities

  1. Quality of blood pressure measurement in community health centres.

    Sandoya-Olivera, Edgardo; Ferreira-Umpiérrez, Augusto; Machado-González, Federico

    To determine the quality of the blood pressure measurements performed during routine care in community health centres. An observational, cross-sectional study was conducted in 5 private and public health centres in Maldonado, Uruguay, in July-August 2015. The observations were made during the measurements performed by health personnel, using the requirements established by the American Heart Association. An analysis was made on 36 variables that were grouped in categories related to environment, equipment, interrogation, patient, and observer. Statistical analysis was performed using Chi(2) test or Fisher test. Statistical significance was considered to be less than 5% (p<.05). The measurements were made by a registered nurse or nurse in 71% of cases, physician in 20%, and student nurse in 9%. An aneroid sphygmomanometer was used in 89%, and mercury 11%. Satisfactory results were found in variables related to environment (93%), equipment (99%), and patient attitude (82%), and intermediate in the attitudes of the operator (64%), and poor in relation to the interrogation (18%), with the mean of correct variables per measurement being 69%. The main flaws in the procedure were the operator. The measurement of blood pressure is a manoeuvre that healthcare professionals perform thousands of times a year. If the measurement is used for the diagnosis and/or chronic management of arterial hypertension, not systematically applying the established recommendations leads to an inappropriate care of a very significant number of patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  2. Community involvement in health services at Namayumba and Bobi health centres: A case study

    Jane F. Namatovu


    Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.

  3. The Pholela Health Centre - the origins of community-oriented ...

    government's purchase of land for a clinic, to the appointment of outsiders ... were play groups but also served as nutrition education and feeding centres. ... This process of annual extensions allowed .... and kwashiorkor; (ii/) high incidence of infectious diseases, .... (working class white community) ... Decision on evaluation.

  4. Factors predicting drop-out in community mental health centres.

    Reneses, Blanca; Muñoz, Elena; López-Ibor, Juan José


    This study aimed to identify treatment, therapist and patient factors associated with dropping out of treatment in four outpatient mental health services. The experimental group comprised all 789 individuals who attended for the first time the mental health services during one year and dropped out of treatment in the same year or during the two following ones. The control group consisted of the same number of individuals, chosen at random from patients who, in the same year, attended for the first time the services and did not subsequently drop out of treatment. The overall drop-out rate was 33.2%. According to logistic regression analysis, the predictive factors of dropping out were: being treated in a particular centre, the involvement of more than one therapist in treatment, having no previous history of psychiatric disorders, being young and being male.

  5. Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

    Hains Jenny


    Full Text Available Abstract Background Early onset and high prevalence of chronic disease among Indigenous Australians call for action on prevention. However, there is deficiency of information on the extent to which preventive services are delivered in Indigenous communities. This study examined the variation in quality of preventive care for well adults attending Indigenous community health centres in Australia. Methods During 2005-2009, clinical audits were conducted on a random sample (stratified by age and sex of records of adults with no known chronic disease in 62 Indigenous community health centres in four Australian States/Territories (sample size 1839. Main outcome measures: i adherence to delivery of guideline-scheduled services within the previous 24 months, including basic measurements, laboratory investigations, oral health checks, and brief intervention on lifestyle modification; and ii follow-up of abnormal findings. Results Overall delivery of guideline-scheduled preventive services varied widely between health centres (range 5-74%. Documentation of abnormal blood pressure reading ([greater than or equal to]140/90 mmHg, proteinuria and abnormal blood glucose ([greater than or equal to]5.5 mmol/L was found to range between 0 and > 90% at the health centre level. A similarly wide range was found between health centres for documented follow up check/test or management plan for people documented to have an abnormal clinical finding. Health centre level characteristics explained 13-47% of variation in documented preventive care, and the remaining variation was explained by client level characteristics. Conclusions There is substantial room to improve preventive care for well adults in Indigenous primary care settings. Understanding of health centre and client level factors affecting variation in the care should assist clinicians, managers and policy makers to develop strategies to improve quality of preventive care in Indigenous communities.

  6. A survey of hypertensive practices at two community health centres ...

    Normally distributed data were analysed using the Student's t-test, and .... to the nearest zero, indicating uniform digital bias. This implies that BP is only .... insurance and rely on the public sector for their health care. Major deficiencies were ...

  7. The development of an intelligent laboratory information system for a community health promotion centre.

    Chae, Young Moon; Lim, Hwan-Sub; Lee, Ju Hon; Bae, Mi Young; Kim, Gyu Hyung


    This study aimed to develop an Intelligent Laboratory Information System (ILIS) for the community health promotion centre in Kwachun city to help process an increasing amount of laboratory test data in an efficient manner, and to support the clinical decision-making of public health doctors. A sample of 170 cases was used for validation of the system. Overall, the system correctly predicted 92.5% of the cases. This paper also analysed the economic feasibility of the ILIS based on the Information Economics approach. The results showed that the ILIS not only helps screen more people by increasing the capacity of a health promotion centre, but also brings in more revenue to the centre.

  8. Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

    Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit


    Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues

  9. The rehabilitation of stroke patients at community health centres in the Western Cape

    A. Rhoda


    Full Text Available The structure and process of rehabilitation of stroke patientsaffects the outcomes of the patients. The aim of this study was to determine thestructure and process of rehabilitation of stroke patients at Community HealthCentres  (CHCs in the Western Cape, South A frica. A  quantitative descriptive study was conducted. Questionnaires and archived records were used to collect the data. The study sample used to collect information related to the structure consisted of therapists (16 employed at the centres; while the study sample used to collect information related to the process consisted of 100 first time stroke patients. Descriptive statistics were conducted using Excel and SPSS. The results of the study revealed that there is a lack of occupational and speech therapy services at the centres forming partof the study sample. At centres where these services are provided the frequency and intensity with which the services are received by the patients is extremely low. Further research is needed to determine if the decreased intensity is onlyas a result of decreased availability of services or if inability of stroke clients to access the services also plays a role.

  10. Governance structure reform and antibiotics prescription in community health centres in Shenzhen, China.

    Liang, Xiaoyun; Xia, Tingsong; Zhang, Xiulan; Jin, Chenggang


    It is unclear whether changing the governance structure of community health centres (CHCs) could affect antibiotic prescribing behaviour. To explore how changes in governance structure affect antibiotic prescription for children younger than 5 years of age with acute upper respiratory tract infections (AURI) in CHCs in Shenzhen, China. This study used an interrupted time series design with a comparison series. On 1 June 2009, the Health Bureau of Shenzhen's Baoan District transferred CHCs from a hospital-affiliated model to a self-managed independent model regarding finance, personnel and employee compensation. We collected 23481 electronic medical records of children younger than 5 years of age who were treated for AURI on an outpatient basis 1 year before and 1 year after governance structure reform. We used segmented regression analysis to evaluate the effect of reform on antibiotic prescription. After the reform, the proportion of patients receiving an antibiotic injection per month and the proportion of patients receiving two or more antibiotics conditional on receiving an antibiotic per month decreased 9.17% and 7.34%, respectively (P governance structure reform can have positive effects on behaviour for antibiotic prescribing. Moreover, this short-term effect might have important implications for further community health reforms in China. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:

  11. Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China.

    Liu, Danping; Meng, Hongdao; Dobbs, Debra; Conner, Kyaien O; Hyer, Kathryn; Li, Ningxiu; Ren, Xiaohui; Gao, Bo


    Public investment in community health centres (CHCs) has been increasing as a response to rapid urbanisation in China. The objectives of this study were: (1) to examine factors associated with CHC use among residents from a recently urbanised community in western China and (2) to describe satisfaction with CHC among users. Cross-sectional design. A community recently converted to urban status with a newly constructed CHC in Southwest China. A random sample of 2259 adults in the Hezuo community in Chengdu, China, completed the survey in 2013. Trained staff interviewed study participants in their homes using structured questionnaires. The survey included questions regarding sociodemographics, health status, access to and usage of healthcare, health behaviours and CHC use. The Andersen's behavioural model of health service use was used to guide multivariable logistic regression modelling in identifying predisposing, enabling and need factors associated with the likelihood of using CHC. Descriptive statistics were used to describe residents' satisfaction with the CHC. A total of 71.8% of the respondents reported using the CHC during the past year. Factors influencing adults' CHC use included: gender, marital status, education level and knowledge of one's blood pressure (predisposing factors); annual household per capita income and walking time to the CHC (enabling factors) and self-rated health as well as physical activities (need factors). CHC users reported modest satisfaction across various aspects of the CHC. Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education. © Article author(s) (or their employer

  12. Knowledge and attitudes of nurses in community health centres about electronic medical records

    Don O'Mahony


    Full Text Available Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation.Objectives: The aim of this study is to explore nurses’ knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR systems.Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis.Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers.Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs. 

  13. Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.

    Alba-Leonel, Adela; Carvajal, Alfonso; Fierro, Immaculada; Castillo-Nájera, Fernando; Campos-Ramos, Oscar; Villa-Romero, Antonio; Molina-Guarneros, Juan


    Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged. © 2016 The Authors Fundamental & Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of Société Française de Pharmacologie et de Thérapeutique.

  14. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh


    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  15. Oral health screening of elderly people attending a community care centre.

    Diu, S; Gelbier, S


    A socio-dental survey was carried out to determine the level of dental disease and treatment requirement among elderly people attending a Community Care Centre. A screening programme involving 293 elderly people demonstrated a normative need of 82% and a felt need of 53%. Seventy-six per cent would have benefited from dental care. Many individuals who both needed and wanted dental care were not receiving it because they were discouraged from doing so predominantly because of poor mobility. It is recommended, therefore, that dentists be included in multi-disciplinary teams caring for elderly people so that they can be screened and given the opportunity to obtain dental care.

  16. Avoiding "culture rejection" in healthcare mergers and acquisitions: how New Heights Community Health Centres and York Community Services minimized the culture risk when forming Unison Health and Community Services.

    Chan, Jeff


    Among the requirements for a successful merger or acquisition are strategic rationale, rigorous due diligence, the right price and revenue and cost synergies. However, bridging the culture gap between organizations is frequently overlooked. The leaders of New Heights Community Health Centres and York Community Services explicitly considered culture in their merger to form Unison Health and Community Services, and they used employee engagement surveys to assess culture in their merger planning and post-merger integration. How Unison Health leaders avoided the risk of culture rejection to achieve a successful merger, and the lessons learned from their experience, is the focus of this article.

  17. The Relationship between Paramedic Competency, Teamwork and Career Development with Quality of Service at Mengwi I Community Health Centre

    Alit Naya


    Full Text Available Background and objective: Recent survey indicated that patient opinion of services at Mengwi I Community Health Centre was low and there was noticeable decline in patient visits. This study aimed to investigate the issues related to the quality of health services given by the paramedics. Methods: A crosssectional study was conducted with 38 paramedics on duty at the outpatient unit. They were interviewed to obtain the data on their opinions about the quality of their service, competence, teamwork and career development opportunities. Chi square test was used for bivariate analysis and logistic regression for multivariate analysis. Results: The results of bivariate analysis indicated there was significant association between the paramedics’quality of service with the competence, teamwork and career development (p<0,001. Multivariate analysis indicated that the paramedics’competence (OR=43,1; 95%CI: 1,3-1422,5 and development of career (OR=31,7; 95%CI: 1,1-829,7 were related to the paramedics’ quality of service. Conclusion: The quality of service of paramedics at Mengwi I Community Health Centre were significantly associated with the paramedics’competence and development of career. Keywords: competency, teamwork, career development, quality of service

  18. A cross-sectional study of patients with and without substance use disorders in Community Mental Health Centres

    Ruud Torleif


    Full Text Available Abstract Background Epidemiological studies have consistently established high comorbidity between psychiatric disorders and substance use disorders (SUD. This comorbidity is even more prominent when psychiatric populations are studied. Previous studies have focused on inpatient populations dominated by psychotic disorders, whereas this paper presents findings on patients in Community Mental Health Centres (CMHCs where affective and anxiety disorders are most prominent. The purpose of this study is to compare patients in CMHCs with and without SUD in regard to differences in socio-demographic characteristics, level of morbidity, prevalence of different diagnostic categories, health services provided and the level of improvement in psychiatric symptoms. Methods As part of the evaluation of the National Plan for Mental Health, all patients seen in eight CMHCs during a 4-week period in 2007 were studied (n = 2154. The CMHCs were located in rural and urban areas of Norway. The patients were diagnosed according to the ICD-10 diagnoses and assessed with the Health of the Nation Outcome Scales, the Alcohol Use Scale and the Drug Use Scale. Results Patients with SUD in CMHCs are more frequently male, single and living alone, have more severe morbidity, less anxiety and mood disorders, less outpatient treatment and less improvement in regard to recovery from psychological symptoms compared to patients with no SUD. Conclusion CMHCs need to implement systematic screening and diagnostic procedures in order to detect the special needs of these patients and improve their treatment.

  19. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    Adrian Kusambiza-Kiingi


    Full Text Available Background: Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim: To determine stroke survivors’ levels of community reintegration, quality of life (QOL, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method: This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results: A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73 and 58% (n = 62 had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55% caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001 and QOL (r = 0.51, p < 0.0001. A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001. Conclusion: Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  20. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    Kusambiza-Kiingi, Adrian; Maleka, Douglas


    Background Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim To determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p reintegration and caregiver strain (r = -0.37, p reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services. PMID:28730068

  1. Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

    Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica


    Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p reintegration and caregiver strain (r = -0.37, p reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  2. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

    Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul


    The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

  3. Profile of stroke patients treated at a community - based rehabilitation centre in a Cape Town health district

    A. J. Rhoda


    Full Text Available Stroke is a leading cause of death and disability in both developed and developing countries. Limited information is available, in South Africa, on the epidemiological profile of stroke survivors requiring rehabilitation. A descriptive study was therefore undertaken to compile, amongst others the demographic and medical profile of stroke patients attending  rehabilitation at a primary health care facility (Bishop Lavis Rehabilitation Centre.  Both medical- and rehabilitation records were reviewed to ensure completeness of information and to minimize missing clinical data bias. Relevant data was  captured on a data capture sheet.  The latter was based on key findings from the literature and developed by the researcher. The mean age of the population of stroke patients studied was 59 years, which is markedly younger than what has been reported globally in the literature. As was expected, hypertension was found to be the most prevalent risk factor. The presence of a combination of risk factors in the  majority of the group (on average, 2.4 risk factors per person warrants the introduction of aggressive health  education and stroke prevention programmes at this primary health care centre.



    May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.

  5. Preconsult interactive computer-assisted client assessment survey for common mental disorders in a community health centre: a randomized controlled trial

    Ahmad, Farah; Lou, Wendy; Shakya, Yogendra; Ginsburg, Liane; Ng, Peggy T.; Rashid, Meb; Dinca-Panaitescu, Serban; Ledwos, Cliff; McKenzie, Kwame


    Background: Access disparities for mental health care exist for vulnerable ethnocultural and immigrant groups. Community health centres that serve these groups could be supported further by interactive, computer-based, self-assessments. Methods: An interactive computer-assisted client assessment survey (iCCAS) tool was developed for preconsult assessment of common mental disorders (using the Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder 7-item [GAD-7] scale, Primary Care Post-traumatic Stress Disorder [PTSD-PC] screen and CAGE [concern/cut-down, anger, guilt and eye-opener] questionnaire), with point-of-care reports. The pilot randomized controlled trial recruited adult patients, fluent in English or Spanish, who were seeing a physician or nurse practitioner at the partnering community health centre in Toronto. Randomization into iCCAS or usual care was computer generated, and allocation was concealed in sequentially numbered, opaque envelopes that were opened after consent. The objectives were to examine the interventions' efficacy in improving mental health discussion (primary) and symptom detection (secondary). Data were collected by exit survey and chart review. Results: Of the 1248 patients assessed, 190 were eligible for participation. Of these, 148 were randomly assigned (response rate 78%). The iCCAS (n = 75) and usual care (n = 72) groups were similar in sociodemographics; 98% were immigrants, and 68% were women. Mental health discussion occurred for 58.7% of patients in the iCCAS group and 40.3% in the usual care group (p ≤ 0.05). The effect remained significant while controlling for potential covariates (language, sex, education, employment) in generalized linear mixed model (GLMM; adjusted odds ratio [OR] 2.2; 95% confidence interval [CI] 1.1-4.5). Mental health symptom detection occurred for 38.7% of patients in the iCCAS group and 27.8% in the usual care group (p > 0.05). The effect was not significant beyond potential

  6. Treatment of Chronic Hepatitis C Infection among Current And Former Injection Drug Users within a Multidisciplinary Treatment Model at a Community Health Centre

    Adam I Newman


    Full Text Available The aim of the present prospective observational study was to assess uptake and success of hepatitis C virus (HCV treatment among a group of former and current injection drug users with chronic HCV infection at the Street Health Centre in Kingston, Ontario. The Street Health Centre offers hepatitis C education, assessment and treatment within a multidisciplinary, integrated and collaborative treatment model of care delivered by primary care professionals. The study enrolled a convenience sample of 34 patients. Seventy per cent of study patients had no postsecondary education, 85% were unemployed and one-third were unstably housed. A majority of study patients self-reported mental health problems. Of the 14 patients who initiated antiviral treatment in the study period, eight (57% achieved sustained virological response. Regardless of virological outcome, patients who initiated treatment showed positive trends toward increased social and psychiatric stability, and decreases in high-risk behaviours. These results suggest that not only is successful treatment of chronic HCV infection in current and former injection drug users with concurrent psychiatric disorders possible, but the benefits of such treatment delivered in a community-based, multidisciplinary, primary care model may extend beyond narrowly defined virological outcomes.

  7. Myanmar: The Community Learning Centre Experience.

    Middelborg, Jorn; Duvieusart, Baudouin, Ed.

    A community learning centre (CLC) is a local educational institution outside the formal education system, usually set up and managed by local people. CLCs were first introduced in Myanmar in 1994, and by 2001 there were 71 CLCs in 11 townships. The townships are characterized by remoteness, landlessness, unemployment, dependency on one cash crop,…

  8. Challenges to the implementation of the integrated management of childhood illness (IMCI) at community health centres in West Java province, Indonesia.

    Titaley, C R; Jusril, H; Ariawan, I; Soeharno, N; Setiawan, T; Weber, M W


    The integrated management of childhood illness (IMCI) is a comprehensive approach to child health, which has been adopted in Indonesia since 1997. This study aims to provide an overview of IMCI implementation at community health centres (puskesmas) in West Java province, Indonesia. Data were derived from a cross-sectional study conducted in 10 districts of West Java province, from November to December 2012. Semi-structured interviews were used to obtain information from staff at 80 puskesmas, including the heads (80 informants), pharmacy staff (79 informants) and midwives/nurses trained in IMCI (148 informants), using semi-structured interviews. Quantitative data were analysed using frequency tabulations and qualitative data were analysed by identifying themes that emerged in informants' responses. Almost all (N = 79) puskesmas implemented the IMCI strategy; however, only 64% applied it to all visiting children. Several barriers to IMCI implementation were identified, including shortage of health workers trained in IMCI (only 43% of puskesmas had all health workers in the child care unit trained in IMCI and 40% of puskesmas conducted on-the-job training). Only 19% of puskesmas had all the essential drugs and equipment for IMCI. Nearly all health workers acknowledged the importance of IMCI in their routine services and very few did not perceive its benefits. Lack of supervision from district health office staff and low community awareness regarding the importance of IMCI were reported. Complaints received from patients'families were generally related to the long duration of treatment and no administration of medication after physical examination. Interventions aiming to create local regulations endorsing IMCI implementation; promoting monitoring and supervision; encouraging on-the-job training for health workers; and strengthening training programmes, counselling and other promotional activities are important for promoting IMCI implementation in West Java province

  9. Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka

    Sangeetha S Balamurugan


    Full Text Available Background: Reproductive tract infections (RTIs is a global health problem including both sexually transmitted infections (STIs and non-sexually transmitted infections (non-STIs of the reproductive tract. RTI/STI is an important concern, as it possess risk for human immunodeficiency virus transmission. Hence a community study was done in Hubli, in terms of active search of the cases based on the symptoms, clinical examination, and feasible laboratory tests along with providing treatment, counseling, and follow-up. Objectives: The objective was to know the prevalence of RTIs among the reproductive age group women and the socio-demographic factors influencing the occurrence of the disease. Materials and Methods: A cross-sectional study was done using a simple random sampling technique to select households. A pretested structured pro forma was used to collect data on RTIs from 656 women of 15-45 years, residing in the field practice area. This was followed by clinical examination and collection of samples for laboratory tests in Urban Health Training Centre, attached to Karnataka Institute of Medical Sciences, Hubli. Results: The prevalence of RTIs among the reproductive age group women was 40.4% based on their symptoms, with majority having abnormal vaginal discharge. The prevalence of RTIs based on clinical finding was 37.4% with majority having vaginitis. The laboratory test revealed a prevalence of 34.3% with majority having Candidiasis. The influence of socio-demographic factors like increased parity, poor socio-economic conditions, poor menstrual hygiene, illiteracy has its direct effect on occurrence of RTI in the community. Conclusion: This depicts that whereever possible, clinical and laboratory findings should support self-reported morbidity to know the exact prevalence of any disease in the community.

  10. Assessing health centre systems for guiding improvement in diabetes care

    Robinson Gary


    Full Text Available Abstract Background Aboriginal people in Australia experience the highest prevalence of diabetes in the country, an excess of preventable complications and early death. There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to assess the status of systems for chronic illness care in Aboriginal community health centres, and to explore whether more developed systems were associated with better quality of diabetes care. Methods This cross-sectional study was conducted in 12 Aboriginal community health centres in the Northern Territory of Australia. Assessment of Chronic Illness Care scale was adapted to measure system development in health centres, and administered by interview with health centre staff and managers. Based on a random sample of 295 clinical records from attending clients with diagnosed type 2 diabetes, processes of diabetes care were measured by rating of health service delivery against best-practice guidelines. Intermediate outcomes included the control of HbA1c, blood pressure, and total cholesterol. Results Health centre systems were in the low to mid-range of development and had distinct areas of strength and weakness. Four of the six system components were independently associated with quality of diabetes care: an increase of 1 unit of score for organisational influence, community linkages, and clinical information systems, respectively, was associated with 4.3%, 3.8%, and 4.5% improvement in adherence to process standards; likewise, organisational influence, delivery system design and clinical information systems were related to control of HbA1c, blood pressure, and total cholesterol. Conclusion The state of development of health centre systems is reflected in quality of care outcome measures for patients. The health centre systems assessment tool should be useful in assessing and guiding development of systems for improvement of

  11. Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

    Decat, P.; Nelson, E.; de Meyer, S.; Jaruseviciene, L.; Orozco, M.; Segura, Z.; Gorter, A.; Vega, B.; Cordova, K.; Maes, L.; Temmerman, M.; Leye, E.; Degomme, O.


    Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and repr

  12. [The coordination of care in health centres].

    Ribardière, Olivia


    Health centres are structurally designed to facilitate the coordination of care. However, evolutions in society have resulted in forms of consumption of health care which are not necessarily compatible with efficient care coordination. On a local level, teams are nevertheless organising and structuring themselves to offer the right form of care, to the right patient and at the right time.

  13. Primary care clinicians’ experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters

    Douglas S Krakower


    Full Text Available Introduction: An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. Methods: During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Results and discussion: Thirty-two clinicians (response rate=91% completed the surveys. Nearly all clinicians (97% had prescribed PrEP (median 20 patients, interquartile range 11–33. Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians’ practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79% rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. Conclusions: In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this

  14. Primary care clinicians’ experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters

    Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H


    Introduction An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. Methods During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Results and discussion Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11–33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians’ practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. Conclusions In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious

  15. Innovation in youth mental health services in Australia: common characteristics across the first headspace centres.

    Rickwood, Debra; Van Dyke, Nina; Telford, Nic


    headspace centres comprise a significant innovation in community-based youth mental health service delivery in Australia. This paper examines the service activity of the first headspace centres to determine common and unique practice characteristics across headspace centres in this new approach to mental health service delivery. Data come from quarterly progress reports provided by the first 30 headspace centres during the 2010-2011 financial year. The information from 120 reports was analysed qualitatively using thematic analysis techniques to determine the types of activities reported by centres against key performance indicators. The main finding was the large number and wide range of centre activity. This heterogeneity may be explained in part by the diversity of communities across Australia and the importance that headspace places on addressing the specific needs of the local community as well as drawing upon the existing capacity that is available within a community. The most common activities were community engagement, building local partnerships and providing a youth friendly environment. There was a particularly strong focus by the majority of centres on establishing and supporting a Youth Reference Group to guide centre development and implementation. The progressive upscaling of headspace centres across Australia provides a unique opportunity to observe how a significant reorientation in health service delivery is implemented in practice to meet the needs of diverse communities. Further investigation of the headspace experience will provide critical lessons for other countries investing in new approaches to youth mental health. © 2013 Wiley Publishing Asia Pty Ltd.

  16. Science Centres: A Resource for School and Community

    Pilo, Miranda; Mantero, Alfonso; Marasco, Antonella


    We present a science centre established in Genoa on an agreement between Municipality of Genoa and Department of Physics of University of Genoa. The aim is to offer children, young people and community an opportunity to approach science in a playful way. The centre staffs guide the visitors through the exhibits, attracting their interests towards…

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

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


    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.

  18. The Rankin Inlet Birthing Centre: community midwifery in the Inuit context.

    Douglas, Vasiliki Kravariotis


    To trace the historical development of the Rankin Inlet Birthing Centre since its inception in 1993 in the context of plans to make it the nucleus of a system of community birthing centres throughout Nunavut. This is an analytical historical study using a combination of oral history interviews, government documents and existing literature. Oral history interviews with current and former employees of the Birthing Centre, founding organizers and women who gave birth there were combined with a review of the literature using MEDLINE, Anthropology PLUS, CINAHL and Historical Abstracts, as well as a search of the records of the Nunavut Government and the debates of the Nunavut Legislature and its predecessor, the NWT Legislature. Results. The Rankin Inlet Birthing Centre has been successful, but only marginally so. The majority of births for residents of this region still occur in southern hospitals, either in Churchill or Winnipeg. Although the long-term plan for the Centre is to train and employ Inuit midwives, thus far only two maternity care workers are employed at the Centre. All the midwives are from southern Canada and rotate through the Centre and the community on fixed terms. The Centre has been very successful at gaining and retaining support at the political level, with a strong official commitment to it from the Nunavut Legislature, and active support from the medical communities in the Kivalliq and in Manitoba through the Northern Health Unit at the University of Manitoba. Community support within Rankin Inlet is less apparent and has been halting. Plans to extend the model of the Centre to other communities are long-standing, but have been slow to come to fruition. The Rankin Inlet Birthing Centre has remained an important, but peripheral, institution in Rankin Inlet. It is in many ways a southern institution located in the Arctic; for this reason, and due to the social networks present in Rankin Inlet itself, it has suffered from a lack of enthusiastic

  19. Outcomes of Chronic Hepatitis C Therapy in Patients Treated in Community Versus Academic Centres in Canada: Final Results of APPROACH (A Prospective Study of Peginterferon alfa-2a and Ribavirin at Academic and Community Centres in Canada

    Robert P Myers


    Full Text Available BACKGROUND: In patients chronically infected with the hepatitis C virus (HCV, it is not established whether viral outcomes or health-related quality of life (HRQoL differ between individuals treated at academic or community centres.

  20. Rapid health assessments of evacuation centres in areas affected by Typhoon Haiyan

    Ruth Alma Ramos


    Full Text Available Introduction: Typhoon Haiyan caused thousands of deaths and catastrophic destruction, leaving many homeless in Region 8 of the Philippines. A team from the Philippine Field Epidemiology Training Program conducted a rapid health assessment survey of evacuation centres severely affected by Haiyan. Methods: A descriptive study was conducted whereby a convenience sample of evacuation centres were assessed on the number of toilets per evacuee, sanitation, drinking-water, food supply source and medical services. Results: Of the 20 evacuation centres assessed, none had a designated manager. Most were located in schools (70% with the estimated number of evacuees ranging from 15 to 5000 per centre. Only four (20% met the World Health Organization standard for number of toilets per evacuee; none of the large evacuation centres had even half the recommended number of toilets. All of the evacuation centres had available drinking-water. None of the evacuation centres had garbage collection, vector control activities or standby medical teams. Fourteen (70% evacuation centres had onsite vaccination activities for measles, tetanus and polio virus. Many evacuation centres were overcrowded. Conclusion: Evacuation centres are needed in almost every disaster. They should be safely located and equipped with the required amenities. In disaster-prone areas such as the Philippines, schools and community centres should not be designated as evacuation centres unless they are equipped with adequate sanitation services.



    Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. ... the child's health, culturally based beliefs and ..... immunization safety as this was a rural ... Charles SW, Olalekan AU, Peter MN,.



    2Department of Community Health, University of Benin, Benin City, Nigeria. ... public health problem that can lead to a great burden of disability in the community. ..... women. Equally worthy of note, is the fact that a higher proportion of females ...

  3. Facilitating organizational mergers: amalgamation of community care access centres.

    Mercer, Kevin


    The development of 14 Local Health Integration Networks (LHINs) in Ontario necessitated the re-organization of Community Care Access Centres (CCACs). The achievement of LHIN objectives was contingent upon the organizations responsible for home and long-term care placement being aligned within the LHIN geographic boundaries. This re-alignment required 42 provincial organizations to re-structure, integrate and reduce to 14. This project was focused on the amalgamation of two CCACs in the Waterloo Wellington LHIN. Both were distinctly different due to their organizational evolution, the composition of the region and leadership approach. The different organizational cultures, if not managed properly, could result in a derailing of several current projects that were underway and were also key to the overall health system transformation agenda. A literature search provided a plethora of critiques of organizational change approaches and practical suggestions. Of particular relevance was a report to the Royal Commission on Health Care in 2002 that authenticates the dismal success in health care to meet change objectives. The project included a joint planning day for the leadership teams of the two organizations followed by an Organizational Readiness Assessment conducted by the Canadian Council on Health Services Accreditation (CCHSA). Both activities brought the leadership and staff of Waterloo and Wellington together, started the integration process and solicited staff participation. A follow-up survey of the leadership teams revealed the effectiveness of the project in advancing integration between the two organizations and recognizing organizational cultural differences. The CCHSA Organizational Readiness Assessment process was viewed as an effective means for advancing the integration of the two organizations, particularly as it relates to allowing the staff groups to define for themselves the benefits of the merger. The lack of hard evidence on the benefits of a



    payment for health care services; a widely used strategy to supplement ... and opportunities for sustainable health care financing for low income communities in sub-. Saharan ..... funding and rising costs for health care services, More so, evidence from research studies have ... provider payment method has the potential to.

  5. Vertex-centred Method to Detect Communities in Evolving Networks

    Canu, Maël; d'Allonnes, Adrien Revault


    Finding communities in evolving networks is a difficult task and raises issues different from the classic static detection case. We introduce an approach based on the recent vertex-centred paradigm. The proposed algorithm, named DynLOCNeSs, detects communities by scanning and evaluating each vertex neighbourhood, which can be done independently in a parallel way. It is done by means of a preference measure, using these preferences to handle community changes. We also introduce a new vertex neighbourhood preference measure, CWCN, more efficient than current existing ones in the considered context. Experimental results show the relevance of this measure and the ability of the proposed approach to detect classical community evolution patterns such as grow-shrink and merge-split.


    Journal of Community Medicine and Primary Health Care. ... This is one of the factors that determine whether or ..... Expired vaccines found in fridge / cold box .... date vaccine temperature monitoring charts. were stored on refrigerator door ...

  7. The role of community centres in offering protection: UNHCR and Al Ghaith Association in Yemen

    Nicolas Martin-Achard


    Full Text Available Community centres play an important role in offering protection for displaced communities, particularly for members of those communities who have specific needs. Somali refugees in Yemen formed the Al Ghaith Association and are now running their own community centres to support fellow refugees. Below, UNHCR and Al Ghaith discuss their approaches.


    M.H. Saheb-Zamani


    Full Text Available Twenty to twenty-five years ago, the Community Mental Health Center (CHMC, had scarcely been heard of. Today, it is indeed a movement, and apparently widespread. A total of ten services considered to be necessary to provide adequate mental health services: (1 in patient, (2 out-patient, (3 partial hospitalization, (4 emergency, (5 consultation, (6 diagn1ostic, (7 rehabilitative, (8 precare and aftercare, (9 training, (10 research and evaluation services. This Concept of Community Mental Health would include as many community agents as possible in co-operative efforts. To the average educated layman, and, unfortunately to most mental health practitioners the community mental health care has become synonymous with the provision of mere psycho-therapy. The community mental health center has not succeeded in becoming inductor of catalytic agent in the growth of its patients, nor has it become significantly involved with the community as a scrcla1 system. These are grim facts. But new hope has begun to appear. It is contained in four revolutions now under way – revolutions in understanding, in research, in nu1ternal and child care and in education for mental health.

  9. Indian Health Service: Community Health

    ... provide for community health. A variety of programs, disciplines, strategies and interventions work together to pursue the ... Office of Finance and Accounting - 10E54 Office of Human Resources - 11E53A Office of Information Technology - 07E57B Office of ...

  10. The Rankin Inlet Birthing Centre: community midwifery in the Inuit context

    Douglas, Vasiliki Kravariotis


    To trace the historical development of the Rankin Inlet Birthing Centre since its inception in 1993 in the context of plans to make it the nucleus of a system of community birthing centres throughout Nunavut...

  11. The Rankin Inlet Birthing Centre: community midwifery in the Inuit context

    Vasiliki Kravariotis Douglas


      To trace the historical development of the Rankin Inlet Birthing Centre since its inception in 1993 in the context of plans to make it the nucleus of a system of community birthing centres throughout Nunavut...

  12. Air Pollution Affects Community Health

    Shy, Carl M.; Finklea, John F.


    Community Health and Environmental Surveillance System (CHESS), a nationwide program relating community health to environmental quality, is designed to evaluate existing environmental standards, obtain health intelligence for new standards, and document health benefits of air pollution control. (BL)

  13. Mental, physical and social health problems of call centre workers

    P Bhuyar


    Full Text Available Background: Call centre workers in BPO face unique occupational hazards - mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from two cities Pune and Mumbai were surveyed by both qualitative and quantitative methods for the above health problems. Results: A high proportion of workers faced sleep disturbances and associated mental stress and anxiety. Sleep disturbance and anxiety was significantly more in international call centres compared to domestic. There was also disturbance in circadian rhythms due to night shift. Physical problems such as musculoskeletal disorders, obesity, eye, and hearing problems were also present. Psychosocial problems included disruption in family life, use of tobacco and alcohol, and faulty eating habits. Conclusion: Better personal management, health education and more research is indicated to study the health problems in this emerging occupation.

  14. A relational conceptual framework for multidisciplinary health research centre infrastructure

    Johnson Joy L


    Full Text Available Abstract Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds. Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts. The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning. A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation.

  15. Mental and Physical health related problems of Call centre workers.

    Dr. Vaibhavkumar Ramanuj


    Full Text Available Abstract: Background: The employees of a call centre in BPO may have certain occupational hazards which are unique for the industry. These may be mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from day and night shifts were interviewed to find out about various health problems. Results: Mental stress was one of the main self reported health problem, reported by 44% and 54% of the respondents of day and night shift respectively. Sleep disturbance and disturbance in biological rhythm was mainly reported by the night shift workers.

  16. Service quality perceptions in primary health care centres in Greece.

    Papanikolaou, Vicky; Zygiaris, Sotiris


    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  17. Service quality perceptions in primary health care centres in Greece

    Papanikolaou, Vicky; Zygiaris, Sotiris


    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  18. Community Bioethics: The Health Decisions Community Council.

    Gallegos, Tom; Mrgudic, Kate


    Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…

  19. Nursing care community health

    Diana Acosta-Salazar


    Full Text Available Process Nursing Care (PAE is a systematic tool that facilitates the scientificity of care in community practice nurse, the application of scientific method in community practice, allows nursing to provide care in logical, systematic and comprehensive reassessing interventions to achieve the proposed results. It began with the valuation of Marjory Gordon Functional Patterns and then at the stage of diagnosis and planning North American Nursing Diagnosis Association (NANDA, Nursing Interventions Classification (NIC and Nursing Outcomes Classification (NOC is interrelate. It is a descriptive and prospective study. Diagnosis was made by applying the instruments measuring scale of the socio-demographic characteristics, symptom questionnaire for early detection of mental disorders in the community and appreciation for functional patterns. The PAE includes more frequent diagnoses, criteria outcomes, indicators, interventions and activities to manage community issues. alteration was evidenced in patterns: Adaptation and Stress Tolerance, Self-perception-Self-concept-, Role-Relationships, sleep and rest and Perception and Health Management. A standardized NANDA-NIC-NOC can provide inter care holistic care from the perspective of community mental health with a degree of scientific nature that frames the professional work projecting the individual, family and community care.

  20. Integrated Marketing Communications Plan for Health Centre Rhein-Neckar

    Stock, Katharina


    In today’s competitive environment, medical practices cannot do without advertising their services in order to attract and retain patients. Marketing in health care has become as essential as within any other industry. Therefore, this product-oriented thesis aims at creating an integrated marketing communications plan for the case company, Orthopaedic Health Centre Rhein-Neckar. The company’s objective is to increase sales generated by its diagnostic methods and treatment options for arthrosi...

  1. Analysis of factors influencing the outpatient workload at Chinese health centres

    Yin Ping


    Full Text Available Abstract Background Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs. Methods A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression. Results and Conclusions The analysis suggested several key factors for increasing the outpatient workload (OW at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence.

  2. Oral Health in Rural Communities

    ... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...


    in Nigeria includes but not limited to the following; 1, immunization schedule of her National programme. 9, 10 .... vaccinate their under-fives and three-fifths of characteristics and self reported ability to pay for ..... Centre for Disease Control.

  4. Guidelines to reduce sexually trasmitted infections at primary health care centres - Part 2

    S.T.J. Molapo


    Full Text Available Sexually transmitted diseases are the second highest cause of death among women aged 15-44 years. The incidence and prevalence of sexually transmitted diseases is on the increase at many health care centres despite their dreadfulness and many preventative measures. According to the Scope of Practice of registered professional nurses working in a community health clinic, the registered professional nurse has a responsibility to prevent disease and promote health as well as do research. This paper aims to describe guidelines to reduce sexually transmitted infections at primary health care centres based on research done to investigate the community specific knowledge, attitudes and perceptions regarding sexually transmitted infections. Structured interviews were used to collect data from 1694 participants (males and females who were consulted at a primary health care clinic in Mamelodi, Gauteng province. Existing patients’ records were also utilised to calculate the incidence rate of sexually transmitted infections. Data were computerised and analysed quantitatively to reflect the results in frequencies and percentages as reported in Part 1 of this research. Guidelines to direct the practice of registered professional nurse were developed based on the findings of the results. These guidelines must underpin community specific interventions to reduce the incidence of sexually.

  5. Community health workers adherence to referral guidelines

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy;


    Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs...... artemisinin-based combination therapy (ACT) and recognize symptoms in children that required immediate referral to the nearest health centre. Intervention arm CHWs had additional training on how to conduct an RDT; CHWs in the control arm used a presumptive diagnosis for malaria using clinical signs...

  6. Actividad clínica en la consulta médica a demanda de un Centro Penitenciario frente a la de un Centro de Salud Comparisons between clinical practice consultation in a prison and in community health centres: differences and repercussions

    C. Chérrez


    y de la conflictividad, sugiere un papel más relevante del médico general en un CP que en el conjunto del SPS y puede ser un dato a tener en cuenta en la planificación de la anunciada integración de la SP en el SPS.Objectives: To describe and quantify clinical practice consultancy in a prison health care unit so as to evaluate likely differences from a community Health Care Centre. To identify possible training needs when transferring health care staff from one system to another in the light of probable integration of Prison Health Care into the Public Health System. Methods: A transversal descriptive study was used for three Primary Health Care teams: an urban health centre with a high work load, a rural health centre with a low work load, and the health care unit of a provincial prison (not a mega-prison. Ransom sequential sampling was used to include all the medical activity generated in the consultancy. All activity programmed by the health professional and administrative consultancy was excluded, while efforts were made to locate troubled consultations. Comparisons were made by contrasting differences in proportions. Results: The Prison Health Care Unit showed higher statistically significant clinical activity in mental health, drug abuse, HIV and HCV infection management and specific Primary Health Care problems (biopsychosocial integration is a therapeutic priority. In both community Health Centres there is more statistically significant activity in Internal Medicine and Geriatrics. In the prison environment there is significantly higher troubled consultation. Conclusions: In a future context of integration of prison health care services into the Public Health Service, training in mental health care (especially addictive disorders and in HIV-HCV infection management may be necessary for community health centre professionals wishing to transfer to prison health care units. The prison health care professional who wants to work in a public health centre may



    223 nursing mothers with babies over three months old on the immunization clinic days at Federal Medical Center,. Abeokuta. ... prevalent in communities with poor food hygiene,. 1 ... rice, mashed potatoes, and boiled carrots help in reducing ...

  8. Canada's International Development Research Centre's eco-health projects with Latin Americans: origins, development and challenges.

    Cole, Donald C; Crissman, Charles C; Orozco, A Fadya


    Since its founding in 1970, Canada's International Development Research Centre (IDRC) has supported research by concerned Latin American researchers on environments and human health relationships. Framing of such relationships has changed through different periods. Participant observation, bibliographic searches, document review, and interviews with key IDRC staff. From the early years of multiple different projects, IDRC developed more focussed interest in tropical diseases, pesticides, agriculture and human health in the 1980s. The United Nations Conference on Sustainable Development in the early 1990s gave impetus to examination of links between ecosystems and human health or "EcoHealth". Projects in Latin America built on earlier work but extended it in methods (transdisciplinarity, community participation, gendered approach) and scope (broader land use and development paradigm issues tackled). A key IDRC-funded activity in Latin America was "EcoSalud", an Ecuadorian effort, which has worked with farming communities, agricultural researchers, health practitioners and local politicians to advance integrated pest management, better recognize and treat poisonings and improve pesticide-related policies. ONGOING CHALLENGES INCLUDE: mobilizing sufficient resources for the primary prevention focus of EcoHealth activities when primary care infrastructure remains stretched, promoting micro-level change in diverse communities and ecosystems, and addressing power structures at the global level that profoundly affect environmental change.


    2Department of Health Policy and Management, Faculty of Public Health, College of Medicine and University ... 86 (21%) had primary school education, 210 (51.3%) were married, and 357 (87.3%) were employed. ...... patient satisfaction and behavioral intentions in. 5. .... Psychological Assessment 1995; 7 (3):309-319.

  10. Indian aspects of drug information resources and impact of drug information centre on community.

    Chauhan, Nitesh; Moin, Sabeeya; Pandey, Anushree; Mittal, Ashu; Bajaj, Umakant


    Drug information centre refer to facility specially set aside for, and specializing in the provision of drug information and related issues. The purpose of drug information center is to provide authentic individualized, accurate, relevant and unbiased drug information to the consumers and healthcare professionals regarding medication related inquiries to the nation for health care and drug safety aspects by answering their call regarding the all critical problems on drug information, their uses and their side effects. Apart from that the center also provides in-depth, impartial source of crucial drug information to meet the needs of the practicing physicians, pharmacists and other health care professionals to safeguard the health, financial and legal interests of the patient and to broaden the pharmacist role visible in the society and community. The service should include collecting, reviewing, evaluating, indexing and distributing information on drugs to health workers. Drug and poisons information centers are best established within major teaching hospitals. This allows access to clinical experience, libraries, research facilities and educational activities. Information present in the current paper will not only enlighten the role of drug information center but also focused on the rational use of drug.

  11. Indian aspects of drug information resources and impact of drug information centre on community

    Nitesh Chauhan


    Full Text Available Drug information centre refer to facility specially set aside for, and specializing in the provision of drug information and related issues. The purpose of drug information center is to provide authentic individualized, accurate, relevant and unbiased drug information to the consumers and healthcare professionals regarding medication related inquiries to the nation for health care and drug safety aspects by answering their call regarding the all critical problems on drug information, their uses and their side effects. Apart from that the center also provides in-depth, impartial source of crucial drug information to meet the needs of the practicing physicians, pharmacists and other health care professionals to safeguard the health, financial and legal interests of the patient and to broaden the pharmacist role visible in the society and community. The service should include collecting, reviewing, evaluating, indexing and distributing information on drugs to health workers. Drug and poisons information centers are best established within major teaching hospitals. This allows access to clinical experience, libraries, research facilities and educational activities. Information present in the current paper will not only enlighten the role of drug information center but also focused on the rational use of drug.



    be used to design policies and programmes to help workers identify environmental health risks, and improve their ... and his/her co-workers, who are subject to (SHE) departments and the Staff Clinic. It ... television and internet sources.



    Cervical cancer remains a major public health challenge in developing countries ... relation to knowledge on cervical cancer, primary level of education ... Latin America and Southeast Asia. ... practices such as level of awareness, educational.



    catastrophic health expenditures (CHE) and risk of being impoverished as a result of cost of care were assessed. Statistical ... Impact and contributors to cost of managing long term conditions in a ... sectors is ongoing, it has become clear that.



    This was a cross-sectional, multi clinic study involving 265 mothers whose children had erupted at least a tooth and attending the ... parents, health care workers and personal experiences were the sources of beliefs ..... Ethiopians abroad.

  16. Towards a Smart Community Centre: SEIDET Digital Village

    Phahlamohlaka, J


    Full Text Available South African communities are constantly being developed through new ICT projects which are initiated by individuals, government and private organisations. The problem with these developments is that they are implemented in isolation. This isolation...

  17. Service planning in the Victorian community health sector.

    Roussy, Véronique; Livingstone, Charles


    Until now, comprehensive service planning has been uncommon in the Victorian community health sector. Where it has occurred, it has primarily been undertaken by community health services embedded within larger, hospital-based health services. Reflections on the utility and efficacy of community health service planning are largely absent from the Australian peer-reviewed literature. Using a case study focussed on a specific centre in Melbourne's outer suburbs, this paper explores how community health service planning is shaped by the current policy context, the legal status of registered community health services, and the data and methodologies available to inform planning. It argues that regular and systematic service planning could support registered community health centres to better understand their unique position within the primary health-care landscape, having regard to their inherent opportunities and vulnerabilities. Furthermore, consistent and effective service planning is proposed to benefit agencies in establishing themselves as critical players in promoting local population health initiatives and driving improved health outcomes.


    Lifestyle Changes and the Risk of Colorectal Cancer among. Immigrants in the United .... food rich in red meat, animal fat, sugars and refined of CRC in Africa .... region to improve health care delivery and secure the is obtainable in the UK, ...



    Tobacco is a risk factor Organization (WHO) at World Health Assembly for six of the ... information. Stata statistical software version 11 was used to describe the data and determine ... Only 5% of respondents ever received training on tobacco control. .... Pharmacist. 54. 23.2 .... and dental students surveyed in Lagos by .15.




    May 1, 2012 ... quality service delivery as perceived by the respondents', however it remains ... However, there remain the problems of inequities in tertiary ... unrelenting struggle in financing health households to the financial risk ... other things improve efficiency in utilization of Using a cross-sectional approach, this study.



    eligible patients as they emerged from the pharmacy with their ... compare proportions while student's t-test was used to compare .... preference between the free and B.I. health services in an LGA in ... and training manual for the development.


    study assessed the knowledge and practice of disease surveillance and notification ... for active surveillance especially if an outbreak Health workers play a key role in .... ethical clearance was obtained from the ethics and Eighty one percent of .... Salami S. Knowledge of disease notification among New York: John Wiley ...

  3. Lifelong Learning in a Learning Society: Are Community Learning Centres the Vehicle?

    Manzoor Ahmed


    Full Text Available This chapter provides a historical perspective on the evolving concepts of lifelong learning and the learning society and makes the case for the community learning centre as a potential institutional vehicle for the promotion of adult and lifelong learning. It highlights the pertinence of lifelong learning/learning society in the post-2015 Development Agenda discourse. Arguments in favour of the community learning centre as a vehicle for lifelong learning/learning society are illustrated using the example of Bangladesh and drawing on parallels and contrasts with China and India. Finally, lessons derived from a recent review of the Asia-Pacific region are evaluated with respect to the development of strategic actions intended to offer adult and lifelong learning within and through community learning centres.

  4. Evaluating quality of health services in health centres of Zanjan district of Iran.

    Mohammadi, Ali; Mohammadi, Jamshid


    To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

  5. Local Experiences in Community Health

    Sébastien Fleuret


    Full Text Available This paper presents the findings of international research with an original approach anchored in health geography, which illustrates the importance of place as a dimension in community health. The aim of the research is to identify the success factors in the processes used to build community health initiatives at the local level. The study is based on interviews encoded and analysed using the framework of the grounded theory. Three main themes—the place, the community and healthcare supply—and two cross-cutting issues referring to 18 explanatory dimensions are identified. These findings are then put to the test in France through an action research approach. Overall, the work suggest avenues to enable the transferability of successful elements of community health initiatives.

  6. Community Involvement - Health / Service


    Elizabeth Andress: Partnerships Produce a National Center for Home Food Preservation. Diana Friedman: National 4-H Healthy Lifestyles Grant. H. Wallace Goddard: Big Surprises on the Road to Happiness. Nancy Kershaw: Connecting the 4-H Clothing Project and Community. Jane A. Landis: NEAFCS Living Well Public Service Campaign. Rhea Lanting: The Healthy Diabetes Plate. Phyllis B. Lewis: Product Look-Alikes. Anna Martin: Raising Diabetes Awareness in Latino Communities. Earl Mcalexander: Youth Fi...

  7. [The sainsbury centre for mental health: forensic mental health services in England and wales].

    Rutherford, M; Duggan, S


    The Sainsbury Centre for Mental Health (SCMH) is a charity founded in 1985 by Gatsby Charitable Foundation. The SCMH works to improve the quality of life for people with mental health problems by influencing policy and practice in mental health and related services. Working to improve the quality of mental health care for people in prison is one of SCMH main work theme. This paper describes some epidemiological aspects of mental health situation of prisoners in England and Wales and the available forensic facilities to manage this kind of patients in prison.

  8. Delivery of eye and vision services in Aboriginal and Torres Strait Islander primary health care centres

    Anthea M Burnett


    Full Text Available Background: Routine eye and vision assessments are vital for the detection and subsequent management of vision loss, which is particularly important for Aboriginal and Torres Strait Islander people, who face higher rates of vision loss than other Australians. In order to guide improvements, this paper will describe patterns, variations and gaps in these eye and vision assessments for Aboriginal and Torres Strait Islander people. Methods: Clinical audits from 124 primary health care centres (sample size 15,175 from five Australian States and Territories were conducted during 2005-2012. Main outcome measure was adherence to current guidelines for delivery of eye and vision assessments to adults with diabetes, those without a diagnosed major chronic disease and children attending primary health care centres. Results: Overall delivery of recommended eye and vision assessments varied widely between health centres. Of the adults with diabetes, 45% had a visual acuity assessment recorded within the previous 12 months (health centre range 0-88%, and 33% had a retinal examination recorded (health centre range 0-73%. Of the adults with no diagnosed major chronic disease, 31% had a visual acuity assessment recorded within the previous two years (health centre range 0-30%, and 13% had received an examination for trichiasis (health centre range 0-40%. In children, 49% had a record of a vision assessment (health centre range 0-97%, and 25% had a record of an examination for trachoma within the previous 12 months (health centre range 0-63%. Conclusions: There was considerable range, and variation in the recorded delivery of scheduled eye and vision assessments across health centres. Sharing the successful strategies of the better-performing health centres to support focused improvements in key areas of need may increase overall rates of eye examinations – important for the timely detection, referral and treatment of eye conditions affecting Aboriginal and

  9. Portfolio of Outpatients Attending Centre for Urban Health, Madhya Pradesh, Central India

    Arti Gupta


    Full Text Available Background: Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS Bhopal (CUHA. Methodology: A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014 were included. Descriptive analysis was done. Results: A total of 6685 new episodes of illnesses were treated. Adults (>15 years constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2% followed by the digestive disorders (10.9%, circulatory disorders (9.9%, musculoskeletal disorders (8.8%, and infectious and parasitic disorders (7.4%. Conclusion: This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients’ needs and help in training health staff.

  10. Measuring information technology investment among Canadian academic health sciences centres.

    Pederson, Lorraine; Leonard, Kevin


    Many recent studies have attempted to accurately measure the expenditure by hospitals in the area of new information technology (IT), for example see Leonard 1998 and Pink et al. 2001. This is usually done as an exercise to compare the healthcare sector with other industries that have had much more success in implementing and leveraging their IT investment (Willcocks 1992; Chan 2000). It is normally hoped that such investigation would help explain some of the differences among the various industries and provide insight into where (and how much) future IT spending should occur in healthcare (Leonard 2004). Herein, we present the results from a study of eight Canadian academic health sciences centres that contributed data in order to analyze the amount of information technology spending in their organizations. Specifically, we focus on one specific indicator: the IT spend ratio. This ratio is defined as the percentage of total IT net costs to total hospital net operating costs, and aims to provide a "relative (or percentage) measure of spending" so as to make the comparisons meaningful. One such comparison shows that hospitals spend only 55% of the amount the financial services sector spends.

  11. Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

    Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna


    Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system 'hardware' and 'software' acting on mechanisms of accountability. Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers' frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient-provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our findings confirm the usefulness of combining Sheikh et al

  12. Designing and evaluating a health education session on respiratory infections addressed to caregivers of children under three years of age attending day-care centres in Porto, Portugal: A community-based intervention.

    Alexandrino, Ana Manuela Ferreira da Silva; Santos, Rita Isabel Garrido Vieira Dos; Melo, Maria Cristina Damas Argel de; Bastos, José Adelino Mesquita


    Acute respiratory infections (ARI) are common in children, increasing the pressure on clinicians to prescribe antibiotics and affecting public health Objectives: This study aimed to design a health education session (HES) for caregivers of children, and to evaluate its effects on caregivers' needs, as well as on their knowledge and attitudes concerning ARI. A generalized model of developing, implementing and evaluating a community-based intervention was followed, including caregivers of children under three years of age. Caregivers were randomly distributed into an intervention group (IG) (n = 41) and a control group (CG) (n = 51) and the HES was administered to the IG. The caregivers' needs as well as knowledge of and attitudes to ARI were evaluated in both groups, before (M0) and two months after the HES (M1). At M0 the caregivers from both groups had 'some or great need' about all HES domains; at M1 the caregivers in the IG expressed 'no or low need', whereas the CG maintained 'some or great need' about all HES domains (0.011 ≤ P ≤ .047). Concerning caregivers' knowledge of and attitudes to ARI, at M1 there was a higher frequency of caregivers with right answers in the IG than in the CG (IG =7.5 ± 1 versus CG =6.0 ± 2; P = .000). Those differences occurred in domain (e) nasal clearance techniques, revealing a higher percentage of caregivers who used correctly nasal irrigation (P = .000), nasal aspirators (0.000 ≤P ≤ .001) and nebulization (P = .000) in IG. The HES met the caregivers' needs regarding ARI and increased their knowledge and attitudes towards ARI, especially regarding nasal clearance techniques.

  13. Establishing an Online Community of Inquiry at the Distance Education Centre, Victoria

    Jackson, Luke C.; Jackson, Alun C.; Chambers, Dianne


    This pilot intervention focused on three courses that were redesigned to utilize the online environment to establish an online community of inquiry (CoI). The setting for this research study was the Distance Education Centre, Victoria (DECV), an Australian co-educational school with approximately 3000 students who, for a variety of reasons, are…

  14. The structure and dynamics of health centres in the Netherlands: an institutional analysis.

    Batenburg, R.; Eyck, A.


    Context: Health centres are seen as a preferred organization of the modernized and integrated primary care. they are expected to facilitate an accessible contact point for medical care as close to people’s homes. Also, health centres are expected to deliver care in an efficient and effective way,

  15. The structure and dynamics of health centres in the Netherlands: an institutional analysis.

    Batenburg, R.; Eyck, A.


    Context: Health centres are seen as a preferred organization of the modernized and integrated primary care. they are expected to facilitate an accessible contact point for medical care as close to people’s homes. Also, health centres are expected to deliver care in an efficient and effective way, mi

  16. Establishing common ground in community-based arts in health.

    White, Mike


    This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus


    N Rasheed


    Full Text Available Background: Quality of services shows a variation between the client and the provider. Therefore, it needs to be explored whether the quality of care or the lack of quality can explain the utilization of government health care. Objectives:This paper attempts to assess the utilization of health services and client satisfaction for services provided by a Primary Health Centre (PHC at Delhi, India. Setting and design: The study was a facility based cross sectional study. Exit interviews were conducted among 400 patients seeking outdoor patient department (OPD services of thePHC Palam, New Delhi from May 2010 to November 2010. Material and Methods: Exit interviews were conducted among the patients at each of the service delivery points in the PHC to assess the utilization of services and the satisfaction of clients with the available services. Results: Most respondents rated the services to be of good quality on various parameters of health delivery. The PHC was the preferred health facility (98% for treatment seeking in comparison to other healthcare facilities in the area.The main factors affecting utilization of primary health care services provided by the government were easy accessibility, low cost, less waiting time, and presence of co-operative health personnel. Conclusion:Provision of quality primary healthcare services to clients can result in better utilization of services at the primary level, thereby reducing the unnecessary burden of secondary and tertiary level facilities in addition to improving the health status of the community.

  18. How to do a person-centred eye health consultation

    Renée du Toit


    Full Text Available The care we give should focus on our patients – their needs, beliefs, and preferences – and not just on their disease. This is known as patient-centred care. We can take this idea further and talk about person-centred care, which reminds us that we should be concerned with the whole person – and their life – when they are outside of the clinic too, not just when they are in front of us.

  19. Prescription writing trends of antihistamines at the university health centre.

    Kumar, Anil; Beenta


    The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 %) were male and 207 (41.4 %) were female and maximum patients were in the age group of 21-40 (34.8 %). Chlorpheniramine maleate (235 prescriptions) was the highest prescribed among antihistamine prescriptions (36.89 %) followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%), cetirizine (175 prescriptions, 27.47 %) and promethazine (41 prescriptions, 6.4%). In comparison to generic drugs (169 prescriptions, 26.54%), branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99%) followed by liquid formulations (195 prescriptions, 30.61%) and injections (28 prescriptions, 4.40%). The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6%) had the knowledge regarding the medication prescribed and 242 (48.4%) were unaware of the medication prescribed.

  20. Prescription writing trends of antihistamines at the university health centre

    Kumar Anil


    Full Text Available The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 % were male and 207 (41.4 % were female and maximum patients were in the age group of 21-40 (34.8 %. Chlorpheniramine maleate (235 prescriptions was the highest prescribed among antihistamine prescriptions (36.89 % followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%, cetirizine (175 prescriptions, 27.47 % and promethazine (41 prescriptions, 6.4%. In comparison to generic drugs (169 prescriptions, 26.54%, branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99% followed by liquid formulations (195 prescriptions, 30.61% and injections (28 prescriptions, 4.40%. The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6% had the knowledge regarding the medication prescribed and 242 (48.4% were unaware of the medication prescribed.

  1. Contraceptive practices adopted by women attending an urban health centre.

    Prateek, S S; Saurabh, R S


    India was the first country in world to launch - The National Family Welfare Programme in 1951 but even today the couple protection rate (CPR) is still not achieved as desired. To determine extent of awareness regarding contraception among married women. To estimate proportion of couples using contraceptive methods, identify reasons for their adoption & non adoption and to assess unmet needs for contraception. A cross sectional descriptive study of four months duration was conducted among married women in reproductive age group (15 - 49 years) attending general out-patient department in Urban Health Centre (UHC) employing universal sampling method. Participants not willing to respond and pregnant women were excluded. Total of 180 women were selected as study participants. Every woman was interviewed face to face with pre-tested questionnaire after taking informed consent. The data was analyzed by SPSS version 16. 94 (52.2%) were in age group of 20 - 24 years. 52.4% of women were aware about contraceptive practices, of which only 32.2% of subjects were using contraceptive methods. Out of these subjects, 89.66% used temporary methods and 10.34% used permanent methods. Cu-T (41.37%) was most preferred method. 93 subjects (51.6%) had unmet need for contraception. Religion, education status and age at marriage were significantly associated with contraceptive usage. The results suggest a significant Knowledge - Application Gap with regards to contraceptives knowledge and their actual usage in study participants. Almost fifty percent of the subjects had unmet need for contraception. This shows the need for more intense awareness campaigns for promoting contraceptive usage.


    Sandra Fikawati; Ita Yulita


    Dentist and dental nurse as dental health personnel in community health center are spearheads in community dental health service. The effectiveness and efficacy of community dental health service needs updated adequate dental health knowledge and skill. One effort to assure the fulfillment of those needs is by providing community dental health survey training. This training aims at improving the skill and capability of dental health personnel to conduct dental health survey. The training cons...

  3. Length of stay in asylum centres and mental health in asylum seekers

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A


    BACKGROUND: The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic...



    availability and affordability of ACTs in Secondary Health Care (SHC) facilities in Lagos State and ... percent (37.5%) of the hospitals did not have the drug in stock at the time of visit and drugs had been out of .... Only one in the community pharmacies as single dose .... funding and international competitive bidding for.



    Journal of Community Medicine and Primary Health Care. 26 (1) 96-107 ... obesity. Specific criteria for MetS developed by. 19 of hypertension. .... Triglycerides 150 mg/dL or more or on Christians 329 (96.2%); and lower grade income.


    western Nigeria to Participate in Community Based Health Insurance. 1. 2 ..... Islam. Others. 159. 225. 3. 41.1. 58.1. 0.8. Marital status. Single. Married. 96. 287. 24.8 ..... services in southeast Nigeria. ... and the poor: evidence from Nigeria",.

  7. Patient moderator interaction in online health communities.

    Huh, Jina; McDonald, David W; Hartzler, Andrea; Pratt, Wanda


    An increasing number of people visit online health communities to share experiences and seek health information. Although studies have enumerated reasons for patients' visits to online communities for health information from peers, we know little about how patients gain health information from the moderators in these communities. We qualitatively analyze 480 patient and moderator posts from six communities to understand how moderators fulfill patients' information needs. Our findings show that patients use the community as an integral part of their health management practices. Based on our results, we suggest enhancements to moderated online health communities for their unique role to support patient care.

  8. A Canadian model for building university and community partnerships: centre for research & education on violence against women and children.

    Jaffe, Peter G; Berman, Helene; MacQuarrie, Barb


    The importance of Canadian research on violence against women became a national focus after the 1989 murder of 14 women at École Polytechnique in Montreal. This tragedy led to several federal government studies that identified a need to develop centers for applied research and community-university alliances on violence against women. One such center is the Centre for Research & Education on Violence against Women and Children. The Centre was founded in London, Canada in 1992 out of a partnership of a university, a community college, and community services. The centre's history and current activities are summarized as a model for the development and sustainability of similar centers.

  9. Evaluate the Effect of Palliative Care in the Jing’an Temple Street Community Health Service Centre%静安寺街道社区卫生服务中心开展舒缓疗护效果评价



    目的:对静安寺街道社区卫生服务中心开展的舒缓疗护进行效果评价。方法选取2014年1月~2014年12月在静安寺社区卫生服务中心舒缓疗护病房住院的临终患者113例,给予舒缓疗护并进行效果评价。结果临终患者接受舒缓疗护后,患者的 SAS、SDS、VAS 评分明显下降(P <0.05),QOL 评分明显上升(P <0.05)。另外111例患者家属对舒缓疗护满意,家属满意度为98.23%。结论对临终患者予以舒缓疗护,可以帮助患者减轻恐惧,使其宁静、安详、有尊严的度过余生,得到家属的高度评价。%Objective To evaluate the effect of palliative care in the Jing’an Street Temple Community Health Service Centre. Methods From January 2014 to December 2014, 113 terminal patients that were admitted to the ward of Jing’an Temple Street Community Health Service Centre were selected. The patients received the palliative care, the effect was evaluated. Results After receiving palliative care, the SAS, SDS and VAS scores of the terminal patients were significantly decreased (P<0.05), and the QOL score was significantly increased (P<0.05). In addition, the family members of 111 patients were satisfied with the treatment of palliative care, and the satisfaction of patients was 98.23%. Conclusion For terminal patients, the palliative care is good to relieve the patient’s fear and peacefully, serenely and dignifiedly live the rest of their life, get a high evaluation of family members.

  10. Evaluation of current care effectiveness: a survey of hypertension guideline implementation in Finnish health centres

    Alanen, Seija I; Johannala-Kemppainen, Riitta; Ijäs, Jarja J;


    OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information implement......OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information...... implementers or disseminators respectively). DESIGN: A cross-sectional study. Development of a questionnaire and criteria for assessing the extent and style of implementation of the HT Guideline. SETTING: Primary healthcare. SUBJECTS: All head physicians and senior nursing officers in Finnish health centres (n...... =290). MAIN OUTCOME MEASURES: The extent of adoption of the HT Guideline in health centres and the characteristics associated with the implementation style. RESULTS: Responses were received from 410 senior medical staff (246 senior nursing officers and 164 head physicians) representing altogether 264...

  11. How does a shortage of physicians impact on the job satisfaction of health centre staff?

    Saxén, Ulla; Jaatinen, Pekka T; Kivelä, Sirkka-Liisa


    The aim was to determine how a shortage of physicians at Finnish health centres has affected the job satisfaction of the entire staff. A questionnaire was posted to 2848 employees working with patients at health centres in the Finnish provinces of Satakunta and Varsinais-Suomi. The information concerning the shortage of physicians at health centres was taken from research undertaken by the Finnish Medical Association in October 2003. The health centres were divided into four groups according to the severity of the shortage. The questionnaire was returned by 1447 employees. The staff at health centres with the most severe shortage of physicians were less satisfied with the management of the organization. Employees at health centres with a minor shortage of physicians were more satisfied with the quality of services in their operational unit. The shortage of physicians had no impact on staff satisfaction regarding the operation of their work unit, the strain of dealing with issues within their work environment, feelings of stress, the strain of working under pressure that they experienced, or interest in finding a new job. The majority of healthcare employees are satisfied and motivated in their work. The shortage of physicians has only a slightly negative impact on their satisfaction.

  12. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

    Kirigia Joses M


    Full Text Available Abstract Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i to estimate the relative technical efficiency (TE and scale efficiency (SE of a sample of public hospitals and health centres in Ghana; and (ii to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47% hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD of 12%. Ten (59% hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%. Out of the 17 health centres, 3 (18% were technically inefficient, with a mean TE score of 49% (STD = 27%. Eight health centres (47% were scale inefficient, with an average SE score of 84% (STD = 16%. Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres in the course of the implementation of health sector reforms.

  13. The Community-First Land-Centred Theoretical Framework: Bringing a "Good Mind" to Indigenous Education Research?

    Styres, Sandra D.; Zinga, Dawn M.


    This article introduces an emergent research theoretical framework, the community-first Land-centred research framework. Carefully examining the literature within Indigenous educational research, we noted the limited approaches for engaging in culturally aligned and relevant research within Indigenous communities. The community-first Land-centred…

  14. The Community-First Land-Centred Theoretical Framework: Bringing a "Good Mind" to Indigenous Education Research?

    Styres, Sandra D.; Zinga, Dawn M.


    This article introduces an emergent research theoretical framework, the community-first Land-centred research framework. Carefully examining the literature within Indigenous educational research, we noted the limited approaches for engaging in culturally aligned and relevant research within Indigenous communities. The community-first Land-centred…

  15. Stabilisation of health as the centre point of a health psychology of ageing.

    Scholz, Urte; König, Claudia; Eicher, Stefanie; Martin, Mike


    Current health psychological theories and research mainly cover improvement of health, recovery from illness or maintenance of health. With this theoretical manuscript, we argue that in ageing societies in which chronic illness and multimorbidity become the norm rather than the exception, this focus of health psychology is no longer sufficient. Instead, in line with a recent conceptualisation of health as "the ability to adapt and to self-manage", we suggest that the centre point of a health psychology of ageing needs to be the stabilisation of health. Current theories of lifespan development, such as the model of selection, optimisation and compensation, the motivational theory of life span development, the two-process model of assimilative and accommodative coping and the recently introduced functional quality of life model are described with regard to their assumptions and related research focussing on stabilisation. All of these models explicitly comprise stabilisation as an important process of successful, healthy ageing. So far, however, the empirical research examining these models does not take stabilisation into account. Implications for research methods and practise of health stabilisation are discussed.

  16. Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

    N. Mlenzana


    Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

  17. The post-literacy perceptions of newly literate adult learners at a rural community learning centre

    van Wyk, Jerry


    Full Text Available Literature suggests that post-literacy (PL is a seriously under-researched field in most African countries including South Africa. Various authors emphasise the importance of PL to prevent relapsing into illiteracy, the applicability of PL in enhancing everyday private and occupational life, as well as the potential contribution of PL to poverty reduction, social, economic and political development and in sustaining communities. However, PL is often not viewed as a government priority. Consequently a gap exists between what PL programmes offer, and what the newly literate adults may need. The aim of this study was to identify the PL perceptions of newly literate adults in a PL programme at a Community Learning Centre in the Western Cape of South Africa. A small scale study collected qualitative data through ten semi-structured interviews. The results indicate that a learner-centred PL programme may be required which focuses mainly on non-formal and vocational programmes for developing individual literacy and sustaining the community and its economic development.

  18. Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

    Dube, Christopher; Hayakawa, Tadao; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B


    Abstract Problem Despite the Government’s effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. Approach The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Local setting Mumbwa is a rural district with an area of 23 000 km2 and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. Relevant changes The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases “lost to follow-up”. This might be due to the closer involvement of the community and the better support offered by these services to rural clients. Lessons learnt These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live. PMID:20931065

  19. A Study on Birth Asphyxia at Tertiary Health Centre

    Ekta A Dalal


    Methodology: This was the cross sectional study conducted in the tertiary care centre of Ahmedabad on the full term babies with birth asphyxia. The maternal, fetal and newborn correlates were recorded according to predesigned proforma. Results: There were total 401 (6.6% babies born with apgar score of less than 7 at one minute and among them, 320 (79.8% were full term babies and 81 (20.2% were preterm babies. Among the babies 52.5% were male, 56.9% were primigravida, and only 41.9% had antenatal care present, 42.2% had MSL and 47.2% were small for date babies. Conclusion: Birth asphyxia is common the babies of the mother who had not received proper antenatal care. Maternal anaemia, primipara, meconium stained liquor babies have more chances of getting birth asphyxia. [Natl J Med Res 2013; 3(4.000: 374-376

  20. Calls to the British Columbia Drug and Poison Information Centre: A summary of differences by health service areas

    Henderson, Sarah B; Kent, Debra; Kosatsky, Tom


    Objectives Poison control centres provide information on the management of poisoning incidents. The British Columbia (BC) Drug and Poison Information Centre recently implemented an electronic database system for recording case information, making it easier to use case data as a potential source of population-based information on health services usage and health status. This descriptive analysis maps poisoning case rates in BC, highlighting differences in patient age, substance type, medical outcome, and caller location. Methods There were 50,621 human exposure cases recorded during 2012 and 2013. Postal code or city name was used to assign each case to a Health Service Delivery Area (HSDA). Case rates per 1,000 person-years were calculated, including crude rates, age-standardized rates, age-specific rates, and rates by substance type, medical outcome, and caller location. Results The lowest case rate was observed in Richmond, a city where many residents do not speak English as a first language. The highest rate was observed in the Northwest region, where the economy is driven by resource extraction. Pharmaceutical exposures were elevated in the sparsely populated northern and eastern areas. Calls from health care facilities were highest in the Northwest region, where there are many remote Aboriginal communities. Conclusions Case rates were generally highest in the primarily rural northern and eastern areas of the province. Considering these results alongside contextual factors informs further investigation and action: addressing cultural and language barriers to accessing poison centre services, and developing a public health surveillance system for severe poisoning events in rural and remote communities. PMID:25379127

  1. Community-centred Networks and Networking among Companies, Educational and Cultural Institutions and Research

    Konnerup, Ulla; Dirckinck-Holmfeld, Lone


    and research as formulated in the Triple Helix Model (Etzkowitz 2008). The article draws on a case study of NoEL, a network on e-learning among business, educational and cultural institutions and research, all in all 21 partners from all around Denmark. Focus is how networks and networking change character......This article presents visions for community-centred networks and networking among companies, educational and cultural institutions and research based on blended on- and off-line collaboration and communication. Our point of departure is the general vision of networking between government, industry...

  2. Acute care in Tanzania: Epidemiology of acute care in a small community medical centre

    Rachel M. Little


    Discussion: Respiratory infections, malaria, and skin or soft tissue infections are leading reasons for seeking medical care at a small community medical centre in Arusha, Tanzania, highlighting the burden of infectious diseases in this type of facility. Males may be more likely to present with trauma, burns, and laceration injuries than females. Many patients required one or no procedures to determine their diagnosis, most treatments administered were inexpensive, and most patients were discharged home, suggesting that providing acute care in this setting could be accomplished with limited resources.

  3. Co-designing person-centred mental health care


    Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions.......Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions....

  4. Towards evaluation of the quality of care in health centres.

    Saturno, P J


    There is wide acknowledgement that quality assurance is desirable in primary health care. Considerable success has been achieved in this field by the Iberian Programme of Training and Implementation of Quality Assurance Activities in Primary Health Care, the basis for which is outlined below.

  5. Faith community as a centre of liberationist praxis in the city

    Elina Hankela


    Full Text Available Theologians speak of the silence of churches’ prophetic voice in the ‘new’ South Africa, whilst the country features amongst the socio-economically most unequal countries in the world, and the urban areas in particular continue to be characterised by segregation. In this context I ask: where is liberation theology? I spell out my reading of some of the recent voices in the liberationist discourse. In dialogue with these scholars I, firstly, argue for the faith community to be made a conscious centre of liberationist debates and praxis. Secondly, I do this by suggesting two theoretical building blocks (i.e. critical deconstruction and radical friendship for local faith communities that wish to grow in a liberationist fashion.

  6. ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

    Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi


    End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme ( the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) ( and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

  7. Social contract of academic medical centres to the community: Dr Howard Atwood Kelly (1858-1943), a historical perspective.

    Allen, Paul


    Academic medical centres have traditionally been bastions of teaching and research. Outreach to the community at large and involvement in community affairs have sometimes been lacking in the overall mission and activities of academic medical centres. This paper provides an historical perspective first on the numerous achievements of a physician and surgeon and then on the topic of involvement in community affairs by reviewing the many contributions of America's pioneer gynaecological surgeon and one of the four physician founders of the Johns Hopkins Hospital and School of Medicine in 1889 - Dr Howard Atwood Kelly.

  8. Preserving community in health care.

    Emanuel, E J; Emanuel, L L


    There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in

  9. Through the Looking Glass: Public and Professional Perspectives on Patient-centred Professionalism in Modern-day Community Pharmacy

    Frances Rapport


    Full Text Available This paper presents five consultation workshops with 29 community pharmacists, stakeholders and patients that examined "patient-centred professionalism" in terms of pharmacists' working day and environment. The concept is ill-defined in both medical and pharmacy literature and the study aimed to clarify the situated nature of the term for patients and health professionals across settings. Workshops were supported by bio-photographic datasets of "in-situ" practice and Nominal Group Work. The thematic content analyses led to the following aspects: building caring relationships; managing external forces; the effects of space and environment, and different roles and expectations. The study reveals how patient-centred professionalism cannot be defined in any singular or stationary sense, but should be seen as a "moveable feast", best understood through everyday examples of practice and interaction, in relation to whose experience is being expressed, and whose needs considered. The phrase is being mobilised by a whole set of interests and stakeholders to reshape practice, the effect of which remains both uncertain and contested. Whilst patients prioritise a quick and efficient dispensing service from knowledgeable pharmacists, pharmacists rail against increasing public demands and overtly formalised consultations that take them away from the dispensary where the defining aspects of their professionalism lie. URN: urn:nbn:de:0114-fqs100177

  10. Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study.

    Anwari, Zelaikha; Shukla, Mahesh; Maseed, Basir Ahmad; Wardak, Ghulam Farooq Mukhlis; Sardar, Sakhi; Matin, Javid; Rashed, Ghulam Sayed; Hamedi, Sayed Amin; Sahak, Hedayatullah; Aziz, Abdul Hakim; Boyd-Boffa, Mariah; Trasi, Reshma


    Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments. We piloted an intervention that placed a people-centred health systems governance approach in the hands of multi-stakeholder committees that govern provincial and district health systems. We report the results of this intervention from three provinces and eleven districts in Afghanistan over a six month period. This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions. The outcomes of interest are governance scores and health system performance indicators. We document the application of a people-centred health systems governance conceptual model based on applying four effective governing practices: cultivating accountability, engaging with stakeholders, setting a shared strategic direction, and stewarding resources responsibly. We present a participatory approach where health system leaders identify and act on opportunities for making themselves and their health systems more accountable and responsive to the needs of the communities they serve. We found that health systems governance can be improved in fragile and conflict affected environments, and that consistent application of the effective governing practices is key to improving governance. Intervention was associated with a 20% increase in antenatal care visit rate in pilot provinces. Focus group discussions showed improvements across the four governing practices, including: establishment of new sub-committees that oversee financial transparency and governance

  11. Hypertension care at a Cape Town community health centre | Lunt ...

    Blood pressure control - mean blood pressure of aggregated readings; and ... There were no significant gender differences with regard to these measures. ... loss to follow-up compared with previous South African studies in similar settings.

  12. A survey of hypertensive practices at two community health centres ...

    Consecutive patients attending hypertension clinics at two CHCs were ... with hypertension guidelines, factors leading to treatment non-adherence, and delivery of care. ... The mean number of antihypertensive drugs was 2.4 per patient.

  13. Virginia Community Health Centre, Dublin Road, Virginia, Cavan.

    Tong, Pin


    Recent studies generating complete human sequences from Asian, African and European subgroups have revealed population-specific variation and disease susceptibility loci. Here, choosing a DNA sample from a population of interest due to its relative geographical isolation and genetic impact on further populations, we extend the above studies through the generation of 11-fold coverage of the first Irish human genome sequence.

  14. [The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

    Povazhnaia, E A; Bobrovnitskiĭ, I P


    The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

  15. [The Centre for Medical Research and Health in Niamey, Niger. The new CERMES].

    Ouwe Missi Oukem-Boyer, O


    After 20 years under the umbrella of the Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies (organization for coordination and cooperation against major endemic diseases), the Centre de Recherche sur les Méningites et les Schistosomoses (the meningitis and schistosomiasis research center) has been placed under the Niger Ministry of Public Health. It has become the Centre de Recherche Médicale et Sanitaire (medical and health research center) and thus keeps its acronym, CERMES. In 2008, CERMES became a full member of the Institut Pasteur International Network. Its main research interests include meningitis, malaria, and interactions between health, environment, and climate. CERMES also works in the areas of public health and health training. Here, 12 years after the creation of the new CERMES, we present its main research results, as well as the challenges and opportunities it faces.

  16. Provision of hearing aids to children in Bangladesh: costs and cost-effectiveness of a community-based and a centre-based approach.

    Ekman, Björn; Borg, Johan


    The aim of this study is to provide evidence on the costs and health effects of two alternative hearing aid delivery models, a community-based and a centre-based approach. The study is set in Bangladesh and the study population is children between 12 and 18 years old. Data on resource use by participants and their caregivers were collected by a household survey. Follow-up data were collected after two months. Data on the costs to providers of the two approaches were collected by means of key informant interviews. The total cost per participant in the community-based model was BDT 6,333 (USD 79) compared with BDT 13,718 (USD 172) for the centre-based model. Both delivery models are found to be cost-effective with an estimated cost per DALY averted of BDT 17,611 (USD 220) for the community-based model and BDT 36,775 (USD 460) for the centre-based model. Using a community-based approach to deliver hearing aids to children in a resource constrained environment is a cost-effective alternative to the traditional centre-based approach. Further evidence is needed to draw conclusions for scale-up of approaches; rigorous analysis is possible using well-prepared data collection tools and working closely with sector professionals. Implications for Rehabilitation Delivery models vary by resources needed for their implementation. Community-based deliver models of hearing aids to children in low-income countries are a cost-effective alternative. The assessment of costs and effects of hearing aids delivery models in low-income countries is possible through planned collaboration between researchers and sector professionals.

  17. Towards a Conceptualization of Online Community Health

    Wagner, David; Richter, Alexander; Trier, Matthias


    Along with the increasing popularity of social media and online communities in many business settings, the notion of online community health has become a common means by which community managers judge the condition or state of their communities. It has also been introduced to the literature, yet...... the concept remains underspecified and fragmented. In this paper, we work toward a construct conceptualization of online community health. Through a review of extant literature and dialogue with specialists in the field, we develop a multi-dimensional construct of online community health, consisting of seven...... elements. In writing this paper, we attempt to foster theory development around new organizational forms by advancing a new and important construct. The paper further provides guidance to the managers of social media and online communities by taking a systematic look at the well-being of their communities....

  18. Considering place in community health nursing.

    Bender, Amy; Clune, Laurie; Guruge, Sepali


    When a geographic location is assigned meaning, it becomes a place. The authors argue that place matters as both geographical location and lived experience. They extend the current conceptualization of nursing geography to encompass community health nursing and address intricacies of community nursing practice and research that often go unnoticed. They do so by exploring the notion of place in home and community, including the structural/spatial dimensions of the nurse-client relationship. The authors review the health geography literatures, then discuss the implications for practice and research in community health. They invite community health nurses to critically examine their practice and research with reference to such issues as the power of the nurse, marginalized places as determinants of health, and how best to care for clients living in diverse community settings.

  19. Personas in online health communities.

    Huh, Jina; Kwon, Bum Chul; Kim, Sung-Hee; Lee, Sukwon; Choo, Jaegul; Kim, Jihoon; Choi, Min-Je; Yi, Ji Soo


    Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users' needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged-Caretakers, Opportunists, Scientists, and Adventurers. The results inform users' interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support.

  20. Community Mental Health Clinic Cost Reports

    U.S. Department of Health & Human Services — Healthcare Cost Report Information System (HCRIS) Dataset - Community Mental Health Center (CMHC). This data was reported on form CMS-2088-92. The data in this...

  1. The impact of nutrition education at three health centres in Central Province, Kenya

    Hoorweg, J.C.; Niemeijer, R.


    This report contains an account of a study of the effects of nutrition education as given at three health centres in different ecological zones in Central Province, Kenya. Two groups of mothers in similar social and economic situations were selected for interviewing: frequent and infrequent visitors

  2. Role of the Poison Control Centre of Morocco in the Improvement of Public Health

    Naima Rhalem


    How to cite this article: Rhalem N, Aghandous R, Chaoui H, Eloufir R, Badrane N, Windy M, et al. Role of the Poison Control Centre of Morocco in the Improvement of Public Health. Asia Pac J Med Toxicol 2013;2:82-6.

  3. Intimate partner violence among women of childbearing age in a primary health care centre in Nigeria.

    Ilika, Amobi L; Okonkwo, Prosper I; Adogu, Prosper


    This study assessed the prevalence and characteristics of intimate partner violence among women of childbearing age in a primary health centre. With interviewer-administered questionnaire, information on partner violence was elicited from three hundred women of childbearing age selected by systematic sampling in a primary health care (PHC) centre. Over 40% had experienced violence within the last 12 months. Type of marriage and partner's education had effect on violence. Perceived reasons for violence were economic demand (56.1%), reproductive issues (42.5%), alcohol and drugs (61.2%). Forty eight per cent reported to family members. Only 1% reported to the Police. Intimate partner violence is a prevalent public health problem in eastern Nigeria. Health workers and social organisations should recognise the problem and offer necessary support, and women should be empowered to navigate through the problem.

  4. Comparison of Family Clinic Community Health Service Model with State-owned Community Health Service Model

    万方荣; 卢祖洵; 张金隆


    Summary: Based on a survey of community health service organization in several cities, communi-ty health service model based on the family clinic was compared with state-owned communityhealth service model, and status quo, advantages and problems of family community health serviceorganization were analyzed. Furthermore, policies for the management of community health ser-vice organization based on the family clinic were put forward.

  5. [Community health building: the safe community promotion experience].

    Pai, Lu


    Safety and health promotion at the community level involves special concerns and approaches. A community may develop into a safe community or healthy city depending on the focus of relevant promotion efforts. Neither area nor population size should be factors affecting an initial decision to start safe community or healthy city programs. However, one should consider the diversity of issues that may have the potential impact on people with different gender and age or on different environments and situations, and whether a planned program is sustainable. While safe communities and healthy cities may be linked to international networks, the qualifications for joining such networks differ. The Healthy City Alliance emphasizes outcome measures and the International Safe Community Network emphasizes the appropriateness of sustainability mechanisms. While Taiwan communities are eligible for designation as international safe communities, they may are eligible for associate membership only in the Healthy City Alliance. The author has the following recommendations with regard to sustainability in community health building in Taiwan: 1) The relevant infrastructure must involve both public and private sectors; 2) The community should try to receive financial support from diverse sources; 3) involve significant numbers of active volunteers; and 4) charge local health centers with data collection and analysis responsibilities.


    Department of Social, Historical and Political Studies. University for ... In Ghana, a series of policies and programmes outlining strategies for community ... the Community Based Health Planning and Services (CHPS) (WHO, 1978; MOH, ... tion in Ghana in the search for the evolving forms, nature and content of community.

  7. Team management in community mental health.

    McGuinness, M


    The community mental health team is now the established model for mental health service delivery in the community. Managing CMHTs requires a diverse range of managerial skills, role clarity and authority. More research needs to be undertaken on the role and effectiveness of the CMHT manager.

  8. Developing Community Health Worker Diabetes Training

    Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.


    We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

  9. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    Behbehani, J M


    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

  10. Person-centred health care: a critical assessment of current and emerging research approaches.

    Martin, Carmel M; Félix-Bortolotti, Margot


    Person-centred health care is prominent in international health care reforms. A shift to understanding and improving personal care at the point of delivery has generated debates about the nature of the person-centred research agenda. This paper purviews research paradigms that influence current person-centred research approaches and traditions that influence knowledge foundations in the field. It presents a synthesis of the emergent approaches and methodologies and highlights gaps between static academic research and the increasing accessibility of evaluation, informatics and big data from health information systems. Paradigms in health services research range from theoretical to atheoretical, including positivist, interpretive, postmodern and pragmatic. Interpretivist (subjective) and positivist (objectivist) paradigms have been historically polarized. Yet, integrative and pragmatic approaches have emerged. Nevertheless, there is a tendency to reductionism, and to reduce personal experiences to metrics in the positivist paradigm. Integrating personalized information into clinical systems is increasingly driven by the pervasive health information technology, which raises many issues about the asymmetry and uncertainty in the flow of information to support personal health journeys. The flux and uncertainty of knowledge between and within paradigmatic or pragmatic approaches highlights the uncertainty and the 'unorder and disorder' in what is known and what it means. Transdisciplinary, complex adaptive systems theory with multi-ontology sense making provides an overarching framework for making sense of the complex dynamics in research progress. A major challenge to current research paradigms is focus on the individualizing of care and enhancing experiences of persons in health settings. There is an urgent need for person-centred research to address this complex process. A transdisciplinary and complex systems approach provides a sense-making framework. © 2014 John

  11. The narrative psychology of community health workers.

    Murray, Michael; Ziegler, Friederike


    Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work.



    and use of voluntary HTC (VHTC) services by students of the Niger Delta ... engender a more positive attitude and increased use of available VHTC services on campus. ... attending antenatal clinics in Nigeria revealed a ... 14.7% of females and males respectively had and counseling centre located close to the lecture. 6.

  13. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis.

    Martineau, Fred P


    The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses.

  14. Health Knowledge Effects: An Integrated Community Health Promotion Platform.

    Chang, I-Chiu; Lin, Chih-Yu; Tseng, Hsiao-Ting; Ho, Wen-Yu


    The Taiwanese government subsidizes healthcare providers offering preventive medicine to patients to help reduce the threats of chronic sickness and halt skyrocketing medical expenditures. Usually, nurses are the primary workers who perform community health promotion; however, because of the chronic shortage of working nurses, many Taiwan hospitals have closed wards and deferred the responsibility of promoting primary prevention. With a community health promotion platform integrating interactive response features and Web sites for community patients and hospital staff, a case hospital efficiently sustained the community health services. The objective of this study was to assess the impact of the integrated community health promotion platform for conducting education. Fifty-four patients/residents were invited to join a quasi-experiment of health education, and a follow-up survey was conducted to assess the acceptance of the community health promotion platform from both the experimental group of learners/users and the hospital staff. The results showed that the community health promotion platform was effective in improving participant health awareness. The experimental group outperformed the control group, with higher posttest scores and longer knowledge retention. Furthermore, users indicated a high acceptance of the community health promotion platform.

  15. Health literacy of an urban business community.

    Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M


    The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.

  16. The Prediction of Disruptive Behaviour Disorders in an Urban Community Sample: The Contribution of Person-Centred Analyses

    Burt, Keith B.; Hay, Dale F.; Pawlby, Susan; Harold, Gordon; Sharp, Deborah


    Background: Variable- and person-centred analyses were used to examine prediction of middle childhood behaviour problems from earlier child and family measures. Method: A community sample of 164 families, initially recruited at antenatal clinics at two South London practices, was assessed for children's behaviour problems and cognitive ability,…

  17. Examining the family-centred approach to genetic testing and counselling among UK Pakistanis: a community perspective.

    Darr, A; Small, N; Ahmad, W I U; Atkin, K; Corry, P; Benson, J; Morton, R; Modell, B


    WHO advice suggests a family-centred approach for managing the elevated risk of recessively inherited disorders in consanguineous communities, whilst emerging policy recommends community engagement as an integral component of genetic service development. This paper explores the feasibility of the family-centred approach in the UK Pakistani origin community. The study took place within a context of debate in the media, professional and lay circles about cousin marriage causing disability in children. Using qualitative methods, a total of six single-sex focus group discussions (n = 50) were conducted in three UK cities with a high settlement of people of Pakistani origin. Tape-recorded transcripts were analysed using framework analysis. Kinship networks within Pakistani origin communities are being sustained and marriage between close blood relatives continues to take place alongside other marriage options. Study participants were critical of what was perceived as a prevalent notion that cousin marriage causes disability in children. They were willing to discuss cousin marriage and disability, share genetic information and engage with genetic issues. A desire for accurate information and a public informed about genetic issues was articulated whilst ineffective communication of genetic risk information undermined professionals in their support role. This study suggests a community that is embracing change, one in which kinship networks are still active and genetic information exchange is taking place. At the community level, these are conditions supportive of the family-centred approach to genetic testing and counselling.

  18. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats


    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  19. [Behaviour concerning smoking among the patients making use of advice in women health centres].

    Kowalska, Alina; Szymański, Przemysław; Rzeźnicki, Adam; Stelmach, Włodzimierz


    The level of knowledge in the society about the harmful influence of smoking is increasing systematically. But there are still many people ignoring the warnings and prohibitions concerning smoking. The results of the research show that it is highly worrying that there are people for whom smoking is incredibly dangerous, e.g. children, youth, women, especially pregnant women. The aim of the work was to establish the percentage of smoking women among the patients of the women health centre, with the special focus on pregnant women. There were 120 women encompassed in this study in the health centre in Opoczno and 120 women using a similar health centre in Lodz between the 1st and the 15th March 2007, using a auditoria survey questionnaire. The collected data was worked out statistically. In the group of 240 tested people, 87 admitted to smoking, which is 36.3% of the respondents. Among the 185 women who were not pregnant, but were smoking, there were 75 (40.5%) and in the group of 55 pregnant women, there were 12 who smoked (f=0.22). Over 22% of the smoking women smoked over 10 cigarettes a day. From among 87 of the surveyed, 35.6% claimed they smoked everywhere they wanted. Majority of the respondents that is 52.9% lived with at least one other smoking person. Over 70% of them would like to quit smoking. Almost 48% stated their doctor has never talked with them about the influence of smoking on their health and almost 42% stated that no nurse or midwife has ever talked to them about this subject. Frequency of smoking among the tested people who were using the women health centre was high. Especially worrying was the percentage of the smoking pregnant women--every fifth of them smoked.

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

    Petersen, Poul Erik; Kwan, Stella


    of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences......, and especially the evaluation, of community oral disease prevention programmes and oral health promotion programmes should be developed and updated regularly. WHO Collaborating Centres could have a role in promoting good practice, training and collaboration between teams throughout the world. Centres undertaking......Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health...

  1. Community health centers and community development financial institutions: joining forces to address determinants of health.

    Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N


    Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

  2. Documentation of person-centred health plans for patients with acute coronary syndrome.

    Jansson, Inger; Fors, Andreas; Ekman, Inger; Ulin, Kerstin


    Personalised care planning is argued for but there is a need to know more about what the plans actually contain. To describe the content of person-centred health, plans documented at three healthcare levels for patients with acute coronary syndrome. Patients with acute coronary syndrome aged under 75 years and admitted to two coronary care units at a university hospital were enrolled in the study. This retrospective descriptive study documented 89 person-centred health plans at three healthcare levels: hospital, outpatient and primary care. In total, 267 health plans were reviewed and a quantitative content analysis conducted. The health plans included commonly formulated goals, patients' own resources and support needed. The health plan goals were divided into three categories: lifestyle changes, illness management and relational activities. The most frequently reported goal for better health was increased physical activity, followed by social life/leisure activities and return to paid professional work. In order to reach the goals, patients identified three ways: own resources, family and social support and healthcare system, in total three categories. The most frequently reported own capability was self-motivation. Spouses and children were important sources of family and social support. The most frequently reported healthcare support was cardiac rehabilitation. In traditional care and treatment plans devised by health professionals, patient goals often comprise behavioural changes. When patients identify their own goals and resources with the help of professionals, they include maintaining social relations and being able to return to important activities such as work.

  3. Community socioeconomic status and children's dental health.

    Gillcrist, J A; Brumley, D E; Blackford, J U


    Although a substantial decline in dental caries has occurred among U.S. children, not everyone has benefited equally. The first-ever surgeon general's report on oral health in America indicates that the burden of oral diseases is found in poor Americans. This study investigates the relationship between community socioeconomic status, or SES, and dental health of children. An oral health survey of 17,256 children, representing 93 percent of children residing in 62 Tennessee communities, was conducted in public elementary schools during the 1996-1997 school year. Portable dental equipment was used for examinations, and data from each examination were entered directly into a laptop computer. The authors performed analyses of covariance to examine the relationship between community SES (low/medium/high) and dental health, controlling for community fluoridation. Community SES was significantly related to caries experience in the primary teeth, the proportion of untreated caries in the primary and permanent teeth, dental treatment needs, dental sealants and incisor trauma. Overall, dental health was significantly worse for low-SES communities than for medium- and high-SES communities. The authors conclude that all specific dental indexes used to measure children's dental health in this study, with the exceptions of caries experience in the permanent teeth and sealant presence, were inversely related to the communities' SES. The percentage of children with dental sealants was directly related to the community's SES. Further improvements in oral health will necessitate that community-based preventive programs and access to quality dental care be made available to children who are identified as being at highest risk of experiencing oral disease.

  4. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie


    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. 2016 INCAM Research Symposium: Expanding Person-Centred Care through Integrative Health Research.

    Boon, Heather; Gaboury, Isabelle; Balneaves, Lynda G; Tsui, Teresa; Ng, Jeremy Y; Bozinovski, Natalie


    The following are abstracts of research presentations given at the 9th INCAM Research Symposium. The theme for this year's conference was "Expanding Person-Centred Care through Integrative Health Research", which was held on November 18 and 19, 2016 at the Toronto Marriott Bloor Yorkville Hotel in Ontario, Canada. The abstracts are grouped under the categories of oral or poster presentation based on their presentation at the Symposium. For more information, please visit:

  6. Distribution of Malaria Case in Simpenan Public Health Centre Sukabumi District in 2011

    Hubullah Fuadzy


    Full Text Available The number of malaria in Simpenan public health centre area needs a quick step in the patients finding by malaria microscopic officers, both by Active Case Detection (ACD and Passive Case Detection (PCD. The objective of th is article is to determine the distribution of malaria cases at Simpenan public health centre in Sukabumi during 2011. Data collection was carried out by malaria officersfrom Simpenan public health centre by identifying malaria parasite with microscope to any gold miners who just got home and was having a highfever. Malaria cases during the year 2011 experienced an increasing trend (R2 = 0.0175 from January (8.86% to December (15.18%, 79 cases of malaria was found and the peak of cases happened in December. Malaria was notfound in the age group of 0-14 years, but cases ofmalaria were found in productive age group (15-44 years old = 83%, 45-59 years old = 14%, 2: 60 years old = 3%, and also to all people working as gold miners in malaria-endemic areas i.e. Aceh, Bangka, Jambi, Kalimantan, Medan, Papua, Riau, and Sumbawa. This indicated that malaria in Simpenan was predicted as import cases.

  7. New Developments in Mental Health and Community

    Isabel Fazenda


    Full Text Available The community mental health model implies a bio‐psycho‐social perspective of mental health/illness issues, as well as a set of values that advocate equity in service access, community treatment, respect for human rights, a recovery vision, promotion of independent living, social integration and user and family participation. In accordance with the priorities set by the European Union, mental health services must guarantee that these principles are applied in the prevention, treatment, rehabilitation and promotion of mental health. Inter‐sector cooperation is an essential part of developing transversal policies that ensure society’s involvement in mental health promotion. Advances in community mental health in‐ dicate the relevance of considering human rights both in policy development and in practice, of the recovery perspective and of the need to promote the participation of user and carer organizations.

  8. Brazilian community health agents and qualitative primary healthcare information.

    Zanchetta, Margareth S; Pinto, Rogério Meireles; Galhego-Garcia, Wilson; da Cunha, Zeilma; Cordeiro, Hésio A; Fagundes-Filho, Francisco E; Pinho, Mônica A L; Voet, Susan M V; Talbot, Yves; Caldas, Rodrigo S; de Souza, Thiago J; Costa, Edwaldo


    The aim of this study was to explore female community health agents' views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients' improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele's social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary

  9. Measuring health literacy in community agencies

    Elsworth, Gerald R.; Beauchamp, Alison; Osborne, Richard H.


    for its use in community health settings. Methods: Data were provided by 813 clients of 8 community agencies in Victoria, Australia who were administered the HLQ during the needs assessment stage of the Ophelia project, a health literacy-based intervention. Most analyses were conducted using Bayesian...... including community-based health promotion and support services. We report a follow-up study of the psychometric properties of the HLQ with respondents from a diverse range of community-based organisations with the principal goal of contributing to the development of a soundly validated evidence base....... These analyses provide researchers, program managers and policymakers with a range of robust evidence by which they can make judgements about the appropriate use of the HLQ for their community-based setting....

  10. Reproductive Health in a Rural Ngwa Community

    the study were collected from a rural Ngwva community using two separate surveys — a ... factors that affect maternal reproductive health status. Little attempt has been made to investigate ... one point the Ngwa see the family in its nuclear.

  11. Community mental health in two sectors: County Caroni and St. George East--an evaluation.

    James, V


    An evaluation of the community mental health program in Trinidad in two sectors with differing sociological backgrounds is made. Results showed that both sectors had regular outpatient clinics, outpatient group psychotherapy, and mental health officers partly community based. County Caroni had a low admission rate to St. Ann's Hospital, an ongoing education programme, an outpatient club, and an Extended Care Centre with Day Care Centre. The predominant illnesses seen in County Caroni were Alcoholism in the males and Depression and Anxiety States in the females. In St. George East, there was a higher admission rate to St. Ann's Hospital. The education program was irregular. There was an Extended Care Centre in Tacarigua half of which was allocated to psychiatric patients and a Day Care Centre at the Tumpuna Rehabilitation Centre. The most frequent illnesses in St. George East were Schizophrenia and Alcoholism in the males, and Schizophrenia and Depression with equal frequency in the females. The results indicated that the specific needs of each sector were different--hence the need for different approaches. The difficulties of implementing the Community Mental Health programme are discussed.

  12. Mothers' Community Participation and Child Health

    Nobles, Jenna; Frankenberg, Elizabeth


    We use rich data from the Indonesia Family Life Survey to assess the relationship between mothers' access to social capital via participation in community activities and their children's health. We exploit the advantages of longitudinal data and community fixed effects to mitigate some of the concerns about spuriousness and reverse causality that…

  13. Clinico-epidemiological profile of malaria: Analysis from a primary health centre in Karnataka, Southern India

    Ramachandra Kamath


    Full Text Available Malaria continues to be a major public health problem in India and worldwide. The present study was based on records from a primary health centre in Karnataka. Morbidity patterns and important features of malaria transmission specific to Udupi district were investigated. The incidence of malaria and various morbidity patterns during 2010 and 2011 were compared and analyzed. Factors such as rapid urbanization, increased construction activities and influx of migratory workers were highlighted as the leading causes for the advent of malaria in the area. Recommendations have been provided for implementation in the near future.

  14. Human Centred Design Considerations for Connected Health Devices for the Older Adult

    Richard P. Harte


    Full Text Available Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications.

  15. Human-centred methods in the design of an e-health solution for patients undergoing weight loss treatment

    Das, Anita; Svanæs, Dag


    Background and objective Patients undergoing weight loss treatment require follow-up as part of the treatment process. E-health solutions may be used for this purpose. We have used an iterative design approach to develop a patient-centred e-health solution for patients undergoing weight loss...... in the design process. Our findings imply that involving stakeholders separately during specific human-centred activities is important in order to capture subtle, but critical aspects of the users’ requirements. Conclusion Applying human-centred methods in the design of e-health solutions requires...

  16. The role of the community health nurse in environmental health.

    Neufer, L


    Chemical contamination in the environment is affecting public health in increasing numbers of communities across the country. Although historically and theoretically well within the realm of nursing, methods for assessing and diagnosing threats to community environmental health are not being included in community health nurses' training. A community's environmental health is assessed by retrieving information from federal, state, and local sources. Developing the diagnosis involves four steps: identifying a community aggregate at highest risk of exposure, determining the potential or actual health response, citing related host and environmental factors, and correlating any existing epidemiologic data that may substantiate the nursing diagnosis. To illustrate these concepts, a systematic environmental health assessment was conducted for Douglas, Arizona. The results indicated elevated lead levels in residential soils and led to the community diagnosis, potential for injury: children in Douglas are at risk of developing adverse neurobehavioral health effects, and pregnant women in Douglas are at risk of developing adverse reproductive health effects related to several environmental and host factors, as evidenced by average blood lead level, in children exceeding the Centers for Disease Control recommended level of 10 micrograms/dl.

  17. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A


    The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group...... of asylum seekers to study if the incidence of mental disorders increased with length of stay....

  18. Obtaining consensus about patient-centred professionalism in community nursing: nominal group work activity with professionals and the public.

    Hutchings, Hayley; Rapport, Frances; Wright, Sarah; Doel, Marcus; Jones, Aled


      To report on the development of a ranked thematic list encompassing the positive and challenging exemplars of patient-centred professionalism in community nursing.   There has been little research exploring what 'patient-centred professionalism' means to those working within the healthcare settings. Consensus methods, such as those developed through Nominal Group Work, can help establish the extent of agreement on a particular issue whilst overcoming some of the problems associated with group decision-making.   Mixed methods studying through consultation workshops.   The study took place in South-west Wales, UK between October 2009-September 2010. Thirty-four participants consisting of community nurses (9), newly qualifying nurses (13), nursing stakeholders (6) and members of the public (6) took part in the study. An adapted Nominal Group Work approach was used in five individual consultation workshops: two with community nurses, one with newly qualifying nurses, one with stakeholders and one with members of the public followed by a mixed-group Forum event.   Each of the five workshops resulted in the production of approximately ten positive and ten challenging exemplars of patient-centred professionalism. The thematization of these exemplars allowed the development of eight broad themes. The Forum event then provided a mechanism for ranking the importance of these themes. The patient, community nurse as a person and nursing ethos were ranked as the most important themes by study participants.   The adapted Nominal Group Work approach was a useful method to allow the development of a ranked thematic list that illustrated the important positive and challenging exemplars of patient-centred professionalism in community nursing. © 2012 Blackwell Publishing Ltd.

  19. [Implementation of good quality and safety practices. Descriptive study in a occupational mutual health centre].

    Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J


    To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  20. Sexual health needs and the LGBT community.

    Campbell, Sue

    Lesbian, gay, bisexual and trans (LGBT) individuals have particular vulnerabilities to sexually transmitted infections and HIV infection. Globally, reasons for this include physiological factors, discrimination and poor understanding of their sexual health needs. In many countries LGBT individuals are not able to exercise fully their rights to health care. This raises public health concerns for the LGBT community and the wider population. This article explores these issues, and makes recommendations for the healthcare profession to address health inequalities and promote improved health outcomes for LGBT populations. This article aims to promote an evidence-based approach that focuses on rights and public health issues.

  1. Mind the gap: Person-centred delivery of mental health information to post-secondarystudents

    Laura Lynne Armstrong


    Full Text Available Mental illnesses are rapidly escalating on university and college campuses. It is well known that postsecondary institutions are not doing enough to address mental health concerns: this represents a significant gap in our attempts to meet the mental health needs of young people. Deficits in mental health knowledge are now proposed as a major contributing factor to both stigma and low service access, but little research as explored this issue. There is also little research to date concerning what young people want to know about mental health and how best to disseminate mental health knowledge. Without such information, knowledge may not be shared in a person-centred, meaningful manner that youth will use. We explored these issues in the present study. First year postsecondary students (N = 271; n = 183 females; n = 85 males; n = 3 other from Ottawa, Ontario, Canada participated in the online survey. Almost half of the postsecondary youth participants, particularly males, had difficulty recognizing common mental illnesses, such as anxiety, eating disorders, and psychosis. Youth held inaccurate beliefs and stigma, as well as attitudes not in favour of help-seeking. They primarily wanted to know about symptoms of mental illnesses as well as how to cope with stress. Post-secondary students wanted to learn about mental health issues through public presentations, the Internet, and media. The present research suggests the need for an awareness and acknowledgement among policy-makers of first year post-secondary students' knowledge gaps and youth appropriate knowledge sharing. Assessing mental health knowledge, what post-secondary students want to know about mental health, and knowledge transfer preferences could aid in the development of a framework to address the significant gap in the mental health needs of post-secondary students in a person centred manner.

  2. From periphery to the centre: Towards repositioning churches for a meaningful contribution to public health care

    Vhumani Magezi


    Full Text Available The role of communities in health care has gained prominence in the last few years. Churches as community structures have been identified as instrumental in health-care delivery. Whilst it is widely acknowledged that churches provide important health services, particularly in countries where there are poorly-developed health sectors, the role of churches in health care is poorly understood and often overlooked. This article discusses some causes of this lacuna and makes suggestions for repositioning churches for a meaningful contribution to health care. Firstly, the article provides a context by reviewing literature on the church and health care. Secondly, it clarifies the nature of interventions and the competencies of churches. Thirdly, it discusses the operational meaning of church and churches for assessing health-care contributions. Fourthly, it explores the health-care models that are discerned in church and health-care literature. Fifthly, it discusses the contribution of churches within a multidisciplinary health team. Sixthly, it proposes an appropriate motivation that should drive churches to be involved in health care and the ecclesiological design that underpins such health care interventions.

  3. Health status of children with cerebral palsy living in Europe: a multi-centre study

    Beckung, E; White-Koning, M; Marcelli, M


    AIM: The aim of this report is to describe the health status of 8-12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ). METHOD: A total of 818 children with CP from nine centres in defined geographical areas participated. CP type......, gross and fine motor function, additional impairments were classified and family data were obtained. The CHQ was used to measure the parent's perception of their child's physical (PHY) and psychosocial (PSY) health. RESULTS: PHY scores were lower than the reference samples with a median of 46......, parental education and employment revealed gross motor function, cognitive level and type of school attended were significant prognostic factors. CONCLUSION: This report is based on the largest sample to date of children with CP. Health status as measured using the CHQ was affected in all children...

  4. Health Educators and Community Health Workers

    ... Contact & Help Economic Releases Latest Releases » Major Economic Indicators » Schedules for news Releases » By Month By News ... support groups or home health agencies. They lead hospital efforts in ... nutrition, or stress management. They develop materials to be used by other ...

  5. Public health action following an outbreak of toxigenic cutaneous diphtheria in an Auckland refugee resettlement centre.

    Reynolds, Gary E; Saunders, Helen; Matson, Angela; O'Kane, Fiona; Roberts, Sally A; Singh, Salvin K; Voss, Lesley M; Kiedrzynski, Tomasz


    Global forced displacement has climbed to unprecedented levels due largely to regional conflict. Degraded public health services leave displaced people vulnerable to multiple environmental and infectious hazards including vaccine preventable disease. While diphtheria is rarely notified in New Zealand, a 2 person outbreak of cutaneous diphtheria occurred in refugees from Afghanistan in February 2015 at the refugee resettlement centre in Auckland. Both cases had uncertain immunisation status. The index case presented with a scalp lesion during routine health screen and toxigenic Corynebacterium diphtheriae was isolated. A secondary case of cutaneous diphtheria and an asymptomatic carrier were identified from skin and throat swabs. The 2 cases and 1 carrier were placed in consented restriction until antibiotic treatment and 2 clearance swabs were available. A total of 164 contacts were identified from within the same hostel accommodation as well as staff working in the refugee centre. All high risk contacts (n=101) were swabbed (throat, nasopharynx and open skin lesions) to assess C. diphtheriae carriage status. Chemoprophylaxis was administered (1 dose of intramuscular benzathine penicillin or 10 days of oral erythromycin) and diphtheria toxoid-containing vaccine offered regardless of immunisation status. Suspected cases were restricted on daily monitoring until swab clearance. A group of 49 low risk contacts were also offered vaccination. Results suggest a significant public health effort was required for a disease rarely seen in New Zealand. In light of increased worldwide forced displacement, similar outbreaks could occur and require a rigorous public health framework for management.

  6. Developing a student-led health and wellbeing clinic in an underserved community: collaborative learning, health outcomes and cost savings.

    Stuhlmiller, Cynthia M; Tolchard, Barry


    The University of New England (UNE), Australia decided to develop innovative placement opportunities for its increasing numbers of nursing students. Extensive community and stakeholder consultation determined that a community centre in rural New South Wales was the welcomed site of the student-led clinic because it fit the goals of the project-to increase access to health care services in an underserved area while providing service learning for students. Supported by a grant from Health Workforce Australia and in partnership with several community organisations, UNE established a student-led clinic in a disadvantaged community using an engaged scholarship approach which joins academic service learning with community based action research. The clinic was managed and run by the students, who were supervised by university staff and worked in collaboration with residents and local health and community services. Local families, many of whom were Indigenous Australians, received increased access to culturally appropriate health services. In the first year, the clinic increased from a one day per week to a three day per week service and offered over 1000 occasions of care and involved 1500 additional community members in health promotion activities. This has led to improved health outcomes for the community and cost savings to the health service estimated to be $430,000. The students learned from members of the community and community members learned from the students, in a collaborative process. Community members benefited from access to drop in help that was self-determined. The model of developing student-led community health and wellbeing clinics in underserved communities not only fulfils the local, State Government, Federal Government and international health reform agenda but it also represents good value for money. It offers free health services in a disadvantaged community, thereby improving overall health and wellbeing. The student-led clinic is an invaluable

  7. A retrospective study of prescription pattern of antimicrobials in an Urban Health Centre run by a medical college

    Bala, Sharmin S; Chincholkar, Aparna S; Wagh, Ranjit J; Mutalik, Madhav M


    .... Materials and Methods: A retrospective prescription audit was done of all 655 prescriptions issued between 01/01/2012 and 31/12/2012 at the outpatient department of Urban Health Centre attached to a medical college...

  8. Community Health Workers Support Community-based Participatory Research Ethics:

    Smith, Selina A.; Blumenthal, Daniel S.


    Ethical principles of community-based participatory research (CBPR)— specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability—stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR. PMID:23124502


    Craig Sharp


    Full Text Available 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK In recent years, partly because of the ever-younger exten-sion of high quality sport representation and partly, para-doxically, due to ever-increasing levels of obesity in the young, the discipline of paediatric physiology has moved from being an interesting curiosity to an extremely impor-tant area of practical knowledge. For example, children thermoregulate qualitatively and quantitatively differently from adults - before puberty their sweat rate per square metre of skin is less than half their adult level - and they may well have, proportionate to mass, 40% greater body surface area than an adult. On the musculo-skeletal side, they come late into 'kinetic-balance', into an appropriately economic mode of running or walking, so such effort is harder for them. In many other areas children, especially younger children, differ importantly from adults, and those involved in any aspects of their exercise, sport or medicine should be well aware of this. Hence the impor-tance of the discipline, and hence the reason for a very hearty celebration of the 20th anniversary of the Chil-dren's Health and Exercise Centre (CHERC, which, as is demonstrated here, has pioneered and expanded the entire discipline, as one of the world's leading paediatric labora-tories.To celebrate the 20th anniversary of the Children's Health and Exercise Centre (1987-2007 past and present mem-bers of the centre were invited to contribute a review article on paediatric exercise science. The collection of reviews, written by current and former PhD students, visiting research fellows and professors, visiting interns and current members of CHERC, discusses an array of topics, which have helped shaped the work of our centre. We would also like to take the opportunity to acknowl-edge all those associated with CHERC over the past 20 years, in particular the many children who have partici-pated in our



    For effective malaria control in Nigeria, free or subsidized malaria treatment and rural health insurance scheme ... triggers productive asset sales or high levels of debt,. Cost of malaria ..... November, 2012. Insurance Schemes and promotion/.



    birth attendants, and if there is a proper division of labour amongst the three tiers of the health system. 3 ... Obstetric. Care,. Traditional. Birth. Attendants,. Maternal. Mortality,. Neonatal ..... interview believed that sudden onset of labor and.



    Knowledge about andropause is better among older men (p<0.05) but educational status ... erectile dysfunction, changes in mood (depression ... quality of life [Karazindiyanoglu 2008]. represented ... with older patients about sexual health.


    satisfy the perceived needs of the clients they serve. age (15-45years) is put at .... Table 3: ANC clients' satisfaction of interpersonal relationship with Health .... listening to them, provider understanding their complaints are usually lodged, ...

  14. Assessing Community Leadership: Understanding Community Capacity for Health Improvement.

    Castle, Billie; Wendel, Monica; Kelly Pryor, Brandy N; Ingram, Monique

    The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to

  15. Journal of Community Medicine and Primary Health Care

    Journal of Community Medicine and Primary Health Care. ... of research findings, reviews, theories and information on all aspects of public health. ... health planning and management, health policy, health care financing, public health nutrition, ...

  16. Korea Community Health Survey Data Profiles.

    Kang, Yang Wha; Ko, Yun Sil; Kim, Yoo Jin; Sung, Kyoung Mi; Kim, Hyo Jin; Choi, Hyung Yun; Sung, Changhyun; Jeong, Eunkyeong


    In 2008, Korea Centers for Disease Control and Prevention initiated the first nationwide survey, Korea Community Health Survey (KCHS), to provide data that could be used to plan, implement, monitor, and evaluate community health promotion and disease prevention programs. This community-based cross-sectional survey has been conducted by 253 community health centers, 35 community universities, and 1500 interviewers. The KCHS standardized questionnaire was developed jointly by the Korea Centers for Disease Control and Prevention staff, a working group of health indicators standardization subcommittee, and 16 metropolitan cities and provinces with 253 regional sites. The questionnaire covers a variety of topics related to health behaviors and prevention, which is used to assess the prevalence of personal health practices and behaviors related to the leading causes of disease, including smoking, alcohol use, drinking and driving, high blood pressure control, physical activity, weight control, quality of life (European Quality of Life-5 Dimensions, European Quality of Life-Visual Analogue Scale, Korean Instrumental Activities of Daily Living ), medical service, accident, injury, etc. The KCHS was administered by trained interviewers, and the quality control of the KCHS was improved by the introduction of a computer-assisted personal interview in 2010. The KCHS data allow a direct comparison of the differences of health issues among provinces. Furthermore, the provinces can use these data for their own cost-effective health interventions to improve health promotion and disease prevention. For users and researchers throughout the world, microdata (in the form of SAS files) and analytic guidelines can be downloaded from the KCHS website ( in Korean.

  17. Less equal than others? Experiences of AYUSH medical officers in primary health centres in Andhra Pradesh.

    Lakshmi, J K


    The National Rural Health Mission (NRHM) includes, inter alia, the establishment of an AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) component (practitioner, trained assistants, drugs and equipment) in every primary health centre (PHC). However, five years following the launch of the NRHM, the AYUSH mainstreaming scenario is below expectations, riddled with ethical and governance issues. Accounts from AYUSH practitioners at PHCs in various regions of the state of Andhra Pradesh reveal enormous lacunae in implementation: unfilled positions, inequitable emoluments, inadequate or absent infrastructure, assistance and supplies, unethical interpersonal arrangements, and limited support from non-AYUSH personnel. The widespread negative impact of these conditions undermines the value of AYUSH, demotivating both practitioners and patients, and failing to provide the intended support to the public health system.

  18. [Community health in primary health care teams: a management objective].

    Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex


    To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  19. Who should decide how much and what information is important in person-centred health care?

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn


    implicitly segues into the patient having made a 'good decision'. In person-centred health care, whether, in what form, and with what weight, 'information' is included as a criterion of decision quality is a matter for the person involved, to decide in the light of their own values, preferences, and time......Most guidelines for clinical practice, and especially those for the construction of decision support tools, assume that the individual person (the patient) needs to be in possession of information of particular sorts and amount in order to qualify as having made an 'informed decision'. This often...

  20. Evaluating the effectiveness of IPTi on malaria using routine health information from sentinel health centres in southern Tanzania

    Mshinda Hassan


    Full Text Available Abstract Background Intermittent preventive treatment of malaria in infants (IPTi consists of the administration of a treatment dose of sulphadoxine-pyrimethamine (SP at the time of routine vaccinations. The use of routine Health Management and Information Services (HMIS data to investigate the effect of IPTi on malaria, anaemia, and all-cause attendance in children aged 2-11 months presenting to 11 health centres in southern Tanzania is described. Methods Clinical diagnosis of malaria was confirmed with a positive blood slide reading from a quality assurance laboratory. Anaemia was defined using two thresholds (mild [Hb Results Seventy two per cent of infants presenting in intervention areas received at least one dose of IPTi- 22% received all three. During March 2006 - April 2007, the incidence of all cause attendance was two attendances per person, per year (pppy, including 0.2 episodes pppy of malaria, 0.7 episodes of mild and 0.13 episodes of severe anaemia. Point estimates for the effect of IPTi on malaria varied between 18% and 52%, depending on the scope of the analysis, although adjustment for clustering rendered these not statistically significant. Conclusions The point estimate of the effect of IPTi on malaria is consistent with that from a large pooled analysis of randomized control trials. As such, it is plausible that the difference seen in health centre data is due to IPTi, even thought the effect did not reach statistical significance. Findings draw attention to the challenges of robust inference of effects of interventions based on routine health centre data. Analysis of routine health information can reassure that interventions are being made available and having desired effects, but unanticipated effects should trigger data collection from representative samples of the target population.


    users of the services, desire for more children, fear of side effects and partner's ... It confers important health and potential to control population growth and in the ... number of children, thereby enhance reproductive planning would avert a total of ..... collection of the data. review and recommendation for future policy decision.



    Breastfeeding is the super food for babies and is sufficient if given exclusively in the ... Approximately 90% of all mothers interviewed had heard about EBF, although with .... formula for proportion was used to estimate a total ..... diseases was one important benefit mentioned in ... and her health are different, he is healthier.


    4 and optimal use. In Nigeria, despite the The main objective of this study is therefore to .... Islam. Others. 185. 205. 5. 46.8. 51.9. 1.3. Utilization (use) of PHC Services and educational qualifications and of low socio-economic .... other zones except in the south-east region. .... primary health care interventions, the evidence is.

  4. Mental health, sexual violence and the work of Sexual Assault Referral centres (SARCs) in England.

    Brooker, Charlie; Durmaz, Emma


    There is a clear link between mental health status both before and after rape. It is known, for example, that approximately 40% of attendees to a Sexual Assault Referral centre (SARC) are already known to mental health services. Sexual Violence can also lead to the development of a mental illness. SARCs have been established, inter alia, to provide healthcare to the victims of rape where a mental health risk assessment should be undertaken. All 37 SARCs in England where asked to complete a short survey and a response rate of 68% was achieved. A high proportion (40%) of SACRs clients are already known to mental health services, however, only just under half of SARCs routinely assess mental health and when such an assessment is completed this is by an FME and substance misuse issues are not always included. Almost two-thirds of SARC services report problems in referring on to mental health services for a variety of reasons. More research is needed in this important area and NHS England should fully define the skills required to undertake a mental health risk assessment when someone has been the victim of rape.

  5. A designated centre for people with disabilities operated by Health Service Executive, Monaghan

    Day, Mary Rose


    Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.

  6. Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh (2009 – 2010.

    Saurabh RamBihariLal Shrivastava


    Full Text Available TITLE: - Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh (2009 – 2010. BACKGROUND: - Rogi Kalyan Samiti (RKS was started under National Rural Health Mission (NRHM in year 2006 by Government of India to provide sustainable quality care with accountability and to ensure people’s participation with total transparency. This study was planned to assess the implementation of RKS at Primary Health Centre (PHC Durvesh in the year 2009-2010. METHODS: A Cross-sectional descriptive study was conducted at PHC Durvesh in a tribal area of Thane district. Permission of District Health Officer was taken prior to start of study. Study participants were members of governing & executive body, beneficiaries at PHC. Information was collected by in-depth interviews of members, exit interviews of the beneficiaries, assessment of audit reports & records and observation of physical infrastructure. Later on PHC staff was also interviewed to know their views regarding RKS. RESULTS: Members of the Governing and Executive body were not matching with the guidelines. They could not specify their individual roles. The signatories had better knowledge of fund expenditure in comparison to other members who solely depended on the directives of signatories. Most of the RKS meetings were irregular and were usually merged with other meetings. CONCLUSION: Assessment mechanism for the achievement of objectives of RKS was inadequate as it was done only annually, limited only up to scrutiny of bills, no assessment of quality of work, opinion of beneficiaries or health care workers was not considered. [TAF Prev Med Bull 2012; 11(3.000: 307-314

  7. Mobile health monitoring system for community health workers

    Sibiya, G


    Full Text Available . Functional description The application provides technology for real time, dependable and intelligent health monitoring by health workers in the field. It integrates a set of wearable wireless sensors with a mobile computing device, such as a 3... communities remain a challenge for many governments, technological innovations that can increase prevention and control of NCDs are needed. Wearable health devices such as ambulatory blood pressure (ABP) monitors are a step in the right direction. ABP...

  8. Ethical considerations in community oral health.

    Naidoo, Sudeshni


    As the public's oral health care needs increase in complexity, there is renewed attention to the ethical dimensions of community oral health decision making and the development of public health ethics in teaching and research in dentistry. Despite their reduction globally, oral diseases persist with a particular distribution pattern that is a reflection of the increasingly widespread inequality in access to community oral health preventive and dental care. This is due to differences in the appropriateness, availability, accessibility, and acceptability of oral health education and the care provided. This article provides an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care to the underserved. The need for a paradigm shift from highly technical and individualistic dental training curricula is discussed, together with the need to instill a holistic approach to ethical and social responsibility in new dental graduates. It concludes with some possible strategies, using the overarching principles of ethics and bioethics that are applicable to practice among vulnerable populations.

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

    M. Barker


    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

  10. Public health and health education in faith communities.

    Chatters, L M; Levin, J S; Ellison, C G


    This special issue of Health Education & Behavior is devoted to broadly examining the interconnections among public health, health education, and faith-based communities. In addition to a focus on questions related to the practice of public health and health education within religious settings (e.g., program development, implementation, and evaluation), the articles in this issue examine a broad range of both substantive and methodological questions and concerns. These articles include contributions that address (1) various theoretical and conceptual issues and frameworks explaining the relationships between religious involvement and health; (2) substantive reviews of current research in the area; (3) individual empirical studies exploring the associations between religious involvement and health attitudes, beliefs, and behaviors; (4) evaluations of health education programs in faith communities; and (5) religious institutions and their contributions to the development of health policy. The articles comprising the issue are selective in their coverage of the field and provide different and complementary perspectives on the connections between religious involvement and health. It is hoped that this approach will appeal to a broad audience of researchers, practitioners, policy makers, and others from health education, public health, and related social and behavioral science disciplines.

  11. Influence of age on community health worker's knowledge and ...

    Influence of age on community health worker's knowledge and service provision for ... in community health worker (CHW) programs to address rural health needs. ... there was no statistical difference in CHW knowledge retention, and service ...

  12. Profile: Manhiça Health Research Centre (Manhiça HDSS).

    Sacoor, Charfudin; Nhacolo, Ariel; Nhalungo, Delino; Aponte, John J; Bassat, Quique; Augusto, Orvalho; Mandomando, Inácio; Sacarlal, Jahit; Lauchande, Natu; Sigaúque, Betuel; Alonso, Pedro; Macete, Eusébio; Munguambe, Khátia; Guinovart, Caterina; Aide, Pedro; Menendez, Clara; Acácio, Sozinho; Quelhas, Diana; Sevene, Esperança; Nhampossa, Tacilta


    The Manhiça Health Research Centre, established in 1996 in a rural area of southern Mozambique, currently follows around 92 000 individuals living in approximately 20 000 enumerated and geo-positioned households. Its main strength is the possibility of linking demographic data and clinical data to promote and conduct biomedical research in priority health areas. Socio-demographic data are updated twice a year and clinical data are collected on a daily basis. The data collected in Manhiça HDSS comprises household and individual characteristics, household socio-economic assets, vital data, migration, individual health history and cause of death, among others. Studies conducted in this HDSS contributed to guide the health authorities and decision-making bodies to define or adjust health policies such as the introduction of Mozambique's expanded programme of immunization with different vaccines (Haemophilus influenzae type b, Pneumococcus) or the development of the concept of Intermittent Preventive Treatment for Infants (IPTi) that led to the World Health Organization recommendation of this method as best practice for the control of malaria among infants. Manhiça's data can be accessed through a formal request to Diana Quelhas ( accompanied by a proposal that will be analysed by the Manhiça HDSS internal scientific and ethics committees.

  13. Creating a safety culture at the Children's and Women's Health Centre of British Columbia.

    Verschoor, Katrina N; Taylor, Annemarie; Northway, Tracie L; Hudson, Denise G; Van Stolk, Dori E; Shearer, Kim J; McDougall, Debbie L; Miller, Georgene


    The Children's' and Women's Health Centre of British Columbia (C&W) is the largest hospital providing specialized care to women and children across the province of British Columbia in Canada. The values of quality and safety are threaded throughout the C&W strategic plan which emphasizes that safety is vital for better health. At C&W, a multifaceted approach is used to create and sustain a culture of safety. The Institute for Healthcare Improvement (IHI) has developed tools to facilitate the development of safety cultures within hospital settings. This article describes the implementation of some of these tools, such as the Safety Briefings Model and Patient Safety Leadership Walkrounds. We will discuss how we adapted these strategies to our pediatric settings; what we learned through the implementation process-our successes and challenges; and implications for future success.

  14. Effect of Health Services Quality to Inpatient Satisfaction in Health Centre of Jayapura Regency, Papua

    Taufik A AWibowo


    Full Text Available To measure the quality of health care using five dimensions of service quality that is direct evidence (Tangibles responsiveness (responsiveness, reliability (realibility, security (assurance, and empathy. The purpose of this study is to determine the effect of the quality of inpatient health care with patient satisfaction in the health center Jayapura district. Survey method with cross sectional analytic study population in this study that all patients hospitalized at the health center during the month of August to September 2016. Sampling was conducted with a total sampling technique with a number of 106 respondents. Sources of primary data obtained from questionnaires and secondary data from six health centers in the county inpatient Jayapura. Analysis of data using multiple linear regression. The results showed that the most dominant variables linked to patient satisfaction compared with other variable is direct evidence (tangibles. The quality of health services at the health center Jayapura district has a significant relationship to the direct evidence (tangibles with patient satisfaction. Jayapura Regency Government through the Department of Health to maintain and continuously improve the quality of health care is the most basic health centers by strengthening institutions, infrastructure, and financing of adequate health centers so as to improve the quality of health centers and satisfaction to the patient.

  15. Community Changes Address Common Health Threat


    This podcast helps residents living in multiunit housing, like apartments and condos, understand the threat of secondhand smoke. It also helps residents understand what steps they can take to breathe a little easier if involuntarily exposed to secondhand smoke.  Created: 9/30/2013 by Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 9/30/2013.

  16. Use of the community assessment for public health emergency response to conduct community health assessments for public health accreditation.

    Conley, Ashley M; Vagi, Sara; Horney, Jennifer A


    A community health assessment (CHA) is a collaborative process of collecting and analyzing data to learn about the health status of a community. Community health assessments are also a requirement of public health accreditation for state and local health departments and of the Affordable Care Act for nonprofit hospitals. One element of a CHA is primary data collection. This article describes the use of the Community Assessment for Public Health Emergency Response (CASPER) method for primary data collection to meet public health accreditation requirements in 2 case study communities--Nashua, New Hampshire, and Davidson County, North Carolina; CASPER is a flexible and efficient method for the collection of population-based primary data in an urban or rural setting.

  17. Health workforce equity in urban community health service of China.

    Chen, Rui; Zhao, Yali; Du, Juan; Wu, Tao; Huang, Yafang; Guo, Aimin


    To reveal the equity of health workforce distribution in urban community health service (CHS), and to provide evidence for further development of community health service in China. A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39) was better than that of doctors per square kilometer (G = 0.44) (P = 0.005). Among the total 6,573 health workers, 1,755(26.7%) had undergraduate degree or above, 2,722(41.4%)had junior college degree and 215(3.3%) had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52), which was worse than that of health works per 10000 population (Purban CHS centers.

  18. Gatekeepers of health: A qualitative assessment of child care centre staff's perspectives, practices and challenges to enteric illness prevention and management in child care centres

    Adams Cindy L


    Full Text Available Abstract Background Enteric outbreaks associated with child care centres (CCC have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

  19. Cash planning in community mental health agencies.

    Williams, E


    Community mental health agencies often receive funds from a number of different sources with varying restrictions. Cash planning can help them manage these funds properly and avoid serious problems. The use of a projected cash flow statement may even help produce additional income for them.

  20. Primary Health Centre disaster preparedness after the earthquake in Padang Pariaman, West Sumatra, Indonesia

    Mansyur Muchtaruddin


    Full Text Available Abstract Background The West Sumatra earthquake that occurred on September 30, 2009, caused severe damage in some districts, including Padang Pariaman. As Padang Pariaman is an earthquake-prone area, disaster and emergency management is necessary. Due to the limited health facilities, the health services completely rely on Puskesmas (Primary Health Centres, PHCs. This study is aimed at assessing the preparedness of PHCs to response to potential disasters in their surrounding area. Findings Padang Pariaman district was used in a case study setting to assess the readiness and preparedness of the PHCs there to face disasters. Self-administered questionnaire, key informant interview, and direct observation were used to obtain the data on human resources, facilities preparedness, and the procedures. The investigation focused on measuring four aspects, i.e. human resources, facilities preparedness, standard operating procedure (SOP, and policy. Due to the limited co-operation of the head of the PHCs, three PHCs were directly observed as a subsample. The evaluation was performed six months after the impact phase of the earthquake and three months after the PHCs' health staff training on improving the primary health care services. The number and quality of health staff in Padang Pariaman was far below ideal. Fewer than half of the PHCs had emergency facilities and only one considered the need for triage and fire management, whereas the transportation mode was still limited. An SOP and policy for facing disasters were not available in any of the PHCs. Therefore, promoting disaster preparedness, technical provision, including health staff training, is necessary. Conclusions Padang Pariaman district has not yet prepared its PHCs to face disaster, so it is apparent that PHCs' disaster preparedness in Padang Pariaman and also other earthquake-prone areas in Indonesia should be promoted. This should include increasing the number of doctors, providing training

  1. Dental Health Behavior in the Prevention of Pulmonary TB at Health Centre in Several Provinces

    Indirawati Tjahja Notohartojo


    Full Text Available Background: Pulmonary TB is an infectious disease of the respiratory tract caused by bacteria. Dental health professionals such as dentists and dental nurses are in charge of health personnel to prevent, treat, cure, teeth the mouth, so as not to arise or aggravate toothache. In doing their job as dental health workers is expected to use gloves or masks, and always wash their hands to avoid the transmission of pulmonary TB disease. Methods: A cross sectional study was conducted involving 78 dental health professionals in 50 primary health centers that were chosen in six districts in three provinces of Banten, South Kalimantan and Gorontalo. Data were obtained by interviews and processed using SPSSResults: More than 90% dental health workers in work wore masks gloves and washed their hands after work. There was a signifi cant relationship between exercise with dental health professionals with a p value of 0.007, which means a signifi cant. Conclusion: In performing their duties, dental health workers have already used personal protective equipment such asmasks, gloves, and washed their hands and did enough exercise. Recommendation: need to increase knowledge about pulmonary TB in dental health professionals.

  2. Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India.

    Tiwari, H; Kumar, A; Kulkarni, S K


    The present pilot study was conducted in order to establish the drug-prescribing trend of anti-hypertensive agents at the Panjab University Health Centre in India. A pilot study of six-month duration was conducted at the Panjab University Health Centre. The information was collected from the patients attending the outpatient department through a random sample method. World Health Organisation-based prescription-auditing proforma was used for data collection. This study revealed that most of the male patients were on monotherapy (60 percent). In the monotherapy category, four classes of drugs were used. These were calcium channel blockers (48.1 percent), beta-blockers (46.2 percent), ACE inhibitors (3.9 percent) and diuretics (1.9 percent). Among monotherapy drugs, calcium channel blockers were prescribed most whereas diuretics were least used. Among those who were treated with drug combinations, 92.1% received two drugs and 7.9 percent received three drugs. In combination therapy, a two-drug combination consisting of beta-blockers and calcium channel blockers was given to the majority of the patients. Overall, 57.8 percent patients were treated with a single anti-hypertensive drug and 42.2 percent were treated with anti-hypertensive drug combinations. The present study represents the current prescribing trend for anti-hypertensive agents and it highlights certain shortcomings in the existing prescribing practice. There is a considerable scope for improvement, particularly the under-utilisation of diuretics in the present prescribing pattern of anti-hypertensive drugs.

  3. Community health education: reaching ethnically diverse elders.

    States, Rebecca A; Susman, William M; Riquelme, Luis F; Godwin, Ellen M; Greer, Ellen


    To address disparities in access to health care information, we developed a model program of community-based, health education workshops to be delivered in English and Spanish to older urban adults from diverse ethnic, cultural, and language backgrounds. The workshops were created through an interdisciplinary collaboration among faculty from seven health care professions and focused on three healthcare topics identified in Healthy People 2010: dementia and depression, stress reduction, and physical activity. The development of workshop content and structure, including didactic and interactive components, an approach to interdisciplinary student involvement, and program evaluation by clients and community center staff, are presented as a model for other educators. The workshops presented at five senior centers were attended by 1110 mostly female clients with an average age of 74 yrs and with a large proportion self-identified as of minority background. One hundred seven students from seven healthcare programs helped deliver the workshops. Interviews and surveys of the clients demonstrated that most had a positive learning experience, whereas the evidence of intent to take action on health care issues was less definitive. Analysis of student essays demonstrated increased student understanding of older adults and of community services. A website, Geriatric Educational Resources for Instructors and Elders (, was created to provide access to the instructional and resource materials used for the workshops, including presentation materials in Spanish. This model program may help address the substantial health education needs of a growing population of older adults from diverse ethnic, cultural, and language minorities.

  4. Community health nursing vision for 2020: shaping the future.

    Schofield, Ruth; Ganann, Rebecca; Brooks, Sandy; McGugan, Jennifer; Dalla Bona, Kim; Betker, Claire; Dilworth, Katie; Parton, Laurie; Reid-Haughian, Cheryl; Slepkov, Marlene; Watson, Cori


    As health care is shifting from hospital to community, community health nurses (CHNs) are directly affected. This descriptive qualitative study sought to understand priority issues currently facing CHNs, explore development of a national vision for community health nursing, and develop recommendations to shape the future of the profession moving toward the year 2020. Focus groups and key informant interviews were conducted across Canada. Five key themes were identified: community health nursing in crisis now, a flawed health care system, responding to the public, vision for the future, and CHNs as solution makers. Key recommendations include developing a common definition and vision of community health nursing, collaborating on an aggressive plan to shift to a primary health care system, developing a comprehensive social marketing strategy, refocusing basic baccalaureate education, enhancing the capacity of community health researchers and knowledge in community health nursing, and establishing a community health nursing center of excellence.

  5. Factors influencing choice of care-seeking for acute fever comparing private chemical shops with health centres and hospitals in Ghana: a study using case-control methodology.

    Ansah, Evelyn K; Gyapong, Margaret; Narh-Bana, Solomon; Bart-Plange, Constance; Whitty, Christopher J M


    Several public health interventions to improve management of patients with fever are largely focused on the public sector yet a high proportion of patients seek care outside the formal healthcare sector. Few studies have provided information on the determinants of utilization of the private sector as against formal public sector. Understanding the differences between those who attend public and private health institutions, and their pathway to care, has significant practical implications. The chemical shop is an important source of care for acute fever in Ghana. Case-control methodology was used to identify factors associated with seeking care for fever in the Dangme West District, Ghana. People presenting to health centres, or hospital outpatients, with a history or current fever were compared to counterparts from the same community with fever visiting a chemical shop. Of 600 patients, 150 each, were recruited from the district hospital and two health centres, respectively, and 300 controls from 51 chemical shops. Overall, 103 (17.2 %) patients tested slide positive for malaria. Specifically, 13.7 % (41/300) of chemical shop patients, 30.7 % (46/150) health centre and 10.7 % (16/150) hospital patients were slide positive. While it was the first option for care for 92.7 % (278/300) chemical shop patients, 42.7 % (64/150) of health centre patients first sought care from a chemical shop. More health centre patients (61.3 %; 92/150) presented with fever after more than 3 days than chemical shop patients (27.7 %; 83/300) [AOR = 0.19; p < 0.001 CI 0.11-0.30]. Although the hospital was the first option for 83.3 % (125/150) of hospital patients, most (63.3 %; 95/150) patients arrived there over 3 days after their symptoms begun. Proximity was significantly associated with utilization of each source of care. Education, but not other socioeconomic or demographic factors were significantly associated with chemical shop use. The private drug retail sector is

  6. Multiculturalism, Medicine and Health Part V: Community Considerations

    Masi, R.


    In this article the author examines multicultural health issues from a community perspective, dealing with relationships between cultural communities and health-care systems in terms of: hospitals and health-care institutions, family and social supports, social norms, and community-health programs. PMID:21248882

  7. Awareness and Practice of Biomedical Waste Management Among Different Health Care Personnel at Tertiary Care Centre, Rajkot, India

    Rajesh K Chudasama


    Full Text Available Background: Bio medical waste collection and proper disposal has become a significant concern for both the medical and general community. Objective: To know the awareness and practice of biomedical waste management (BMW among health care personnel working at a tertiary care centre. Methods: The study was conducted from January 2013 to June 2013. It was a descriptive observational hospital based cross sectional study. Study participants included the resident and intern doctors, nursing staff, laboratory technicians, sanitary staff (ward boys, aaya and sweepers working in the P D U Government Medical College and Civil Hospital, Rajkot who are dealing with BMW. The study was conducted by using pretested, semi-structured pro forma. Results: Total 282 health care personnel participated, including 123 resident and intern doctors, 92 nursing personnel, 13 laboratory technicians and 54 sanitary staff. Only 44.3% study participants received training for bio medical waste management. Except for doctors (98.4%, awareness regarding identification and use of color coded bags as per BMW act, was very poor among health care personnel. Record keeping for injuries related to biomedical waste was very poor for all health care personnel. Significant number of paramedics maintained record of BMW at work place, practiced disinfection and segregation of BMW at work place, used personal protective measures while handling BMW. Significant number of resident and intern doctors practiced correct method for collecting sharps and needles than paramedical staff. Conclusion: Intensive training program at regular time interval and a system of monitoring and surveillance about practice of day to day BMW management should be evolved.

  8. Finding Sustainability: University-community collaborations focused on arts in health

    Mike White


    Full Text Available This article describes a number of community-based arts in health projects in schools and disadvantaged communities in Northern England that connect with the interdisciplinary research interests of the Centre for Medical Humanities at Durham University ( It examines issues about what makes for sustainability in both practice and research of arts in health when operating from a university base and stresses the importance of relationship-based work in health promotion interventions in communities. It attempts to set arts development work in the policy context of how community health has been addressed over the last decade. It provides both practical and metaphorical illustrations of how community cohesion and emotional literacy can be developed and recognised in schools and communities when supported by ethnographic research that is underpinned by theories of social capital, resilience and participatory arts practice. The significance that the artwork can attain as a social gift, with a special meaning for its creators, is examined from an anthropological perspective. Looking historically and comparatively at some longitudinal projects in community-based arts in health, the article assesses what makes for both success and failure in practice, and looks particularly at the significance of the arts in helping to deliver strategies for improving child health and education. In a strategic development context, explanation is given of several strands of university-community collaboration in arts in health, with interlinked project examples drawn from Tyneside and West Yorkshire. Finally, the article looks at the prospects for sustaining arts in health within the coming transfer of the public health function to local government. Keywords Sustainability, arts in community health, resilience, child mental health, social capital

  9. Towards One Health Knowledge Networks: A Southern African Centre of Infectious Disease Surveillance case study

    Eric Beda


    Full Text Available The dynamic nature of new information and/or knowledge is a big challenge for information systems. Early knowledge management systems focused entirely on technologies for storing, searching and retrieving data; these systems have proved a failure. Juirsica and Mylopoulos1 suggested that in order to build effective technologies for knowledge management, we need to further our understanding of how individuals, groups and organisations use knowledge. As the focus on knowledge management for organisations and consortia alike is moving towards a keen appreciation of how deeply knowledge is embedded in people’s experiences, there is a general realisation that knowledge cannot be stored or captured digitally. This puts more emphasis in creating enabling environments for interactions that stimulate knowledge sharing.Our work aims at developing an un-obtrusive intelligent system that glues together effective contemporary and traditional technologies to aid these interactions and manage the information captured. In addition this system will include tools to aid propagating a repository of scientific information relevant to surveillance of infectious diseases to complement knowledge shared and/or acts as a point of reference.This work is ongoing and based on experiences in developing a knowledge network management system for the Southern African Centre of Infectious Disease Surveillance (SACIDS, A One Health consortium of southern African academic and research institutions involved with infectious diseases of humans and animals in partnership with world-renowned centres of research in industrialised countries.

  10. Knowledge flows in health communities of practice.

    Perrott, Bruce E


    This article will examine a case study of an outpatient's clinic in an Australian public hospital with the objective of gaining a better understanding of the issues related to knowledge dynamics in communities of practice within a health care environment. This case study research approach was considered to provide a fine-grained approach recommended for improved understanding of nuances, detail, and the forces underlying the phenomena under observation. Focus on detail was an important attribute of this study notwithstanding possible shortcomings in not being able to externalize the research findings. Of the four modes of knowledge exchange observed to take place in this public hospital community of practice, Mode C (tacit to explicit) stands out as a key finding. Here, the release of each individual's tacit knowledge is forthcoming and free flowing given the established culture of trust in this clinic. The informal communication environment in the luminal space of their workplace corridor provided a conducive environment that enabled a free-flowing exchange of community knowledge. Health-care managers are increasingly required to guide the use and flow of knowledge within their organizations. The insights gained from this project will provide them with a better understanding of knowledge dynamics within a health-care community of practice, which is a microcosm of the larger organization.

  11. Community control of health services. Dr. Martin Luther King, Jr. Health Center's community management system.

    Tichy, N M; Taylor, J I


    This article presents the case of Dr. Martin Luther King Jr. Health Center's unique community management system in which neighborhood workers have been developed to assume managerial responsibilities and are directing the Center. The Martin Luther King Center experience is instructive because the Center was able to achieve significant community control by focusing primarily on the internal dimension of control, namely, management, without experiencing destructive conflicts and the deterioration of health services.

  12. Economic analysis of delivering primary health care services through community health workers in 3 North Indian states.

    Shankar Prinja

    Full Text Available We assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India's policy of introducing a second auxiliary nurse midwife (ANM at the sub-centre compared to scenario of single ANM sub-centre.We undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants.Annually it costs INR 1.03 million (USD 19,381, or INR 187 (USD 3.5 per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10 per full ANC care, INR 767 (USD 14 per PNC case registered, INR 974 (USD 18 per DOTS treatment completed and INR 97 (USD 1.8 per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432.Our estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India's policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective.

  13. Towards a lifelong learning society through reading promotion: Opportunities and challenges for libraries and community learning centres in Viet Nam

    Hossain, Zakir


    The government of Viet Nam has made a commitment to build a Lifelong Learning Society by 2020. A range of related initiatives have been launched, including the Southeast Asian Ministers of Education Organization Centre for Lifelong Learning (SEAMEO CELLL) and "Book Day" - a day aimed at encouraging reading and raising awareness of its importance for the development of knowledge and skills. Viet Nam also aims to implement lifelong learning (LLL) activities in libraries, museums, cultural centres and clubs. The government of Viet Nam currently operates more than 11,900 Community Learning Centres (CLCs) and is in the process of both renovating and innovating public libraries and museums throughout the country. In addition to the work undertaken by the Viet Nam government, a number of enterprises have been initiated by non-governmental organisations and non-profit organisations to promote literacy and lifelong learning. This paper investigates some government initiatives focused on libraries and CLCs and their impact on reading promotion. Proposing a way forward, the paper confirms that Viet Nam's libraries and CLCs play an essential role in promoting reading and building a LLL Society.

  14. A study of automated self-assessment in a primary care student health centre setting.

    Poote, Aimee E; French, David P; Dale, Jeremy; Powell, John


    We evaluated the advice given by a prototype self-assessment triage system in a university student health centre. Students attending the health centre with a new problem used the automated self-assessment system prior to a face-to-face consultation with the general practitioner (GP). The system's rating of urgency was available to the GP, and following the consultation, the GP recorded their own rating of the urgency of the patient's presentation. Full data were available for 154 of the 207 consultations. Perfect agreement, where both the GP and the self-assessment system selected the same category of advice, occurred in 39% of consultations. The association between the GP assessment and the self-assessment rankings of urgency was low but significant (rho = 0.19, P = 0.016). The self-assessment system tended to be risk averse compared to the GP assessments, with advice for more urgent level of care seeking being recommended in 86 consultations (56%) and less urgent advice in only 8 (5%). This difference in assessment of urgency was significant (P self-assessed and GP-assessed urgency was not associated with symptom site or socio-demographic characteristics of the user. Although the self-assessment system was more risk averse than the GPs, which resulted in a high proportion of patients being triaged as needing emergency or immediate care, the self-assessment system successfully identified a proportion of patients who were felt by the GP to have a self-limiting condition that did not need a consultation. In its prototype form, the self-assessment system was not a replacement for clinician assessment and further refinement is necessary.

  15. Patient-centred medicine through student-centred teaching: a student perspective on the key impacts of community- based learning in undergraduate medical education.

    Howe, A


    The UK General Medical Council has proposed that increased use of community settings is essential to enhancement of medical education. However, such curriculum developments have been directed by educationalists and clinical faculty; there is to date little to show whether student perspectives accord with such expectations. To examine student views on whether community-based learning during a UK undergraduate medical education course results in new learning in the areas expected, and to elucidate any process factors which enhance attainment of learning objectives. Nominal group technique, to develop consensus on important learning outcomes and process factors, and questionnaire survey, developed from the views of the nominal groups. 89 students participated (response rate 70% for the nominal groups, and 88% for questionnaire). Students perceived increased learning in many of the areas expected. In particular, students reported significant learning from: witnessing the impact of a longer term and more personal relationship with patients; the visible impact of social environment on health; the importance of dealing with people rather than diseases, and the use of the whole team for care. In addition, they emphasized that tutor, staff and patient enthusiasm for student presence and learning greatly enhanced the student learning experience. Community settings appear to achieve the expected attitudinal adaptation of students. The role of the committed tutor and team is seen as pivotal to learning. The conclusions support an increased emphasis in contemporary medical education and related research activity on the key impact of relationships in the learning environment.

  16. Health workforce equity in urban community health service of China.

    Rui Chen

    Full Text Available OBJECTIVES: To reveal the equity of health workforce distribution in urban community health service (CHS, and to provide evidence for further development of community health service in China. METHODS: A community-based, cross-sectional study was conducted in China from September to December 2011. In the study, 190 CHS centers were selected from 10 provinces of China via stratified multistage cluster sampling. Human resources profiles and basic characteristics of each CHS centers were collected. Lorenz curves and Gini Coefficient were used to measure the inequality in the distribution of health workforce in community health service centers by population size and geographical area. Wilcoxon rank test for paired samples was used to analyze the differences in equity between different health indicators. RESULTS: On average, there were 7.37 health workers, including 3.25 doctors and 2.32 nurses per 10,000 population ratio. Significant differences were found in all indicators across the samples, while Beijing, Shandong and Zhejiang ranked the highest among these provinces. The Gini coefficients for health workers, doctors and nurses per 10,000 population ratio were 0.39, 0.44, and 0.48, respectively. The equity of doctors per 10,000 population ratio (G = 0.39 was better than that of doctors per square kilometer (G = 0.44 (P = 0.005. Among the total 6,573 health workers, 1,755(26.7% had undergraduate degree or above, 2,722(41.4%had junior college degree and 215(3.3% had high school education. Significant inequity was found in the distribution of workers with undergraduate degree or above (G = 0.52, which was worse than that of health works per 10000 population (P<0.001. CONCLUSIONS: Health workforce inequity was found in this study, especially in quality and geographic distribution. These findings suggest a need for more innovative policies to improve health equity in Chinese urban CHS centers.

  17. Client-centred coaching in the paediatric health professions: a critical scoping review.

    Schwellnus, Heidi; King, Gillian; Thompson, Laura


    Coaching is mainstream in business and is expanding into paediatric health care. With the focus on evidence-informed health practice, it is imperative to identify the key active components of interventions. Coaching is by definition a complex intervention with numerous components. The purpose of this critical review is to determine how coaching is currently defined, its prevalence in paediatric health care services and the frequency of the active components of coaching and to consider the findings of research to date. A critical review of the literature was conducted. Inclusion/exclusion criteria were based on the International Coach Federation, which stipulates that coaching is a collaborative process that involves client-centred goal setting, facilitation, self-discovery and capacity building. Seventeen studies were selected for thorough review. Throughout the literature, there was inconsistency in how coaching was defined. Studies included various components, but overall the literature lacked cohesion. To advance the field, a list of components that foster client engagement was developed along with a comprehensive definition of coaching involving affective, behavioural and cognitive components and a path of research necessary to evaluate this complex intervention. Implications for Rehabilitation A comprehensive approach to coaching involves consideration of multiple components. A coaching approach can enhance engagement in rehabilitation interventions. The operationalization of holistic ABC coaching that encapsulates the important components, which are affective, behavioural and cognitive in nature.

  18. Use of Electronic Health Records in Residential Care Communities

    ... the National Technical Information Service NCHS Use of Electronic Health Records in Residential Care Communities Recommend on ... Facilities Most residential care communities did not use electronic health records in 2010, and use varied by ...

  19. The International Development Research Centre: A Guide for the Canadian University Research Community = Le Centre de recherches pour le developpement international: guide a l'intention des scientifiques des universites Canadiennes.

    Tillman, George; Wasilewski, Ania, Ed.

    Written in both English and French this is a manual for the Canadian research community. It describes the International Development Research Centre (IDRC) and its operations. The main objective of the IDRC is to assist scientists in developing countries to identify and conduct research into long term practical solutions to development problems.…

  20. Community Health Nursing through a Global Lens.

    Sarkar, Norma; Dallwig, Amber; Abbott, Patricia


    Community Health Nursing (N456) is a required senior clinical course in the undergraduate nursing curriculum at the University of Michigan in which students learn to assess and address the health of populations and communities. In 2012, we began our efforts to internationalize the curriculum using a globally engaged nursing education framework. Our goal is for all students to have an intercultural learning experience understanding that all students are unable to travel internationally. Therefore, this intercultural learning was implemented through a range of experiences including actual immersion, virtual activities (videoconferencing) and interventions with local vulnerable populations. Grants were obtained to provide immersion experiences in Quito, Ecuador and New Delhi, India. Several technologies were initiated with partner nursing schools in Leogane, Haiti and New Delhi, India. Weekly videoconferencing utilizing BlueJeans software and exchange of knowledge through the Knowledge Gateway facilitated intercultural exchange of knowledge and culture. Local clinical groups work with a variety of vulnerable populations. A private blog was developed for all sections to share community assessment data from local and international communities. Qualitative evaluation data was collected for local and international students to begin to assess cultural competence and student learning. Analysis of data documented increased awareness of culture and identified the many positive benefits of interaction with a global partner.

  1. Peruvian community health promoters: expanding the spaces of health voluntarism.

    Jenkins, Katy


    This paper emphasises the importance of recognising the global South as a key site for understanding the patterning of geographies of health voluntarism. Feeding into a broader critique of neoliberal health and development policies, the paper explores what a case study of health promoters in a popular settlement in Lima, Peru, can add to our understanding of practices of health voluntarism rooted in distinct places, emphasising the uneven and gendered nature of such voluntary activity. In particular, the paper considers the ways in which urban community spaces are negotiated, inhabited and shaped by volunteer women health workers, arguing that an exploration of these everyday practices provides a more nuanced picture of the role of voluntarism in healthcare provisioning under neoliberal regimes.

  2. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    Hallas, Peter; Hansen, Anne R; Stæhr, Mia A; Munk-Andersen, Ebbe; Jorgensen, Henrik L


    Background The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. Methods The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 – December 2002 the Red Cross prospectively registered health related data on all new applications (n = 4516) to the Immigration Service regarding referrals to medical specialists. We used these records to analyse the association between length of stay in the asylum centres and overall rate of referral for mental disorders. Data was analysed using weighted linear regression. Results We found that referrals for mental disorders increased with length of stay in asylum centres in a large, multiethnic population of asylum seekers. The association was found in all the categories of psychiatric illness studied and for a majority of the nationality groups studied. Conclusion Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness among asylum seekers should be addressed by political and humanitarian means, giving prevention of illness the highest priority. PMID:17931414

  3. Community mental health in India: A rethink

    Aynkran Jothy R


    Full Text Available Abstract Background Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF, an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes. Methods One hundred and eighty five patients with chronic mental illness were followed up and their present treatment status determined using a modified version of the Psychiatric and Personal History Schedule (PPHS. The resources created earlier were assessed and qualitative information was gathered during interviews with patient and families and other stakeholders to identify the reasons behind the sustenance or failure of these initiatives. Results Of the 185 patients followed up, 15% had continued treatment, 35% had stopped treatment, 21% had died, 12% had wandered away from home and 17% were untraceable. Of the patients who had discontinued treatment 25% were asymptomatic while 75% were acutely psychotic. The referral service was used by only 15% of the patients and mental health services provided by the PHC stopped within a year. The Citizen's group was functional for only a year and apart from chicken rearing, all other self-employment schemes were discontinued within a period of 6 months to 3 years. There were multiple factors contributing to the failure, the primary reasons being the

  4. Community College Student Mental Health: A Comparative Analysis

    Katz, Daniel Seth; Davison, Karen


    This study explores community college student mental health by comparing the responses of California community college and traditional university students on the American College Health Association-National College Health Assessment II (ACHA-NCHA II). Using MANOVA, we compared community college and traditional university students, examining…

  5. The Health of the School Nurse Community: A Framework

    Christeson, Elisabeth P.


    School nursing is based on a conceptual foundation of community health nursing. Using community health nursing as a reference point, this article describes a viewpoint of school nurses as the population of care. With this perspective, school nurses will better understand how to foster the health of their community. Developed on the basis of…

  6. A student-centred electronic health record system for clinical education.

    Elliott, Kristine; Judd, Terry; McColl, Geoff


    Electronic Health Record (EHR) systems are an increasingly important feature of the national healthcare system [1]. However, little research has investigated the impact this will have on medical students' learning. As part of an innovative technology platform for a new masters level program in medicine, we are developing a student-centred EHR system for clinical education. A prototype was trialed with medical students over several weeks during 2010. This paper reports on the findings of the trial, which had the overall aim of assisting our understanding of how trainee doctors might use an EHR system for learning and communication in a clinical setting. In primary care and hospital settings, EHR systems offer potential benefits to medical students' learning: Longitudinal tracking of clinical progress towards established learning objectives [2]; Capacity to search across a substantial body of records [3]; Integration with online medical databases [3]; Development of expertise in creating, accessing and managing high quality EHRs [4]. While concerns have been raised that EHR systems may alter the interaction between teachers and students [3], and may negatively influence physician-patient communication [6], there is general consensus that the EHR is changing the current practice environment and teaching practice needs to respond. Final year medical students on clinical placement at a large university teaching hospital were recruited for the trial. Following a four-week period of use, semi-structured interviews were conducted with 10 participants. Audio-recorded interviews were transcribed and data analysed for emerging themes. Study participants were also surveyed about the importance of EHR systems in general, their familiarity with them, and general perceptions of sharing patient records. Medical students in this pilot study identified a number of educational, practical and administrative advantages that the student-centred EHR system offered over their existing ad

  7. A designated centre for people with disabilities operated by Camphill Communities of Ireland, Kildare

    Ohmann, Christian


    Abstract Background A recent survey has shown that data management in clinical trials performed by academic trial units still faces many difficulties (e.g. heterogeneity of software products, deficits in quality management, limited human and financial resources and the complexity of running a local computer centre). Unfortunately, no specific, practical and open standard for both GCP-compliant data management and the underlying IT-infrastructure is available to improve the situation. For that reason the "Working Group on Data Centres" of the European Clinical Research Infrastructures Network (ECRIN) has developed a standard specifying the requirements for high quality GCP-compliant data management in multinational clinical trials. Methods International, European and national regulations and guidelines relevant to GCP, data security and IT infrastructures, as well as ECRIN documents produced previously, were evaluated to provide a starting point for the development of standard requirements. The requirements were produced by expert consensus of the ECRIN Working group on Data Centres, using a structured and standardised process. The requirements were divided into two main parts: an IT part covering standards for the underlying IT infrastructure and computer systems in general, and a Data Management (DM) part covering requirements for data management applications in clinical trials. Results The standard developed includes 115 IT requirements, split into 15 separate sections, 107 DM requirements (in 12 sections) and 13 other requirements (2 sections). Sections IT01 to IT05 deal with the basic IT infrastructure while IT06 and IT07 cover validation and local software development. IT08 to IT015 concern the aspects of IT systems that directly support clinical trial management. Sections DM01 to DM03 cover the implementation of a specific clinical data management application, i.e. for a specific trial, whilst DM04 to DM12 address the data management of trials across the unit

  8. Promoting health within the community: community therapy as strategy

    Martha Fuentes R


    Full Text Available Objective: to identify, by assessing the records of community therapy meetings, the everyday problems that affect communities in order to understand and map the pain and suffering expressed by the participants. Methodology: the records created by the therapists after each meeting were used for data collection. The following two topics were chosen for analysis purposes: the problems that were presented and the ones that were chosen. Likewise, analysis categories were identified based on the frequency with which they were mentioned by the participants. The records of 774 meetings were analyzed. Such meetings took place from August, 2006 to December, 2008. An average of 9 to 20 people attended each meeting. Results: openness, freedom, warmth, and respect were characteristics of these meetings. The most common problems were: domestic violence, sexual abuse, divorce, discrimination, feelings of guilt, abandonment, rage, fear, negligence, problems with children, partners, co-workers or neighbors, losing one’s job, one’s loved ones or one’s material possessions, drug addiction, alcoholism, smoking, etc. Conclusions: community therapy has led not only to identify the people who really are in need of treatment, but also contributed to reduce the demand for the municipality’s health services. Having people meet without judging them by what they say, feel or think makes it easier for them to cope with their suffering and fears. It also creates social support networks, develops better attitudes of solidarity, responsibility and affectiveness, empowers the people and the community, and makes it easier to find better ways of overcoming problems. At the same time, it makes it possible to learn how people live and cope with their daily problems, thus allowing them to reframe these problems, and enabling the development of more effective care.

  9. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam


    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  10. Community and school-based health education for dengue control in rural Cambodia: a process evaluation.

    Sokrin Khun

    Full Text Available Dengue fever continues to be a major public health problem in Cambodia, with significant impact on children. Health education is a major means for prevention and control of the National Dengue Control Program (NDCP, and is delivered to communities and in schools. Drawing on data collected in 2003-2004 as part of an ethnographic study conducted in eastern Cambodia, we explore the approaches used in health education and their effectiveness to control dengue. Community health education is provided through health centre outreach activities and campaigns of the NDCP, but is not systematically evaluated, is under-funded and delivered irregularly; school-based education is restricted in terms of time and lacks follow-up in terms of practical activities for prevention and control. As a result, adherence is partial. We suggest the need for sustained routine education for dengue prevention and control, and the need for approaches to ensure the translation of knowledge into practice.

  11. Monks' Health: Holistic Health Care Model by Community Participation

    Decha Buates


    Full Text Available Problem statement: Monks’ health tended to be a continuous increased problem. They were groups who had limitations to access health services due to their monastic disciplines and their most importance for Buddhist institution. Without urgent solution, their normal way of life would have been affected. Approach: This research aimed to study current conditions and to develop monks’ holistic health care models by community participation in central region of Thailand. The study was a qualitative research conducted in 9 temples; 3 temples in urban area, 3 in semi-urban area and 3 in rural area. Samples were 224 persons; consisted of monks, public health officers from Department of Religious Affairs, local administrative organizations and people; selected by purposive sampling method. Observation form, survey form, interview form, focus group discussion and workshop were used as research tools while data was analyzed by descriptive research. Results: The result founded that in former time culture of monks’ health care was leaned on community, social, culture and tradition. People spoke in style of central Thai language and were in agricultural sector as well as had their belief in merit, sin and elder respect. Relation in communities was in form of generosity and living as similar as relatives. When some monk got sick, they would visit, take care and give foods and medicines. Most of medicines were household remedy and Thai herbal medicine that bought from drug stores in local market or grocery stores in village and monks were sent to hospital in case of severe illness. Temple was a part of community, so they had close relation. Nowadays people increasingly worked in manufactories that caused conflicts and alienations among them. Monks leaned on local markets for receiving foods offering and most of foods were cooked from flour, sugar, coconut milk and fat. These caused three-fourth of monks having chronic disease as diabetes

  12. Psychosocial stressors and depression at a Swedish primary health care centre. A gender perspective study

    Strömberg Ranja


    Full Text Available Abstract Background Psychosocial stress may account for the higher prevalence of depression in women and in individuals with a low educational background. The aim of this study was to analyse the association between depression and socio-demographic data, psychosocial stressors and lifestyle circumstances from a gender perspective in a relatively affluent primary care setting. Methods Patients, aged 18- 75 years, visiting a drop-in clinic at a primary care health centre were screened with Beck's Depression Inventory (BDI. The physicians used also targeted screening with BDI. A questionnaire on socio-demographic data, psychosocial stressors and use of alcohol and tobacco was distributed. Among patients, who scored BDI ≥10, DSM-IV-criteria were used to diagnose depression. Of the 404 participants, 48 men and 76 women were diagnosed with depression. The reference group consisted of patients with BDI score Results The same three psychosocial stressors: feeling very stressed, perceived poor physical health and being dissatisfied with one's family situation were associated with depression equally in men and women. The negative predictive values of the main effect models in men and women were 90.7% and 76.5%, respectively. Being dissatisfied with one's work situation had high ORs in both men and women. Unemployment and smoking were associated with depression in men only. Conclusions Three questions, frequently asked by physicians, which involve patient's family and working situation as well as perceived stress and physical health, could be used as depression indicators in early detection of depression in men and women in primary health care.




    Full Text Available BACKGROUND Anaemia in pregnancy has serious adverse effects on the health of the mother and the developing foetus. OBJECTIVES The study aims to estimate the prevalence of anaemia in pregnant woman attending the Nagaon Primary Health Centre (PHC in Barpeta district, Assam. METHODS A cross-sectional study was carried out from 1 April, 2014 to 1 May, 2014. 100 pregnant women attending Nagaon PHC were interviewed using a predesigned and pretested interview schedule followed by a short clinical examination for pallor and laboratory estimation of haemoglobin. Sahli’s (Acid Haematin method was used for haemoglobin estimation. Haemoglobin level below the cut-off 11 g/dL was used to label a pregnant woman as anaemic and further classified as mild (10-10.9 g/dL, moderate anaemia (7-9.9 g/dL and severe anaemia (<7 g/dL. RESULTS 77% women were suffering from anaemia. Out of these, 57 %were mildly anaemic and 20% were moderately anaemic. Women of younger age groups, greater parity, a gap less than 3 years between subsequent pregnancies, less education and practising Hinduism had a greater prevalence of anaemia. CONCLUSION Awareness about the serious consequences that anaemia can lead to and advocacy of a proper iron-rich diet, regular intake of IFA tablets and purification of water to prevent infestation by parasites can help in reduction of anaemia.

  14. Flexible work in call centres: Working hours, work-life conflict & health.

    Bohle, Philip; Willaby, Harold; Quinlan, Michael; McNamara, Maria


    Call-centre workers encounter major psychosocial pressures, including high work intensity and undesirable working hours. Little is known, however, about whether these pressures vary with employment status and how they affect work-life conflict and health. Questionnaire data were collected from 179 telephone operators in Sydney, Australia, of whom 124 (69.3%) were female and 54 (30.2%) were male. Ninety-three (52%) were permanent full-time workers, 37 (20.7%) were permanent part-time, and 49 (27.4%) were casual employees. Hypothesised structural relationships between employment status, working hours and work organisation, work-life conflict and health were tested using partial least squares modelling in PLS (Chin, 1998). The final model demonstrated satisfactory fit. It supported important elements of the hypothesised structure, although four of the proposed paths failed to reach significance and the fit was enhanced by adding a path. The final model indicated that casual workers reported more variable working hours which were relatively weakly associated with greater dissatisfaction with hours. The interaction of schedule control and variability of hours also predicted dissatisfaction with hours. Conversely, permanent workers reported greater work intensity, which was associated with both lower work schedule control and greater work-life conflict. Greater work-life conflict was associated with more fatigue and psychological symptoms. Labour market factors and the undesirability of longer hours in a stressful, high-intensity work environment appear to have contributed to the results.

  15. Emissions during the BHP Billiton mozal aluminium smelter Fume Treatment Centre (FTC) rebuild – A human health perspective

    Wright, C


    Full Text Available some are probable human carcinogens. As a result MOZAL initiated a human health risk assessment (HHRA) study concerning this operation, in order to understand the potential health impacts on the surrounding communities, including Mahlampsene, Sikuama...

  16. Evaluating community-based participatory research to improve community-partnered science and community health.

    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


    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. 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. 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. 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. Study methodologies and lessons learned can help community-academic research partnerships translate research in communities.

  17. Beyond the biomedical: community resources for mental health care in rural Ethiopia.

    Medhin Selamu

    Full Text Available The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.We employed resource mapping within the Programme for Improving Mental Health Care (PRIME, to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs represented all the biomedical health services in the district. In addition the Health Development Army (HDA are community volunteers who support health promotion and prevention activities.The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be

  18. Beyond the biomedical: community resources for mental health care in rural Ethiopia.

    Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw


    The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support

  19. Long-term employment and health inequalities in Canadian communities.

    Safaei, Jalil


    This study examines the long-term unemployment rate and various health outcomes across Canadian communities to estimate employment-related health inequalities in these communities. The study uses cross-sectional community-level health data along with data on the long-term employment rate for various communities across Canada to quantify health inequalities among these communities. The health outcomes that are considered in this study include total and disease specific mortality rates; health conditions such as high blood pressure, diabetes, injuries, and self rated health; and life expectancies at birth and at age 65. Health inequalities are estimated using the concentration index, which is used to measure health inequalities along socioeconomic dimensions. The concentration index is estimated by a regression of weighted relative health (ill health) over weighted cumulative relative rank of the populations. All the estimates are provided separately for males and females. The findings of the study support the existence of inequalities in community health outcomes as related to the long-term employment rates in those communities. Communities with lower long term employment rates (higher unemployment rates) have poorer health outcomes in terms of higher mortality rates, worse health conditions, and shorter life expectancies. Health inequalities related to long-term employment have important policy implications. They call for policies that would increase and maintain long term employment rates as part of a broader socioeconomic approach to health. Long term employment ensures income security and prevents the psychosocial experiences leading to mental and physical ill health.

  20. A Worksite Health Education Workshop as Empowerment Intervention for Health Promotion in the National Research Centre of Egypt

    Nagat Mohamed Amer


    Full Text Available AIM: The study aimed to assess worksite health education workshops as a successful tool for health promotion of employees. MATERIAL AND METHODS: A one day workshop was held for individuals engaged in research activities in the National research Centre of Egypt at the worksite. Its main objective was to highlight the nature, causes, symptoms and management of job stress. Participants were asked to fill a personality assessment sheet, a self-reported questionnaire for job satisfaction. Other questionnaires for assessment of falsification of type and some socio-demographic data were filled by the attendants. A concise survey was introduced at the end of the workshop for feedback collection. RESULTS: Attendants of the workshop were 36 subjects mainly females (94.4%. Mean age was 40.5 years with 63.9% of participants at their postdoctoral studies stage. Participants were at midway in the scale of job satisfaction (3.3 and did not suffer from falsification (0.3. The feedback survey score (11.5 showed great acceptance for the intervention. Special interest in the topic of stress was reported by 35.1% of attendants who found it the best item in the workshop and the interactive manipulation came next as declared by 18.9% of the participants. CONCLUSION: Worksite health education workshops seem to be a successful practice for empowerment in the Egyptian workplace.

  1. Air pollution and health implications of regional electricity transfer at generational centre and design of compensation mechanism

    Relhan, Nemika

    India's electricity generation is primarily from coal. As a result of interconnection of grid and establishment of pithead power plants, there has been increased electricity transfer from one region to the other. This results in imbalance of pollution loads between the communities located in generation vis-a-vis consumption region. There may be some states, which are major power generation centres and hence are facing excessive environmental degradation. On the other hand, electricity importing regions are reaping the benefits without paying proper charges for it because present tariff structure does not include the full externalities in it. The present study investigates the distributional implications in terms of air pollution loads between the electricity generation and consumption regions at the state level. It identifies the major electricity importing and exporting states in India. Next, as a case study, it estimates the health damage as a result of air pollution from thermal power plants (TPPs) located in a critically polluted region that is one of the major generator and exporter of electricity. The methodology used to estimate the health damage is based on impact pathway approach. In this method, air pollution modelling has been performed in order to estimate the gridded Particulate Matter (PM) concentration at various receptor locations in the study domain. The air quality modeling exercise helps to quantify the air pollution concentration in each grid and also apportion the contribution of power plants to the total concentration. The health impacts as a result of PM have been estimated in terms of number of mortality and morbidity cases using Concentration Response Function (CRF's) available in the literature. Mortality has been converted into Years of Life Lost (YOLL) using life expectancy table and age wise death distribution. Morbidity has been estimated in terms of number of cases with respect to various health end points. To convert this health

  2. Psychology in the community: a community psychologist looks at 30 years in community mental health.

    Morgan, John R


    I review my 30 years in the community mental health field, emphasizing the personal and historical context that shaped this career. I especially highlight the origins of the values that guided significant career decisions, including family, neighborhood, religious and educational influences. The core guiding value was the belief that public service is both a privilege and an obligation, and that righting social injustice through such service is a noble calling. I trace the evolution of my thoughts and actions reflecting this value, from an early desire to "help children," through preparation to become a child psychologist, and ultimately to practice in a public community mental health setting and a career dedicated first to primary prevention and then to broader safety net services for those in need. I highlight a corresponding intellectual evolution as well, a progressive change in identity from "clinical psychologist in the community" to community psychologist.

  3. Community health worker in hard-to-reach rural areas of Myanmar: filling primary health care service gaps.

    Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway


    Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than

  4. Establishing health-promoting workplaces in Aboriginal community organisations: healthy eating policies.

    MacDonald, Catherine; Genat, Bill; Thorpe, Sharon; Browne, Jennifer


    Aboriginal community controlled health organisations (ACCHOs) and cooperatives function at the centre of community life for local Aboriginal people across Victoria. Local Aboriginal people govern them, work within them as managers and service providers, access health and community services from them and form the constituents who determine their directions. Victorian ACCHOs reflect the unique characteristics of the local Aboriginal community. Thus, potentially, Victorian ACCHOs are key strategic sites for health promotion activities that seek to establish and nurture healthy community, family and peer norms. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) partnered five metropolitan, regional and rural ACCHOs in a pilot project towards the establishment of healthy food policies and practices in their organisations. Project activities combined both 'top-down' policy-oriented and 'bottom-up' practice-oriented strategies. This paper, drawing upon both baseline and follow-up quantitative and qualitative data, describes initiatives leading to increases in healthy catering choices and related challenges for Aboriginal workplace health promotion practice.

  5. Transforming nursing home-based day care for people with dementia into socially integrated community day care: process analysis of the transition of six day care centres.

    van Haeften-van Dijk, A M; Meiland, F J M; van Mierlo, L D; Dröes, R M


    The community-based Meeting Centres Support Programme for people with dementia and their carers has been proven more effective in influencing behaviour and mood problems of people with dementia and improving sense of competence of carers compared to nursing home-based day care centres for people with dementia. Six Dutch nursing home-based day care centres were transformed into Community-based day care centres with carer support, according to this Meeting Centres model. To determine which factors facilitate or impede the transition to Community-based day care. A process evaluation was conducted with a qualitative study design. Six nursing home-based day care centres transformed into Community-based day care centres for people with dementia and their carers. Stakeholders (n=40) that were involved during the transition. Factors that facilitated or impeded the transition were traced by means of (audiotaped and transcribed) interviews with stakeholders and document analysis. All data were coded by two independent researchers and analyzed using thematic analysis based on the Theoretical framework of adaptive implementation. Six nursing home-based day care centres successfully made the transition to Community-based day care with carer support. Success factors for the start of the project were: the innovation being in line with the current trend towards more outpatient care and having motivated pioneers responsible for the execution of the transition. Barriers were difficulties reaching/recruiting the target group (people with dementia and carers), inflexible staff and little or no experience with collaboration with community-based care and welfare organizations. Facilitating factors during the implementation phase were: finding a suitable location in the community, positive changes in staff attitude and adoption of the new vision, and good cooperation with care and welfare organizations. Barriers were insufficient involvement of, and support from the managers of the

  6. The ethics of allocation of scarce health care resources: a view from the centre.

    Calman, K C


    Resource allocation is a central part of the decision-making process in any health care system. Resources have always been finite, thus the ethical issues raised are not new. The debate is now more open, and there is greater public awareness of the issues. It is increasingly recognised that it is the technology which determines resources. The ethical issues involved are often conflicting and relate to issues of individual rights and community benefits. One central feature of resource allocation is the basing of decisions on the outcomes of health care and on their subsequent economic evaluation. The knowledge base is therefore of great importance as is the audit of results of clinical treatment. Public involvement is seen as an integral part of this process. For all parts of the process, better methodologies are required.

  7. Community matters - why outbreak responses need to integrate health promotion.

    Kickbusch, Ilona; Reddy, K Srikanth


    Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working 'with' rather than 'on' communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

  8. A designated centre for people with disabilities operated by Kingsriver Community Holdings Ltd, Kilkenny

    Sanders, A E


    The extent to which welfare states may influence health outcomes has not been explored. It was hypothesised that policies which target the poor are associated with greater income inequality in oral health quality of life than those that provide earnings-related benefits to all citizens.

  9. Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia.

    Gausia, Kaniz; Thompson, Sandra C; Nagel, Tricia; Schierhout, Gill; Matthews, Veronica; Bailie, Ross


    This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre. The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. University-Rural Community Partnership for People-Centred Development: Experiences from Makhado Municipality, Limpopo Province

    Francis, J.; Dube, B.; Mokganyetji, T.; Chitapa, T.


    Children, youth, women, the elderly, men and their leaders are integral components of rural communities. It is important to ensure that their unique needs and perceptions shape development programming. However, despite having various policies and legal frameworks introduced to deepen democracy in South Africa, current rural development programming…

  11. A designated centre for people with disabilities operated by St John of God Community Services Limited, Kildare

    Bennett, Annemarie E


    Adults with an intellectual disability have poorer diets than the general adult population. The Able 2 Cook 4 Health cookery course aims to improve the diets of adults with mild to moderate intellectual disability. This study aims to evaluate the course by obtaining the views of course participants and the views of managers hosting the course. Thirty course participants took part in focus groups. Five managers hosting the course participated in a semi-structured interview. Positive features of the course included the group cooking, social interaction and course instructors. Collaboration between centres hosting the course and participants\\' home environment is needed to help transfer the skills learned to all home settings. The Able 2 Cook 4 Health cookery course provided participants with an important social outlet to learn essential occupational skills. These findings could particularly influence the diets of adults with an intellectual disability moving into independent living.

  12. A study of female genital swabs in primary health care centres in Jos, Nigeria

    Samuel Nwadioha


    Full Text Available Objective: To detect some common microbial agents of female genital discharges in order to improve the current syndromic management of abnormal vaginal discharge. Methods: A prospective study of female genital swabs collected from Primary Health Care Centres, Jos, and analysed for microscopy, culture and sensitivity in Jos University Teaching Hospital, December 2006 to December 2007 was carried out. Results: Microbial agents were detected in 70% (700 of a total 1 000 female genital swabs studied. Candida species peaked with 42.0% (420 out of the 1000 samples, followed by Gardnerella vaginalis, an agent of bacterial vaginosis with 26.0%. The distribution of abnormal vaginal discharge was highest in young adults aged 21 to 30 years. Conclusions: It is concluded that abnormal vaginal discharge is most prevalent in the young sexually active age group with Candida species as the commonest agent. We recommend prevention, early diagnosis and prompt treatment of infective female genital discharge in order to reduce the menace of HIV transmission.

  13. Alcohol and drug use in students attending a student health centre.

    Cahill, E


    Alcohol and drug use amongst 3rd level students in Ireland is a concern and has been reported previously in the CLAN Survey. The aim of our study was to determine the alcohol and drug use and any alcohol associated adverse consequences amongst students attending the health centre of University College Cork (UCC). 178 (98.3%) of the 181 students who replied reported having ever drunk alcohol. 157 (91.3%) students drank spirits in the past year v 148 (86.5%) who drank beer\\/cider v 135 (78.5%) who drank wine. 81 (44.8%) students reported binge drinking at least once weekly. 48 (26.5%) students used cannabis in the past year v 12 (6.9%) who used cocaine and 7 (4%) who used ecstasy. All students who drink reported at least one adverse consequence. 114 (63%) of students report adverse consequences of other peoples drinking. The changing drinking behaviour of female students is of particular concern.

  14. How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

    Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J


    In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new

  15. Trust the process: community health psychology after Occupy.

    Cornish, Flora; Montenegro, Cristian; van Reisen, Kirsten; Zaka, Flavia; Sevitt, James


    This article argues that community health psychology's core strategy of 'community mobilisation' is in need of renewal and proposes a new way of conceptualising community health action. Taking the Occupy movement as an example, we critique modernist understandings of community mobilisation, which are based on instrumental action in the service of a predetermined goal. Aiming to re-invigorate the 'process' tradition of community health psychology, we explore possibilities of an open-ended, anti-hierarchical and inclusive mode of community action, which we label 'trusting the process'. The gains to be made are unpredictable, but we suggest that the risk is worth taking.

  16. Health Information Technology Adoption in California Community Health Centers

    Kim, Katherine K.; Rudin, Robert S.; Wilson, Machelle D.


    Objectives National and state initiatives to spur adoption of electronic health record (EHR) use and health information exchange (HIE) among providers in rural and underserved communities have been in place for 15 years. Our goal was to systematically assess the impact of these initiatives by quantifying the level of adoption and key factors associated with adoption among community health centers (CHCs) in California. Study Design Cross-sectional statewide survey. Methods We conducted a telephone survey of all California primary care CHCs from August to September 2013. Multiple logistic regressions were fit to test for associations between various practice characteristics and adoption of EHRs, Meaningful Use (MU)–certified EHRs, and HIE. For the multivariable model, we included those variables which were significant at the P = .10 level in the univariate tests. Results We received responses from 194 CHCs (73.5% response rate). Adoption of any EHRs (80.3%) and MU–certified EHRs (94.6% of those with an EHR) was very high. Adoption of HIE is substantial (48.7%) and took place within a few years (mean = 2.61 years; SD = 2.01). More than half (54.7%) of CHCs are able to receive data into the EHR, indicating some level of interoperability. Patient engagement capacity is moderate, with 21.6% offering a personal health record, and 55.2% electronic visit summaries. Rural location and belonging to a multi-site clinic organization both increase the odds of adoption of EHRs, HIE, and electronic visit summary, with odds ratios ranging from 0.63 to 3.28 (all P values <.05). Conclusions Greater adoption of health information technology (IT) in rural areas may be the result of both federal and state investments. As CHCs lack access to capital for investments, continued support of technology infrastructure may be needed for them to further leverage health IT to improve healthcare. PMID:26760431

  17. Using an academic-community partnership model and blended learning to advance community health nursing pedagogy.

    Ezeonwu, Mabel; Berkowitz, Bobbie; Vlasses, Frances R


    This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery.

  18. Health status of internationally adopted children. The experience of an Italian “GLNBI” paediatric centre

    Piero Valentini


    Full Text Available

    Background: according to ISTAT (National Institute of Statistics-Italy, in 2011 20.7% of the foreign population in Italy is composed by children, either coming along with their families or alone, like in international adoptions. Immigrant children have some peculiarities related to their previous living conditions, although there are no significant differences between immigrant and native children’ diseases.

    Methods: in 3.5 years we evaluated every adoptee that reached our university centre, by using GLNBI (Gruppo di Lavoro Nazionale del Bambino Immigrato diagnostic – aiding protocol, in order to assess infectious diseases, nutritional deficiencies, immunization status, intestinal parasitosis or other pathologies; this protocol is actually applied only in research centres.

    Results: we evaluated 358 international adoptees from 4 different Zones of the world; average age at first visit was approximately 5 years. Health certifications concerning vaccination history records were considered “valid” in 59.2% (212/358, 49.5% (105/212 of which had a complete panel of immunization. QuantiFERON®_TB Gold In-Tube (QTF test resulted negative in 94.0% cases (313/333 and positive in 6.0% (20/333. HIV, HCV and Syphilis tests resulted in 0.3% positive test for each serology (1/358. Cysticercosis’ serology was positive in 8.9% (32/358 using immunoenzymatic assay (not confirmed by immunoblotting and Toxocariasis in 13.1% (47/358. Parasitological investigation of faeces were found positive on 42.7% (153/358 children, throat swabs in 11.5% (41/358 children. There were 82.4% (295/358 abnormal blood count, 41.9% (150/358 low ferritin, 89.9% (322/358 endocrine abnormalities and 20.4% (73/358 various pathologies evaluated by specialists.

    Conclusions: pathologies affecting our study group are the same affecting other categories of immigrant children, because they often

  19. Exploring the community nurse role in family-centred care for patients with dementia.

    Dening, Karen Harrison; Hibberd, Penny


    A diagnosis of dementia can have a significant effect, not only on the person diagnosed, but also on the person's family. Drivers within national policy and strategy to raise awareness and promote education have improved the understanding of dementia across professional groups, as well as within the wider population. However, families living with dementia still struggle to find information and support. This paper explores the common issues faced by families, and focuses on a relationship approach to care. The role of the community nurse can be central to supporting people with dementia and their families to live well in their own communities. The paper uses a case-study approach to discuss three scenarios commonly raised by family carers and people with dementia: (1) seeking help and support at point of seeking diagnosis, (2) knowing the 'right time' to seek help and advice, and (3) when symptomatic changes affect wellbeing and relationships.

  20. A designated centre for people with disabilities operated by Camphill Communities of Ireland, Monaghan

    McHugh, Seamus M


    AIMS: We will examine the latest advances in genomic and proteomic laboratory technology. Through an extensive literature review we aim to critically appraise those studies which have utilized these latest technologies and ascertain their potential to identify clinically useful biomarkers. METHODS: An extensive review of the literature was carried out in both online medical journals and through the Royal College of Surgeons in Ireland library. RESULTS: Laboratory technology has advanced in the fields of genomics and oncoproteomics. Gene expression profiling with DNA microarray technology has allowed us to begin genetic profiling of colorectal cancer tissue. The response to chemotherapy can differ amongst individual tumors. For the first time researchers have begun to isolate and identify the genes responsible. New laboratory techniques allow us to isolate proteins preferentially expressed in colorectal cancer tissue. This could potentially lead to identification of a clinically useful protein biomarker in colorectal cancer screening and treatment. CONCLUSION: If a set of discriminating genes could be used for characterization and prediction of chemotherapeutic response, an individualized tailored therapeutic regime could become the standard of care for those undergoing systemic treatment for colorectal cancer. New laboratory techniques of protein identification may eventually allow identification of a clinically useful biomarker that could be used for screening and treatment. At present however, both expression of different gene signatures and isolation of various protein peaks has been limited by study size. Independent multi-centre correlation of results with larger sample sizes is needed to allow translation into clinical practice.

  1. Developing Interactive Video Resource Materials for Community Dental Health.

    Bartoli, Claire; And Others


    Describes the creation of a series of interactive video modules on dental hygiene at Luzerne County Community College. These modules are intended to supplement instruction in a community dentistry and health education course and to guide students in an assignment to develop and implement dental health projects in their community. (MBR)

  2. Developing community in care homes through a relationship-centred approach.

    Brown Wilson, Christine


    Within the literature, the formation of therapeutic relationships between professionals, older people and others significant to them in their lives has been considered as central to current care philosophies. Furthermore, relationships between staff, residents and their families have emerged within the literature as fundamental to the experiences of life within the community of a care home. This paper reports part of a wider study that explored relationships between residents, families and staff. The aim of this paper is to contribute to an understanding of the factors that may be significant in the formation of relationships in care homes, and how this may support the development of community. Three case studies of care homes were undertaken using a constructivist approach. Constructivist methodology seeks to share multiple perceptions between participants with the aim of creating a joint construction. This process supported the development of shared meanings as views and ideas were shared between participants using interviews, participant observation and focus groups. The key factors influencing relationships that emerged were leadership, continuity of staff, personal philosophy of staff and contribution of residents and families. This paper suggests that considering how the style of leadership influences the organisation of care may be a useful starting point in developing community within care homes.

  3. Community health workers adherence to referral guidelines

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy


    Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs) and trea......Background Many malaria-endemic countries have implemented national community health worker (CHW) programmes to serve remote populations that have poor access to malaria diagnosis and treatment. Despite mounting evidence of CHWs’ ability to adhere to malaria rapid diagnostic tests (RDTs......) and treatment guidelines, there is limited evidence whether CHWs adhere to the referral guidelines and refer severely ill children for further management. In southwest Uganda, this study examined whether CHWs referred children according to training guidelines and described factors associated with adherence...... to the referral guideline. Methods A secondary analysis was undertaken of data collected during two cluster-randomized trials conducted between January 2010 and July 2011, one in a moderate-to-high malaria transmission setting and the other in a low malaria transmission setting. All CHWs were trained to prescribe...

  4. Developing sustainable models of rural health care: a community development approach.

    Allan, J; Ball, P; Alston, M


    Globally, small rural communities frequently are demographically similar to their neighbours and are consistently found to have a number of problems linked to the international phenomenon of rural decline and urban drift. For example, it is widely noted that rural populations have poor health status and aging populations. In Australia, multiple state and national policies and programs have been instigated to redress this situation. Yet few rural residents would agree that their town is the same as an apparently similar sized one nearby or across the country. This article reports a project that investigated the way government policies, health and community services, population characteristics and local peculiarities combined for residents in two small rural towns in New South Wales. Interviews and focus groups with policy makers, health and community service workers and community members identified the felt, expressed, normative and comparative needs of residents in the case-study towns. Key findings include substantial variation in service provision between towns because of historical funding allocations, workforce composition, natural disasters and distance from the nearest regional centre. Health and community services were more likely to be provided because of available funding, rather than identified community needs. While some services, such as mental illness intervention and GPs, are clearly in demand in rural areas, in these examples, more health services were not needed. Rather, flexibility in the services provided and work practices, role diversity for health and community workers and community profiling would be more effective to target services. The impact of industry, employment and recreation on health status cannot be ignored in local development.

  5. At the heart of an early psychosis centre: the core components of the 2014 Early Psychosis Prevention and Intervention Centre model for Australian communities.

    Hughes, Frank; Stavely, Heather; Simpson, Raelene; Goldstone, Sherilyn; Pennell, Kerryn; McGorry, Patrick


    To describe the core components of the Early Psychosis Prevention and Intervention Centre service model as the template agreed with the Australian Federal Government for national upscaling. The Early Psychosis Prevention and Intervention Centre model of early intervention has two main goals: to reduce the period of time between the onset of psychosis and the commencement of treatment and to bring about symptomatic recovery and restore the normal developmental trajectory as early as possible. The Early Psychosis Prevention and Intervention Centre comprises three elements of service provision for young people experiencing a first episode of psychosis: (i) early detection; (ii) acute care during and immediately following a crisis; (iii) recovery-focused continuing care, featuring multimodal interventions to enable the young person to maintain or regain their social, academic and/or career trajectory during the critical first 2-5 years following the onset of a psychotic illness. It does this via a combination of 16 core components, which provide a flexible, comprehensive, integrated service that is able to respond quickly, appropriately and consistently to the individual needs of the young person and their family. Innovative service reforms, such as Early Psychosis Prevention and Intervention Centre, that recognise the value of early intervention are crucial to reducing the impact of serious mental illness on young people and their families and, ultimately, on our society. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  6. The Los Angeles County Community Disaster Resilience Project - a community-level, public health initiative to build community disaster resilience.

    Eisenman, David; Chandra, Anita; Fogleman, Stella; Magana, Aizita; Hendricks, Astrid; Wells, Ken; Williams, Malcolm; Tang, Jennifer; Plough, Alonzo


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

  7. Factors associated with job satisfaction among Chinese community health workers: a cross-sectional study

    Ge Cuixia


    Full Text Available Abstract Background With the medical reform, the function of community health centres emerged to be more important recently in China. However, the health service capabilities were tremendously different between metropolitan cities and small cities. This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan (Shenyang and a small city (Benxi in Liaoning province and explore its associated factors. Methods A cross-sectional survey was conducted from December 2009 to February 2010. A multi-stage sample was used and a total of 2,100 Chinese community health workers from the two cities completed self-administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire (MSQ, demographic characteristic and working situations, stress and job burnout. The effective response rate was 80.7%. Hierarchical regression analysis was performed to explore the related factors. All data analyses for the two cities were performed separately. Results The averages of overall job satisfaction score of Chinese community health workers were 67.17 in Shenyang and 69.95 in Benxi. Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi (p Conclusion From this study, the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions, which represented they are not fully satisfied with their jobs. Community health workers in Shenyang had lower job satisfaction as compared to those in Benxi. This study strengthened the evidence that stress and burnout were important predictors of intrinsic and extrinsic job satisfactions.

  8. Factors associated with job satisfaction among Chinese community health workers: a cross-sectional study


    Background With the medical reform, the function of community health centres emerged to be more important recently in China. However, the health service capabilities were tremendously different between metropolitan cities and small cities. This study aims to clarify the level of job satisfaction of Chinese community health workers between a metropolitan (Shenyang) and a small city (Benxi) in Liaoning province and explore its associated factors. Methods A cross-sectional survey was conducted from December 2009 to February 2010. A multi-stage sample was used and a total of 2,100 Chinese community health workers from the two cities completed self-administered questionnaire pertaining to job satisfaction indicated by Minnesota Satisfaction Questionnaire (MSQ), demographic characteristic and working situations, stress and job burnout. The effective response rate was 80.7%. Hierarchical regression analysis was performed to explore the related factors. All data analyses for the two cities were performed separately. Results The averages of overall job satisfaction score of Chinese community health workers were 67.17 in Shenyang and 69.95 in Benxi. Intrinsic job satisfaction and extrinsic job satisfaction among Chinese community health workers were significantly different between Shenyang and Benxi (p job satisfactions, respectively. In Benxi, the fourth model explained 48%, 52% of the variance of intrinsic and extrinsic job satisfactions, respectively. Three significant predictors of intrinsic and extrinsic job satisfactions for the two cities were the two dimensions (social support and decision latitude) of stress and cynicism of burnout. Conclusion From this study, the job satisfaction among Chinese community health workers in the two cities enjoyed a moderate level of job satisfactions, which represented they are not fully satisfied with their jobs. Community health workers in Shenyang had lower job satisfaction as compared to those in Benxi. This study strengthened the

  9. Aligning community engagement with traditional authority structures in global health research: a case study from northern Ghana.

    Tindana, Paulina O; Rozmovits, Linda; Boulanger, Renaud F; Bandewar, Sunita V S; Aborigo, Raymond A; Hodgson, Abraham V O; Kolopack, Pamela; Lavery, James V


    Despite the recognition of its importance, guidance on community engagement practices for researchers remains underdeveloped, and there is little empirical evidence of what makes community engagement effective in biomedical research. We chose to study the Navrongo Health Research Centre in northern Ghana because of its well-established community engagement practices and because of the opportunity it afforded to examine community engagement in a traditional African setting. Our findings suggest that specific preexisting features of the community have greatly facilitated community engagement and that using traditional community engagement mechanisms limits the social disruption associated with research conducted by outsiders. Finally, even in seemingly ideal, small, and homogeneous communities, cultural issues exist, such as gender inequities, that may not be effectively addressed by traditional practices alone.

  10. UK community health visiting: challenges faced during lean implementation

    Carr SM


    Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

  11. A model for extending antiretroviral care beyond the rural health centre

    Wools-Kaloustian Kara K


    Full Text Available Abstract Background A major obstacle facing many lower-income countries in establishing and maintaining HIV treatment programmes is the scarcity of trained health care providers. To address this shortage, the World Health Organization has recommend task shifting to HIV-infected peers. Methods We designed a model of HIV care that utilizes HIV-infected patients, community care coordinators (CCCs, to care for their clinically stable peers with the assistance of preprogrammed personal digital assistants (PDAs. Rather than presenting for the standard of care, monthly clinic visits, in this model, patients were seen every three months in clinics and monthly by their CCCs in the community during the interim two months. This study was conducted in Kosirai Division, western Kenya, where eight of the 24 sub-locations (defined geographic areas within the division were randomly assigned to the intervention with the remainder used as controls. Prior to entering the field, CCCs underwent intensive didactic training and mentoring related to the assessment and support of HIV patients, as well as the use of PDAs. PDAs were programmed with specific questions and to issue alerts if responses fell outside of pre-established parameters. CCCs were regularly evaluated in six performance areas. An impressionistic analysis on the transcripts from the monthly group meetings that formed the basis of the continuous feedback and quality improvement programme was used to assess this model. Results All eight of the assigned CCCs successfully passed their training and mentoring, entered the field and remained active for the two years of the study. On evaluation of the CCCs, 89% of their summary scores were documented as superior during Year 1 and 94% as superior during Year 2. Six themes emerged from the impressionistic analysis in Year 1: confidentiality and "community" disclosure; roles and responsibilities; logistics; clinical care partnership; antiretroviral adherence; and

  12. EQ-5D Health Utility Scores: Data from a Comprehensive Canadian Cancer Centre.

    Naik, Hiten; Howell, Doris; Su, Susie; Qiu, Xin; Brown, M Catherine; Vennettilli, Ashlee; Irwin, Margaret; Pat, Vivien; Solomon, Hannah; Wang, Tian; Hon, Henrique; Eng, Lawson; Mahler, Mary; Thai, Henry; Ho, Valerie; Xu, Wei; Seung, Soo Jin; Mittmann, Nicole; Liu, Geoffrey


    To improve the precision of health economics analyses in oncology, reference datasets of health utility (HU) scores are needed from cancer survivors across different disease sites. These data are particularly sparse amongst Canadian survivors. A survey was completed by 1759 ambulatory cancer survivors at the Princess Margaret Cancer Centre which contained demographic questions and the EuroQol-5D (EQ-5D) instrument. Clinical information was abstracted from electronic records and HU scores were calculated using Canadian health state valuations. Construct validity was assessed through correlation of HU and visual analog scale (VAS) scores (Spearman) and by comparing HU scores between performance status groups (effect size). The influence of socio-demographic clinical variables on HU was analyzed by non-parametric between-group comparisons and multiple linear regression. Mean EQ-5D HU scores were derived for 26 cancers. Among all survivors, the mean ± standard error of the mean EQ-5D utility score was 0.81 ± 0.004. Scores varied significantly by performance status (p < 0.0001) and correlated with VAS (Spearman r = 0.61). The cancer sites with the lowest mean HU scores were acute lymphoblastic leukemia (0.70 ± 0.03) and pancreatic cancer (0.76 ± 0.03); testicular cancer (0.89 ± 0.02) and chronic lymphocytic leukemia (0.90 ± 0.05) had the highest mean scores. A multiple regression model showed that scores were influenced by disease site (p < 0.001), education level (p < 0.001), partner status (p < 0.001), disease extent (p = 0.0029), and type of most recent treatment (p = 0.0061). This work represents the first set of HU scores for numerous cancer sites derived using Canadian preference weights. The dataset demonstrated construct validity and HU scores varied by general socio-demographic and clinical parameters.

  13. Richness, composition and trophic groups of an avian community in the Pernambuco Endemism Centre, Alagoas, Brazil.

    Toledo-Lima, Guilherme S; Macario, Phoeve; Lyra-Neves, Rachel M de; Teixeira, Bruno P; Lima, Luiz A F de; Sugliano, Gabriel O S; Telino-Júnior, Wallace R


    In northeastern Brazil, the reduction of the natural forest cover to a series of small, isolated fragments has had negative consequences for the local avian fauna, in particular, a loss of the more specialized species, while the populations of some generalists have tended to increase. The present study focuses on the composition and trophic groups of a bird community on a farm in the northeastern Brazilian state of Alagoas. Monthly surveys were conducted between November 2008 and October 2009, based on mist-netting and systematic observations. Overall, 112 species were recorded, of which 76 were associated with the two forest fragments surveyed, while all the others were observed exclusively in the surrounding matrix of pasture and orchards. The bird community presented a predominance of insectivorous species, followed by omnivores. However, specialized trunk-creeping and understory insectivores accounted for only around 15% of the species in this feeding category. The reduced diversity of other guilds and species with more specialized diets, and the complete absence of sensitive species such as large parrots and raptors, reflects the severe fragmentation and degradation of the local forests, which has greatly reduced the availability of dietary resources and breeding sites.

  14. Richness, composition and trophic groups of an avian community in the Pernambuco Endemism Centre, Alagoas, Brazil



    Full Text Available In northeastern Brazil, the reduction of the natural forest cover to a series of small, isolated fragments has had negative consequences for the local avian fauna, in particular, a loss of the more specialized species, while the populations of some generalists have tended to increase. The present study focuses on the composition and trophic groups of a bird community on a farm in the northeastern Brazilian state of Alagoas. Monthly surveys were conducted between November 2008 and October 2009, based on mist-netting and systematic observations. Overall, 112 species were recorded, of which 76 were associated with the two forest fragments surveyed, while all the others were observed exclusively in the surrounding matrix of pasture and orchards. The bird community presented a predominance of insectivorous species, followed by omnivores. However, specialized trunk-creeping and understory insectivores accounted for only around 15% of the species in this feeding category. The reduced diversity of other guilds and species with more specialized diets, and the complete absence of sensitive species such as large parrots and raptors, reflects the severe fragmentation and degradation of the local forests, which has greatly reduced the availability of dietary resources and breeding sites.

  15. Testing initiatives increase rates of HIV diagnosis in primary care and community settings: an observational single-centre cohort study.

    Prini Mahendran

    Full Text Available The primary objective was to examine trends in new HIV diagnoses in a UK area of high HIV prevalence between 2000 and 2012 with respect to site of diagnosis and stage of HIV infection.Single-centre observational cohort study.An outpatient HIV department in a secondary care UK hospital.1359 HIV-infected adults.Demographic information (age, gender, ethnicity, and sexual orientation, site of initial HIV diagnosis (Routine settings such as HIV/GUM clinics versus Non-Routine settings such as primary care and community venues, stage of HIV infection, CD4 count and seroconversion symptoms were collated for each participant.There was a significant increase in the proportion of new HIV diagnoses made in Non-Routine settings (from 27.0% in 2000 to 58.8% in 2012; p<0.001. Overall there was a decrease in the rate of late diagnosis from 50.7% to 32.9% (p=0.001. Diagnosis of recent infection increased from 23.0% to 47.1% (p=0.001. Of those with recent infection, significantly more patients were likely to report symptoms consistent with a seroconversion illness over the 13 years (17.6% to 65.0%; p<0.001.This is the first study, we believe, to demonstrate significant improvements in HIV diagnosis and a shift in diagnosis of HIV from HIV/GUM settings to primary practice and community settings due to multiple initiatives.

  16. Working with women to improve child and community eye health

    Gopa Kothari


    Full Text Available In the slums and rural areas of India, visual impairment, blindness, and childhood blindness are usually more prevalent.In order to improve the eye health of children and the community in these areas, it is important to understand the influence women and mothers have over children’s eye health and the eye health of the community as a whole.

  17. Making Things Happen: Community Health Nursing and the Policy Arena.

    Williams, Carolyn A.


    It is important that nurses, particularly those who consider themselves community health nursing specialists, assign a high priority to participation in the formation of health policy and broader public policy. To put subsequent remarks about policy into perspective, it is useful to consider the case for seeing community health nursing as…

  18. Determinants of patient enablement at primary health care centres in central Ethiopia: a cross-sectional study

    Woldie, Mirkuzie K.; Assefa, Tsion; Morankar, Sudhakar


    Abstract Background Patient enablement is associated with behaviours like treatment adherence and self-care and is becoming a well-accepted indicator of quality of care. However, the concept of patient enablement has never been subjected to scientific inquiry in Ethiopia. Objectives The aim of this study was to determine the degree of patient enablement and its predictors after consultation at primary health care centres in central Ethiopia. Method Data were collected from 768 outpatients from six primary health care centres in central Ethiopia during a cross-sectional study designed to assess patient satisfaction. Consecutive patients, 15 years or older, were selected for the study from each health centre. Multinomial logistic regression was performed to identify predictors of patient enablement using SPSS (version 16.0). Results The study showed that 48.4% of patients expressed an intermediate level of enablement, while 25.4% and 26.2% of the patients expressed low and high levels of patient enablement, respectively. Four models were developed to identify predictors of patient enablement. The first model included socio-demographic variables, showing that residence, educational status and occupational status were significantly associated with patient enablement (p non-verbal communication, familiarity with the provider, information sharing about illness and arrangement for follow-up visits were strong predictors of patient enablement (p < 0.05). Conclusion The present study revealed specific predictors of patient enablement, which health care providers should consider in their practice to enhance patient enablement after consultation.

  19. The factors which have an impact on patients when they are choosing health care centres in Poland

    A.M. Krukowska-Miler


    Full Text Available The aim of the article. The aim of this article is the presentation of factors, which have an impact on patients when they are choosing services in health care sector. The results of the analysis. In the article, factors, which have an impact on patients when they are choosing services in health care sector, are presented. The kinds of needs and the characteristic features of medical services, which influence directly on patients are shown in the paper. Presented research of appropriate group of health care centre respondents has shown that the main emphasis they put on the time of waiting for an appointment, doctors’ competences and the staff’s attitude towards patients. Good transport connections and the equipment of health centres are less important. This permits the management to improve the patient services by staff training, which makes the quality of services better, kind and full of empathy treating them. Also it is approved that it would be good if the practice in the health centre became the observation of patients’ and staff’s behaviour which could enable to distinguish appearing needs and possibilities of their fulfilling. The expectations of medical services purchasers are determined. It can be their earlier experience, friends’ opinions and heard information. It is proved that creating of too low level of expectations can make difficulties in encouraging large group of people to buy an offer. Too high level of expectations can make customers dissatisfied. At the same time when companies are concentrated on a customer, their goal of actions and basic success meter is purchaser’s satisfaction, but there should be the balance between the satisfaction level and company profitability. The research highlights also the aspect which is the most visible in the Polish health care system (it is common not only in Poland but in some European countries as well – the time of waiting for the appointments, mainly with specialists. It


    Nitin Y. Dhupdale


    Full Text Available The Global Diabetes Report 2016 states, “Globally, an estimated 422 million adults were living with diabetes in 2014 compared to 108 million in 1980. Diabetes is especially a significant secondary cause for the development of dyslipidaemia. Diabetes patients are prone to have an atherogenic mixture of high Triglycerides (TGs; high, small, dense Low-Density Lipoprotein (LDL fractions; and low High-Density Lipoprotein (HDL. This study is aimed at finding the prevalence of dyslipidaemia among type 2 diabetes patients residing in a suburban area of Goa. METHODOLOGY A record-based cross-sectional study design was employed to find the proportion of dyslipidaemia prevalent among the type 2 diabetes patients attending OPD of the Urban Health and Training Centre (UHTC at Santa Cruz in Goa. A sample of 100 type 2 DM patient records were randomly selected to capture the information of the type 2 DM patients. Patient records of fasting and postprandial blood sugars and fasting lipid parameters were utilised for this study. SPSS version 23 was utilised for statistical analysis; proportions, and chi-square test were used for analysis. RESULTS The overall prevalence of dyslipidaemia was 85% among the type 2 DM cases. Prevalence of hyperlipidaemia among females was high (88.7% as compared to males (78.9%. The mean level of total cholesterol was 188.78±38.25 mg/dL. Mean HDL-C level was 48.5±14.06 mg/dL. Mean value of LDL-C was 109.93±35.67 mg/dL. Mean level of LDL-C was 137.67±59.77 mg/dL. CONCLUSION The type 2 diabetes patients have very high prevalence of dyslipidaemia and should be monitored on regular basis to prevent cardiovascular events.

  1. Mentoring perception and academic performance: an Academic Health Science Centre survey.

    Athanasiou, Thanos; Patel, Vanash; Garas, George; Ashrafian, Hutan; Shetty, Kunal; Sevdalis, Nick; Panzarasa, Pietro; Darzi, Ara; Paroutis, Sotirios


    To determine the association between professors' self-perception of mentoring skills and their academic performance. Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills Self-Assessment Survey. Statement scores were aggregated to provide a score for each shared core, mentor-specific and mentee-specific skill. Univariate and multivariate regression analyses were used to evaluate their relationship with quantitative measures of academic performance (publications, citations and h-index). There were 104 professors that responded (response rate 48%). There were no statistically significant negative correlations between any mentoring statement and any performance measure. In contrast, several mentoring survey items were positively correlated with academic performance. The total survey score for frequency of application of mentoring skills had a statistically significant positive association with number of publications (B=0.012, SE=0.004, p=0.006), as did the frequency of acquiring mentors with number of citations (B=1.572, SE=0.702, p=0.030). Building trust and managing risks had a statistically significant positive association with h-index (B=0.941, SE=0.460, p=0.047 and B=0.613, SE=0.287, p=0.038, respectively). This study supports the view that mentoring is associated with high academic performance. Importantly, it suggests that frequent use of mentoring skills and quality of mentoring have positive effects on academic performance. Formal mentoring programmes should be considered a fundamental part of all AHSCs' configuration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  2. [Historical changes in community concepts and the effect of such on community health nursing praxis].

    Yeh, Lily; Chen, Yi-Hsing


    In the 21st century, many healthcare programs are delivered in community settings. As such, successfully recruiting target members of the community to participate in programs represents a key challenge for the nursing profession. Although the "community" is not a new concept, its meaning has changed over the past century or more of public healthcare, which has had a profound effect on community health nursing praxis. This article describes changes in community concepts through history in order to define the significance of community participation in today's community health nursing practice.

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

    Zotti, Marianne E.; And Others


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

  4. The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing.

    Conger, Cynthia O'Neill; Baldwin, Joan H.; Abegglen, JoAnn; Callister, Lynn C.


    Brigham Young University's nursing curriculum was revised to reflect the community-driven nature of primary health care. Curricular threads of inquiry, practice, stewardship, spirituality, and service are the framework for integrating community health nursing practice. (SK)

  5. Community participation for transformative action on women's, children's and adolescents' health.

    Marston, Cicely; Hinton, Rachael; Kean, Stuart; Baral, Sushil; Ahuja, Arti; Costello, Anthony; Portela, Anayda


    The Global strategy for women's, children's and adolescents' health (2016-2030) recognizes that people have a central role in improving their own health. We propose that community participation, particularly communities working together with health services (co-production in health care), will be central for achieving the objectives of the global strategy. Community participation specifically addresses the third of the key objectives: to transform societies so that women, children and adolescents can realize their rights to the highest attainable standards of health and well-being. In this paper, we examine what this implies in practice. We discuss three interdependent areas for action towards greater participation of the public in health: improving capabilities for individual and group participation; developing and sustaining people-centred health services; and social accountability. We outline challenges for implementation, and provide policy-makers, programme managers and practitioners with illustrative examples of the types of participatory approaches needed in each area to help achieve the health and development goals.

  6. A designated centre for people with disabilities operated by St John of God Community Services Limited, Kildare

    Sweeney, J


    Electronic health records (EHR) support clinical management, administration, quality assurance, research, and service planning. The aim of this study was to evaluate a clinical data management programme to improve consistency, completeness and accuracy of EHR information in a large primary care centre with 10 General Practitioners (GPs). A Clinical Data Manager was appointed to implement a Data Management Strategy which involved coding consultations using ICPC-2 coding, tailored support and ongoing individualised feedback to clinicians. Over an eighteen month period there were improvements in engagement with and level of coding. Prior to implementation (August 2011) 4 of the 10 GPs engaged in regular coding and 69% of their consultation notes were coded. After 12 months, all 10 GPs and 6 nurses were ICPC-2 coding their consultations and monthly coding levels had increased to 98%. This structured Data Management Strategy provides a feasible sustainable way to improve information management in primary care.

  7. Abortion care services delivered from a community sexual and reproductive health setting: views of health care professionals.

    Michie, Lucy; Cameron, Sharon T; Glasier, Anna


    Abortion services should provide high-quality contraceptive care. The community sexual and reproductive health (SRH) services may be well placed to deliver more abortion care in the UK. We wished to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion (EMA) was due to commence. An anonymous questionnaire distributed to attendees at a UK SRH scientific meeting collected data on demographics, current practice of and attitude to abortion, and views on delivery of abortion services. An internet questionnaire distributed by e-mail to staff at a community SRH clinic in Scotland sought demographics, views regarding the planned introduction of an EMA service and willingness to participate in it. 165 questionnaires were completed out of 200 distributed at the scientific meeting (an 82% response rate). 128 (78%) respondents felt that abortion services were suited to community clinics and 115 (70%) stated that they would be willing to participate in them. 62/90 (69%) staff from the SRH clinic responded to the internet questionnaire. 44 (71%) felt the plan to introduce abortion services was a natural extension to services already offered and the same number would be willing to be involved in such a service. There is clear support amongst health professionals in community SRH in the UK towards greater participation in the provision of abortion care services.

  8. Growing urban health: community gardening in South-East Toronto.

    Wakefield, Sarah; Yeudall, Fiona; Taron, Carolin; Reynolds, Jennifer; Skinner, Ana


    This article describes results from an investigation of the health impacts of community gardening, using Toronto, Ontario as a case study. According to community members and local service organizations, these gardens have a number of positive health benefits. However, few studies have explicitly focused on the health impacts of community gardens, and many of those did not ask community gardeners directly about their experiences in community gardening. This article sets out to fill this gap by describing the results of a community-based research project that collected data on the perceived health impacts of community gardening through participant observation, focus groups and in-depth interviews. Results suggest that community gardens were perceived by gardeners to provide numerous health benefits, including improved access to food, improved nutrition, increased physical activity and improved mental health. Community gardens were also seen to promote social health and community cohesion. These benefits were set against a backdrop of insecure land tenure and access, bureaucratic resistance, concerns about soil contamination and a lack of awareness and understanding by community members and decision-makers. Results also highlight the need for ongoing resources to support gardens in these many roles.

  9. Patient Centred Systems: Techno-Anthropological reflections on the challenges of 'meaningfully engaging' patients within health informatics research.

    Wong, Ming-Chao; Almond, Helen; Cummings, Elizabeth; Roehrer, Erin; Showell, Chris; Turner, Paul


    This chapter explores how Techno-Anthropology can contribute to more explicitly professional and ethically responsible reflections on the socio-technical practices involved in meaningfully engaging patients in health informatics research. The chapter draws on insights from health informatics research projects focused on chronic disease and self-management conducted in Tasmania during the last 10 years. Through these projects the paper explores three topics of relevance to 'meaningful engagement' with patients: (i) Patient Self-Management and Chronic Disease (ii) Patients as Users in Health Informatics research, and, (iii) Evaluations of outcomes in Health and Health Informatics Interventions. Techno-Anthropological reflections are then discussed through the concepts of liminality, polyphony and power. This chapter argues that beyond its contribution to methodology, an important role for Techno-Anthropology in patient centred health informatics research may be its capacity to support new ways of conceptualising and critically reflecting on the construction and mediation of patients' needs, values and perspectives.

  10. Using Community Health Assessment to Teach and Explore Health Status Disparities

    Sullivan, Marianne; Levine, Jack


    Introduction: Community health assessment (CHA) is a useful tool for identifying health status disparities at the community level. Developing the skills of master's level public health students to conduct CHA addresses a number of the Association of Schools of Public Health Core competencies for graduate public health education. Teaching…

  11. Promotores de salud and community health workers: an annotated bibliography.

    WestRasmus, Emma K; Pineda-Reyes, Fernando; Tamez, Montelle; Westfall, John M


    For underserved and disenfranchised communities in the United States, affordable, effective health care can be nearly inaccessible, which often leads to the exclusion of these communities from relevant medical information and care. Barriers to care are especially salient in minority communities, where language, traditions and customs, socioeconomics, and access to education can serve as additional roadblocks to accessing health care information and services. These factors have contributed to a national health disparity crisis that unnecessarily places some communities in a vulnerable position without adequate prevention and treatment opportunities. One solution to the exclusion some communities face in the health care system may be the promotores de salud (PdS)/community health worker (CHW), an approach to culturally competent health care delivery whose popularity in the mainstream health care system has been steadily growing in recent decades. Known by a wide variety of names and broad in the spectrum of health issues they address, the PdS/CHW serves as cultural brokers between their own community and the formal health care system and can play a crucial role in promoting health and wellness within their community. This annotated bibliography was created to educate the reader about the history, definition, key features, utility, outcomes, and broad potential of the CHW approach in a variety of populations. Intended to serve as a reference point to a vast body of information on the CHW/PdS approach, this document is a resource for those wishing to effect change in the disparities within the health care system, and to improve the access to, quality, and cost of health care for underserved patients and their communities. Promotores de Salud is a Spanish term that translates to Health Promoter. A female health worker may be referred to as a Promotora, a male as a Promotor, and the plural of both is Promotores. For the purposes of this bibliography, the terms community

  12. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared

    Niklaus Daniel Labhardt


    Full Text Available Introduction: Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs to scale up the provision of antiretroviral therapy (ART. We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. Methods: The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Results: Of 3747 patients, 2042 (54.5% started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81 and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001. These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR: 0.89, 95% confidence interval (CI: 0.73–1.09 and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20–1.96. The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51–0.93. Conclusions: In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities

  13. "People at the Heart of Our Processes", a Case Study of How a Nursery School and Children's Centre Promotes Community Cohesion

    Duggan Bio, Martine


    This article reports on a doctoral case study of how an English integrated nursery school and children's centre fulfils its legal duty to promote community cohesion. The provocation for the enquiry derives from the author's growing unease over the perceived limitations of a target-driven culture currently pervading English schools. A case is made…

  14. Survey on the provision and demand of elderly-care unit in a community health service centre of Shanghai%上海某社区卫生服务中心老年护理病房供求现状调查

    孙海英; 徐娟娟; 黄海蓉


    The provision and demand of elderly-care unit in a community health service center was surveyed by questionnaire and enquiry on focus group. The study items included human resource and service type, condition of caring workers and demander. Results showed that the main service type of elderly-care unit was medical service, which accounted for 82. 6% of the total cost The average activity of daily life score of patients was 25, and nursing was the main needs of patients. The quality and quantity of nursing staff was relatively low, which impedes the provision of the service, so social caring should be encouraged to overcome the obstacles.%对上海某社区卫生服务中心老年护理病房供求双方进行问卷调查及小组访谈.内容包括供方的人力资源配置、运营模式、护工状况以及需求方状况等.结果 显示,老年护理病房(150张床)运营模式以医疗为主,医疗费用占总结算费用的82.6%;住院患者日常生活活动能力(ADL)评分平均为25分,护理需求偏蕈;73%的护工为小学文化程度;供求双方存在护工依赖现象,出入院瓶颈问题凸显.因此需改进服务模式,动员社会护理力量,解决出入院瓶颈问题.

  15. Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

    Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso


    The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain.

  16. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily


    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice.

  17. Moving health promotion communities online: a review of the literature.

    Sunderland, Naomi; Beekhuyzen, Jenine; Kendall, Elizabeth; Wolski, Malcom


    There is a need to enhance the effectiveness and reach of complex health promotion initiatives by providing opportunities for diverse health promotion practitioners and others to interact in online settings. This paper reviews the existing literature on how to take health promotion communities and networks into online settings. A scoping review of relevant bodies of literature and empirical evidence was undertaken to provide an interpretive synthesis of existing knowledge on the topic. Sixteen studies were identified between 1986 and 2007. Relatively little research has been conducted on the process of taking existing offline communities and networks into online settings. However, more research has focused on offline (i.e. not mediated via computer networks); 'virtual' (purely online with no offline interpersonal contact); and 'multiplex' communities (i.e. those that interact across both online and offline settings). Results are summarised under three themes: characteristics of communities in online and offline settings; issues in moving offline communities online, and designing online communities to match community needs. Existing health promotion initiatives can benefit from online platforms that promote community building and knowledge sharing. Online e-health promotion settings and communities can successfully integrate with existing offline settings and communities to form 'multiplex' communities (i.e. communities that operate fluently across both online and offline settings).

  18. A designated centre for people with disabilities operated by St John of God Community Services Limited, Louth

    Whitford, David L


    BACKGROUND: There has been little development of the general practice consultation over the years, and many aspects of the present consultation do not serve communities with multiple health and social problems well. Many of the problems presenting to general practitioners in socio-economically disadvantaged areas are not amenable to a purely medical solution, and would particularly benefit from a multidisciplinary approach. Socio-economic deprivation is also associated with those very factors (more psychosocial problems, greater need for health promotion, more chronic diseases, more need for patient enablement) that longer consultations have been shown to address. This paper describes our study protocol, which aims to evaluate whether a lengthened multidisciplinary primary care team consultation with families in a socially deprived area can improve the psychological health of mothers in the families. METHODS\\/DESIGN: In a randomised controlled trial, families with a history of social problems, substance misuse or depression are randomly allocated to an intervention or control group. The study is based in three general practices in a highly deprived area of North Dublin. Primary health care teams will be trained in conducting a multidisciplinary lengthened consultation. Families in the intervention group will participate in the new style multidisciplinary consultation. Outcomes of families receiving the intervention will be compared to the control group who will receive only usual general practitioner care. The primary outcome is the psychological health of mothers of the families and secondary outcomes include general health status, quality of life measures and health service usage. DISCUSSION: The main aim of this study is to evaluate the effectiveness of a lengthened multidisciplinary team consultation in primary care. The embedded nature of this study in general practices in a highly deprived area ensures generalisability to other deprived communities, but more

  19. Health Promotion as Part of a Holistic Approach to Community ...

    Health Promotion as Part of a Holistic Approach to Community Mental Health Care in Sierra Leone. ... of service is probably plagued by the strong stigma that prevails in society. Reliable quantitative data on mental illness is extremely minimal.

  20. Electronic health record project initiation and early planning in a community health center.

    Cortelyou-Ward, Kendall; Noblin, Alice; Martin, Jeremy


    Community health centers exist to help their constituents become proactive in addressing their own health care needs and to improve the overall well-being of the community. However, they pose a different set of challenges when implementing an electronic health record system. This article applies 2 project management principles, initiation and early planning, to the electronic health record implementation in a community health center. Issues such as planning, financial considerations, and quality improvement are discussed.

  1. Pharmacy assistance programs in a community health center setting.

    Torres, Maxsimo C; Herman, Debra; Montano, Seferino; Love, Leah


    Prescription drug costs represent the fastest growing item in health care and are a driving force in rapidly increasing health care costs. Community health centers serve an indigent population with limited access to pharmaceuticals. Pharmaceutical companies sponsor patient assistance programs. These pharmacy assistance programs can be developed to facilitate the provision of needed pharmaceuticals to this vulnerable population. La Casa de Buena Salud is a rural community health center in eastern New Mexico, which has provided access to a substantial amount of pharmaceuticals to indigent patients through patient assistance programs. Cost savings potential are considerable for a community health center and for patients when a pharmacy assistance program is organized efficiently and employed systematically. Secondary benefits are derived from the entire medical community. While some community health centers currently make effective use of pharmaceutical company-sponsored pharmacy assistance programs, a comprehensive, long-term approach at a national level may be required.

  2. Fitness Equipment in Public Parks: Frequency of Use and Community Perceptions in a Small Urban Centre.

    Copeland, Jennifer L; Currie, Cheryl; Walker, Ali; Mason, Erin; Willoughby, Taura N; Amson, Ashley


    Providing freely accessible exercise facilities may increase physical activity at a population level. An increasingly popular strategy is outdoor fitness equipment in urban parks. Few studies have evaluated the effectiveness of this intervention in smaller cities. This study examined fitness equipment use, perceived effectiveness, and ways to increase use in a city of 100,000 people in 2015. Two parks with fitness equipment and 4 without were directly observed. Interviews with 139 adults in active parks or living nearby were also conducted. Only 2.7% of adult park users used the fitness equipment over 100 hours of observation across 3 seasons. In contrast, 22.3% of adults interviewed reported monthly or more use of the equipment, highlighting the limitations of self-report methods. Adults interviewed perceived the equipment as potentially beneficial and suggested strategies to increase public use, including increased advertising, the introduction of programming to teach and encourage use, improved equipment quality, and improved maintenance of the equipment and surrounding area. In a low density city, park fitness equipment may not be an effective public health practice without additional efforts to market, introduce programming, and maintain these sites.

  3. [Drop-out from a mental health centre after the first contact].

    Palmieri, Giovanni; D'Amore, Carlo; Cecchetti, Rita; Bonamoneta, Nadia; Gonnella, Maria Antonietta; Moio, Margherita; Paoletti, Stefania; Vendetti, Stefania; Schiavella, Rita; Picardi, Angelo


    Many patients drop-out from treatment after a single contact; however, characteristics have only rarely been investigated. We aimed at estimating the frequency of early drop-out and identifying possible risk factors. The study was performed at the Palestrina Mental Health Centre, located near Rome, Italy. The clinical charts of all first-time attenders who did not come back during a 7-year index period (2000-2006) were reviewed and information was collected on sociodemographic factors, psychiatric history, clinical presentation, and process of care. During the index period, 97 of 1.001 first-time attenders dropped out after the first contact. We excluded patients with symptoms of organic (N = 9) or severe mental disorders (N = 3). Of the remaining 85 patients, 49 presented with symptoms related to life events or situations ("reactive symptoms", RS), while 36 had "non-reactive symptoms" (NRS). Eighty-five randomly selected patients with comparable conditions (psychogenic reaction; anxiety, dysthymic or somatoform disorder; ICD-9 code 300.x, 308.x, 309.x) who came back to visit were included as controls. First-only contact patients tended to present with RS more often (58% vs. 43%) than controls. Therefore, the analyses were stratified for reactivity of symptoms. Among patients with NRS, first-only contact patients tended to be younger than controls. Among patients with RS, time until the next appointment tended to be longer in first-only contact patients than in controls. No other differences were observed between first-only contact patients and controls on sociodemographic variables, source of referral, and previous treatment history. The occurrence of early drop-out was relatively low. The higher prevalence of RS among first-only contact patients may suggest a greater disposition towards conflict or ambivalence in interpersonal situations. Patient-perceived service availability, in the form of shorter appointment delay, seems to promote maintenance of contact

  4. Motivating and demotivating factors for community health workers: A qualitative study in urban slums of Delhi, India.

    George, Mathew Sunil; Pant, Shradha; Devasenapathy, Niveditha; Ghosh-Jerath, Suparna; Zodpey, Sanjay P


    Background Community health workers play an important role in delivering health-care services, especially to underserved populations in low- and middle-income countries. They have been shown to be successful in providing a range of preventive, promotive and curative services. This qualitative study investigated the factors motivating or demotivating community health workers in urban settings in Delhi, India. Methods In this sub-study of the ANCHUL (Ante Natal and Child Healthcare in Urban Slums) implementation research project, four focus-group discussions and nine in-depth interviews were conducted with community health workers and medical officers. Utilizing a reflexive and inductive qualitative methodology, the data set was coded, to allow categories of motivating and demotivating factors to emerge. Results Motivating factors identified were: support from family members for their work, improved self-identity, job satisfaction and a sense of social responsibility, prior experiences of ill health, the opportunity to acquire new skills and knowledge, social recognition and status conferred by the community, and flexible work and timings. Negative experiences in the community and at health centres, constraints in the local health system in response to the demand generated by the community health workers, and poor pay demotivated community health workers in this study, even causing some to quit their jobs. Conclusion Community-health-worker programmes that focus on ensuring the technical capacity of their staff may not give adequate attention to the factors that motivate or discourage these workers. As efforts get under way to ensure universal access to health care, it is important that these issues are recognized and addressed, to ensure that community health worker programmes are effective and sustainable.

  5. A survey of community gardens in upstate New York: implications for health promotion and community development.

    Armstrong, D


    Twenty community garden programs in upstate New York (representing 63 gardens) were surveyed to identify characteristics that may be useful to facilitate neighborhood development and health promotion. The most commonly expressed reasons for participating in gardens were access to fresh foods, to enjoy nature, and health benefits. Gardens in low-income neighborhoods (46%) were four times as likely as non low-income gardens to lead to other issues in the neighborhood being addressed; reportedly due to organizing facilitated through the community gardens. Additional research on community gardening can improve our understanding of the interaction of social and physical environments and community health, and effective strategies for empowerment, development, and health promotion.

  6. Developing Community Health Conditions for Happiness, Phase 1

    Chalard Chantarasombat


    Full Text Available Problem statement: Complete health of physical, social and intellectual development is an appropriate plan of human development and raises the quality of life in communities. If the development plan is integrated into the local community it will create peace and generosity. Good health is also fundamental to sustainable development which will create a peaceful society where community members are happy and content. Approach: The purpose of this research in Phase 1, is to (1 Identify leaders in communities at village and sub-district level to drive the ongoing research study and development to achieve good community health conditions in all aspects and dimensions. (2 To have the participants and researchers identify the key elements and indicators of health issues that communities feel are most important to their way of life. Results: Village communities were selected by cluster sampling from the provinces of Roi-Et and Maha Sarakham. The developed model for developing community health for living happily in communities is an appropriate and practical method that can be utilized in other communities. Conclusion: The model is in accordance with Participatory Action Research (PAR and the procedures are flexible and the development plans which are the results of Phase 1 can be extended to other communities and backgrounds.

  7. Evaluating community-based public health leadership training.

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


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

  8. A Community Health Approach to Asthma in the Schools

    Weiss-Randall, Debra


    Asthma is a leading cause of school absenteeism in the United States, especially in poor and minority communities, where prevalence and hospitalization rates are significantly higher than average. A community health approach can help poorer school districts hire full-time nurses and access other health resources.

  9. Community Health Nursing Curriculum. Components in Baccalaureate Nursing Education.

    Catell, Grace Manion

    Community health nursing curriculum components in a sample of baccalaureate nursing programs were investigated. Questionnaires were sent to a sample of 12 National League of Nursing (NLN) accredited, generic, baccalaureate nursing programs representative of the four NLN regions in the United States. Community health nursing content in theory…

  10. Service Learning and Community Health Nursing: A Natural Fit.

    Miller, Marilyn P.; Swanson, Elizabeth


    Community health nursing students performed community assessments and proposed and implemented service learning projects that addressed adolescent smoking in middle schools, home safety for elderly persons, industrial worker health, and sexual abuse of teenaged girls. Students learned to apply epidemiological research methods, mobilize resources,…

  11. Danish translation and validation of the Oslo Sports Trauma Research Centre questionnaires on overuse injuries and health problems

    Jorgensen, J. E.; Rathleff, C. R.; Rathleff, Michael Skovdal;


    The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O) and the Oslo Sports Trauma Research Centre questionnaire on Health Problems (The OSTRC-H) make it possible to monitor illness and injury at regular intervals capturing prevalence and incidence of acute injury, overuse...... respondents; response rate was 89%. The OSTRC-H was distributed to 58 heterogenous respondents; response rate was 86%. No major disagreements were observed between the original and translated versions of the questionnaires. The OSTRC-O had high internal consistency (Cronbach's alpha 0.80-0.93). The primary...... reliability analyses including all participants, showed reliability ICC: 0.62 (95% CI: 0.42-0.77. The secondary reliability analyses that only included subjects who did not change injury region from the test to the retest showed an ICC of 0.86 (95% CI: 0.77-0.92).The questionnaires were found to be valid...

  12. Human Resources and Vaccine Management at Provincial Health Office, District/City Health Office and Primary Health Centre

    Andi Leny Susyanty


    Full Text Available ABSTRAKlatar Belakang: Keputusan Menteri Kesehatan tentang Gerakan Akselerasi Imunisasi Nasional Universal Child Immunization 2010–2014 (GAIN UCI 2010–2014 menyatakan bahwa secara umum permasalahan penurunan cakupan maupun kualitas pelayanan imunisasi disebabkan oleh beberapa hal, di antaranya kekurangan jumlah, kualitas dan distribusi pengelola vaksin. Metode: Pengumpulan data dilakukan dengan kuesioner melalui wawancara mendalam, penelusuran data sekunder dan observasi. Analisis data dilakukan dengan melakukan skoring data pendidikan, lama kerja, pelatihan dan pengetahuan. Hasil:Jumlah petugas pengelola vaksin masih kurang, beberapa dinas kesehatan kabupaten/kota hanya memiliki satu pengelola Program Imunisasi yang merangkap sebagai pengelola vaksin, begitu juga dengan beberapa Puskesmas yang hanya memiliki satu pengelola program imunisasi yang merangkap pengelola vaksin dan juru imunisasi. Sementara dalam pedoman penyelenggaraan imunisasi dibutuhkan minimal dua tenaga pelaksana. Pengetahuan pengelola vaksin di puskesmas masih kurang, terutama dalam hal pengenalan vaksin dan pengenalan rantai vaksin (ILR. Pengelola vaksin di Dinkes Provinsi sudah mendapatkan pelatihan, namun pengelola vaksin Dinkes Kabupaten/Kota dan Puskesmas belum semua mendapat pelatihan. Pengetahuan pengelola vaksin di Puskesmas masih kurang, terutama dalam hal pengenalan vaksin dan pengenalan Coldchain (ILR.Saran:Diperlukan penambahan kuantitas dan kualitas pengelola vaksin, karena kualitas pengelola vaksin sangat berpengaruh terhadap kualitas vaksin, karena vaksin memerlukan penanganan yang khusus untuk menjaga kualitas vaksin tetap baik dan dapat memberikan kekebalan tubuh serta menghindarkan terjadinya penyakit yang dapat dicegah dengan imunisasi (PD3I.Kata kunci: vaksin, pengelola vaksin, pelatihan, pengetahuanABSTRACTBackground: In the Decree of the Minister of Health on the National Immunisation Movement Acceleration Universal Child Immunization 2010–2014

  13. Selecting alternative strategies for community health education in guineaworm control.

    Brieger, W R; Ramakrishna, J; Akpovi, S U; Adeniyi, J D


    Community health education strategies in guineaworm control can be applied at several intervention levels. Community development mobilizes local resources to provide safe water supplies such as wells. Mass education in schools and communities can teach personal protection measures such as filtering water. Training of volunteer community health workers produces front line staff, who by being culturally in tune with the community can demonstrate and promote the use of appropriate prevention and treatment measures. Advocacy assists community members to express their needs to government and ministry decision makers. All of these strategies have been applied in a community health education/primary health care program in Idere, Ibarapa District, Oyo State. Community development for well construction was found to be a long-term strategy that first must overcome problems of village organization and resource location. Mass education, to be effective, must have a simple and acceptable technology to promote. Trained village health workers must overcome traditional beliefs that inhibit use of preventive and treatment measures. Advocacy requires basic political education of community leaders. A variety of health education strategies is needed to address short- and long-term priorities as well as to overcome the different barriers to guineaworm control.

  14. Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

    Kar, S S; Premarajan, K C; L, Subitha; Archana, R; Iswarya, S; A, Sujiv


    Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching-learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching-learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. The study was done among 87 fifth semester undergraduate medical students (batch of 2010-11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching-learning methods and assessment process for each session. The facilitators had 3-5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick's training evaluation model by using a rating scale Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching-learning tool. Innovative assessment methods such as crosswords and 'chocopati' were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items 'sessions were useful', 'sessions were enjoyable' and 'sessions improved my knowledge' were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. The

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

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


    In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (Pservices providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (Peducation materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

  16. [Methodology for health assets mapping in a community].

    Botello, Blanca; Palacio, Sergio; García, Mercedes; Margolles, Mario; Fernández, Federico; Hernán, Mariano; Nieto, Javier; Cofiño, Rafael


    Within the development of a regional strategy for community health engagement in Asturias (Spain), and connected to the Health Observatory, we carried out a methodology to initiate the mapping of health assets at a local level. This methodology begins with a description of the most formal resources and of the pre-existing community activities, together with a characterization of the most informal, personal and symbolic health resources. We introduce our tools, grouped for the development of mapping, and explain their connection with the theoretical models of salutogenesis, asset model and community development.

  17. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers.

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha


    The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the

  18. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha


    Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and

  19. Consultation on the Libyan health systems: towards patient-centred services

    Reida M. El Oakley


    Full Text Available The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i Health Governance; ii Health Care Finance; iii Health Service Delivery; iv Human Resources for Health; v Pharmaceuticals and Health Technology; and vi Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.

  20. Benefits of community-based education to the community in South African health science facilities

    Paula Diab


    Full Text Available Background: Community-based education (CBE is utilised by health science facultiesworldwide to provide a relevant primary care experience for students and a service tounderserved communities and, hopefully, to affect student career choices. The benefits totraining institutions and students are well documented, but it may well be that communities,too, will be able to benefit from a more balanced partnership, where they are consulted in theplanning of such training programmes.Method: An exploratory qualitative study was undertaken by three South African universitiesin the provinces of Limpopo, KwaZulu-Natal and the Western Cape. Focus group interviewswere conducted in their local languages with groups of community leaders, patients andsupervisors at community sites involved in CBE training. A thematic analysis of their viewswas undertaken with the aid of NVivo (version 9. Ethics approval was obtained from therespective universities and health care training sites.Results: Benefits to the community could be categorised into short-term and long-term benefits.Short-term benefits included improved service delivery, reduction in hospital referrals, homevisits and community orientated primary health care, improved communication with patientsand enhanced professionalism of the health care practitioner. Long-term benefits includedimproved teaching through a relationship with an academic institution and student familiaritywith the health care system. Students also became involved in community upliftment projects,thereby acting as agents of change in these communities.Conclusion: Communities can certainly benefit from well-planned CBE programmes involvinga training site ‑ community site partnership. 

  1. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru

    Zumaran Adriana


    Full Text Available Abstract Objective To describe the profile of community health workers – health promoters, traditional birth attendants and traditional healers – in rural Quechua communities from Ayacucho, Peru. Methods Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. Results The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. Conclusion It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

  2. [Health for all--the development of community health nursing and public health nursing from the perspective of education].

    Lin, Pay-Fan


    The purpose of this article was to examine the development of community health nursing and public health nursing in Taiwan from an educational perspective. Key issues addressed include: teaching strategies and scopes of practice used in community health nursing in Taiwan between 1910 and the 1950s; the philosophical foundations for the concepts of "health for all" and "social justice" in Taiwan's community health nursing; the five "P"s of community health nursing teaching and practice (population, prevention, promotion, policy, and partnership); the core competencies and scope of practice of community health nursing proposed by the TWNA Community Health Nursing Committee; and the core competencies and the tiers of classification proposed by the Quad Council of Public Health Nursing Organizations. This article helps to elucidate the inseparable relationship between community health nursing education and practice at both the micro and macro level and examines possible future directions for community health nursing in Taiwan. The author proposes the following recommendations for future community health nursing education development in Taiwan: 1) implement competence classifications appropriate to each nursing education preparation level, 2) promote multidisciplinary cooperation among education, practice, and policy, and 3) promote collaboration and consensus among community health nursing and public health related associations.

  3. Using Community Health Workers in Community-Based Growth Promotion: What Stakeholders Think

    Afulani, Patience A.; Awoonor-Williams, John K.; Opoku, Ernest C.; Asunka, Joseph


    The Nutrition and Malaria Control for Child Survival Project is a community-based growth promotion project that utilizes Community Health Workers (CHWs), referred to as Community Child Growth Promoters (CCGPs), as the principal change agents. The purpose of this study was to identify perceptions of key stakeholders about the project and the role…

  4. Rural Community as Context and Teacher for Health Professions Education.

    Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana; Renouf, Tia


    Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed "community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.

  5. Community perceptions of mental health needs: a qualitative study in the Solomon Islands

    Silove Derrick


    Communities identify and are responding to a wide range of mental health challenges; the health system generally can do more to learn about how this is being done, and build more comprehensive services and policy on this foundation. The findings underscore the need to promote awareness of those services which are available, to extend mental health care beyond urban centres to rural villages where the majority of the population live, and to promote community input to policy so as to ensure that it 'fits' the context.

  6. Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel


    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

  7. Teleaid -en ny form for samarbeid : en observasjonsstudie med evaluering av et telemedisinsk pilotprosjekt mellom Methodist Public Health Centre Mursan, India og Kvinneklinikken, Rikshospitalet.

    Jacobsen, Silje Berild; Simensen, Susann


    Teleaid –a new way of cooperation. An observation study with evaluation of a pilot project between Methodist Public Health Centre Mursan, India and Kvinneklinikken, Rikshospitalet. Background: In September 2003 a pilot project were initiated between Kvinneklinikken, Rikshospitalet and Methodist Public Health Centre Mursan, India. The intention was to try a new way of providing medical assistance to rural areas through telecommunication. Our role in this project was to visit India to see ho...

  8. Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

    Soili Vesterinen; Marjo Suhonen; Arja Isola; Leena Paasivaara; Helena Laukkala


    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four...

  9. Preparedness for Protecting the Health of Community-Dwelling Vulnerable Elderly People in Eastern and Western Japan in the Event of Natural Disasters.

    Tsukasaki, Keiko; Kanzaki, Hatsumi; Kyota, Kaoru; Ichimori, Akie; Omote, Shizuko; Okamoto, Rie; Kido, Teruhiko; Sakakibara, Chiaki; Makimoto, Kiyoko; Nomura, Atsuko; Miyamoto, Yukari


    We clarified the preparedness necessary to protect the health of community-dwelling vulnerable elderly people following natural disasters. We collected data from 304 community general support centres throughout Japan. We found the following in particular to be challenging: availability of disaster-preparedness manuals; disaster countermeasures and management systems; creation of lists of people requiring assistance following a disaster; evacuation support systems; development of plans for health management following disasters; provision of disaster-preparedness guidance and training; disaster-preparedness systems in the community; disaster information management; the preparedness of older people themselves in requiring support; and support from other community residents.

  10. Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community

    Kline, Cathy C.; Godolphin, William J.; Chhina, Gagun S.; Towle, Angela


    Communication between health care professionals and Aboriginal patients is complicated by cultural differences and the enduring effects of colonization. Health care providers need better training to meet the needs of Aboriginal patients and communities. We describe the development and outcomes of a community-driven service-learning program in…

  11. Capacity building for health through community based participatory nutrition intervention research in rural communities

    Building community capacity for health promotion in small rural communities is essential if health promotion research is to yield sustainable outcomes. Since its inception, capacity-building has been a stated goal of the Delta Nutrition Intervention Research initiative, a tri-state collaboration in ...

  12. Enabling and Barriers of Implantable Contraceptive Use at Health Centre I North Denpasar

    Nida Gustikawati


    Full Text Available Background and purpose: The objective of this study was to explore the supporting and the inhibiting factors influencing the use of implant contraceptive use by women of childbearing age. Methods: The study was qualitative using a phenomenological approach. Data collection involved a purposively selected sample, conducting two FGD (10 implant users and 10 non-users and 11 in-depth interviews among private midwives, government midwives, husbands, in-laws, and family planning staff. Results: FGD found that perceptions and attitudes towards implants of those already using the contraceptive were positive, while the perceptions and attitudes of non-users were less so. Some respondents intimated that they experienced side effects though these were not a deterring factor in usage. Enabling factors for the use of implant contraceptives were the availability and accessibility to the healthcare facilities and the support of their husbands. Access to facilities and infrastructure were not inhibiting factors either for the users or the non-users. Findings from in-depth interviews indicated that inhibiting factors included were the desire to have more children and the lack of promotion of the implant contraceptives. Healthcare provider informants stated that the lack of training was an inhibiting factor. Conclusion: Enabling factors for the use of implant contraceptives were the availability and accessibility to the healthcare facilities and the support of their husbands. Inhibiting factors were the desire to have more children, the lack of proper training for the health workers, as well as the lack of promotion of the implant contraceptive in the community.

  13. Perceptions of the community on the pricing of community mental health services.

    Ogden, J R; Ogden, D T


    In the past few years there has been a decrease in governmental support of Community Mental Health centers. Because of this, there has been some concern, on the part of Community Mental Health professionals, as to the overall impact of this decreased governmental support. Research has been conducted that speculates on how best to handle this mini-crisis. One article suggests moving to an overall marketing approach to help combat this dollar support decline (Day and Ford 1988). Others provide methods for surveying Community Mental Health users (Ludke, Curry & Saywell 1983). William Winston (1988) suggests an overall psychographic segmentation approach to developing market targets. There has also been research detailing promotional methods for expanded marketing coverage (Moldenhauer 1988), however little has been written defining the pricing impact on Community Mental Health services. This study addresses the perceptions of Community Mental Health Center users toward the price variable of the marketing mix.

  14. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

    Leigh F Johnson


    Full Text Available Introduction: There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART. Methods: Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. Results: After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6% were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8% were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults. Conclusions: South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.

  15. Patient-centred interprofessional collaboration in primary care: challenges for clinical, educational and health services research. An EGPRN keynote paper.

    Van Royen, Paul; Rees, Charlotte E; Groenewegen, Peter


    The theme 'patient-centred interprofessional collaboration' of the EGPRN conference in October 2012, captures in just three words important challenges for European primary care and its research agenda. Challenges for future research are formulated, in three domains: clinical, educational and health services research. Transferability of research, based upon advanced computational infrastructure, will facilitate a rapid learning health care system. In educational research, this includes the use of observational and reflexivity methods. Outcomes should be defined in terms of improvement of functional status and social participation rather than in terms of disease-specific outcomes. Partnership with all stakeholders, patients, GPs and their health care colleagues and students, can help in reducing avoidable waste in the production and reporting of research evidence.

  16. Policing, Community Fragmentation, and Public Health: Observations from Baltimore.

    Gomez, Marisela B


    Studies show that policing, when violent, and community fragmentation have a negative impact on health outcomes. This current study investigates the connection of policing and community fragmentation and public health. Using an embedded case study analysis, semi-structured interviews were conducted with 21 African-American female and male residents, ages 21-64 years of various neighborhoods of high arrest rates and health and socioeconomic depravation in Baltimore City, MD. Baltimore residents' perceptions of policing, stress, community fragmentation, and solutions are presented. Analysis of the perceptions of these factors suggests that violent policing increases community fragmentation and is a public health threat. Approaches to address this public health threat are discussed.

  17. Neighborhood adversity, child health, and the role for community development.

    Jutte, Douglas P; Miller, Jennifer L; Erickson, David J


    Despite medical advances, childhood health and well-being have not been broadly achieved due to rising chronic diseases and conditions related to child poverty. Family and neighborhood living conditions can have lasting consequences for health, with community adversity affecting health outcomes in significant part through stress response and increased allostatic load. Exposure to this "toxic stress" influences gene expression and brain development with direct and indirect negative consequences for health. Ensuring healthy child development requires improving conditions in distressed, high-poverty neighborhoods by reducing children's exposure to neighborhood stressors and supporting good family and caregiver functioning. The community development industry invests more than $200 billion annually in low-income neighborhoods, with the goal of improving living conditions for residents. The most impactful investments have transformed neighborhoods by integrating across sectors to address both the built environment and the social and service environment. By addressing many facets of the social determinants of health at once, these efforts suggest substantial results for children, but health outcomes generally have not been considered or evaluated. Increased partnership between the health sector and community development can bring health outcomes explicitly into focus for community development investments, help optimize intervention strategies for health, and provide natural experiments to build the evidence base for holistic interventions for disadvantaged children. The problems and potential solutions are beyond the scope of practicing pediatricians, but the community development sector stands ready to engage in shared efforts to improve the health and development of our most at-risk children.

  18. Sexual and Reproductive Health Behaviors of California Community College Students

    Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp


    Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…

  19. Actions States and Communities Can Take to Address Cognitive Health


    In this podcast, CDC’s Dr. Lynda Anderson highlights the important roles that states and communities can play in addressing cognitive health as part of overall health.  Created: 6/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/9/2014.

  20. Community Health Workers and Their Value to Social Work

    Spencer, Michael S.; Gunter, Kathryn E.; Palmisano, Gloria


    Community health workers (CHWs) play a vital and unique role in linking diverse and underserved populations to health and social service systems. Despite their effectiveness, as documented by empirical studies across various disciplines including public health, nursing, and biomedicine, the value and potential role of CHWs in the social work…

  1. Importance of effective collaboration between health professionals for the facilitation of optimal community diabetes care.

    Melville-Smith, Jo; Kendall, Garth E


    Diabetes places a significant burden on the individuals concerned, their families and society as a whole. The debilitating sequelae of diabetes can be limited or prevented altogether through strict glycaemic control. Despite the seemingly uncomplicated nature of the disorder, effective management can be elusive, as the impact of having to deal with diabetes on a daily basis can be profound and appropriate professional support is not always readily available. As the roles of general practitioners (GPs) and allied health professionals have evolved, a major issue now facing all is that of developing and maintaining effective collaborative relationships for the facilitation of optimal community diabetes care. Using a simple survey methodology, the present exploratory study investigated the referral patterns of GPs to diabetic educators (DEs) working for a community health service in an Australian town, and reasons for referral and non-referral in order to identify factors that contribute to a sound and sustainable collaborative relationship. The results provide some evidence that GPs and DEs in this town do work collaboratively towards achieving client-centred goals and highlight the need to inform GPs who are new to communities, such as this one, of the available DE services. Most importantly, the study identified that there are many opportunities to strengthen collaboration so as to facilitate optimal community diabetes care. This information is valuable, because there is limited empirical evidence either nationally or internationally about the process of collaboration between health professionals in the management of chronic diseases, such as diabetes.

  2. Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

    Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina


    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

  3. Latino children's health and the family-community health promotion model.

    Mendoza, F S; Fuentes-Afflick, E.


    A majority of Latino children in the US live in poverty. However, unlike other poor children, Latino children do not seem to have a consistent association between poverty and poor health. Instead, many poor Latino children have unexpectedly good health outcomes. This has been labeled an epidemiologic paradox. This paper proposes a new model of health, the family-community health promotion model, to account for this paradox. The family-community health promotion model emphasizes the family-com...

  4. Modeling the principles of community-based participatory research in a community health assessment conducted by a health foundation.

    Williams, Karen Jaynes; Gail Bray, Patricia; Shapiro-Mendoza, Carrie K; Reisz, Ilana; Peranteau, Jane


    The authors discuss strategies used and lessons learned by a health foundation during development of a community health assessment model incorporating community-based participatory research (CBPR) approaches. The assessment model comprises three models incorporating increasing amounts of CPBR principles. Model A combines local-area analysis of quantitative data, qualitative information (key informants, focus groups), and asset mapping. Model B, a community-based participatory model, emphasizes participatory rural appraisal approaches and quantitative assessment using rapid epidemiological assessment. Model C, a modified version of Model B, is financially more sustainable for our needs than Model B. The authors (a) describe origins of these models and illustrate practical applications and (b) explore the lessons learned in their transition from a traditional, nonparticipatory, quantitative approach to participatory approaches to community-health assessment. It is hoped that this article will contribute to the growing body of knowledge of practical aspects of incorporating CBPR approaches into community health assessments.

  5. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

    Chola Lumbwe


    Full Text Available Abstract Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions.

  6. Website Sharing in Online Health Communities: A Descriptive Analysis.

    Nath, Chinmoy; Huh, Jina; Adupa, Abhishek Kalyan; Jonnalagadda, Siddhartha R


    An increasing number of people visit online health communities to seek health information. In these communities, people share experiences and information with others, often complemented with links to different websites. Understanding how people share websites can help us understand patients' needs in online health communities and improve how peer patients share health information online. Our goal was to understand (1) what kinds of websites are shared, (2) information quality of the shared websites, (3) who shares websites, (4) community differences in website-sharing behavior, and (5) the contexts in which patients share websites. We aimed to find practical applications and implications of website-sharing practices in online health communities. We used regular expressions to extract URLs from 10 WebMD online health communities. We then categorized the URLs based on their top-level domains. We counted the number of trust codes (eg, accredited agencies' formal evaluation and PubMed authors' institutions) for each website to assess information quality. We used descriptive statistics to determine website-sharing activities. To understand the context of the URL being discussed, we conducted a simple random selection of 5 threads that contained at least one post with URLs from each community. Gathering all other posts in these threads resulted in 387 posts for open coding analysis with the goal of understanding motivations and situations in which website sharing occurred. We extracted a total of 25,448 websites. The majority of the shared websites were .com (59.16%, 15,056/25,448) and WebMD internal (23.2%, 5905/25,448) websites; the least shared websites were social media websites (0.15%, 39/25,448). High-posting community members and moderators posted more websites with trust codes than low-posting community members did. The heart disease community had the highest percentage of websites containing trust codes compared to other communities. Members used websites to

  7. The value of using schools as community assets for health.

    Caan, W; Cassidy, J; Coverdale, G; Ha, M-A; Nicholson, W; Rao, M


    In planning, designing, procuring and ensuring delivery of improved services ('commissioning') for the school age population, the outcomes should be students who are healthy to learn and who learn to be healthy. Intuitively, linking education and health development together within the wider learning environment seems a good start to planning school health. However there has been a shortage of either theoretical models that can span different settings or experimental research that demonstrates improved community health. Is there evidence that the wider learning environment provided in a school is valuable in improving health? An initial scoping exercise identified domains of health where there was a promise of health gain. International literature on school health outcomes using the framework of Asset-Based Community Development (ABCD) has been reviewed. It was found that research on a variety of interventions was relevant to schools as an asset for public health. Effective areas for health gain were identified for local planning and evaluation using this community model. However, none of the studies reviewed was originally designed to test schools as assets and most of the research lacked methodological rigour, especially regarding children in low income countries. The ABCD model could help national governments develop resources for both education and health, but there is a global need to generate better quality evidence. Then people who commission for their local communities can make more effective use of these multifaceted assets to improve health and education outcomes for children.

  8. Patient centred care in infertility health care: direct and indirect associations with wellbeing during treatment.

    Gameiro, Sofia; Canavarro, Maria Cristina; Boivin, Jacky


    To investigate whether different dimensions of patient centred care (PCC) were directly associated with wellbeing or indirectly, via lower concerns about medical procedures and/or increased tolerability of treatment. Cross-sectional study with 322 women and 111 men undergoing fertility diagnosis or treatment recruited online and in clinical setting. Participants completed questionnaires that assess PCC (PCQ-Infertility), individual (BSI Anxiety and Depression subscales) and relational wellbeing (FertiQoL Relational Domain), treatment concerns (CART Procedural Concerns scale) and tolerability (FertiQoL Tolerability Domain) and they filled a socio-demographic and fertility data file. All dimensions of PCC were positively associated with better wellbeing except for organization of care. Information provision and continuity of care were indirectly associated with better individual wellbeing, the first via lower treatment concerns and the second via higher treatment tolerability. Competence, accessibility, continuity and communication were indirectly associated with better relational wellbeing via higher treatment tolerability. Patient centred care promotes wellbeing during treatment. PCC is directly associated to wellbeing but also indirectly. The mode of action of the different PCC dimensions on wellbeing varies. To promote patients' wellbeing during treatment clinics should provide treatment related information and allow patients to establish a stable clinical relationship with a trustworthy and competent physician. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. [[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

    Mabika, Hines


    It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.

  10. Does sustained participation in an online health community affect sentiment?

    Zhang, Shaodian; Bantum, Erin; Owen, Jason; Elhadad, Noémie


    A large number of patients rely on online health communities to exchange information and psychosocial support with their peers. Examining participation in a community and its impact on members' behaviors and attitudes is one of the key open research questions in the field of study of online health communities. In this paper, we focus on a large public breast cancer community and conduct sentiment analysis on all its posts. We investigate the impact of different factors on post sentiment, such as time since joining the community, posting activity, age of members, and cancer stage of members. We find that there is a significant increase in sentiment of posts through time, with different patterns of sentiment trends for initial posts in threads and reply posts. Factors each play a role; for instance stage-IV members form a particular sub-community with patterns of sentiment and usage distinct from others members.

  11. Relationship-centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care.

    Wyer, Peter C; Alves Silva, Suzana; Post, Stephen G; Quinlan, Patricia


    Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as 'patient-centred care' (PCC) typifies system-wide discordance. We contrast the fragmented descriptions of PCC and related tools to its own origins in the writings of Balint and to a subsequent construct, relationship-centred care (RCC). We identify the explicit and elaborated connection between RCC and a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments between RCC and independently developed constructs. Among these, we emphasize Schon's reflective practice, Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying consequences of adherence to less adequate epistemological frameworks such as positivism. We offer RCC not as an 'antidote' to the dilemmas identified at the outset but as an example that illuminates the value and importance of explicit identification of the premises and assumptions underlying approaches to improvement of the health care system. We stress the potential value of identifying epistemological affinities across otherwise disparate fields and disciplines.

  12. Capacity building for health through community-based participatory nutrition intervention research in rural communities.

    Downey, Laura H; Castellanos, Diana Cuy; Yadrick, Kathy; Threadgill, Paula; Kennedy, Betty; Strickland, Earline; Prewitt, T Elaine; Bogle, Margaret


    Since its inception, capacity building has been a stated goal of the Delta Nutrition Intervention Research Initiative, a tri-state collaboration in the Lower Mississippi Delta to address high rates of chronic disease. Textual analysis of project documents identifies and describes strategies carried out to foster capacity building. Strategies to build community capacity include fostering participation, cultivating leadership opportunities, training community members as co-researchers, securing community resources, and implementing the intervention together. Incorporating capacity-building approaches in health promotion and nutrition-intervention programming in rural communities provides a means to enhance potential for sustainability of health outcomes and developed effectiveness.

  13. Preparation for Community Health Nursing: Issues and Problems.

    And Others; White, Caroline


    Highlights of a survey of community health nursing agencies and faculty suggest the need for better planning and collaboration between service and education in preparing students for this field. Survey data tables are included. (CT)

  14. Quality assurance of malaria case management in an urban and in sub-rural health centres in Goma, Congo

    Prosper M. Lutala


    Full Text Available Background: Every year, up to three million deaths throughout the world occur as a result of malaria, 90% of which occur in Africa. Despite training providers in malaria case management and the availability of appropriate medical suppliers, there are still weaknesses in the management chain of malaria.Objectives: Our aim was to assess the quality of malaria case management in two primary health care centres in the Goma health district. Specific objectives were the assessment of quality accuracy in the dosage, the duration of treatment, the intervals between administrations, and the routes of administration of anti-malarial medication in two health centres, as well as the subsequent comparison of those two sites. Method: A descriptive retrospective study was conducted using the malaria register’s review to assess two health centres in the Goma health district. Socio-demographical and clinical data were recorded and the quality was assessed against the national guidelines. Descriptive statistics with percentages and Chi-square values were computed. Results: Under-dosage was more common in CCLK (Centre Chrétien du Lac Kivu [Lake Kivu Christian Centre] with 55 patients (62.5%; 95% CI, 52% – 71.8% patients, whilst the over-dosage was present in 64 patients (80%; 95% CI, 69.9% – 87.2% in CASOP (Caisse de Solidarité Ouvrière et Paysanne [Fund of Solidarity Workers and Peasants]. The duration of treatment was shorter in CCLK in 15 patients (93.7%; 95% CI, 71.6% – 98.8%; CASOP had a high rate of inappropriate intervals between the administration of drugs in 14 patients (82.3%; 95% CI, 58.9% – 93.8%. Intravenous administration rates were high in both sites with respectively 102 patients in CASOP (62.5%; 95% CI, 54.9% – 69.6% and 61 patients in CCLK (37.4%; 95% CI, 30.3% – 45.0%. Significant differences were found between the two sites with regard to intervals of administration (χ2 = 7.11, p = 0.007, duration of treatment (χ2 = 8.51, p

  15. Application of 16S rRNA metagenomics to analyze bacterial communities at a respiratory care centre in Taiwan.

    Tang, Chuan Yi; Yiu, Siu-Ming; Kuo, Han-Yueh; Tan, Te-Sheng; Liao, Ki-Hok; Liu, Chih-Chin; Hon, Wing-Kai; Liou, Ming-Li


    In this study, we applied a 16S ribosomal RNA (rRNA) metagenomics approach to survey inanimate hospital environments (IHEs) in a respiratory care center (RCC). A total of 16 samples, including 9 from medical devices and 7 from workstations, were analyzed. Besides, clinical isolates were retrospectively analyzed during the sampling period in the RCC. A high amount of microbial diversity was detected, with an average of 1,836 phylotypes per sample. In addition to Acinetobacter, more than 60 % of the bacterial communities present among the top 25 abundant genera were dominated by skin-associated bacteria. Differences in bacterial profiles were restricted to individual samples. Furthermore, compliance with hand hygiene guidelines may be unsatisfactory among hospital staff according to a principal coordinate analysis that indicated clustering of bacterial communities between devices and workstations for most of the sampling sites. Compared to the high incidence of clinical isolates in the RCC, only Staphylococcus and Acinetobacter were highly abundant in the IHEs. Despite Acinetobacter was the most abundant genus present in IHEs of the RCC, potential pathogens, e.g., Acinetobacter baumannii, might remain susceptible to carbapenem. This study is the first in Taiwan to demonstrate a high diversity of human-associated bacteria in the RCC via 16S rRNA metagenomics, which allows for new assessment of potential health risks in RCCs, aids in the evaluation of existing sanitation protocols, and furthers our understanding of the development of healthcare-associated infections.

  16. Workforce diversity and community-responsive health-care institutions.

    Nivet, Marc A; Berlin, Anne


    While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.

  17. Aftercare and Rehabilitation in a Community Mental Health Center

    Scoles, Pascal; Fine, Eric W.


    The community, state mental hospitals, and a community mental health center work together to provide an environment conducive to the continued well being of chronic mental patients in an area of West Philadelphia, Pennsylvania. The authors describe a program that involves day care centers and the patients' everyday living. (Author)

  18. The Wellness Mobile: Bringing Preventative Health Services to Rural Communities.

    Nilson, Ralph; And Others


    The Wellness Mobile transports medical supplies, equipment, informational materials, and staff to rural Saskatchewan communities to assist them in developing wellness programs that stress disease prevention. Staff from the Wellness Mobile offer health-risk screening and appraisal to community members and work with local practitioners and schools…

  19. Functionalism and holism: community nurses' perceptions of health.

    Long, A; Baxter, R


    This paper reports the results of a study that was designed to explore and examine the perceptions of two groups of newly qualified community nurses about the factors they considered to be embedded within the concepts of health, health-enhancing behaviours at individual, family and community levels and their 'innermost self'. The research was exploratory in nature, and included two sample groups: group 1 comprised 16 newly qualified health visitors; group 2 comprised 16 newly qualified community mental health nurses. Purposive sampling was used and data were collected using semi-structured interviews. The group of health visitors perceived health in terms of physical fitness and functional states. At a global level they perceived the need to provide education on health matters. They gave generously to 'charities' and perceived the 'inner self' as 'that part that matters'. The group of community mental health nurses perceived health in terms of holism and being states. Their concept of health was related to listening to each individual's perception of what is 'right' and 'health-enhancing' for them. At a global level they considered the protection of the ozone layer and the promotion of a just and equitable society which focused on the reduction of poverty, to be key health-enhancing activities. They perceived their 'innermost self' to be 'that part of me that makes life worth living', and the soul. The findings have implications for developing new and creative approaches for teaching the holistic concept of health and healing. Educational activities could be designed which strive to ensure that nurses themselves have safe and health embracing opportunities for exploring all the elements that are embedded within the topic of health. Their role in facilitating holistic health promoting activities for all clients also needs to be addressed.

  20. Utilisation of the National Antiretroviral Therapy Guidelines among health care professionals working in Abuja treatment centres, Nigeria

    Lindiwe I. Zungu


    Full Text Available Background: Access to and utilisations of the National Antiretroviral Treatment Guidelines (NATG are valuable factors for effective programme implementation. The objective of this study was to investigate the accessibility of the NATG and their utilisation by health care professionals from five treatment centres in Abuja, Nigeria.Method: A quantitative cross-sectional descriptive survey was conducted in 2007 using purposively sampled health care professionals. Questionnaires were self-administered to participants who consented in writing to participate in the survey.Results: 97 health care professionals participated in this study with about equal numbers of men and women: 48 (49.5% women and 49 (50.5% men. Of these, 21.6% were unaware of the existence of the NATG in their treatment centres. More than half (51.5% reported that they did not have access to the NATG as opposed to those (48.5% who had access to the guidelines. Furthermore, 16.5% of the participants confirmed that they had access to an institutional copy of the NATG while 14.4% indicated that they had individual copies and only 3.1% stated that they had individual copies and access to the hospital copy as well. Regarding utilisation of the NATG, 41.2% rarely used them, 32.9% never used them and only 25.7% often used them. The most frequent use of the NATG was among pharmacists (38.1% compared to the least frequent use among nurses (20.0%.Conclusion: Poor accessibility of the NATG may have a negative impact on guidelines utilisation among health care professionals in Nigeria.

  1. Towards generic online multicriteria decision support in patient-centred health care

    Dowie, Jack; Kaltoft, Mette Kjer; Salkeld, Glenn


    scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey...... in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. METHODS: The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all...... software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade...

  2. A designated centre for people with disabilities operated by Health Service Executive, Westmeath

    Quinlan, Catherine


    Children on hemodialysis are at increased risk of thrombosis, especially when dialyzed via a central venous catheter (CVC); there are limited published data regarding the safety and efficacy of tinzaparin in this group. We conducted a retrospective chart review of all children in the National Pediatric Hemodialysis Centre for Ireland diagnosed with a CVC thrombus and treated with subcutaneous tinzaparin over a 10 year period. Seven children were treated with subcutaneous tinzaparin for 10 CVC thrombi. Tinzaparin was commenced at 175 IU\\/kg\\/day and the dose was titrated by measuring anti-factor Xa levels, aiming for levels of 0.3-1.0 IU\\/ml. Treatment was continued until resolution of the CVC thrombus. Restoration of normal flows during dialysis occurred within 3 days in all patients. There were no episodes of bleeding and all children tolerated the treatment well.

  3. The Gap between Tobacco Treatment Guidelines, Health Service Organization, and Clinical Practice in Comprehensive Cancer Centres

    R. Mazza


    Full Text Available Smoking cessation is necessary to reach a higher quality of life, and, for a cancer patient, it represents an important step in improving the outcome of both prognosis and therapy. Being a cancer patient addicted to nicotine may be a critical situation. We conducted a survey to monitor how many comprehensive cancer centres in Italy have an outpatient smoker clinic and which kinds of resources are available. We also inquired about inpatient services offering psychological and pharmacological support for smoking cessation, reduction, or care of acute nicotine withdrawal symptoms. What we have witnessed is a significant gap between guidelines and services. Oncologists and cancer nurses are overscheduled, with insufficient time to engage in discussion on a problem that they do not consider directly related to cancer treatment. Furthermore, smoking habits and limited training in tobacco dependence and treatment act as an important barrier and lead to the undervaluation of smokers' needs.

  4. Health effects[1997 Scientific Report of the Belgian Nuclear Research Centre

    Mahieu, L.


    The objectives of the research in the field of epidemiology , performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study. For radiobiology, the main objectives are: (1) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phase of its development, (2) to assess the genetic risks of maternal exposure to ionizing radiation, (3) to elucidate the mechanisms by which damage to the brain and mental retardation are caused in man after prenatal irradiation. The main achievements in these domains for 1997 are presented.

  5. The social determinants of health and health service access: an in depth study in four poor communities in Phnom Penh Cambodia

    Soeung Sann


    Full Text Available Abstract Background Increasing urbanization and population density, and persisting inequities in health outcomes across socioeconomic groupings have raised concerns internationally regarding the health of the urban poor. These concerns are also evident in Cambodia, which prompted the design of a study to identify and describe the main barriers to access to health services by the poor in the capital city, Phnom Penh. Sources and Methods Main sources of data were through a household survey, followed by in-depth qualitative interviews with mothers, local authorities and health centre workers in four very poor communities in Phnom Penh. Main findings Despite low incomes and education levels, the study communities have moderate levels of access to services for curative and preventive care. However, qualitative findings demonstrate that households contextualize poor health and health access in terms of their daily living conditions, particularly in relation to environmental conditions and social insecurity. The interactions of low education, poor living conditions and high food costs in the context of low and irregular incomes reinforce a pattern of “living from moment to moment” and results in a cycle of disadvantage and ill health in these communities. There were three main factors that put poor communities at a health disadvantage; these are the everyday living conditions of communities, social and economic inequality and the extent to which a society assesses and acts on inequities in their health care access. Conclusions In order to improve access to health and health services for the urban poor, expansion of public health functions and capacities will be required, including building partnerships between health providers, municipal authorities and civil society.

  6. Community health needs assessments: filling data gaps for population health research and management.

    Alberti, Philip


    Community health needs assessments (CHNA) are completed to meet varied regulatory and statutory requirements for local public health departments, tax-exempt 501(c)(3) hospitals, and Federally Qualified Health Centers. Although compliance is a motivating factor, these entities are committed to understanding the communities they serve and to developing strategies to address health needs and inequities in health and health care. CHNAs have the potential to improve the health of communities and populations by giving crucial qualitative and quantitative context to hospital and patient data, thereby enhancing opportunities for health services and clinical outcomes researchers. Filling in these data gaps can help to improve population health by highlighting community-and social determinant-related dynamics relevant to the improved health of the community. Successful models exist that that have used CHNAs and the resulting data to improve population health management and reduce inequities, as do health systems that have used the EHR and community-based performance measurement data to achieve population health goals.

  7. The experience of community health workers training in Iran: a qualitative study

    Javanparast Sara


    Full Text Available Abstract Background The role of Community Health Workers (CHWs in improving access to basic healthcare services, and mobilising community actions on health is broadly recognised. The Primary Health Care (PHC approach, identified in the Alma Ata conference in 1978, stressed the role of CHWs in addressing community health needs. Training of CHWs is one of the key aspects that generally seeks to develop new knowledge and skills related to specific tasks and to increase CHWs’ capacity to communicate with and serve local people. This study aimed to analyse the CHW training process in Iran and how different components of training have impacted on CHW performance and satisfaction. Methods Data were collected from both primary and secondary sources. Training policies were reviewed using available policy documents, training materials and other relevant documents at national and provincial levels. Documentary analysis was supplemented by individual interviews with ninety-one Iranian CHWs from 18 provinces representing a broad range of age, work experience and educational levels, both male and female. Results Recognition of the CHW program and their training in the national health planning and financing facilitates the implementation and sustainability of the program. The existence of specialised training centres managed by district health network provides an appropriate training environment that delivers comprehensive training and increases CHWs’ knowledge, skills and motivation to serve local communities. Changes in training content over time reflect an increasing number of programs integrated into PHC, complicating the work expected of CHWs. In-service training courses need to address better local needs. Conclusion Although CHW programs vary by country and context, the CHW training program in Iran offers transferable lessons for countries intending to improve training as one of the key elements in their CHW program.

  8. Quality and Electronic Health Records in Community Health Centers

    Lesh, Kathryn A.


    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  9. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    Lee, Eunji


    Studies have described the opportunities and challenges of applying service design techniques to health services, but empirical evidence on how such techniques can be implemented in the context of eHealth services is still lacking. This paper presents how a service design thinking approach can be applied for specification of an existing and new eHealth service by supporting evaluation of the current service and facilitating suggestions for the future service. We propose Service Journey Modelling Language and Service Journey Cards to engage stakeholders in the design of eHealth services.

  10. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Qarin Lood


    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration.Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level.Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way.Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  11. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Qarin Lood


    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration. Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way. Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  12. Setting health priorities in a community: a case example

    Sousa, Fábio Alexandre Melo do Rego; Goulart, Maria José Garcia; Braga, Antonieta Manuela dos Santos; Medeiros, Clara Maria Oliveira; Rego, Débora Cristina Martins; Vieira, Flávio Garcia; Pereira, Helder José Alves da Rocha; Tavares, Helena Margarida Correia Vicente; Loura, Marta Maria Puim


    ABSTRACT OBJECTIVE To describe the methodology used in the process of setting health priorities for community intervention in a community of older adults. METHODS Based on the results of a health diagnosis related to active aging, a prioritization process was conceived to select the priority intervention problem. The process comprised four successive phases of problem analysis and classification: (1) grouping by level of similarity, (2) classification according to epidemiological criteria, (3) ordering by experts, and (4) application of the Hanlon method. These stages combined, in an integrated manner, the views of health team professionals, community nursing and gerontology experts, and the actual community. RESULTS The first stage grouped the identified problems by level of similarity, comprising a body of 19 issues for analysis. In the second stage these problems were classified by the health team members by epidemiological criteria (size, vulnerability, and transcendence). The nine most relevant problems resulting from the second stage of the process were submitted to expert analysis and the five most pertinent problems were selected. The last step identified the priority issue for intervention in this specific community with the participation of formal and informal community leaders: Low Social Interaction in Community Participation. CONCLUSIONS The prioritization process is a key step in health planning, enabling the identification of priority problems to intervene in a given community at a given time. There are no default formulas for selecting priority issues. It is up to each community intervention team to define its own process with different methods/techniques that allow the identification of and intervention in needs classified as priority by the community. PMID:28273229

  13. Setting health priorities in a community: a case example

    Fábio Alexandre Melo do Rego Sousa

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

  14. Community mental health care worldwide: current status and further developments.

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire


    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low- and middle-income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long-term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness.

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

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


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

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


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

  17. Preparing the U.S. health community for climate change.

    Jackson, Richard; Shields, Kyra Naumoff


    In society's effort to address and prepare for climate change, the health community itself must ensure that it is prepared. Health personnel will require flexible and iterative action plans to address climate change at the individual, hospital, local health department, state, and national levels. This requires that health workers analyze the impact of climate change with a view to human health, and then formulate robust policy and demonstrate authentic leadership. In this review, we summarize the status of the health community's preparation for climate change and provide specific recommendations for action at each level. Although preparation status and recommendations vary, our observation is that it is not enough for public health and medical care agencies and departments to develop policies and advocate change. They have a direct responsibility to demonstrate substantive leadership.

  18. Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service.

    McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne


    Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.

  19. Holism, health and data - managing the person-centred digital haystack.

    Rigby, Michael


    There is currently very legitimate pressure to change the function of health information systems to more explicitly serve and support the individual. Concurrently other support services to health, including condition monitoring, social care and intelligent housing, add to the complexity of patient health related data. A paradigm shift is needed, to recognize that many agencies and systems outside as well as within the health sector all work to support the citizen's health, yet the essential integrated view is not being provided, even though much needed not least by the citizen and their agents. Broker technologies can enable this new paradigm. Moreover, a move to identifying the patient's appointments and support services would enable a daily life dimension to be given due weight, and would recognize the patient's viewpoint in wanting to live an ordered life, not one subservient and reactive to the delivery of care by providers.

  20. Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru.

    Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cárdenas, María K; Carrillo-Larco, Rodrigo M; Lazo-Porras, María; Moscoso-Porras, Miguel; Pesantes, M Amalia; Ponce, Vilarmina; Araya, Ricardo; Beran, David; Busse, Peter; Boggio, Oscar; Checkley, William; García, Patricia J; Huicho, Luis; León-Velarde, Fabiola; Lescano, Andrés G; Mohr, David C; Pan, William; Peiris, David; Perel, Pablo; Rabadán-Diehl, Cristina; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; Trujillo, Antonio J; Wells, Jonathan C K; Yan, Lijing L; García, Héctor H; Gilman, Robert H


    Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture




    Full Text Available Modern healthcare systems are seeking to adopt a more client - oriented approach to the delivery of healthcare. Assessment of patient satisfaction is critical for efficient planning and monitoring of the healthcare system. Healthcare accessibility, quality of care provided, and its cost are the three domains of high priority which influence patients' health - related behavior. Patients' satisfaction is a powerful predictor of their health - related behavior which influences treatment outcomes in turn . There is a scarcity of information available on t his aspect of health care in this region of the country especially for the urban areas , therefore the present study is being undertaken . AIM: To assess the client’s satisfaction regarding service utilization at UHC. MATERIALS AND METHODS: Settings: Urban Health Centre, Dayanand Medical College and Hospital Ludhiana . STUDY DESIGN: Cross sectional study . A total of 422 willing patients who attended the Out Patient Department ( OPD of the Urban Health Centre from 1 st July 2014 to 30 th September 2014 were incl uded in the study. The patients didn’t agree to participate , who were previously interviewed in the study and the beneficiaries ( <18 years of age not accompanied by adult members or parents were excluded from the study. Informed written consent was taken from the patients and they were interviewed regarding the health services being provided at UHC. Statistical Analysis: Microsoft Excel , SPSS version 20. RESULTS : Major motivating factors for the patients to utilize the health services at UHC were the cost effectiveness, the proximity to their residence and their faith in the doctors. It was found that the patients were highly satisfied with the accessibility , services provided at waiting area , doctor - patient communication, and consultation and examination facilities. However, availability of the prescribed drugs and the waiting time for consultation came out to be the areas

  2. Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

    Jones, Emily; Wittie, Michael


    To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

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

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


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

  4. 29 January 2013 - Japanese Toshiba Corporation Executive Officer and Corporate Senior Vice President O. Maekawa in the ATLAS visitor centre with representatives of the CERN-Japanese community led by Former Collaboration Spokesperson P. Jenni.

    Maximilien Brice


    29 January 2013 - Japanese Toshiba Corporation Executive Officer and Corporate Senior Vice President O. Maekawa in the ATLAS visitor centre with representatives of the CERN-Japanese community led by Former Collaboration Spokesperson P. Jenni.

  5. Mental health nurses' contributions to community mental health care: An Australian study.

    Heslop, Brett; Wynaden, Dianne; Tohotoa, Jenny; Heslop, Karen


    Australian mental health policy is focused on providing mental health care in the community setting and community mental health teams provide services to clients in a shared model with primary care. The historical literature reports that community mental health nurses' experience high levels of stress and are often allocated the most complex and challenging clients managed by the team. Yet information on their specific roles remains limited. This paper reports on research conducted at one Australian public mental health service to identify the components of the community mental health nursing role and to quantify the time nurses spent in each component during the study period. Six focus groups were conducted with community mental health nurses to identify their perceived role within the team. Data analysis identified 18 components of which 10 were related to direct clinical contact with clients and eight covered administrative and care coordination activities. A data collection tool based on the findings of the focus groups was designed and nurses recorded workload data on the tool in 15-min intervals over a 4-week period. Seventeen nurses collected 1528 hours of data. Internal coordination of care was identified as the top workload item followed by clinical documentation and national data collection responsibilities supporting the complexity of the community mental health nursing role. The high rating attached to the internal coordination of care role demonstrates an important contribution that community mental health nurses make to the functioning of the team and the delivery of quality mental health care.

  6. Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

    Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S


    Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p

  7. Reproductive Health in a. Rural Ngvva Community

    It was found out that Ngwa women view reproductive health as vital t0 a woman's identity .... ber of their family and a guarantee for good treat— ment. The main purpose ..... health-seeking behaviour and notions among the people. Conclusions ...

  8. Health Issues in the Latino Community.

    Aguirre-Molina, Marilyn, Ed.; Molina, Carlos W., Ed.; Zambrana, Ruth Enid, Ed.

    This collection of papers includes 6 parts. Part 1, "Latino Populations in the United States," includes: (1) "Latino Health Policy: Beyond Demographic Determinism" (Angelo Falcon, Marilyn Aguirre-Molina, and Carlos W. Molina); (2) "Latino Health Status" (Olivia Carter-Pokras and Ruth Enid Zambrana); and (3)…

  9. A survey of malaria and some arboviral infections among suspected febrile patients visiting a health centre in Simawa, Ogun State, Nigeria.

    Ayorinde, Adenola F; Oyeyiga, Ayorinde M; Nosegbe, Nwakaego O; Folarin, Onikepe A


    Most febrile patients are often misdiagnosed with malaria due to similar symptoms, such as fever shared by malaria and certain arboviral infections. This study surveyed the incidence of malaria, chikungunya and dengue infections among a number of suspected febrile patients visiting Simawa Health Centre, Ogun State, Nigeria. Venous blood samples were obtained from 60 febrile patients (age 3-70 years) visiting the centre between April and May 2014. The rapid diagnostic test (RDT) was used to detect the presence of chikungunya (CHK) antibodies (IgM), dengue (DEN) virus and antibodies (NS1, IgM and IgG) and malaria parasites (Plasmodium falciparum and Plasmodium vivax). Malarial confirmatory tests were by microscopy and nested polymerase chain reaction (PCR) using the polymorphic region of Glutamate-Rich Protein (GLURP) gene. The complexity of P. falciparum infection in the community also determined by the use of nested PCR. These three mosquito-borne infections were observed in 63% (38) of the patients. The prevalence of CHK, DEN and malarial infections singularly were 11%, 0% and 63%, respectively, whereas malaria with either CHK or DEN infections were 24% (9) and 3% (1), respectively. No subjects were positive for CHK and DEN co-infection. Malarial microscopic confirmation was in 94% (32) of the malaria RDT-positive samples, 50% (17) were successfully analysed by nested PCR and the mean multiplicity of infection was 1.6 (1-3 clones). One patient sample harboured both P. falciparum and P. vivax. The study reports the presence of some arboviral infections having similar symptoms with malaria at Simawa, Ogun State. The proper diagnosis of infectious diseases is important for controlling them.

  10. Intestinal obstruction in children due to Ascariasis: A tertiary health centre experience

    Mishra P


    Full Text Available Background: Ascariasis is the infestation by the largest intestinal nematode of man, a common problem in the tropics attributed to poor hygienic and low socioeconomic conditions. The aim of this research is to analyse the presentation, diagnosis and management of bowel obstruction caused by Ascaris lumbricoides, with special emphasis on the role of conservative management. Materials and Methods: This is a single centre, two consultant based 5 year retrospective study of childhood intestinal obstruction due to worms. Diagnosis in the suspected patients was based on history of passage of worms per mouth or rectum and on x-ray and ultrasonography findings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides were treated in the past five years at our centre. Abdominal pain was the most common presentation seen in 96 children followed by vomiting in 77 children. 20 children had history of vomiting worms and another 43 had history of passing worms in stool. Abdominal tenderness was present in 50 children, 48 had abdominal distension of varying degree, 50 had abdominal mass due to worm bolus, and 16 had or developed abdominal guarding or rigidity. All the children were managed as for acute intestinal obstruction along with hypertonic saline enema. The aim of management was "to starve the worm and hydrate the patient". 87 patients (84.47% responded favourably and were relieved of the obstruction by the conservative management, 16 children (15.53% had abdominal guarding or rigidity and underwent emergency exploration. Conclusion: Roundworm obstruction should be considered in the differential diagnoses of all cases of intestinal obstruction in children. Clinical history and examination along with X-ray and ultrasonography are very helpful for diagnosis of this

  11. Home visits by Family Health Strategy nurses and community health agents

    Luciana Valadão Alves Kebian


    Full Text Available The objective of this article was to describe the practice of nurses and community health agents within the context of the Family Health Strategy home visits. This is a descriptive study with a qualitative approach. Data collection was performed between January and March of 2010, through semi-structured interviews with eight nurses and seven community health agents from two family health units in the city of Rio de Janeiro. Data were submitted to content analysis. Low interaction was observed between nurses and community health agents in the home visits. Work overload and violence are the main hindrances identified for performing home visits. It was found that the home visit planning was unsystematic. Permanent education should be intensified with the purpose to discuss, following a problem-posing approach, the roles and attributions of each team member in the home visit, as well as the systematization of this activity. Descriptors: Family Health; Nursing; Community Health Workers; Home Visit.

  12. Community Dental Health Promotion for Children: Integrating Applied Behavior Analysis and Public Health.

    Kramer, Kathryn D.; Geller, E. Scott


    The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…

  13. Toward a Model of Psychological Health Empowerment: Implications for Health Care in Multicultural Communities.

    Menon, Sanjay T.


    The context for health empowerment includes individuals, health providers, and the regulatory environment. Psychological health empowerment consists of perceived control, perceived competence, and goal internalization. In multicultural communities, barriers to empowerment include locus of control, access to health care, and language and cultural…

  14. Oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy.

    Percival, T; Aylett, S E; Pool, F; Bloch-Zupan, A; Roberts, G J; Lucas, V S


    To investigate the oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy. 39 children and adolescents with intractable epilepsy at a residential school, the UK National Centre For Young People With Epilepsy (NCYPE) were age, gender and ethnicity matched with 39 healthy children from local schools in Surrey (England). Dental examinations were completed for indices for both the primary and permanent dentitions comprising decayed, missing and filled teeth and surfaces, plaque index, gingivitis index, developmental enamel defects, and incisor tooth trauma. There was no significant difference in the dmfs, dmft, DMFS or DMFT in the children with epilepsy compared with the controls. There was a significantly greater mean plaque score associated with permanent teeth in the children with epilepsy 68.0 SD+/- 31.5, compared with the control children, 142.9 SD+/- 23.2, pepilepsy 47.9+/-33.8, compared with the control children, 15.85+/-21.8, pepilepsy had experienced anterior tooth trauma, 54% in all, compared with the controls, 12.5% pepilepsy had greater mean plaque and gingivitis scores, the prevalence of dental caries was low. Children and teenagers with intractable epilepsy were more likely to have sustained dental trauma than controls. A dental service aimed at early attention to anterior tooth trauma is needed. In addition, there is an ongoing need for improving the oral hygiene of these individuals to prevent the development of periodontal disease in later life.

  15. LIS-lnterlink-connecting laboratory information systems to remote primary health-care centres via the Internet.

    Clark, B; Wachowiak, B; Crawford, E W; Jakubowski, Z; Kabata, J


    A pilot study was performed to evaluate the feasibility of using the Internet to securely deliver patient laboratory results, and the system has subsequently gone into routine use in Poland. The system went from design to pilot and then to live implementation within a four-month period, resulting in the LIS-Interlink software product. Test results are retrieved at regular intervals from the BioLink(TM) LIS (Laboratory Information System), encrypted and transferred to a secure area on the Web server. The primary health-care centres dial into the Internet using a local-cell service provided by Polish Telecom (TP), obtain a TCP/IP address using the TP DHCP server, and perform HTTP 'get' and 'post' operations to obtain the files by secure handshaking. The data are then automatically inserted into a local SQL database (with optional printing of incoming reports)for cumulative reporting and searching functions. The local database is fully multi-user and can be accessed from different clinics within the centres by a variety of networking protocols.

  16. Health Literacy and Happiness: A Community-Based Study

    Angner, Erik; Miller, Michael J.; Ray, Midge N.; Saag, Kenneth G.; Allison, Jeroan J.


    The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: "How confident are you in filling out medical forms by yourself?" Happiness was measured using an adapted…

  17. Health Literacy and Happiness: A Community-Based Study

    Angner, Erik; Miller, Michael J.; Ray, Midge N.; Saag, Kenneth G.; Allison, Jeroan J.


    The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: "How confident are you in filling out medical forms by yourself?" Happiness was measured using an adapted…

  18. An Informatics Approach to Establishing a Sustainable Public Health Community

    Kriseman, Jeffrey Michael


    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  19. Canadian community pharmacists' use of digital health technologies in practice.

    Leung, Valerie; Tharmalingam, Sukirtha; Cooper, Janet; Charlebois, Maureen


    In 2010, a pan-Canadian study on the current state and benefits of provincial drug information systems (DIS) found that substantial benefits were being realized and that pharmacists perceived DIS to be a valuable tool in the evolving models of pharmacy practice. To understand changes in digital health and the impact on practice since that time, a survey of community pharmacists in Canada was conducted. In 2014, Canada Health Infoway (Infoway) and the Canadian Pharmacists Association (CPhA) invited community pharmacists to participate in a Web-based survey to understand their use and perceived benefits of digital health in practice. The survey was open from April 15 to May 12, 2014. Of the 447 survey responses, almost all used some form of digital health in practice. Those with access to DIS and provincial laboratory information systems (LIS) reported increased productivity and better quality of care. Those without access to these systems would overwhelmingly like access. There have been significant advances in digital health and community pharmacy practice over the past several years. In addition to digital health benefits in the areas of productivity and quality of care, pharmacists are also experiencing substantial benefits in areas related to recently expanded scope of practice activities such as ordering lab tests. Community pharmacists frequently use digital health in practice and recognize the benefits of these technologies. Digital health is, and will continue to be, a key enabler for practice transformation and improved quality of care. Can Pharm J (Ott) 2016;149:xx-xx.

  20. Papago Indian Modernization: A Community Scale for Health Research

    Patrick, Ralph; Tyroler, H. A.


    An index of the modernization of Papago communities was developed to test whether social and cultural processes are involved in the determination of human health and whether rapid social change affects health. An earlier version of this paper was presented at the annual meeting of the American Anthropological Association, Detroit, 1964. (FF)

  1. The Impact of Economic Stress on Community Mental Health Services.

    Hagan, Brian J.; And Others


    Warns that community mental health services are threatened by reductions in federal support and increased numbers of clients. Reviews literature on the effect of adverse economic events on mental health. Identifies issues and answers for managing this dilemma including planning, financial diversification, and inter-agency cooperation. (Author/JAC)

  2. Exploring Community Health through the Sustainable Livelihoods Framework

    Barnidge, Ellen K.; Baker, Elizabeth A.; Motton, Freda; Fitzgerald, Teresa; Rose, Frank


    Health disparities are a major concern in the United States. Research suggests that inequitable distribution of money, power, and resources shape the circumstances for daily life and create and exacerbate health disparities. In rural communities, inequitable distribution of these structural factors seems to limit employment opportunities. The…

  3. "Razoo Health:" A Community-Based Nursing Education Initiative.

    Kraus, Marjorie B.; Morgan, Connie M.; Matteson, Peggy S.


    In New Orleans, nursing faculty and students partnered with inner-city schools and churches to mobilize neighborhood assets and improve health care. Students learned community assessment skills and worked with empowered citizens who reclaimed their health resources. (Contains 28 references.) (SK)

  4. Quality, bias and service user experience in healthcare: 10 years of mental health guidelines at the UK National Collaborating Centre for Mental Health.

    Kendall, Tim; Glover, Naomi; Taylor, Clare; Pilling, Stephen


    The guideline programme developed by the National Collaborating Centre for Mental Health (NCCMH) for the National Institute for Health and Clinical Excellence (NICE) is probably the most comprehensive and methodologically advanced mental health guideline programme in the world, covering most adults and children with mental health problems and addressing a broad range of pharmacological and psychological/psychosocial interventions. As the success of the NICE programme gains momentum, its influence in the National Health Service (NHS) grows. If guidelines contain systematic bias the effects will be widespread. Over the last 10 years the NCCMH has recognized imperfections and patterns of bias in the way that evidence is generated and included in guidelines, including psychological/psychosocial interventions and drug treatments. The pharmaceutical industry remains a major source of bias through selective reporting and publishing, and represents a threat to ensuring the evidence underpinning guidelines and clinical decision-making is as complete and reliable as possible. The inclusion of service users into guideline development at the NCCMH has developed in parallel to the identification and understanding of evidential bias, and is now becoming an important focus for high-quality guidelines which are becoming increasingly person-centred. For mental health this is as radical as the integration of psychological/psychosocial treatments into what has, for many years, been a largely medical domain. The future role of service users in monitoring their own experience of care and ensuring that trusts are accountable to them is now a real possibility and is likely to have an impact upon the traditional power relations in mental health and the stigma usually associated with psychiatric problems.

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

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


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

  6. A review of current practices to increase Chlamydia screening in the community--a consumer-centred social marketing perspective.

    Phillipson, Lyn; Gordon, Ross; Telenta, Joanne; Magee, Chris; Janssen, Marty


    Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults. To assess effectiveness of Chlamydia screening interventions targeting young adults in community-based settings, describe strategies utilized and assess them according to social marketing benchmark criteria. A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken. Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown. Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized. © 2015 John Wiley & Sons Ltd.

  7. PA30 Why specialist community public health nurses should work in end of life care.

    Knowles, Sandy


    Overview of roots of public health nursing in UK. Specialist Community Public Health Nurses, formerly known as Health Visitors, have been responding to key health priorities in the United Kingdom for the past 150 years. The profession emerged in response to the appalling poverty and high infant mortality rates which characterised nineteenth century Victorian slums, and transformed itself in the twentieth century to provide family welfare "from the cradle to the grave", including social and mental health. Acheson's 1998 definition of public health as "the organised application of resources to achieve the greatest health for the greatest number", dominated practice and preceded The New NHS: Modern and Dependable (1997) which put public health at the top of the agenda. The new approach meant crossing traditional boundaries and putting the 'community' at the centre of healthcare through empowerment. Throughout these changes, the underpinning principles have remained the same, including the search for health needs, stimulation of awareness of health needs, influence on policies affecting health and facilitation of health-enhancing activities. To learn from other public health professionals. Literature review. Specialist Community Public Health Nurses with an interest and experience in end of life care, can apply these same principles to the new public health approach to death and dying, searching for death and dying needs whilst stimulating an awareness. This would lead to exerting influence on policies affecting death and dying and facilitating health-enhancing activities. The public health approach is new to palliative and end of life care so it makes sense to learn from those professionals who have a long history of successfully responding, adapting to change, rising to contemporary challenges and harnessing opportunities. Understanding of how and when the public health agenda emerged. Other professionals have skills we need. © 2015, Published by the BMJ Publishing

  8. Morphological Spectrum of Orbitoocular Diseases in a Tertiary Health Centre in Keffi, North Central Nigeria

    Ifeyinwa Mary Onwubuya


    Full Text Available Aim. The aim of this study was to carry out a retrospective clinicopathological analysis of the ocular lesions requiring biopsy seen in the Department of Histopathology, Federal Medical Centre (FMC, Keffi, in North Central Nigeria. Materials and Method. A retrospective review of the clinicopathologic profile of orbitoocular lesions diagnosed at the FMC, Keffi, was done. Clinical and pathological data were obtained from the patients’ clinical records and original biopsy reports, respectively. Results. Sixty-six cases of orbitoocular lesions were reviewed for this study. Of the 54 cases investigated, 28 were HIV negative while 26 were HIV positive (37.1% of all cases. There were 30 cases of Ocular Surface Squamous Neoplasia (OSSN with a male-to-female ratio of 0.9 : 1. Squamous cell carcinoma (SCC was the most frequent OSSN with 17 cases. The mean age of cases of SCC is 37.1 ± 7.6 SD (years. The mean age of carcinoma in situ is 35.8 ± 11.4 years. Conclusion. There was no significant difference in the sex distribution of patients with OSSN. It is probable that a diagnosis of squamous cell carcinoma may be encountered in about a year after diagnosis of a carcinoma in situ especially if the in situ carcinoma is left untreated or improperly treated.

  9. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources.

    Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John


    Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.

  10. The Availability and Eligibility of Drug Warehouse at Health Centre Based on Geography and Topography in Indonesia (Rifaskes Data 2011

    Rukmini Rukmini


    Full Text Available ABSTRAKLatar Belakang: Gudang obat Puskesmas merupakan salah satu sarana pelayanan kefarmasian yang perlu diperhatikan dalam upaya penyimpanan obat untuk menjamin mutu obat. Tulisan ini bertujuan untuk menganalisis ketersediaan dan kelayakan gudang obat Puskesmas di Indonesia, berdasarkan lokasi puskesmas secara geografi dan topografi. Metode: Penelitian ini merupakan analisis lanjut data sekunder Riset Fasilitas Kesehatan (Rifaskes tahun 2011 yang dilaksanakan di seluruh Puskesmas di 33 Propinsi di Indonesia. Hasil: Ketersediaan gudang obat pada Puskesmas di Indonesia berdasarkan geografi dan topografi sudah diatas 90%, kecuali Puskesmas pada daerah sangat terpencil (89,7%. Komponen fasilitas gudang obat di Indonesia, yang paling tinggi ketersediaannya adalah fasilitas pencatatan dan penataan obat yaitu catatan keluar masuk obat tahun 2010, dan paling rendah adalah fasilitas pendukung berupa lemari narkotika/psikotropik. Ketersediaan sarana tersebut semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Kelayakan gudang obat Puskesmas di Indonesia, menunjukkan sebagian besar dalam kategori layak, dan proporsinya semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Hasil uji statistik (Mann Whitney dan korelasi Spearman menunjukkan, kelayakan gudang obat berhubungan signifikan dengan geografi dan topografi kepulauan dan keterpencilan. Kesimpulan: Ketersediaan dan kelayakan gudang obat Puskesmas di Indonesia, sebagian besar sudah tersedia dalam kategori layak, dan proporsinya semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Saran: Pemerintah Daerah dan Pusat wajib untuk meningkatkan sarana dan prasarana gudang obat melalui peningkatan anggaran kesehatan, untuk menjamin penyimpanan obat yang tepat dan sesuai dengan standar.Kata kunci: gudang obat, ketersediaan, kelayakan, geografi dan topografiABSTRACTBackground: Drug warehouse at health centres is one of pharmacy service that should be paid attention to store

  11. [Blood supply and demand at the Fifth District Health Centre in Bamako (Mali)].

    Traore, Mamadou; Dumont, Alexandre; Kaya, Amadou Balobo; Traore, Soumana Oumar; Traore, Oumar Moussokoro; Dolo, Amadou


    An adequate uncontaminated blood supply is an essential element of an effective health care system. A regional blood transfusion policy was defined in 2004 by the Direction of Health in Bamako, Mali. The objective of this study is to analyse the coverage of transfusion needs at the Fifth District health Center in Bamako after the implementation of this policy. This prospective study, conducted from December 2006 through May 2007, included 134 patients for whom transfusion orders were recorded in the laboratory. The coverage rate of transfusion needs was estimated by dividing the number of units transfused by the number of units that health professionals requested. The blood supply was regular (46 units per month, on average) and consistent with demand (59 units per month on average). Overall, 75% of the transfusions were required for obstetric complications. All patients received at least one 450-mL unit of whole blood. The coverage of transfusion needs has reached 65% of the total number of units required (95% CI = 60-70%). The implementation of a functioning system of blood transfusion is complex. In Bamako, a system based on a centralized transfusion center met a high proportion of the needs in a reference hospital where demand was high while ensuring a high level of patient safety. Further studies are needed to guide the implementation of feasible and sustainable strategies for providing sufficient quantities of safe blood in other contexts and to assess the impact of these different strategies on global health, and on maternal health in particular.

  12. The evolution of the Fenway Community Health model.

    Mayer, K; Appelbaum, J; Rogers, T; Lo, W; Bradford, J; Boswell, S


    Fenway Community Health was founded by community activists in 1971 in the Fenway neighborhood of Boston, Mass, and within a decade had rapidly expanded its medical services for gay men in response to the AIDS epidemic. Increased expertise and cultural competence in lesbian, gay, bisexual, and transgender (LGBT) care led to expansion of medical services to address broader community concerns, ranging from substance use to parenting issues to domestic and homophobic violence, as well as specialized programs for lesbians, bisexuals, and transgendered individuals. Fenway began as a grassroots neighborhood clinic. In 1975, the center recorded 5000 patient care visits; in 2000, Fenway's clinical departments recorded 50,850 visits by 8361 individuals, including more than 1100 individuals receiving HIV-associated care. The center now has more than 170 staff people responsible for clinical programs, community education, research, administration, planning, and development. Over the past few years, Fenway's annual budget has exceeded $10 million. Fenway has established standards for improved cultural competence about LGBT health issues for other health providers and has developed programs to educate the general community about specific LGBT health concerns. This health center may provide a model of comprehensive LGBT health services that have a local impact.

  13. Virtual community consultation? Using the literature and weblogs to link community perspectives and health technology assessment.

    Street, Jackie M; Braunack-Mayer, Annette J; Facey, Karen; Ashcroft, Richard E; Hiller, Janet E


    Community views, expressed in social impact assessments and collected through community consultation, should play an important role in health technology assessment (HTA). Yet HTA methodologists have been slow to include outcomes of these forms of inquiry in analyses, in part because collecting community views is time-consuming and resource intensive. To explore how community views sourced from published studies, grey literature and informal internet web pages can inform HTA. A technology reviewed by Adelaide HTA in 2004 was selected: retinal photography for detection of diabetic retinopathy. Published literature, 'grey' literature and informal web pages were searched to examine the availability of evidence about service community and user community views with respect to this technology. Particular efforts were made to source evidence relating to rural, remote and Aboriginal populations. We found that journal articles, reports from the grey literature and informal internet web pages (including blogs and discussion forums) can provide valuable insight into community views. Although there was little empirical evidence relating to the experience of diabetes and diabetes management in rural, remote and Aboriginal communities, there were indications that some evidence may be transferable from other populations. Community perspectives on selected health technologies can be gauged from available resources in published and grey literature and perspectives collected in this way can provide insight into whether the introduction of the technology would be acceptable to the community. The limitations of this approach are discussed.

  14. [Community health workers: promoters of interaction between territories].

    da Costa, Samira Lima; de Carvalho, Emílio Nolasco


    This article presents reflections originating from a series of meetings with community health workers over a period of ten years. It identifies the consolidation of two existential territories, which are sometimes closer and at other times more distant from each other, namely the territory of technical knowledge about health and the territory of popular knowledge about health. Starting with the analysis of some quotes from health workers and reflections which tally with the theoretical reference in the area, this paper discusses some of the dilemmas and deadlocks of access and affiliation from the perspective of some of these health workers, as well as the strategies devised on a day-to-day basis from the crossovers that take place between these two territories. It identifies the function of community health workers as frontier agents, at times acting as inventors or motivators of contact zones between the territories, and at other times acting as a representative by one territory inside the other.

  15. A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives.

    Widyawati, Widyawati; Jans, Suze; Utomo, Sutarti; van Dillen, Jeroen; Janssen, A L M Lagro


    Anemia in pregnancy remains a major problem in Indonesia over the past decade. Early detection of anaemia in pregnancy is one of the components which is unsuccessfully implemented by nurse-midwives. This study aims to explore nurse-midwives' experiences in managing pregnant women with anaemia in Public Health Centres. We conducted a qualitative study with semi-structured face to face interviews from November 2011 to February 2012 with 23 nurse-midwives in five districts in Yogyakarta Special Province. Data analysis was thematic, using the constant comparison method, making comparison between participants and supported by ATLAS.ti software. Twelve nurse-midwives included in the interviews had less than or equal to 10 years' working experience (junior nurse-midwives) and 11 nurse-midwives had more than 10 years' working experience (senior nurse-midwives) in Public Health Centres. The senior nurse-midwives mostly worked as coordinators in Public Health Centres. Three main themes emerged: 1) the lack of competence and clinical skill; 2) cultural beliefs and low participation of family in antenatal care programme; 3) insufficient facilities and skilled support staff in Public Health Centres. The nurse-midwives realized that they need to improve their communication and clinical skills to manage pregnant women with anaemia. The husband and family involvement in antenatal care was constrained by the strength of cultural beliefs and lack of health information. Moreover, unfavourable work environment of the Public Health Centres made it difficult to apply antenatal care the pregnant womens' need. The availability of facilities and skilled staffs in Public Health Centre as well as pregnant women's husbands or family members contribute to the success of managing anaemia in pregnancy. Nurse-midwives and pregnant women need to be empowered to achieve the optimum result of anaemia management. We recommend a more comprehensive approach in managing pregnant women with anaemia

  16. Empowering Minority Communities with Health Information - WSSU

    McMurray, L. and W. Templin-Branner


    Environmental health focus with training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine HBCU ACCESS Project at Winston-Salem State University, NC on November 10, 2010.

  17. Improving the health of the community: Duke's experience with community engagement.

    Michener, J Lloyd; Yaggy, Susan; Lyn, Michelle; Warburton, Samuel; Champagne, Mary; Black, MaryAnn; Cuffe, Michael; Califf, Robert; Gilliss, Catherine; Williams, R Sanders; Dzau, Victor J


    Evidence is accumulating that the United States is falling behind in its potential to translate biomedical advances into practical applications for the population. Societal forces, increased awareness of health disparities, and the direction of clinical and translational research are producing a compelling case for AHCs to bridge the gaps between scientific knowledge and medical advancement and between medical advancement and health. The Duke University Health System, the city and county of Durham, North Carolina, and multiple local nonprofit and civic organizations are actively engaged in addressing this need. More than a decade ago, Duke and its community partners began collaborating on projects to meet specific, locally defined community health needs. In 2005, Duke and Durham jointly developed a set of Principles of Community Engagement reflecting the key elements of the partnership and crafted an educational infrastructure to train health professionals in the principles and practice of community engagement. And, most recently, Duke has worked to establish the Duke Translational Medicine Institute, funded in part by a National Institutes of Health Clinical Translational Science Award, to improve health through innovative behavioral, social, and medical knowledge, matched with community engagement and the information sciences.

  18. The community need index. A new tool pinpoints health care disparities in communities throughout the nation.

    Roth, Richard; Barsi, Eileen


    Catholic Healthcare West, San Francisco (CHW), has developed a national Community Need Index (CNI) in partnership with Solucient, an information products company, to help health care organizations, not-for-profits, and policymakers identify and address barriers to health care access in their communities. The CNI aggregates five socioeconomic indicators long known to contribute to health disparity--income, culture/language, education, housing status, and insurance coverage--and applies them to every zip code in the United States. Each zip code is then given a score ranging from 1.0 (low need) to 5.0 (high need). Residents of communities with the highest CNI scores were shown to be twice as likely to experience preventable hospitalization for manageable conditions--such as ear infections, pneumonia or congestive heart failure--as communities with the lowest CNI scores. The CNI provides compelling evidence for addressing socioeconomic barriers when considering health policy and local health planning. The tool highlights health care disparities between geographic regions and illustrates the acute needs of several notable geographies, including inner city and rural areas.Further, it should enable health care providers, policymakers, and others to allocate resources where they are most needed, using a standardized, quantitative tool. The CNI provides CHW with an important means to strategically allocate resources where it will be most effective in maintaining a healthy community.

  19. Community intervention in higher education of environmental health

    Cidália Guia; Raquel Rodrigues dos Santos; Rogério da Silva Nunes


    Currently, in the Bologna context, university teaching methods focus on the student and on a learning experience based on practical methods. Under the guidance of teachers, students in the second year of the first Environmental Health Course at the Polytechnic Institute of Beja have designed and developed the following nine community intervention projects relating to environmental health: dangerous products (mercury); habitability and geriatrics; health education and the environment; drinking...

  20. A Community Oriented Approach to Primary Health Care

    Lee, Leslie


    A broader perspective is needed in family medicine. The traditional nuclear family is in transition; extended, single parent, reconstituted and surrogate families and couples living together without marrying, are becoming more common. The community is therefore replacing the family as the functional unit of society, and has become a significant determinant of health. Also, there are still social and economic barriers to health care. Those of lower socioeconomic status have poorer health and u...

  1. Assessing health-care providers' readiness for reporting quality and patient safety indicators at primary health-care centres in Lebanon: a national cross-sectional survey.

    Alameddine, Mohamad; Saleh, Shadi; Natafgi, Nabil


    Successful endorsement of quality indicators hinges on the readiness and acceptability of care providers for those measures. This paper aims to assess the readiness of care providers in the primary health-care sector in Lebanon for the implementation of quality and patient safety indicators. A cross-sectional survey methodology was utilized to gather information from 943 clinical care providers working at 123 primary health-care centres in Lebanon. The questionnaire included two sections: the first assessed four readiness dimensions (appropriateness, management support, efficacy, and personal valence) of clinical providers to use quality and safety indicators using the Readiness for Organization Change (ROC) scale, and the second section assessed the safety attitude at the primary care centre utilizing the Agency of Health Research and Quality (AHRQ) Safety Attitude Questionnaire (SAQ)-Ambulatory version. Although two thirds (66%) of respondents indicated readiness for implementation of quality and patient safety indicators in their centres, there appear to be differences by professional group. Physicians displayed the lowest scores on all readiness dimensions except for personal valence which was the lowest among nurses (60%). In contrast, allied health professionals displayed the highest scores across all readiness dimensions. Generally, respondents reflected a positive safety attitude climate in the centres. Yet, there remain a few areas of concern related to punitive culture (only 12.8% agree that staff should not be punished for reported errors/incidents), continuity of care (41.1% believe in the negative consequences of lack in continuity of care process), and resources (48.1% believe that the medical equipment they have are adequate). Providers with the highest SAQ score had 2.7, 1.7, 7 and 2.4 times the odds to report a higher readiness on the appropriateness, efficacy, management and personal valence ROC subscales, respectively (P value quality and patient

  2. Use of Development Centre Methodology to Focus Workforce Learning Strategies--Case Study: NSW Department of Community Services

    O'Toole, Sean; Ferres, Natalie


    This paper examines the use of development centre methodology to measure the gap in performance for fieldwork staff in a social welfare organisation. The process follows the construction of a capability framework, a set of work-based simulations for participants and the use of a 360-degree instrument. These processes are combined to measure and…

  3. Towards a Lifelong Learning Society through Reading Promotion: Opportunities and Challenges for Libraries and Community Learning Centres in Viet Nam

    Hossain, Zakir


    The government of Viet Nam has made a commitment to build a Lifelong Learning Society by 2020. A range of related initiatives have been launched, including the Southeast Asian Ministers of Education Organization Centre for Lifelong Learning (SEAMEO CELLL) and "Book Day"--a day aimed at encouraging reading and raising awareness of its…

  4. Psychological and socioeconomic health of community-dwelling older adults.

    Chen, Kuei-Min; Lin, Mei-Hui; Wang, Yueh-Chin; Li, Chun-Huw; Huang, Hsin-Ting


    Different dimensions of health are intertwined. The purposes of this study were: (1) to investigate the psychological and socioeconomic health status of community-dwelling older adults in Taiwan, and (2) to compare the psychological and socioeconomic health differences among people of different age groups, gender, marital status, and exercise habits. Using stratified random sampling, 384 Taiwanese community-dwelling older adults were recruited for this survey research. Based on the Health Model of Older Adults, seven constructs were measured: (1) psychological health: sleep quality, emotional health, cognitive functioning, and health promotion behaviors; (2) socioeconomic health: social engagement, social support, and financial status. Results showed that most participants were in a good state of psychological and socioeconomic health, except that 38.02% of them suffered from sleep disruptions, and the majority of them were not involved in any social group, nor engaged in any volunteer work. Young-old older adults had better psychological and socioeconomic health than middle-old and old-old older adults. Male older adults had better psychological health than female older adults; however, they had less social engagement and social support than female older adults. Married older adults and exercisers performed better in most of the psychological and socioeconomic health indicators than single/widowed older adults and non-exercisers.

  5. The EU-project United4Health: User-centred design of an information system for a Norwegian telemedicine service.

    Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago; Fensli, Rune


    Organizational changes of health care services in Norway brought to light a need for new clinical pathways. This study presents the design and evaluation of an information system for a new telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge. A user-centred design approach was employed composed of a workshop with end-users, two user tests and a field trial. For data collection, qualitative methods such as observations, semi-structured interviews and a questionnaire were used. User workshop's outcome informed the implementation of the system initial prototype, evaluated by end-users in a usability laboratory. Several usability and functionality issues were identified and solved, such as the interface between the initial colour scheme and the triage colours. Iterative refinements were made and a second user evaluation showed that the main issues were solved. The responses to a questionnaire presented a high score of user satisfaction. In the final phase, a field trial showed satisfactory use of the system. This study showed how the target end-users groups were actively involved in identifying the needs, suggestions and preferences. These aspects were addressed in the development of an information system through a user-centred design process. The process efficiently enabled users to give feedback about design and functionality. Continuous refinement of the system was the key to full development and suitability for the telemedicine service. This research was a result of the international cooperation between partners within the project United4Health, a part of the Seventh Framework Programme for Research of the European Union. © The Author(s) 2015.

  6. Neurosurgery in Nigeria II - Evaluation of the perceptions of health personnel after the commencement of services in a new centre

    Jude Kennedy C Emejulu


    Full Text Available Background: Prior to the commencement of neurosurgical services in our new centre, in 2006, the awareness of and perceptions about this specialty amongst the health workers were studied. One year after, having experienced first-hand the activities of the unit, these perceptions were again re-evaluated amongst the same workers to determine the impact of the unit on the opinions about the specialty. Methods and Materials: This study was carried out with a questionnaire designed with the 5-point Likert scale, and the respondents comprised of doctors, nurses, students, paramedics and administrators, randomly selected. The same questionnaire was used in the first study but was slightly modified for the present study. Results: Out of 400 questionnaires distributed randomly, 342 were completed and returned. Most of the respondents 282 (82.5% were aged 20 - 30years, mostly students 220 (64.3%, and majority 318 (93% have heard of neurosurgery prior to the establishment of our unit. The service need was rated very necessary by most 286(83.6%, availability of services in Nigeria rated inadequate by 177 (51.8%, and the quality of services rated fair 155(45.3%. The services in our centre were rated fair 138 (40.4% and lack of equipment/facilities was adjudged the greatest hindrance to practice 216 (63.2%, and majority 289 (84.5% strongly recommended that services continue. Conclusion: Neurosurgical services are still significantly inadequate in Nigeria, and though the establishment of new units has positively changed the perception of health workers about the specialty, provision of more manpower and modern facilities remains the major challenge.

  7. The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms.

    Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R


    There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded HCC data together with geocoded records of disturbances in the drinking water network was feasible.

  8. Factors associated with sense of community among allied health students.

    Haar, Mindy; Scanlan, Craig


    Over the last decade, there has been a substantial increase in online education in the health professions, as well as growing recognition that teamwork and collaboration are essential to success. While the impact of students' sense of community on factors such as course satisfaction and retention has been studied among college enrollees in general, there is little research exploring this concept among allied health students. To address this shortcoming, a convenience sample of students enrolled in a large northeastern school of health-related professions was surveyed to gather information on their demographics, curriculum and selected course attributes, perceived instructor teaching perspectives, and sense of community. Univariate analysis indicated that entry-level students experienced a greater sense of community than post-professional students. Multivariate analysis revealed that instructor-determined factors of encouraging discussion, encouraging expression of opinions, and specifying response times best predicted sense of community. With all other variables controlled, perceptions of community were significantly lower in online courses, among students for whom English was their second language, and in courses where instructors were perceived as focused primarily on content delivery. This study supports promoting selected course and instructor-related attributes associated with sense of community in allied health education, with a particular focus on both non-native English speakers and post-professional students. Enhancement of online courses with strategies that increase instructor presence, better engage students, and facilitate interaction also are warranted.

  9. Training of Community Health Agents in health hearing children: current perspectives.

    Castro, Taís Teixeira de Oliveira; Zucki, Fernanda


    To characterize the training of Community Health Workers in the field of child hearing health. A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed. The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese. A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review. The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified. Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

  10. The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

    Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina


    One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. A designated centre for people with disabilities operated by Health Service Executive, Wexford

    Mikkers, Misja


    A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.

  12. Community participation in rural health: a scoping review

    Kenny Amanda


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

  13. Who Are the High-Cost Users? A Method for Person-Centred Attribution of Health Care Spending.

    Sara J T Guilcher

    Full Text Available To develop person-centered episodes of care (PCE for community-dwelling individuals in the top fifth percentile of Ontario health care expenditures in order to: (1 describe the main clinical groupings for spending; and (2 identify patterns of spending by health sector (e.g. acute care, home care, physician billings within and across PCE.Data were drawn from population-based administrative databases for all publicly funded health care in Ontario, Canada in 2010/11.This study is a retrospective cohort study.A total of 587,982 community-dwelling individuals were identified among those accounting for the top 5% of provincial health care expenditures between April 1, 2010 and March 31, 2011. PCE were defined as starting with an acute care admission and persisting through subsequent care settings and providers until individuals were without health system contact for 30 days. PCE were classified according to the clinical grouping for the initial admission. PCE and non-PCE costs were calculated and compared to provide a comprehensive measurement of total health system costs for the year.Among this community cohort, 697,059 PCE accounted for nearly 70% ($11,815.3 million (CAD of total annual publicly-funded expenditures on high-cost community-dwelling individuals. The most common clinical groupings to start a PCE were Acute Planned Surgical (35.2%, Acute Unplanned Medical (21.0% and Post-Admission Events (10.8%. Median PCE costs ranged from $3,865 (IQR = $1,712-$10,919 for Acute Planned Surgical to $20,687 ($12,207-$39,579 for Post-Admission Events. Inpatient acute ($8,194.5 million and inpatient rehabilitation ($434.6 million health sectors accounted for the largest proportions of allocated PCE spending over the year.Our study provides a novel methodological approach to categorize high-cost health system users into meaningful person-centered episodes. This approach helps to explain how costs are attributable within individuals across sectors and has

  14. Psychological distress and community approach to the voice of the community health agent

    Pâmela Câmpelo Paiva


    Full Text Available The user in psychological distress needs a service that provides a targeted assistance, that welcomes when required, acting as originator care device to the user on the network of health care. This study aimed to describe how people in psychological distress are perceived by the community in the voice of the community health worker. It is a qualitative research conducted with eighteen Community Health Agents, a Primary Care Unit Health (UAP located in BE IV, in Fortaleza, Ceará. We used a semi-structured and individual interview. Data processing was due to the content analysis. Ethical and legal aspects on the advice No. 957,595. Through the speeches of ACS, it describes how the community perceives the person in psychic suffering and how it positions itself in the face of your everyday problems, as regards the rejection, prejudice, discrimination ne loss of identity. However it is emphasized that, because of being inserted in the community, the community health worker realizes more accurate way in which this social group is the person in mental distress. The rejection of the person who became ill is seen as a fairly common reaction, accompanied by prejudice and discrimination, marginalizing her from society.

  15. Involving local health departments in community health partnerships: evaluation results from the partnership for the public's health initiative.

    Cheadle, Allen; Hsu, Clarissa; Schwartz, Pamela M; Pearson, David; Greenwald, Howard P; Beery, William L; Flores, George; Casey, Maria Campbell


    Improving community health "from the ground up" entails a comprehensive ecological approach, deep involvement of community-based entities, and addressing social determinants of population health status. Although the Centers for Disease Control and Prevention, the Office of the Surgeon General, and other authorities have called for public health to be an "inter-sector" enterprise, few models have surfaced that feature local health departments as a key part of the collaborative model for effecting community-level change. This paper presents evaluation findings and lessons learned from the Partnership for the Public's Health (PPH), a comprehensive community initiative that featured a central role for local health departments with their community partners. Funded by The California Endowment, PPH provided technical and financial resources to 39 community partnerships in 14 local health department jurisdictions in California to promote community and health department capacity building and community-level policy and systems change designed to produce long-term improvements in population health. The evaluation used multiple data sources to create progress ratings for each partnership in five goal areas related to capacity building, community health improvement programs, and policy and systems change. Overall results were generally positive; in particular, of the 37 partnerships funded continuously throughout the 5 years of the initiative, between 25% and 40% were able to make a high level of progress in each of the Initiative's five goal areas. Factors associated with partnership success were also identified by local evaluators. These results showed that health departments able to work effectively with community groups had strong, committed leaders who used creative financing mechanisms, inclusive planning processes, organizational changes, and open communication to promote collaboration with the communities they served.

  16. A designated centre for people with disabilities operated by Health Service Executive, Tipperary

    Xiao, Liang


    In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR.

  17. Het Dutch Wildlife Health Centre – kennis over wildziekten in Nederland

    Rijks, J.M.; Giessen, van der J.; Roest, H.I.J.; Kuiken, T.; Grone, A.


    Veel dierziekten inclusief zoönosen hebben wilde dieren als reservoir. Kennis over ziekten onder wilde dieren is van belang voor zowel de dier- en volksgezondheid, en vormt een essentieel onderdeel van het One health-concept. Een expertisecentrum wildziekten, waar dergelijke kennis vermeerderd en ge

  18. A designated centre for people with disabilities operated by Health Service Executive, Sligo

    Burke, Sara


    A new Irish government came to power in March 2011 with the most radical proposals for health system reform in the history of the state, including improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016. All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s. The authors assess how well the system coped with a downsizing of resources by an analysis of coverage and health system activity indicators. These show a health system that managed \\'to do more with less\\' from 2008 to 2012. They also demonstrate a system that was \\'doing more with less\\' by transferring the cost of care onto people and by significant resource cuts. From 2013, the indicators show a system that has no choice but \\'to do less with less\\' with diminishing returns from crude cuts. This is evident in declining numbers with free care, of hospital cases and home care hours, alongside increased wait-times and expensive agency staffing. The results suggest a limited window of benefit from austerity beyond which cuts and rationing prevail which is costly, in both human and financial terms.

  19. A designated centre for people with disabilities operated by Health Service Executive, Cork

    O'Connor, Mairead


    Participation in organized cervical cancer screening has declined recently. While research has focussed on barriers to screening participation, less attention has been paid to what motivates women to attend. Moreover, little is known about health care provider\\/practitioner-level barriers and facilitators to participation. Better understanding of these issues could help inform strategies to improve participation.

  20. Screening of patients with diabetes mellitus for tuberculosis in community health settings in China.

    Lin, Yan; Innes, Anh; Xu, Lin; Li, Ling; Chen, Jinou; Hou, Jinglong; Mi, Fengling; Kang, Wanli; Harries, Anthony D


    To assess the feasibility and results of screening of patients with DM for TB in routine community health services in China. Agreement on how to screen patients with DM for TB and monitor and record the results was obtained at a stakeholders meeting. Subsequent training was carried out for staff at 10 community health centres, with activities implemented from June 2013 to April 2014. Patients with DM were screened for TB at each clinical visit using a symptom-based enquiry, and those positive to any symptom were referred to the TB clinic for TB investigation. A total of 2942 patients with DM visited these ten clinics. All patients received at least one screening for TB. Two patients were identified as already known to have TB. In total, 278 (9.5% of those screened) who had positive TB symptoms were referred for TB investigations and 209 arrived at the TB centre or underwent a chest radiograph for TB investigation. One patient (0.5% of those investigated) was newly diagnosed with active TB and was started on anti-TB treatment. The TB case notification rate of those screened was 102/100,000. This pilot project shows it is feasible to carry out TB screening among patients with DM in community settings, but further work is needed to better characterise patients with DM at higher risk of TB. This may require a more targeted approach focused on high-risk groups such as those with untreated DM or poorly controlled hyperglycaemia. © 2015 John Wiley & Sons Ltd.

  1. Operational Efficiency of an Immunization Clinic Attached to Rural Health Training Centre in Delhi, India: A Time and Motion Study

    Varun Kumar


    Full Text Available Background. Obtaining baseline data about current patterns of work is important for assessing the effects of interventions designed to improve care delivery. Time and motion studies allow for the most accurate measurement of structured components. Therefore, the present study was conducted to study the operational efficiency of an immunization clinic in Delhi, India. Methods. An observational cross-sectional study was conducted at the immunization clinic of Rural Health Training Centre in Delhi, India, from January 2014 to March 2014. The study composed two stage evaluations, a passive observation and a time and motion study. Systemic random sampling method was used to select 863 mothers/caregivers attending the immunization clinic. Results. At the immunization clinic, the study participants spent 64.1% of their total time in waiting. For new cases, the mean time taken for initial registration and receiving postvaccination advice was found to be significantly longer than old cases. Delivering health care services took more time during Mondays and also during the first hour of the day. Conclusion. Results of this study will guide public health decision-makers at all government levels in planning and implementation of immunization programs in developing countries.

  2. Comparison of high- versus low-intensity community health worker intervention to promote newborn and child health in Northern Nigeria

    Findley SE


    Full Text Available Sally E Findley,1 Omolara T Uwemedimo,2 Henry V Doctor,1,3 Cathy Green,4 Fatima Adamu,5 Godwin Y Afenyadu61Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA; 2Pediatric Global Health Program, Cohen Children’s Medical Centre of New York, Division of General Pediatrics, New Hyde Park, NY, USA; 3Operations Research Unit, Programme for Reviving Routine Immunization in Northern Nigeria-Maternal Newborn and Child Health (PRRINN-MNCH, Abia State House, Abuja, Nigeria; 4Health Partners International, Waterside Centre, Lewes, East Sussex, United Kingdom; 5Social Development and Community Engagement Unit, 6Operations Research Unit, PRRINN-MNCH Programme, Nassarawa GRA, Kano State, NigeriaBackground: In Northern Nigeria, infant mortality rates are two to three times higher than in the southern states, and, in 2008, a partnership program to improve maternal, newborn, and child health was established to reduce infant and child mortality in three Northern Nigeria states. The program intervention zones received government-supported health services plus integrated interventions at primary health care posts and development of community-based service delivery (CBSD with a network of community volunteers and community health workers (CHWs, who focus on educating women about danger signs for themselves and their infants and promoting appropriate responses to the observation of those danger signs, consistent with the approach of the World Health Organization Integrated Management of Neonatal and Childhood Illness strategy. Before going to scale in the rest of the state, it is important to identify the relative effectiveness of the low-intensity volunteer approach versus the more intensive CBSD approach with CHWs.Methods: We conducted stratified cluster sample household surveys at baseline (2009 and follow-up (2011 to assess changes in newborn and sick child care practices among women with births in

  3. The Greater Vancouver Mental Health Service Society: 20 years' experience in urban community mental health.

    Sladen-Dew, N; Bigelow, D A; Buckley, R; Bornemann, S


    Caring for people in the community with persistent and disabling mental illnesses presents a major challenge to government, planners and mental health professionals. The success with which mentally disabled people are integrated into community life says much about the society in which we live. This article describes the experience of the Greater Vancouver Mental Health Service Society in offering community-based mental health services to persons with schizophrenia and other major mental disorders over the past 20 years. The key to its success lies in a decentralized, relatively non hierarchical organizational structure which allows committed and skilled multidisciplinary teams to work with patients and their families in their community. The resulting services are fully integrated within the fabric of the community and are responsive to local needs. Partnerships among professionals, patients, families and community agencies result in work that is creative, productive and effective.

  4. Aligning Provider Team Members With Polyvalent Community Health Workers.

    Brooks, Beth A; Davis, Sheila; Kulbok, Pamela; Frank-Lightfoot, Loraine; Sgarlata, Lisa; Poree, Shawanda


    In light of the fragmentation of health care services and the need for health promotion and disease prevention, it is time to consider the important role community health workers (CHWs) could play as part of the health care team. Globally, CHWs tend to focus on a single patient condition, resulting in fragmented, uncoordinated health care services. Polyvalent (or multimodal) CHWs can provide a comprehensive, patient-centric range of care coordination services with other members of the health care team, ultimately improving patient outcomes and decreasing the cost of care. The potential benefits of the polyvalent CHW to the health care team are not widely understood in the United States. To fill this knowledge gap, a toolkit for nurse leaders in mainstream health care settings was created. The toolkit outlines the key elements essential to a successful CHW program and offers strategies for navigating the various challenges involved when integrating this new role into existing models of care.

  5. A designated centre for people with disabilities operated by Health Service Executive, Donegal

    Murphy, Deirdre J


    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  6. Emergency preparedness training of tribal community health representatives.

    Hites, Lisle S; Granillo, Brenda S; Garrison, Edward R; Cimetta, Adriana D; Serafin, Verena J; Renger, Ralph F; Wakelee, Jessica F; Burgess, Jefferey L


    This study describes the development and evaluation of online Public Health Emergency Preparedness (PHEP) training adapted to the learning styles and needs of tribal Community Health Representatives (CHRs). Working through a university-tribal community college partnership, the Arizona Center for Public Health Preparedness at the University of Arizona and Diné College of the Navajo Nation delivered a blended online and face-to-face public health preparedness certificate program based on core public health emergency preparedness competencies. This program was carefully adapted to meet the environmental and learning needs of the tribal CHRs. The certificate program was subsequently evaluated via a scenario-based decision-making methodology. Significant improvements in five of six competency areas were documented by comparison of pre- and post-certificate training testing. Based on statistical support for this pedagogical approach the cultural adaptations utilized in delivery of the certificate program appear to be effective for PHEP American Indian education.

  7. Topical xylitol administration by parents for the promotion of oral health in infants: a caries prevention experiment at a Finnish Public Health Centre.

    Mäkinen, Kauko K; Järvinen, Kirsti L; Anttila, Carita H; Luntamo, Leena M; Vahlberg, Tero


    This demonstration programme tested topical use of xylitol as a possible oral health promoting regimen in infants at a Finnish Public Health Centre in 2002-2011. Parents (usually mothers) began once- or twice-daily administration of a 45% solution of xylitol (2.96 m) onto all available deciduous teeth of their children at the age of approximately 6-8 months. The treatment (xylitol swabbing), which continued till the age of approximately 36 months (total duration 26-28 months), was carried out using cotton swabs or a children's toothbrush; the approximate daily xylitol usage was 13.5 mg per each deciduous tooth. At the age of 7 years, caries data on the deciduous dentition of 80 children were compared with those obtained from similar, untreated children (n = 90). Xylitol swabbing resulted in a significant (P caries compared with the comparison subjects (relative risk 2.1 and 4.0, respectively; 95% confidence intervals 1.42-3.09 and 2.01-7.98, respectively). Similar findings were obtained when the children were 5 or 6 years old. The treatment reduced the need of tooth filling relative risk and 95% confidence intervals at 7 years: 11.86 and 6.36-22.10, respectively; P dental health was accomplished in infants participating in a topical at-home xylitol administration experiment, which was offered to families in the area by the Public Health Centre as a supplement to standard oral health care. Caregiver assessment of the programme was mostly rated as high or satisfactory. © 2013 FDI World Dental Federation.

  8. Healthy communities: addressing vulnerability and environmental health

    Wright, C


    Full Text Available Air pollution in South Africa is a serious environmental health threat, particularly in urban and peri-urban metropolitan areas, but also in low income settlements where indoor air pollution from domestic fuel use is a concern. A healthy population...

  9. Empowering Minority Communities with Health Information - UDC

    McMurray, L.; R. Foster; and R. Womble


    Training update with Environmental a health focus. Training conducted as part of the United Negro College Fund Special Programs Corporation/National Library of Medicine - HBCU ACCESS Project at the University of the District of Columbia, Washington, DC on November 2, 2010.

  10. Improving health literacy in community populations: a review of progress.

    Nutbeam, Don; McGill, Bronwyn; Premkumar, Pav


    Governments around the world have adopted national policies and programs to improve health literacy. This paper examines progress in the development of evidence to support these policies from interventions to improve health literacy among community populations. Our review found only a limited number of studies (n=7) that met the criteria for inclusion, with many more influenced by the concept of health literacy but not using it in the design and evaluation. Those included were diverse in setting, population and intended outcomes. All included educational strategies to develop functional health literacy, and a majority designed to improve interactive or critical health literacy skills. Several papers were excluded because they described a protocol for an intervention, but not results, indicating that our review may be early in a cycle of activity in community intervention research. The review methodology may not have captured all relevant studies, but it provides a clear message that the academic interest and attractive rhetoric surrounding health literacy needs to be tested more systematically through intervention experimentation in a wide range of populations using valid and reliable measurement tools. The distinctive influence of the concept of health literacy on the purpose and methodologies of health education and communication is not reflected in many reported interventions at present. Evidence to support the implementation of national policies and programs, and the intervention tools required by community practitioners are not emerging as quickly as needed. This should be addressed as a matter of priority by research funding agencies.

  11. Understanding Determinants of Cardiovascular Health in a Mexican American Community.

    Larimer, Karen A; Gulanick, Meg; Penckofer, Sue


    Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed. Fifteen community leaders were interviewed using guided interviews. Database searches and direct observations were conducted. Using these methods provided comprehensive assessment of social and physical determinants of health, and access issues that were unique to the community studied. Findings demonstrated greater awareness of diabetes than CVD as a health problem, with little knowledge of CVD risk factors. Lack of access to health services (lack of insurance, lack of a medical home) and presence of cultural and socioeconomic barriers such as language, unemployment, low income, and lack of insurance were identified. The physical determinants such as environment presented fewer barriers, with adequate access to fruits and vegetables, transportation, and parks. Results revealed target areas for intervention.

  12. A designated centre for people with disabilities operated by Health Service Executive, Sligo

    McNicholas, F


    Children in care in Ireland have increased by 27% in the last decade. This population is recognized to be among the most vulnerable. This study aims to describe their placement histories, service use and mental health needs. Data was obtained on 174 children (56.5% of eligible sample) with a mean age of 10.83 (SD = 5.04). 114 (65.5%) were in care for three years or more. 29 (16.7%) did not have a SW and 49 (37.7%) had no GP 50 (28.7%) were attending CAMHS. Long term care, frequent placement changes and residential setting were significantly related with poorer outcomes and increased MH contact. Given the increase in numbers in care and the overall decrease in resource allocation to health and social care, individual care planning and prioritizing of resources are essential.

  13. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva


    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  14. Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

    Shaily Agarwal


    Conclusions: VIA is useful for detection of precursor lesions of cervical cancer not only in low-resource settings but also in well-equipped health centers and cancer centers. In these non low-resource settings, VIA has a positive predictive value comparable to the conventional Pap smear, but it is more likely to achieve earlier diagnosis, follow-up, and treatment than cytology based screening. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 752-756

  15. Community Health Asset Mapping Partnership Engages Hispanic/Latino Health Seekers and Providers.

    Cutts, Teresa; Langdon, Sarah; Meza, Francis Rivers; Hochwalt, Bridget; Pichardo-Geisinger, Rita; Sowell, Brandon; Chapman, Jessica; Dorton, Linda Batiz; Kennett, Beth; Jones, Maria Teresa


    The Hispanic/Latino population in Forsyth County, North Carolina, is growing quickly and experiencing significant disparities in access to care and health outcomes. Assessing community perceptions and utilization of health care resources in order to improve health equity among Hispanics/Latinos at both the county and state levels is critical. Our community engagement process was guided by the Community Health Assets Mapping Partnerships (CHAMP) approach, which helps identify gaps in health care availability and areas for immediate action to improve access to and quality of health care. Specifically, we invited and encouraged the Hispanic/Latino population to participate in 4 different workshops conducted in Spanish or English. Participants were identified as either health care providers, defined as anyone who provides health care or a related service, or health care seekers, defined as anyone who utilizes such services. The most commonly cited challenges to access to care were cost of health care, documentation status, lack of public transportation, racism, lack of care, lack of respect, and education/language. These data were utilized to drive continued engagement with the Hispanic community, and action steps were outlined. While participation in the workshops was acceptable, greater representation of health care seekers and community providers is needed. This process is fundamental to multilevel initiatives under way to develop trust and improve relationships between the Hispanic/Latino community and local health care entities in Forsyth County. Follow-through on recommended action steps will continue to further identify disparities, close gaps in care, and potentially impact local and state policies with regard to improving the health status of the Hispanic/Latino community. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  16. SEQUenCE: a service user-centred quality of care instrument for mental health services.

    Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul


    To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  17. Promoting the Health of Families and Communities: A Moral Imperative.

    Mason, Diana J


    The Hill Burton Act, which was signed into law in 1946 and ended in 1997, was one of the most significant forces that shaped the health care system we have today. Providing grants and loans for the construction and expansion of hospitals across the country, it required beneficiary hospitals to give some amount of uncompensated care to the poor and uninsured in return. The act not only led to our health care system's current emphasis on the acute-care hospital as the primary site of health care delivery, but it also had a profound effect on nursing, fully involving the profession in an acute-care world. The act created jobs for nurses at an unprecedented level. There are over 3.4 million nurses in the United States, and in 2013, 63 percent of all nurses worked for hospitals. Nursing education continues to emphasize acute care, despite the calls for shifting the curriculum to more community-based content and experiences that focus on health promotion and wellness for individuals, families, and communities. It is my premise that the nursing profession and all who profess to be committed to promoting health have a moral obligation to help the nation adopt a Hill-Burton Act of the twenty-first century that will focus on building healthy communities, supporting families in ways that promote health, and helping individuals to live healthier lives. This would require a shift in resources from a costly health care system to investing in community development, whether job creation, building safe places to play and exercise, providing access to affordable and nutritious foods, advancing the quality of education, or other approaches to addressing and improving the social determinants of health. Making this kind of investment would speak to the principles of beneficence, least harm, and justice, particularly for socioeconomically stressed communities.

  18. Local communities and health disaster management in the mining sector

    Freek Cronjé


    Full Text Available Mining activities throughout the Southern African Development Community (SADC have impacted on the health and safety of mining communities for many decades. Despite the economic contribution of mining to surrounding communities, a huge amount of social and environmental harm is associated with the industry. In this regard, mining companies have, on the one hand, contributed toward improved social development by providing jobs, paying taxes and earning foreign exchange. On the other hand, they have been linked publicly to poor labour conditions, corruption, pollution incidents, health and safety failings, as well as disrespect of human rights. The objectives of this study are to give an overview of social and natural factors relating to health disasters in selected communities in the mining environment. Regarding the findings, this paper focuses on the social and natural factors involved in the creation of health disasters. The social factors include poverty, unemployment, poor housing and infrastructure, prostitution and a high influx of unaccompanied migrant labour. Major health issues in this regard, which will be highlighted, are the extraordinary high incidence rate of HIV and STIs (sexually transmitted infections, addiction and mental illness. The environmental (natural threats to health that will be discussed in the study are harmful particles in the air and water, excessive noise and overcrowded and unhygienic living conditions. In conclusion, the paper also finds that communities need to be ‘fenced in’ in terms of health disaster management instead of being excluded. Specific recommendations to mining companies to reduce health and safety disasters will be made to conclude the paper.

  19. Bringing Health Policy Issues Front and Center in the Community: Expanding the Role of Community Health Coalitions

    Joel S. Meister, PhD


    Full Text Available Background Systemic, environmental, and socioeconomic conditions create the context in which community members deal with their health concerns. Comprehensive, community-based chronic disease prevention interventions should address community-wide or regional policy issues that influence lifestyle behaviors associated with chronic diseases. Context In two communities along the Arizona-Mexico border, community coalitions that administered a comprehensive diabetes prevention and control intervention expanded their membership to become policy and advocacy coalitions with broad community representation. These coalitions, or Special Action Groups (SAGs, identified and prioritized policy issues that directly or indirectly affect physical activity or nutrition. Methods Local schools were one focus of advocacy. The Centers for Disease Control and Prevention’s School Health Index was implemented as part of the overall intervention; the SAGs supported schools in advocating for more physical education programs, removal of vending machines, substitution of more healthful options in vending machines, and changes in health education curricula. In the broader community, the SAGs promoted opportunities for walking and bicycling, long-term planning by their cities and counties, and healthy food choices in local grocery stores. Advocacy tactics included attending and making presentations at city council, school board, parks and recreation, and planning and zoning commission meetings; participating on long-range planning committees; organizing an annual community forum for elected and appointed officials; and presenting healthy food and cooking demonstrations in local markets. Consequences After three years, SAGs were able to document changes in local policies and practices attributable to their activities. Interpretation The SAGs contributed to systems changes in their communities and were able to obtain new resources that support protective behaviors. Also, the

  20. Improving the health of Missouri communities: a process approach.

    Stafford-Alewine, S


    It is important to note that while many states have communities involved in processes similar to CHART, few, if any, offer a team of professionals to support these initiatives, and none have a statewide partnership that is as committed to the process as Missouri does. The relationship between the key partner organizations is a unique phenomenon, and is certainly a key success factor for the process. CHART is an active member of the Coalition for Healthier Cities and Communities, a national network that exists as a multi-sector partnership to service the widespread communities movement in the U.S. The Coalition serves as both a link to resources, and as a voice for policy and action. The issues and concerns, as well as the successes, of Missouri communities are carried to this national Coalition to present a unified voice for communities nationwide. CHART is an innovative approach to empowered community development. It provides communities the opportunity to participate in the process of change. The CHART process provides a vehicle for communities to take charge of the future, to determine locally how issues are addressed, and to set a course that assures improved health, quality of life, and sustainable community systems for the 21st century.

  1. Early experiences on the feasibility, acceptability, and use of malaria rapid diagnostic tests at peripheral health centres in Uganda-insights into some barriers and facilitators

    Asiimwe Caroline


    Full Text Available Abstract Background While feasibility of new health technologies in well-resourced healthcare settings is extensively documented, it is largely unknown in low-resourced settings. Uganda's decision to deploy and scale up malaria rapid diagnostic tests (mRDTs in public health facilities and at the community level provides a useful entry point for documenting field experience, acceptance, and predictive variables for technology acceptance and use. These findings are important in informing implementation of new health technologies, plans, and budgets in low-resourced national disease control programmes. Methods A cross-sectional qualitative descriptive study at 21 health centres in Uganda was undertaken in 2007 to elucidate the barriers and facilitators in the introduction of mRDTs as a new diagnostic technology at lower-level health facilities. Pre-tested interview questionnaires were administered through pre-structured patient exit interviews and semi-structured health worker interviews to gain an understanding of the response to this implementation. A conceptual framework on technology acceptance and use was adapted for this study and used to prepare the questionnaires. Thematic analysis was used to generate themes from the data. Results A total of 52 of 57 health workers (92% reported a belief that a positive mRDT result was true, although only 41 of 57 (64% believed that treatment with anti-malarials was justified for every positive mRDT case. Of the same health workers, only 49% believed that a negative mRDT result was truly negative. Factors linked to these findings were related to mRDT acceptance and use, including the design and characteristics of the device, availability and quality of mRDT ancillary supplies, health worker capacity to investigate febrile cases testing negative with the device and provide appropriate treatment, availability of effective malaria treatments, reliability of the health commodity supply chain, existing national

  2. Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers with Primary Care

    Cherrington, Andrea L.; Agne, April A; Lampkin, Yolanda; Birl, Annie; Shelton, Tanya C.; Guzman,Alfredo; Willig, James H.


    Community Health Worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the healthcare team and enhance care. We tested a model for the integration of a CHW delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using t...

  3. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

    Fayers Peter


    Full Text Available Abstract Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1 To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2 To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1 To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1 in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2 To conduct patient focus group discussions at each of these (Phase 1 to determine care received. 3 To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2. 4 To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2. 5 To undertake document

  4. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza



    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  5. Improving Community Health Using an Outcome-Oriented CQI Approach to Community-Engaged Health Professions Education

    Clithero, Amy; Ross, Simone Jacquelyn; Middleton, Lyn; Reeve, Carole; Neusy, Andre-Jacques


    Health professionals providing health-care services must have the relevant competencies and clinical experiences needed to improve population health outcomes in different contexts. Current models of health profession education often fail to produce a fit-for-purpose workforce ready and willing to provide relevant, quality care to underserved communities. Evidence is emerging that community-engaged and socially accountable health workforce education, i.e., aligned with priority health needs, produces a workforce ready and willing to work in partnership with underserved regions. This model of education fosters greater affiliation between education and service delivery systems and requires institutions to measure graduate outcomes and institutional impact. The Training for Health Equity Network (THEnet), a partnership of socially accountable health workforce education institutions, has developed and tested a Social Accountability Framework for Health Workforce Education (the Framework) and toolkit to improve alignment of health workforce education with outcomes to assess how well education institutions meet the needs of the communities they serve. The Framework links education and service delivery creating a continuous quality improvement feedback loop to ensure that education addresses needs and maximizes impact on the quality of service delivery. The Framework also provides a unifying set of guidelines for health workforce policy and planning, accreditation, education, research, and service delivery. A key element to ensuring consistent high quality service delivery is an appropriately trained and equitably distributed workforce. An effective and comprehensive mechanism for evaluation is the method of CQI which links the design, implementation, accreditation, and evaluation of health workforce education with health service delivery and health outcomes measurement. PMID:28289678

  6. Experiences from three community health promotion projects in Greenland

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


    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...... aspects of community capacity building. CONCLUSION: We need to learn more about how to employ the resources of communities, how to achieve better partnerships and how to support people in their efforts in order to secure population participation at all project stages. It is important to build coalitions...

  7. Promoting community participation in priority setting in district health systems

    Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict


    Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting...... of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions....... is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience...

  8. Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities

    West, Jenny S.; Price, Matthew; Gros, Kirstin Stauffacher; Ruggiero, Kenneth J.


    Objective We examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health. Methods A representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support. A series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples. Results Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants. Conclusions Community support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. PMID:24274123

  9. Recent developments in community mental health: Relevance and relationship with the mental health care bill

    Rakesh Kumar Chadda


    Full Text Available Community mental health refers to the treatment of persons with mental disorders in the community. In the earlier periods, treatment of patients with mental illness was limited to the mental hospitals or asylums. This paper traces the beginnings of community psychiatry in India from the time Dr. Vidya Sagar initiated his famous experiment of treating patients with mental illnesses along with family members in tents outside the mental hospital, Amritsar. It then discusses the role of the National Mental Health Program and the District Mental Health Program. The role of the United Nations Convention on the Rights of Persons with Disability in leading onto the development of the current Mental Health Care Bill, 2013 is discussed. Authors critically evaluate some of the merits and drawbacks of the Bill as related to recent developments in community mental health in India.

  10. Developing communities of practice in health care

    Jørgensen, Rasmus; Edwards, Kasper

    the use of SOPs. A CoP is a social community formed around a practice (e.g. ICU nursing) which induce a propensity to share experiences and thereby constitute knowledge sharing (Lave & Wenger 1991; Brown & Duguid 1991). CoP was conceived as a descriptive construct but has gained popularity and is found...... to improve practice performance, but knowledge about developing and measuring CoP is lacking (Ison et al. 2014). We propose a method to develop a CoP and the method is tested in a blood analysis unit at ‘Nordsjællands Hospital’ in Denmark. Design/methodology/approach The interventions were identified from...... current CoP research. Interventions were initiated just after baseline measurement.  The following interventions took place: The practice was operationalized narrowly as employees performing a specific operational task. The practice was chosen due to a high frequency and recurring problems. A voluntary Co...

  11. The influence of Community Access to Child Health (CATCH) program on community pediatrics.

    Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David


    The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.

  12. Using a human resource management approach to support community health workers: experiences from five African countries.

    Raven, Joanna; Akweongo, Patricia; Baba, Amuda; Baine, Sebastian Olikira; Sall, Mohamadou Guelaye; Buzuzi, Stephen; Martineau, Tim


    Like any other health worker, community health workers (CHWs) need to be supported to ensure that they are able to contribute effectively to health programmes. Management challenges, similar to those of managing any other health worker, relate to improving attraction, retention and performance. Exploratory case studies of CHW programmes in the Democratic Republic of Congo, Ghana, Senegal, Uganda and Zimbabwe were conducted to provide an understanding of the practices for supporting and managing CHWs from a multi-actor perspective. Document reviews (n = 43), in-depth interviews with programme managers, supervisors and community members involved in managing CHWs (n = 31) and focus group discussions with CHWs (n = 13) were conducted across the five countries. Data were transcribed, translated and analysed using the framework approach. CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities. Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts. Front-line supervisors, such as health centre nurses and senior CHWs, play a major role in the management of CHWs and are central to the implementation of HRM practices. On the other hand, community members and programme managers have little involvement with managing the CHWs. This study highlighted that CHW expectations are not always met through HRM practices. This paper calls for a coordinated HRM approach to support CHWs, whereby HRM practices are designed to not only address expectations but also ensure that the CHW programme meets its goals. There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective

  13. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)


    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  14. Illness management and recovery (IMR) in Danish community mental health centres

    Dalum, Helle Stentoft; Korsbek, Lisa; Mikkelsen, John Hagel


    and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR. Methods/Design: The trial design......Background: Schizophrenia and bipolar disorder are severe mental illnesses that can have a significant disabling impact on the lives of people. Psychosocial interventions that stress hope and recovery as a part of a multidimensional approach are possibly indicated to support people with severe...... mental illness in facilitating recovery. Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge...

  15. Illness management and recovery (IMR) in Danish community mental health centres

    Dalum, Helle Stentoft; Korsbek, Lisa; Mikkelsen, John Hagel


    Background: Schizophrenia and bipolar disorder are severe mental illnesses that can have a significant disabling impact on the lives of people. Psychosocial interventions that stress hope and recovery as a part of a multidimensional approach are possibly indicated to support people with severe...... mental illness in facilitating recovery. Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge...... and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR. Methods/Design: The trial design...

  16. Illness management and recovery (IMR) in Danish community mental health centres

    Dalum, Helle Stentoft; Korsbek, Lisa; Mikkelsen, John Hagel


    mental illness in facilitating recovery. Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge...... and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR. Methods/Design: The trial design....... Discussion: If the results of this trial show IMR to be effective these positive results will strengthen the evidence of IMR as an effective comprehensive psychosocial intervention with a recovery-oriented approach for people with severe mental illness. This will have significant implications...

  17. A Multidisciplinary Approach to Treating Obesity in a Community Health Centre.

    Kovač Blaž, Milena; Švab, Igor


    The aim of the study is to assess the weight loss programme with regards to the long-term effectiveness of weight reduction and weight maintenance, using completion rate and BMI, blood sugar, cholesterol and blood pressure levels as outcomes. The aim of the study also includes identifying the factors associated with adherence to the programme. The programme was developed by a multidisciplinary team. It included 6 months of introduction and another 18 months of maintenance. The data for 397 participants was collected after 24 months. 346 participants have completed the introduction and 123 have completed the programme. In the introduction, the average weight loss was 12% of the initial weight. The participants, who completed the full programme, lost 9.4% of their initial weight. The participants also significantly (padherence to the programme are: age over 50, lower educational levels, lower initial weight and higher weight loss in the introduction. The multi-disciplinary approach to obesity treatment was effective for a selected group of people. The proportion of dropouts was relatively high, but still low compared to similar programmes. Group treatment and mutual support are of a great importance in bringing about and maintaining the changes.

  18. A queer-theoretical approach to community health psychology.

    Easpaig, Bróna R Nic Giolla; Fryer, David M; Linn, Seònaid E; Humphrey, Rhianna H


    Queer-theoretical resources offer ways of productively rethinking how central concepts such as 'person-context', 'identity' and 'difference' may be understood for community health psychologists. This would require going beyond consideration of the problems with which queer theory is popularly associated to cautiously engage with the aspects of this work relevant to the promotion of collective practice and engaging with processes of marginalisation. In this article, we will draw upon and illustrate the queer-theoretical concepts of 'performativity' and 'cultural intelligibility' before moving towards a preliminary mapping of what a queer-informed approach to community health psychology might involve.

  19. Reimagining community health psychology: maps, journeys and new terrains.

    Campbell, Catherine; Cornish, Flora


    This special issue celebrates and maps out the 'coming of age' of community health psychology, demonstrating its confident and productive expansion beyond its roots in the theory and practice of small-scale collective action in local settings. Articles demonstrate the field's engagement with the growing complexity of local and global inequalities, contemporary forms of collective social protest and developments in critical social science. These open up novel problem spaces for the application and extension of its theories and methods, deepening our understandings of power, identity, community, knowledge and social change - in the context of evolving understandings of the spatial, embodied, relational, collaborative and historical dimensions of health.

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

    Petersen, Poul Erik; Kwan, Stella


    national and community oral health programmes. Twenty-two invitees from 15 countries attended in addition to WHO staff. The first day was devoted to presentations of oral health promotion and oral disease prevention programmes from around the world. During the second day, WHO staff at Headquarters in Geneva discussed aspects of evaluation of public health programmes. Two working groups were formed to discuss agreed topics, and the reports from their deliberations, together with the general discussion, resulted in the presentation of emerging key issues and recommendations. In summary, it was agreed that evaluation of oral health promotion and disease prevention programmes should integrate, whenever possible, with general health programmes. While the design and advantages of RCTs in clinical evaluations are well documented, the relevance of this design in evaluation of community oral disease preventive programmes and oral health promotion programmes are much less clearly defined. Subsequently, the conduct of such programmes may be inappropriately evaluated in systematic reviews. There is a need for more research into appropriate immediate, interim and ultimate outcome measures, as well as process evaluation, an assessment that is poorly understood and practised less often than outcome evaluation. Guidance on potential design, conduct, and especially the evaluation, of community oral disease prevention programmes and oral health promotion programmes should be developed and updated regularly. WHO Collaborating Centres could have a role in promoting good practice, training and collaboration between teams throughout the world. Centres undertaking systematic reviews should consider the guidelines given in the proposed WHO document when defining their evaluation criteria.