A community-based exercise intervention transitions metabolically abnormal obese adults to a metabolically healthy obese phenotype

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Dalleck, Lance C; Van Guilder, Gary P; Richardson, Tara B; Bredle, Donald L; Janot, Jeffrey M

2014-01-01

Background Lower habitual physical activity and poor cardiorespiratory fitness are common features of the metabolically abnormal obese (MAO) phenotype that contribute to increased cardiovascular disease risk. The aims of the present study were to determine 1) whether community-based exercise training transitions MAO adults to metabolically healthy, and 2) whether the odds of transition to metabolically healthy were larger for obese individuals who performed higher volumes of exercise and/or experienced greater increases in fitness. Methods and results Metabolic syndrome components were measured in 332 adults (190 women, 142 men) before and after a supervised 14-week community-based exercise program designed to reduce cardiometabolic risk factors. Obese (body mass index ≥30 kg · m2) adults with two to four metabolic syndrome components were classified as MAO, whereas those with no or one component were classified as metabolically healthy but obese (MHO). After community exercise, 27/68 (40%) MAO individuals (Pmetabolically healthy, increasing the total number of MHO persons by 73% (from 37 to 64). Compared with the lowest quartiles of relative energy expenditure and change in fitness, participants in the highest quartiles were 11.6 (95% confidence interval: 2.1–65.4; Pexercise transitions MAO adults to metabolically healthy. MAO adults who engaged in higher volumes of exercise and experienced the greatest increase in fitness were significantly more likely to become metabolically healthy. Community exercise may be an effective model for primary prevention of cardiovascular disease. PMID:25120373

Assessing control of postural stability in community-living older adults using performance-based limits of stability

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Boissy Patrick

2008-03-01

Full Text Available Abstract Background Balance disability measurements routinely used to identify fall risks in frail populations have limited value in the early detection of postural stability deficits in community-living older adults. The objectives of the study were to 1 measure performance-based limits of stability (LOS in community-living older adults and compare them to theoretical LOS computed from data proposed by the Balance Master® system, 2 explore the feasibility of a new measurement approach based on the assessment of postural stability during weight-shifting tasks at performance-based LOS, 3 quantify intra-session performance variability during multiple trials using the performance-based LOS paradigm. Methods Twenty-four healthy community-living older adults (10 men, 14 women aged between 62 to 85 (mean age ± sd, 71.5 ± 6 yrs participated in the study. Subjects' performance-based LOS were established by asking them to transfer their body weight as far as possible in three directions (forward, right and left without changing their base of support. LOS were computed as the maximal excursion of the COP in each direction among three trials. Participants then performed two experimental tasks that consisted in controlling, with the assistance of visual feedback, their centre of pressure (COP within two predefined targets set at 100% of their performance-based LOS. For each tasks 8 trials were performed. Ground reaction forces and torques during performance-based LOS evaluation and experimental tasks were recorded with a force plate. Sway area and medio-lateral mean COP displacement speed variables were extracted from force plate recordings. Results Significant differences between theoretical LOS computed from maximum leaning angles derived from anthropometric characteristics and performance-based LOS were observed. Results showed that a motor learning effect was present as the participants optimized their weight-shifting strategy through the first three

A metasynthesis study of family caregivers' transition experiences caring for community-dwelling persons with advanced cancer at the end of life.

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Duggleby, Wendy; Tycholiz, Jamie; Holtslander, Lorraine; Hudson, Peter; Nekolaichuk, Cheryl; Mirhosseini, Mehrnoush; Parmar, Jasneet; Chambers, Thane; Alook, Angele; Swindle, Jennifer

2017-07-01

Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. To (a) explore the transition experience of family caregivers caring for persons with advanced cancer living in the community, (b) describe potential triggers for transitions, (c) identify what influences this experience, and (d) develop a conceptual framework of their transition experience. Sandelowski and Barroso's methodology for synthesizing qualitative research included (a) a comprehensive search of empirical literature, (b) quality appraisal of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Literature was sourced from six electronic data bases. Inclusion criteria were as follows: (a) published qualitative studies (and mixed-method designs) of the caregiving experience of family caregivers of community-living persons with advanced cancer at the end of life, (b) participants (caregivers and care recipients) of 18 years of age and above, (c) studies published in English in any country, and (d) studies published between 2004 and 2014. A total of 72 studies were included in the metasynthesis. Family caregivers experience a "life transition" whereby their lives are permanently altered. The participants described the process of redefining normal which consisted of coming to terms with their situation and connecting with others. Outcomes of these processes were as follows: (a) maintaining a sense of personhood, (b) reframing hope, (c) maintaining self-efficacy, (d) finding meaning, and (e) preparing for the death of their care recipient. The findings provide a framework to guide the development of supportive programs and future research.

A community living management program for people with disabilities who have moved out of nursing homes: a pilot study.

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Lee, Danbi; Hammel, Joy; Wilson, Tom

2015-06-23

This study describes implementation and evaluation of the Stepping Stones program, a community living management program designed to assist people with disabilities to gain community living skills after moving out of nursing homes. Thirteen people with diverse disabilities participated in the 10-week Stepping Stones program. The participants attended two sessions a day every week, over a 5-week period. Interviewer-administered surveys were used at baseline and 1 week post-intervention to evaluate the impact of the program. Focus group interviews were conducted at 1 week post-intervention. Analyses of quantitative data demonstrated improved self-efficacy in community living management skills, with medium-to-high effect sizes. Participants reported improved sense of empowerment and confidence in finding resources and managing community living. They also reported high satisfaction with the program. Preliminary findings suggest that the Stepping Stones program is beneficial to the target group. The study indicates that application of social learning and self-efficacy theories is effective to empower and enable people with disabilities to manage their lives in the community. The Stepping Stones program may be provided as a risk management intervention after individuals' transition into the community. Implications for Rehabilitation Long-term institutionalization negatively influences people with disabilities' self-esteem, autonomy and ability to independently live in the community. Successful community living requires complex management involving the coordination of personal, social, resource and environmental factors. This study shows that programming on choice and control and community living skill development improved participants' confidence in managing community living.

Wayfinding the Live 5-2-1-0 Initiative-At the Intersection between Systems Thinking and Community-Based Childhood Obesity Prevention.

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Amed, Shazhan; Shea, Stephanie; Pinkney, Susan; Wharf Higgins, Joan; Naylor, Patti-Jean

2016-06-21

Childhood obesity is complex and requires a 'systems approach' that collectively engages across multiple community settings. Sustainable Childhood Obesity Prevention through Community Engagement (SCOPE) has implemented Live 5-2-1-0-a multi-sector, multi-component childhood obesity prevention initiative informed by systems thinking and participatory research via an innovative knowledge translation (KT) model (RE-FRAME). This paper describes the protocol for implementing and evaluating RE-FRAME in two 'existing' (>2 years of implementation) and two 'new' Live 5-2-1-0 communities to understand how to facilitate and sustain systems/community-level change. In this mixed-methods study, RE-FRAME was implemented via online resources, webinars, a backbone organization (SCOPE) coordinating the initiative, and a linking system supporting KT. Qualitative and quantitative data were collected using surveys and stakeholder interviews, analyzed using thematic analysis and descriptive statistics, respectively. Existing communities described the consistency of Live 5-2-1-0 and extensive local partnerships/champions as catalysts for synergistic community-wide action; new communities felt that the simplicity of the message combined with the transfer of experiential learning would inform their own strategies and policies/programs to broadly disseminate Live 5-2-1-0. RE-FRAME effectively guided the refinement of the initiative and provided a framework upon which evaluation results described how to implement a community-based systems approach to childhood obesity prevention.

The Lived Experiences of Nurses Transitioning to a Preceptor Role

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Miller, Janice Ampil

2013-01-01

This study explores the lived experiences of nurses who have transitioned to a nurse preceptor role and provides examples of how individuals learn in the workplace. Historically, nurses who agreed to become preceptors were chosen based on their availability and experience, not necessarily their teaching and learning abilities. Nursing research has…

A community based field research project investigating anaemia amongst young children living in rural Karnataka, India: a cross sectional study

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Black Jim

2009-02-01

Full Text Available Abstract Background Anaemia is an important problem amongst young children living in rural India. However, there has not previously been a detailed study of the biological aetiology of this anaemia, exploring the relative contributions of iron, vitamin B12, folate and Vitamin A deficiency, inflammation, genetic haemoglobinopathy, hookworm and malaria. Nor have studies related these aetiologic biological factors to household food security, standard of living and child feeding practices. Barriers to conducting such work have included perceived reluctance of village communities to permit their children to undergo venipuncture, and logistical issues. We have successfully completed a community based, cross sectional field study exploring in detail the causes of anaemia amongst young children in a rural setting. Methods and design A cross sectional, community based study. We engaged in extensive community consultation and tailored our study design to the outcomes of these discussions. We utilised local women as field workers, harnessing the capacity of local health workers to assist with the study. We adopted a programmatic approach with a census rather than random sampling strategy in the village, incorporating appropriate case management for children identified to have anaemia. We developed a questionnaire based on existing standard measurement tools for standard of living, food security and nutrition. Specimen processing was conducted at the Primary Health Centre laboratory prior to transport to an urban research laboratory. Discussion Adopting this study design, we have recruited 415 of 470 potentially eligible children who were living in the selected villages. We achieved support from the community and cooperation of local health workers. Our results will improve the understanding into anaemia amongst young children in rural India. However, many further studies are required to understand the health problems of the population of rural India, and

A community based field research project investigating anaemia amongst young children living in rural Karnataka, India: a cross sectional study.

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Pasricha, Sant-Rayn; Vijaykumar, Varalaxmi; Prashanth, N S; Sudarshan, H; Biggs, Beverley-Ann; Black, Jim; Shet, Arun

2009-02-17

Anaemia is an important problem amongst young children living in rural India. However, there has not previously been a detailed study of the biological aetiology of this anaemia, exploring the relative contributions of iron, vitamin B12, folate and Vitamin A deficiency, inflammation, genetic haemoglobinopathy, hookworm and malaria. Nor have studies related these aetiologic biological factors to household food security, standard of living and child feeding practices. Barriers to conducting such work have included perceived reluctance of village communities to permit their children to undergo venipuncture, and logistical issues. We have successfully completed a community based, cross sectional field study exploring in detail the causes of anaemia amongst young children in a rural setting. A cross sectional, community based study. We engaged in extensive community consultation and tailored our study design to the outcomes of these discussions. We utilised local women as field workers, harnessing the capacity of local health workers to assist with the study. We adopted a programmatic approach with a census rather than random sampling strategy in the village, incorporating appropriate case management for children identified to have anaemia. We developed a questionnaire based on existing standard measurement tools for standard of living, food security and nutrition. Specimen processing was conducted at the Primary Health Centre laboratory prior to transport to an urban research laboratory. Adopting this study design, we have recruited 415 of 470 potentially eligible children who were living in the selected villages. We achieved support from the community and cooperation of local health workers. Our results will improve the understanding into anaemia amongst young children in rural India. However, many further studies are required to understand the health problems of the population of rural India, and our study design and technique provide a useful demonstration of a

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

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Martina Schäfer

2018-04-01

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

Community Living Skills Guide: Art.

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Sobol, Sheila; Kreps, Alice Roelofs

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Art. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized persons to eventual…

Flexibility in competency-based workplace transition programs: an exploratory study of community child and family health nursing.

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Cusack, Lynette; Gilbert, Sandra; Fereday, Jennifer

2013-03-01

Successful transition to practice programs that use competency-based assessment require the involvement of all staff, especially those undertaking the preceptor role. Qualitative data were collected using interview methods. Participants were 14 newly employed nurses and 7 preceptors in the child and family community health service in South Australia. Participant narratives were recorded electronically, transcribed, and thematically analyzed using the paradigm of critical social science. Five themes were identified that describe enablers as well as barriers to applying a flexible transition to practice program using competency-based assessment. These included flexibility in the program design, flexibility on the part of preceptors, flexibility to enable recognition of previous learning, flexibility in the assessment of competencies, and flexibility in workload. To ensure successful application of a transition to practice program using competency-based assessment, preceptors must understand the flexible arrangements built into the program design and have the confidence and competence to apply them. Copyright 2013, SLACK Incorporated.

Transitions to Care in the Community for Prison Releasees with HIV: a Qualitative Study of Facilitators and Challenges in Two States.

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Hammett, Theodore M; Donahue, Sara; LeRoy, Lisa; Montague, Brian T; Rosen, David L; Solomon, Liza; Costa, Michael; Wohl, David; Rich, Josiah D

2015-08-01

One in seven people living with HIV in the USA passes through a prison or jail each year, and almost all will return to the community. Discharge planning and transitional programs are critical but challenging elements in ensuring continuity of care, maintaining treatment outcomes achieved in prison, and preventing further viral transmission. This paper describes facilitators and challenges of in-prison care, transitional interventions, and access to and continuity of care in the community in Rhode Island and North Carolina based on qualitative data gathered as part of the mixed-methods Link Into Care Study of prisoners and releasees with HIV. We conducted 65 interviews with correctional and community-based providers and administrators and analyzed the transcripts using NVivo 10 to identify major themes. Facilitators of effective transitional systems in both states included the following: health providers affiliated with academic institutions or other entities independent of the corrections department; organizational philosophy emphasizing a patient-centered, personal, and holistic approach; strong leadership with effective "champions"; a team approach with coordination, collaboration and integration throughout the system, mutual respect and learning between corrections and health providers, staff dedicated to transitional services, and effective communication and information sharing among providers; comprehensive transitional activities and services including HIV, mental health and substance use services in prisons, timely and comprehensive discharge planning with specific linkages/appointments, supplies of medications on release, access to benefits and entitlements, case management and proactive follow-up on missed appointments; and releasees' commitment to transitional plans. These elements were generally present in both study states but their absence, which also sometimes occurred, represent ongoing challenges to success. The qualitative findings on the

Facility and market factors affecting transitions from nursing home to community.

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Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

2011-09-01

Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

"They See Us as Resource": The Role of a Community-Based Youth Center in Supporting the Academic Lives of Low-Income Chinese American Youth

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Wong, Nga-Wing Anjela

2008-01-01

Based on a 15-week ethnographic-based research, this article examines the role of a community-based youth center in supporting the academic lives of Chinese American youth from low-income families in an east coast city I call "Harborview." This study demonstrates the significant role that community-based organizations play for low-income immigrant…

Lived experiences of HIV community workers participating in a community empowerment programme

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Juliana Horn

2014-08-01

Objectives: The researcher explored the lived experiences of HIV community workers participating in two CEPs in Ladysmith, KwaZulu-Natal in order to develop recommendations for CEPs. Method: Data were explored using a qualitative hermeneutic phenomenological approach. Ten participants who had been involved in HIV CEPs for more than six months were identified and individual interviews were held. Results: Three themes emerged, namely, giving of yourself, maintaining sustainability and assisting the CEPs and community workers. Each of these themes also contained a number of subthemes. Exploring the lived experience of the community workers revealed that there are a number of ways in which to promote the sustainability of CEPs. Conclusion: The community should be involved in all aspects of the CEP and community workers must respect the community and their knowledge, experience and value systems.

Health care transition for youth living with HIV/AIDS.

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Dowshen, Nadia; D'Angelo, Lawrence

2011-10-01

There are ~1 million people in the United States living with HIV/AIDS, and >50,000 new infections occur each year. With an estimated 13% of all new infections occurring among young people aged 13 to 24 years and an increasing number of perinatally infected youth surviving to adulthood, there is now an increasing need to transition both perinatally and behaviorally infected youth to the adult health care setting. Recently, pediatric providers and professional societies have prioritized the development of transition programs for adolescents with chronic disease to address the many challenges these youth face in the process. Although multiple position papers have called for continuous, coordinated, culturally appropriate, compassionate, family-centered transition programs for youth with special health care needs and have recognized the need for evidence-based models, few data exist on what strategies are most effective. To date, published data on health care transition for HIV-positive youth are limited and include only 2 studies, which considered behaviorally infected youth. In this state-of-the-art review, we discuss the unique transition challenges to consider for this population, including socioeconomic and health insurance status, the special role of the pediatric or adolescent provider as family, stigma and disclosure issues, cognitive development and mental health issues, medication adherence, and sexual, reproductive, and gender health concerns. Future research will need to include the experiences of transition in low-resource settings and examine clinical outcomes and factors that may predict success or failure of the transition process.

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

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Alev ELÇİ

2016-12-01

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

The School-to-Community Transition of Hearing-Impaired Persons with Developmental Disabilities: A Review of the Empirical Literature.

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Davis, Cheryl; Bullis, Michael

1990-01-01

This article summarizes 43 empirical studies of school-to-community transition of hearing-impaired persons with developmental disabilities; discusses data collection and interpretation issues; and recommends future research, development, and evaluation. The studies deal with such areas as career/vocational preparation, independent living skills,…

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

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

2014-07-01

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

Community Living Skills Guide: Additional Activities for Nutrition, Cooking, Homemaking, and Family Living.

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Nickovich, Marti; Kreps, Alice Roelofs

These activities are intended to supplement materials for three courses available in the Community Living Skills Guide for the College for Living series: Cooking/Food Preparation (CE 024 475), Homemaking and Family Living (CE 024 477), and Nutrition (CE 024 484). These courses for developmentally disabled adults are intended to supplement…

Objective community integration of mental health consumers living in supported housing and of others in the community.

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Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

2012-01-01

Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

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Roanne Thomas

2016-07-01

Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

Resident Transitions to Assisted Living: A Role for Social Workers

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Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

2012-01-01

This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide,…

Community Living Skills Guide: Cooking/Food Preparation.

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Nickovich, Marti; Kreps, Alice Roelofs

One of twenty course guides in the Community Living Skills Guide for the College for Living series, this document provides guidelines and workbook activities for the course, Cooking/Food Preparation. The series of courses for developmentally disabled adults is intended to supplement residential programs and to aid in orienting institutionalized…

Falls prevention education between older adults and healthcare providers during transition from hospital to community-living

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Lee, Den-Ching Angel

2017-01-01

Background: Falls are a problem for older adults. In particular, older hospitalised adults and those recently discharged from hospital have been shown to be at an increased risk of falls compared to older adults living in the community. Falls impact negatively on the physical and psychosocial well-being of older adults. They increase the burden of care for their family, caregivers and the healthcare system. However, many falls in older adults are preventable. Cochrane reviews demonstrated man...

Resident transitions to assisted living: a role for social workers.

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Fields, Noelle LeCrone; Koenig, Terry; Dabelko-Schoeny, Holly

2012-08-01

This study explored key aspects of resident transitions to assisted living (AL), including the frequency and importance of preadmission resident education and the potential role of social workers in this setting. To examine the factors that may help or hinder resident transitions to AL, a written survey was administered to a statewide, geographically representative purposive sample of Medicaid Assisted Living Waiver providers (N = 28). Findings suggest a positive relationship between the availability of a social worker and the frequency and importance of resident preadmission education in several areas. Results also suggest a gap between what AL providers believe is important for resident transitions and what is actually happening in their facilities. Social workers may play a significant role in providing preadmission education and are well positioned to address the unmet psychosocial needs of residents and family members during the transition to AL. Future studies should specifically examine the contributing role of social workers during the period of adjustment to AL and the effect of social work services on the well-being of AL residents and families in AL settings.

Health behaviour change of people living with HIV after a comprehensive community-based HIV stigma reduction intervention in North-West Province in South Africa.

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Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael

2014-01-01

Abstract All over the world, health behaviour is considered a complex, far reaching and powerful phenomenon. People's lives are influenced by their own or others' health behaviour on a daily basis. Whether it has to do with smoking, drinking, pollution, global warming or HIV management, it touches lives and it challenges personal and community responses. Health behaviour, and health behaviour change, probably holds the key to many a person's immediate or prolonged life or death outcomes. The same can be said about communities, culture groups and nations. This SANPAD-funded study focused on research questions relating to health behaviour change for people living with HIV (PLWH) in the North-West Province in South Africa. It investigated whether a comprehensive community-based HIV stigma reduction intervention caused health behaviour change in PLWH. An quantitative single system research design with one pre- and four repetitive post-tests utilizing purposive sampling was used to test change-over-time in the health behaviour of 18 PLWH. The results of the study indicated statistical and/or practical significant change-over-time. The intervention not only addressed the health behaviour of PLWH, but also their HIV stigma experiences, HIV signs and symptoms and their quality of life in the context of being HIV positive. The recommendations include popularization of the comprehensive community-based HIV stigma reduction intervention and extending it to include a second intervention to strengthen health behaviour and quality of life for PLWH in the community at large.

Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

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Spoorenberg, Sophie L W; Wynia, Klaske; Fokkens, Andrea S; Slotman, Karin; Kremer, Hubertus P H; Reijneveld, Sijmen A

2015-01-01

Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2) Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

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Lima, Christina Martins Borges; Alves, Heloisa Veiga Dias; Mograbi, Daniel Correa; Pereira, Flávia Furtado; Fernandez, Jesus Landeira; Charchat-Fichman, Helenice

2017-01-01

Objective To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil) who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods A total of 264 educated older adults (> 60 years of age of both genders) were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS). Results The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT), mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15) indicated mild symptoms of depression in 16.8% of the sample Conclusion This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil. PMID:29213494

Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

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Christina Martins Borges Lima

Full Text Available ABSTRACT Objective: To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods: A total of 264 educated older adults (> 60 years of age of both genders were evaluated by the Brief Cognitive Screening Battery (BCSB, Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS . Results: The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT, mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15 indicated mild symptoms of depression in 16.8% of the sample. Conclusion: This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil.

Emancipated Foster Youth's Transition from Care to Virginia Community Colleges

Science.gov (United States)

Scott, Shylan E.

2012-01-01

The focus of this study was the experience of students who had successfully achieved the transition from foster care to enrollment in Virginia Community Colleges. The following questions guided the inquiry: How do students who are emancipating from foster care describe their transition to enrollment at one of the Virginia Community Colleges? What…

28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

Youth's Strategies for Staying Safe and Coping with the Stress of Living in Violent Communities

Science.gov (United States)

Teitelman, Anne; McDonald, Catherine C.; Wiebe, Douglas J.; Thomas, Nicole; Guerra, Terry; Kassam-Adams, Nancy; Richmond, Therese S.

2010-01-01

Youth living in urban environments of pervasive violence are exposed to a variety of violence-related stressors. This qualitative descriptive study sought to ascertain how community-dwelling youth perceived exposure to violence and how these youth identified and used available resources. The intent of this community-based participatory research…

Urban Community Planning in the Context of Transition in China: Theory Interpretation and Practice Exploration Based on Relationship Reconstruction

OpenAIRE

Jiayan 　LIU

2017-01-01

Along with a full-scale transition in both the urban development pattern and the socio-economic development in China, the planning of urban residential pace has experienced a significant transition process from the residential area planning in traditional Danwei system, to the commercial housing estate planning in marketized housing system, then to the springing up of contemporary community planning. On the basis of an analysis of the primary goal, form, and limitations of community planning ...

Community engagement among men who have sex with men living with HIV/AIDS in Taiwan.

Science.gov (United States)

Chuang, Deng-Min; Lacombe-Duncan, Ashley

2016-01-01

Community engagement was developed as a global principle in the provision of HIV/AIDS services, yet evidence-based research of implementation of the principle is lacking in Taiwan. This short report aims to understand factors associated with engagement in two types of activities with varying levels of visibility: HIV-related community events and HIV-related community action, in Taiwanese men who have sex with men (MSM) living with HIV. A cross-sectional survey was distributed to a purposive sample of participants recruited from AIDS service organizations (ASOs). Among participants (n = 178), 63.6% were involved in HIV-related community events, while less than half (47.7%) were involved in HIV-related community action. In multivariable analysis, age, involvement in ASOs, and AIDS knowledge were positively associated with engagement in community events, and living in the north of Taiwan, years of infection, and self-stigma were negatively associated with this type of engagement. Few factors, with the exception of involvement in ASOs, were positively associated with engagement in HIV-related community action. To this end, ASOs appear to play a strong role in improving and organizing both types of community engagement in Taiwan. Future studies should evaluate tailored programs delivered through ASOs for strengthening community connectedness among younger, stigmatized, and longer diagnosed MSM living with HIV.

Transitioning to low carbon communities-from behaviour change to systemic change: Lessons from Australia

International Nuclear Information System (INIS)

Moloney, Susie; Horne, Ralph E.; Fien, John

2010-01-01

Transitioning to low carbon communities requires an understanding of community practices and resultant emissions, as well as the technologies, infrastructures and institutions associated with and accessed by communities. Moreover, it requires an understanding of the connections between these integrated system components, its dynamics, a defined transition and potential 'levers' involved in 'transitioning'. This paper accepts the notion that 'levers' include programmes designed to achieve practice or behaviour change in households which result in less carbon intensive lifestyles, and focuses on the factors that shape human behaviour and influence householder energy consumption. Research to date by the authors and others indicates that a comprehensive socio-technical framework that considers both individual psychological factors as well as the systems, standards and norms under which individuals operate is fundamental to the development of successful strategies to shift towards low carbon communities. A database has been compiled of over one hundred local programmes aimed at realising carbon neutral communities across Australia largely through approaches to behaviour change. This paper presents the findings of an analysis of these programmes, particularly with regard to the extent to which they take account of a socio-technical framework or understanding of domestic consumption behaviours and whether they are aware of or aim to influence changing standards and expectations around consumption practices within the home. While a number of exemplary community-based programmes adopt an integrated approach to addressing both technical and behavioural dimensions in the shift to low carbon communities, it was found that most fail to take sufficient account of the systems, standards and norms shaping consumption. Conclusions include directions for policy and programme design based on the study findings.

Catastrophic regime shifts in model ecological communities are true phase transitions

International Nuclear Information System (INIS)

Capitán, J A; Cuesta, J A

2010-01-01

Ecosystems often undergo abrupt regime shifts in response to gradual external changes. These shifts are theoretically understood as a regime switch between alternative stable states of the ecosystem dynamical response to smooth changes in external conditions. Usual models introduce nonlinearities in the macroscopic dynamics of the ecosystem that lead to different stable attractors among which the shift takes place. Here we propose an alternative explanation of catastrophic regime shifts based on a recent model that pictures ecological communities as systems in continuous fluctuation, according to certain transition probabilities, between different micro-states in the phase space of viable communities. We introduce a spontaneous extinction rate that accounts for gradual changes in external conditions, and upon variations on this control parameter the system undergoes a regime shift with similar features to those previously reported. Under our microscopic viewpoint we recover the main results obtained in previous theoretical and empirical work (anomalous variance, hysteresis cycles, trophic cascades). The model predicts a gradual loss of species in trophic levels from bottom to top near the transition. But more importantly, the spectral analysis of the transition probability matrix allows us to rigorously establish that we are observing the fingerprints, in a finite size system, of a true phase transition driven by background extinctions

The Transiting Exoplanet Community Early Release Science Program for JWST

Science.gov (United States)

Berta-Thompson, Zachory K.; Batalha, Natalie M.; Stevenson, Kevin B.; Bean, Jacob; Sing, David K.; Crossfield, Ian; Knutson, Heather; Line, Michael R.; Kreidberg, Laura; Desert, Jean-Michel; Wakeford, Hannah; Crouzet, Nicolas; Moses, Julianne I.; Benneke, Björn; Kempton, Eliza; Lopez-Morales, Mercedes; Parmentier, Vivien; Gibson, Neale; Schlawin, Everett; Fraine, Jonathan; Kendrew, Sarah; Transiting Exoplanet Community ERS Team

2018-06-01

The James Webb Space Telescope offers astronomers the opportunity to observe the composition, structure, and dynamics of transiting exoplanet atmospheres with unprecedented detail. However, such observations require very precise time-series spectroscopic monitoring of bright stars and present unique technical challenges. The Transiting Exoplanet Community Early Release Science Program for JWST aims to help the community understand and overcome these technical challenges as early in the mission as possible, and to enable exciting scientific discoveries through the creation of public exoplanet atmosphere datasets. With observations of three hot Jupiters spanning a range of host star brightnesses, this program will exercise time-series modes with all four JWST instruments and cover a full suite of transiting planet characterization geometries (transits, eclipses, and phase curves). We designed the observational strategy through an open and transparent community effort, with contributions from an international collaboration of over 100 experts in exoplanet observations, theory, and instrumentation. Community engagement with the project will be centered around open Data Challenge activities using both simulated and real ERS data, for exoplanet scientists to cross-validate and improve their analysis tools and theoretical models. Recognizing that the scientific utility of JWST will be determined not only by its hardware and software but also by the community of people who use it, we take an intentional approach toward crafting an inclusive collaboration and encourage new participants to join our efforts.

Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial.

Science.gov (United States)

Fahlström, Gunilla; Kamwendo, Kitty; Forsberg, Jenny; Bodin, Lennart

2017-08-29

Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention. © 2017

Together We Can Live and Learn. Living-Learning Communities as Integrated Curricular Experiences

Science.gov (United States)

Dunn, Merrily S.; Dean, Laura A.

2013-01-01

This article briefly outlines the history of living-learning communities (LLC) in colleges and universities. It details conceptualization, design, implementation and assessment of such programs. Model recreation and leisure LLC are highlighted and discussed.

Live imaging-based model selection reveals periodic regulation of the stochastic G1/S phase transition in vertebrate axial development.

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Mayu Sugiyama

2014-12-01

Full Text Available In multicellular organism development, a stochastic cellular response is observed, even when a population of cells is exposed to the same environmental conditions. Retrieving the spatiotemporal regulatory mode hidden in the heterogeneous cellular behavior is a challenging task. The G1/S transition observed in cell cycle progression is a highly stochastic process. By taking advantage of a fluorescence cell cycle indicator, Fucci technology, we aimed to unveil a hidden regulatory mode of cell cycle progression in developing zebrafish. Fluorescence live imaging of Cecyil, a zebrafish line genetically expressing Fucci, demonstrated that newly formed notochordal cells from the posterior tip of the embryonic mesoderm exhibited the red (G1 fluorescence signal in the developing notochord. Prior to their initial vacuolation, these cells showed a fluorescence color switch from red to green, indicating G1/S transitions. This G1/S transition did not occur in a synchronous manner, but rather exhibited a stochastic process, since a mixed population of red and green cells was always inserted between newly formed red (G1 notochordal cells and vacuolating green cells. We termed this mixed population of notochordal cells, the G1/S transition window. We first performed quantitative analyses of live imaging data and a numerical estimation of the probability of the G1/S transition, which demonstrated the existence of a posteriorly traveling regulatory wave of the G1/S transition window. To obtain a better understanding of this regulatory mode, we constructed a mathematical model and performed a model selection by comparing the results obtained from the models with those from the experimental data. Our analyses demonstrated that the stochastic G1/S transition window in the notochord travels posteriorly in a periodic fashion, with doubled the periodicity of the neighboring paraxial mesoderm segmentation. This approach may have implications for the characterization of

Conceptual Foundations of Improving the Living Standards of Territorial Community Based on the Introduction and Development of New Forms of Innovation and Investment Cooperation Between Regional Authorities and the Local Community

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Popadynets, V.I.

2015-03-01

Full Text Available The main provisions have been formulated for elaboration, implementation and development of the regional target programs based on new methodological and financial resources and realization of sales of the most significant products of regional companies and organizations for the sustainable improvement of the local community living standards.

Dynamical Detection of Topological Phase Transitions in Short-Lived Atomic Systems

OpenAIRE

Setiawan, F.; Sengupta, K.; Spielman, I. B.; Sau, Jay D.

2015-01-01

We demonstrate that dynamical probes provide direct means of detecting the topological phase transition (TPT) between conventional and topological phases, which would otherwise be difficult to access because of loss or heating processes. We propose to avoid such heating by rapidly quenching in and out of the short-lived topological phase across the transition that supports gapless excitations. Following the quench, the distribution of excitations in the final conventional phase carries signat...

Transition Initiatives as Light Intentional Communities: Uncovering Liminality and Friction

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Elisabeth van de Grift

2017-03-01

Full Text Available The Transition Network is a global grassroots network that supports community-led resilience in the face of global change. This paper reports on an ethnographic study of one of its longest-running projects, Transition Town Lewes (TTL in the United Kingdom. The aim of the study is to analyse TTL as a community. More specifically, we ask two questions: (1 what type of community is TTL? and (2 what are the challenges TTL faces as a community? With this, we contribute to the existing literature on local sustainability initiatives and in particular on Transition initiatives, by providing an in-depth understanding of the challenges and social dynamics at play in a day-to-day setting. We conducted three months of intensive ethnographic fieldwork using participant observation, interviews, and a focus group. Our analysis shows that TTL is a community that, on the one hand, is motivated by explicit intentions and goals, but that, on the other hand, leaves openness and flexibility regarding the level and specifics of participants’ engagement. We introduce the novel concept of ‘light intentional community’ to describe this type of community. We first investigate intentionality in TTL, finding that differences exist between individual participant motivations and stated TTL objectives. We go on to describe the ‘light’ aspect of TTL—the differences in levels of engagement between community participants. Our analysis shows that TTL and its participants face two main challenges. First, TTL participants experience ‘multi-dimensional liminality’: they operate in a liminal space between mainstream society and TTL practices, and additionally experience a continuous sense of transitioning toward a moving goal. Second, TTL as a community faces internal and external frictions. These challenges are interrelated and stem from the structure and dynamics of TTL as a light intentional community. We conclude by reflecting on our analysis of the nature and

Nursing Living-Learning Communities and Student Retention: A Qualitative Study.

Science.gov (United States)

Bauer, Renee N; Kiger, Susan

Living-learning communities have been known to promote student performance and a sense of collegiality. Most studies on this topic have utilized quantitative methods. This qualitative comparison case study examined personal experiences associated with residing in a living-learning community. The study was conducted to explore findings associated with promoting student retention. A secondary goal was to explore student experiences with mentoring. Data were collected using taped recordings of live interviews at two universities that have nursing-themed housing. The targeted sample size was 14. Themes that emerged from the data were mutual support, importance of the resident assistant, and self-determination. Nursing students enjoy themed housing and especially desire the resident assistant to be a nursing student.

People with an intellectual disability living in an intentional community.

Science.gov (United States)

Randell, M; Cumella, S

2009-08-01

Hospital closure programmes in England have generally sought to attain a fulfilling life for people with an intellectual disability by locating them in domestic-style housing in urban settings. Few have been placed in intentional or 'village' communities. Yet comparative studies of different housing types have found that intentional communities have better or similar outcomes for their residents than dispersed housing or residential clusters on former hospital sites. A possible explanation is the distinctive pattern of social relationships that exist in many intentional communities and the impact this has on the lives of their residents. This paper reports the results of research that explores the perceptions of people with an ID living in an intentional community and the meaning of their community to them. The research used an ethnographic approach to interview a sample of 15 residents in a large intentional community (Botton Village), which is part of the Camphill Movement. Interviews used Makaton, pictures and symbols where required. Respondents included 10 men and 5 women aged between 38 and 78 years. Length of residence in Botton Village ranged from 5 to 50 years. All lived with the families of co-workers and valued these relationships. All but one (who had retired) worked in a diverse range of employment in the village. Almost all were positive about their work. Respondents reported that they took part in both individual and communal leisure activities and all but two had a network of friends. Opportunities for friendship were enhanced by proximity to other people with an ID and a sense of personal security in the village. As in many villages and communities in society in general, these advantages were balanced by some loss of privacy. Results confirm those from earlier studies of intentional communities and suggest that positive outcomes derive from the absence of the overt subordination of residents to staff, the facilitation of friendship with other people

FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

Science.gov (United States)

Cattelani, Luca; Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Becker, Clemens; Chesani, Federico; Chiari, Lorenzo

2015-02-18

About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. FRAT-up is based on the assumption that a subject's fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer

Living City: community mobilization to build active transport policies and programs in Santiago, Chile

OpenAIRE

L. Sagaris

2010-01-01

Although the usefulness of walking and cycling to promote health is increasingly recognized, the importance of civil society leadership in developing new policies and activities is often overlooked. This case study, of Living City (Ciudad Viva) a community-based organization in Santiago, Chile, examines how several communities used knowledge about transport’s impact on the environment and health, gained through opposition to a major highway project, to build effective sustainable urban transp...

Community Care and the Care Transition in the Netherlands

Directory of Open Access Journals (Sweden)

Ymke Kelders

2016-12-01

Full Text Available “Community care” en de zorgtransitie in Nederland De transitie in de gezondheidszorg in Nederland is al jaren een centraal thema in de politiek en het maatschappelijke debat. De recente veranderingen vereisen (opnieuw aandacht in onder andere onderzoek en onderwijs. In dit artikel reflecteren we op de ideologie en doelen die schuilen achter de transitie in Nederland en linken we deze naar het onderzoek en onderwijs dat georganiseerd wordt door het lectoraat Community Care. Wat betekent het “nieuwe denken” van de transitie voor het Community Care gedachtegoed in relatie tot onderwijs en onderzoek? Het lectoraat Community Care van de Hogeschool van Amsterdam houdt zich bezig met verschillende onderzoeksonderwerpen verdeeld onder drie stromingen: informele zorg, sociale inclusie en netwerkversterking. Binnen deze drie onderzoekslijnen wordt er gefocust op zorg door de samenleving en hoe dit gelinkt kan worden aan professionele zorg. In dit artikel zetten we uiteen waarom dit relevant is in onderzoek en onderwijs, zeker wanneer de transitie in Nederland eens temeer benadrukt dat zorg in en door de samenleving belangrijk is, en de rol van de zorgprofessional verandert. Tot slot reflecteren we op de manieren waarop we dit gedachtegoed en het huidige zorgbeleid kunnen vertalen in onderwijs voor studenten die later in het sociaal- en zorgdomein werkzaam zullen zijn. Community Care and the Care Transition in the NetherlandsThe transition taking place within the Dutch healthcare system has been a central theme in politics and public debate for decades. The recent changes again demand the full attention of researchers and educators in the field. In this article, we reflect on the current ideology and goals of the transition and link these to the range of ideas that lie behind the ideal of “community care”. Additionally, we pose the question of what these changes may mean for research and education within the social care domain in general and

Critical Time Intervention for Homeless People Making the Transition to Community Living: A Randomized Controlled Trial

NARCIS (Netherlands)

Vet, R. de; Beijersbergen, M.D.; Jonker, I.E.; Lako, D.A.M.; Hemert, A.M. van; Herman, D.B.; Wolf, J.R.L.M.

2017-01-01

To help create an evidence base in Europe for effective interventions that improve the well-being of homeless people, we tested whether critical time intervention (CTI), a time-limited intervention developed to support vulnerable people during times of transition, is effective outside the United

Development of the Community Healthy Living Index: a tool to foster healthy environments for the prevention of obesity and chronic disease.

Science.gov (United States)

Kim, Soowon; Adamson, Katie Clarke; Balfanz, Deborah R; Brownson, Ross C; Wiecha, Jean L; Shepard, Dennis; Alles, Wesley F

2010-01-01

This paper presents a new, comprehensive tool for communities to assess opportunities for active living and healthy eating and to mobilize all sectors of society to conquer obesity and chronic disease. Relevant existing tools and input from an expert panel were considered to draft the Community Healthy Living Index (CHLI). CHLI covers five major sectors where people live, work, learn, and play: schools, afterschools, work sites, neighborhoods, and the community-at-large. CHLI and the accompanying procedures enable community teams to assess programs, the physical environment, and policies related to healthy living and to plan improvement strategies. In 2008, with local YMCAs acting as conveners, community assessment teams from six US communities pilot-tested CHLI for cognitive response testing, inter-rater reliability, and implementation feasibility. CHLI was revised to reflect the test results. Pilot analyses demonstrated that the process was feasible, with most questions being interpreted as intended and showing substantial to almost perfect agreement between raters. The final CHLI is being disseminated nationally. Preliminary data illustrate CHLI obtains reliable results and is feasible to implement. CHLI is a promising tool for community-based prevention efforts to draw attention to opportunities for healthy living and create impetus for community changes.

The Intersection of Black Lives Matter and Adult Education: One Community College Initiative

Science.gov (United States)

Miller, Brian; Schwartz, Joni

2016-01-01

This chapter is a call to action for adult educators to critically engage the Black Lives Matter Movement through pedagogy, community engagement and scholarly activism. It explores the intersection of the Black Lives Matter movement and adult education by highlighting the response of one community college initiative.

Living in an older adult community: a pharmacy student's experience.

Science.gov (United States)

Anastasia, Emily; Estus, Erica

2013-12-01

Interacting with older adults is a daily practice for pharmacists. It is important to understand how medications affect their wellbeing, but there are many other factors that affect quality of life. To truly understand some of the challenges facing older adults, Emily Anastasia, a sixth-year pharmacy student at the University of Rhode Island, moved into South Bay Retirement Living, a senior living community, for an eight-day immersion experience as a special project within one of her advanced pharmacy practice experience rotations. During her stay, she did not attend classes nor leave the facility unless on the South Bay bus with the other assisted living residents. She lived with a 92-year-old roommate, developed close friendships with many of the residents, and kept a detailed journal of her experience. The purpose of this reflection is to share her experience and recognize lifestyle as well as social and physical environment as factors in understanding the aging process. Immersing a pharmacy student within an assisted living community provides a unique opportunity to observe and appreciate characteristics of older adults that cannot be learned within a classroom setting.

System flexibility in the rehabilitation process of mentally disabled persons in a hostel that bridges between the hospital and the community.

Science.gov (United States)

Baloush-Kleinman, Vered; Schneidman, Michael

2003-01-01

Deinstitutionalization and community mental health services have become the focus of mental health care in the United States, Italy and England, and now in Israel. Tirat Carmel MHC developed an intervention model of organizational change implemented in a rehabilitation hostel. It is an interim service based on graduated transition from maintenance care to a transitional Half-way House, followed by a Transitional Living Skills Center oriented for independent community living. Of 205 rehabilitees who resided in the hostel since the beginning of the project, 138 were discharged to community residential settings: 67 patients were discharged to reinforced community hostels; 27 to sheltered housing and 23 to independent residential quarters; 7 patients were discharged to comprehensive hostels, 3 to old-age homes and 11 returned home to their families. In terms of employment, 79 were placed in sheltered employment facilities, 24 work in the open market and 3 returned to school; 22 work in therapeutic occupational settings and 10 patients discharged to comprehensive hostels and old-age homes are engaged in sheltered employment programs in those settings. The system flexibility model and the rehabilitation processes anchored in normalization supported the relocation of hospitalized psychiatric patients to community-based settings and enabled the rehabilitees to cope with readjustment to community life.

Community patterns of stigma towards persons living with HIV: A population-based latent class analysis from rural Vietnam

LENUS (Irish Health Repository)

Pharris, Anastasia

2011-09-18

Abstract Background The negative effects of stigma on persons living with HIV (PLHIV) have been documented in many settings and it is thought that stigma against PLHIV leads to more difficulties for those who need to access HIV testing, treatment and care, as well as to limited community uptake of HIV prevention and testing messages. In order to understand and prevent stigma towards PLHIV, it is important to be able to measure stigma within communities and to understand which factors are associated with higher stigma. Methods To analyze patterns of community stigma and determinants to stigma toward PLHIV, we performed an exploratory population-based survey with 1874 randomly sampled adults within a demographic surveillance site (DSS) in rural Vietnam. Participants were interviewed regarding knowledge of HIV and attitudes towards persons living with HIV. Data were linked to socioeconomic and migration data from the DSS and latent class analysis and multinomial logistic regression were conducted to examine stigma group sub-types and factors associated with stigma group membership. Results We found unexpectedly high and complex patterns of stigma against PLHIV in this rural setting. Women had the greatest odds of belong to the highest stigma group (OR 1.84, 95% CI 1.42-2.37), while those with more education had lower odds of highest stigma group membership (OR 0.45, 95% CI 0.32-0.62 for secondary education; OR 0.19, 95% CI 0.10-0.35 for tertiary education). Long-term migration out of the district (OR 0.61, 95% CI 0.4-0.91), feeling at-risk for HIV (OR 0.42, 95% CI 0.27-0.66), having heard of HIV from more sources (OR 0.44, 95% CI 0.3-0.66), and knowing someone with HIV (OR 0.76, 95% CI 0.58-0.99) were all associated with lower odds of highest stigma group membership. Nearly 20% of the population was highly unsure of their attitudes towards PLHIV and persons in this group had significantly lower odds of feeling at-risk for HIV (OR 0.54, 95% CI 0.33-0.90) or of knowing

Evaluation of Achieving a College Education Plus: A Credit-Based Transition Program

Science.gov (United States)

Luna, Gaye; Fowler, Michael

2011-01-01

This ex post facto study evaluated Achieving a College Education (ACE) Plus program, a credit-based transition program between a high school district and a community college. Achieving a College Education Plus is an early outreach program. It is designed to aid at-risk students in graduating from high school and making a smooth transition to…

Learning How to Use Buildings: An Exploration of the Potential of Design Interactions to Support Transition to Low-Impact Community Living

Directory of Open Access Journals (Sweden)

Rachael Luck

2014-11-01

Full Text Available In this paper, I study how a housing project is designed and show the architects in conversation with the residents talking about living in a community with lower impact, to reveal different conceptual understandings of building technologies and systems within the home. In this account, it can be seen that building systems and technologies become entangled with dwelling, patterns of living and maintenance scenarios on a housing estate. Shown are several ways that these design interactions can be considered pedagogic and transformative. It is proposed that similar events between architects and users are established in the design stage for other building types and for more of the UK housing stock.

Spirituality, depression, living alone, and perceived health among Korean older adults in the community.

Science.gov (United States)

You, Kwang Soo; Lee, Hae-Ok; Fitzpatrick, Joyce J; Kim, Susie; Marui, Eiji; Lee, Jung Su; Cook, Paul

2009-08-01

Both theoretical and empirical studies have documented the protective effect of religiosity and spirituality on general health in older adults in community and hospital settings; however, no study has documented the relationship between spirituality and depression among older adults living alone in communities in Korea. We tested two hypotheses: Hypothesis 1: Korean older adults living alone would be more depressed and less healthy than older adults living with family, and Hypothesis 2: Individuals who are more religious and spiritual would report a lower level of depression and a higher level of general health even when other demographic and living status variables are controlled. A descriptive, comparative, and correlational design with a convenience sampling method was conducted among community-dwelling Korean older adults in Chounbook Providence, South Korea. This study included 152 men and women older than 65 years old. Hypothesis 1 was supported as Korean older adults living alone were significantly more depressed than were older adults living with family (Preligion with general health and depression.

A Community-Level Initiative to Prevent Obesity: Results From Kaiser Permanente's Healthy Eating Active Living Zones Initiative in California.

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Cheadle, Allen; Atiedu, Akpene; Rauzon, Suzanne; Schwartz, Pamela M; Keene, Laura; Davoudi, Mehrnaz; Spring, Rebecca; Molina, Michelle; Lee, Lynda; Boyle, Kathryn; Williamson, Dana; Steimberg, Clara; Tinajero, Roberta; Ravel, Jodi; Nudelman, Jean; Azuma, Andrea Misako; Kuo, Elena S; Solomon, Loel

2018-05-01

A growing number of health systems are leading health promotion efforts in their wider communities. What impact are these efforts having on health behaviors and ultimately health status? This paper presents evaluation results from the place-based Kaiser Permanente Healthy Eating Active Living Zones obesity prevention initiative, implemented in 2011-2015 in 12 low-income communities in Kaiser Permanente's Northern and Southern California Regions. The Healthy Eating Active Living Zones design targeted places and people through policy, environmental, and programmatic strategies. Each Healthy Eating Active Living Zone is a small, low-income community of 10,000 to 20,000 residents with high obesity rates and other health disparities. Community coalitions planned and implemented strategies in each community. A population-dose approach and pre and post surveys were used to assess impact of policy, program, and environmental change strategies; the analysis was conducted in 2016. Population dose is the product of reach (number of people affected by a strategy divided by target population size) and strength (the effect size or relative change in behavior for each person exposed to the strategy). More than 230 community change strategies were implemented over 3 years, encompassing policy, environmental, and programmatic changes as well as efforts to build community capacity to sustain strategies and make changes in the future. Positive population-level results were seen for higher-dose strategies, particularly those targeting youth physical activity. Higher-dose strategies were more likely to be found in communities with the longest duration of investment. These results demonstrate that strong (high-dose), community-based obesity prevention strategies can lead to improved health behaviors, particularly among youth in school settings. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is

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

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

2013-10-15

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

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

Science.gov (United States)

2013-01-01

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

Shifting the evaluative gaze: Community-based program evaluation in the homeless sector

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Bruce Wallace

2015-09-01

Full Text Available Homelessness is a growing social issue that is a consequence of structural inequities and contributor to the development of health inequities. Community-based research (CBR has been proposed as an effective research strategy for addressing health equities and promoting social justice through participatory processes. The purpose of this article is to examine the application of CBR principles and practices in the homeless sector and the implications for the production of knowledge and social change to address homelessness. Drawing on our experiences as researchers and service providers, we reflect on the significant successes and challenges associated with using CBR in the homelessness sector. In our discussion we emphasise insights, challenges and lessons learned from a community-university partnership that focused on an evaluation of a transitional shelter program in a large urban centre where housing is expensive and often unavailable. Keywords: Homelessness, housing, transitional housing, transitional shelter, program evaluation, community-based research

Live cell plasma membranes do not exhibit a miscibility phase transition over a wide range of temperatures.

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Lee, Il-Hyung; Saha, Suvrajit; Polley, Anirban; Huang, Hector; Mayor, Satyajit; Rao, Madan; Groves, Jay T

2015-03-26

Lipid/cholesterol mixtures derived from cell membranes as well as their synthetic reconstitutions exhibit well-defined miscibility phase transitions and critical phenomena near physiological temperatures. This suggests that lipid/cholesterol-mediated phase separation plays a role in the organization of live cell membranes. However, macroscopic lipid-phase separation is not generally observed in cell membranes, and the degree to which properties of isolated lipid mixtures are preserved in the cell membrane remain unknown. A fundamental property of phase transitions is that the variation of tagged particle diffusion with temperature exhibits an abrupt change as the system passes through the transition, even when the two phases are distributed in a nanometer-scale emulsion. We support this using a variety of Monte Carlo and atomistic simulations on model lipid membrane systems. However, temperature-dependent fluorescence correlation spectroscopy of labeled lipids and membrane-anchored proteins in live cell membranes shows a consistently smooth increase in the diffusion coefficient as a function of temperature. We find no evidence of a discrete miscibility phase transition throughout a wide range of temperatures: 14-37 °C. This contrasts the behavior of giant plasma membrane vesicles (GPMVs) blebbed from the same cells, which do exhibit phase transitions and macroscopic phase separation. Fluorescence lifetime analysis of a DiI probe in both cases reveals a significant environmental difference between the live cell and the GPMV. Taken together, these data suggest the live cell membrane may avoid the miscibility phase transition inherent to its lipid constituents by actively regulating physical parameters, such as tension, in the membrane.

Zooplankton community structure and dynamics during the transition ...

African Journals Online (AJOL)

This study investigates the zooplankton community structure and dynamics of Kufena Rock Pool during the transition from dry season (March to April) to rainy season (May to June) in Zaria, Nigeria. Physicochemical parameters such as temperature, hydrogen ion concentration, electrical conductivity and total dissolved ...

Avoiding Institutional Outcomes for Older Adults Living with Disability: The Use of Community-Based Aged Care Supports

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Ellison, Caroline; White, Amy; Chapman, Libby

2011-01-01

Background: Most people with a disability want to remain living in their own home as they age. Without additional support, people with a disability may not be able to avoid moving into residential aged care, attending day programs, or becoming isolated from participation in the wider community. This study examined whether participants perceived…

The Effects of Activity and Aging on Rural Community Living and Consuming.

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Miller, Nancy J.; Kim, Soyoung; Schofield-Tomschin, Sherry

1998-01-01

Discusses a study of the effects of social activity and aging on variables related to individual motivations, community membership, and consumer behavior of respondents (n=630) living in rural communities. Findings suggest an embeddedness of marketplace activity in the social networks of rural communities. (Author/JOW)

Phase transitions in community detection: A solvable toy model

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Ver Steeg, Greg; Moore, Cristopher; Galstyan, Aram; Allahverdyan, Armen

2014-05-01

Recently, it was shown that there is a phase transition in the community detection problem. This transition was first computed using the cavity method, and has been proved rigorously in the case of q = 2 groups. However, analytic calculations using the cavity method are challenging since they require us to understand probability distributions of messages. We study analogous transitions in the so-called “zero-temperature inference” model, where this distribution is supported only on the most likely messages. Furthermore, whenever several messages are equally likely, we break the tie by choosing among them with equal probability, corresponding to an infinitesimal random external field. While the resulting analysis overestimates the thresholds, it reproduces some of the qualitative features of the system. It predicts a first-order detectability transition whenever q > 2 (as opposed to q > 4 according to the finite-temperature cavity method). It also has a regime analogous to the “hard but detectable” phase, where the community structure can be recovered, but only when the initial messages are sufficiently accurate. Finally, we study a semisupervised setting where we are given the correct labels for a fraction ρ of the nodes. For q > 2, we find a regime where the accuracy jumps discontinuously at a critical value of ρ.

Living alone and fall risk factors in community-dwelling middle age and older adults.

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Elliott, Sharon; Painter, Jane; Hudson, Suzanne

2009-08-01

As part of a larger study on fall-related risk factors, this study investigated the relationship between living alone status and fall-related variables among community-dwelling adults who lived in a rural county in eastern North Carolina. A convenience sample of 666 community-dwelling adults ages 50 and over participated in this 4-year study and completed a fall questionnaire. Significant findings were found in relation to living alone status and experiencing a fall, who they informed about their fall, injuries, safety equipment, ambulatory devices, and personal emergency response system usage. Three hundred thirty-eight participants stated they lived alone, compared to 300 who lived with others. The percentage reporting a fall was appreciably larger for those living alone (52%) than for those living with others (48%) in both genders in all age groups except for the 61-70 year old adults where the percentage was less. Findings from this research enhance knowledge about the prevalence and contributing fall-related factors in adults who live alone compared to those who live with others. Insights gained from this research will assist community and public health leaders and health care professionals in developing more efficacious intervention strategies to prevent or reduce falls, and associated psychological and physical consequences.

Anxiety and Depression during Transition from Hospital to Community in Older Adults: Concepts of a Study to Explain Late Age Onset Depression

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Aislinn F. Lalor

2015-06-01

Full Text Available The transition between extended hospitalization and discharge home to community-living contexts for older adults is a critical time period. This transition can have an impact on the health outcomes of older adults such as increasing the risk for health outcomes like falls, functional decline and depression and anxiety. The aim of this work is to identify and understand why older adults experience symptoms of depression and anxiety post-discharge and what factors are associated with this. This is a mixed methods study of adults aged 65 years and over who experienced a period of hospitalization longer than two weeks and return to community-living post-discharge. Participants will complete a questionnaire at baseline and additional monthly follow-up questionnaires for six months. Anxiety and depression and their resulting behaviors are major public health concerns and are significant determinants of health and wellbeing among the ageing population. There is a critical need for research into the impact of an extended period of hospitalization on the health status of older adults post-discharge from hospital. This research will provide evidence that will inform interventions and services provided for older adults after they have been discharged home from hospital care.

Active living environment assessments in four rural Latino communities

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Cynthia K. Perry

2015-01-01

Conclusions: These four rural towns have some policies, programming and infrastructure in place that support active living. The information from the RALA can be used to inform program and policy development to enhance physical activity in these rural communities.

Systems thinking in 49 communities related to healthy eating, active living, and childhood obesity.

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Brennan, Laura K; Sabounchi, Nasim S; Kemner, Allison L; Hovmand, Peter

2015-01-01

Community partnerships to promote healthy eating and active living in order to prevent childhood obesity face a number of challenges. Systems science tools combined with group model-building techniques offer promising methods that use transdisciplinary team-based approaches to improve understanding of the complexity of the obesity epidemic. This article presents evaluation methods and findings from 49 Healthy Kids, Healthy Communities sites funded to implement policy, system, and environmental changes from 2008 to 2014. Through half-day group model-building sessions conducted as part of evaluation site visits to each community between 2010 and 2013, a total of 50 causal loop diagrams were produced for 49 communities (1 community had 2 causal loop diagrams representing different geographic regions). The analysis focused on the following evaluation questions: (1) What were the most prominent variables in the causal loop diagrams across communities? (2) What were the major feedback structures across communities? (3) What implications from the synthesized causal loop diagram can be translated to policy makers, practitioners, evaluators, funders, and other community representatives? A total of 590 individuals participated with an average of 12 participants per session. Participants' causal loop diagrams included a total of 227 unique variables in the following major subsystems: healthy eating policies and environments, active living policies and environments, health and health behaviors, partnership and community capacity, and social determinants. In a synthesized causal loop diagram representing variables identified by at least 20% of the communities, many feedback structures emerged and several themes are highlighted with respect to implications for policy and practice as well as assessment and evaluation. The application of systems thinking tools combined with group model-building techniques creates opportunities to define and characterize complex systems in a manner

Lived Lives: A Pavee Perspective. An arts-science community intervention around suicide in an indigenous ethnic minority [version 1; referees: 2 approved

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Kevin M. Malone

2017-04-01

Full Text Available Background: Suicide is a significant public health concern, which impacts on health outcomes. Few suicide research studies have been interdisciplinary. We combined a psychobiographical autopsy with a visual arts autopsy, in which families donated stories, images and objects associated with the lived life of a loved one lost to suicide. From this interdisciplinary research platform, a mediated exhibition was created (Lived Lives with artist, scientist and families, co-curated by communities, facilitating dialogue, response and public action around suicide prevention. Indigenous ethnic minorities (IEMs bear a significant increased risk for suicide. Irish Travellers are an IEM with social and cultural parallels with IEMs internationally, experiencing racism, discrimination, and poor health outcomes including elevated suicide rates (SMR 6.6. Methods: An adjusted Lived Lives exhibition, Lived Lives: A Pavee Perspective manifested in Pavee Point, the national Traveller and Roma Centre. The project was evaluated by the Travelling Community as to how it related to suicide in their community, how it has shaped their understanding of suicide and its impacts, and its relevance to other socio-cultural contexts, nationally and internationally. The project also obtained feedback from all relevant stakeholders. Evaluation was carried out by an international visual arts research advisor and an independent observer from the field of suicide research. Results: Outputs included an arts-science mediated exhibition with reference to elevated Irish Traveller suicide rates. Digital online learning materials about suicide and its aftermath among Irish Travellers were also produced. The project reached its target audience, with a high level of engagement from members of the Travelling Community. Discussion: The Lived Lives methodology navigated the societal barriers of stigma and silence to foster communication and engagement, working with cultural values, consistent

Pakistanis in Spain: a study based on the community living in the city of Barcelona

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Montserrat Solé Aubia

2005-01-01

Full Text Available One of the characteristics of Spain becoming a country of immigration is the greater protagonism that some countries have acquired which had not traditionally been a major source of migration movements towards Spain. Such is the case of Pakistan, whose nationals living in Spain have considerably increased in recent years, mainly in the area of Barcelona. This study seeks to undertake a research line in order to get to know more deeply the reality of this community.

Qualitative Evaluation of the Coach Training within a Community Paramedicine Care Transitions Intervention.

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Lau, Hunter Singh; Hollander, Matthew M; Cushman, Jeremy T; DuGoff, Eva H; Jones, Courtney M C; Kind, Amy J H; Lohmeier, Michael T; Coleman, Eric A; Shah, Manish N

2018-02-12

The Care Transitions Intervention (CTI) has potential to improve the emergency department (ED)-to-home transition for older adults. Community paramedics may function as the CTI coaches; however, this requires the appropriate knowledge, skills, and attitudes, which they do not receive in traditional emergency medical services (EMS) education. This study aimed to define community paramedics' perceptions regarding their training needs to serve as CTI coaches supporting the ED-to-home transition. This study forms part of an ongoing randomized controlled trial evaluating a community paramedic-implemented CTI to enhance the ED-to-home transition. The community paramedics' training covered the following domains: the CTI program, geriatrics, effective coaching, ED discharge processes, and community paramedicine. Sixteen months after starting the study, we conducted audio-recorded semi-structured interviews with community paramedics at both study sites. After transcribing the interviews, team members independently coded the transcripts. Ensuing group analysis sessions led to the development of final codes and identifying common themes. Finally, we conducted member checking to confirm our interpretations of the interview data. We interviewed all 8 participating community paramedics. Participants consisted solely of non-Hispanic whites, included 5 women, and had a mean age of 43. Participants had extensive backgrounds in healthcare, primarily as EMS providers, but minimal experience with community paramedicine. All reported some prior geriatrics training. Four themes emerged from the interviews: (1) paramedics with positive attitudes and willingness to acquire the needed knowledge and skills will succeed as CTI coaches; (2) active rather than passive learning is preferred by paramedics; (3) the existing training could benefit from adjustments such as added content on mental health, dementia, and substance abuse issues, as well as content on coaching subjects with a range of

Not all are free-living: high-throughput DNA metabarcoding reveals a diverse community of protists parasitizing soil metazoa.

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Geisen, S; Laros, I; Vizcaíno, A; Bonkowski, M; de Groot, G A

2015-09-01

Protists, the most diverse eukaryotes, are largely considered to be free-living bacterivores, but vast numbers of taxa are known to parasitize plants or animals. High-throughput sequencing (HTS) approaches now commonly replace cultivation-based approaches in studying soil protists, but insights into common biases associated with this method are limited to aquatic taxa and samples. We created a mock community of common free-living soil protists (amoebae, flagellates, ciliates), extracted DNA and amplified it in the presence of metazoan DNA using 454 HTS. We aimed at evaluating whether HTS quantitatively reveals true relative abundances of soil protists and at investigating whether the expected protist community structure is altered by the co-amplification of metazoan-associated protist taxa. Indeed, HTS revealed fundamentally different protist communities from those expected. Ciliate sequences were highly over-represented, while those of most amoebae and flagellates were under-represented or totally absent. These results underpin the biases introduced by HTS that prevent reliable quantitative estimations of free-living protist communities. Furthermore, we detected a wide range of nonadded protist taxa probably introduced along with metazoan DNA, which altered the protist community structure. Among those, 20 taxa most closely resembled parasitic, often pathogenic taxa. Therewith, we provide the first HTS data in support of classical observational studies that showed that potential protist parasites are hosted by soil metazoa. Taken together, profound differences in amplification success between protist taxa and an inevitable co-extraction of protist taxa parasitizing soil metazoa obscure the true diversity of free-living soil protist communities. © 2015 John Wiley & Sons Ltd.

Feasibility of an experiential community garden and nutrition programme for youth living in public housing.

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Grier, Karissa; Hill, Jennie L; Reese, Felicia; Covington, Constance; Bennette, Franchennette; MacAuley, Lorien; Zoellner, Jamie

2015-10-01

Few published community garden studies have focused on low socio-economic youth living in public housing or used a community-based participatory research approach in conjunction with youth-focused community garden programmes. The objective of the present study was to evaluate the feasibility (i.e. demand, acceptability, implementation and limited-effectiveness testing) of a 10-week experiential theory-based gardening and nutrition education programme targeting youth living in public housing. In this mixed-methods feasibility study, demand and acceptability were measured using a combination of pre- and post-programme surveys and interviews. Implementation was measured via field notes and attendance. Limited-effectiveness was measured quantitatively using a pre-post design and repeated-measures ANOVA tests. Two public housing sites in the Dan River Region of south central Virginia, USA. Forty-three youth (primarily African American), twenty-five parents and two site leaders. The positive demand and acceptability findings indicate the high potential of the programme to be used and be suitable for the youth, parents and site leaders. Field notes revealed numerous implementation facilitators and barriers. Youth weekly attendance averaged 4·6 of 10 sessions. Significant improvements (Pgardening knowledge, knowledge of MyPlate recommendations), but not all limited-effectiveness measures (e.g. willingness to try fruits and vegetables, fruit and vegetable eating self-efficacy). This community-based participatory research study demonstrates numerous factors that supported and threatened the feasibility of a gardening and nutrition programme targeting youth in public housing. Lessons learned are being used to adapt and strengthen the programme for future efforts targeting fruit and vegetable behaviours.

The Greater Involvement of People Living with AIDS principle: theory versus practice in Ontario's HIV/AIDS community-based research sector.

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Travers, R; Wilson, M G; Flicker, S; Guta, A; Bereket, T; McKay, C; van der Meulen, A; Cleverly, S; Dickie, M; Globerman, J; Rourke, S B

2008-07-01

Drawing on the Greater Involvement of People with HIV/AIDS (GIPA) principle, the HIV/AIDS movement began to "democratize" research in Canada in the mid-1990s. To date, there is little evidence about the success of the community-based research (CBR) movement in relation to the implementation of GIPA. We draw on findings from a larger study examining barriers and facilitating factors in relation to HIV-related CBR in Ontario, Canada. An online survey was completed by 39 senior managers in Ontario AIDS service organizations (ASOs). Twenty-five in-depth, semi-structured interviews were then conducted to further explore the survey findings. Survey respondents reported that, compared to researchers and frontline service providers, people living with HIV/AIDS (PLWHA) tended to be the least involved in all stages (input, process and outcome) of CBR projects. AIDS service organizations with a mandate that included serving rural and urban communities reported even lower levels of PLWHA involvement in CBR. Qualitative data reveal complex barriers that make meaningful PLWHA engagement in CBR difficult, including: HIV-related stigma; health-related challenges; "credentialism"; lack of capacity to engage in research; other issues taking priority; and mistrust of researchers. Facilitating factors included valuing lived experience; training and mentoring opportunities; financial compensation; trust building; and accommodating PLWHA's needs. While there is strong support for the GIPA principles in theory, practice lags far behind.

[Impact of fall risk and fear of falling on mobility of independently living senior citizens transitioning to frailty: screening results concerning fall prevention in the community].

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Anders, J; Dapp, U; Laub, S; von Renteln-Kruse, W

2007-08-01

and over the three risk groups of chronic disorders like cardiac failure (75.9%) and disturbed vision or hearing (64.6%). According to the rising risk of falling over the three risk groups (low, medium and high), there were symptoms of fast functional decline or frailty like diminished walking speed (6.3 vs 36.8 vs 72.0%), sarcopenia (failed chairrise test: 0 vs 18.4 vs 28%) or already perceived fall events (0 vs 5.3 vs 56.0%) and ongoing restriction in basic activities. Those results were proven by the data on fall frequencies after one year (follow-up). We found an increase in falls over all three risk groups (12.5 vs 31.6 vs 28%) with fall-related severe injuries (fractures) in two persons classified in the high fall-risk group. The results of the fall-risk screening were useful to classify groups with different probability to fall in the near future. Fear-offalling and symptoms of frailty were related to an increasing risk of falling and loss of mobility and autonomy in still independently living senior citizens. The fall-risk screening instrument ("Sturz-Risiko-Check" questionnaire) was useful and valid to predict risk of falling and functional decline in independently living senior citizens transitioning to frailty. This screening will be part of a prevention approach in the City of Hamburg to offer primary and secondary prevention interventions adapted to special target groups of community- dwelling elder people (robust in contrast to frail elderly). The implementation should be accompanied by training sessions for physicians in the primary care sector and health improvement programmes for elder citizens.

Transition from Hospital to Community Care: The Experience of Cancer Patients

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Hanna Admi

2015-12-01

Full Text Available Purpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77 and quantitative (n=422 methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs. The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001. Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as:  Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4:34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

Transition Communities and the Glass Ceiling of Environmental Sustainability Policies at Three Universities

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Pardellas Santiago, Miguel; Meira Cartea, Pablo; Iglesias da Cunha, Lucía

2017-01-01

Purpose: This paper deals with the experiences of three European universities that have implemented transition initiatives, using the Transition Network's methodology to promote their sustainability plans. The Transition Communities' model for change is presented from a socio-educational perspective as an effective methodology for encouraging…

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

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Adam J McKee

2016-10-01

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

Strategies for Recruiting Women Living with Human Immunodeficiency Virus in Community-Based Research: Lessons from Canada.

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Webster, Kath; Carter, Allison; Proulx-Boucher, Karène; Dubuc, Danièle; Nicholson, Valerie; Beaver, Kerrigan; Gasingirwa, Claudine; Ménard, Brigitte; O'Brien, Nadia; Mitchell, Kayla; Bajard, Micaela Pereira; Ding, Erin; de Pokomandy, Alexandra; Loutfy, Mona; Kaida, Angela

2018-01-01

This study sought to describe the recruitment of women living with HIV (WLWH) into the community-based Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS), because women are under-represented in HIV research. There were 1,424 WLWH were enrolled from British Columbia, Ontario, and Québec, who completed detailed questionnaires administered by peer research associates (PRAs; WLWH with research training). During screening, participants were asked: "How did you hear about the study?" We describe recruitment strategies by subpopulation and offer reflections on challenges and successes. Of 1,131 participants with complete data, 40% identified as White, 33% African/Caribbean/Black, and 19% Indigenous. The median age was 45 years (interquartile range, 37-51) and 4% identified as trans women. Overall, 35% were recruited through PRAs/peers, 34% clinics, and 19% AIDS service organizations (ASOs). PRAs/peers were the predominant recruitment method in Ontario (49%), compared with clinics in British Columbia (40%), and Québec (43%). Nationally, PRAs/peers were more successful in recruiting WLWH commonly considered to be "harder to reach" (e.g., women identifying as trans, using drugs, not receiving HIV care). Clinics were more effective in recruiting younger women (16-29 years) and women not using ASOs. Recruitment challenges centered on engaging these harder to reach women. Successes included hiring PRAs who built participant trust, linking with clinics to reach women isolated from HIV communities, involving outreach workers to engage street-involved women, and disseminating study information to diverse stakeholders. Having multiple approaches, engaging a diverse team of PRAs, ensuring flexibility, and cultivating reciprocal relationships with community stakeholders were key to recruiting a diverse and representative sample of WLWH.

The 24-month metabolic benefits of the healthy living partnerships to prevent diabetes: A community-based translational study.

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Pedley, Carolyn F; Case, L Douglas; Blackwell, Caroline S; Katula, Jeffrey A; Vitolins, Mara Z

2018-05-01

Large-scale clinical trials and translational studies have demonstrated that weight loss achieved through diet and physical activity reduced the development of diabetes in overweight individuals with prediabetes. These interventions also reduced the occurrence of metabolic syndrome and risk factors linked to other chronic conditions including obesity-driven cancers and cardiovascular disease. The Healthy Living Partnerships to Prevent Diabetes (HELP PD) was a clinical trial in which participants were randomized to receive a community-based lifestyle intervention translated from the Diabetes Prevention Program (DPP) or an enhanced usual care condition. The objective of this study is to compare the 12 and 24 month prevalence of metabolic syndrome in the two treatment arms of HELP PD. The intervention involved a group-based, behavioral weight-loss program led by community health workers monitored by personnel from a local diabetes education program. The enhanced usual care condition included dietary counseling and written materials. HELP PD included 301 overweight or obese participants (BMI 25-39.9kg/m 2 ) with elevated fasting glucose levels (95-125mg/dl). At 12 and 24 months of follow-up there were significant improvements in individual components of the metabolic syndrome: fasting blood glucose, waist circumference, HDL, triglycerides and blood pressure and the occurrence of the metabolic syndrome in the intervention group compared to the usual care group. This study demonstrates that a community diabetes prevention program in participants with prediabetes results in metabolic benefits and a reduction in the occurrence of the metabolic syndrome in the intervention group compared to the enhanced usual care group. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Do Community Based Initiatives foster sustainability transitions? Towards a unique Environmental Impact Assessment.

Science.gov (United States)

Martellozzo, Federico; Hendrickson, Cary; Gozdowska, Iga; Groß, Helge; Henderson, Charles; Reusser, Dominik

2015-04-01

The active participation in Community Based Initiatives (CBI) is a spreading phenomenon that has reached a significant magnitude and - in some cases - CBIs are also supposed to have catalysed social and technological innovation, thus contributing to global transition into low-carbon economy. Generally speaking, CBIs are grassroots initiatives with broad sustainability foci that promote a plethora of activities such as alternative transportation, urban gardening, renewable energy implementation, waste regeneration/reduction, etc. Some advocate that such practices fostered by bottom-up activities, rather than top-down policies, represent a proficient countermeasure to alleviate global environmental change and effectively foster a societal transition towards sustainability. However, thus far most empirical research grounds mainly on anecdotal evidence and little work has been done to quantitatively assess CBIs' "environmental impacts" (EI) or their carbon footprints using comparative methodologies. This research main aim is to frame a methodology to assess univocally CBIs' EIs which are crucial to understanding their role in societal sustainability transition. However, to do so, three main caveats need to be addressed: first, some CBIs do not directly produce tangible measurable outputs, nor have an intelligibly defined set of inputs (e.g. CBIs focusing on environmental education and awareness rising). Thus, calculating their "indirect" EI may represent an intricate puzzle that is very much open to subjective interpretation. Second, CBIs' practices are heterogenic and therefore existing methodologies to make comparisons of their EIs are neither straightforward nor proficient, also given the lack of available data. Third, another issue closely related to the one previously mentioned, is a general lack of consensus among already existing impact-assessment frameworks for certain practices (e.g. composting). A potential way of estimating a CBI's EI is a standard Carbon

Home and Community-Based Service Use by Vulnerable Older Adults.

Science.gov (United States)

Weaver, Raven H; Roberto, Karen A

2017-06-01

The purpose of this study was to identify different types of clients who use home and community-based services. Enrollment characteristics of 76 clients at risk of nursing home placement and Medicaid spend-down who were enrolled in the Virginia Community Living Program were analyzed. Two-step cluster analysis identified 4 groups of service users. Enabling resources (caregiver relationship to participant, participant living arrangement, and length of time caregiver provided assistance to participant) and disability type (physical, cognitive, traumatic brain injury, or other) differentiated the client groups. Groups differed on average service cost per day and likelihood of nursing home placement if services were not provided. Findings point to the value of having practitioners assist vulnerable clients in tailoring services to meet different care needs and the need for refining policies guiding home and community-based care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Veterans' Transitions to Community College: A Case Study

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Wheeler, Holly A.

2012-01-01

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

Planning ahead for livable communities along the Powell–Division Bus Rapid Transit : neighborhood conditions and change.

Science.gov (United States)

2017-07-04

New transit investments can be a double-edged sword for disadvantaged communities (e.g., those included in environmental justice and Title VI protected classes). Transit investments improve communities mobility and access, and may improve health w...

Experiencing Postsecondary Transition Planning: The Perspective of Students with Moderate Special Needs

Science.gov (United States)

Platt, Petra W.

2013-01-01

Special educators must engage students with special needs in transition planning to help students set and achieve goals with regard to postsecondary education, vocation, community engagement, and independent living. Researchers have examined many aspects of transition planning, but few have examined how students with special needs experience the…

Adolescent Mothers in a Transitional Living Facility: An Exploratory Study of Support Networks and Attachment Patterns

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Schwartz, Ann E.; McRoy, Ruth G.; Downs, A. Chris

2004-01-01

Most of the research literature on attachment and adolescent transitions has addressed youth in family settings. This article explores these issues with a sample of 25 pregnant and parenting teens living in a transitional shelter. Using case records and interview data as well as results of standardized measures of depression, self-esteem, child…

Evaluation of a community transition to professional practice program for graduate registered nurses in Australia.

Science.gov (United States)

Aggar, Christina; Gordon, Christopher J; Thomas, Tamsin H T; Wadsworth, Linda; Bloomfield, Jacqueline

2018-03-26

Australia has an increasing demand for a sustainable primary health care registered nursing workforce. Targeting graduate registered nurses who typically begin their nursing career in acute-care hospital settings is a potential workforce development strategy. We evaluated a graduate registered nurse Community Transition to Professional Practice Program which was designed specifically to develop and foster skills required for primary health care. The aims of this study were to evaluate graduates' intention to remain in the primary health care nursing workforce, and graduate competency, confidence and experiences of program support; these were compared with graduates undertaking the conventional acute-care transition program. Preceptor ratings of graduate competence were also measured. All of the 25 graduates (n = 12 community, n = 13 acute-care) who completed the questionnaire at 6 and 12 months intended to remain in nursing, and 55% (n = 6) of graduates in the Community Transition Program intended to remain in the primary health care nursing workforce. There were no differences in graduate experiences, including level of competence, or preceptors' perceptions of graduate competence, between acute-care and Community Transition Programs. The Community Transition to Professional Practice program represents a substantial step towards developing the primary health care health workforce by facilitating graduate nurse employment in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.

A Community-based Healthy Living Promotion Program Improved Self-esteem Among Minority Children.

Science.gov (United States)

Wong, William W; Ortiz, Christina L; Stuff, Janice E; Mikhail, Carmen; Lathan, Debra; Moore, Louis A; Alejandro, Mercedes E; Butte, Nancy F; Smith, Elliot O'Brian

2016-07-01

Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority children. The after-school program was implemented at community centers in low-income neighborhoods with close proximity to public schools. The program consisted of 3 6-week sessions. Each week, children attended 2 2-hour sessions. Each 2-hour session in the intervention included 90 minutes of structured physical activities and 30 minutes of nutrition and healthy habit lessons. The control group received typical enrichment programs. Outcomes were measured before the intervention and at the end of each 6-week session. We enrolled 877 children (age 10.2 ± 0.1 years (mean ± SE); body mass index z score: 1.49 ± 0.1; 52.0% boys; 72.6% Hispanic) in the program with 524 children received the intervention at 14 community centers and 353 children served as control at 10 community centers. The intervention led to no improvements in BMI z score (P = 0.78) and dietary habits (P = 0.46). Significant improvements (P ≤ 0.02) were detected in the amount of exercise that a child perceived to be required to offset a large meal and in several key self-esteem scores. No improvements were detected in physical activities (P ≥ 0.21). The improvement in some key self-esteem scores and nutrition knowledge may act as a mediator to motivate these children to adopt a healthier lifestyle in the future.

Free-living protozoa in drinking water supplies: community composition and role as hosts for Legionella pneumophila

NARCIS (Netherlands)

Valster, R.M.

2011-01-01

Free-living protozoa in drinking water supplies: community composition and role as hosts for Legionella pneumophila

Free-living protozoa, which feed on bacteria, play an important role in the communities of microorganisms and invertebrates in drinking water supplies and in (warm)

The right to live in the community as the right to have rights

OpenAIRE

Gradwohl, Csilla

2017-01-01

The present thesis explores Article 19 of the United Nations Convention on the Rights of Persons with Disabilities, which recognizes the right of all persons with disabilities to live in the community, with choices equal to others. The relationship between Article 19 and the other articles of the Convention are explored, in order to discuss the role of Article 19 in the Convention. The thesis examines whether the right to live in the community, set out in Article 19, can be considered as the ...

Knowledge and Attitudes regarding Cervical Cancer Screening among Women with Physical Disabilities Living in the Community

Science.gov (United States)

Wu, Li-Wei; Lin, Lan-Ping; Chen, Si-Fan; Hsu, Shang-Wei; Loh, Ching-Hui; Wu, Chia-Ling; Lin, Jin-Ding

2012-01-01

The study aims to explore knowledge and attitudeSs regarding cervical cancer screening and to examine its determinants based on the perspectives of Taiwanese women with physical disabilities living in the community. A cross-sectional survey was employed in the study, and we recruited 498 women aged more than 15 years who were officially registered…

Free-living protozoa in drinking water supplies: community composition and role as hosts for Legionella pneumophila

OpenAIRE

Valster, R.M.

2011-01-01

Free-living protozoa in drinking water supplies: community composition and role as hosts for Legionella pneumophila Free-living protozoa, which feed on bacteria, play an important role in the communities of microorganisms and invertebrates in drinking water supplies and in (warm) tap water installations. Several bacteria, including opportunistic human pathogens such as Legionella pneumophila, are able to survive and replicate within protozoan hosts, and certain free-living protozoa are opp...

Web-Based Interventions to Improve Mental Health, General Caregiving Outcomes, and General Health for Informal Caregivers of Adults With Chronic Conditions Living in the Community: Rapid Evidence Review.

Science.gov (United States)

Ploeg, Jenny; Markle-Reid, Maureen; Valaitis, Ruta; McAiney, Carrie; Duggleby, Wendy; Bartholomew, Amy; Sherifali, Diana

2017-07-28

Most adults with chronic conditions live at home and rely on informal caregivers to provide support. Caregiving can result in negative impacts such as poor mental and physical health. eHealth interventions may offer effective and accessible ways to provide education and support to informal caregivers. However, we know little about the impact of Web-based interventions for informal caregivers of community-dwelling adults with chronic conditions. The purpose of this rapid evidence review was to assess the impact of Web-based interventions on mental health, general caregiving outcomes, and general health for informal caregivers of persons with chronic conditions living in the community. A rapid evidence review of the current literature was employed to address the study purpose. EMBASE, MEDLINE, PsychInfo, CINAHL, Cochrane, and Ageline were searched covering all studies published from January 1995 to July 2016. Papers were included if they (1) included a Web-based modality to deliver an intervention; (2) included informal, unpaid adult caregivers of community-living adults with a chronic condition; (3) were either a randomized controlled trial (RCT) or controlled clinical trial (CCT); and (4) reported on any caregiver outcome as a result of use or exposure to the intervention. A total of 20 papers (17 studies) were included in this review. Study findings were mixed with both statistically significant and nonsignificant findings on various caregiver outcomes. Of the 17 included studies, 10 had at least one significant outcome. The most commonly assessed outcome was mental health, which included depressive symptoms, stress or distress, and anxiety. Twelve papers examined the impact of interventions on the outcome of depressive symptoms; 4 found a significant decrease in depressive symptoms. Eight studies examined the outcome of stress or distress; 4 of these found a significant reduction in stress or distress as a result of the intervention. Three studies examined the

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL questionnaire

Directory of Open Access Journals (Sweden)

Cecilia Collingwood

2014-12-01

Full Text Available Background: The dementia diagnosis gap in sub-Saharan Africa (SSA is large, partly due to difficulties in assessing function, an essential step in diagnosis. Objectives: As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening. Design: The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC curve analysis. Results: An 11-item questionnaire (IDEA-IADL was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level. Conclusions: The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required.

Community Foresight for Urban Sustainability

DEFF Research Database (Denmark)

Mortensen, Jonas Egmose; Eames, Malcolm

2011-01-01

be necessary to deliver sustainability. In so doing, however, backcasting may run the risk of obscuring significant differences in current lived experience, negating alternative problem framings and normatively derived views of what constitutes sustainability. This paper reports an innovative UK attempt...... to develop an inclusive 'bottom-up' Community Foresight process for urban sustainability research. Unlike most backcasting studies, the methodology was initially grounded in an exploration of the community participants' current lived experience and understandings of sustainability. Given the particular...... purpose of the study the primary outcome from the work was structured around the articulation of a 'community-led' agenda for urban sustainability research, rather than an explicit normative vision and transition pathway. However, the methodology could easily be adapted for use in other contexts...

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

Science.gov (United States)

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

2011-06-01

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

Environmental, behavioral, and psychological predictors of transit ridership: Evidence from a community intervention

Science.gov (United States)

Brown, Barbara B.; Werner, Carol M.; Smith, Ken R.; Tribby, Calvin P.; Miller, Harvey J.; Jensen, Wyatt A.; Tharp, Doug

2016-01-01

Understanding who takes advantage of new transit (public transportation) interventions is important for personal and environmental health. We examine transit ridership for residents living near a new light rail construction as part of “complete street,” pedestrian-friendly improvements. Adult residents (n=536) completed surveys and wore accelerometer and GPS units that tracked ridership before and after new transit service started. Transit riders were more physically active. Those from environments rated as more walkable were likely to be continuing transit riders. Place attachment, but not perceived physical incivilities on the path to transit, was associated with those who continued to ride or became new riders of transit. This effect was mediated through pro-city attitudes, which emphasize how the new service makes residents eager to explore areas around transit. Thus, place attachment, along with physical and health conditions, may be important predictors and promoters of transit use. PMID:27672237

The Sea Floor: A Living Learning Residential Community

Science.gov (United States)

Guentzel, J. L.; Rosch, E.; Stoughton, M. A.; Bowyer, R.; Mortensen, K.; Smith, M.

2016-02-01

Living learning communities are collaborations between university housing and academic departments designed to enhance the overall student experience by integrating classroom/laboratory learning, student life and extracurricular activities. At Coastal Carolina University, the residential community associated with the Marine Science program is known as the Sea Floor. Students selected to become members of the Sea Floor remain "in residence" for two consecutive semesters. These students are first-time freshman that share a common course connection. This course is usually Introduction to Marine Science (MSCI 111) or MSCI 399s, which are one credit field/laboratory centered internships. The common course connection is designed so residents can establish and maintain an educational dialog with their peers. Activities designed to enhance the students' networking skills and educational and social development skills include monthly lunches with marine science faculty and dinner seminars with guest speakers from academia, industry and government. Additionally, each semester several activities outside the classroom are planned so that students can more frequently interact with themselves and their faculty and staff partners. These activities include field trips to regional aquariums, local boat trips that include water sample collection and analysis, and an alternative spring break trip to the Florida Keys to study the marine environment firsthand. The resident advisor that supervises the Sea Floor is usually a sophomore or junior marine science major. This provides the residents with daily communication and mentoring from a marine science major that is familiar with the marine science program and residence life. Assessment activities include: a university housing community living survey, student interest housing focus groups, fall to spring and fall to fall retention, and evaluation of program advisors and program activities.

An interprofessional education project to address the health care needs of women transitioning from prison to community reentry.

Science.gov (United States)

Busen, Nancy H

2014-01-01

With the implementation of the Patient Protection and Affordable Care Act, the need for health care providers to work collaboratively in teams to provide cost-effective, quality health care has become even more apparent because an estimated additional 22 million Americans gain health care coverage by 2014. The need for evidenced-based care that combines the expertise of various disciplines has been acknowledged by policy makers and health educators. With support from national Association for Prevention, Teaching and Research, an interprofessional education course was designed and implemented by health professionals in nursing, nutrition, and dentistry, in collaboration with a local community agency, to address the health care needs of women transitioning from prison to the community. Health care needs of women in prison are often overlooked, and access to care is limited. When released from prison, utilization of even basic health services is rare. Four interactive teaching-learning sessions were offered at a residential facility for women in transition over a 12-week period. Topics were selected based on feedback from the participants and included stress reduction, self-beast examination, hypertension, and common dental conditions. Teaching methods and materials were interactive and designed for sustainability. The model for this interprofessional education project, which employed a service-learning approach, can be adapted for other communities. Working with our communities requires innovative thinking to be effective but provides an enriching life experience to those involved. A community-based reciprocal learning environment benefits all partners in the real-world environment. Copyright © 2014 Elsevier Inc. All rights reserved.

HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

Science.gov (United States)

Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian; Hausler, Harry; Van Damme, Wim

2016-01-01

In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household

HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

Directory of Open Access Journals (Sweden)

Caroline Masquillier

Full Text Available In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs. Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his

Commuting, Transitions and Belonging: The Experiences of Students Living at Home in Their First Year at University

Science.gov (United States)

Pokorny, Helen; Holley, Debbie; Kane, Suzanne

2017-01-01

In this study, our cross-case analysis of students' lives challenges the conventional home-university model of transition and highlights the importance of acknowledging the influence of this complex symbiotic relationship for students who attend university and live at home. We argue that as with stay-at-home holidays, or "staycations",…

The burden of non-communicable disease in transition communities in an Asian megacity: baseline findings from a cohort study in Karachi, Pakistan.

Directory of Open Access Journals (Sweden)

Faisal S Khan

Full Text Available The demographic transition in South Asia coupled with unplanned urbanization and lifestyle changes are increasing the burden of non-communicable disease (NCD where infectious diseases are still highly prevalent. The true magnitude and impact of this double burden of disease, although predicted to be immense, is largely unknown due to the absence of recent, population-based longitudinal data. The present study was designed as a unique 'Framingham-like' Pakistan cohort with the objective of measuring the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection in a multi-ethnic, middle to low income population of Karachi, Pakistan.We selected two administrative areas from a private charitable hospital's catchment population for enrolment of a random selection of cohort households in Karachi, Pakistan. A baseline survey measured the prevalence and risk factors for hypertension, obesity, diabetes, coronary artery disease and hepatitis B and C infection.Six hundred and sixty-seven households were enrolled between March 2010 and August 2011. A majority of households lived in permanent structures (85% with access to basic utilities (77% and sanitation facilities (98% but limited access to clean drinking water (68%. Households had high ownership of communication technologies in the form of cable television (69% and mobile phones (83%. Risk factors for NCD, such as tobacco use (45%, overweight (20%, abdominal obesity (53%, hypertension (18%, diabetes (8% and pre-diabetes (40% were high. At the same time, infectious diseases such as hepatitis B (24% and hepatitis C (8% were prevalent in this population.Our findings highlight the need to monitor risk factors and disease trends through longitudinal research in high-burden transition communities in the context of rapid urbanization and changing lifestyles. They also demonstrate the urgency of public health intervention programs tailored for

Community influences on intimate partner violence in India: Women's education, attitudes towards mistreatment and standards of living.

Science.gov (United States)

Boyle, Michael H; Georgiades, Katholiki; Cullen, John; Racine, Yvonne

2009-09-01

Intimate partner violence (IPV) directed towards women is a serious public health problem. Women's education may offer protection against IPV, but uncertainty exists over how it might reduce risk for IPV at the community and individual levels. The objectives of this study are to: (1) disentangle community from individual-level influences of women's education on risk for IPV; (2) quantify the moderating influence of communities on individual-level associations between women's education and IPV; (3) determine if women's attitudes towards mistreatment and living standards at the community and individual levels account for the protective influence of women's education; and (4) determine if the protective influence of education against IPV is muted among women living in communities exhibiting attitudes more accepting of mistreatment. Study information came from 68,466 married female participants in the National Family Health Survey conducted throughout India in 1998-1999. Multilevel logistic regression was used to address the study objectives. IPV showed substantial clustering at both the state (10.2%) and community levels (11.5%). At the individual level, there was a strong non-linear association between women's education and IPV, partially accounted for by household living standards. The strength of association between women's education and IPV varied from one community to the next with evidence that the acceptance of mistreatment at the community level mutes the protective influence of higher education. Furthermore, women's attitudes towards mistreatment and their standards of living accounted for community-level associations between women's education and IPV. Place of residence accounted for substantial variation in risk of IPV and also modified individual-level associations between IPV and women's education. At the community level, women's education appeared to exert much of its protective influence by altering population attitudes towards the acceptability of

Dynamical Detection of Topological Phase Transitions in Short-Lived Atomic Systems

Science.gov (United States)

Setiawan, F.; Sengupta, K.; Spielman, I. B.; Sau, Jay D.

2015-11-01

We demonstrate that dynamical probes provide direct means of detecting the topological phase transition (TPT) between conventional and topological phases, which would otherwise be difficult to access because of loss or heating processes. We propose to avoid such heating by rapidly quenching in and out of the short-lived topological phase across the transition that supports gapless excitations. Following the quench, the distribution of excitations in the final conventional phase carries signatures of the TPT. We apply this strategy to study the TPT into a Majorana-carrying topological phase predicted in one-dimensional spin-orbit-coupled Fermi gases with attractive interactions. The resulting spin-resolved momentum distribution, computed by self-consistently solving the time-dependent Bogoliubov-de Gennes equations, exhibits Kibble-Zurek scaling and Stückelberg oscillations characteristic of the TPT. We discuss parameter regimes where the TPT is experimentally accessible.

Food security for community-living elderly people in Beijing, China.

Science.gov (United States)

Cheng, Yang; Rosenberg, Mark; Yu, Jie; Zhang, Hua

2016-11-01

Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education (OR = 1.68) and better health (OR = 1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old (OR = 0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone (OR = 0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future. © 2015 John Wiley & Sons Ltd.

Self-perceived health status and sleep quality of older adults living in community after elastic band exercises.

Science.gov (United States)

Chan, Shu-Ya; Chen, Kuei-Min

2017-07-01

To test the effectiveness of a six-month senior elastic band exercise programme on the self-perceived health status and sleep quality of older adults living in community settings. Health issues common among older adults living in community settings include poor physical and mental health conditions and sleep quality. Engagement in appropriate exercise programmes facilitates alleviating these health issues among older adults. A quasi-experimental design was applied. A convenience sample of older adults was drawn from six senior-citizen activity centres in southern Taiwan. Participants were assigned to either an experimental group (three centres, n = 97) or a control group (three centres, n = 102) based on the senior-citizen activity centres they attended. The participants in the experimental group carried out the Senior Elastic Band exercise programme for six months (three times per week and 40 minutes per session) in addition to their daily activities. The participants in the control group maintained their daily activities. The participants' self-perceived health status and sleep quality were examined at the baseline, three-month interval and six-month interval. In total, 169 participants completed the six-month study: 84 constituted the experimental group and 85 constituted the control group. At the three-month interval, the participants in the experimental group had greater improvements in self-perceived physical health, overall sleep quality, sleep latency and sleep duration compared with those in the control group; these significant changes continued throughout the six-month study. The Senior Elastic Band exercise programme showed promising effects in improving the self-perceived physical health and sleep quality of older adults living in community settings. Healthcare professionals can incorporate the Senior Elastic Band exercise programme as one of the health promotion activities for older adults living in community settings. © 2016 John Wiley & Sons

Nectar-living yeasts of a tropical host plant community: diversity and effects on community-wide floral nectar traits

Science.gov (United States)

2017-01-01

We characterize the diversity of nectar-living yeasts of a tropical host plant community at different hierarchical sampling levels, measure the associations between yeasts and nectariferous plants, and measure the effect of yeasts on nectar traits. Using a series of hierarchically nested sampling units, we extracted nectar from an assemblage of host plants that were representative of the diversity of life forms, flower shapes, and pollinator types in the tropical area of Yucatan, Mexico. Yeasts were isolated from single nectar samples; their DNA was identified, the yeast cell density was estimated, and the sugar composition and concentration of nectar were quantified using HPLC. In contrast to previous studies from temperate regions, the diversity of nectar-living yeasts in the plant community was characterized by a relatively high number of equally common species with low dominance. Analyses predict highly diverse nectar yeast communities in a relatively narrow range of tropical vegetation, suggesting that the diversity of yeasts will increase as the number of sampling units increases at the level of the species, genera, and botanical families of the hosts. Significant associations between specific yeast species and host plants were also detected; the interaction between yeasts and host plants impacted the effect of yeast cell density on nectar sugars. This study provides an overall picture of the diversity of nectar-living yeasts in tropical host plants and suggests that the key factor that affects the community-wide patterns of nectar traits is not nectar chemistry, but rather the type of yeasts interacting with host plants. PMID:28717591

Nectar-living yeasts of a tropical host plant community: diversity and effects on community-wide floral nectar traits

Directory of Open Access Journals (Sweden)

Azucena Canto

2017-07-01

Full Text Available We characterize the diversity of nectar-living yeasts of a tropical host plant community at different hierarchical sampling levels, measure the associations between yeasts and nectariferous plants, and measure the effect of yeasts on nectar traits. Using a series of hierarchically nested sampling units, we extracted nectar from an assemblage of host plants that were representative of the diversity of life forms, flower shapes, and pollinator types in the tropical area of Yucatan, Mexico. Yeasts were isolated from single nectar samples; their DNA was identified, the yeast cell density was estimated, and the sugar composition and concentration of nectar were quantified using HPLC. In contrast to previous studies from temperate regions, the diversity of nectar-living yeasts in the plant community was characterized by a relatively high number of equally common species with low dominance. Analyses predict highly diverse nectar yeast communities in a relatively narrow range of tropical vegetation, suggesting that the diversity of yeasts will increase as the number of sampling units increases at the level of the species, genera, and botanical families of the hosts. Significant associations between specific yeast species and host plants were also detected; the interaction between yeasts and host plants impacted the effect of yeast cell density on nectar sugars. This study provides an overall picture of the diversity of nectar-living yeasts in tropical host plants and suggests that the key factor that affects the community-wide patterns of nectar traits is not nectar chemistry, but rather the type of yeasts interacting with host plants.

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China.

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Xiao, Lishan; Lin, Tao; Chen, Shaohua; Zhang, Guoqin; Ye, Zhilong; Yu, Zhaowu

2015-01-01

The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas.

Lessons learned from community-based approaches to sodium reduction.

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

2015-01-01

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

How does the impact of a community trial on cardio-metabolic risk factors differ in terms of gender and living area? Findings from the Isfahan healthy heart program

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Nizal Sarrafzadegan

2012-01-01

Full Text Available Objective: To assess the impact of gender and living area on cardiovascular risk factors in the context of a comprehensive lifestyle intervention program. Design: Data from independent sample surveys before (2000--2001 and after (2007 a community trial, entitled the Isfahan Healthy Heart Program (IHHP were used to compare differences in the intervention area (IA and reference area (RA by gender and living area. Setting: The interventions targeted the population living in Isfahan and Najaf-Abad counties as IA and Arak as RA. Participants: Overall, 12 514 individuals who were more than 19 years of age were studied at baseline, and 9570 were studied in postintervention phase. Interventions: Multiple activities were conducted in connection with each of the four main strategies of healthy nutrition, increasing physical activity, tobacco control, and coping with stress. Main Outcomes: Comparing serum lipids levels, blood pressure, blood glucose and obesity indices changes between IA and RA based on sex and living areas during the study. Results: In IA, while the prevalence of hypertension declined in urban and rural females (P < 0.05. In IA, the prevalence of hypercholesterolemia and hypertriglyceridemia decreased in both females and males of urban and rural areas except for hypercholesterolemia in rural males (P < 0.01. In RA, the significant changes include both decrease in the hypercholesterolemia among rural males (P < 0.001 and hypertriglyceridemia in urban females (P < 0.01, while hypertriglyceridemia was significantly increased in rural females (P < 0.01. Conclusions: This comprehensive community trial was effective in controlling many risk factors in both sexes in urban and rural areas. These findings also reflect the transitional status of rural population in adopting urban lifestyle behaviors.

Effect of Evidence-Based Supported Employment vs Transitional Work on Achieving Steady Work Among Veterans With Posttraumatic Stress Disorder: A Randomized Clinical Trial.

Science.gov (United States)

Davis, Lori L; Kyriakides, Tassos C; Suris, Alina M; Ottomanelli, Lisa A; Mueller, Lisa; Parker, Pamela E; Resnick, Sandra G; Toscano, Richard; Scrymgeour, Alexandra A; Drake, Robert E

2018-04-01

Posttraumatic stress disorder (PTSD) often interferes with a person's ability to obtain or sustain employment, which leads to premature exit from the labor force and reduced income. To determine whether individual placement and support (IPS)-supported employment is more effective than stepwise vocational rehabilitation involving transitional work assignments at helping veterans with PTSD attain steady, competitive employment. The Veterans Individual Placement and Support Toward Advancing Recovery (VIP-STAR) study was a prospective, multisite, randomized clinical trial that included 541 unemployed veterans with PTSD at 12 Veterans Affairs medical centers. Data were collected from December 23, 2013, to May 3, 2017. Intent-to-treat analysis was performed. Individual placement and support is a supported employment intervention that rapidly engages people with disabilities in community job development to obtain work based on their individual job preferences. Transitional work is a stepwise vocational rehabilitation intervention that assigns people temporarily to noncompetitive jobs as preparation for competitive employment in the community. A priori hypotheses were that, compared with those in transitional work, more participants in the IPS group would become steady workers (primary) and earn more income from competitive jobs (secondary) over 18 months. Steady worker was defined as holding a competitive job for at least 50% of the 18-month follow-up period. A total of 541 participants (n = 271 IPS; n = 270 transitional work) were randomized. Mean (SD) age was 42.2 (11) years; 99 (18.3%) were women, 274 (50.6%) were white, 225 (41.6%) were African American, and 90 (16.6%) were of Hispanic, Spanish, or Latino ethnicity. More participants in the IPS group achieved steady employment than in the transitional work group (105 [38.7%] vs 63 [23.3%]; odds ratio, 2.14; 95% CI, 1.46-3.14). A higher proportion of IPS participants attained any competitive job (186 [68.6%] vs

Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

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West, Nikki; Berman, Audrey; Karshmer, Judith; Prion, Susan; Van, Paulina; Wallace, Jonalyn

2014-06-01

Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence. Copyright 2014, SLACK Incorporated.

Agent Based Model in SAS Environment for Rail Transit System Alignment Determination

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I Made Indradjaja Brunner

2018-04-01

Full Text Available Transit system had been proposed for the urban area of Honolulu. One consideration to be determined is the alignment of the transit system. Decision to set the transit alignment will have influences on which areas will be served, who will be benefiting, as well as who will be impacted. Inputs for the decision usually conducted through public meetings, where community members are shown numbers of maps with pre-set routes. That approach could lead to a rather subjective decision by the community members. This paper attempts to discuss the utilization of grid map in determining the best alignment for rail transit system in Honolulu, Hawaii. It tries to use a more objective approach using various data derived from thematic maps. Overlaid maps are aggregated into a uniform 0.1-square mile vector based grid map system in GIS environment. The large dataset in the GIS environment is analyzed and manipulated using SAS software. The SAS procedure is applied to select the location of the alignment using a rational and deterministic approach. Grid cells that are superior compared to the others are selected based on several predefined criteria. Location of the dominant cells indicates possible transit alignment. The SAS procedure is designed to allow a transient vector called the GUIDE (Grid Unit with Intelligent Directional Expertise agent to analyze several cells at its vicinity and to move towards a cell with the highest value. Each time the agent landed on a cell, it left a mark. The chain of those marks shows location for the transit alignment. This study shows that the combination of ArcGIS and SAS allows a robust analysis of spatial data and manipulation of its datasets, which can be used to run a simulation mimicking the Agent-Based Modelling. This study also opens up further study possibilities by increasing number of factors analyzed by the agent, as well as creating a composite value of multi-factors.

Transitions from hospital to community care: the role of patient-provider language concordance.

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Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

2014-01-01

Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study.

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Hayter, Arabella K M; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

2015-01-01

Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.

A systematic community-based participatory approach to refining an evidence-based community-level intervention: the HOLA intervention for Latino men who have sex with men.

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Rhodes, Scott D; Daniel, Jason; Alonzo, Jorge; Duck, Stacy; García, Manuel; Downs, Mario; Hergenrather, Kenneth C; Alegría-Ortega, José; Miller, Cindy; Boeving Allen, Alex; Gilbert, Paul A; Marsiglia, Flavio F

2013-07-01

Our community-based participatory research partnership engaged in a multistep process to refine a culturally congruent intervention that builds on existing community strengths to promote sexual health among immigrant Latino men who have sex with men (MSM). The steps were the following: (1) increase Latino MSM participation in the existing partnership, (2) establish an Intervention Team, (3) review the existing sexual health literature, (4) explore needs and priorities of Latino MSM, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latino MSM's lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. The developed intervention contains four modules to train Latino MSM to serve as lay health advisors known as Navegantes. These modules synthesize locally collected data with other local and national data; blend health behavior theory, the lived experiences, and cultural values of immigrant Latino MSM; and harness the informal social support Latino MSM provide one another. This community-level intervention is designed to meet the expressed sexual health priorities of Latino MSM. It frames disease prevention within sexual health promotion.

Applying community-based participatory research to better understand and improve kinship care practices

DEFF Research Database (Denmark)

Chukwudozie, Oge; Feinstein, Clare; Jensen, Celina

2015-01-01

While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented. This art...... and highlights how the research process enabled action and advocacy initiatives at different levels-leading to an increase in support and policy attention for children living in kinship care....

Individual- and community-level determinants of social acceptance of people living with HIV in Kenya: results from a national population-based survey.

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Chiao, Chi; Mishra, Vinod; Sambisa, William

2009-09-01

Using the 2003 Kenya Demographic and Health Survey, we investigated the influence of individual- and community-level factors on accepting attitudes toward people living with HIV (PLHIV) using three outcomes: (1) willingness to care for an infected household member, (2) willingness to buy vegetables from an infected vendor, and (3) willingness to allow an infected female teacher to continue teaching. In multilevel logistic regression models, we found that individuals who expressed greater acceptance of PLHIV were more likely to be male, older, more educated, high AIDS knowledge, and exposed to mass media. At the community level, differences in accepting attitudes were associated with community AIDS knowledge, community education, and community AIDS experience, but not for region, or place of residence. The findings suggest the important role of community factors in determining social acceptance of PLHIV. Programmatic strategies aimed at increasing these accepting attitudes should consider both individual- and community-level factors.

Optimizing care transitions: the role of the community pharmacist

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Melody, Karleen T; McCartney, Elizabeth; Sen, Sanchita; Duenas, Gladys

2016-01-01

Transitions of care (TOC) refer to the movement of patients across institutions, among providers, between different levels of care, and to and from home. Medication errors that occur during TOC have the potential to result in medical complications that are serious for the patient and costly to the health care system. Positive outcomes have been demonstrated when pharmacists are involved in providing TOC services, including reducing preventable adverse drug reactions, medication-related problems, and rehospitalizations, as well as improving the discharge process. This review explores TOC models involving community pharmacy practice, the current impact of pharmacist interventions in TOC, and patient satisfaction with TOC services provided by community pharmacists. Common barriers and potential solutions to TOC services provided in the community pharmacy, such as patient identification, information gathering, standardization of services, administrative support, reimbursement, and time restraints, are also discussed. PMID:29354539

[Plant communities in the terrestrial-aquatic transition zone in the paramo of Chingaza, Colombia].

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Schmidt-Mumm, Udo; Vargas Ríos, Orlando

2012-03-01

Plant communities in the terrestrial-aquatic transition zone in the paramo of Chingaza, Colombia. High Andean paramo ecosystems are an important water resource for many towns, and major cities in this region. The aquatic and wetland vegetation of different paramo lakes, pond, swamps and bogs was studied according to the classical phytosociological approach, which is based on homogenous stands, but excludes any border phenomena or transitional zone. The present research aimed at determining the aquatic and wetland vegetation along different moisture gradients. A total of 89 species in 30 transects were reported, of which Crassula venezuelensis, Carex honplandii, Callitriche nubigena, Eleocharis macrostachya, Ranunculus flagelliformis, R. nubigenus, Eleocharis stenocarpa, Galium ascendens y Alopecurus aequalis were present in more than one third of the transects. Numerical classification and indicator species analysis resulted in the definition of the next 18 communities: 1) Calamagrostis effusa, 2) Sphagnum cuspidatum, 3) Cyperus rufus, 4) Eleocharis stenocarpa, 5) Carex acutata, 6) Poa annua,7) Valeriana sp., 8) Ranunculus flagelliformis, 9) Carex bonplandii, 10) Festuca andicola. 11) Muhlenbergia fustigiata, 12) Elatine paramoana, 13) Isoëtes palmeri, 14) Crassula venezuelensis, 15) Lilaeopsis macloviana, 16) Callitriche nubigena, 17) Potamogeton paramoanus and 18) Potamogeton illinoensis. The ordination of communities reveals the presence of three different aquatic-terrestrial gradients which are related to the life form structure of species that characterized the various communities. We concluded that patchiness and heterogeneity of the vegetation is mainly the result of alterations caused by human activities (burning, cattle raise and material extraction for road and dam construction).

Community matrons as problem-solvers for people living with multi-co-morbid disease.

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Randall, Sue; Thunhurst, Colin; Furze, Gill

2016-12-02

Working with patients in their own homes gives community matrons an advantage of seeing patients in the context of their everyday lives. This allows comprehensive assessment of need with an aim of promoting health or promoting stability for people living with chronic disease. Complex issues are resolved through problem-solving and this can result in patients being maintained in their own homes and thus in reduced unplanned hospitalisation. Data were collected from participants using semi-structured interviews and audio diaries. The sample comprised professionals: CMs (n=21), managers (n=4), former commissioners (n=2) and GPs (n=3); and patients (n=10) and their family carers (n=5). In this article, data from community matrons is discussed. Community matrons often drew on the social determinants model of health to problem solve and to create meaningful strategies that work for patients in their care. Raising awareness of the high-level skills of community matrons and promoting appreciation of the importance of a social determinants model of health is important in explaining why nurses are such a crucial element of the primary health care workforce.

Move the Neighbourhood: Study design of a community-based participatory public open space intervention in a Danish deprived neighbourhood to promote active living

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Charlotte Skau Pawlowski

2017-05-01

Full Text Available Abstract Background A limited amount of research has examined the effect of changing public open spaces on active living. This paper will present the study protocol of a community-based intervention study co-designed in an interdisciplinary collaboration with community members to develop urban installations highly tailored to promote active living among children (10–13-years-old and seniors (>60-years-old in a deprived neighbourhood in Copenhagen. Methods The study builds on a quasi-experimental study design with two sub-studies: 1 a children study and 2 a senior study. The interventions will be developed, designed and implemented in collaboration with local children and seniors, respectively, using different co-design tools and methods. We will evaluate the effect of the interventions on children’s and senior’s use of the new-built urban installations using accelerometers in combination with GPS as well as systematic observation using the System for Observing Play and Recreation in Communities (SOPARC. A process evaluation with focus groups consisting of the various stakeholders in the two sub-studies will be used to gain knowledge of the intervention processes. Discussion The paper presents new approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, and tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods in the future. Trial registration Retrospectively registered with study ID ISRCTN50036837 . Date of registration: 16 December 2016.

Move the Neighbourhood: Study design of a community-based participatory public open space intervention in a Danish deprived neighbourhood to promote active living.

Science.gov (United States)

Pawlowski, Charlotte Skau; Winge, Laura; Carroll, Sidse; Schmidt, Tanja; Wagner, Anne Margrethe; Nørtoft, Kamilla Pernille Johansen; Lamm, Bettina; Kural, René; Schipperijn, Jasper; Troelsen, Jens

2017-05-19

A limited amount of research has examined the effect of changing public open spaces on active living. This paper will present the study protocol of a community-based intervention study co-designed in an interdisciplinary collaboration with community members to develop urban installations highly tailored to promote active living among children (10-13-years-old) and seniors (>60-years-old) in a deprived neighbourhood in Copenhagen. The study builds on a quasi-experimental study design with two sub-studies: 1) a children study and 2) a senior study. The interventions will be developed, designed and implemented in collaboration with local children and seniors, respectively, using different co-design tools and methods. We will evaluate the effect of the interventions on children's and senior's use of the new-built urban installations using accelerometers in combination with GPS as well as systematic observation using the System for Observing Play and Recreation in Communities (SOPARC). A process evaluation with focus groups consisting of the various stakeholders in the two sub-studies will be used to gain knowledge of the intervention processes. The paper presents new approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, and tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods in the future. Retrospectively registered with study ID ISRCTN50036837 . Date of registration: 16 December 2016.

Understanding the Educational Lives of Community College Students: A Photovoice Project, a Bourdieusian Interpretation, and Habitus Dissonance Spark Theory

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Latz, Amanda O.

2012-01-01

Too little research exists that provides windows into the day-to-day lives of community college students. The purpose of this paper is to explicate one finding and concomitant grounded theory derived from a photovoice project aimed at understanding the educational lives of community college students. Participants saw the community college as a…

Identification of Important Community Living Skills for Adults with Mental Retardation.

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Lovett, David L.; Harris, Mary B.

1987-01-01

Attempted to identify skills important for successful community living of adults with mental retardation. Individuals (N=73) who had significant contact with adults with mental retardation completed questionnaire on academic, leisure, personal, social, and vocational skills frequently taught to persons with mental handicaps. Subjects considered…

Healthy options: a community-based program to address food insecurity.

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Dailey, Amy B; Hess, Audrey; Horton, Camille; Constantian, Emily; Monani, Salma; Wargo, Betsy; Davidson, Kim; Gaskin, Kathy

2015-01-01

The objectives of this study are to better understand the lived experience of food insecurity in our community and to examine the impact of a community-based program developed to increase access to local, healthy foods. Participants were given monthly vouchers to spend at local farmers' markets and invited to engage in a variety of community activities. Using a community-based participatory research framework, mixed methods were employed. Survey results suggest that most respondents were satisfied with the program and many increased their fruit and vegetable consumption. However, over 40% of respondents reported a higher level of stress over having enough money to buy nutritious meals at the end of the program. Photovoice results suggest that the program fostered cross-cultural exchanges, and offered opportunities for social networking. Building on the many positive outcomes of the program, community partners are committed to using this research to further develop policy-level solutions to food insecurity.

Costs of community-based interventions from the Community Transformation Grants.

Science.gov (United States)

Khavjou, Olga A; Honeycutt, Amanda A; Yarnoff, Benjamin; Bradley, Christina; Soler, Robin; Orenstein, Diane

2018-07-01

Limited data are available on the costs of evidence-based community-wide prevention programs. The objective of this study was to estimate the per-person costs of strategies that support policy, systems, and environmental changes implemented under the Community Transformation Grants (CTG) program. We collected cost data from 29 CTG awardees and estimated program costs as spending on labor; consultants; materials, travel, and services; overhead activities; partners; and the value of in-kind contributions. We estimated costs per person reached for 20 strategies. We assessed how per-person costs varied with the number of people reached. Data were collected in 2012-2015, and the analysis was conducted in 2015-2016. Two of the tobacco-free living strategies cost less than $1.20 per person and reached over 6 million people each. Four of the healthy eating strategies cost less than $1.00 per person, and one of them reached over 6.5 million people. One of the active living strategies cost $2.20 per person and reached over 7 million people. Three of the clinical and community preventive services strategies cost less than $2.30 per person, and one of them reached almost 2 million people. Across all 20 strategies combined, an increase of 10,000 people in the number of people reached was associated with a $0.22 reduction in the per-person cost. Results demonstrate that interventions, such as tobacco-free indoor policies, which have been shown to improve health outcomes have relatively low per-person costs and are able to reach a large number of people. Copyright © 2018 Elsevier Inc. All rights reserved.

Lessons Learned From Community-Based Approaches to Sodium Reduction

Science.gov (United States)

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

2017-01-01

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

“To live with the Sea” Development of the Velondriake Community ...

African Journals Online (AJOL)

serves as a liaison between conservation scientists and community members, providing input and insight into all phases of conservation planning, from research activities to implementation of management plans. The management committee also selected a unifying name for the network: Velondriake, which means “to live ...

Constructing Leadership Identities through Participation in a Leadership Living-Learning Community

Science.gov (United States)

Priest, Kerry Louise

2012-01-01

This case study conceptually illustrated how a leadership living-learning community provided an educational context well suited to enhance development of leaders within changing leadership and educational paradigms. Specifically, it highlighted how both leadership and learning have come to be viewed as sociocultural processes, and presented…

Effectiveness of community-based support for pregnant women living with HIV: a cohort study in South Africa.

Science.gov (United States)

Fatti, Geoffrey; Shaikh, Najma; Eley, Brian; Grimwood, Ashraf

2016-01-01

Antiretroviral treatment (ART) initiation in HIV-infected pregnant women in sub-Saharan Africa (SSA) remains inadequate, and there is a severe shortage of professional healthcare workers in the region. The effectiveness of community support programmes for HIV-infected pregnant women and their infants in SSA is unclear. This study compared initiation of maternal antiretrovirals and infant outcomes amongst HIV-infected pregnant women and their infants who received and did not receive community-based support (CBS) in a high HIV-prevalence setting in South Africa. A cohort study, including HIV-infected pregnant women and their infants, was conducted at three sentinel surveillance facilities between January 2009 and June 2012, utilising enhanced routine clinical data. Through home visits, CBS workers encouraged uptake of interventions in the ART cascade, provided HIV-related education, ART initiation counselling and psychosocial support. Outcomes were compared using Kaplan-Meier analyses and multivariable Cox and log-binomial regression. Amongst 1105 mother-infant pairs included, 264 (23.9%) received CBS. Amongst women eligible to start ART antenatally, women who received CBS had a reduced risk of not initiating antenatal ART, 5.4% vs. 30.3%; adjusted risk ratio (aRR) = 0.18 (95% CI: 0.08-0.44; P Pregnant women living with HIV who received CBS had improved antenatal triple ART initiation in eligible women, women initiated ART and ZDV with shorter delays, and had a lower risk of stillbirth. CBS is an intervention that shows promise in improving maternal and infant health in high HIV-prevalence settings.

Identifying factors associated with perceived success in the transition from hospital to home after brain injury.

Science.gov (United States)

Nalder, Emily; Fleming, Jennifer; Foster, Michele; Cornwell, Petrea; Shields, Cassandra; Khan, Asad

2012-01-01

: To identify the factors associated with perceived success of the transition from hospital to home after traumatic brain injury (TBI). : Prospective longitudinal cohort design with data collection at discharge and 1, 3, and 6 months postdischarge. : A total of 127 individuals with TBI discharged to the community and 83 significant others. : An analog scale (0-100) of perceived success of the transition from hospital to home rated by individuals and significant others; Sentinel Events Questionnaire; EuroQol Group Quality-of-Life measure visual analog scale; Sydney Psychosocial Reintegration Scale; Mayo-Portland Adaptability Inventory-4; short form of the Depression, Anxiety, Stress Scales; Craig Hospital Inventory of Environmental Factors; and Caregiver Strain Index. : Greater perceived success of transition for individuals with a TBI was associated with higher levels of health-related quality of life, level of community integration, and more severe injury. Among survivors, sentinel events such as returning to work and independent community access and changing living situation were associated with greater perceived success; financial strain and difficulty accessing therapy services were associated with less success. Among significant others, lower ratings of transition success were associated with higher significant other stress levels as well as lower levels of community integration and changes in the living situation of the individual with TBI. : A combination of sentinel events and personal and environmental factors influences the perceptions of individuals and their families regarding the success of the transition from hospital to home.

Sexual violence and sub-Saharan migrants in Morocco: a community-based participatory assessment using respondent driven sampling.

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Keygnaert, Ines; Dialmy, Abdessamad; Manço, Altay; Keygnaert, Jeroen; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

2014-05-08

The European Union contracted Morocco to regulate migration from so-called “transit migrants” from Morocco to Europe via the European Neighbourhood Policy. Yet, international organisations signal that human, asylum and refugee rights are not upheld in Morocco and that many sub-Saharan migrants suffer from ill-health and violence. Hence, our study aimed at 1) investigating the nature of violence that sub-Saharan migrants experience around and in Morocco, 2) assessing which determinants they perceive as decisive and 3) formulating prevention recommendations. Applying Community-Based Participatory Research, we trained twelve sub-Saharan migrants as Community Researchers to conduct in-depth interviews with peers, using Respondent Driven Sampling. We used Nvivo 8 to analyse the data. We interpreted results with Community Researchers and the Community Advisory Board and commonly formulated prevention recommendations. Among the 154 (60 F-94 M) sub-Saharan migrants interviewed, 90% reported cases of multiple victimizations, 45% of which was sexual, predominantly gang rape. Seventy-nine respondents were personally victimized, 41 were forced to witness how relatives or co-migrants were victimized and 18 others knew of peer victimisation. Severe long lasting ill-health consequences were reported while sub-Saharan victims are not granted access to the official health care system. Perpetrators were mostly Moroccan or Algerian officials and sub-Saharan gang leaders who function as unofficial yet rigorous migration professionals at migration ‘hubs’. They seem to proceed in impunity. Respondents link risk factors mainly to their undocumented and unprotected status and suggest that migrant communities set-up awareness raising campaigns on risks while legal and policy changes enforcing human rights, legal protection and human treatment of migrants along with severe punishment of perpetrators are politically lobbied for. Sub-Saharan migrants are at high risk of sexual

Assessing Transition Service for Handicapped Youth: A Cooperative Interagency Approach.

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Stodden, Robert A.; Boone, Rosalie

1987-01-01

The article presents a cooperative interagency approach for assessing effectiveness of programs and services to facilitate the transition of handicapped students from school to adult community living. Features of the model include cooperative planning at the policy level, implementation level, and direct service level; and collaboration by state…

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

Science.gov (United States)

Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Characterizing Urban Household Waste Generation and Metabolism Considering Community Stratification in a Rapid Urbanizing Area of China.

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Lishan Xiao

Full Text Available The relationship between social stratification and municipal solid waste generation remains uncertain under current rapid urbanization. Based on a multi-object spatial sampling technique, we selected 191 households in a rapidly urbanizing area of Xiamen, China. The selected communities were classified into three types: work-unit, transitional, and commercial communities in the context of housing policy reform in China. Field survey data were used to characterize household waste generation patterns considering community stratification. Our results revealed a disparity in waste generation profiles among different households. The three community types differed with respect to family income, living area, religious affiliation, and homeowner occupation. Income, family structure, and lifestyle caused significant differences in waste generation among work-unit, transitional, and commercial communities, respectively. Urban waste generation patterns are expected to evolve due to accelerating urbanization and associated community transition. A multi-scale integrated analysis of societal and ecosystem metabolism approach was applied to waste metabolism linking it to particular socioeconomic conditions that influence material flows and their evolution. Waste metabolism, both pace and density, was highest for family structure driven patterns, followed by lifestyle and income driven. The results will guide community-specific management policies in rapidly urbanizing areas.

Leading change: evidence-based transition.

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Lewis, Brennan; Allen, Stephanie

2015-01-01

The purpose of this article was to provide a framework for evidence-based transition of patient populations within an acute care pediatric institution. Transition within a hospital is foreseeable, given the ever-changing needs of the patients within an evolving healthcare system. These changes include moving patient populations because of expansion, renovation, or cohorting similar patient diagnoses to provide care across a continuum. Over the past 1 to 2 years, Children's Health Children's Medical Center Dallas has experienced a wide variety of transition. To provide a smooth transition for patients and families into new care areas resulting in a healthy work environment for all team members. The planning phase for patient population moves, and transition should address key aspects to include physical location and care flow, supplies and equipment, staffing model and human resources (HR), education and orientation, change process and integrating teams, and family preparation. It is imperative to consider these aspects in order for transitions within a healthcare system to be successful. During a time of such transitions, the clinical nurse specialist (CNS) is a highly valuable team member offering a unique perspective and methodological approach, which is central to the new initiative's overall success. The themes addressed in this article on evidence-based transition are organized according to the CNS spheres of influence: system/organization, patient/family, and nursing. An evidence-based transition plan was developed and implemented successfully with the support from the CNS for 3 patient populations. Organizational leadership gained an increased awareness of the CNS role at the conclusion of each successful transition. The CNS plays a pivotal role as clinical experts and proponents of evidence-based practice and effects change in the system/organization, nursing, and patient/family spheres of influence. While transitions can be a source of stress for leaders

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

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

2014-01-01

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

Continuity and Respect for Diversity: Strengthening Early Transitions in Peru. Working Papers in Early Childhood Development, No. 56. Studies in Early Childhood Transitions

Science.gov (United States)

Ames, Patricia; Rojas, Vanessa; Portugal, Tamia

2010-01-01

This working paper is part of a series on early transitions from "Young Lives," a 15-year longitudinal study of childhood poverty in Ethiopia, India, Peru and Vietnam. It explores the diverse experiences of 28 children from four contrasting communities in Peru as they start school. These detailed case studies highlight common problems:…

Cost Effective Community Based Dementia Screening: A Markov Model Simulation

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Erin Saito

2014-01-01

Full Text Available Background. Given the dementia epidemic and the increasing cost of healthcare, there is a need to assess the economic benefit of community based dementia screening programs. Materials and Methods. Markov model simulations were generated using data obtained from a community based dementia screening program over a one-year period. The models simulated yearly costs of caring for patients based on clinical transitions beginning in pre dementia and extending for 10 years. Results. A total of 93 individuals (74 female, 19 male were screened for dementia and 12 meeting clinical criteria for either mild cognitive impairment (n=7 or dementia (n=5 were identified. Assuming early therapeutic intervention beginning during the year of dementia detection, Markov model simulations demonstrated 9.8% reduction in cost of dementia care over a ten-year simulation period, primarily through increased duration in mild stages and reduced time in more costly moderate and severe stages. Discussion. Community based dementia screening can reduce healthcare costs associated with caring for demented individuals through earlier detection and treatment, resulting in proportionately reduced time in more costly advanced stages.

Identity related to living situation in six individuals with congenital quadriplegia.

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Robey, Kenneth L

2008-01-01

This study was a preliminary examination of structural aspects of identity, particularly identity associated with living situation, in individuals who have quadriplegia due to cerebral palsy. A hierarchical classes algorithm (HICLAS) was used to construct idiographic 'identity structure' models for three individuals who are living in an inpatient hospital setting and for three individuals living in community-based group residences. Indices derived from the models indicate that the identity 'myself as one who has a disability' was structurally superordinate (i.e., resided at a high hierarchical level) for all six participants, suggesting a high level of importance of this identity in participants' sense of self. The models also indicate that while identity associated with one's particular living situation was superordinate for persons living in the hospital, it was not for persons living in community residences. While conclusions based on this small sample are necessarily limited, the data suggest that identity associated with living situation might differ in structural centrality, and presumably subjective importance, for persons living in inpatient versus community-based settings.

The Transition Handbook: from oil dependency to local resilience; Manuel de transition. De la Dependance au Petrole a la Resilience Locale

Energy Technology Data Exchange (ETDEWEB)

Hopkins, Rob

2010-10-21

We live in an oil-dependent world, and have got to this level of dependency in a very short space of time, using vast reserves of oil in the process - without planning for when the supply is not so plentiful. Most of us avoid thinking about what happens when oil runs out (or becomes prohibitively expensive), but The Transition Handbook shows how the inevitable and profound changes ahead can have a positive outcome. These changes can lead to the rebirth of local communities, which will grow more of their own food, generate their own power, and build their own houses using local materials. They can also encourage the development of local currencies, to keep money in the local area. The book has three sections, the Head, the Heart and the Hands. The Head explores the issues of peak oil and climate change, and how when looked at together, we need to be focusing on the rebuilding of resilience as well as cutting carbon emissions. It argues that the focus of our lives will become increasingly local and small scale as we come to terms with the real implications of the energy crisis we are heading into. The Heart looks at where we find the personal tools for responding to what can feel like overwhelming challenges. It argues that key to our success will be our ability to generate positive visions of future, to harness the power of engaged optimism, and overcome powerlessness. The Hands offers a detailed exploration of the Transition model, setting out its principles, its origins, the 12 Steps of Transition, how they were applied in the first year of Transition Town Totnes, as well as offering a taste of how the model has been applied in a range of other settings. The book also contains lots of 'Tools for Transition', exercises and activities that can help to deepen this work in your community. There are now over 40 Transition Towns in the UK, with more joining as the idea takes off. With little pro-activity at government level, communities are taking matters into

Children's Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity.

Science.gov (United States)

Wilken, Lynne R; Novotny, Rachel; Fialkowski, Marie K; Boushey, Carol J; Nigg, Claudio; Paulino, Yvette; Leon Guerrero, Rachael; Bersamin, Andrea; Vargo, Don; Kim, Jang; Deenik, Jonathan

2013-10-09

Although surveillance data are limited in the US Affiliated Pacific, Alaska, and Hawaii, existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US. Strategies for addressing the childhood obesity epidemic in the region support the use of community-based, environmentally targeted interventions. The Children's Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific, Alaska, and Hawaii to design a community randomized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment. The Children's Healthy Living Program community randomized trial is an environmental intervention trial in four matched-pair communities in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and Hawaii and two matched-pair communities in Alaska. A cross-sectional sample of children (goal n = 180) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months (18 months post-intervention). In addition to the collection of the participant-based measures of anthropometry, diet, physical activity, sleep and acanthosis nigricans, community assessments are also being conducted in intervention trial communities. The Freely Associated States of Micronesia (Federated States of Micronesia, and Republics of Marshall Islands and Palau) is only conducting elements of the Children's Healthy Living Program sampling framework and similar measurements to provide prevalence data. In addition, anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey. The effectiveness of the environmental intervention trial is being assessed based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. The Children

Kameleon Live: An Interactive Cloud Based Analysis and Visualization Platform for Space Weather Researchers

Science.gov (United States)

Pembroke, A. D.; Colbert, J. A.

2015-12-01

The Community Coordinated Modeling Center (CCMC) provides hosting for many of the simulations used by the space weather community of scientists, educators, and forecasters. CCMC users may submit model runs through the Runs on Request system, which produces static visualizations of model output in the browser, while further analysis may be performed off-line via Kameleon, CCMC's cross-language access and interpolation library. Off-line analysis may be suitable for power-users, but storage and coding requirements present a barrier to entry for non-experts. Moreover, a lack of a consistent framework for analysis hinders reproducibility of scientific findings. To that end, we have developed Kameleon Live, a cloud based interactive analysis and visualization platform. Kameleon Live allows users to create scientific studies built around selected runs from the Runs on Request database, perform analysis on those runs, collaborate with other users, and disseminate their findings among the space weather community. In addition to showcasing these novel collaborative analysis features, we invite feedback from CCMC users as we seek to advance and improve on the new platform.

From the clinical to the managerial domain: the lived experience of role transition from radiographer to radiology manager in South-East Queensland.

Science.gov (United States)

Thompson, Alarna M N; Henwood, Suzanne M

2016-06-01

This study seeks to add to current literature a descriptive account of the lived experience of radiographers' transition to, and experiences of, management roles and identifies additional resources and support that are perceived as being beneficial for this transition. This study employed a descriptive phenomenological stance. Using purposive sampling, six South-East Queensland based private practice radiology managers, who had held their position for longer than 3 months, participated in audiotape recorded in-depth interviews exploring their transition to, and experiences of management in radiology. Thematic analysis was used to describe and make meaning of the data. Overall, five central themes emerged through thematic analysis of the data. The results indicate that all participants' had an underlying drive to succeed during their role transition and highlight the importance of a comprehensive orientation by a mentor; the training and support to enable preparation for the role, especially in the area of people management skills and communication; the importance of access to networking opportunities and the importance of concise expectations from higher management. Role transition can be marred with uncertainty, however; key suggestions indicate the importance of having support mechanisms in place before, during and after transitioning to a managerial role.

School-Based Caries Prevention, Tooth Decay, and the Community Environment.

Science.gov (United States)

Ruff, R R; Niederman, R

2018-04-01

The school and community context can contribute to inequity in child oral health. Whether the school and community affect the effectiveness of school-based caries prevention is unknown. The association between the school and community environment and dental caries, as well as their moderating effects with school-based caries prevention, was assessed using multilevel mixed-effects regression. Data were derived from a 6-y prospective cohort study of children participating in a school-based caries prevention program. For the school and community, living in a dental-shortage area and the proportion of children receiving free or reduced lunch were significantly related to an increased risk of dental caries at baseline. Caries prevention was associated with a significant per-visit decrease in the risk of untreated caries, but the rate of total caries experience increased over time. Caries prevention was more effective in children who had prior dental care at baseline and in schools with a higher proportion of low socioeconomic status students. There was significant variation across schools in the baseline prevalence of dental caries and the effect of prevention over time, although effects were modest. The school and community environment have a direct impact on oral health and moderate the association between school-based caries prevention and dental caries. Knowledge Transfer Statement: School-based caries prevention can be an effective means to reduce oral health inequity by embedding dental care within schools. However, the socioeconomic makeup of schools and characteristics of the surrounding community can affect the impact of school-based care.

Methodological challenges of cross-language qualitative research with South Asian communities living in the UK

Directory of Open Access Journals (Sweden)

Manbinder S. Sidhu

2016-05-01

Full Text Available Objective: We investigate (1 the influence of ethnic, gender, and age concordance with interviewers and (2 how expression of qualitative data varies between interviews delivered in English and community languages (Punjabi/Urdu with monolingual and bilingual participants across three generations of the Indian Sikh and Pakistani Muslim communities living in the UK. Methods: We analyzed and interpreted semi-structured interview transcripts that were designed to collect data about lifestyles, disease management, community practices/beliefs, and social networks. First, qualitative content analysis was applied to transcripts. Second, a framework was applied as a guide to identify cross-language illustrations where responses varied in length, expression and depth. Results: Participant responses differed by language and topic. First-generation migrants when discussing religion, culture, or family practice were far likelier to use group or community narratives and give a longer response, indicating familiarity with or importance of such issues. Ethnic and gender concordance generated greater rapport between researchers and participants centered on community values and practices. Further, open-ended questions that were less direct were better suited for first-generation migrants. Conclusion: Community-based researchers need more time to complete interviews in second languages, need to acknowledge that narratives can be contextualized in both personal and community views, and reframe questions that may lead to greater expression. Furthermore, we detail a number of recommendations with regard to validating the translation of interviews from community languages to English as well as measures for testing language proficiency.

Transition Achievement among Young Adults with Deafness: What Variables Relate to Success?

Science.gov (United States)

Bullis, Michael; And Others

1995-01-01

Examines the transition achievement of deaf persons 3 or 4 years out of high school (n=308). Ten independent variables were used to predict 2 dichotomous dependent variables: engagement with community (56%), and residential status (52% living independently). Results are presented for each dependent variable. (JPS)

7 key measures for France to enter energy transition

International Nuclear Information System (INIS)

Creach, Morgane; Vandaele, Diane; Richard, Marion; Fink, Meike; Quirion, Philippe; Bonduelle, Antoine; Berthier, Julien; Mossalgue, Marc; Louchard, Olivier; Lenoir, Didier; Vormus, Joel; Charru, Madeleine; Claustre, Raphael; Mathis, Paul; Gauthier, Raphaelle; Couturier, Christian; Mijeon, Charlotte; Gavand, Karine; Majnoni d'Intignano, Sophia; Delcroix, Julie

2012-01-01

The authors of this report propose, describe and discuss seven measures to be taken to promote and support energy transition in France: to introduce a climate-energy contribution, to adopt a law for a progressive and complete nuclear phasing out, to set local communities at the heart of energy transition, to introduce a mandatory thermal renewal of existing buildings, to develop a less greenhouse gas emitter agricultural model, to enter into a low-carbon and energy efficient transport infrastructure scheme, and to plan the struggle against urban sprawl at the scale of the living area

The relationship between rural community type and attachment to place for older people living in North Wales, UK.

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Burholt, Vanessa; Naylor, Dawn

2005-06-01

This paper explores the relationship between rural community type and attachment to place for 387 older people aged 70 and over. Six rural settlements in North Wales are characterised according to certain statistics (e.g. age structure, in-migration, strength of local culture, and multiple deprivation) to provide distinct community profiles. It is hypothesised that community type is characterised by particular types of attachment, which are dependent on life course trajectories and changes or stability in the environment. Using a sevenfold classification of attachment to place, the paper tests seven hypotheses. The results support four of the seven hypotheses. Older people living in a retirement destination are more likely to report aesthetic qualities and the appropriateness of the environment. People living in native areas with a strong culture and local language are more likely to note the importance of historical attachment and social integration into the community. Three hypotheses are rejected: older people living in a retirement destination are not less likely to report social support, or a historical perspective in attachment to place, and older people living in areas with high levels of multiple deprivation are not more likely to encounter relocation restraints than are others. Overall, the findings suggest that the taxonomy of attachment to place provides a flexible framework for differentiation by community. The paper concludes that communities are not merely settings-they play a significant role in self-identity and are a vital source of emotional and experiential meaning for the inhabitant.

Energetic Communities: Planning support for sustainable energy transition in small- and medium-sized communities

Directory of Open Access Journals (Sweden)

Christina Valeska Sager-Klauss

2016-04-01

Full Text Available The necessity for transition in the energy sector is beyond dispute and high on the political agendas. Climate change, the depletion of fossil fuels and the vulnerability of economies to resource speculation and unreliable political systems in the producing countries lay path for a broad implementation of smart alternative solutions. This means the integration of more sustainable renewable energy sources in the existing supply structures or the displacement of existing systems by new ones. Cities and communities are central players in the energy transition process. Energy demand is determined by the built environment. Renewable energy production needs space. The conflicts between different interest groups often break out in the context of local implementation measures that affect urban planning and the appearance of landscapes. Small- and medium-sized communities might prove to be game-changers in the overall energy transition because many problems have to be solved within their ambit. Urban planning is dealing with the numerous processes of urban change. Energy is a fairly new task to be addressed and many stakeholders lack experience and criteria for strategic decision making. After a period of fierce determination to turn the wheel against climate change, it seems that there is a growing resignation among politicians, planners and the public because some things have not turned out the way we’d expected and the hope for quick solutions fades. Rebound-effects seem to eat up the savings to a good extent, and alternative ideas of how sustainable energy systems may be put into place have not yet been persuasive in many cases. Energy systems have proved to be complex. They are still perceived to be important but in practice there is a growing uneasiness about the right steps to take. The overarching research question of this thesis is: What do decision makers in smalland medium-sized communities need to become more successful in implementing

Interventions at the Transition from Prison to the Community for Prisoners with Mental Illness: A Systematic Review.

Science.gov (United States)

Hopkin, G; Evans-Lacko, S; Forrester, A; Shaw, J; Thornicroft, G

2018-01-23

Prisoners have high rates of mental illness and the transition from prison to the community is a problematic time for the provision of mental health services and a range of negative outcomes have been identified in this period. A systematic review was conducted to identify interventions for prisoners with diagnosed mental health conditions that targeted this transition period. Fourteen papers from 13 research studies were included. The interventions identified in this review were targeted at different stages of release from prison and their content differed, ranging from Medicaid enrolment schemes to assertive community treatment. It was found that insurance coverage, and contact with mental health and other services can be improved by interventions in this period but the impact on reoffending and reincarceration is complex and interventions may lead to increased return to prison. There is a developing evidence base that suggests targeting this period can improve contact with community mental health and other health services but further high quality evidence with comparable outcomes is needed to provide more definitive conclusions. The impact of programmes on return to prison should be evaluated further to establish the effect of interventions on clinical outcomes and to clarify the role of interventions on reincarceration.

Communities of Practice Transition Online - Lessons learned from NASA's EPO Online Workspace

Science.gov (United States)

Davey, B.

2012-12-01

The Earth Forum Education and Public Outreach (EP/O) community has long interacted to better their practice as a community as well as individually. Working together to share knowledge and grow, they function as a community of practice. In 2009, NASA designed and implemented an online workspace in hopes of promoting the communities continued interactions. This study examines the role of an online workspace component of a community in the work of a community of practice. Much has been studied revealing the importance of communities of practice to organizations, project success, and knowledge management and some of these same successes hold true for virtual communities of practice. Study participants were 75 Education and Public Outreach community members of NASA's Science Mission Directorate Earth Forum. In this mixed methods study, online workspace metrics were used to track participation and a survey completed by 21 members was used to quantify participation. For a more detailed analysis, 15 community members (five highly active users, five average users, and five infrequent users) selected based on survey responses, were interviewed. Finally, survey data was gathered from seven online facilitators to understand their role in the community. Data collected from these 21 community members and five facilitating members suggest that highly active users (logging into the workspace daily), were more likely to have transformative experiences, co-create knowledge, feel ownership of community knowledge, have extended opportunities for community exchange, and find new forms of evaluation. Average users shared some similar characteristics with both the highly active members and infrequent users, representing a group in transition as they become more engaged and active in the online workspace. Inactive users viewed the workspace as having little value, being difficult to navigate, being mainly for gaining basic information about events and community news, and as another demand

From Tree Structure to Interactive Network:A Preliminary Study on Transit-Oriented Spatial Development Patterns of Village-Town Communities

Institute of Scientific and Technical Information of China (English)

Jinyan; WANG; Shuhua; HE; Fang; QIAN

2014-01-01

Based on the relatively developed highway and road network in China’s eastern coastal provinces, the public transit-oriented development model(TOD) for village-town communities aims to create a network connecting the urban and rural public transportation system and the public service system, by selectively constructing 'urban-type' communities with bus stops, thus promoting the mobility of urban and rural factors and to optimize the public service system, so as to change the traditional top-down development mode with tree structure. Through the planning practice in Linyi County, Dezhou City, it is found that a TOD-based spatial development mode in village-town communities can provide references for new countryside planning and construction in China in terms of upgrading the urban-rural functional structure, satisfying local demands, optimizing local government decisions, improving the planning mode, etc.

Children’s Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity

Science.gov (United States)

2013-01-01

Background Although surveillance data are limited in the US Affiliated Pacific, Alaska, and Hawaii, existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US. Strategies for addressing the childhood obesity epidemic in the region support the use of community-based, environmentally targeted interventions. The Children’s Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific, Alaska, and Hawaii to design a community randomized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment. Methods/Design The Children’s Healthy Living Program community randomized trial is an environmental intervention trial in four matched-pair communities in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and Hawaii and two matched-pair communities in Alaska. A cross-sectional sample of children (goal n = 180) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months (18 months post-intervention). In addition to the collection of the participant-based measures of anthropometry, diet, physical activity, sleep and acanthosis nigricans, community assessments are also being conducted in intervention trial communities. The Freely Associated States of Micronesia (Federated States of Micronesia, and Republics of Marshall Islands and Palau) is only conducting elements of the Children’s Healthy Living Program sampling framework and similar measurements to provide prevalence data. In addition, anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey. The effectiveness of the environmental intervention trial is being assessed based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance

Effectiveness of a community-based multifaceted fall-prevention intervention in active and independent older Chinese adults

OpenAIRE

Xia, Q H; Jiang, Y; Niu, C J; Tang, C X; Xia, Z L

2009-01-01

Objective: To evaluate the effectiveness of an 18-month multifaceted intervention designed to reduce the incidence of falls in community-living older adults in China. Methods: A population-based community trial evaluated by before-and-after cross-sectional surveys. Four residential communities were randomised to either a multifaceted intervention or a control condition. Baseline information was collected from a sample of older adults in each community. A 1-year annual fall rate was calculated...

Identification of Free-living and Particle-Associated Microbial Communities Present in Hadal regions of the Mariana Trench

Directory of Open Access Journals (Sweden)

Jonathan eTarn

2016-05-01

Full Text Available Relatively few studies have described the microbial populations present in ultra-deep hadal environments, largely as a result of difficulties associated with sampling. Here we report Illumina-tag V6 16S rRNA sequence-based analyses of the free-living and particle-associated microbial communities recovered from locations within two of the deepest hadal sites on Earth, the Challenger Deep (10,918 meters below surface-mbs and the Sirena Deep (10,667 mbs within the Mariana Trench, as well as one control site (Ulithi Atoll, 761 mbs. Seawater samples were collected using an autonomous lander positioned ~1m above the seafloor. The bacterial populations within the Mariana Trench bottom water samples were dissimilar to other deep-sea microbial communities, though with overlap with those of diffuse flow hydrothermal vents and deep-subsurface locations. Distinct particle-associated and free-living bacterial communities were found to exist. The hadal bacterial populations were also markedly different from one another, indicating the likelihood of different chemical conditions at the two sites. In contrast to the bacteria, the hadal archaeal communities were more similar to other less deep datasets and to each other due to an abundance of cosmopolitan deep-sea taxa. The hadal communities were enriched in thirty four bacterial and four archaeal operational taxonomic units (OTUs including members of the Gammaproteobacteria, Epsilonproteobacteria, Marinimicrobia, Cyanobacteria, Deltaproteobacteria, Gemmatimonadetes, Atribacteria, Spirochaetes, and Euryarchaeota. Sequences matching cultivated piezophiles were notably enriched in the Challenger Deep, especially within the particle-associated fraction, and were found in higher abundances than in other hadal studies, where they were either far less prevalent or missing. Our results indicate the importance of heterotrophy, sulfur-cycling, and methane and hydrogen utilization within the bottom waters of the deeper

Identification of Free-Living and Particle-Associated Microbial Communities Present in Hadal Regions of the Mariana Trench.

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Tarn, Jonathan; Peoples, Logan M; Hardy, Kevin; Cameron, James; Bartlett, Douglas H

2016-01-01

Relatively few studies have described the microbial populations present in ultra-deep hadal environments, largely as a result of difficulties associated with sampling. Here we report Illumina-tag V6 16S rRNA sequence-based analyses of the free-living and particle-associated microbial communities recovered from locations within two of the deepest hadal sites on Earth, the Challenger Deep (10,918 meters below surface-mbs) and the Sirena Deep (10,667 mbs) within the Mariana Trench, as well as one control site (Ulithi Atoll, 761 mbs). Seawater samples were collected using an autonomous lander positioned ~1 m above the seafloor. The bacterial populations within the Mariana Trench bottom water samples were dissimilar to other deep-sea microbial communities, though with overlap with those of diffuse flow hydrothermal vents and deep-subsurface locations. Distinct particle-associated and free-living bacterial communities were found to exist. The hadal bacterial populations were also markedly different from one another, indicating the likelihood of different chemical conditions at the two sites. In contrast to the bacteria, the hadal archaeal communities were more similar to other less deep datasets and to each other due to an abundance of cosmopolitan deep-sea taxa. The hadal communities were enriched in 34 bacterial and 4 archaeal operational taxonomic units (OTUs) including members of the Gammaproteobacteria, Epsilonproteobacteria, Marinimicrobia, Cyanobacteria, Deltaproteobacteria, Gemmatimonadetes, Atribacteria, Spirochaetes, and Euryarchaeota. Sequences matching cultivated piezophiles were notably enriched in the Challenger Deep, especially within the particle-associated fraction, and were found in higher abundances than in other hadal studies, where they were either far less prevalent or missing. Our results indicate the importance of heterotrophy, sulfur-cycling, and methane and hydrogen utilization within the bottom waters of the deeper regions of the Mariana Trench

Urban Transit System Microbial Communities Differ by Surface Type and Interaction with Humans and the Environment.

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Hsu, Tiffany; Joice, Regina; Vallarino, Jose; Abu-Ali, Galeb; Hartmann, Erica M; Shafquat, Afrah; DuLong, Casey; Baranowski, Catherine; Gevers, Dirk; Green, Jessica L; Morgan, Xochitl C; Spengler, John D; Huttenhower, Curtis

2016-01-01

Public transit systems are ideal for studying the urban microbiome and interindividual community transfer. In this study, we used 16S amplicon and shotgun metagenomic sequencing to profile microbial communities on multiple transit surfaces across train lines and stations in the Boston metropolitan transit system. The greatest determinant of microbial community structure was the transit surface type. In contrast, little variation was observed between geographically distinct train lines and stations serving different demographics. All surfaces were dominated by human skin and oral commensals such as Propionibacterium , Corynebacterium , Staphylococcus , and Streptococcus . The detected taxa not associated with humans included generalists from alphaproteobacteria, which were especially abundant on outdoor touchscreens. Shotgun metagenomics further identified viral and eukaryotic microbes, including Propionibacterium phage and Malassezia globosa . Functional profiling showed that Propionibacterium acnes pathways such as propionate production and porphyrin synthesis were enriched on train holding surfaces (holds), while electron transport chain components for aerobic respiration were enriched on touchscreens and seats. Lastly, the transit environment was not found to be a reservoir of antimicrobial resistance and virulence genes. Our results suggest that microbial communities on transit surfaces are maintained from a metapopulation of human skin commensals and environmental generalists, with enrichments corresponding to local interactions with the human body and environmental exposures. IMPORTANCE Mass transit environments, specifically, urban subways, are distinct microbial environments with high occupant densities, diversities, and turnovers, and they are thus especially relevant to public health. Despite this, only three culture-independent subway studies have been performed, all since 2013 and all with widely differing designs and conclusions. In this study, we

Intelligent community management system based on the devicenet fieldbus

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Wang, Yulan; Wang, Jianxiong; Liu, Jiwen

2013-03-01

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

Transitions to Home Mechanical Ventilation: The Experiences of Canadian Ventilator-Assisted Adults and Their Family Caregivers.

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Dale, Craig M; King, Judy; Nonoyama, Mika; Carbone, Sarah; McKim, Douglas; Road, Jeremy; Rose, Louise

2017-12-28

Several studies have explored the experience of ventilator-assisted individual (VAIs) living at home with family caregivers. However, few explore the experiences of these individuals as they transition from a hospital setting to living at home with a view to identifying modifiable processes that could optimize transition. This descriptive, qualitative study sought to elucidate barriers to, and facilitators of, transition to home mechanical ventilation (HMV) from the perspective of Canadian VAIs and their family caregivers. Participant recruitment occurred through hospital and community respiratory clinicians based in the four Canadian provinces of Alberta, British Columbia, Ontario, and Saskatchewan. Semi-structured telephone or face-to-face interviews at home were undertaken with 33 individuals including 19 VAIs and 14 family caregivers between 3 to 24 months of transitioning to HMV. Interview data was analyzed using content analysis. Formal teaching of knowledge and skills relevant to HMV within the hospital setting prior to transition was perceived as having an immediate and enduring positive impact on transition. However, family-clinician conflict, information gaps, and persistent lack of trained personal support workers (PSWs) to provide care in the home contributed to maladjustment relating to transition. Participants strongly recommended improved transitional care in the form of respiratory health professional telephone support, home outreach, in addition to training of PSWs. Transition to HMV is a complex and demanding process. Extended HMV training and support may be helpful in mediating adjustment challenges thus reducing stress, caregiver burden and improving health related quality of life for VAIs and family caregivers.

Institutions in transitioning peri-urban communities: spatial differences in groundwater access

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Gomes, Sharlene L.; Hermans, Leon M.

2016-05-01

Urbanization creates challenges for water management in an evolving socio-economic context. This is particularly relevant in transitioning peri-urban areas like Khulna, Bangladesh where competing demands have put pressure on local groundwater resources. Users are unable to sufficiently meet their needs through existing institutions. These institutions provide the rules for service provision and act as guidelines for actors to resolve their water related issues. However, the evolving peri-urban context can produce fragmented institutional arrangements. For example in Khulna, water supply is based on urban and rural boundaries that has created water access issues for peri-urban communities. This has motivated local actors to manage their groundwater needs in various ways. General institutional theories are well developed in literature, yet little is known about institutions in transitioning peri-urban areas. Institutions that fail to adapt to changing dynamics run the risk of becoming obsolete or counter-productive, hence the need for investigating institutional change mechanisms in this context. This paper examines peri-urban case studies from Khulna using the Institutional Analysis and Development framework to demonstrate how institutions have contributed to spatial differences in groundwater access with local actors investing in formal and informal institutional change as a means of accessing groundwater.

[Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

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Boidin, B

2015-02-01

This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

Military Lives: Coaching Transitions

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Beech, Nick; Gold, Jeff; Beech, Susan

2017-01-01

Purpose: The purpose of this paper is to first consider how veterans use talk to shape interpretations of personal and social identity. Second, this paper seeks to gain an understanding of how veterans see themselves in a civilian world, their ability to re-conceptualise and realign their perspective on life to support their transition in to a…

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

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Kapiarsa, A. B.; Sariffuddin, S.

2018-02-01

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

The Economic Domino Effect: A Phenomenological Study Exploring Community College Faculty's Lived Experiences during Financial Hard Times in Higher Education

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Taylor, Tridai A.

2014-01-01

This qualitative study explored the lived experiences of eight full-time community college faculty members who taught during the economic crisis of 2008. The study was guided by the central research question, "How do community college faculty members describe their lived experiences regarding the recent economic crisis of 2008 and its impact…

Neighborhood characteristics and mental health among African Americans and whites living in a racially integrated urban community.

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Gary, Tiffany L; Stark, Sarah A; LaVeist, Thomas A

2007-06-01

Aspects of the environment in which one lives are increasingly being recognized as major contributors to health, yet few empirical studies have focused on mental health. Therefore, we sought to determine if neighborhood characteristics were associated with mental health outcomes among 1408 African-American (59.3%) and white (40.7%) adults living in a socio-economically homogeneous, racially integrated, urban community in Baltimore, MD. Among African Americans and whites, the perception of severe problems in the community was associated with higher levels of stress (approximately 1.8 units higher), anxiety (approximately 1.8 units higher), and depression (OR= approximately 2.0) compared to those who perceived no or few problems (all pCommunity cohesion, the perception that people generally work together, was associated with better mental health among whites only. These findings give further insight into the complex environment of inner-city communities.

Housing First and Photovoice: Transforming Lives, Communities, and Systems

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Barile, John P.; Ogawa, Terry Yasuko; Peralta, Nelson; Bugg, Reumell; Lau, John; Lamberton, Thomas; Hall, Corazon; Mori, Victor

2018-01-01

This article presents findings from a community-based participatory evaluation of a Housing First program on the Island of O’ahu. In this study, clients in a Housing First program used Photovoice to evaluate the program and to advocate for progressive housing policies. Written together by members of the Housing First Photovoice group, this collaborative article describes the outcomes from both the Housing First program and the Photovoice project and demonstrates the ways in which participatory program evaluations can interact with client-driven programs like Housing First to produce a cumulative, transformative impact. Findings suggest that community psychologists hoping to re-engage with community mental health systems through enacting transformative change should consider taking a community-based participatory approach to program evaluation because increased client voice in community mental health programs and their evaluations can have far-reaching, transformative impacts for research, practice, and policy. PMID:29323410

Social learning as a key factor in sustainability transitions: The case of Okayama City

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Didham, Robert J.; Ofei-Manu, Paul; Nagareo, Masaaki

2017-12-01

The Okayama Education for Sustainable Development (ESD) Project is an ongoing initiative in Okayama City, Japan, established in 2005 by the Regional Centre of Expertise (RCE) Okayama and the Okayama Municipal Government with the aim "to create a community where people learn, think and act together towards realising a sustainable society". With a diverse participant base of over 240 organisations - including community learning centres ( kominkans), schools, universities and non-governmental organisations (NGOs) - this initiative has administered numerous programmes. It has engaged a large and diverse group of citizens from Okayama City in exploring sustainability issues through collective discussion, envisioning and practice with the aim of living more sustainable lives. The decade-long experience of the Okayama ESD Project has gained international attention, and the "Okayama Model" is considered an inspiring example of community-based ESD due to the positive changes it has supported. In this article, the Okayama ESD Project is presented as a case study on effective social learning for sustainability. In particular, the practical efforts made are examined to provide insights into how various elements of a social learning process were strengthened and linked to create active learning cycles among community members. In addition, the conditions for creating an effective learning community are investigated, while the practical actions taken are examined in relation to creating an effective social learning process. Finally, this article presents the important role which social learning has played in Okayama City's transition to sustainability and identifies the key efforts made to address and link each of these elements of social learning into a dynamic cycle.

Investigating the Factors of Resiliency among Exceptional Youth Living in Rural Underserved Communities

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Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.

2016-01-01

Resilience is an important social justice concept that has important implications for educators working with exceptional youth in rural underserved communities who may suffer from the consequences associated with economic hardships. This multi-school qualitative study examined resilience among exceptional youth living in rural poverty through the…

High rate gamma spectroscopy system for activation analysis of short-lived isomeric transitions

Energy Technology Data Exchange (ETDEWEB)

Westphall, G P [Atominstitut der Oesterreichischen Hochschulen, Vienna

1976-07-15

A high rate spectroscopy system specially suited for measurement of short-lived isomeric transitions is described, which, as part of a fast activation analysis facility at the TRIGA Mark II reactor, provides for automatic recording and immediate evaluation of gamma spectra taken from nuclides activated at stationary or pulsed reactor power. The system consists of a commercial de-coupled Ge(Li)-detector of 70 cm/sup 3/ modified for recycling operation for input rates in excess of 500000 c/s /sup 60/Co, a time variant trapezoidal shaping section and a fast constant dead-time ADC coupled to a programmed multichannel analyzer. Novel circuits for efficient pile-up rejection and time variant base line restoration extend the concept of gated integration up to count rates of more than 200000 c/s /sup 60/Co. Time-sequenced recording of spectra is performed by a minicomputer operated as a front-end processor of a larger laboratory computer, where final data processing takes place. New concepts for very simple and cost-effective implementation of multichannel analyzers by means of general purpose small computers are described.

From Leaders, For Leaders: Advice From the Lived Experience of Leaders in Community Health Sector Disaster Recovery After Hurricanes Irene and Sandy.

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Craddock, Hillary A; Walsh, Lauren; Strauss-Riggs, Kandra; Schor, Kenneth

2016-08-01

Hurricanes Sandy and Irene damaged and destroyed homes, businesses, and infrastructure, and recovery after these storms took years. The goal of this article was to learn from the lived experience of local-level decision-makers actively involved in the long-term disaster recovery process after Hurricanes Irene and Sandy. Respondents provided professional recommendations, based on their experience, to assist other organizations in preparing for, responding to, and recovering from disasters. Semi-structured interviews were conducted with professionals actively involved in recovery from Hurricane Irene or Hurricane Sandy in 5 different communities. Transcripts were qualitatively analyzed. Respondents' advice fell into 5 main categories: planning and evaluation, education and training, fundraising and donations management, building relationships, and disaster behavioral health. The lived experience of those in disaster recovery can provide guidance for planning, education, and training both within and outside their communities in order to better respond to and recover from future disasters. These data help to facilitate a community of practice by compiling and sharing the lived experience of leaders who experienced large-scale disasters, and the outcomes of this analysis help to show what areas of planning require special attention in the phases of preparedness, response, and recovery. (Disaster Med Public Health Preparedness. 2016;10:623-630).

A prehabilitation program for physically frail community-living older persons.

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Gill, Thomas M; Baker, Dorothy I; Gottschalk, Margaret; Gahbauer, Evelyne A; Charpentier, Peter A; de Regt, Paul T; Wallace, Sarah J

2003-03-01

To describe the development and implementation of a preventive, home-based physical therapy program (PREHAB) and to provide evidence for the safety and interrater reliability of the PREHAB protocol. Demonstration study. General community. Ninety-four physically frail, community-living persons, aged 75 years or older, who were randomized to the PREHAB program in a clinical trial. The PREHAB program built on the physical therapy component of 2 previous home-based protocols. A total of 223 assessment items were linked to 28 possible interventions, including progressive balance and conditioning exercises, by using detailed algorithms and decisions rules that were automated on notebook computers. The percentages of participants who were eligible for and who completed each intervention, the extent of progress noted in the balance and conditioning exercises, adherence to the training program, and adverse events. Participants who completed the PREHAB program and those who ended it prematurely received an average of 9.7 and 7.2 interventions during an average of 14.9 and 9.5 home visits, respectively. With few exceptions, the completion rate and interrater reliability for the specific interventions were high. Despite high self-reported adherence to the training program, the majority of participants did not advance beyond the initial Thera-Band level for the upper- and lower-extremity conditioning exercises, and only about a third advanced to the highest 2 levels of the balance exercises. Adverse events were no more common in the PREHAB group than in the educational control group. Our results support the feasibility and safety of the PREHAB program, but also show the special challenges and pitfalls of such a strategy when it is implemented among persons of advanced age and physical frailty. Copyright 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults.

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Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-10-05

Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens' clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens' clubs among males. Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

Directory of Open Access Journals (Sweden)

Kimiko Tomioka

2016-10-01

Full Text Available Background: Population-based data examining the relationship between social participation (SP and instrumental activities of daily living (IADL are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods: Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%. Data from 14 956 respondents (6935 males and 8021 females without dependency in basic activities of daily living (ADL were analyzed. The number, type, and frequency of participation in social groups (SGs were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results: After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001. A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions: Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011.

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Mezuk, Briana; Lohman, Matthew; Leslie, Marc; Powell, Virginia

2015-07-01

We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. LTC may be an important point of engagement in suicide prevention.

Ecological succession reveals potential signatures of marine-terrestrial transition in salt marsh fungal communities.

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Dini-Andreote, Francisco; Pylro, Victor Satler; Baldrian, Petr; van Elsas, Jan Dirk; Salles, Joana Falcão

2016-08-01

Marine-to-terrestrial transition represents one of the most fundamental shifts in microbial life. Understanding the distribution and drivers of soil microbial communities across coastal ecosystems is critical given the roles of microbes in soil biogeochemistry and their multifaceted influence on landscape succession. Here, we studied the fungal community dynamics in a well-established salt marsh chronosequence that spans over a century of ecosystem development. We focussed on providing high-resolution assessments of community composition, diversity and ecophysiological shifts that yielded patterns of ecological succession through soil formation. Notably, despite containing 10- to 100-fold lower fungal internal transcribed spacer abundances, early-successional sites revealed fungal richnesses comparable to those of more mature soils. These newly formed sites also exhibited significant temporal variations in β-diversity that may be attributed to the highly dynamic nature of the system imposed by the tidal regime. The fungal community compositions and ecophysiological assignments changed substantially along the successional gradient, revealing a clear signature of ecological replacement and gradually transforming the environment from a marine into a terrestrial system. Moreover, distance-based linear modelling revealed soil physical structure and organic matter to be the best predictors of the shifts in fungal β-diversity along the chronosequence. Taken together, our study lays the basis for a better understanding of the spatiotemporally determined fungal community dynamics in salt marshes and highlights their ecophysiological traits and adaptation in an evolving ecosystem.

“This is Our Last Stop”: Negotiating End of Life Transitions in Assisted Living

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Ball, Mary M.; Kemp, Candace L.; Hollingsworth, Carole; Perkins, Molly M.

2014-01-01

Where people die has important implications for end-of-life (EOL) care. Assisted living (AL) increasingly is becoming a site of EOL care and a place where people die. AL residents are moving in older and sicker and with more complex care needs, yet AL remains largely a non-medical care setting that subscribes to a social rather than medical model of care. The aims of this paper are to add to the limited knowledge of how EOL is perceived, experienced, and managed in AL and to learn how individual, facility, and community factors influence these perceptions and experiences. Using qualitative methods and a grounded theory approach to study eight diverse AL settings, we present a preliminary model for how EOL care transitions are negotiated in AL that depicts the range of multilevel intersecting factors that shape EOL processes and events in AL. Facilities developed what we refer to as an EOL presence, which varied across and within settings depending on multiple influences, including, notably, the dying trajectories and care arrangements of residents at EOL, the prevalence of death and dying in a facility, and the attitudes and responses of individuals and facilities towards EOL processes and events, including how deaths were communicated and formally acknowledged and the impact of death and dying on residents and staff. Our findings indicate that in the majority of cases, EOL care must be supported by collaborative arrangements of care partners and that hospice care is a critical component. PMID:24984903

Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective.

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Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba

2018-03-20

Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been

Being useful: achieving indigenous youth involvement in a community-based participatory research project in Alaska

Directory of Open Access Journals (Sweden)

Tara Ford

2012-05-01

Full Text Available Objectives. To report on a participatory research process in southwest Alaska focusing on youth involvement as a means to facilitate health promotion. We propose youth-guided community-based participatory research (CBPR as way to involve young people in health promotion and prevention strategizing as part of translational science practice at the community-level. Study design. We utilized a CBPR approach that allowed youth to contribute at all stages. Methods. Implementation of the CBPR approach involved the advancement of three key strategies including: (a the local steering committee made up of youth, tribal leaders, and elders, (b youth-researcher partnerships, and (c youth action-groups to translate findings. Results. The addition of a local youth-action and translation group to the CBPR process in the southwest Alaska site represents an innovative strategy for disseminating findings to youth from a research project that focuses on youth resilience and wellbeing. This strategy drew from two community-based action activities: (a being useful by helping elders and (b being proud of our village. Conclusions. In our study, youth informed the research process at every stage, but most significantly youth guided the translation and application of the research findings at the community level. Findings from the research project were translated by youth into serviceable action in the community where they live. The research created an experience for youth to spend time engaged in activities that, from their perspectives, are important and contribute to their wellbeing and healthy living. Youth-guided CBPR meant involving youth in the process of not only understanding the research process but living through it as well.

Establishing the NeuroRecovery Network Community Fitness and Wellness facilities: multi-site fitness facilities provide activity-based interventions and assessments for evidence-based functional gains in neurologic disorders.

Science.gov (United States)

Tolle, Heather; Rapacz, Andrew; Weintraub, Barry; Shogren, Carrie; Harkema, Susan J; Gibson, Jeremy L

2017-08-17

Physical fitness is a necessity for those living with a spinal cord injury, yet access to fitness facilities, equipment, and specially trained fitness experts are limited. This article introduces the concept of a network of fitness facilities specially geared towards individuals with spinal cord injury and other neurological disorders. The Community Fitness and Wellness branch of the NeuroRecovery Network was created to provide a continuum of care after traditional rehabilitation for individuals living with a spinal cord injury and other neurological disorders. Community Fitness and Wellness facilities translate activity-based interventions performed during rehabilitation into a community setting as well as provide other fitness and wellness opportunities. Community Fitness and Wellness facilities are staffed by professionals with training on the specialized needs of individuals living with spinal cord injury or other neurological disorders. Standardized assessments evaluate functional, health, and quality of life gains at regular intervals. A national database gathers information on standardized interventions and assessment outcomes providing a mechanism for evaluation of interventions performed in the community setting. The establishment of Community Fitness and Wellness facilities allows for the quick translation and evaluation of novel, effective approaches from research to individuals in the community. Implications for Rehabilitation Fitness needs of individuals with spinal cord injury living in the community necessitate the use of special equipment and trained staff. Community Fitness and Wellness Programs offer specially trained staff and adaptive equipment providing a continuity of care for those with spinal cord injuries and other neurological disorders.

Living labs design and assessment of sustainable living

CERN Document Server

Guerra-Santin, Olivia; Lockton, Dan

2017-01-01

This book presents the results of a multi-annual project with sustainable Living Labs in the United Kingdom, Sweden, Germany and the Netherlands. Living Labs – as initiated by the authors – have proved to be very promising research, design, co-creation and communication facilities for the development and implementation of sustainable innovations in the home. The book provides an inspiring introduction to both the methodology and business modelling for the Living Lab facilities. Understanding daily living at home is key to designing products and services that support households in their transition to more sustainable lifestyles. This book not only explores new ways of gaining insights into daily practices, but also discusses developing and testing design methods to create sustainable solutions for households. These new methods and tools are needed because those available are either ineffective or cause rebound-effects. Intended for researchers and designers with an interest in the transition to sustainable...

Collaboration Strategies in Nontraditional Community-Based Participatory Research Partnerships: Lessons From an Academic–Community Partnership With Autistic Self-Advocates

Science.gov (United States)

Nicolaidis, Christina; Raymaker, Dora; McDonald, Katherine; Dern, Sebastian; Ashkenazy, Elesia; Boisclair, Cody; Robertson, Scott; Baggs, Amanda

2012-01-01

Background Most community-based participatory research (CBPR) projects involve local communities defined by race, ethnicity, geography, or occupation. Autistic self-advocates, a geographically dispersed community defined by disability, experience issues in research similar to those expressed by more traditional minorities. Objectives We sought to build an academic–community partnership that uses CBPR to improve the lives of people on the autistic spectrum. Methods The Academic Autistic Spectrum Partnership in Research and Education (AASPIRE) includes representatives from academic, self-advocate, family, and professional communities. We are currently conducting several studies about the health care experiences and well-being of autistic adults. Lessons Learned We have learned a number of strategies that integrate technology and process to successfully equalize power and accommodate diverse communication and collaboration needs. Conclusions CBPR can be conducted successfully with autistic self-advocates. Our strategies may be useful to other CBPR partnerships, especially ones that cannot meet in person or that include people with diverse communication needs. PMID:21623016

Microbial community changes in methanogenic granules during the transition from mesophilic to thermophilic conditions

DEFF Research Database (Denmark)

Zhu, Xinyu; Kougias, Panagiotis; Treu, Laura

2017-01-01

Upflow anaerobic sludge blanket (UASB) reactor is one of the most applied technologies for various high-strength wastewater treatments. The present study analysed the microbial community changes in UASB granules during the transition from mesophilic to thermophilic conditions. Dynamicity...

An instrument for the assessment of diarrhoeal severity based on a longitudinal community-based study

Science.gov (United States)

Lee, Gwenyth; Peñataro Yori, Pablo; Paredes Olortegui, Maribel; Caulfield, Laura E; Sack, David A; Fischer-Walker, Christa; Black, Robert E; Kosek, Margaret

2014-01-01

Objective Diarrhoea is a significant contributer to morbidity and is among the leading causes of death of children living in poverty. As such, the incidence, duration and severity of diarrhoeal episodes in the household are often key variables of interest in a variety of community-based studies. However, there currently exists no means of defining diarrhoeal severity that are (A) specifically designed and adapted for community-based studies, (B) associated with poorer child outcomes and (C) agreed on by the majority of researchers. Clinical severity scores do exist and are used in healthcare settings, but these tend to focus on relatively moderate-to-severe dehydrating and dysenteric disease, require trained observation of the child and, given the variability of access and utilisation of healthcare, fail to sufficiently describe the spectrum of disease in the community setting. Design Longitudinal cohort study. Setting Santa Clara de Nanay, a rural community in the Northern Peruvian Amazon. Participants 442 infants and children 0–72 months of age. Main outcome measures Change in weight over 1-month intervals and change in length/height over 9-month intervals. Results Diarrhoeal episodes with symptoms of fever, anorexia, vomiting, greater number of liquid stools per day and greater number of total stools per day were associated with poorer weight gain compared with episodes without these symptoms. An instrument to measure the severity was constructed based on the duration of these symptoms over the course of a diarrhoeal episode. Conclusions In order to address limitations of existing diarrhoeal severity scores in the context of community-based studies, we propose an instrument comprised of diarrhoea-associated symptoms easily measured by community health workers and based on the association of these symptoms with poorer child growth. This instrument can be used to test the impact of interventions on the burden of diarrhoeal disease. PMID:24907244

Decoding size distribution patterns in marine and transitional water phytoplankton: from community to species level.

Directory of Open Access Journals (Sweden)

Leonilde Roselli

Full Text Available Understanding the mechanisms of phytoplankton community assembly is a fundamental issue of aquatic ecology. Here, we use field data from transitional (e.g. coastal lagoons and coastal water environments to decode patterns of phytoplankton size distribution into organization and adaptive mechanisms. Transitional waters are characterized by higher resource availability and shallower well-mixed water column than coastal marine environments. Differences in physico-chemical regime between the two environments have been hypothesized to exert contrasting selective pressures on phytoplankton cell morphology (size and shape. We tested the hypothesis focusing on resource availability (nutrients and light and mixed layer depth as ecological axes that define ecological niches of phytoplankton. We report fundamental differences in size distributions of marine and freshwater diatoms, with transitional water phytoplankton significantly smaller and with higher surface to volume ratio than marine species. Here, we hypothesize that mixing condition affecting size-dependent sinking may drive phytoplankton size and shape distributions. The interplay between shallow mixed layer depth and frequent and complete mixing of transitional waters may likely increase the competitive advantage of small phytoplankton limiting large cell fitness. The nutrient regime appears to explain the size distribution within both marine and transitional water environments, while it seem does not explain the pattern observed across the two environments. In addition, difference in light availability across the two environments appear do not explain the occurrence of asymmetric size distribution at each hierarchical level. We hypothesize that such competitive equilibria and adaptive strategies in resource exploitation may drive by organism's behavior which exploring patch resources in transitional and marine phytoplankton communities.

Developing a theory of change for a community-based response to illegal wildlife trade.

Science.gov (United States)

Biggs, Duan; Cooney, Rosie; Roe, Dilys; Dublin, Holly T; Allan, James R; Challender, Dan W S; Skinner, Diane

2017-02-01

The escalating illegal wildlife trade (IWT) is one of the most high-profile conservation challenges today. The crisis has attracted over US$350 million in donor and government funding in recent years, primarily directed at increased enforcement. There is growing recognition among practitioners and policy makers of the need to engage rural communities that neighbor or live with wildlife as key partners in tackling IWT. However, a framework to guide such community engagement is lacking. We developed a theory of change (ToC) to guide policy makers, donors, and practitioners in partnering with communities to combat IWT. We identified 4 pathways for community-level actions: strengthen disincentives for illegal behavior, increase incentives for wildlife stewardship, decrease costs of living with wildlife, and support livelihoods that are not related to wildlife. To succeed the pathways, all require strengthening of enabling conditions, including capacity building, and of governance. Our ToC serves to guide actions to tackle IWT and to inform the evaluation of policies. Moreover, it can be used to foster dialogue among IWT stakeholders, from local communities to governments and international donors, to develop a more effective, holistic, and sustainable community-based response to the IWT crisis. © 2016 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Use of Home- and Community-Based Services in Taiwan's National 10-Year Long-Term Care Plan.

Science.gov (United States)

Yu, Hsiao-Wei; Tu, Yu-Kang; Kuo, Po-Hsiu; Chen, Ya-Mei

2018-05-01

We aimed to understand the relationships between care recipients' profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

Ecological succession reveals potential signatures of marine-terrestrial transition in salt marsh fungal communities

NARCIS (Netherlands)

Dini-Andreote, Francisco; Pylro, Victor Satler; Baldrian, Petr; van Elsas, Jan Dirk; Salles, Joana Falcão

Marine-to-terrestrial transition represents one of the most fundamental shifts in microbial life. Understanding the distribution and drivers of soil microbial communities across coastal ecosystems is critical given the roles of microbes in soil biogeochemistry and their multifaceted influence on

Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

Science.gov (United States)

Peters, Ray DeV; Petrunka, Kelly; Khan, Shahriar; Howell-Moneta, Angela; Nelson, Geoffrey; Pancer, S Mark; Loomis, Colleen

2016-02-01

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003–2011

Science.gov (United States)

Lohman, Matthew; Leslie, Marc; Powell, Virginia

2015-01-01

Objectives. We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Methods. Data come from the Virginia Violent Death Reporting System (2003–2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Results. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. Conclusions. LTC may be an important point of engagement in suicide prevention. PMID:25973805

Community-based participatory research (CBPR) in South Africa: engaging multiple constituents to shape the research question.

Science.gov (United States)

Mosavel, Maghboeba; Simon, Christian; van Stade, Debbie; Buchbinder, Mara

2005-12-01

Community engagement is an on-going, arduous, and necessary process for developing effective health promotion programs. The challenges are amplified when the particular health issue or research question is not prominent in the consciousness of the targeted community. In this paper, we explore the community-based participatory research (CBPR) model as a means to negotiate a mutual agenda between communities and researchers. The paper is focused on the (perceived) need for cervical cancer screening in an under-resourced community in Cape Town, South Africa. Cervical cancer is a significant health problem in this community and elsewhere in South Africa. Unlike HIV-AIDS, however, many Black South Africans have not been educated about cervical cancer and the importance of obtaining screening. Many may not consider screening a priority in their lives. Our research included extensive consultations and informal interviews with diverse community and regional stakeholders. Following these, we conducted 27 focus groups and 106 demographic surveys with randomly selected youth, parents, local health care personnel, educators and school staff. Focus group data were summarized and analyzed cross-sectionally. Community stakeholders were involved throughout this research. Our consultations, interviews, and focus group data were key in identifying the concerns and priorities of the community. By engaging community stakeholders, we developed a research framework that incorporated the community's concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members' health and wellbeing. Community members helped to refocus our research from cervical cancer to 'cervical health,' a concept that acknowledged the impact on women's bodies and lives of HIV-AIDS and STDs, sexual violence, poverty, and multiple social problems. We conclude that the research agenda and questions in community-based health research should not be

Living Conditions and Psychological Distress in Latino Migrant Day Laborers: The Role of Cultural and Community Protective Factors.

Science.gov (United States)

Organista, Kurt C; Ngo, Samantha; Neilands, Torsten B; Kral, Alex H

2017-03-01

The purpose of this study was to examine the relationship between typically difficult living conditions and psychological distress in Latino migrant day laborers (LMDLs), with attention to the potentially protective roles of contact with family in country of origin (i.e., communication, sending money, etc.), availability of local culture (i.e., food, music, people from one's country of origin), and utilization of community resources perceived to be culturally competent (i.e., services that are respectful, able to serve Latinos, able to solve problems, in Spanish, etc.). Participants were 344 LMDLs surveyed in the San Francisco Bay Area. As hypothesized: (a) difficult living conditions were related to depression, anxiety, and desesperación [desperation], the latter a popular Latino idiom of psychological distress recently validated on LMDLs; (b) contact with family moderated the relation between difficult living conditions and depression and desesperación but not anxiety and (c) access to local culture, and utilization of community resources, mediated the relation between difficult living conditions and depression and desesperación but not anxiety. Implications for intervening at local and larger levels in order to provide some protection against distress built into the LMDL experience in the United States are discussed. © Society for Community Research and Action 2016.

A community of citizens: disability rehabilitation in the Palestinian transition to statehood.

Science.gov (United States)

Giacaman, R

2001-09-20

It has been widely argued that community based programmes offer considerable advantages to the classical institutional forms of health and rehabilitation services delivery. With about 10 years of experience in operating community based rehabilitation projects (CBR) for the disabled, the Palestinian experience points to potentially serious problems relating to the conception and operationalization of such programmes in real life situations. Of importance is the issue of the impact of communal care on the already burdened lives of women, especially when such care is expected to be voluntary in nature. Caretaking in the Palestinian context, especially of the disabled, elderly and the sick, is a pre-defined sex linked role dictated by a patriarchal society and system of policy making that excludes women from economic and social life. The voluntary care aspect entailed in the CBR conception and practice, can and does contribute further to the exclusion of women not only from the labour force, but from most other aspects of life as well. This represents an apparent contradiction between the needs of two excluded groups, the disabled and women. The other problematic entailed in the communal model of caring for the disabled is the strategic and operational bias focusing on community, to the exclusion of the notion of social rights of all citizens, and the role and duty of state structures in the fulfilment of the disabled basic needs. Such an approach can only relegate the disabled rights back to their original place as charity. On the other hand, when CBR projects are operated holistically, in the context of social movements existing within power relation and with a broader democratic agenda engaging different groups-including a disability movement-as is currently taking place in Palestine, CBR projects can also turn into a mobilizing force for the social rights of all excluded groups. Thus the question is not merely one of governmental involvement as opposed to the

At the Intersection of HIV/AIDS and Cancer: A Qualitative Needs Assessment of Community-Based HIV/AIDS Service Organizations

Science.gov (United States)

Burkhalter, Jack E.; Cahill, Sean; Shuk, Elyse; Guidry, John; Corner, Geoffrey; Berk, Alexandra; Candelario, Norman; Kornegay, Mark; Lubetkin, Erica I.

2013-01-01

Due to advances in treatment, persons living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) are living longer, but with aging, immune deficits, and lifestyle factors, they are at increased risk for cancer. This challenges community-based AIDS service organizations (ASOs) to address the growing cancer needs of…

A model for partnering first-year student pharmacists with community-based older adults.

Science.gov (United States)

Martin, Beth A; Porter, Andrea L; Shawl, Lauren; Motl Moroney, Susannah E

2012-06-18

To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists' views on aging and medication use through their work with a healthy, community-based older-adult population. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. The model for partnering first-year student pharmacists with community-based older adults improved students' skills and fostered their connections to pharmacist roles and growth as person-centered providers.

How community-level social and economic developments have changed the patterns of substance use in a transition economy?

Science.gov (United States)

Yang, Xiaozhao Y

2017-07-01

Most social changes take place at the community level before indirectly affecting individuals. Although the contextual effect is far-reaching, few studies have investigated the important questions of: how do community-level developments affect drinking and smoking, and how do they change the existing gender and income patterns of drinking and smoking, particularly in transition economies? In this study, I used a Chinese panel dataset between 1991 and 2011 to reveal the moderating effects of community developments. Through multilevel growth curve modeling that controls for age, period, and cohort effects, as well as individual- and community-level covariates, I found that community-level economic development and social development are negatively associated with drinking and smoking. Moreover, economic and social developments also moderate the important influences of income and gender: women start to drink more in communities with higher economic development; the traditionally positive association between income and smoking/drinking is also reversed, i.e. the rich start to smoke and drink less in communities with higher social development. This study concludes that the rapid changes in communal social and economic structures have created new health disparities based on the gender and socioeconomic hierarchy. Copyright © 2017 Elsevier Ltd. All rights reserved.

Meeting stroke survivors' perceived needs: a qualitative study of a community-based exercise and education scheme.

Science.gov (United States)

Reed, Mary; Harrington, Rachel; Duggan, Aine; Wood, Victorine A

2010-01-01

A qualitative study using a phenomenological approach, to explore stroke survivors' needs and their perceptions of whether a community stroke scheme met these needs. Semi-structured in-depth interviews of 12 stroke survivors, purposively selected from participants attending a new community stroke scheme. Interpretative phenomenological analysis of interviews by two researchers independently. Participants attending the community stroke scheme sought to reconstruct their lives in the aftermath of their stroke. To enable this they needed internal resources of confidence and sense of purpose to 'create their social self', and external resources of 'responsive services' and an 'informal support network', to provide direction and encouragement. Participants felt the community stroke scheme met some of these needs through exercise, goal setting and peer group interaction, which included social support and knowledge acquisition. Stroke survivors need a variety of internal and external resources so that they can rebuild their lives positively post stroke. A stroke-specific community scheme, based on exercise, life-centred goal setting, peer support and knowledge acquisition, is an external resource that can help with meeting some of the stroke survivor's needs.

34 CFR 300.43 - Transition services.

Science.gov (United States)

2010-07-01

..., including postsecondary education, vocational education, integrated employment (including supported...; (2) Is based on the individual child's needs, taking into account the child's strengths, preferences..., acquisition of daily living skills and provision of a functional vocational evaluation. (b) Transition...

Through the lens of our cameras: children's lived experience with food security in a Canadian Indigenous community.

Science.gov (United States)

Genuis, S K; Willows, N; Jardine, C

2015-07-01

The related issues of food security and obesity among North American Indigenous children are serious public health concerns. This community-based participatory study sought to gain deeper understanding of young First Nation children's lived experience with food and to learn, from their perspective, about food security issues in their community. In this Photovoice investigation 26 young children attending a rural reserve school in Canada were asked to take photographs of the food they ate. Nine high school students from the same school were trained as co-researchers: they interviewed the younger students, helped identify emerging themes and contributed to knowledge translation. Data analysis incorporated conventional content analysis, grounded theory's constant-comparative method, and examination of photos and texts. Five primary findings emerged from photographs and interviews: (1) children had a dualistic understanding of healthy vs. unhealthy foods; (2) packaged, quick-preparation foods played a dominant role in children's everyday food experiences; (3) families were critical to children's food-related experiences; (4) although traditional foods are viewed as central to Aboriginal health, few were depicted in the photographs; and (5) photos do not tell the whole story - despite the smaller numbers of fruits and vegetables in photos, children like to eat these foods when they are available at home. The study improved understanding of children's everyday food-related experiences, provided insight into community food security, and demonstrated the contribution of children and youth as experts on their lives and matters affecting them. A photobook representing findings provided a rich, visual tool for communicating the food-related experiences of children and messages about healthy eating within the school and to community members and leaders. Intervention efforts can build on participants' understanding of healthy versus unhealthy foods and on the critical role of

To finance the transition

International Nuclear Information System (INIS)

Regnier, Yannick; Maciel, Guillaume; Zeroual, Bouchra; Leca, Christel; Guillou, Maelle; Mossalgue, Marc; Raguet, Alex; Sabot, Guillaume; Coton, Patrice; Olesen, Gunnar Boye; Friggens, Sam; Pouyet, Regis; Blanc, Nicolas; Laurent, Pierre; Ruedinger, Andreas

2013-01-01

A set of brief articles illustrates the emergence of innovating and operational financing tools aimed at supporting energy transition in France and in Europe. As far as France is concerned, different examples are evoked: raising local savings, crowd-funding for renewable energies, citizen investment, cooperation between industries, communities and citizens, a semi-public company with citizen participation, the case of the Nancy urban community, a joint experience by a local public company and an investment fund. As far as Europe is concerned, the following topics or examples are evoked: local policies as lever for European financing, the Danish example of citizen-based financing, crowd-funding in the UK, the European emergence of cooperatives. As far as banks and institutions are concerned, the following topics are addressed: tools implemented by the Caisse des Depots for energy transition, the roles of banks and of public institutions in the financing of energy transition

Reconsidering Community-based Retailing

OpenAIRE

Maughan, Rebecca; O'Driscoll, Aidan

2012-01-01

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

Comparison of Happiness and Spiritual Well-Being among the Community Dwelling Elderly and those who Lived in Sanitariums.

Science.gov (United States)

Adib-Hajbaghery, Mohsen; Faraji, Mona

2015-07-01

Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison's spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, Pspiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard.

The Changing Nature of Guilt in Family Caregivers: Living Through Care Transitions of Parents at the End of Life.

Science.gov (United States)

Martz, Kim; Morse, Janice M

2017-06-01

Older adults cared for at home by family members at the end of life are at risk for care transitions to residential and institutional care settings. These transitions are emotionally distressing and fraught with suffering for both families and the older adult. A theoretical model titled "The Changing Nature of Guilt in Family Caregivers: Living Through Care Transitions of Parents at the End of Life" was developed using the method of grounded theory. When a dying parent cannot remain at home to die, family members experience guilt throughout the transition process. Findings indicated that guilt surrounding transfers escalated during the initial stages of the transfer but was mitigated by achieving what family members deemed as a "good" death when relatives were receiving hospice care. The findings of this interpretative approach provide new insights into family-focused perspectives in care transfers of the dying.

Administration for Community Living

Science.gov (United States)

... 15, 2017 Grants from the National Institute on Disability, Independent Living, and Rehabilitation Research ... integration, and inclusion throughout life Other ACL Sites Eldercare Locator OlderIndians. ...

UNO contribution to attract energy investments in transition economy countries in cooperation with international organizations, banks, and the business community

International Nuclear Information System (INIS)

Groza, L.

1996-01-01

Limited financial resources hamper the ability of transition economy countries to take advantage of recent technological progress in energy production, distribution, and consumption. Increased cooperation within and outside the UN system imposed new approaches and action programs to identify financing channels in view of implementing the economic development projects. Since the CNE'94 round table discussions on the role of the UN Economic Commission for Europe in energy cooperation for sustainable development and assistance for transition economy countries, new actions initiated by UN are supported by international organizations, banks, and the business community. The paper is based on recent UN documents, data, and information after six years of reforms. (author). 14 refs

Transit-Based Emergency Evacuation with Transit Signal Priority in Sudden-Onset Disaster

Directory of Open Access Journals (Sweden)

Ciyun Lin

2016-01-01

Full Text Available This study presents methods of transit signal priority without transit-only lanes for a transit-based emergency evacuation in a sudden-onset disaster. Arterial priority signal coordination is optimized when a traffic signal control system provides priority signals for transit vehicles along an evacuation route. Transit signal priority is determined by “transit vehicle arrival time estimation,” “queuing vehicle dissipation time estimation,” “traffic signal status estimation,” “transit signal optimization,” and “arterial traffic signal coordination for transit vehicle in evacuation route.” It takes advantage of the large capacities of transit vehicles, reduces the evacuation time, and evacuates as many evacuees as possible. The proposed methods were tested on a simulation platform with Paramics V6.0. To evaluate and compare the performance of transit signal priority, three scenarios were simulated in the simulator. The results indicate that the methods of this study can reduce the travel times of transit vehicles along an evacuation route by 13% and 10%, improve the standard deviation of travel time by 16% and 46%, and decrease the average person delay at a signalized intersection by 22% and 17% when the traffic flow saturation along an evacuation route is 0.81.0, respectively.

The Bands Culture in Victoria, Australia: Live Music Benefits Career Paths, Employment and Community

Science.gov (United States)

Watson, Amanda; Forrest, David

2012-01-01

This study explores the career paths, employment, business opportunities and community contributions made available through the provision and development of the contemporary performance bands' culture in the State of Victoria. It is framed with the support given to live music performers by Arts Victoria, Small Business Victoria and Music Victoria.…

Unresolved transition array based water window soft x-ray source by laser-produced high-Z plasma

International Nuclear Information System (INIS)

Higashiguchi, Takeshi; Dunne, Padraig; O'Sullivan, Gerry

2013-01-01

We demonstrate a table-top broadband emission water window source based on laser-produced high-Z plasmas. resonance emission from multiply charged ions merges to produce intense unresolved transition arrays (UTAs) in the 2 to 4 nm region, extending below the carbon K edge (4.37 nm). Arrays resulting from n=4-n=4 transitions are overlaid with n=4-n=5 emission and shift to shorter wavelength with increasing atomic number. An outline of a microscope design for single-shot live cell imaging is proposed based on a bismuth plasma UTA source, coupled to multilayer mirror optics. At power densities available from 'table-top' solid-state lasers, comparison of emission from a number of targets has shown that 3d-4f UTA in zirconium plasmas have highest overall brightness and in an imaging system based on reflective multilayer mirrors, may, depending on bandwidth, have superior performance than either line or broader-band sources. (author)

Solving fatigue-related problems with cardiac arrest survivors living in the community.

Science.gov (United States)

Kim, Young Joo; Rogers, Joan C; Raina, Ketki D; Callaway, Clifton W; Rittenberger, Jon C; Leibold, Mary Lou; Holm, Margo B

2017-09-01

The aim was to describe fatigue-related problems reported by post-cardiac arrest adults with chronic fatigue and energy conservation strategies generated using an Energy Conservation plus Problem Solving Therapy intervention. Following an introduction to the intervention process outlined in a Participant Workbook, participants engaged in the telephone intervention by identifying one to two fatigue-related problems. They then brainstormed with the interventionist to identify potential strategies to reduce fatigue, tested them, and either modified the strategies or moved to the next problem over three to five sessions. Eighteen cardiac arrest survivors with chronic fatigue identified instrumental activities of daily living and leisure activities as fatigue-related activities more frequently than basic activities of daily living. Energy Conservation strategies used most frequently were: plan ahead, pace yourself, delegate to others, and simplify the task. Post-cardiac arrest adults living in the community with chronic fatigue can return to previous daily activities by using energy conservation strategies such as planning ahead, pacing tasks, delegating tasks, and simplifying tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

Community-Based Care

Science.gov (United States)

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

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

Directory of Open Access Journals (Sweden)

Dyah Kusuma Wardhani

2017-07-01

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

Risk Management and Simulation Based Live Fire Test and Evaluation in the Performance Based Defense Business Environment

National Research Council Canada - National Science Library

Brown, R

1999-01-01

.... The service and acquisition program independent Live Fire Test and Evaluation Community has not fully recognized the changing defense acquisition business environment and modified policy and business...

Network-Based Community Brings forth Sustainable Society

Science.gov (United States)

Kikuchi, Toshiko

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

Beyond section Q: prioritizing nursing home residents for transition to the community

Directory of Open Access Journals (Sweden)

Fries Brant E

2012-07-01

Full Text Available Abstract Background Nursing Facility Transition (NFT programs often rely on self-reported preference for discharge to the community, as indicated in the Minimum Data Set (MDS Section Q, to identify program participants. We examined other characteristics of long-stay residents discharged from nursing facilities by NFT programs, to “flag” similar individuals for outreach in the Money Follows the Person (MFP initiative. Methods Three states identified persons who transitioned between 2001 and 2009 with the assistance of a NFT or MFP program. These were used to locate each participant’s MDS 2.0 assessment just prior to discharge and to create a control sample of non-transitioned residents. Logistic regression and Automatic Interactions Detection were used to compare the two groups. Results Although there was considerable variation across states in transitionees’ characteristics, a derived “Q + Index” was highly effective in identifying persons similar to those that states had previously transitioned. The Index displays high sensitivity (86.5% and specificity (78.7% and identifies 28.3% of all long-stayers for follow-up. The Index can be cross-walked to MDS 3.0 items. Conclusions The Q + Index, applied to MDS 3.0 assessments, can identify a population closely resembling persons who have transitioned in the past. Given the US Government’s mandate that states consider all transition requests and the limited staffing available at local contact agencies to address such referrals, this algorithm can also be used to prioritize among persons seeking assistance from local contact agencies and MFP providers.

Impact of neuropsychological rehabilitation on activities of daily living and community reintegration of patients with traumatic brain injury.

Science.gov (United States)

Kanchan, Amrita; Singh, Amool Ranjan; Khan, Nawab Akhtar; Jahan, Masroor; Raman, Rajesh; Sathyanarayana Rao, T S

2018-01-01

The present study was targeted to observe the impact of neuropsychological rehabilitation on activities of daily living (ADL) and community reintegration of patients with traumatic brain injury (TBI). Based on purposive sampling technique, ten patients with TBI falling in the age range of 20-40 years and fulfilling the inclusion and exclusion criteria were chosen from All India Institute of Speech and Hearing, Mysuru, India. A quasi-experimental design, i.e., nonequivalent control group design was chosen for the study. Patients were assessed on Luria-Nebraska Neuropsychological Battery for Adults, Cognitive Symptoms Checklist, and Community Integration Questionnaire. Patients in experimental group were given neuropsychological rehabilitation for 6 months. Brainwave-R and Talking Pen were used as rehabilitative tools. Patients with TBI have significant neuropsychological deficits observed in memory, visuo-spatial organization, arithmetic, spelling, writing, fine motor coordination, and executive functioning. Neuropsychological deficits have a major impact on ADL and community reintegration. Neuropsychological rehabilitation is effective in rehabilitating neuropsychological deficits, which in turn leads to improvement in ADL and community reintegration. Neuropsychological rehabilitation should be one of the major goals in rehabilitation procedures for patients with TBI in order to bring overall improvement in them.

Long Term Benefits for Women in a Science, Technology, Engineering, and Mathematics Living-Learning Community

Science.gov (United States)

Maltby, Jennifer L.; Brooks, Christopher; Horton, Marjorie; Morgan, Helen

2016-01-01

Science, technology, engineering and math (STEM) degrees provide opportunities for economic mobility. Yet women, underrepresented minority (URM), and first-generation college students remain disproportionately underrepresented in STEM fields. This study examined the effectiveness of a living-learning community (LLC) for URM and first-generation…

Partnership and community capacity characteristics in 49 sites implementing healthy eating and active living interventions.

Science.gov (United States)

Kemner, Allison L; Donaldson, Kate N; Swank, Melissa F; Brennan, Laura K

2015-01-01

One component of the Evaluation of Healthy Kids, Healthy Communities, funded by the Robert Wood Johnson Foundation, was to assess partnership and community capacity characteristics of 49 cross-sector, multidisciplinary community demonstration projects to increase healthy eating and active living as well as to prevent and reduce childhood obesity. From December 2012 to December 2013, an 82-item partnership and community capacity survey instrument assessed perspectives of community partnership members and community representatives from 48 of the 49 communities on the structure and function of their partnerships and the capacity of the community to create change. Through factor analysis and descriptive statistics, the evaluators described common characteristics of the partnerships, their leadership, and their relationships to the broader communities. A total of 603 individuals responded from 48 of the 49 partnerships. Evaluators identified 15 components, or factors that were broken into a themes, including leadership, partnership structure, relationship with partners, partnership capacity, political influence of partnership, and perceptions of partnership's involvement with the community and community members. Survey respondents perceived the Healthy Kids, Healthy Communities partnerships to have the capacity to ensure the partnerships' effectiveness in forming and growing their structures and functions, collaborating to implement policy and environmental change, and planning for sustainability.

Structural changes of marine communities over the Permian-Triassic transition: Ecologically assessing the end-Permian mass extinction and its aftermath

Science.gov (United States)

Chen, Zhong-Qiang; Tong, Jinnan; Liao, Zhuo-Ting; Chen, Jing

2010-08-01

The Permian/Triassic (P/Tr) transition is ecologically assessed based on examining 23 shelly communities from five shallow platform, ramp and shelf basin facies Permian-Triassic boundary (PTB) sections in South China. The shelly communities have undergone two major collapses coinciding with the two episodes of the end-Permian mass extinction. The first P/Tr extinction event devastated shelly communities in all types of settings to some extent. The basin communities have been more severely impacted than both platform and ramp communities. The survival faunas have rebounded more rapidly in shallow niches than in relatively deep habitats. The second P/Tr crisis destroyed the survival communities in shallow setting and had little impact on the basin communities in terms of community structures. The early Griesbachian communities are overall low-diversity and high-dominance. The governorship switch from brachiopods to bivalves in marine communities has been facilitated by two pulses of the end-Permian mass extinction and the whole takeover process took about 200 ka across the P/Tr boundary. Bivalve ecologic takeover initially occurred immediately after the first P/Tr extinction in shallow water habitats and was eventually completed in all niches after the second P/Tr event. Some post-extinction communities have the irregular rarefaction curves due to the unusual community structures rather than sampling intensities.

International Journal of Web Based Communities

DEFF Research Database (Denmark)

2006-01-01

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

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

Science.gov (United States)

Boone, Edgar J.

1992-01-01

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

Do transition towns have the potential to promote health and well-being? A health impact assessment of a transition town initiative.

Science.gov (United States)

Richardson, J; Nichols, A; Henry, T

2012-11-01

Climate change and energy vulnerability present significant challenges for the development and sustainability of our communities. The adverse effects will most likely impact on those already experiencing poverty, as energy and food costs will rise, thus increasing inequalities in health. Transition town initiatives seek to build cohesive sustainable communities to prepare for a future with limited oil and a changing climate. Increasingly, public health practitioners are interested in the role of transition towns as a community development initiative, and their potential to support the wider public health agenda. Health impact assessment (HIA) is an evidence-based process that aims to predict the positive and negative impacts of a strategy, proposal or development. The HIA process provides an opportunity to promote sustainable communities by ensuring that new strategies and developments are considered in the context of their contribution to the health and well-being of local populations. The aim of this study was to use an HIA to examine the potential health and well-being benefits of two related transition town initiatives. A rapid HIA to consider the potential lifestyle changes and health and well-being impacts of Transition Together/Transition Streets (TT/TS) projects. An HIA template was used to assess key documents related to the TT/TS initiatives and those related to the characteristics of the community. Additionally, meetings with 12 key informants (four involved in TT/TS and eight purposively selected for their local knowledge) were held using the HIA template to focus the discussion. The findings highlight the associated lifestyle changes such as increased physical activity and healthy eating, and possible social and well-being benefits of engagement in such an initiative. Engagement may be limited to those already concerned about environmental issues. This paper illustrates the important links between transition towns and the wider public health agenda

Transition to Community College: The Journey of Adult Basic Education English Learners from Non-Credit to Credit Programs

Science.gov (United States)

Csepelyi, Tunde

2012-01-01

This phenomenological study examined the transition of a group of adult English language learners from an Adult Basic Education program to a community college. The purpose of the study was to gain a deeper understanding of the driving forces of Adult Basic Education English language learners who had successfully transitioned from a non-credit…

Communities matter: Institutional preconditions for community renewable energy

International Nuclear Information System (INIS)

Wirth, Steffen

2014-01-01

Energy transitions are high on political agendas. From a practical viewpoint, community approaches are deemed essential in order to transition from a predominantly centralized energy supply to a decentralized one, and to exploit the potential of renewable energies. In this paper, I discuss how the emergence of community-based energy projects can be analyzed from an institutional perspective. In this context, a ‘community’ is treated as an individual institutional order that shapes decisions. I examine how community structures the implementation of biogas cooperatives in the Autonomous Province of South Tyrol in Northern Italy. My findings suggest that ‘community spirit’, a cooperative tradition, and the norms of locality and responsibility are central drivers behind the emergence and constitution of biogas cooperatives. Not only do these institutional features of community influence the decision concerning which farmers are in or out but also plant location and scale. I argue that ‘community’ is a necessary analytical category for understanding community energy. - Highlights: • I analyze the emergence and constitution of biogas cooperatives in South Tyrol. • Emerging processes and the principal constitutions are similar. • Institutional forces influenced the biogas cooperatives' emergence and constitution. • Biogas cooperatives are decisively shaped by community spirit and local tradition. • The concept of community is used as an explanatory category for community energy

Association between stairs in the home and instrumental activities of daily living among community-dwelling older adults.

Science.gov (United States)

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2018-06-04

There is insufficient evidence regarding the relationship of home environment with functional capacity among community-dwelling older people without disabilities. We conducted a population-based longitudinal cohort study and examined whether stairs in the home were associated with capability to perform instrumental activities of daily living (IADL) in community-dwelling high-functioning older adults. The target population was individuals aged 65 years or older living in two municipalities in Nara Prefecture in Japan. At the baseline survey, residents who were independent in IADL (n = 6722) were included as survey subjects. Subjects were divided into three groups according to their home type; one-storey residences, walk-up residences, or residences with an elevator. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Multiple logistic regression analyses stratified by gender were used to calculate the odds ratio (OR) and a 95% confidence interval (CI) for a decline in IADL, with one-storey residences as a reference. Age, studied area, marital status, working status, self-perceived economic status, body mass index, chronic diseases, smoking, drinking, eating habits, basic activities of daily living, cognitive functioning, depression, self-rated health, and social participation were used as covariates. During the 3-year follow-up, 11.6% of the subjects showed a decline in IADL. After adjusting for covariates, women who lived in walk-up residences had a lower risk for IADL decline (adjusted OR = 0.72, 95% CI = 0.52-0.99), while living in a home with an elevator was not associated with IADL decline (adjusted OR = 0.94, 95% CI = 0.49-1.77). In contrast, there was no association between home type and IADL decline in men (walk-up residences, adjusted OR = 0.90, 95% CI = 0.71-1.14; residences with an elevator, adjusted OR = 0.82, 95% CI = 0.39-1.72). The presence of stairs in the home was

Design and implementation of a factorial randomized controlled trial of methadone maintenance therapy and an evidence-based behavioral intervention for incarcerated people living with HIV and opioid dependence in Malaysia.

Science.gov (United States)

Bazazi, Alexander R; Wickersham, Jeffrey A; Wegman, Martin P; Culbert, Gabriel J; Pillai, Veena; Shrestha, Roman; Al-Darraji, Haider; Copenhaver, Michael M; Kamarulzaman, Adeeba; Altice, Frederick L

2017-08-01

Incarcerated people living with HIV and opioid dependence face enormous challenges to accessing evidence-based treatment during incarceration and after release into the community, placing them at risk of poor HIV treatment outcomes, relapse to opioid use and accompanying HIV transmission risk behaviors. Here we describe in detail the design and implementation of Project Harapan, a prospective clinical trial conducted among people living with HIV and opioid dependence who transitioned from prison to the community in Malaysia from 2010 to 2014. This trial involved 2 interventions: within-prison initiation of methadone maintenance therapy and an evidence-based behavioral intervention adapted to the Malaysian context (the Holistic Health Recovery Program for Malaysia, HHRP-M). Individuals were recruited and received the interventions while incarcerated and were followed for 12months after release to assess post-release HIV transmission risk behaviors and a range of other health-related outcomes. Project Harapan was designed as a fully randomized 2×2 factorial trial where individuals would be allocated in equal proportions to methadone maintenance therapy and HHRP-M, methadone maintenance therapy alone, HHRP-M alone, or control. Partway through study implementation, allocation to methadone maintenance therapy was changed from randomization to participant choice; randomization to HHRP-M continued throughout. We describe the justification for this study; the development and implementation of these interventions; changes to the protocol; and screening, enrollment, treatment receipt, and retention of study participants. Logistical, ethical, and analytic issues associated with the implementation of this study are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

Directory of Open Access Journals (Sweden)

Yardlee Kauffman

2014-01-01

Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

A high rate gamma spectroscopy system for activation analysis of short lived isomeric transitions

Energy Technology Data Exchange (ETDEWEB)

Westphal, G P [Atominstitut, Vienna (Austria)

1976-07-01

A high rate spectroscopy system specially suited for measurement of short-lived isomeric transitions is described, which, as part of a fast activation analysis facility at the TRIGA Mark II reactor, provides for automatic recording and immediate evaluation of gamma spectra taken from nuclides activated at stationary or pulsed reactor power. The system consists of a commercial DC-coupled Ge(Li)-detector of 70 cm{sup 3} modified for recycling operation for input rates in excess of 500,000 c/s Co-60, a time variant trapezoidal shaping section and a fast constant dead-time ADC coupled to a programmed multi-channel analyzer. Novel circuits for efficient pile-up rejection and time variant base line restoration extend the concept of gated integration up to count rates of more than 300,000 c/s Co-60. Time-sequenced recording of spectra is performed by a mini computer operated as a front-end processor of a larger laboratory computer, where final data processing takes place. New concepts for very simple and cost-effective implementation of multi-channel analyzers by means of general purpose small computers are described. (author)

The School-to-Community Transition Experiences of Hearing Young Adults and Young Adults Who Are Deaf.

Science.gov (United States)

Bullis, Michael; And Others

1995-01-01

Comparison of hearing (n=222) and deaf (n=217) young adults on employment, independent living, and social experience outcomes found that the hearing group was generally more successful than deaf persons from mainstream or residential schools. Gender differences did not uniformly favor men. Suggestions for improving transition programs for the deaf…

Introducing Opportunity-based Entrepreneurship in a Transition Economy

DEFF Research Database (Denmark)

Perunovic, Zoran

2005-01-01

This paper confronts necessity-based and opportunity-based entrepreneurial concepts in the transition of developing economies. The author constructs a research model and conducts field research (using Serbia as a case study) to explore how different personal and regional characteristics can favour......-up strategy for transition and developing economies....

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

Directory of Open Access Journals (Sweden)

Lydia Hangulu

2017-05-01

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

Abundance, diversity and community composition of free-living protozoa on vegetable sprouts.

Science.gov (United States)

Chavatte, N; Lambrecht, E; Van Damme, I; Sabbe, K; Houf, K

2016-05-01

Interactions with free-living protozoa (FLP) have been implicated in the persistence of pathogenic bacteria on food products. In order to assess the potential involvement of FLP in this contamination, detailed knowledge on their occurrence, abundance and diversity on food products is required. In the present study, enrichment and cultivation methods were used to inventory and quantify FLP on eight types of commercial vegetable sprouts (alfalfa, beetroot, cress, green pea, leek, mung bean, red cabbage and rosabi). In parallel, total aerobic bacteria and Escherichia coli counts were performed. The vegetable sprouts harbored diverse communities of FLP, with Tetrahymena (ciliate), Bodo saltans and cercomonads (flagellates), and Acanthamoeba and Vannella (amoebae) as the dominant taxa. Protozoan community composition and abundance significantly differed between the sprout types. Beetroot harbored the most abundant and diverse FLP communities, with many unique species such as Korotnevella sp., Vannella sp., Chilodonella sp., Podophrya sp. and Sphaerophrya sp. In contrast, mung bean sprouts were species-poor and had low FLP numbers. Sampling month and company had no significant influence, suggesting that seasonal and local factors are of minor importance. Likewise, no significant relationship between protozoan community composition and bacterial load was observed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Community Drive

DEFF Research Database (Denmark)

Magnussen, Rikke

2018-01-01

Schools and educational institutions are challenged by not adequately educating students for independent knowledge collaboration and solving of complex societal challenges (Bundsgaard & Hansen, 2016; Slot et al., 2017). As an alternative strategy to formal learning has Community-driven research...... opportunity to break boundaries between research institutions and surrounding communities through the involvement of new types of actors, knowledge forms and institutions (OECD, 2011). This paper presents the project Community Drive a three year cross disciplinary community-driven game– and data-based project....... In the paper we present how the project Community Drive initiated in May 2018 is based on results from pilot projects conducted from 2014 – 2017. Overall these studies showed that it is a strong motivational factor for students to be given the task to change their living conditions through redesign...

Depression, Anxiety and Somatic Complaints in Colombian Children Living in Rural Communities

Directory of Open Access Journals (Sweden)

Ruby C. Castilla Puentes

2013-08-01

Full Text Available Introduction: In Colombia, children are frequently exposed to traumatic events; however, there are no data regarding the impact on depression, anxiety and somatic correlates of such exposure in children living in rural communities. Objective: To investigate the somatic complaints and symptoms of depression and anxiety among children exposed to traumatic events in a rural community of Colombia. Methods: Design: Cross-Sectional study. Participants: Two hundred and ninety-three Colombian children aged eight to 18 years. Main Outcome Measures: Standardized measures were administered to assess children's depression, anxiety, physical symptoms and exposure to traumatic events. Depression: CDI (Children's Depression Inventory; anxiety: SCARED (The Screen for Child Anxiety Related Emotional Disorders; somatic complaints: CBCL (Child Behavior Checklist, Somatic Complaints scale and reporting traumatic events during the K-SADS-PL (Diagnostic Interview for Children and Adolescents. Results: Ninety-one of the 293 children (31.1% reported somatic complaints. The most common somatic complaint was in the gastrointestinal category (35/91. One hundred and seventy eight children (60.5% had observed traumatic events, including homicides during the last month. Two hundred five (69.9% of the children showed depressive symptom profiles above established norms, and 239 (81.6% exhibited anxiety symptoms according to their own reports. The correlation between depression and traumatic events, anxiety and somatic complaints, and between anxiety and depression were statistically significant (p<0.005. Conclusions: As the first study of its kind in children living in rural communities in Colombia, it demonstrates a clear impact of traumatic events on mental health. Information that somatic complaints are commonly an expression of underlying depression and anxiety may facilitate the treatment and thereby help avoid unnecessary medical workups and sequelae from traumatized

The Design of New Technology Supporting Wellbeing, Independence and Social Participation, for Older Adults Domiciled in Residential Homes and/or Assisted Living Communities

Directory of Open Access Journals (Sweden)

Joan Cahill

2018-01-01

Full Text Available Purpose: The purpose of this study is to identify and validate the requirements for new technology supporting wellness, independence and social participation for older people domiciled in residential homes and/or assisted-living communities. Method: This research adopts a stakeholder evaluation approach to requirements elicitation and user interface design. Specifically, the study design combines several qualitative human–machine interaction (HMI design frameworks/methods, including realist ethnography, scenario-based design, persona-based design, and participatory design. Findings: New technology should reflect positive values around ageing and link to psychosocial models of successful ageing, and biopsychosocial models of health and wellbeing. Resident autonomy, wellness and social participation cannot be conceptualized outside an understanding of the relationships older adults have with others. The design remit for this technology is to enable a resident experience that is similar to living at home. New technologies should facilitate wellness and communication/connection, and not simply risk assessment. New technology provides an opportunity to bridge existing information gaps between care planning, care assessments and daily care. Overall this technology needs to be intuitive and uphold the resident’s dignity and rights. Person-to-person interaction is central to care delivery. The introduction of new technology should enhance this interaction, and not threaten it. Conclusions: Future assisted-living (AL technology should be premised by biopsychosocial models of wellness and support relationships between older adults and members of the personal and professional community. New assisted-living technology affords the possibility for improved social relationships, enhanced wellbeing, better quality of care, and independence. Such technologies require careful consideration in relation to adapting to age/condition and managing issues

Experiences of patients with laryngectomies as they reintegrate into their community.

Science.gov (United States)

Dooks, Penny; McQuestion, Maurene; Goldstein, David; Molassiotis, Alex

2012-03-01

The purpose of this qualitative study is to describe the patient's experiences as they reintegrate into the community following laryngectomy surgery and identify their perceived support and barriers within this transition. Using Thorne's interpretive descriptive approach, purposeful sampling was used to recruit participants from two large urban hospitals. In-depth, audio-taped interviews were conducted with nine participants 6-12 months following surgery. Enveloped under an overarching theme of a "Constant Accommodation to Life with a Laryngectomy," were three main themes: (1) "Impact of Cancer Diagnosis," (2) "Coping with Illness: Trying to Live Life like Before," and (3) "Transitions in Recovery." Subthemes further illuminated the constant accommodation participants had to make following cancer recurrence, surgery, and returning home. Patients with laryngectomies face major changes in lifestyle related to altered airway, loss of voice, body image concerns, and challenges with eating. Support of family, friends, and health care professionals is critical for successful transition during this stressful period. Instant messaging, email, Web-based support groups, and video messaging can contribute to a great improvement in communication and engagement for this population.

The Communication, Awareness, Relationships and Empowerment (C.A.R.E. Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research

Directory of Open Access Journals (Sweden)

Joniqua Ceasar

2017-11-01

Full Text Available Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E. model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB, which influenced the study’s design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities.

The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research.

Science.gov (United States)

Ceasar, Joniqua; Peters-Lawrence, Marlene H; Mitchell, Valerie; Powell-Wiley, Tiffany M

2017-11-21

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study's design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities.

Partnerships in Sustainability: The Transition Town Movement in Minnesota

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Leslie MacKenzie

2017-06-01

Full Text Available Transition Towns is a citizen-led movement that seeks to address individual and societal dependence on fossil fuels and the need to reduce greenhouse gas production in order to fight climate change. The foundation of Transition is permaculture, a design process based on whole-systems thinking informed by the patterns and relationships found in nature. Since its inception in 2005, the Transition movement has spread worldwide, as people in small groups and across large towns look for ways to take practical action to fight climate change: from home vegetable gardens to weatherization work parties, from time banks and tool shares to renewable energy systems. Transition looks different in every location because it meets the needs and draws on the skills of the local community. This article looks at Transition in one community: The Twin Cities of Minneapolis and St. Paul, profiling several Transition Town groups.

Living in history and living by the cultural life script: How older Germans date their autobiographical memories.

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Bohn, Annette; Habermas, Tilmann

2016-01-01

This study examines predictions from two theories on the organisation of autobiographical memory: Cultural Life Script Theory which conceptualises the organisation of autobiographical memory by cultural schemata, and Transition Theory which proposes that people organise their memories in relation to personal events that changed the fabric of their daily lives, or in relation to negative collective public transitions, called the Living-in-History effect. Predictions from both theories were tested in forty-eight-old Germans from Berlin and Northern Germany. We tested whether the Living-in-History effect exists for both negative (the Second World War) and positive (Fall of Berlin Wall) collectively experienced events, and whether cultural life script events serve as a prominent strategy to date personal memories. Results showed a powerful, long-lasting Living-in History effect for the negative, but not the positive event. Berlin participants dated 26% of their memories in relation to the Second World War. Supporting cultural life script theory, life script events were frequently used to date personal memories. This provides evidence that people use a combination of culturally transmitted knowledge and knowledge based on personal experience to navigate through their autobiographical memories, and that experiencing war has a lasting impact on the organisation of autobiographical memories across the life span.

Transition into adult care: factors associated with level of preparedness among adolescents living with HIV in Cambodia.

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Yi, Siyan; Ngin, Chanrith; Pal, Khuondyla; Khol, Vohith; Tuot, Sovannary; Sau, Sokunmealiny; Chhoun, Pheak; Mburu, Gitau; Choub, Sok Chamreun; Chhim, Kolab; Ly, Penhsun

2017-07-17

Preparing adolescents for transition into adult care and supporting their acquisition of self-health care management skills is a critical determinant of their post-transition HIV care outcomes. However, there is a scarcity of research on effective transition strategies. This study explores factors associated with adolescent preparedness for transition into adult care in Cambodia. In August 2016, a cross-sectional study was conducted among 223 adolescents living with HIV aged 15-17, randomly selected from 11 antiretroviral therapy clinics, utilizing a structured questionnaire. The level of preparedness was determined using a pre-existing scale, and adolescents were categorized as having a high- or low level of preparedness for transition. Bivariate and multivariate analyses were conducted. Of 223 adolescents, 55.2% were male, and their mean age was 15.8 years. Overall, 53.3% had a high level of preparedness for transition. As part of the transition protocol, 2.7% had completed a transfer form, 24.7% had a transition case manager, 29.6% had been counselled about the transition, and 19.7% had visited an adult ART clinic. In multivariate analysis, a higher level of preparedness for transition was independently associated with older age (AOR 2.44, 95% CI 1.34-4.46; p = 0.004), family having received social support for their health (AOR 5.32, 95% CI 1.97-14.36; p = 0.001), knowing the kind of treatment they received (ART) (AOR 12.67, 95% CI 2.91-15.19; p = 0.001), trust in friends or family for HIV treatment (AOR 7.82, 95% CI 1.13-8.89; p = 0.008), receiving counseling on transition (AOR 3.17, 95% CI 1.15-8.76; p = 0.03), having a 'Case Manager' identified to support them during the preparation process for transition (AOR 3.89, 95% CI 1.08-13.96; p = 0.04), and satisfaction with preparation process for transition in general (AOR 0.35, 95% CI 0.03-0.87; p = 0.01). A range of individual, social and health system and services factors may determine successful

The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community.

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Chan, Kevin K S; Mak, Winnie W S

2014-11-01

For people with schizophrenia living in the community and receiving outpatient care, the issues of stigma and discrimination and dearth of recovery-oriented services remain barriers to recovery and community integration. The experience of self-stigma and unmet recovery needs can occur regardless of symptom status or disease process, reducing life satisfaction and disrupting overall well-being. The present study examined the mediating role of self-stigma and unmet needs in the relationship between psychiatric symptom severity and subjective quality of life. Structural equation modeling and mediation analyses were conducted based on a community sample of 400 mental health consumers with schizophrenia spectrum disorders in Hong Kong. The model of self-stigma and unmet needs as mediators between symptom severity and subjective quality of life had good fit to the data (GFI = .93, CFI = .93, NNFI = .92, RMSEA = .06, χ(2)/df ratio = 2.62). A higher level of symptom severity was significantly associated with increased self-stigma (R (2) = .24) and a greater number of unmet needs (R (2) = .53). Self-stigma and unmet needs were in turn negatively related to subjective quality of life (R (2) = .45). It is essential that service providers and administrators make greater efforts to eliminate or reduce self-stigma and unmet recovery needs, which are associated with the betterment of the overall quality of life and long-term recovery. Both incorporating empowerment and advocacy-based interventions into recovery-oriented services and providing community-based, person-centered services to people based on personally defined needs are important directions for future recovery-oriented efforts.

Impact of a 3-year multi-centre community-based intervention on risk factors for chronic disease and obesity among free-living adults: the Healthy Alberta Communities study

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Ellina Lytvyak

2016-04-01

Full Text Available Abstract Background Healthy Alberta Communities (HAC was a 3-year community-based intervention to reduce lifestyle-related risk factors for chronic disease and obesity at a population-level. The current paper examines changes in blood pressure (BP and anthropometric indicators within HAC communities compared to secular trends. Methods Between 2006 and 2009, this community-academic partnership sought to create environments supportive of healthier dietary and physical activity behaviours within four diverse communities in Alberta, Canada. Height, weight, waist and hip circumference and BP were measured among 1554 and 1808 community residents at baseline (2006 and follow-up (2009, respectively. A comparison sample was drawn from a representative national survey. Samples were stratified by age and change between pre- and post-intervention was assessed using t-tests. Changes in parameters over time between groups were compared using meta-analysis. The net difference in change in outcomes (change in intervention communities minus change in comparison group represented the effect of the intervention. Results Adjusted systolic (SBP and diastolic (DBP BP declined within most age groups in HAC communities from pre- to post-intervention. The net decline in SBP was 1 mmHg in 20–39 year olds (p = 0.006 and 2 mmHg in 40–59 year olds (p = 0.001, while the net decline in DBP was 3 mmHg in 20–39 year olds (p < 0.001, 2 mmHg in 40–59 year olds (p < 0.001 and 3 mmHg in 60–79 year olds (p < 0.001. The net increase in the proportion of individuals with normal BP was 5.9 % (p < 0.001, while the net decline in the proportion of individuals with stage 1 hypertension was 4.5 % (p < 0.001. BMI and body weight were unchanged. There was a significant net increase in waist and hip circumference among 20–39 year olds within intervention communities. Conclusions Findings suggest HAC succeeded in shifting the population

Social circus program (Cirque du Soleil) promoting social participation of young people living with physical disabilities in transition to adulthood: a qualitative pilot study.

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Loiselle, Frédéric; Rochette, Annie; Tétreault, Sylvie; Lafortune, Michel; Bastien, Josée

2018-05-29

To explore the perceived impact of a social circus program on the participation level of young adults' living with physical disabilities from their own and their parents' perspective. Exploratory phenomenological qualitative design. A social circus program was offered for nine months. Perceived participation level was documented through pre and post semi-structured interviews. A pretested interview guide was used. Interviews were transcribed and coded by two independent researchers. The average age of the participants (n = 9) was 20.0 ± 1.4 years with 2/9 being female. Participation was perceived as being improved after the intervention from both perspectives (participants and parents) mainly for communication, mobility, relationships, community life and responsibilities. The intervention was perceived as strengthening self-perception and self-efficacy, which in turn enhanced participation level and decreased parents' bounding. The results show promises for social circus as a new approach in adult physical rehabilitation for this population in transition.

Caregivers' perception of factors associated with a healthy diet among people with intellectual disability living in community residences: A Concept mapping method.

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Ruud, Marte Pilskog; Raanaas, Ruth Kjærsti; Bjelland, Mona

2016-12-01

Many people with intellectual disabilities (ID) living in community-based residences have been found to have unhealthy diet and weight disturbances. In Norway, a majority of people with ID live in such residences. The aim of the study was to examine factors affecting the caregivers' opportunity to promote a healthy diet among the residents. A concept mapping methodology was adopted, including group-based brainstorming, idea synthesising, sorting, rating and analysis of the results. Informants were caregivers in four different community residences for people with mild to moderate ID in the southeast of Norway. A total of 13 informants were recruited (12 females and 1 male), and 10 informants completed two sessions. Eight clusters were identified as affecting the caregivers' ability to promote a healthy diet: "Availability and accessibility", "Guidance and autonomy", "Competence among staff", "Planning and involvement", "Customization", "External conditions affecting staff", "Legislation, rules and structure" and "Everyday challenges", each including both barriers and facilitators. Multiple factors affect the caregivers' ability to promote a healthy diet. Caregivers' opportunity to promote a healthy diet is complex. Availability and accessibility of healthy food is crucial, but a healthy diet also requires time and competence among the caregivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does Frailty Predict Health Care Utilization in Community-Living Older Romanians?

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Marinela Olaroiu

2016-01-01

Full Text Available Background. The predictive value of frailty assessment is still debated. We analyzed the predictive value of frailty of independent living elderly. The outcomes variables were visits to the general practitioner, hospital admission, and occurrence of new health problems. Methods. A one-year follow-up study was executed among 215 community-living old Romanians. General practitioners reported the outcome variables of patients, whose frailty was assessed one year before, using the Groningen Frailty Indicator. The predictive validity is analyzed by descriptive and regression analysis. Results. Three-quarters of all participants visited their general practitioner three times more last year and one-third were at least once admitted to a hospital. Patients who scored frail one year before were more often admitted to a hospital. Visits to the general practitioner and occurrence of new health problems were not statistically significant related to frailty scores. The frailty items polypharmacy, social support, and activities in daily living were associated with adverse outcomes. Conclusions. The predictive value of frailty instruments as the Groningen Frailty Indicator is still limited. More research is needed to predict health outcomes, health care utilization, and quality of life of frailty self-assessment instruments. Validation research on frailty in different “environments” is recommended to answer the question to what extent contextual characteristics influence the predictive value.

Community-based knowledge translation: unexplored opportunities

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Armstrong Rebecca

2011-06-01

Full Text Available Abstract Background Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools. Discussion Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, suggesting a unique perspective on knowledge translation in these settings. Specifically, community-based organizations tend to value the process of working in collaboration with multi-sector stakeholders in order to achieve an outcome. A feature of such community-based collaborations is the way in which 'evidence' is conceptualized or defined by these partners, which may in turn influence the degree to which generalizable research evidence in particular is relevant and useful when balanced against more contextually-informed knowledge, such as tacit knowledge. Related to the issues of evidence and context is the desire for local information. For knowledge translation researchers, developing processes to assist community-based organizations to adapt research findings to local circumstances may be the most helpful way to advance decision making in this area. A final characteristic shared by community-based organizations is involvement in advocacy activities, a function that has been virtually ignored in traditional knowledge translation approaches. Summary This commentary is intended to stimulate further discussion in the area of community-based knowledge translation. Knowledge translation, and exchange

Finding Feminism, Finding Voice? Mobilising Community Education to Build Women's Participation in Myanmar's Political Transition

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Maber, Elizabeth Jane Tregoning

2016-01-01

This paper explores the role played by women activists and educators in mobilising community education to support new opportunities for women's activism in the context of Myanmar's political transition. Recent political reorientations in Myanmar which have resulted in a civilian-led democracy emerging from a repressive military regime, have…

Behavioural interventions for urinary incontinence in community-dwelling seniors: an evidence-based analysis.

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2008-01-01

In early August 2007, the Medical Advisory Secretariat began work on the Aging in the Community project, an evidence-based review of the literature surrounding healthy aging in the community. The Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the ministry's newly released Aging at Home Strategy.After a broad literature review and consultation with experts, the secretariat identified 4 key areas that strongly predict an elderly person's transition from independent community living to a long-term care home. Evidence-based analyses have been prepared for each of these 4 areas: falls and fall-related injuries, urinary incontinence, dementia, and social isolation. For the first area, falls and fall-related injuries, an economic model is described in a separate report.Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html, to review these titles within the Aging in the Community series.AGING IN THE COMMUNITY: Summary of Evidence-Based AnalysesPrevention of Falls and Fall-Related Injuries in Community-Dwelling Seniors: An Evidence-Based AnalysisBehavioural Interventions for Urinary Incontinence in Community-Dwelling Seniors: An Evidence-Based AnalysisCaregiver- and Patient-Directed Interventions for Dementia: An Evidence-Based AnalysisSocial Isolation in Community-Dwelling Seniors: An Evidence-Based AnalysisThe Falls/Fractures Economic Model in Ontario Residents Aged 65 Years and Over (FEMOR) OBJECTIVE: To assess the effectiveness of behavioural interventions for the treatment and management of urinary incontinence (UI) in community-dwelling seniors. TARGET POPULATION AND CONDITION Urinary incontinence defined as "the complaint of any involuntary leakage of urine" was identified as 1 of the key predictors in a senior's transition from independent community living to admission to a long-term care

Japanese Culture and the Philosophy of Self-Advocacy: The Importance of Interdependence in Community Living

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Tsuda, Eiji

2006-01-01

In Japan, there is a growing network of self-advocacy groups. Some groups are involved in campaigning. Other groups are involved in social events and education. The age of de-institutionalization is gradually arriving and community living for people with learning difficulties is becoming an urgent political issue. Self-advocacy groups can help…

Refugee and Displaced Youth Negotiating Imagined and Lived Identities in a Photography-Based Educational Project in the United States and Colombia

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Guerrero, Alba Lucy; Tinkler, Tessa

2010-01-01

Drawing from sociocultural theories of identity, this study uses ethnographic tools to compare how displaced children living in two distinct international contexts, who are linked by their participation in a community-based photography project, negotiate their identities and the discourses constructed around their experiences of displacement. We…

Promoting Awareness about Psychological Consequences of Living in a Community Oppressed by the Mafia: A Group-Analytic Intervention

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Cecilia Giordano

2017-09-01

Full Text Available The effects of the Mafia have been extensively studied from sociological, economic, and historical points of view. However, little research has investigated the influence of the Mafia on individuals and communities in terms of its psychological and social impact. In order to contribute to the advancement of our understanding of the psychological effects of the Mafia on individuals and communities and to promote a participative process of social change, a group analytic intervention was conducted within a Community Based Participatory Research carried out in Corleone, a small Sicilian town with a historically recognized role in the evolution of the Mafia, as well as in the fight against its control. Qualitative findings from the group intervention revealed the development of an awareness process that allowed participants to become aware of their social unconscious anxieties and defenses and to recognize and manage the strong emotional impact related to the Mafia's presence in their lives. Highlighting how psychological processes can have negative impacts on individual and collective capacity to pursuit transformation and resilience, this article provides important insight on how clinical psychology may operate in socio-cultural contexts to promote the reconstruction of the traumatic social dimensions in the community.

Integration of Community Pharmacists in Transition of Care (TOC) Services: Current Trends and Pharmacist Perceptions.

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Zeleznikar, Elizabeth A; Kroehl, Miranda E; Perica, Katharine M; Thompson, Angela M; Trinkley, Katy E

2017-01-01

Barriers exist for patients transitioning from one health-care setting to another, or to home, and health-care systems are falling short of meeting patient needs during this time. Community pharmacist incorporation poses a solution to the current communication breakdown and high rates of medication errors during transitions of care (TOC). The purpose of this study was to determine community pharmacists' involvement in and perceptions of TOC services. Cross-sectional study using electronic surveys nationwide to pharmacists employed by a community pharmacy chain. Of 7236 pharmacists surveyed, 546 (7.5%) responded. Only 33 (6%) pharmacists reported their pharmacy participates in TOC services. Most pharmacists (81.5%) reported receiving discharge medication lists. The most common reported barrier to TOC participation is lack of electronic integration with surrounding hospitals (51.1%). Most pharmacists agreed that (1) it is valuable to receive discharge medication lists (83.3%), (2) receiving discharge medication lists is beneficial for patients' health (89.1%), (3) discharge medication list receipt improves medication safety (88.8%). Most pharmacists reported receiving discharge medication lists and reported discharge medication lists are beneficial, but less than half purposefully used medication lists. To close TOC gaps, health-care providers must collaborate to overcome barriers for successful TOC services.

Variation in organophosphate pesticide metabolites in urine of children living in agricultural communities.

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Lambert, William E; Lasarev, Michael; Muniz, Juan; Scherer, Jennifer; Rothlein, Joan; Santana, Juanita; McCauley, Linda

2005-04-01

Children of migrant farmworkers are at increased risk of exposure to organophosphate pesticides because of "carry-home" transport processes and residential location. Although this at-risk status is generally recognized, few available reports describe the extent of this exposure among agricultural communities. We quantified dialkyl phosphate (DAP) levels in serial samples of urine from 176 children, 2-6 years of age, in three Oregon communities hosting differing agricultural industries: pears, cherries, and fruit berries. Up to three spot samples of urine were collected from children at the beginning, mid-point, and end of their parents' work seasons. The median levels of dimethylthiophosphate (DMTP), the most commonly detected metabolite, was significantly higher in urine samples from children in each of the three agricultural communities (17.5, 19.0, and 41.0 ng/mL) relative to a reference group of children who lived in an urban community and whose parents did not work in agriculture (6.5 ng/mL; Kruskal-Wallis, p orchards and fields, or the movement of these working families. Additional studies of variation in pesticide exposure across agricultural regions are needed.

Renewal strategy and community based organisations in community ...

African Journals Online (AJOL)

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

The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study

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Diallo Abdoulaye

2012-09-01

Full Text Available Abstract Background Infant mortality rates (IMR remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. Methods A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150 in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Results Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89–143. Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51–88. Infections (35% and preterm births complications (23% were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. Conclusions We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

The high burden of infant deaths in rural Burkina Faso: a prospective community-based cohort study.

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Hama Diallo, Abdoulaye; Meda, Nicolas; Sommerfelt, Halvor; Traore, Germain S; Cousens, Simon; Tylleskar, Thorkild

2012-09-05

Infant mortality rates (IMR) remain high in many sub-Saharan African countries, especially in rural settings where access to health services may be limited. Studies in such communities can provide relevant data on the burden of and risk factors for infant death. We measured IMR and explored risk factors for infant death in a cohort of children born in Banfora Health District, a rural area in South-West Burkina Faso. A prospective community-based cohort study was nested within the PROMISE-EBF trial (NCT00397150) in 24 villages of the study area. Maternal and infant baseline characteristics were collected at recruitment and after birth, respectively. Home visits were conducted at weeks 3, 6, 12, 24 and 52 after birth. Descriptive statistics were calculated using robust standard errors to account for cluster sampling. Cox multivariable regression was used to investigate potential risk factors for infant death. Among the 866 live born children included in the study there were 98 infant deaths, yielding an IMR of 113 per 1000 live births (95% CI: 89-143). Over 75% of infant deaths had occurred by 6 months of age and the post neonatal infant mortality rate was 67 per 1000 live births (95% CI: 51-88). Infections (35%) and preterm births complications (23%) were the most common probable causes of death by 6 months. Multivariable analyses identified maternal history of child death, polygyny, twin births and poor anthropometric z-scores at week-3 as factors associated with increased risk of infant death. We observed a very high IMR in a rural area of Burkina Faso, a country where 75% of the population lives in rural settings. Community-based health interventions targeting mothers and children at high risk are urgently needed to reduce the high burden of infant deaths in these areas.

Does life satisfaction predict five-year mortality in community-living older adults?

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St John, Philip D; Mackenzie, Corey; Menec, Verena

2015-01-01

Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

Numerical simulation of transitional flow on a wind turbine airfoil with RANS-based transition model

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Zhang, Ye; Sun, Zhengzhong; van Zuijlen, Alexander; van Bussel, Gerard

2017-09-01

This paper presents a numerical investigation of transitional flow on the wind turbine airfoil DU91-W2-250 with chord-based Reynolds number Rec = 1.0 × 106. The Reynolds-averaged Navier-Stokes based transition model using laminar kinetic energy concept, namely the k - kL - ω model, is employed to resolve the boundary layer transition. Some ambiguities for this model are discussed and it is further implemented into OpenFOAM-2.1.1. The k - kL - ω model is first validated through the chosen wind turbine airfoil at the angle of attack (AoA) of 6.24° against wind tunnel measurement, where lift and drag coefficients, surface pressure distribution and transition location are compared. In order to reveal the transitional flow on the airfoil, the mean boundary layer profiles in three zones, namely the laminar, transitional and fully turbulent regimes, are investigated. Observation of flow at the transition location identifies the laminar separation bubble. The AoA effect on boundary layer transition over wind turbine airfoil is also studied. Increasing the AoA from -3° to 10°, the laminar separation bubble moves upstream and reduces in size, which is in close agreement with wind tunnel measurement.

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

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Tate, Erika Dawn

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

Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST).

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Nkonki, Lungiswa Ll; Chola, Lumbwe L; Tugendhaft, Aviva A; Hofman, Karen K

2017-08-28

To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality. DemProj Based on National South African Data. A total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition. Reducing child mortality. A total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs. The use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impact of community-based interventions on HIV knowledge, attitudes, and transmission.

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Salam, Rehana A; Haroon, Sarah; Ahmed, Hashim H; Das, Jai K; Bhutta, Zulfiqar A

2014-01-01

In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.

The MaBwana Black men's study: community and belonging in the lives of African, Caribbean and other Black gay men in Toronto.

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George, Clemon; Adam, Barry A; Read, Stanley E; Husbands, Winston C; Remis, Robert S; Makoroka, Lydia; Rourke, Sean B

2012-01-01

In Canada, there is a paucity of research aimed at understanding Black gay men and the antecedents to risk factors for HIV. This study is an attempt to move beyond risk factor analysis and explore the role of sexual and ethnic communities in the lives of these men. The study utilized a community-based research and critical race theory approach. Semi-structured interviews were conducted with eight key informants to augment our understanding of Black gay men and to facilitate recruitment of participants. In-depth interviews were done with 24 Black gay men. Our data showed that the construction of community for Black gay men is challenged by their social and cultural environment. However, these men use their resilience to navigate gay social networks. Black gay men expressed a sense of abjuration from both gay and Black communities because of homophobia and racism. It is essential for health and social programmers to understand how Black gay men interact with Black and gay communities and the complexities of their interactions in creating outreach educational, preventive and support services.

Trust transitivity in social networks.

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Oliver Richters

Full Text Available Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected "fringe" nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its "fringe" peers.

Trust Transitivity in Social Networks

Science.gov (United States)

Richters, Oliver; Peixoto, Tiago P.

2011-01-01

Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust) is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP) web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected “fringe” nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its “fringe” peers. PMID:21483683

"In our stories": The perspectives of women living with HIV on an evidence-based group intervention.

Science.gov (United States)

Dale, Sannisha K; Grimes, Tiffany; Miller, Lauren; Ursillo, Alyssa; Drainoni, Mari-Lynn

2017-07-01

A qualitative study among women living with HIV assessed the aspects of an evidence-based intervention targeting HIV transmission risk reduction (Women Involved in Life Learning from Other Women [WiLLOW]) that women valued and how their lives were impacted. Thirty-one women (80.6% African American) completed interviews. Women valued the personal stories and positive group dynamics (i.e. safety, trust, openness, getting feedback, bonding, and socializing). As a result of WiLLOW, women embraced a strong woman image, joined groups, changed behaviors, accepted their HIV status, became optimistic, and spoke up/advocated in their relationships and communities. Interventions for HIV-positive women may benefit from incorporating the sharing of stories in their curricula and factors that build positive group dynamics.

EFFORTS TO IMPROVE WELFARE BASED ON AQUACULTURE TOWARDS THE COMMUNITY ECONOMIC DEVELOPMENT

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Yunikewaty

2018-04-01

Full Text Available This study aims to produce a continuous improvement model of river basin community welfare by applying the moral values of the society culture. The subject of research is the community of the river Kahayan River Palangkaraya. Based on the results of research can be concluded that the aquaculture based eco-business activities can be done by applying the moral values of the river society culture, so that all economic activities do not damage the environment. The Kahayan River has a high economic potential for the people living around it. However, the current condition has been greatly reduced due to various obstacles encountered, including environmental damage in the upper river, due to refinery plantation companies (accompanied by high levels of pesticide use and chemical fertilizers and intensive cultivation, illegal gold mining, deforestation, illegal use of poison while fishing, industrial and household waste disposal into the Kahayan river.

Pain and Cognitive Function Among Older Adults Living in the Community.

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van der Leeuw, Guusje; Eggermont, Laura H P; Shi, Ling; Milberg, William P; Gross, Alden L; Hausdorff, Jeffrey M; Bean, Jonathan F; Leveille, Suzanne G

2016-03-01

Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research.

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Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth

2012-11-01

As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

Science.gov (United States)

Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

2015-07-22

Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive

Yours, Mine, and Ours: Art and Community

Science.gov (United States)

Kuster, Deborah; TerAvest, Matt

2007-01-01

Christopher Adejumo identified community-based art as "works of art produced by people living within the same locality, and defined by common interests such as shared concerns, cultural heritage, traditions, and language patterns." Community-based art has the potential of heightening students' sense of personal responsibility and generating…

Antiretroviral treatment for HIV in rural Uganda: two-year treatment outcomes of a prospective health centre/community-based and hospital-based cohort.

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Walter Kipp

Full Text Available In sub-Saharan Africa, a shortage of trained health professionals and limited geographical access to health facilities present major barriers to the expansion of antiretroviral therapy (ART. We tested the utility of a health centre (HC/community-based approach in the provision of ART to persons living with HIV in a rural area in western Uganda.The HIV treatment outcomes of the HC/community-based ART program were evaluated and compared with those of an ART program at a best-practice regional hospital. The HC/community-based cohort comprised 185 treatment-naïve patients enrolled in 2006. The hospital cohort comprised of 200 patients enrolled in the same time period. The HC/community-based program involved weekly home visits to patients by community volunteers who were trained to deliver antiretroviral drugs to monitor and support adherence to treatment, and to identify and report adverse reactions and other clinical symptoms. Treatment supporters in the homes also had the responsibility to remind patients to take their drugs regularly. ART treatment outcomes were measured by HIV-1 RNA viral load (VL after two years of treatment. Adherence was determined through weekly pill counts.Successful ART treatment outcomes in the HC/community-based cohort were equivalent to those in the hospital-based cohort after two years of treatment in on-treatment analysis (VL≤400 copies/mL, 93.0% vs. 87.3%, p = 0.12, and in intention-to-treat analysis (VL≤400 copies/mL, 64.9% and 62.0%, p = 0.560. In multivariate analysis patients in the HC/community-based cohort were more likely to have virologic suppression compared to hospital-based patients (adjusted OR = 2.47, 95% CI 1.01-6.04.Acceptable rates of virologic suppression were achieved using existing rural clinic and community resources in a HC/community-based ART program run by clinical officers and supported by lay volunteers and treatment supporters. The results were equivalent to those of a

The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

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Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

2015-01-01

The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

Identifying community healthcare supports for the elderly and the factors affecting their aging care model preference: evidence from three districts of Beijing

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Tianyang Liu

2016-11-01

Full Text Available Abstract Background The Chinese tradition of filial piety, which prioritized family-based care for the elderly, is transitioning and elders can no longer necessarily rely on their children. The purpose of this study was to identify community support for the elderly, and analyze the factors that affect which model of old-age care elderly people dwelling in communities prefer. Methods We used the database “Health and Social Support of Elderly Population in Community”. Questionnaires were issued in 2013, covering 3 districts in Beijing. A group of 1036 people over 60 years in age were included in the study. The respondents’ profile variables were organized in Andersen’s Model and community healthcare resource factors were added. A multinomial logistic model was applied to analyze the factors associated with the desired aging care models. Results Cohabiting with children and relying on care from family was still the primary desired aging care model for seniors (78 %, followed by living in institutions (14.8 % and living at home independently while relying on community resources (7.2 %. The regression result indicated that predisposing, enabling and community factors were significantly associated with the aging care model preference. Specifically, compared with those who preferred to cohabit with children, those having higher education, fewer available family and friend helpers, and shorter distance to healthcare center were more likely to prefer to live independently and rely on community support. And compared with choosing to live in institutions, those having fewer available family and friend helpers and those living alone were more likely to prefer to live independently and rely on community. Need factors (health and disability condition were not significantly associated with desired aging care models, indicating that desired aging care models were passive choices resulted from the balancing of family and social caring resources

Effects of an exercise programme with people living with HIV ...

African Journals Online (AJOL)

Effects of an exercise programme with people living with HIV: research in a disadvantaged setting. Clemens Ley, Lloyd Leach, María Rato Barrio, Susan Bassett. Abstract. This study aimed to analyse the physical health effects of a community based 10-week physical activity programme with people living with HIV.

Self-rated health and health-strengthening factors in community-living frail older people.

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Ebrahimi, Zahra; Dahlin-Ivanoff, Synneve; Eklund, Kajsa; Jakobsson, Annika; Wilhelmson, Katarina

2015-04-01

The aim of this study was to analyse the explanatory power of variables measuring health-strengthening factors for self-rated health among community-living frail older people. Frailty is commonly constructed as a multi-dimensional geriatric syndrome ascribed to the multi-system deterioration of the reserve capacity in older age. Frailty in older people is associated with decreased physical and psychological well-being. However, knowledge about the experiences of health in frail older people is still limited. The design of the study was cross-sectional. The data were collected between October 2008 and November 2010 through face-to-face structured interviews with older people aged 65-96 years (N = 161). Binary logistic regression was used to analyse whether a set of explanatory relevant variables is associated with self-rated health. The results from the final model showed that satisfaction with one's ability to take care of oneself, having 10 or fewer symptoms and not feeling lonely had the best explanatory power for community-living frail older peoples' experiences of good health. The results indicate that a multi-disciplinary approach is desirable, where the focus should not only be on medical problems but also on providing supportive services to older people to maintain their independence and experiences of health despite frailty. © 2014 John Wiley & Sons Ltd.

Travel Patterns And Characteristics Of Transit Users In New York State

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Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Daniel W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reuscher, Tim [Macrosys, Arlington, VA (United States); Chin, Shih-Miao [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Taylor, Rob D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-12-01

This research is a detailed examination of the travel behaviors and patterns of transit users within New York State (NYS), primarily based on travel data provided by the National Household Travel Survey (NHTS) in 2009 and the associated Add-on sample households purchased by the New York State Department of Transportation (NYSDOT). Other data sources analyzed in this study include: NYS General Transit Feed Specification (GTFS) to assist in analyzing spatial relationships for access to transit and the creation of Transit Shed geographic areas of 1, 2.5, and 5 miles from transit stop locations, LandScan population database to understand transit coverage, and Census Bureau s American Community Survey (ACS) data to examine general transit patterns and trends in NYS over time. The majority of analyses performed in this research aimed at identifying transit trip locations, understanding differences in transit usage by traveler demographics, as well as producing trip/mode-specific summary statistics including travel distance, trip duration, time of trip, and travel purpose of transit trips made by NYS residents, while also analyzing regional differences and unique travel characteristics and patterns. The analysis was divided into two aggregated geographic regions: New York Metropolitan Transportation Council (NYMTC) and NYS minus NYMTC (Rest of NYS). The inclusion of NYMTC in all analysis would likely produce misleading conclusions for other regions in NYS. TRANSIT COVERAGE The NYS transit network has significant coverage in terms of transit stop locations across the state s population. Out of the 19.3 million NYS population in 2011, about 15.3 million (or 79%) resided within the 1-mile transit shed. This NYS population transit coverage increased to 16.9 million (or 88%) when a 2.5-mile transit shed was considered; and raised to 17.7 million (or 92%) when the 5-mile transit shed was applied. KEY FINDINGS Based on 2009 NHTS data, about 40% of NYMTC households used transit

Polymethylene-based copolymers by polyhomologation or by its combination with controlled/living and living polymerizations

KAUST Repository

Zhang, Hefeng

2014-01-20

Polyhomologation, recently developed by Shea, is a borane-initiated living polymerization of ylides leading to linear polymethylenes (C1 polymerization) with controlled molecular weight, low polydispersity, and well-defined structures. In this Review, the copolyhomologation of different ylides as well as the combination of polyhomologation with controlled/living (nitroxide-mediated, atom transfer radical, reversible addition-fragmentation chain-transfer) and living (ring opening, anionic) polymerizations is discussed. Polyhomologation of ylides, in combination with living and controlled/living polymerizations, leads to a plethora novel well-defined polymethylene (polyethylene)-based polymeric materials, which are very important for understanding/improving the behavior of industrial polyethylenes. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Help-seeking behaviour among people living with chronic hip or knee pain in the community

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Adamson Joy

2009-12-01

Full Text Available Abstract Background A large proportion of people living with hip or knee pain do not consult health care professionals. Pain severity is often believed to be the main reason for help seeking in this population; however the evidence for this is contradictory. This study explores the importance of several potential risk factors on help seeking across different practitioner groups, among adults living with chronic hip or knee pain in a large community sample. Methods Health care utilization, defined as having seen a family doctor (GP during the past 12 months; or an allied health professional (AHP or alternative therapist during the past 3 months, was assessed in a community based sample aged 35 or over and reporting pain in hip or knee. Adjusted odds ratios were determined for social deprivation, rurality, pain severity, mobility, anxiety/depression, co-morbidities, and body mass index. Results Of 1119 persons reporting hip or knee pain, 52% had pain in both sites. Twenty-five percent of them had seen a doctor only, 3% an AHP only, and 4% an alternative therapist only. Thirteen percent had seen more than one category of health care professionals, and 55% had not seen any health care professional. In the multivariate model, factors associated with consulting a GP were mobility problems (OR 2.62 (1.64-4.17, urban living (OR 2.40 (1.14-5.04 and pain severity (1.28 (1.13-1.44. There was also some evidence that obesity was associated with increased consultation (OR 1.72 (1.00-2.93. Factors were similar for consultation with a combination of several health care professionals. In contrast, seeing an alternative therapist was negatively associated with pain severity, anxiety and mobility problems (adjusting for age and sex. Conclusion Disability appears to be a more important determinant of help-seeking than pain severity or anxiety and depression, for adults with chronic pain in hip or knee. The determinants of seeking help from alternative practitioners

Outcomes related to nutrition screening in community living older adults: A systematic literature review.

Science.gov (United States)

Hamirudin, Aliza Haslinda; Charlton, Karen; Walton, Karen

2016-01-01

Nutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening. A systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines. Fifty-four articles were eligible to be included in the review and malnutrition risk varied from 0% to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the' nutritional status of older adults. Timely nutrition screening of older adults living in the community, if followed up with appropriate intervention and monitoring improves the nutritional status of older adults. This indicates that nutrition intervention should be considered a priority following nutrition screening for malnourished and at risk older adults. Further evaluation of outcomes of nutrition screening and associated interventions, using structured pathways of care, is warranted. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Changeover-time in psychosocial wellbeing of people living with HIV and people living close to them after an HIV stigma reduction and wellness enhancement community intervention.

Science.gov (United States)

Chidrawi, H Christa; Greeff, Minrie; Temane, Q Michael; Ellis, Suria

2015-01-01

HIV stigma continues to affect the psychosocial wellbeing of people living with HIV (PLWH) and people living close to them (PLC). Literature unequivocally holds the view that HIV stigma and psychosocial wellbeing interact with and have an impact on each other. This study, which is part of a larger research project funded by the South Africa Netherlands research Programme on Alternatives in Development (SANPAD), responds to the lack of interventions mitigating the impactful interaction of HIV stigma and psychosocial wellbeing and tests one such intervention. The research objectives were to test the changeover-time in the psychosocial wellbeing of PLWH and PLC in an urban and a rural setting, following a comprehensive community-based HIV stigma reduction and wellness enhancement intervention. An experimental quantitative single system research design with a pre- and four repetitive post-tests was used, conducting purposive voluntary sampling for PLWH (n = 18) and snowball sampling for PLC (n = 60). The average age of participants was 34 years old. The five measuring instruments used for both groups were the mental health continuum short-form scale, the patient health questionnaire, the satisfaction with life scale, the coping self-efficacy scale and the spirituality wellbeing scale. No significant differences were found between the urban-rural settings and data were pooled for analysis. The findings show that initial psychosocial wellbeing changes after the intervention were better sustained (over time) by the PLC than by the PLWH and seemed to be strengthened by interpersonal interaction. Recommendations included that the intervention should be re-utilised and that its tenets, content and activities be retained. A second intervention three to six months after the first should be included to achieve more sustainability and to add focused activities for the enhancement of psychosocial wellbeing. PLWH and PLC are to be encouraged to engage with innovative community

Chapter 11. Community analysis-based methods

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

2010-05-01

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

The Lived Experiences of Asian Americans Who Became Chief Executive Officers (CEOs) of California Community Colleges

Science.gov (United States)

Ramones, Eric

2017-01-01

The purpose of this phenomenological study was to explore the lived experiences of Asian Americans who became chief executive officers (CEOs) of a California Community College District. This study discussed the experiences, the influence of Asian culture, the perception of Asian Americans, and the challenges encountered by Asian American CEOs. To…

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

Science.gov (United States)

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

2002-01-01

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

A qualitative study of in-home robotic telepresence for home care of community-living elderly subjects.

Science.gov (United States)

Boissy, Patrick; Corriveau, Hélène; Michaud, François; Labonté, Daniel; Royer, Marie-Pier

2007-01-01

We examined the requirements for robots in home telecare using two focus groups. The first comprised six healthcare professionals involved in geriatric care and the second comprised six elderly people with disabilities living in the community. The concept of an in-home telepresence robot was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering respite and support to caregivers under certain conditions. The shift from a traditional hospital-centred model of care in geriatrics to a home-based model creates opportunities for using telepresence with mobile robotic systems in home telecare.

Renewal Strategy and Community Based Organisations in Community

African Journals Online (AJOL)

FBL

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

Advantages and Disadvantages for Receiving Internet-Based HIV/AIDS Interventions at Home or at Community Based Organization

Science.gov (United States)

Green, Shana M.; Lockhart, Elizabeth; Marhefka, Stephanie L.

2015-01-01

Within recent years public health interventions have become technologically based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions. The US National HIV/AIDS Strategy states that people living with HIV should have access to effective behavioral interventions like Healthy Relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based Healthy Relationships Video Groups (HR-VG) delivered at home or community based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages, disadvantages and overall preference for home or agency delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective. PMID:26357907

Advantages and disadvantages for receiving Internet-based HIV/AIDS interventions at home or at community-based organizations.

Science.gov (United States)

Green, Shana M; Lockhart, Elizabeth; Marhefka, Stephanie L

2015-01-01

Within recent years, public health interventions have become technology based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions (EBIs). The US National HIV/AIDS Strategy states that people living with HIV should have access to EBIs such as healthy relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based healthy relationships video groups (HR-VG) delivered at home or community-based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages and disadvantages of home or CBO delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure, and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall, privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective.

H.323 based collaborative environment for high energy and nuclear physics

International Nuclear Information System (INIS)

Teiji Nakamura; Kiyoharu Hashimoto; Hitoshi Hirose; Yukio Karita; Youhei Morita; Soh Suzuki; Fukuko Yuasa

2001-01-01

After having evaluated various H.323 products for these two years, KEK and Japanese HENP community started to move from ISDN (H.320)-based video conferencing environment into IP(H.323)-based one. Primary reason for the move is to cut down the ever increasing ISDN communication cost. At the same time the H.323 can offer more powerful collaborative environment. In order to make KEK to be a center for the H.323-based collaborative environment in Japan, PictureTel's LIVE GATEWAY as a H.320/H.323 gateway, which is essential for the smooth transition, Cisco IP/VC 3510 as a H.323/MCU, and Cisco 2610 as a gatekeeper were installed at KEK in March 2001. And the transition started. The authors describe the collaborative environment which the users can have, together with its operational results

[Co-construction of a program to promote community participation among seniors living with psychosocial issues, with or without mental health problems].

Science.gov (United States)

Parisien, Manon; Nour, Kareen; Belley, Anne-Marie; Aubin, Ginette; Billette, Véronique; Dallaire, Bernadette

Objectives A significant proportion of Quebec seniors are living with mental health problems or psychosocial issues such as isolation, bereavement, and psychological distress. These people face many forms of exclusion and are likely to have limited social participation. This paper describes the co-construction steps of a program aimed at promoting community participation among this population.Methods A method for the co-construction of innovative practices in health promotion was used to develop a program that is relevant, rigorous and feasible in diverse settings. The process included several steps, notably: need analysis among seniors and practitioners, development of a logical model for the program, preparation of the leader's manual, validation of the manual by experts, and pilot testing of the program among groups of seniors.Results The goal of the Count me in! program is to promote utilization of the resources of the community that can provide seniors living with mental health conditions or psychosocial issues with activities and positive social contact. The intervention is based on the Strength Model. It includes an individual interview, an eight-meeting workshop, visits to community resources, and collective production of media communication.Conclusion A co-construction process allowed the program to be continuously adjusted in response to stakeholders' feedback. The most important lever for the co-construction was the reconciliation of the partners' practical, conceptual, and experiential expertise. However, contextual factors such as the organization and the availability of mental health services for seniors constituted important barriers to the process.

Informal and formal support among community-dwelling Japanese American elders living alone in Chicagoland: an in-depth qualitative study.

Science.gov (United States)

Lau, Denys T; Machizawa, Sayaka; Doi, Mary

2012-06-01

A key public health approach to promote independent living and avoid nursing home placement is ensuring that elders can obtain adequate informal support from family and friends, as well as formal support from community services. This study aims to describe the use of informal and formal support among community-dwelling Nikkei elders living alone, and explore perceived barriers hindering their use of such support. We conducted English and Japanese semi-structured, open-ended interviews in Chicagoland with a convenience sample of 34 Nikkei elders age 60+ who were functionally independent and living alone; 9 family/friends; and 10 local service providers. According to participants, for informal support, Nikkei elders relied mainly on: family for homemaking and health management; partners for emotional and emergency support; friends for emotional and transportation support; and neighbors for emergency assistance. Perceived barriers to informal support included elders' attitudinal impediments (feeling burdensome, reciprocating support, self-reliance), family-related interpersonal circumstances (poor communication, distance, intergenerational differences); and friendship/neighbor-related interpersonal situations (difficulty making friends, relocation, health decline/death). For formal support, Nikkei elders primarily used adult day care/cultural programs for socializing and learning and in-home care for personal/homemaking assistance and companionship. Barriers to formal support included attitudinal impediments (stoicism, privacy, frugality); perception of care (incompatibility with services, poor opinions of in-home care quality); and accessibility (geographical distance, lack of transportation). In summary, this study provides important preliminary insights for future community strategies that will target resources and training for support networks of Nikkei elders living alone to maximize their likelihood to age in place independently.

Quality of life of community-based chronic schizophrenia patients in Penang, Malaysia.

Science.gov (United States)

Mubarak, A R; Baba, Ismail; Chin, Low Heng; Hoe, Quah Soon

2003-10-01

This is a study of the quality of life (QOL) of 174 community-based chronic schizophrenia patients in Penang, Malaysia. The study samples were selected from the Out Patient Department, Department of Psychiatry, Penang General Hospital, Malaysia. The data was collected through personal interviews with the respondents. A questionnaire prepared by the research team was used to collect data on background characteristics. Lehman's (1988) Quality of Life Interview was used to collect data on patients' QOL. Equal number of males and females participated in the study. The interviews on QOL indicated problems in the areas of life in general, place of living, daily activities, social relations, finance, work and general health. The results also revealed that community-based schizophrenia patients had acute poverty and experienced social isolation, discrimination and exploitation in the workplace. Implications of these results on the implementation process of National Mental Health Policy in Malaysia are discussed. The research paper also discusses the negative impacts of limited rehabilitation facilities available in the community and its implications on the QOL of severely mentally ill patients. The need for immediate research attention on QOL of such patients in the South-east Asian region has been highlighted.

A microscopic approach based on particle-vibration coupling: application to charge-exchange transitions and multiplets in odd nuclei

Directory of Open Access Journals (Sweden)

Colò Gianluca

2016-01-01

Full Text Available In this contribution, we shall describe a formalism that goes beyond the simple time-dependent mean field and is based on particle-vibration coupling (PVC. Such a formalism has been developed with the idea of being self-consistent. It makes use of Skyrme effective forces, and has been used for several applications. We will focus on charge-exchange transitions, namely we will show that our model describes well both the Gamow-Teller giant resonance width, and the low-lying transitions associated with β-decay. In this latter case, including PVC produces a significant improvement of the half-lives obtained at mean-field level, and leads to a good agreement with experimental data. We will end by discussing particle-phonon multiplets in odd nuclei.

A Comparative Analysis of a Game-Based Mobile Learning Model in Low-Socioeconomic Communities of India

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Kim, Paul; Buckner, Elizabeth; Kim, Hyunkyung; Makany, Tamas; Taleja, Neha; Parikh, Vallabhi

2012-01-01

This study explores the effectiveness of a game-based mobile learning model for children living in underdeveloped regions with significant contextual variations. Data for this study came from a total of 210 children between the ages of 6-14 years old from six marginalized communities in India. The findings reveal that children with little or no…

Incarcerated women's relationship-based strategies to avoid drug use after community re-entry.

Science.gov (United States)

Snell-Rood, Claire; Staton-Tindall, Michele; Victor, Grant

2016-10-01

While recent research has stressed the supportive role that family and friends play for incarcerated persons as they re-enter the community, drug-using incarcerated women re-entering the community often have to rely on family, community, and intimate relationships that have played a role in their substance abuse and criminalization. In this study the authors conducted qualitative analysis of clinical sessions with rural, drug-using women (N = 20) in a larger prison-based HIV risk reduction intervention in Kentucky during 2012-2014 to examine incarcerated women's perceptions of the role of their family, community, and intimate relationships in their plans to decrease their substance abuse upon community re-entry. Women stressed the obstacles to receiving support in many of their family and drug-using relationships after community re-entry. Nonetheless, they asserted that changes in their relationships could support their desires to end their substance abuse by setting limits on and using their positive relationships, particularly with their children, to motivate them to change. Interventions to promote incarcerated women's health behavior changes-including substance abuse-must acknowledge the complex social environments in which they live.

Transcriptional changes in the hookworm, Ancylostoma caninum, during the transition from a free-living to a parasitic larva.

Directory of Open Access Journals (Sweden)

Bennett J D Datu

Full Text Available BACKGROUND: Third-stage larvae (L3 of the canine hookworm, Ancylostoma caninum, undergo arrested development preceding transmission to a host. Many of the mRNAs up-regulated at this stage are likely to encode proteins that facilitate the transition from a free-living to a parasitic larva. The initial phase of mammalian host invasion by A. caninum L3 (herein termed "activation" can be mimicked in vitro by culturing L3 in serum-containing medium. METHODOLOGY/PRINCIPAL FINDINGS: The mRNAs differentially transcribed between activated and non-activated L3 were identified by suppression subtractive hybridisation (SSH. The analysis of these mRNAs on a custom oligonucleotide microarray printed with the SSH expressed sequence tags (ESTs and publicly available A. caninum ESTs (non-subtracted yielded 602 differentially expressed mRNAs, of which the most highly represented sequences encoded members of the pathogenesis-related protein (PRP superfamily and proteases. Comparison of these A. caninum mRNAs with those of Caenorhabditis elegans larvae exiting from developmental (dauer arrest demonstrated unexpectedly large differences in gene ontology profiles. C. elegans dauer exiting L3 up-regulated expression of mostly intracellular molecules involved in growth and development. Such mRNAs are virtually absent from activated hookworm larvae, and instead are over-represented by mRNAs encoding extracellular proteins with putative roles in host-parasite interactions. CONCLUSIONS/SIGNIFICANCE: Although this should not invalidate C. elegans dauer exit as a model for hookworm activation, it highlights the limitations of this free-living nematode as a model organism for the transition of nematode larvae from a free-living to a parasitic state.

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

Science.gov (United States)

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

2015-02-01

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

Effects of Nurse-Led Multifactorial Care to Prevent Disability in Community-Living Older People : Cluster Randomized Trial

NARCIS (Netherlands)

Suijker, Jacqueline J.; van Rijn, Marjon; Buurman, Bianca M.; ter Riet, Gerben; van Charante, Eric P. Moll; de Rooij, Sophia E.

2016-01-01

Background To evaluate the effects of nurse-led multifactorial care to prevent disability in community-living older people. Methods In a cluster randomized trail, 11 practices (n = 1,209 participants) were randomized to the intervention group, and 13 practices (n = 1,074 participants) were

Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi.

Science.gov (United States)

Lorenzo, Theresa; van Pletzen, Ermien; Booyens, Margaret

2015-01-01

Persons with disabilities and their families still live with stigma and a high degree of social exclusion especially in rural areas, which are often poorly resourced and serviced. Community-based workers in health and social development are in an ideal position to assist in providing critical support for some of those most at risk of neglect in these areas. This article analyses the work of community disability workers (CDWs) in three southern African countries to demonstrate the competencies that these workers acquired to make a contribution to social justice for persons with disabilities and their families. It points to some gaps and then argues that these competencies should be consolidated and strengthened in curricula, training and policy. The article explores local experiences and practices of CDWs so as to understand and demonstrate their professional competencies and capacity to deliver disability-inclusive services in rural areas, ways that make all information, activities and programs offered accessible and available to persons with disabilities. A qualitative interpretive approach was adopted, informed by a life history approach. Purposive sampling was used to select 16 CDWs who had at least 5 years experience of disability-related work in a rural area. In-depth interviews with CDWs were conducted by postgraduate students in Disability Studies. An inductive and interpretative phenomenological approach was used to analyse data. Three main themes with sub-categories emerged demonstrating the competencies of CDWs. First, integrated management of health conditions and impairments within a family focus comprised 'focus on the functional abilities' and 'communication, information gathering and sharing'. Second, negotiating for disability-inclusive community development included four sub-categories, namely 'mobilising families and community leaders', 'finding local solutions with local resources', 'negotiating retention and transitions through the education

Feasibility of a UK community-based, eTherapy mental health service in Greater Manchester: repeated-measures and between-groups study of 'Living Life to the Full Interactive', 'Sleepio' and 'Breaking Free Online' at 'Self Help Services'.

Science.gov (United States)

Elison, Sarah; Ward, Jonathan; Williams, Chris; Espie, Colin; Davies, Glyn; Dugdale, Stephanie; Ragan, Kathryn; Chisnall, Leanne; Lidbetter, Nicky; Smith, Keith

2017-07-20

There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service. 'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester. 1068 service users referred to the service for secondary care for their mental health difficulties. Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need. Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment. Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, pmental health scores were found within all three groups (all pmental health difficulties (pmental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Pharmacy in transition: A work sampling study of community pharmacists using smartphone technology.

Science.gov (United States)

van de Pol, Jeroen M; Geljon, Jurjen G; Belitser, Svetlana V; Frederix, Geert W J; Hövels, Anke M; Bouvy, Marcel L

2018-03-09

The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice. Self-reporting work sampling was used to register the activities of community pharmacists. A smartphone application, designed specifically for this purpose, alerted participants to register their current activity five times per working day for 6 weeks. Participants also completed an online survey about baseline characteristics. Ninety-one Dutch community pharmacists provided work-sampling data (7848 registered activities). Overall, 51.5% of their time was spent on professional activities, 35.4% on semi-professional activities, and 13.1% on non-professional activities. The proportion of time devoted to CPS decreased during the workweek, whereas the time spent on traditional task increased. This study shows it is feasible to collect work-sampling data using smartphone technology. Community pharmacists spent almost half of their time on semi-professional and non-professional activities, activities that could be delegated to other staff members. In practice, the transition to CPS is hampered by competing traditional tasks, which prevents community pharmacists from profiling themselves as pharmaceutical experts in daily practice. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Role of art centres for Aboriginal Australians living with dementia in remote communities.

Science.gov (United States)

Lindeman, Melissa; Mackell, Paulene; Lin, Xiaoping; Farthing, Annie; Jensen, Heather; Meredith, Maree; Haralambous, Betty

2017-06-01

To explore the role art centres in remote communities play for Aboriginal and Torres Strait Islander Australians living with dementia. A comprehensive literature search was undertaken, with no restrictions on articles regarding year of publication. Art programmes have been found to be of benefit to both people living with dementia and their carers, particularly when programmes are administered in environments that are culturally revered. Findings indicate remote art centres play a key role in maintaining traditions, culture and practices unique to Aboriginal and Torres Strait Islanders, but there is a gap in knowledge regarding how they cater for the needs of people with dementia. Addressing this gap will be helpful in remote areas where prevalence of dementia is up to five times that of non-Aboriginal people, and there are limited health and support services. Further research is required to explore strengths and gaps of current practices. © 2017 AJA Inc.

The Value of a Gardening Service for the Frail Elderly and People With a Disability Living in the Community.

Science.gov (United States)

Same, Anne; Lee, Elinda Ai Lim; McNamara, Beverley; Rosenwax, Lorna

2016-11-01

Little is known about the significance of gardening services for frail elderly people. This study explored the value of a gardening service for frail older people and people with a disability living in the community. Using qualitative and quantitative data collected from pre-gardening ( n = 38) and post-gardening service delivery interviews ( n = 35) and the Housing Enabler, the value of a gardening service was examined. Findings suggest that the service had a positive impact on the independence and emotional well-being of frail aged people and younger people with a functional disability, with little impact on physical health. Results indicate that gardening services should be fundamental to planning for these populations to remain or return to living in the community.

Predicting domestic and community violence by soldiers living in a conflict region.

Science.gov (United States)

Nandi, Corina; Elbert, Thomas; Bambonye, Manassé; Weierstall, Roland; Reichert, Manfred; Zeller, Anja; Crombach, Anselm

2017-11-01

Past research revealed war trauma and posttraumatic stress disorder (PTSD) symptoms as potential predictors for domestic and community violence in crisis regions and among soldiers in different armed conflicts. The impact of family violence and other adversities experienced in childhood as well as of a combat-enhanced appeal for aggressive behavior (appetitive aggression) remains to be specified. In the present study, the authors separately predicted violence against children, intimate partner violence and community violence in 381 Burundian soldiers returning from foreign deployment and living in a post- conflict region. Using path analysis, they aimed to disentangle the independent contributions and pathways of the following variables: Exposure to war trauma and childhood familial violence, PTSD and depression symptom severity, and appetitive aggression. Childhood familial violence had an independent effect on all contexts of violence and was the only significant predictor for violence against the soldiers' own children. Intimate partner violence was additionally predicted by depression symptom severity, while community violence was additionally predicted by PTSD symptom severity and appetitive aggression. Besides war-related mental ill-health and appetitive aggression, violent experiences during childhood development must not be overlooked as a factor fueling the cycle of violence in conflict regions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Transition-Metal-Free Biomolecule-Based Flexible Asymmetric Supercapacitors.

Science.gov (United States)

Yang, Yun; Wang, Hua; Hao, Rui; Guo, Lin

2016-09-01

A transition-metal-free asymmetric supercapacitor (ASC) is successfully fabricated based on an earth-abundant biomass derived redox-active biomolecule, named lawsone. Such an ASC exhibits comparable or even higher energy densities than most of the recently reported transition-metal-based ASCs, and this green ASC generation from renewable resources is promising for addressing current issues of electronic hazard processing, high cost, and unsustainability. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Exploring the Academic and Social Experiences of Latino Engineering Community College Transfer Students at a 4-Year Institution: A Qualitative Research Study

Science.gov (United States)

Hagler, LaTesha R.

As the number of historically underrepresented populations transfer from community college to university to pursue baccalaureate degrees in science, technology, engineering, and mathematics (STEM), little research exists about the challenges and successes Latino students experience as they transition from 2-year colleges to 4-year universities. Thus, institutions of higher education have limited insight to inform their policies, practices, and strategic planning in developing effective sources of support, services, and programs for underrepresented students in STEM disciplines. This qualitative research study explored the academic and social experiences of 14 Latino engineering community college transfer students at one university. Specifically, this study examined the lived experiences of minority community college transfer students' transition into and persistence at a 4-year institution. The conceptual framework applied to this study was Schlossberg's Transition Theory, which analyzed the participant's social and academic experiences that led to their successful transition from community college to university. Three themes emerged from the narrative data analysis: (a) Academic Experiences, (b) Social Experiences, and (c) Sources of Support. The findings indicate that engineering community college transfer students experience many challenges in their transition into and persistence at 4-year institutions. Some of the challenges include lack of academic preparedness, environmental challenges, lack of time management skills and faculty serving the role as institutional agents.

Building a community-based culture of evaluation.

Science.gov (United States)

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

2017-12-01

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

Community-based biological control of malaria mosquitoes using Bacillus thuringiensis var. israelensis (Bti) in Rwanda: community awareness, acceptance and participation.

Science.gov (United States)

Ingabire, Chantal Marie; Hakizimana, Emmanuel; Rulisa, Alexis; Kateera, Fredrick; Van Den Borne, Bart; Muvunyi, Claude Mambo; Mutesa, Leon; Van Vugt, Michelle; Koenraadt, Constantianus J M; Takken, Willem; Alaii, Jane

2017-10-03

Targeting the aquatic stages of malaria vectors via larval source management (LSM) in collaboration with local communities could accelerate progress towards malaria elimination when deployed in addition to existing vector control strategies. However, the precise role that communities can assume in implementing such an intervention has not been fully investigated. This study investigated community awareness, acceptance and participation in a study that incorporated the socio-economic and entomological impact of LSM using Bacillus thuringiensis var. israelensis (Bti) in eastern Rwanda, and identified challenges and recommendations for future scale-up. The implementation of the community-based LSM intervention took place in Ruhuha, Rwanda, from February to July 2015. The intervention included three arms: control, community-based (CB) and project-supervised (PS). Mixed methods were used to collect baseline and endline socio-economic data in January and October 2015. A high perceived safety and effectiveness of Bti was reported at the start of the intervention. Being aware of malaria symptoms and perceiving Bti as safe on other living organisms increased the likelihood of community participation through investment of labour time for Bti application. On the other hand, the likelihood for community participation was lower if respondents: (1) perceived rice farming as very profitable; (2) provided more money to the cooperative as a capital; and, (3) were already involved in rice farming for more than 6 years. After 6 months of implementation, an increase in knowledge and skills regarding Bti application was reported. The community perceived a reduction in mosquito density and nuisance biting on treated arms. Main operational, seasonal and geographical challenges included manual application of Bti, long working hours, and need for transportation for reaching the fields. Recommendations were made for future scale-up, including addressing above-mentioned concerns and

International comparison of cost of falls in older adults living in the community: a systematic review.

Science.gov (United States)

Davis, J C; Robertson, M C; Ashe, M C; Liu-Ambrose, T; Khan, K M; Marra, C A

2010-08-01

Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries. The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community. This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged > or =60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond's checklist. Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK. The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries.

Live face detection based on the analysis of Fourier spectra

Science.gov (United States)

Li, Jiangwei; Wang, Yunhong; Tan, Tieniu; Jain, Anil K.

2004-08-01

Biometrics is a rapidly developing technology that is to identify a person based on his or her physiological or behavioral characteristics. To ensure the correction of authentication, the biometric system must be able to detect and reject the use of a copy of a biometric instead of the live biometric. This function is usually termed "liveness detection". This paper describes a new method for live face detection. Using structure and movement information of live face, an effective live face detection algorithm is presented. Compared to existing approaches, which concentrate on the measurement of 3D depth information, this method is based on the analysis of Fourier spectra of a single face image or face image sequences. Experimental results show that the proposed method has an encouraging performance.

A Comparison of Live Classroom Instruction and Internet-Based Lessons for a Preparatory Training Course Delivered to 4th Year Pharmacy Students

Science.gov (United States)

Nuffer, Wesley; Duke, Jodi

2013-01-01

To compare the effectiveness of an internet-based training series with a traditional live classroom session in preparing pharmacy students to oversee a diabetes management program in community settings. Two cohorts of students were identified that prepared by utilizing a recorded online training exclusively, and two separate cohorts of students…

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

African Journals Online (AJOL)

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

Perceived Stigma towards Leprosy among Community Members Living Close to Nonsomboon Leprosy Colony in Thailand

Science.gov (United States)

Kaehler, Nils; Adhikar, Bipin; Raut, Shristi; Marahatta, Sujan Babu; Chapman, Robert Sedgwick

2015-01-01

Background Interpretation of Leprosy as a sickness differs among society. The set of beliefs, knowledge and perceptions towards a disease play a vital role in the construction of stigma towards a disease. The main purpose of this study was to explore the extent and correlates of the perceived stigma towards leprosy in the community living close to the leprosy colony in Non Somboon region of Khon Kaen Province of Thailand. Methods A cross-sectional study was conducted among 257 leprosy unaffected community participants, above the age of 18 who were living close to the Leprosy colony in Non Somboon region of Thailand. Each participant was asked a questionnaire containing characteristics of the participants in terms of socio-demographic background and knowledge regarding the disease. In addition perceived stigma towards leprosy was measured using EMIC (Explanatory Model Interview Catalogue) questionnaire. Results Among EMIC items, shame or embarrassment in the community due to leprosy was felt by 54.5%, dislike to buy food from leprosy affected persons were 49.8% and difficulty to find work for leprosy affected persons were perceived by 47.1%. Higher total EMIC score was found in participants age 61 years or older (p = 0.021), staying longer in the community (p = 0.005), attending fewer years of education (p = 0.024) and who were unemployed (p = 0.08). Similarly, perceptions about leprosy such as difficult to treat (p = 0.015), severe disease (p = 0.004) and punishment by God (p = 0.011) were significantly associated with higher perceived stigma. Conclusions Perceived stigma towards leprosy was found highest among participants with age 61 years or older, longer duration of stay in community close to the leprosy colony, lower duration of education and participants who were unemployed had higher perceived stigma. Similarly, participants with perceptions of leprosy such as difficult to treat, severe disease and punishment by God had higher perceived stigma towards

Prevalence and predictors of HIV-related stigma among institutional- and community-based caregivers of orphans and vulnerable children living in five less-wealthy countries

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Messer Lynne C

2010-08-01

Full Text Available Abstract Background In the face of the HIV/AIDS epidemic that has contributed to the dramatic increase in orphans and abandoned children (OAC worldwide, caregiver attitudes about HIV, and HIV-related stigma, are two attributes that may affect caregiving. Little research has considered the relationship between caregiver attributes and caregiver-reported HIV-related stigma. In light of the paucity of this literature, this paper will describe HIV-related stigma among caregivers of OAC in five less wealthy nations. Methods Baseline data were collected between May 2006 through February 2008. The sample included 1,480 community-based and 192 institution-based caregivers. Characteristics of the community-based and institution-based caregivers are described using means and standard deviations for continuous variables or counts and percentages for categorical variables. We fit logistic regression models, both for the full sample and separately for community-based and institution-based caregivers, to explore predictors of acceptance of HIV. Results Approximately 80% of both community-based and institution-based caregivers were female; and 84% of institution-based caregivers, compared to 66% of community-based caregivers, said that they would be willing to care for a relative with HIV. Similar proportions were reported when caregivers were asked if they were willing to let their child play with an HIV-infected child. In a multivariable model predicting willingness to care for an HIV-infected relative, adjusted for site fixed effects, being an institution-based caregiver was associated with greater willingness (less stigma than community-based caregivers. Decreased willingness was reported by older respondents, while willingness increased with greater formal education. In the adjusted models predicting willingness to allow one's child to play with an HIV-infected child, female gender and older age was associated with less willingness. However, willingness

A review of instruments to measure interprofessional collaboration for chronic disease management for community-living older adults.

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Bookey-Bassett, Sue; Markle-Reid, Maureen; McKey, Colleen; Akhtar-Danesh, Noori

2016-01-01

It is acknowledged internationally that chronic disease management (CDM) for community-living older adults (CLOA) is an increasingly complex process. CDM for older adults, who are often living with multiple chronic conditions, requires coordination of various health and social services. Coordination is enabled through interprofessional collaboration (IPC) among individual providers, community organizations, and health sectors. Measuring IPC is complicated given there are multiple conceptualisations and measures of IPC. A literature review of several healthcare, psychological, and social science electronic databases was conducted to locate instruments that measure IPC at the team level and have published evidence of their reliability and validity. Five instruments met the criteria and were critically reviewed to determine their strengths and limitations as they relate to CDM for CLOA. A comparison of the characteristics, psychometric properties, and overall concordance of each instrument with salient attributes of IPC found the Collaborative Practice Assessment Tool to be the most appropriate instrument for measuring IPC for CDM in CLOA.

The family and community lives of older people after the Second World War: new evidence from York.

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Freeman, Mark; Wannell, Louise

2009-01-01

This article uses the findings of a detailed and unpublished survey, carried out in York in 1947 and 1948, to examine the support networks, social lives and economic conditions of older people in a period when considerable sociological attention was being paid to this section of the population. It is argued that the sociology of old age in this period overstated the role of families, and downplayed the involvement of the wider community, in the social networks of older people. The article also shows that even many of those who were physically restricted in some way could participate fully in social activities. Friends, visiting and social clubs played an important role in many lives. However, the financial circumstances of many older people restricted many areas of social participation, and contemporaneous poverty surveys probably understated the real extent of poverty among the elderly. These high levels of poverty themselves underscore the importance of the family and community support networks that are uncovered using the York data.

Living Smart Homes: A Pilot Australian Sustainability Education Programme

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Miller, Evonne; Buys, Laurie; Bell, Lorraine

2009-01-01

This article documents the rationale and experience of a pilot Australian sustainability education programme, "Living Smart Homes" (LSH) based on a community-based social marketing model. Inspired by the Australian "Land for Wildlife" scheme, LSH is designed to engage homeowners with sustainable practices through face-to-face…

Living well to the end: A phenomenological analysis of life in extra care housing

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Rachel L. Shaw

2016-05-01

Full Text Available Objectives: To understand older adults’ experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. Design: A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. Methods: Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential–phenomenological theory of well-being. Results: Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. Conclusions: An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents’ quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling—empathic imagination—in caregiving may help staff and residents relate better to each other, thus helping individuals to

Living well to the end: A phenomenological analysis of life in extra care housing.

Science.gov (United States)

Shaw, Rachel L; West, Karen; Hagger, Barbara; Holland, Carol A

2016-01-01

To understand older adults' experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential-phenomenological theory of well-being. Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents' quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling-empathic imagination-in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end.

Determinants of utilization of a no-cost HIV transition clinic: a cross-sectional study of young adults living with HIV/AIDS

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Nyabigambo A

2014-05-01

Full Text Available Agnes Nyabigambo,1,2,* Joshua Kanaabi Muliira,3,* Lynn Atuyambe,1,* Harriet M Babikako,1,* Andrew Kambugu,2,* Christopher Ndoleriire4,* 1School of Public Health, 2Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda; 3College of Nursing, Sultan Qaboos University, Al Khod, Muscat, Oman; 4Department of ENT, College of Health Sciences, Makerere University, Kampala, Uganda*These authors contributed equally to this workAbstract: There is minimal research that has been conducted among young adults to understand the determinants of the utilization of human immunodeficiency virus (HIV health services in this population. The purpose of this study was to explore the levels and determinants of HIV transition clinic (HTC services utilization by young adults living with HIV/acquired immunodeficiency syndrome (YALHA. The study used a cross-sectional design and quantitative methods to collect data from a sample of 379 YALHA between the ages of 15–24 years who were registered clients of an HTC in Uganda. During data analysis, utilization was categorized into two levels: regular (kept all appointment visits and irregular (missed one or more appointment visits utilization. Univariable, bivariable, and multivariable logistic regression analyses were used to examine the determinants associated with HTC utilization. The HTC services that were most utilized by the YALHA were those based at the clinic and provided by professional health care providers and these were: clinical examination (96%; laboratory services (87.1%; and counseling (69.7%. The services that were least utilized were home visiting (5.8% and peer support services (19.8%. Of the 379 YALHA, only 32.4% regularly utilized the HTC. Multivariable analysis showed that the main determinants of HTC utilization were CD4 count category of ≥251/µL (adjusted odds ratio [AOR] =0.58, 95% confidence interval [CI] =0.36–0.95; not being on antiretroviral therapy (AOR

Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

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Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

2012-07-11

In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

Community participation and mental health during retirement in community sample of Australians.

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Olesen, Sarah C; Berry, Helen L

2011-03-01

This study considered whether community participation during later adulthood is more strongly associated with mental health during retirement than it is while in employment; i.e. in the absence of paid work. Participants were 322 men and 311 women aged 45 years and older, who were part of a random sample of an Australian coastal community. The frequency of participation across 14 types of community-based activities was assessed. Overall mental health was measured on a 10-item Kessler Psychological Distress Scale. Linear regression models tested the multivariate associations between distress and community participation, and whether this association differed for retired and working people. Retirees did not participate in their communities more than working people. The association between community participation and psychological distress did not differ by retirement status when people of all ages were considered together; however, stronger associations between several activities and (less) distress were found for retirees compared to their working peers in a younger cohort (aged 45 to 54). This cohort coincides with the average age of transition to retirement in Australia. These findings offer some support for the view that community participation may assist in managing the mental health implications of the transition from work to retirement.

The Urban Transition Performance of Resource-Based Cities in Northeast China

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Juntao Tan

2016-10-01

Full Text Available Resource-based cities face unique challenges when undergoing urban transitions because their non-renewable resources will eventually be exhausted. In this article, we introduce a new method of evaluating the urban transition performance of resource-based cities from economic, social and eco-environmental perspectives. A total of 19 resource-based cities in Northeast China are studied from 2003 to 2012. The results show that resource-based cities in Jilin and Liaoning provinces performed better than those in Heilongjiang province. Liaoyuan, Songyuan and Baishan were ranked as the top three resource-based cities; and Jixi, Yichun and Heihe were ranked last. Multi-resource and petroleum resource-based cities performed better than coal and forestry resource-based cities. We also analyzed the factors influencing urban transition performance using the method of the geographic detector. We found that capital input, road density and location advantage had the greatest effects on urban transition performance, followed by urban scale, remaining resources and the level of sustainable development; supporting policies and labor input had the smallest effects. Based on these insights, we have formulated several recommendations to facilitate urban transitions in China’s resource-based cities.

Community-based approaches to address childhood undernutrition and obesity in developing countries.

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Shetty, Prakash

2009-01-01

Community-based approaches have been the mainstay of interventions to address the problem of child malnutrition in developing societies. Many programs have been in operation in several countries for decades and originated largely as social welfare, food security and poverty eradication programs. Increasingly conceptual frameworks to guide this activity have been developed as our understanding of the complex nature of the determinants of undernutrition improves. Alongside this evolution, is the accumulation of evidence on the types of interventions in the community that are effective, practical and sustainable. The changing environment is probably determining the altering scenario of child nutrition in developing societies, with rapid developmental transition and urbanization being responsible for the emerging problems of obesity and other metabolic disorders that are largely the result of the now well-recognized linkages between child undernutrition and early onset adult chronic diseases. This dramatic change is contributing to the double burden of malnutrition in developing countries. Community interventions hence need to be integrated and joined up to reduce both aspects of malnutrition in societies. The evidence that community-based nutrition interventions can have a positive impact on pregnancy outcomes and child undernutrition needs to be evaluated to enable programs to prioritize and incorporate the interventions that work in the community. Programs that are operational and successful also need to be evaluated and disseminated in order to enable countries to generate their own programs tailored to tackling the changing nutritional problems of the children in their society. Copyright (c) 2009 S. Karger AG, Basel.

Evaluating a novel Integrated Community of Care (ICoC) for patients from an urbanised low-income community in Singapore using the participatory action research (PAR) methodology: a study protocol.

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Low, Lian Leng; Maulod, Adlina; Lee, Kheng Hock

2017-10-08

Poorer health outcomes and disproportionate healthcare use in socioeconomically disadvantaged patients is well established. However, there is sparse literature on effective integrated care interventions that specifically target these high-risk individuals. The Integrated Community of Care (ICoC) is a novel care model that integrates hospital-based transitional care with health and social care in the community for high-risk individuals living in socially deprived communities. This study aims to evaluate the effectiveness of the ICoC in reducing acute hospital use and investigate the implementation process and its effects on clinical outcomes using a mixed-methods participatory action research (PAR) approach. This is a single-centre prospective, controlled, observational study performed in the SingHealth Regional Health System. A total of 250 eligible patients from an urbanised low-income community in Singapore will be enrolled during their index hospitalisation. Our PAR model combines two research components: quantitative and qualitative, at different phases of the intervention. Outcomes of acute hospital use and health-related quality of life are compared with controls, at 30 days and 1 year. The qualitative study aims at developing a more context-specific social ecological model of health behaviour. This model will identify how influences within one's social environment: individual, interpersonal, organisational, community and policy factors affect people's experiences and behaviours during care transitions from hospital to home. Knowledge on the operational aspects of ICoC will enrich our evidence-based strategies to understand the impact of the ICoC. The blending of qualitative and quantitative mixed methods recognises the dynamic implementation processes as well as the complex and evolving needs of community stakeholders in shaping outcomes. Ethics approval was granted by the SingHealth Centralised Institutional Review Board (CIRB 2015/2277). The findings

Government, market and community in urban solid waste management; problems and potentials in the transition to sustainable development?

NARCIS (Netherlands)

Post, J.; Baud, I.S.A.; Baud, I.S.A.; Furedy, C.; Post, J.

2004-01-01

-Post, Johan and Isa Baud (2004) Government, market and community in urban solid waste management; problems and potentials in the transition to sustainable development? in: Baud, Isa., Johan. Post and Christine Furedy (2004) Solid Waste Management and Rec

Healthy living in Nunavut: an on-line nutrition course for inuit communities in the Canadian arctic.

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Hamilton, Sue; Martin, Jeff; Guyot, Melissa; Trifonopoulos, Mary; Caughey, Amy; Chan, Hing Man

2004-09-01

It is recognized that empowerment of Indigenous Peoples through training and education is a priority. The objective was to design a course that would provide an innovative training approach to targeted workers in remote communities and enhance learning related to the Nunavut Food Guide, traditional food and nutrition, and diabetes prevention. A steering committee was established at the outset of the project with representation from McGill University and the Government of Nunavut (including nutritionists, community nurses and community health representatives (CHRs), as well as with members of the target audience. Course content and implementation, as well as recruitment of the target audience, were carried out with guidance from the steering committee. An 8-week long course was developed for delivery in January - March, 2004. Learning activities included presentation of the course content through stories, online self-assessment quizzes, time-independent online discussions and telephone-based discussions. Invitations were extended to all prenatal nutrition program workers, CHRs, CHR students, home-care workers, Aboriginal Diabetes Initiative workers and public health nurses in Nunavut. Ninety-six health-care workers registered for Healthy Living in Nunavut, with 44 actively participating, 23 with less active participation and 29 who did not participate. Despite having to overcome numerous technological, linguistic and cultural barriers, approximately 40% of registrants actively participated in the online nutrition course. The internet may be a useful medium for delivery of information to target audiences in the North.

Factors in social interaction in cohousing communities

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Bouma, Jantine; Voorbij, Liek

2008-01-01

Cohousing communities can be considered alternatives for living independently in old age. However, currently the factors that influence the success of these communities are unclear. Based on literature and case studies gathered by students a new interactionmodel was created that shows the relevant

Community-based recreational football

DEFF Research Database (Denmark)

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

2014-01-01

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

A community-based healthy living promotion program improved self-esteem among minority children

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Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority c...

The association between nutrition transition score and measures of obesity: results from a cross-sectional study among Latina/o immigrants in Baltimore.

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Martínez, Airín D; Juon, Hee-soon; Levine, David M; Lyford-Pike, Victoria; Peters, Sadie

2014-07-07

Studies suggest that US Latinos have a higher prevalence of obesity than White Americans. However, obesity may differ by pre-immigration factors and Latinos' cultural representations of ideal body image. This paper explores whether country of origin's stage in the nutrition transition is related to Latino immigrants' BMI category and self-perception of weight. Primary data originated from a cross-sectional questionnaire of Latina/o immigrants in Baltimore in 2011. A convenience sample of self-identified Latinos, ≥18 years old, living in Baltimore was recruited from a community-based organization. Data for each country represented in the sample were obtained from the WHO Demographic and Health Surveys and the UN Food and Agriculture Organization. Each country was scored for its stage in the nutrition transition using a six-point scoring system. Descriptive statistics were conducted to characterize the sample. Bivariate analyses were conducted to examine the relationship between the outcome variables and the predictors. Multivariate logistic regressions were conducted to examine whether a country's stage in the nutrition transition increased one's odds of having an obese BMI score (≥30 kg/cm2) and perceiving one's weight as overweight, while controlling for socio-demographic variables. The sample (n = 149) consisted of immigrants from 12 Latin American countries. Participants lived in the US for x=10.24 years. About 40% of the sample had BMI ≥30 kg/m2 (obese). The longer Latina immigrants' lived in the US, the less likely their country of origin's nutrition transition score would increase their odds of having a BMI ≥30 kg/m2 (OR = 0.97 p nutrition transition score, the more likely BMI influenced Latino immigrants' perception of their weight as above normal (OR = 1.06, p nutrition transition score had a stronger effect on females than males. These results suggest that country of origin's nutrition transition score and gender affect Latino

Facilitating energy transition through energy commons : An application of socio-ecological systems framework for integrated community energy systems

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Acosta, Cristina; Ortega, Mariana; Bunsen, Till; Koirala, B.P.; Ghorbani, A.

2018-01-01

Integrated Community Energy Systems (ICES) are an emerging local energy system focusing on the collective use of distributed energy resources (DER). These socio-technical systems (STSs) have a high potential to advance the transition towards socially inclusive, environmentally-friendly energy

Facilitating energy transition through energy commons : An application of socio-ecological systems framework for integrated community energy systems

NARCIS (Netherlands)

Acosta, Cristina; Ortega, Mariana; Bunsen, Till; Koirala, Binod Prasad; Ghorbani, Amineh

2018-01-01

Integrated Community Energy Systems (ICES) are an emerging local energy system focusing on the collective use of distributed energy resources (DER). These socio-technical systems (STSs) have a high potential to advance the transition towards socially inclusive, environmentally-friendly energy

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

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

2013-01-01

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

Transit space

DEFF Research Database (Denmark)

Raahauge, Kirsten Marie

2008-01-01

This article deals with representations of one specific city, Århus, Denmark, especially its central district. The analysis is based on anthropological fieldwork conducted in Skåde Bakker and Fedet, two well-off neighborhoods. The overall purpose of the project is to study perceptions of space...... and the interaction of cultural, social, and spatial organizations, as seen from the point of view of people living in Skåde Bakker and Fedet. The focus is on the city dwellers’ representations of the central district of Århus with specific reference to the concept of transit space. When applied to various Århusian...

From Controlled Trial to Community Adoption: The Multisite Translational Community Trial

Science.gov (United States)

Murimi, Mary; Gonzalez, Anjelica; Njike, Valentine; Green, Lawrence W.

2011-01-01

Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. PMID:21680935

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

Science.gov (United States)

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

2013-01-01

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

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

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

2016-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

Age-Based Differences in Care Setting Transitions over the Last Year of Life

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Donna M. Wilson

2011-01-01

Full Text Available Context. Little is known about the number and types of moves made in the last year of life to obtain healthcare and end-of-life support, with older adults more vulnerable to care setting transition issues. Research Objective. Compare care setting transitions across older (65+ years and younger individuals. Design. Secondary analyses of provincial hospital and ambulatory database data. Every individual who lived in the province for one year prior to death from April 1, 2005 through March 31, 2007 was retained (N=19,397. Results. Transitions averaged 3.5, with 3.9 and 3.4 for younger and older persons, respectively. Older persons also had fewer ER and ambulatory visits, fewer procedures performed in the last year of life, but longer inpatient stays (42.7 days versus 36.2 for younger persons. Conclusion. Younger and older persons differ somewhat in the number and type of end-of-life care setting transitions, a matter for continuing research and healthcare policy.

Community and evidence-based approaches to healthcare ...

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

2016-04-29

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

Effect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prison.

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Rozanova, Julia; Brown, Shan-Estelle; Bhushan, Ambika; Marcus, Ruthanne; Altice, Frederick L

This paper examines how family and social relations facilitate and inhibit adherence to antiretroviraltherapy (ART) for people living with HIV (PLH) who have underlying substance use disorders and are transitioningto the community post-incarceration. Combining the methods of inductive close reading and constantcomparison, we analyzed the data from 30 semi-structured interviews of PLH who had recently transitioned to thecommunity within the previous 90 days. Three central themes were anticipated as important socialrelationships post-release: self-reported family, friends and clinicians. Among these, four sub-themes (social isolation, 'double jeopardy', search for belonging, and trust and respect) emerged, highlighting how they impacted ART adherence. Post-release, participants returned to resource-poor communities where they experienced socialisolation. ART adherence was enabled by having a purpose in life, which correlated with having robust family support structures. Many former prisoners felt that a chasm between them and their families existed, both because of HIV stigma and their addiction problems. In this context, relationships with untrustworthy friends from their druguse networks led to relapse of drug use and risky behaviors, jeopardizing participants' ART adherence and persistence. To avoid the double jeopardy, defined as seeking friends for support but who were also the ones who contributed to drug relapse, participants searched for new social anchors, which often included their healthcare providers who represented trusted and respected persons in their life. While some former prisonersperceived doctors as uncaring and their relationships asymmetrical, positive relationships with these providers,when respect and trust was mutual, reinforced the participants' sense of belonging to what they called 'the world that don't do drugs' and motivated them to adhere to ART.

Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.

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Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko

2014-09-01

In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

[Community-based approaches in the fight against Buruli ulcer : review of the literature].

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Ndongo, Paule Yolande; Fond-Harmant, Laurence; Deccache, Alain

2014-01-01

Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It mainly affects poor communities living close to bodies of water. In the absence of early treatment, this "neglected" disease can cause lasting deformities and may require limb amputation. It is reported in 34 countries and is the third most common mycobacterial disease in immunocompetent patients. Considerable progress has been made in treatment and prevention. The Cotonou Declaration (2009) describes the recommended control strategies. Although effective, current control strategies are limited because they do not take into account all the factors that influence emergence, prevention and cure of the disease. The control of Buruli ulcer mainly depends on intervention on social, cultural and psychosocial factors that influence preventive and self-care behaviour. The health promotion approach requires collaboration with populations in order to perform simultaneous actions on BU factors in the community setting. Although effective on many health problems, health promotion is not applied in the fight against BU due to the absence of action on all factors such as poverty. This article presents a review of the literature on BU strategies and community approaches. 407 relevant articles published in 1998-2013 period were examined. Eleven programmes are based on a top-down approach, which does not include populations in decision-making processes, unlike the bottom-up participatory approaches recommended in health promotion. Three health promotion programmes and 6 community-based participatory approaches were identified and examined. Community participation and empowerment constitute the basis for a community approach in the fight against Buruli ulcer.

Intergenerational Perspectives on Autonomy Following a Transition to a Continuing Care Retirement Community.

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Ayalon, Liat

2016-02-01

The study evaluated the concept of autonomy from the perspective of older adults and their adult children following a transition of the older adult to a continuing care retirement community (CCRC). Overall, 70 interviews (with older adults and their adult children; 34 dyads) were analyzed, using a line-by-line open coding, followed by dyadic analysis. Autonomy was not portrayed as a uniform, homogenous construct, but rather encompassed four different domains: (a) the focus of one's attention or concerns: on others, on self, or not at all; (b) the ability to exercise decisions and make independent choices; (c) the degree of physical functioning and ability of the older adult; and (d) the financial ability of the older adult. The duality in the relationships between older adults and their adult children is discussed in relation to the give and take of autonomy that occur following a transition to a CCRC. © The Author(s) 2015.

Students’ Lived Experience of Project-Based Learning

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Sandy Ferianda

2017-07-01

Full Text Available Inspired by personal experiences during the study time in the Graduate Program in English Language Studies (ELS Sanata Dharma University Yogyakarta, this research focused mainly on investigating the ELS students’ lived experience of project-based learning implemented by the ELS lecturers. This study employed hermeneutic phenomenology since it described and interpreted the meanings of ELS students lived experience. The participants of this study were the three ELS students considered to be illuminating from the three different streams batch of 2015. In this study we used one-on-one in depth interview to gain the data. The findings of this study consisted of four prefigured meanings and two emergent meanings namely a authentic learning, b learner autonomy, c cooperative learning, d multiple intelligences, e understanding others, and f personal development. The findings of this study gave implications not only to the ELS students and lecturers, but also to the audience. Lastly, recommendations were also addressed to the ELS students as their habit formation, to the ELS lecturers as their inputs to give more feedbacks to their students, and to the future researchers. Keywords: Lived experience, project-based learning.

An Overview of Quality Programs that Support Transition-Aged Youth

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Christopher M. Kalinyak

2016-12-01

Full Text Available This article provides a concise overview of several programs that deliver services to transition-aged youth, ages 14–29. Included are family support, the Assisting Unaccompanied Children and Youth program, the Substance Abuse and Mental Health Services Administration services, the wraparound approach, intensive home-based treatment, multisystemic therapy, foster care, independent living, mentoring, the Steps to Success program, the Jump on Board for Success program, the Options program, the Positive Action program, the Transition to Success model, and the Transition to Independence Program. Primary focus is placed upon the usefulness of each of the programs in facilitating successful outcomes for transition-aged youth.

Assessment of knowledge, attitude, and practice related to epilepsy: a community-based study

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Teferi J

2015-05-01

Full Text Available Jalle Teferi,1 Zewdu Shewangizaw2 1Addis Ababa Health Bureau, Zewuditu Specialized Hospital, Addis Ababa, Ethiopia; 2College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia Abstract: Religious and sociocultural beliefs influence the nature of treatment and care received by people with epilepsy. Many communities in Africa and other developing nations believe that epilepsy results from evil spirits, and thus, treatment should be through the use of herbaceous plants from traditional doctors and religious leadership. Community-based cross-sectional study designs were used to assess the knowledge, attitude, and practice related to epilepsy and its associated factors by using a pretested, semi-structured questionnaire among 660 respondents living in Sululta Woreda, Oromia, Ethiopia. According to the results of this study, 59.8% of the respondents possessed knowledge about epilepsy, 35.6% had a favorable attitude, and 33.5% of them adopted safe practices related to epilepsy. The following factors had significant association to knowledge, attitude, and practice related to epilepsy: being rural dwellers, living alone, those with more years of formal education, heard information about epilepsy, distance of health facility from the community, had witnessed an epileptic seizure, age range from 46 years to 55 years, had heard about epilepsy, prior knowledge of epilepsy, occupational history of being self-employed or a laborer, history of epilepsy, and history of epilepsy in family member. The findings indicated that the Sululta community is familiar with epilepsy, has an unfavorable attitude toward epilepsy, and unsafe practices related to epilepsy, but has a relatively promising knowledge of epilepsy. Keywords: Oromia, favorable attitude, safe practice, rural

Active living in rural Appalachia: Using the rural active living assessment (RALA tools to explore environmental barriers

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Adam Hege

2017-12-01

Full Text Available People residing in rural communities are more likely to be physically inactive and subsequently have elevated risks for chronic disease. Recent evidence has shown this could stem from environmental barriers, inadequate programming and policies directed at the promotion of physical activity (PA in rural settings. The objective of this research was to assess active living features in rural towns and townships (n=16 across seven counties in northwestern North Carolina (NC. The study utilized the Town-Wide and Street Segment components of the Rural Active Living Assessment (RALA as well as the 2014 American Community Survey results. The assessments were conducted in the summer of 2016 in the rural Appalachia region of NC. Using the RALA town-wide assessment scoring system (0−100, the range of scores was 18–84, with the mean being 50.06. Three towns had no sidewalks, nine towns had sidewalks on only one side of the main streets, and four had sidewalks on both sides of the main streets. One town was rated as highly walkable, seven towns as moderately walkable, five towns as moderately unwalkable, and three towns as highly unwalkable. The rural Appalachia region of NC offers unique topographic, geographic and environmental barriers to PA. However, our findings indicate many rural towns offer common PA amenities. Future research should utilize qualitative methods and a community-based participatory research approach to more fully understand the challenges with increasing PA in the rural and often isolated Appalachia communities. Keywords: Rural active living assessment (RALA, Health disparities, Physical activity, Rural Appalachia

Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant.

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Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Ng, Tze Pin

2013-01-01

The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

Barriers for pregnant women living in rural, agricultural villages to accessing antenatal care in Cambodia: A community-based cross-sectional study combined with a geographic information system.

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Yasuoka, Junko; Nanishi, Keiko; Kikuchi, Kimiyo; Suzuki, Sumihiro; Ly, Po; Thavrin, Boukheng; Omatsu, Tsutomu; Mizutani, Tetsuya

2018-01-01

Maternal morbidity and mortality is still a major public health issue in low- and middle-income countries such as Cambodia. Improving access to antenatal care (ANC) services for pregnant women has been widely recognized as one of the most effective means of reducing maternal mortality and morbidity. As such, this study examined the barriers for pregnant women living in rural, agricultural villages to accessing ANC based on data collected in the Ratanakiri province, one of the least developed provinces in Cambodia, using a combination of a community-based cross-sectional survey and a geographic information system (GIS). A community-based cross-sectional survey was conducted among 377 mothers with children under the age of two living in 62 villages in the Ratanakiri province, Cambodia, in December 2015. Face-to-face interviews were conducted to ask mothers about their ANC service use, knowledge of ANC, barriers to accessing health facilities, and complications they experienced during the most recent pregnancy. At the same time, GIS data were also collected using a Global Positioning System (GPS) to accurately measure actual travel distance of pregnant women to access health facilities and to examine geographical and environmental barriers in greater detail. Only a third of the mothers met the recommendations made by the World Health Organization (WHO) of receiving ANC four times or more (achieved ANC4+), and a quarter of the mothers had never received ANC during their most recent pregnancy. Factors positively associated with achieving ANC4+ were mother's secondary or higher education (adjusted odds ratio [AOR] = 5.50, 95% confidence interval [CI]: 1.74, 17.37), being aware that receiving ANC is recommended (AOR = 2.74, 95% CI: 1.25, 6.00), and knowledge about the recommended frequency for ANC (AOR = 2.26, 95% CI: 7.22). Actual travel distance was negatively associated with achieving ANC4+. Mothers who had to travel 10.0-14.9 km were 68% less likely (AOR = 0.32, 95

A narrative exploration of older people's transitions into residential care.

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Lee, Victoria S P; Simpson, Jane; Froggatt, Katherine

2013-01-01

Moving into residential care has been argued to be a significant life transition for older people, often resulting in stress and anxiety. This research aimed to explore qualitatively older people's experiences of this transition, including how relocation is reflected upon and incorporated into their personal narratives. Eight older adults (65-97 years) living in a residential facility for between three and 12 months participated in interviews focussed on their experiences of relocating to a residential care home. Narrative analysis revealed that rather than depicting time bound stages of transition, participants' experiences reflected key plots of 'control', 'power', 'identity' and 'uncertainty' interwoven throughout their narratives. Participants experienced some difficulties in incorporating this transition into their life stories. Furthermore, participants discussed not feeling confident in their decision to move, living in constant fear of losing their memory, and limited expectations for their future. Professionals should move away from considering transition as a stage-based process ending in acceptance, instead focussing on how residents perceive relocation in relation to previous life experiences, unspoken fears evoked by moving and how the environment and relationships with staff may be altered to assist residents in maintaining their identity and sense of control.

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

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

2015-01-01

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

Characteristics of Patients Accepting and Declining Participation in a Transition of Care Service Provided by a Community Pharmacy

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Julianne M Kowalski, PharmD

2017-02-01

Full Text Available Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service. Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis. Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%. None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29. Of the 66 patients who declined, 51 gave a reason (77.3%. Thirty-nine patients saw no benefit (76.5%, five patients had perceived barriers (10%, and seven patients gave reasons that fell into both categories (13.5%. Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential

Community capacity building and sustainability: outcomes of community-based participatory research.

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Hacker, Karen; Tendulkar, Shalini A; Rideout, Catlin; Bhuiya, Nazmim; Trinh-Shevrin, Chau; Savage, Clara P; Grullon, Milagro; Strelnick, Hal; Leung, Carolyn; DiGirolamo, Ann

2012-01-01

For communities, the value of community-based participatory research (CBPR) is often manifested in the outcomes of increased capacity and sustainable adoption of evidence-based practices for social change. Educational opportunities that promote discourse between community and academic partners can help to advance CBPR and better define these outcomes. This paper describes a community-academic conference to develop shared definitions of community capacity building and sustainability related to CBPR and to identify obstacles and facilitators to both. "Taking It to the Curbside: Engaging Communities to Create Sustainable Change for Health" was planned by five Clinical Translational Science Institutes and four community organizations. After a keynote presentation, breakout groups of community and academic members met to define community capacity building and sustainability, and to identify facilitators and barriers to achieving both. Groups were facilitated by researcher-community partner teams and conversations were recorded and transcribed. Qualitative analysis for thematic content was conducted by a subset of the planning committee. Important findings included learning that (1) the concepts of capacity and sustainability were considered interconnected; (2) partnership was perceived as both a facilitator and an outcome of CBPR; (3) sustainability was linked to "transfer of knowledge" from one generation to another within a community; and (4) capacity and sustainability were enhanced when goals were shared and health outcomes were achieved. Community capacity building and sustainability are key outcomes of CBPR for communities. Co-learning opportunities that engage and mutually educate both community members and academics can be useful strategies for identifying meaningful strategies to achieve these outcomes.

Community-based natural resource management

DEFF Research Database (Denmark)

Treue, Thorsten; Nathan, Iben

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

Modal Transition Systems as the Basis for Interface Theories and Product Lines

DEFF Research Database (Denmark)

Nyman, Ulrik

and a subset of modal transition systems is proved. The developed interface theory, which can describe liveness properties, is also applied as a behavioral variability theory for product line development. The two last papers of the thesis concern themselves with modal and mixed transition systems. The first....... It also proves PSPACE-hardness for consistency of mixed specifications and establishes a number of reductions between the different decision problems. Keywords: Modeling, Software Product Lines, Embedded Software, Modal Refinement, Labeled Transition Systems, Modal Transition Systems, Mixed Transition......This thesis presents research taking its outset in component-based software development, interface theory and software product lines, as well as modeling formalisms for describing component based software systems and their interfaces. The main part of the thesis consists of five papers. The first...

ECOLOGICAL INTELLIGENCE OF COASTAL COMMUNITY ON BIODIVERSITY CONSERVATION (Case Study of Bajau Coastal Communities, Gorontalo

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Ramli Utina

2017-04-01

Full Text Available Human behavior is a part of the ecological system, therefore overcoming the ecological crisis and living resources need to explore human traditions, way of life and human behavior toward natural resources. Understanding and translation of human harmonious relationship with all elements along with other living beings is a form of human ecological intelligence. The objective of this study was to describe the traditions and coastal communities behavior that contains the value of ecological intelligence in coastal biodiversity conservation. The study was based on observation, focus group discussion and identification of Bajau coastal community tradition in their lives and livelihoods on fishing, as well as the behavior toward biological resources. Bajau coastal communities settled in three villages in Pohuwato regency, Gorontalo. There are two themes that contains the value of ecological intelligence of  Bajau communities in the conservation of biodiversity, namely; mamia kadialo in tradition of fishing, and fishing behavior. The prohibition in the tradition of mamia kadialo contains the value of conservation of biodiversity. Usage of simple equipment on fishing activities provide a positive ecological consequences for the conservation of coastal biodiversity.

Female and Male Juvenile Offenders with Disabilities: Differences in the Barriers to Their Transition to the Community

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Unruh, Deanne; Bullis, Michael

2005-01-01

This article examined differences between young women and men who were incarcerated juvenile offenders with disabilities in Oregon in terms of the barriers they faced in their transition from the correctional system back into the community. Data were gathered on 72 females and 276 males, all of whom presented disabilities and who were…

Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial.

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Chatterjee, Sudipto; Leese, Morven; Koschorke, Mirja; McCrone, Paul; Naik, Smita; John, Sujit; Dabholkar, Hamid; Goldsmith, Kimberley; Balaji, Madhumitha; Varghese, Mathew; Thara, Rangaswamy; Patel, Vikram; Thornicroft, Graham

2011-01-13

There is a large treatment gap with few community services for people with schizophrenia in low income countries largely due to the shortage of specialist mental healthcare human resources. Community based rehabilitation (CBR), involving lay health workers, has been shown to be feasible, acceptable and more effective than routine care for people with schizophrenia in observational studies. The aim of this study is to evaluate whether a lay health worker led, Collaborative Community Based Care (CCBC) intervention, combined with usual Facility Based Care (FBC), is superior to FBC alone in improving outcomes for people with schizophrenia and their caregivers in India. This trial is a multi-site, parallel group randomised controlled trial design in India.The trial will be conducted concurrently at three sites in India where persons with schizophrenia will be screened for eligibility and recruited after providing informed consent. Trial participants will be randomly allocated in a 2:1 ratio to the CCBC+FBC and FBC arms respectively using an allocation sequence pre-prepared through the use of permuted blocks, stratified within site. The structured CCBC intervention will be delivered by trained lay community health workers (CHWs) working together with the treating Psychiatrist. We aim to recruit 282 persons with schizophrenia. The primary outcomes are reduction in severity of symptoms of schizophrenia and disability at 12 months. The study will be conducted according to good ethical practice, data analysis and reporting guidelines. If the additional CCBC intervention delivered by front line CHWs is demonstrated to be effective and cost-effective in comparison to usually available care, this intervention can be scaled up to expand coverage and improve outcomes for persons with schizophrenia and their caregivers in low income countries. The trial is registered with the International Society for the Registration of Clinical Trials and the allocated unique ID number is ISRCTN

Sexual Intimacy Constructions of Heterosexual Couples Living in a Low-Income, "Colored," Farmworker Community in South Africa.

Science.gov (United States)

Lesch, Elmien; Adams, Arlene R

2016-01-01

This study has been motivated by the scarcity of research that adopts an unproblematic focus on sexuality in South African Black and Colored low-income communities. We explored the sexual intimacy constructions of 15 Colored married/cohabiting couples who live in a low-income, historical South African farmworker community. Using a social constructionist thematic analysis method, we identified four themes: (a) metaphoric and indirect sexual language; (b) the use of a romantic discourse to talk about sexual experiences; (c) male-centered sexual relationships; and (d) lack of privacy brings both restriction and pleasure. We consider how these themes may be linked to the participants' community context and colonial and apartheid history. Finally, we emphasize the need for research that also explores positive sex functions and experiences rather than focuses narrowly on problematic sexual behavior.

Making daddies into fathers: community-based fatherhood programs and the construction of masculinities for low-income African American men.

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Roy, Kevin M; Dyson, Omari

2010-03-01

In this analysis, we explore how low-income African American fathers build understandings of successful manhood in the context of community-based responsible fatherhood programs. Drawing on life history interviews with 75 men in Illinois and Indiana, we explore men's attempts to fulfill normative expectations of fatherhood while living in communities with limited resources. We examine the efforts of community-based fatherhood programs to shape alternative African American masculinities through facilitation of personal turning points and "breaks with the past," use of social support and institutional interventions, and the reframing of provision as a priority of successful fatherhood. We refer to Connell's hegemonic masculinity framework (Connell in Masculinities, Polity Press, Cambridge, 1995) and discuss how both men and programs borrow from hegemonic and street masculinities to develop alternative approaches to paternal involvement for marginalized men.

Evidence-Based Approaches to Remedy and Also to Prevent Abuse of Community-Dwelling Older Persons

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Donna M. Wilson

2011-01-01

Full Text Available Elder abuse is a global issue, with an estimated 4–10% of older persons in Canada abused each year. Although Canadian legislation has been created to prevent and punish the abuse of older persons living in nursing homes and other care facilities, community-dwelling older persons are at greater risk of abuse. This paper highlights the importance of evidence-based actions targeted at three determinants of health: (a personal health practices and coping skills, (b social support networks, and (c social environments. Two research studies are profiled as case studies that illustrate the ready possibility and value of two specific types of actions on community-based older-person abuse. This paper argues for the immediate and widespread adoption of these evidence-based measures and for additional empirical evidence to guide the correction of underreporting of abuse, raise awareness of its serious nature, and increase options to not only stop it but ultimately prevent it.

Spousal Violence in 5 Transitional Countries: A Population-Based Multilevel Analysis of Individual and Contextual Factors.

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Ismayilova, Leyla

2015-11-01

I examined the individual- and community-level factors associated with spousal violence in post-Soviet countries. I used population-based data from the Demographic and Health Survey conducted between 2005 and 2012. My sample included currently married women of reproductive age (n = 3932 in Azerbaijan, n = 4053 in Moldova, n = 1932 in Ukraine, n = 4361 in Kyrgyzstan, and n = 4093 in Tajikistan). I selected respondents using stratified multistage cluster sampling. Because of the nested structure of the data, multilevel logistic regressions for survey data were fitted to examine factors associated with spousal violence in the last 12 months. Partner's problem drinking was the strongest risk factor associated with spousal violence in all 5 countries. In Moldova, Ukraine, and Kyrgyzstan, women with greater financial power than their spouses were more likely to experience violence. Effects of community economic deprivation and of empowerment status of women in the community on spousal violence differed across countries. Women living in communities with a high tolerance of violence faced a higher risk of spousal violence in Moldova and Ukraine. In more traditional countries (Azerbaijan, Kyrgyzstan, and Tajikistan), spousal violence was lower in conservative communities with patriarchal gender beliefs or higher financial dependency on husbands. My findings underscore the importance of examining individual risk factors in the context of community-level factors and developing individual- and community-level interventions.

Evaluation of the effectiveness of professionally guided self-care for people with multiple sclerosis living in the community: a randomized controlled trial.

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O'Hara, Louise; Cadbury, Heather; De, Souza Lorraine; Ide, Lorely

2002-03-01

The aim of the study was to assess the efficacy of a patient-focused professionally guided self-care programme for the management of multiple sclerosis (MS) in the community. This was a single-blind randomized controlled trial. The study was conducted with people with MS living in the community. Two hundred and seventy-eight people with MS were invited to take part in the study. One hundred and eighty-nine people consented to take part (68%). Of these 183 began the study and 169 (92.3%) completed it. Seventy-three individuals were in the intervention group and 96 were in the control group. The intervention comprised discussion of self-care based on client priorities, using an information booklet about self-care. These included the Barthel Index, a measure of mobility, the SF-36, and the Standard Day Dependency Record (SDDR) which measures the need for assistance with daily activities. Assessments were conducted at baseline and again six months later. Changes in health status were small. However, at follow-up the intervention group had better SF-36 health scores, in mental health (p = 0.04), and vitality (p = 0.05) and considered help with daily activities to be less essential, as measured by the SDDR (p = 0.04), than the control group. Participants in the intervention group had maintained levels of independence at follow-up (p = 0.62) while the control group showed a significant decrease in independence (p= 0.001). This intervention could be a useful aid for health professionals who are supporting people with MS living in the community.

Support needs of people living with Mycobacterium ulcerans (Buruli ulcer) disease in a Ghana rural community: a grounded theory study.

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Effah, Alex; Ersser, Steven J; Hemingway, Ann

2017-12-01

Mycobacterium ulcerans (also known as Buruli ulcer) disease is a rare skin disease which is prevalent in rural communities in the tropics mostly in Africa. Mortality rate is low, yet morbidity and consequent disabilities affect the quality of life of sufferers. The aim of this paper is to use the grounded theory method to explore the support needs of people living with the consequences of Buruli ulcer in an endemic rural community in Ghana. We used the grounded theory research approach to explore the experiences of people living with Mycobacterium ulcerans in a rural district in Ghana and provide a basis to understand the support needs of this group. The key support needs identified were: functional limitations, fear and frequency of disease recurrence, contracture of limbs and legs, loss of sensation and numbness in the affected body area, lack of information from health professionals about self-care, feeling tired all the time, insomnia, lack of good diet, lack of access to prostheses, having to walk long distances to access health services, and loss of educational opportunities. The study discusses how the systematically derived qualitative data has helped to provide a unique insight and advance our understanding of the support needs of people living with BU and how they live and attempt to adapt their lives with disability. We discuss how the availability of appropriate interventions and equipment could help them self-manage their condition and improve access to skin care services. The support needs of this vulnerable group were identified from a detailed analysis of how those living with BU coped with their lives. A key issue is the lack of education to assist self-management and prevent deterioration. Further research into the evaluation of interventions to address these support needs is necessary including self-management strategies. © 2017 The International Society of Dermatology.

Cultural and Rhetorical Bases for communicating knowledge in web based communities

DEFF Research Database (Denmark)

Kampf, Constance; Kommers, Piet

2008-01-01

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

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

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Loria, Kristen

2013-01-01

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

Evidence-Based Secondary Transition Practices for Enhancing School Completion

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Test, David W.; Fowler, Catherine H.; White, James; Richter, Sharon; Walker, Allison

2009-01-01

Approximately 28% of students with disabilities do not complete high school (National Longitudinal Transition Study-2, 2005). This increases the likelihood that these students will experience low wages, high rates of incarceration, and limited access to postsecondary education. This article reviews evidence-based secondary transition practices…

Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa.

Directory of Open Access Journals (Sweden)

Edwin Wouters

Full Text Available Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1 receive the support from a community-based health worker or (2 to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors-such as age, health status and coping styles-our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family's changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those

Peripheral blood cells among community residents living near nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Lee, Yuan-Teh; Hsu, Hsiu-Ching; Chien, Kuo-Liong; Yang, Chi-Yu; Chen, Wen Jone [Department of Internal Medicine, National Taiwan University College of Medicine, No. 7 Chungshan South Road, 10020 Taipei (Taiwan, Province of China); Sung, Fung C. [Institute of Environmental Health, National Taiwan University College of Public Health, Taipei (Taiwan, Province of China); Lin, Ruey S. [Institute of Epidemiology, National Taiwan University College of Public Health, Taipei (Taiwan, Province of China)

2001-12-03

Information about hematopoieses as a result of exposure to very low levels of radiation is scarce. To investigate the human hematopoietic effect of very low level radiation exposure, measurements of peripheral blood components were performed among 3602 men and women, aged 35 and above, living in a community near two nuclear power installations in Chinshan, Taiwan. The radiation level that each individual was exposed to was represented by a surrogate level, '+', a transformed distance from each individual's residence to the two power plants D{sub 1} and D{sub 2}. In addition to comparing average hematology measurements, multiple regression analyses were done to include age, gender, smoking, drinking status and the surrogate radiation exposure level as independent variables. Univariate and bivariate analyses showed that the hematology measurements had significant associations with age, gender, smoking or drinking. The multiple regression analyses revealed that significant positive associations with '+' were found for hemoglobin, hematocrit, platelet, white blood cell and red blood cell. The platelet count might increase for 208.7x10{sup 3}/{mu}l if the exposure from the nuclear plants increased by one exposure unit. This type of association implies that those who lived closer to the nuclear power installation had a higher blood cell count; we suspect that this could be a type of radiation hormesis.

The impact of seizures on epilepsy outcomes: A national, community-based survey.

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Josephson, Colin B; Patten, Scott B; Bulloch, Andrew; Williams, Jeanne V A; Lavorato, Dina; Fiest, Kirsten M; Secco, Mary; Jette, Nathalie

2017-05-01

The aim of this study was to examine the impact of seizures on persons living with epilepsy in a national, community-based setting. The data source was the Survey of Living with Neurological Conditions in Canada (SLNCC), a cohort derived from a national population-based survey of noninstitutionalized persons aged 15 or more years. Participants had to be on a seizure drug or to have had a seizure in the past 5 years to meet the definition of active epilepsy. The respondents were further stratified by seizure status: the seizure group experienced ≥1 seizure in the past 5 years versus the no seizure group who were seizure-free in the past ≥5 years regardless of medication status. Weighted overall and stratified prevalence estimates and odds ratios were used to estimate associations. The SLNCC included 713 persons with epilepsy with a mean age of 45.4 (standard deviation 18.0) years. Fewer people in the seizure group (42.7%) reported being much better than a year ago versus those in the no seizure group (70.1%). Of those with seizures, 32.1% (95% confidence interval [95% CI] 18.8-45.3) had symptoms suggestive of major depression (as per the Patient Health Questionnaire-9) compared to 7.7% (95% CI 3.4-11.9) of those without seizures. Driving, educational, and work opportunities were also significantly limited, whereas stigma was significantly greater in those with seizures. This community-based study emphasizes the need for seizure freedom to improve clinical and psychosocial outcomes in persons with epilepsy. Seizure freedom has an important influence on overall health, as those with at least one seizure over the prior 5 years had an increased risk of mood disorders, worse quality of life, and faced significantly more stigma. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Fear of falling and its predictors among community-living older adults in Korea.

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Oh, Eunmi; Hong, Gwi-Ryung Son; Lee, Seonhye; Han, Soojeong

2017-04-01

To explore the prevalence and predicting factors of fear of falling (FOF) among community-living older adults in Korea. Secondary data analysis of the 2011 Korean National Elderly Living Conditions and Welfare Desire Survey was used. Logistic regression analysis was conducted to examine the predictors of FOF. In total, 75.6% of older adults with normal cognition have FOF. Factors associated with an increased risk of FOF in older adults are previous experience with falling (OR = 3.734, 95% CI = 2.996-4.655), limitations in the performance of exercise involving lower extremities (OR = 2.428, 95% CI = 2.063-2.858), being female (OR = 2.335, 95% CI = 2.023-2.694), having more than three chronic diseases (OR = 1.994, 95% CI = 1.625-2.446), limitations in instrumental activities of daily living (IADLs) (OR = 1.745, 95% CI = 1.230-2.477), limitations in the performance of exercise involving upper extremities (OR = 1.646, 95% CI = 1.357-1.997), living without a spouse (OR = 1.626, 95% CI = 1.357-1.948), having poor self-rated health (OR = 1.571, 95% CI = 1.356-1.821), limitations in muscle strength (OR = 1.455, 95% CI = 1.150-1.841), age (≥75 years) (OR = 1.320, 95% CI = 1.150-1.516), lower levels of education (0-6 years) (OR = 1.231, 95% CI = 1.075-1.409), and life satisfaction (OR = 1.104, 95% CI = 1.065-1.114). A multidimensional construct of general characteristics, physical, and psychosocial variables act as risk factors for FOF. Preventive intervention should be developed to decrease the FOF among Korean older adults.

Integrated community-based dementia care: the Geriant model

Directory of Open Access Journals (Sweden)

Ludo Glimmerveen

2015-09-01

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

Genomic signatures of evolutionary transitions from solitary to group living

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Kapheim, Karen M.; Pan, Hailin; Li, Cai; Salzberg, Steven L.; Puiu, Daniela; Magoc, Tanja; Robertson, Hugh M.; Hudson, Matthew E.; Venkat, Aarti; Fischman, Brielle J.; Hernandez, Alvaro; Yandell, Mark; Ence, Daniel; Holt, Carson; Yocum, George D.; Kemp, William P.; Bosch, Jordi; Waterhouse, Robert M.; Zdobnov, Evgeny M.; Stolle, Eckart; Kraus, F. Bernhard; Helbing, Sophie; Moritz, Robin F. A.; Glastad, Karl M.; Hunt, Brendan G.; Goodisman, Michael A. D.; Hauser, Frank; Grimmelikhuijzen, Cornelis J. P.; Pinheiro, Daniel Guariz; Nunes, Francis Morais Franco; Soares, Michelle Prioli Miranda; Tanaka, Érica Donato; Simões, Zilá Luz Paulino; Hartfelder, Klaus; Evans, Jay D.; Barribeau, Seth M.; Johnson, Reed M.; Massey, Jonathan H.; Southey, Bruce R.; Hasselmann, Martin; Hamacher, Daniel; Biewer, Matthias; Kent, Clement F.; Zayed, Amro; Blatti, Charles; Sinha, Saurabh; Johnston, J. Spencer; Hanrahan, Shawn J.; Kocher, Sarah D.; Wang, Jun; Robinson, Gene E.; Zhang, Guojie

2017-01-01

The evolution of eusociality is one of the major transitions in evolution, but the underlying genomic changes are unknown. We compared the genomes of 10 bee species that vary in social complexity, representing multiple independent transitions in social evolution, and report three major findings. First, many important genes show evidence of neutral evolution as a consequence of relaxed selection with increasing social complexity. Second, there is no single road map to eusociality; independent evolutionary transitions in sociality have independent genetic underpinnings. Third, though clearly independent in detail, these transitions do have similar general features, including an increase in constrained protein evolution accompanied by increases in the potential for gene regulation and decreases in diversity and abundance of transposable elements. Eusociality may arise through different mechanisms each time, but would likely always involve an increase in the complexity of gene networks. PMID:25977371

Meeting the home-care needs of disabled older persons living in the community: does integrated services delivery make a difference?

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Raîche Michel

2011-10-01

Full Text Available Abstract Background The PRISMA Model is an innovative coordination-type integrated-service-delivery (ISD network designed to manage and better match resources to the complex and evolving needs of elders. The goal of this study was to examine the impact of this ISD network on unmet needs among disabled older persons living in the community. Methods Using data from the PRISMA study, we compared unmet needs of elders living in the community in areas with or without an ISD network. Disabilities and unmet needs were assessed with the Functional Autonomy Measurement System (SMAF. We used growth-curve analysis to examine changes in unmet needs over time and the variables associated with initial status and change. Sociodemographic characteristics, level of disability, self-perceived health status, cognitive functioning, level of empowerment, and the hours of care received were investigated as covariates. Lastly, we report the prevalence of needs and unmet needs for 29 activities in both areas at the end of the study. Results On average, participants were 83 years old; 62% were women. They had a moderate level of disability and mild cognitive problems. On average, they received 2.07 hours/day (SD = 1.08 of disability-related care, mostly provided by family. The findings from growth-curve analysis suggest that elders living in the area where ISD was implemented and those with higher levels of disability experience better fulfillment of their needs over time. Besides the area, being a woman, living alone, having a higher level of disability, more cognitive impairments, and a lower level of empowerment were linked to initial unmet needs (r2 = 0.25; p Conclusions In spite of more than 30 years of home-care services in the province of Quebec, disabled older adults living in the community still have unmet needs. ISD networks such as the PRISMA Model, however, appear to offer an effective response to the long-term-care needs of the elderly.

Health care transition for adolescents with special health care needs: a report on the development and use of a clinical transition service.

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McLaughlin, Suzanne; Bowering, Nancy; Crosby, Barbara; Neukirch, Jodie; Gollub, Eliza; Garneau, Deborah

2013-04-01

A growing population of adolescents with special healthcare needs is aging into adulthood. These emerging adults face the transition challenges of their healthy peers but also potentially heightened risks and challenges related to their conditions. We describe the process of developing a pilot program to support healthcare services for emerging adults with chronic conditions and present preliminary data on utilization. An outpatient multidisciplinary consult model was developed based on patient, family and physician feedback. Patients with diverse conditions were equally referred from primary care, subspecialists and families and community agencies. Services provided included needs assessments (100%), referral to adult physicians (77%), care coordination (52%) and referrals to adult community services (10%). Clinical billing did not fully support the cost of providing services. The pilot program offered multidisciplinary transition services that were utilized by a diverse patient population. Local and national resources for health care transition are provided.

Social Work and Lived Citizenship

DEFF Research Database (Denmark)

Warming, Hanne; Fahnøe, Kristian

2017-01-01

Warming and Fahnøe offers, through introduction of the sensitising concept of lived citizenship and a socio-spatial perspective, a much needed renewal of the rights and strength based approach to social work practice and research towards an almost anthropological understanding of the social...... of meaning and power as (re-) producing practices through which clients experience and negotiate rights, responsibilities, participation, identity and belonging, and thereby of dynamics of inclusion and exclusion related to social work....... situation of vulnerable groups. Indeed, they show how the concept of lived citizenship, and four supporting concepts (disciplinary versus inclusive identity shaping; intimate citizenship; space; community governance) enables contextualized analyses of the complexities of social work as a social space...

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

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

2016-03-01

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

The everyday lives of energy transitions: Contested sociotechnical imaginaries in the American West.

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Smith, Jessica M; Tidwell, Abraham Sd

2016-06-01

This article brings together two growing literatures - on sociotechnical imaginaries in science and technology studies and on resource materialities in anthropology - to explore how two energy-producing communities in the American West understand the moral salience of energy systems and the place of labor within them. Studies of energy sociotechnical imaginaries overwhelmingly focus on the role that state and transnational actors play in shaping perceptions of the 'good society', rather than how these imaginaries inform and are transformed in the lived experience of everyday people. We illuminate the contested dimension of sociotechnical imaginaries and their positioning within structures of power that inform visions of moral behavior and social order. Whereas the role of energy in national imaginaries is grounded almost entirely in the consumption it enables, examining the everyday ethics of people who live and work in Colorado's uranium-rich Western Slope and Wyoming's coal-rich Powder River Basin reveals an insistence that 'good' energy systems also provide opportunities for dignified and well-paid blue-collar work. This imaginary, we argue, remains 'bounded' at a local scale rather than circulating more widely to gain national or international traction. Theorizing this boundedness illustrates not only the contested nature of sociotechnical imaginaries, but also the constraints that material assemblages and sediments of the past place on imagined futures.

Classification trees for identifying non-use of community-based long-term care services among older adults.

Science.gov (United States)

Penkunas, Michael James; Eom, Kirsten Yuna; Chan, Angelique Wei-Ming

2017-10-01

Home- and center-based long-term care (LTC) services allow older adults to remain in the community while simultaneously helping caregivers cope with the stresses associated with providing care. Despite these benefits, the uptake of community-based LTC services among older adults remains low. We analyzed data from a longitudinal study in Singapore to identify the characteristics of individuals with referrals to home-based LTC services or day rehabilitation services at the time of hospital discharge. Classification and regression tree analysis was employed to identify combinations of clinical and sociodemographic characteristics of patients and their caregivers for individuals who did not take up their referred services. Patients' level of limitation in activities of daily living (ADL) and caregivers' ethnicity and educational level were the most distinguishing characteristics for identifying older adults who failed to take up their referred home-based services. For day rehabilitation services, patients' level of ADL limitation, home size, age, and possession of a national medical savings account, as well as caregivers' education level, and gender were significant factors influencing service uptake. Identifying subgroups of patients with high rates of non-use can help clinicians target individuals who are need of community-based LTC services but unlikely to engage in formal treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Community integration and life satisfaction among individuals with spinal cord injury living in the community after receiving institutional care in Bangladesh.

Science.gov (United States)

Ahmed, Nayeema; Quadir, Mohammad Morshedul; Rahman, Mohammad Akhlasur; Alamgir, Hasanat

2018-05-01

This study reports level of community integration and life satisfaction among individuals who sustained traumatic spinal cord injuries, received institutional rehabilitation care services, and went back to live in the community in Bangladesh. It examines the impact of type of injury, demographic characteristics, socio-economic profile, and secondary health conditions on community integration and life satisfaction and explores the association between these two measures. Individuals with spinal cord injury were telephone interviewed by the Centre for the Rehabilitation of the Paralysed, Bangladesh from February to June of 2014. Data were collected from the subjects on type of injury, demographic and socio-economic profile, and secondary health conditions. The outcome measures were determined by using two validated tools - Community Integration Questionnaire and Life Satisfaction 9 Questionnaire. Total community integration and life satisfaction scores were 15.09 and 3.69, respectively. A significant positive relationship between community integration and life satisfaction was revealed. Type of injury, gender, and age were found to be significant predictors of both community integration and life satisfaction scores. Higher education was significantly related to community integration and life satisfaction scores. Participants scored low in total community integration and life satisfaction, suggesting there is a great need to develop interventions by governmental and non-governmental organizations to better integrate individuals with spinal cord injury in the community. Implications for Rehabilitation Government and non-government organizations should offer disability friendly public transportation facilities for individuals with spinal cord injury so that they can return to education, resume employment, and involve in social activities. Entrepreneurs and businesses should develop assistive devices featuring low technology, considering the rural structure and housing