Sample records for sustainable community selfmanagement

  1. Sustaining self-management in diabetes mellitus. (United States)

    Mitchell-Brown, Fay


    Successful management of diabetes depends on the individual's ability to manage and control symptoms. Self-management of diabetes is believed to play a significant role in achieving positive outcomes for patients. Adherence to self-management behaviors supports high-quality care, which reduces and delays disease complications, resulting in improved quality of life. Because self-management is so important to diabetes management and involves a lifelong commitment for all patients, health care providers should actively promote ways to maintain and sustain behavior change that support adherence to self-management. A social ecological model of behavior change (McLeroy, Bibeau, Steckler, & Glanz, 1988) helps practitioners provide evidence-based care and optimizes patients' clinical outcomes. This model supports self-management behaviors through multiple interacting interventions that can help sustain behavior change. Diabetes is a complex chronic disease; successful management must use multiple-level interventions.

  2. Adapting Hypertension Self-Management Interventions to Enhance their Sustained Effectiveness among Urban African Americans


    Ameling, Jessica M.; Ephraim, Patti L.; Bone, Lee R.; Levine, David M.; Roter, Debra L.; Wolff, Jennifer L.; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L.; Noronha, Gary J.; Fagan, Peter J.; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette


    African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions’ cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community ...

  3. Adapting hypertension self-management interventions to enhance their sustained effectiveness among urban African Americans. (United States)

    Ameling, Jessica M; Ephraim, Patti L; Bone, Lee R; Levine, David M; Roter, Debra L; Wolff, Jennifer L; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L; Noronha, Gary J; Fagan, Peter J; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A; Aboumatar, Hanan J; Albert, Michael C; Flynn, Sarah J; Boulware, L Ebony


    African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions' cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial.

  4. Adapting Hypertension Self-Management Interventions to Enhance their Sustained Effectiveness among Urban African Americans (United States)

    Ameling, Jessica M.; Ephraim, Patti L.; Bone, Lee R.; Levine, David M.; Roter, Debra L.; Wolff, Jennifer L.; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L.; Noronha, Gary J.; Fagan, Peter J.; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A.; Aboumatar, Hanan J.; Albert, Michael C.; Flynn, Sarah J.; Boulware, L. Ebony


    African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions’ cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial. PMID:24569158

  5. Wellness and illness self-management skills in community corrections. (United States)

    Kelly, Patricia J; Ramaswamy, Megha; Chen, Hsiang-Feng; Denny, Donald


    Community corrections provide a readjustment venue for re-entry between incarceration and home for inmates in the US corrections system. Our goal was to determine how self-management skills, an important predictor of re-entry success, varied by demographic and risk factors. In this cross-sectional study, we analyzed responses of 675 clients from 57 community corrections programs run by the regional division of the Federal Bureau of Prisons. A self-administered survey collected data on self-management skills, demographics, and risk factors; significant associations were applied in four regression models: the overall self-management score and three self-management subscales: coping skills, goals, and drug use. Over one-quarter (27.2%/146) of participants had a mental health history. White race, no mental health history and high school education were associated with better overall self-management scores; mental health history and drug use in the past year were associated with lower coping scores; female gender and high school education were associated with better self-management goals; female gender was associated with better self-management drug use scores. Self-management programs may need to be individualized for different groups of clients. Lower scores for those with less education suggest an area for targeted, nurse-led interventions.

  6. The environmental self-management in the university community

    Directory of Open Access Journals (Sweden)

    Rogelio García-Tejera


    Full Text Available The System of Education Cuban power to the school like center promoter of the development, their social projection includes the satisfaction of the educational necessities of the community. The community environmental education for the sustainable development is inserted in the educational administration of the school like cultural center. To consider the university space as a community, he/she gives the possibility to carry out actions of self-management with the objective of improving the atmosphere in the university community, when the experiences that characterize to the cultural practices of the university students taking advantage. For the non formal road, it is contributed to the environmental formation, when stimulating the responsibility for the planning and execution of the methods that characterize the administration of their atmosphere, to make emphasis in the critic to the not wanted behaviors, to promote the voluntary commitment of the active participation of each one of their members and to achieve the work of the juvenile organizations.

  7. Improving hypertension self-management with community health coaches. (United States)

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman


    Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. © 2014 Society for Public Health Education.

  8. Permanence of Two Self-Managed Treatments of Overweight in University and Community Populations (United States)

    And Others; Hall, Robert G.


    Males and females from community and university samples were assigned to two self-management treatments, nonspecific, or no-treatment controls. At six month follow-up, differences were not significant. Results are discussed in terms of conceptualizations of self-management and the utility of treatments employed. (Author)

  9. Community Foresight for Urban Sustainability

    DEFF Research Database (Denmark)

    Mortensen, Jonas Egmose; Eames, Malcolm


    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...

  10. Activating Patients for Sustained Chronic Disease Self-Management: Thinking Beyond Clinical Outcomes. (United States)

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet H


    This article describes the impact of an 8-week community program implemented by trained volunteers on the hypertension self-management of 185 patients who were batch randomized to intervention or wait-list control groups. Compared with control group participants, a higher proportion of treatment group participants moved from the cognitive to behavioral stages of motivational readiness for being physically active (P healthy eating habits (P = .001), handling stress well (P = .001), and living an overall healthy lifestyle (P = .003). They also demonstrated a greater average increase in perceived competence for self-management, F(1.134) = 4.957, P = .028, η2 = .036, and a greater increase in mean hypertension-related knowledge, F(1.160) = 16.571, P < .0005, η(2) = .094. Enduring lifestyle changes necessary for chronic disease self-management require that psychosocial determinants of health behavior are instilled, which is typically beyond standard medical practice. We recommend peer-led, community-based programs as a complement to clinical care and support the increasing health system interest in promoting population health beyond clinical walls. © The Author(s) 2016.

  11. The environmental self-management in the university community: a road to propitiate desirable changes in the environmental behaviors of the university youths, from their own cultural practices

    Directory of Open Access Journals (Sweden)

    Rogelio García-Tejera


    Full Text Available The Cuban Education System power to the school as a promoter of development center, its social projection includes meeting the educational needs of the community, and community environmental education for sustainable development is inserted into the educational management of the school as cultural center of Higher Education. Consider the space as a community college gives the possibility of self-management actions, with the aim of improving environmental way the university community, using experiences that characterize the cultural practices of the university. For non-formal way contributes to environmental training, to stimulate responsibility for the planning and implementation of methods that characterize the management of their environment.

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

    NARCIS (Netherlands)

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


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

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

    NARCIS (Netherlands)

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


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

  14. Towards sustainable urban communities

    International Nuclear Information System (INIS)

    Haapio, Appu


    Requirements for the assessment tools of buildings have increased, assessing of building components or separate buildings is not enough. Neighbourhoods, built environment, public transportations, and services, should be considered simultaneously. Number of population living in urban areas is high and increasing rapidly. Urbanisation is a major concern due to its detrimental effects on the environment. The aim of this study is to clarify the field of assessment tools for urban communities by analysing the current situation. The focus is on internationally well known assessment tools; BREEAM Communities, CASBEE for Urban Development and LEED for Neigborhood Development. The interest towards certification systems is increasing amongst the authorities, and especially amongst the global investors and property developers. Achieved certifications are expected to bring measureable publicity for the developers. The assessment of urban areas enables the comparison of municipalities and urban areas, and notably supports decision making processes. Authorities, city planners, and designers would benefit most from the use of the tools during the decision making process. - Highlights: ► The urban assessment tools have strong linkage to the region. ► The tools promote complementary building and retrofitting existing sites. ► Sharing knowledge and experiences is important in the development of the tools.

  15. A theoretical framework for a virtual diabetes self-management community intervention. (United States)

    Vorderstrasse, Allison; Shaw, Ryan J; Blascovich, Jim; Johnson, Constance M


    Due to its high prevalence, chronic nature, potential complications, and self-management challenges for patients, diabetes presents significant health education and support issues. We developed and pilot-tested a virtual community for adults with type 2 diabetes to promote self-management education and provide social support. Although digital-based programs such as virtual environments can address significant barriers to reaching patients (i.e., child care, transportation, location), they must be strongly grounded in a theoretical basis to be well-developed and effective. In this article, we discuss how we synthesized behavioral and virtual environment theoretical frameworks to guide the development of SLIDES (Second Life Impacts Diabetes Education and Support). © The Author(s) 2014.

  16. Effects of a dietary self-management programme for community-dwelling older adults: a quasi-experimental design. (United States)

    Chen, Su-Hui; Huang, Yu-Ping; Shao, Jung-Hua


    Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations. To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults. For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis. Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts. Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable

  17. Premises of Sustainable Development on Rural Communities

    Directory of Open Access Journals (Sweden)

    Anca Turtureanu


    Full Text Available In this paper the authors want to highlight the opportunity on rural areas and development in termsof durability. The content of sustainable development offers to local communities real and lasting solutions.In this sense for a community to be truly sustainable, it must adopt a holistic approach, taking into accountshort-term environmental and economic sustainability of natural and cultural resources. The authors believethat a sustainable community among its objectives to include their major environmental issues, povertyeradication, improvement of quality of life, developing and maintaining an effective and viable localeconomies, leading to a global vision of sustainable development of all sectors of the community.

  18. Supporting self-management by Community Matrons through a group intervention; an action research study. (United States)

    Barkham, Abigail M; Ersser, Steven J


    The aim of this study was to examine the feasibility and impact of a group intervention by Community Matrons to support those living with multiple long-terms conditions. Little evidence exists as to how the role of the Community Matron (CM) should be delivered to effectively enhance disease self-management and levels of self-efficacy for the service users. This qualitative participatory action research study explored the use of group work as a method of intervention by CMs. A purposive sample of 29 participants was recruited. Each patient group had 8-10 participants, led by a CM working in both the researcher and practitioner role, operating over 12-month period. Data were collected by participant observation, researcher reflexive account and interviews. Grounded theory method was used to systematically analyse the data. Three main data categories emerged: (i) comparison by patients that leads to re-motivation of the self; (ii) learning, leading to enhanced self-management techniques, through storytelling and understanding of each other's experiences; and (iii) ownership that resulted in the self-awareness, cognisance and insight into the role of the support group they were based in and how it benefited them. The core category of 'Taking back the self - understanding the whole,' conveyed the impact that this care delivery method had upon readjusting the balance of power between health professional and service users and its consequence in refreshing and improving their self-management and the patients' self-efficacy. It was concluded that CM intervention using a model of group learning can lead to more effective and efficient support, through improving self-efficacy and patients' related self-management ability. © 2017 John Wiley & Sons Ltd.

  19. Community nurses and self-management of blood glucose. (United States)

    Abbott, S; Burns, J; Gleadell, A; Gunnell, C


    Self-monitoring of blood glucose (SMBG) is commonly recommended to patients with diabetes, although the rationale for this is unclear. This small research project was designed to explore the reasons why nurses working in the community recommend SMBG. Seven interviews were carried out with community nurses caring primarily for housebound patients. Those interviewed believed that a sound evidence-base supported the recommendation that patients test their blood, but not urine, for glucose levels. Though nurses believed in the importance of patient choice and empowerment, the scope for these was limited among housebound patients. There was no evidence that patients understood how to respond to test results, or that comprehensive care planning was normal practice. Although small, this study suggests that nurses working in community settings may need to update their knowledge. It also suggests that a national debate is necessary to disseminate better the evidence about SMBG, and its implications for nursing practice.

  20. User-centered design of a web-based self-management site for individuals with type 2 diabetes - providing a sense of control and community. (United States)

    Yu, Catherine H; Parsons, Janet A; Hall, Susan; Newton, David; Jovicic, Aleksandra; Lottridge, Danielle; Shah, Baiju R; Straus, Sharon E


    To design and test a web-based self-management tool for patients with type 2 diabetes for its usability and feasibility. An evidence-based, theory-driven website was created for patients with type 2 diabetes. Twenty-three patients with type 2 diabetes aged ≥ 25 years were recruited from 2 diabetes care centers in Toronto, Canada. We employed focus group methodology to assess acceptability, sustainability, strengths and weaknesses of the self-management website. Based on these results, revisions were made to the website. Three cycles of individual usability testing sessions using cognitive task analysis were conducted with patients with type 2 diabetes. Revisions to the website were made based on results from this testing. We identified five themes concerning participants' experiences of health care and related unmet needs: 1) Desire for information and for greater access to timely and personalized care to gain a sense of control of their disease; 2) Desire for community (sharing experiences with others) to fulfill practical and emotional needs; 3) Potential roles of an online self-management website in self-empowerment, behavior change, self-management and health care delivery; 4) Importance of a patient-centered perspective in presenting content (e.g. common assumptions, medical nomenclature, language, messaging, sociocultural context); 5) Barriers and facilitators to use of a self-management website (including perceived relevance of content, incorporation into usual routine, availability for goal-directed use, usability issues). Participants outlined a series of unmet health care needs, and stated that they wanted timely access to tailored knowledge about their condition, mechanisms to control and track their disease, and opportunities to share experiences with other patients. These findings have implications for patients with type 2 diabetes of diverse ages, socioeconomic backgrounds, and disease severity, as well as to the design of other computer

  1. Seizing Community Participation in Sustainable Development

    DEFF Research Database (Denmark)

    Balslev Clausen, Helene; Gyimóthy, Szilvia


    and cultural sustainability defined in the Mexican national tourism program Pueblos Mágicos are put into practice. The analysis is focused on how citizenship, local participation and democracy are operationalized and what are the local consequences of this governmental program in the community of Álamos...... migrant community in shaping sustainable tourism development as cultural brokers, social entrepreneurs and mediators of market knowledge. The paper criticizes the notion of homogenous local communities as an instrumental condition of sustainable and participatory development....

  2. Outcomes at 18 Months From a Community Health Worker and Peer Leader Diabetes Self-Management Program for Latino Adults. (United States)

    Spencer, Michael S; Kieffer, Edith C; Sinco, Brandy; Piatt, Gretchen; Palmisano, Gloria; Hawkins, Jaclynn; Lebron, Alana; Espitia, Nicolaus; Tang, Tricia; Funnell, Martha; Heisler, Michele


    This study evaluated the effectiveness of a community health worker (CHW) diabetes self-management education (DSME) program, followed by two different approaches to maintain improvements in HbA 1c and other clinical and patient-centered outcomes over 18 months. The study randomized 222 Latino adults with type 2 diabetes and poor glycemic control from a federally qualified health center to 1 ) a CHW-led, 6-month DSME program or 2 ) enhanced usual care (EUC). After the 6-month program, participants randomized to the CHW-led DSME were further randomized to 1 ) 12 months of CHW-delivered monthly telephone outreach (CHW-only) or 2 ) 12 months of weekly group sessions delivered by peer leaders (PLs) with telephone outreach to those unable to attend (CHW+PL). The primary outcome was HbA 1c . Secondary outcomes were blood pressure, lipid levels, diabetes distress, depressive symptoms, understanding of diabetes self-management, and diabetes social support. Assessments were conducted at baseline and at 6, 12, and 18 months. Participants in the CHW intervention at the 6-month follow-up had greater decreases in HbA 1c (-0.45; 95% CI -0.87, -0.03; P diabetes distress (-0.3; 95% CI -0.6, -0.03; P diabetes distress at 12 and 18 months. CHW+PL participants also had significantly fewer depressive symptoms at 18 months compared with EUC (-2.2; 95% CI -4.1, -0.3; P diabetes social support and in understanding of diabetes self-management at 6 months relative to EUC, but these intervention effects were not sustained at 18 months. This study demonstrates the effectiveness of a 6-month CHW intervention on key diabetes outcomes and of a volunteer PL program in sustaining key achieved gains. These are scalable models for health care centers in low-resource settings for achieving and maintaining improvements in key diabetes outcomes. © 2018 by the American Diabetes Association.

  3. Partnership for Sustainable Communities - Grants Map - (United States)

    Department of Transportation — The Partnership for Sustainable Communities is comprised of the Department of Housing and Urban Development (HUD), the US Department of Transportation (DOT), and the...

  4. Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults. (United States)

    Yamada, Minoru; Arai, Hidenori


    Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

  5. Long-Term Condition Self-Management Support in Online Communities: A Meta-Synthesis of Qualitative Papers (United States)

    Vassilev, Ivaylo; Kennedy, Anne; Rogers, Anne


    Background Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness “workforce.” Objective The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life. Methods A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis. Results The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator

  6. Building Blocks for Sustainable Communities: Assistance from Grantees (United States)

    EPA awarded Building Blocks for Sustainable Communities grants to four nonprofit organizations with extensive expertise in community sustainability. These organizations deliver technical assistance to communities.

  7. Resilience-based Diabetes Self-management Education: Perspectives From African American Participants, Community Leaders, and Healthcare Providers. (United States)

    Lehrer, H Matthew; Dubois, Susan K; Brown, Sharon A; Steinhardt, Mary A


    Purpose The purpose of this qualitative, focus group study was to further refine the Resilience-based Diabetes Self-management Education (RB-DSME) recruitment process and intervention, build greater trust in the community, and identify strategies to enhance its sustainability as a community-based intervention in African American church settings. Methods Six 2-hour focus groups (N = 55; 10 men and 45 women) were led by a trained moderator with a written guide to facilitate discussion. Two sessions were conducted with individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in previous RB-DSME pilot interventions and their family members, two sessions with local church leaders, and two sessions with community healthcare providers who care for patients with T2DM. Two independent reviewers performed content analysis to identify major themes using a grounded theory approach. The validity of core themes was enhanced by external review and subsequent discussions with two qualitative methods consultants. Results There was expressed interest and acceptability of the RB-DSME program. Church connection and pastor support were noted as key factors in building trust and enhancing recruitment, retention, and sustainability of the program. Core themes across all groups included the value of incentives, the need for foundational knowledge shared with genuine concern, teaching with visuals, dealing with denial, balancing the reality of adverse consequences with hope, the importance of social support, and addressing healthcare delivery barriers. Conclusion Focus groups documented the feasibility and potential effectiveness of RB-DSME interventions to enhance diabetes care in the African American community. In clinical practice, inclusion of these core themes may enhance T2DM self-care and treatment outcomes.

  8. A template for integrated community sustainability planning. (United States)

    Ling, Christopher; Hanna, Kevin; Dale, Ann


    This article describes a template for implementing an integrated community sustainability plan. The template emphasizes community engagement and outlines the components of a basic framework for integrating ecological, social and economic dynamics into a community plan. The framework is a series of steps that support a sustainable community development process. While it reflects the Canadian experience, the tools and techniques have applied value for a range of environmental planning contexts around the world. The research is case study based and draws from a diverse range of communities representing many types of infrastructure, demographics and ecological and geographical contexts. A critical path for moving local governments to sustainable community development is the creation and implementation of integrated planning approaches. To be effective and to be implemented, a requisite shift to sustainability requires active community engagement processes, political will, and a commitment to political and administrative accountability, and measurement.

  9. Community-based asthma care: trial of a "credit card" asthma self-management plan. (United States)

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


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

  10. Community-based peer-led diabetes self-management: a randomized trial. (United States)

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


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

  11. The Hepatitis C Self-Management Program: Sustainability of Primary Outcomes at 1 Year (United States)

    Groessl, Erik J.; Ho, Samuel B.; Asch, Steven M.; Stepnowsky, Carl J.; Laurent, Diana; Gifford, Allen L.


    Objective: Chronic hepatitis C infection afflicts millions of people worldwide. Although antiviral treatments are increasingly effective, many hepatitis C virus (HCV) patients avoid treatment, do not complete or respond to treatment, or have contraindications. Self-management interventions are one option for promoting behavioral changes leading to…

  12. Sustainable Communities Regional Planning Grantees (NGDA) (United States)

    Department of Housing and Urban Development — The Sustainable Communities Regional Planning (SCRP) Grant Program supports locally-led collaborative efforts that bring together diverse interests from the many...

  13. Sustainable Development: The Challenge for Community Development. (United States)

    Gamble, Dorothy N.; Weil, Marie O.


    Five areas of inquiry shape the sustainable development movement: environmental movement, women's movement, overpopulation concerns, critique of development models, and new indicators of social progress. Community development workers are challenged to prepare local development projects within a sustainable development framework. (SK)

  14. Enhancing Sustainability Curricula through Faculty Learning Communities (United States)

    Natkin, L. W.; Kolbe, Tammy


    Purpose: Although the number of higher education institutions adopting sustainability-focused faculty learning communities (FLCs) has grown, very few of these programs have published evaluation research. This paper aims to report findings from an evaluation of the University of Vermont's (UVM's) sustainability faculty fellows (SFF) program. It…

  15. Barriers and facilitators to diabetes self-management: perspectives of older community dwellers and health professionals in China. (United States)

    Shen, Huixia; Edwards, Helen; Courtney, Mary; McDowell, Jan; Wei, Juan


    Little is known about self-management among people with Type 2 diabetes living in mainland China. Understanding the experiences of this target population is needed to provide socioculturally relevant education to effectively promote self-management. The aim of this study was to explore perceived barriers and facilitators to diabetes self-management for both older community dwellers and health professionals in China. Four focus groups, two for older people with diabetes and two for health professionals, were conducted. All participants were purposively sampled from two communities in Shanghai, China. Six barriers were identified: overdependence on but dislike of western medicine, family role expectations, cuisine culture, lack of trustworthy information sources, deficits in communication between clients and health professionals, and restriction of reimbursement regulations. Facilitators included family and peer support, good relationships with health professionals, simple and practical instruction and a favourable community environment. The findings provide valuable information for diabetes self-management intervention development in China, and have implications for programmes tailored to populations in similar sociocultural circumstances. © 2013 Wiley Publishing Asia Pty Ltd.

  16. Sustainable mining, local communities and environmental regulation

    Directory of Open Access Journals (Sweden)

    Kokko Kai


    Full Text Available Sustainable mining is an objective as well as a tool for balancing economic, social, and environmental considerations. Each of these three dimensions of mining – and sustainable development – has many components, some of which were chosen for closer study in the SUMILCERE project. While there is no single component that in itself provides a definitive argument for or against sustainable mining, the research reveals some that have proven valuable in the process of balancing the different dimensions of sustainability. In the SUMILCERE project, comparative studies enabled us to identify factors such as the following, which are essential when discussing the balancing in practice of the three dimensions of sustainable mining cited above: the framework and functionality of environmental regulation to protect the environment (environmental sustainability; competitiveness of the mining industry in light of environmental regulation and its enforcement (economic sustainability; public participation and the opportunities local communities have to influence their surroundings, as well as communities’ acceptance of projects (social sustainability before and during operations; and the protection of Sámi cultural rights in mining projects (social and cultural sustainability. Although each of the three dimensions of sustainability leaves room for discretion in the weight assigned to it, ecological sustainability, protected by smart environmental regulation and minimum standards, sets essential boundaries that leave no room for compromises. Economic and social sustainability are possible only within these limits. Details of the analyses in the Kolarctic area and accounts of the methods used can befound in the cited SUMILCERE articles.

  17. Energy sustainable communities - social and psychological aspects

    International Nuclear Information System (INIS)

    Schweizer-Ries, P.; Baasch, St.; Jagszent, J.


    Besides technical, political and economic aspects of energy sustainability there are several social, behavioural and psychological dimensions of vital importance for a successful implementation of Renewable Energy Systems (RES) and Rational Use of Energy (RUE) within communities. The European Project ''Sustainable Communities-on the energy dimension'' pursues an interdisciplinary approach to detect essential success and facilitating factors. In the last years social and psychological aspects in the process of sustainability came to the fore more and more. Not only as a complementary science to facilitate the technical aims in the change process but also as an essential part for success. (authors)

  18. Community Health Global Network and Sustainable Development

    Directory of Open Access Journals (Sweden)

    Rebekah Young


    Full Text Available With the achievements, failures and passing of the Millennium Development Goals (MDG, the world has turned its eyes to the Sustainable Development Goals (SDG, designed to foster sustainable social, economic and environmental development over the next 15 years.(1 Community-led initiatives are increasingly being recognised as playing a key role in realising sustainable community development and in the aspirations of universal healthcare.(2 In many parts of the world, faith-based organisations are some of the main players in community-led development and health care.(3 Community Health Global Network (CHGN creates links between organisations, with the purpose being to encourage communities to recognise their assets and abilities, identify shared concerns and discover solutions together, in order to define and lead their futures in sustainable ways.(4 CHGN has facilitated the development of collaborative groups of health and development initiatives called ‘Clusters’ in several countries including India, Bangladesh, Kenya, Tanzania, Zambia and Myanmar. In March 2016 these Clusters met together in an International Forum, to share learnings, experiences, challenges, achievements and to encourage one another. Discussions held throughout the forum suggest that the CHGN model is helping to promote effective, sustainable development and health care provision on both a local and a global scale.


    Directory of Open Access Journals (Sweden)

    Zainal Md Zan


    Full Text Available The much-talked about issues such as the rising of heavy crime cases, problems in solid waste management, air and water pollution as well as traffic congestion detering the quality of life among urban community members. Urgent and proactive measure is highly desireable in order to preserve and maintain the integral parts of urban’s higher quality of life. All parties should take part in ongoing efforts to achieve sustainable development through various means. Local Agenda 21 (LA21 serves as one of the efforts in achieveing the ultimate goal of sustainable development through better collaboration and cooperation among stakeholders including local government, non-governmental organisations and the community at large. The core principle of the LA21 program lies in the spirit of cooperation among community members, local authorities and the private sectors. This could be achieved through various activities including from the beginning such as through a comprehensive planning for the local area to achieve the sustainable development. Community members should be involved in brainstorming of the ideas and expressing their views so that authorities would be able to identify the real and arising issues in the community. Through this way a sustainable town and municipal planning could be developed and initiated. This paper discusses the importance of urbancommunity participation in achieving sustainable development as practicedthrough LA21 in Seberang Perai Municipal Council, Penang.

  20. Understanding the environmental issues in diabetes self-management education research: a reexamination of 8 studies in community-based settings. (United States)

    Jack, Leonard; Liburd, Leandris; Spencer, Tirzah; Airhihenbuwa, Collins O


    Eight studies included in a recent systematic review of the efficacy of diabetes self-management education were qualitatively reexamined to determine the presence of theoretical frameworks, methods used to ensure cultural appropriateness, and the quality of the instrument. Theoretical frameworks that help to explain complex pathways that produce health outcomes were lacking; culture indices were not incorporated into diabetes self-management education; and the instruments used to measure outcomes were inadequate. We provide recommendations to improve research on diabetes self-management education in community settings through use of a contextual framework that encourages targeting multiple levels of influence--individual, family, organizational, community, and policy.

  1. Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting. (United States)

    Smith, Lorraine; Bosnic-Anticevich, Sinthia Z; Mitchell, Bernadette; Saini, Bandana; Krass, Ines; Armour, Carol


    Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its chronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process- clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings.

  2. Evolving prosocial and sustainable neighborhoods and communities. (United States)

    Biglan, Anthony; Hinds, Erika


    In this review, we examine randomized controlled trials of community interventions to affect health. The evidence supports the efficacy of community interventions for preventing tobacco, alcohol, and other drug use; several recent trials have shown the benefits of community interventions for preventing multiple problems of young people, including antisocial behavior. However, the next generation of community intervention research needs to reflect more fully the fact that most psychological and behavioral problems of humans are interrelated and result from the same environmental conditions. The evidence supports testing new comprehensive community interventions that focus on increasing nurturance in communities. Nurturing communities will be ones in which families, schools, neighborhoods, and workplaces (a) minimize biologically and socially toxic events, (b) richly reinforce prosocial behavior, and (c) foster psychological acceptance. Such interventions also have the potential to make neighborhoods more sustainable.

  3. Creating a sustainable collaborative consumer health application for chronic disease self-management. (United States)

    Johnson, Constance M; McIlwain, Steve; Gray, Oliver; Willson, Bradley; Vorderstrasse, Allison


    As the prevalence of chronic diseases increase, there is a need for consumer-centric health informatics applications that assist individuals with disease self-management skills. However, due to the cost of development of these applications, there is also a need to build a disease agnostic architecture so that they could be reused for any chronic disease. This paper describes the architecture of a collaborative virtual environment (VE) platform, LIVE©, that was developed to teach self-management skills and provide social support to those individuals with type 2 diabetes. However, a backend database allows for the application to be easily reused for any chronic disease. We tested its usability in the context of a larger randomized controlled trial of its efficacy. The usability was scored as 'good' by half of the participants in the evaluation. Common errors in the testing and solutions to address initial usability issues are discussed. Overall, LIVE© represents a usable and generalizable platform that will be adapted to other chronic diseases and health needs in future research and applications. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. A Community Health Worker Intervention for Diabetes Self-Management Among the Tz'utujil Maya of Guatemala. (United States)

    Micikas, Mary; Foster, Jennifer; Weis, Allison; Lopez-Salm, Alyse; Lungelow, Danielle; Mendez, Pedro; Micikas, Ashley


    Despite the high prevalence of diabetes in rural Guatemala, there is little education in diabetes self-management, particularly among the indigenous population. To address this need, a culturally relevant education intervention for diabetic patients was developed and implemented in two rural communities in Guatemala. An evaluative research project was designed to investigate if the structured, community-led diabetes self-management intervention improved selected health outcomes for participants. A one-group, pretest-posttest design was used to evaluate the effectiveness of the educational intervention by comparing measures of health, knowledge, and behavior in patients pre- and postintervention. A survey instrument assessed health beliefs and practices and hemoglobin A1c (HgA1c) measured blood glucose levels at baseline and 4 months post initiation of intervention (n = 52). There was a significant decrease (1.2%) in the main outcome measure, mean HgA1c from baseline (10.1%) and follow-up (8.9%; p = .001). Other survey findings were not statistically significant. This study illustrates that a culturally specific, diabetes self-management program led by community health workers may reduce HgA1c levels in rural populations of Guatemala. However, as a random sample was not feasible for this study, this finding should be interpreted with caution. Limitations unique to the setting and patient population are discussed in this article. © 2014 Society for Public Health Education.

  5. Bridges self-management program for people with stroke in the community: A feasibility randomized controlled trial. (United States)

    McKenna, Suzanne; Jones, Fiona; Glenfield, Pauline; Lennon, Sheila


    Enabling self-management behaviors is considered important in order to develop coping strategies and confidence for managing life with a long-term condition. However, there is limited research into stroke-specific self-management interventions. The aim of this randomized controlled trial was to evaluate the feasibility of delivering the Bridges stroke self-management program in addition to usual stroke rehabilitation compared with usual rehabilitation only. Participants recruited from the referrals to a community stroke team were randomly allocated to the Bridges stroke self-management program, receiving either one session of up to one-hour per week over a six-week period in addition to usual stroke rehabilitation, or usual rehabilitation only. Feasibility was measured using a range of methods to determine recruitment and retention; adherence to the program; suitability and variability of outcome measures used; application and fidelity of the program; and acceptability of the program to patients, carers and professionals. Twenty-five people were recruited to the study over a 13-month period. Eight out of the 12 participants in the Bridges stroke self-management program received all six sessions; there was one withdrawal from the study. There were changes in outcomes between the two groups. Participants who received the Bridges stroke self-management program appeared to have a greater change in self-efficacy, functional activity, social integration and quality of life over the six-week intervention period and showed less decline in mood and quality of life at the three-month follow-up. Professionals found the program acceptable to use in practice, and feedback from participants was broadly positive. The findings from this study appear promising, but questions remain regarding the feasibility of delivering the Bridges stroke self-management program in addition to usual rehabilitation. The dose response of receiving the program cannot be ruled out, and the next stage

  6. Effective Strategies for Sustaining Professional Learning Communities (United States)

    Bennett, Patricia R.


    Professional Learning Communities (PLCs), in which educators work collaboratively to improve learning for students, need effective strategies to sustain them. PLCs promote continuous improvement in student learning and build academic success with increased teacher expertise. Grounded in organizational systems theory, participative leadership…

  7. Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

    Directory of Open Access Journals (Sweden)

    Cheryl Dye


    Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

  8. A Sustainability Assessment Framework For Waterfront Communities

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    Sally Said Eldeeb


    Full Text Available It is predicted that the global phenomena of Climate change will have far reaching effects and implications on different local urban systems. For incidence, global average sea levels are expected to rise between 7 and 36 cm by the 2050s, and between 9 and 69 cm by the 2080s. Waterfront communities are the first to be affected by such impacts putting them at high risk. Planning tools are needed to assist these communities and increase their adaptive and learning capacities in the face of diverse challenges to their urban sub-systems.  The research investigates a number of sustainability frameworks and assessment rating systems for neighbourhoods and communities. It investigates the sustainable evaluation criteria carried out by three assessment rating systems. First is the LEED (Leadership in Energy & Environmental Design, USA, the second is BREEAM (Building Research Establishment Environmental Assessment Method, UK, and the third is the Estidama PEARL rating system (UAE.Examples of waterfront communities which applied the previous rating systemsare analyzed in order to determine the applicability and relevance of these systems to waterfront communities in particular.  The research concludes with a proposed framework of indicators for waterfront communities. The similarities and differences between the different rating systems and featured indicators specific to waterfront planning applied in the analyzed examples, yet absent in the three rating systems, have informed the selection of indicators in the proposed assessment framework. The proposed framework could be an effective tool for the planning and development of a waterfront community in the MENA region. In order to validate the framework, theset of environmental and physical indicators were applied on the case study of Abu Qir waterfront, Alexandria, Egypt. Conclusions and recommendations  are made that would enhance the resilience of this waterfront community and provide a comprehensive

  9. Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale. (United States)

    Smith, David; Harvey, Peter; Lawn, Sharon; Harris, Melanie; Battersby, Malcolm


    To evaluate the factor structure of the revised Partners in Health (PIH) scale for measuring chronic condition self-management in a representative sample from the Australian community. A series of consultations between clinical groups underpinned the revision of the PIH. The factors in the revised instrument were proposed to be: knowledge of illness and treatment, patient-health professional partnership, recognition and management of symptoms and coping with chronic illness. Participants (N = 904) reporting having a chronic illness completed the revised 12-item scale. Two a priori models, the 4-factor and bi-factor models were then evaluated using Bayesian confirmatory factor analysis (BCFA). Final model selection was established on model complexity, posterior predictive p values and deviance information criterion. Both 4-factor and bi-factor BCFA models with small informative priors for cross-loadings provided an acceptable fit with the data. The 4-factor model was shown to provide a better and more parsimonious fit with the observed data in terms of substantive theory. McDonald's omega coefficients indicated that the reliability of subscale raw scores was mostly in the acceptable range. The findings showed that the PIH scale is a relevant and structurally valid instrument for measuring chronic condition self-management in an Australian community. The PIH scale may help health professionals to introduce the concept of self-management to their patients and provide assessment of areas of self-management. A limitation is the narrow range of validated PIH measurement properties to date. Further research is needed to evaluate other important properties such as test-retest reliability, responsiveness over time and content validity.

  10. Energy sustainable communities: Environmental psychological investigations

    International Nuclear Information System (INIS)

    Schweizer-Ries, Petra


    Energy sustainability is becoming an increasing issue-or rather 'the' issue in our society. Often it is reduced to a purely technical problem. Renewable energies and energy-efficient technologies are developed to solve the problem, but finally the end-users will 'decide' how much and what kind of energy they are going to consume. This article is targeted on showing the environmental psychological aspects of the change of energy demand and supply. It builds upon a transactional model of human technology interchange and summarises environmental psychological work done during more than 5 years. It refers to the idea of energy sustainable communities (ESCs), shows the development of one example community and concentrates on one aspect of the social dimension of ESCs, the 'acceptance of renewable energy technology', its definition and measurement in Germany

  11. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.


    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health

  12. Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

    Directory of Open Access Journals (Sweden)

    Arfiza Ridwan


    Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

  13. Impact of community pharmacists' interventions on asthma self-management care. (United States)

    Kovačević, Milena; Ćulafić, Milica; Jovanović, Marija; Vučićević, Katarina; Kovačević, Sandra Vezmar; Miljković, Branislava


    Asthma self-management is aimed to improve the quality and effectiveness of asthma care by supporting the patients to manage their illness by themselves. The aim of the study was to evaluate the impact of pharmacist-delivered counselling on patients knowledge and beliefs about the medicines, adherence level, and asthma control. A prospective intervention study was conducted in community pharmacies. A total of 90 patients completed the study. Four questionnaires were used: (1) Beliefs about medicines questionnaire (BMQ), (2) Knowledge of asthma and asthma medicine (KAM), (3) Asthma control test (ACT), and (4) 8-item Morisky medication adherence scale questionnaire (MMAS-8). Questionnaires were completed at baseline and 3 months later. Low level of adherence and poor asthma control were determined initially. Better asthma control was significantly associated with higher adherence level, lower concerns regarding the medication use, and knowledge of triggers. Statistically significant improvement was found after 3 months in patients knowledge of asthma and its medications, their attitude towards medications (decrease in harm, overuse and concern; increase in necessity score), asthma control score (increased from 19 to 20, p < 0.05) and level of adherence (MMAS-8 score decreased from 3 to 2 p < 0.05). Better asthma control was achieved in 60% of patients. Sixteen patients (18%) were transferred from poor to well-controlled asthma, implying no need for patients' referral to the doctor and no additional cost for the health system. Improved disease control could be a result of enhanced knowledge and understanding of the disease-medication relationship, improved inhalation technique, and support on patients' adherence. Acquired knowledge and skills, as well as improved attitude, empowered patients to take a more active part in asthma management. Education in further patients' follow-up should consider topics tailored to the patients' characteristics, needs, and prior

  14. Patients' Attitudes and Approaches to the Self-Management of Hypertension: Perspectives from an Australian Qualitative Study in Community Pharmacy. (United States)

    Bajorek, Beata; Lemay, Kate; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol


    In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.

  15. Resilient Communities: From Sustainable to Secure (United States)

    Bragdon, Clifford R.


    A sustainable biosphere is an absolute necessity to support the world's growing population, (now exceeding 6.2 billion persons), as civilization advances through the 21st century. Sustainability primarily refers to a bio-physical environment that is not a risk, which can provide the necessary support system for both plant and human habitat involving the earth's lithosphere, hydrosphere and atmosphere. However, that alone will not provide the necessary protection, since our human habitat must also be safe and secure. A more operable term should be resilient, rather than sustainable, since a climate positive community, with an on-site CO2 emission near zero, does not mean the population is protected from both natural and manmade disasters. Effective neoteric planning of our biosphere is necessary as it involves spatial, temporal, and sensory aspects of the community habitat. Two-dimensional planning that addresses just the surface (e.g., land), fails to be comprehensive, since both aerial and subsurface features are omitted. Effective neoteric planning of our biosphere is necessary as it involves spatial, temporal, and sensory aspects of the community habitat. Two-dimensional planning that addresses just the surface (e.g., land), is not comprehensive, since aerial and subsurface features are omitted. A three dimensional approach is needed, which involves the combination of the x, y and z axis, in order to be spatially accurate. Our personal transportation based mobility systems, along with its accompanying infrastructure, has resulted in a drive-thru society that is becoming supersized. Urban obesity in terms of modes of transport and today's living environment has resulted in McMansions and mega-vehicles have created an energy demand that if unchecked could create a carhenge by the year 3000. Infrastructure gridlock besides global warming is costing the world's economy, approximately 6% of the gross domestic product (GDP). Impaired global mobility which threatens

  16. Impact of a community-based diabetes self-management program on key metabolic parameters

    Directory of Open Access Journals (Sweden)

    Johnson C


    Full Text Available Objective: Characterize the impact of a pharmacist-led diabetes self-management program on three key metabolic parameters: glycosylated hemoglobin (HbA1c, low-density lipoprotein cholesterol (LDL-C, and mean arterial blood pressure (MAP among employee health program participants. Methods: A self-insured company in the Kansas City metropolitan area began offering a pharmacist-led diabetes self-management program to eligible company employees and their dependents in 2008. A retrospective pre-post analysis was conducted to determine if the program affected key metabolic parameters in participants by determining mean change after one year of participation. Results: Among 183 program participants, 65 participants met inclusion criteria. All three key metabolic parameters were significantly reduced from baseline to one year of program participation: HbA1c decreased from 8.1% to 7.3% (p=0.007; LDL-C decreased from 108.3 mg/dL to 96.4 mg/dL (p=0.009; and MAP decreased from 96.1 to 92.3 mm Hg (p=0.005. Conclusions: The pharmacist-led diabetes self-management program demonstrated significant reductions in HbA1c, LDL-C, and MAP from baseline to one year of program participation. Improvements were statistically significant and clinically relevant for each parameter. Previous studies indicate these reductions may cause reduced overall healthcare costs.

  17. Sustaining Ecotourism in Tanzania through Community

    Directory of Open Access Journals (Sweden)

    Liliane Pasape


    Full Text Available This study explores the contribution of community empowerment to the sustainability of ecotourism in Tanzania using education programmes, access to information and language. Through the survey approach data was collected from Tanzania’s ecotourism stakeholders (N=250 in the eight selected regions of Dar es Salaam, Pwani, Morogoro, Tanga and Zanzibar (for the eastern tourism circuit and Arusha, Kilimanjaro and Manyara (for the northern circuit and thereafter a qualitative analysis was employed complemented by estimation of the multinomial logistic regression model. The findings show that tourism stakeholders lack sufficient knowledge on ecotourism conservation and preservation. Likewise community members have poor access to information due to insufficient ecotourism publications, tourist information centres, a reliable mechanism for communicating with stakeholders and the use of foreign languages in most of the publications. It is therefore the study’s recommendation that community members be empowered through being provided with adequate education programmes and access to relevant information and the use of a language that is understood by them in order to broaden their level of understanding, enhance their management skills and contribute significantly to ecotourism-related activities.

  18. What promotes sustainability in Safe Community programmes? (United States)

    Nordqvist, Cecilia; Timpka, Toomas; Lindqvist, Kent


    The theory and practice of safety promotion has traditionally focused on the safety of individuals. This study also includes systems, environments, and organizations. Safety promotion programmes are designed to support community health initiatives taking a bottom-up approach. This is a long-term and complex process. The aim of this study was to try to empirically identify factors that promote sustainability in the structures of programmes that are managed and coordinated by the local government. Four focus group sessions with local government politicians and administrators in designated Safe Communities were conducted and analyzed using qualitative content analysis. Collaboration was found to be the basis for sustainability. Networks, enabling municipalities to exchange ideas, were reported to positively influence the programmes. Personal contacts rather than organizations themselves, determine whether collaboration is sustained. Participants reported an increase in cross-disciplinary collaboration among staff categories. Administrators and politicians were reported to collaborate well, which was perceived to speed up decision-making and thus to facilitate the programme work. Support from the politicians and the county council was seen as a prerequisite. Participants reported an increased willingness to share information between units, which, in their view, supports sustainability. A structure in which all local authorities' offices were located in close proximity to one another was considered to support collaboration. Appointing a public health coordinator responsible for the programme was seen as a way to strengthen the relational resources of the programme. With a public health coordinator, the 'external' negotiating power was concentrated in one person. Also, the 'internal' programme strength increased when the coordination was based on a bureaucratic function rather than on one individual. Increased relational resources facilitated the transfer of information

  19. What promotes sustainability in Safe Community programmes?

    Directory of Open Access Journals (Sweden)

    Lindqvist Kent


    Full Text Available Abstract Background The theory and practice of safety promotion has traditionally focused on the safety of individuals. This study also includes systems, environments, and organizations. Safety promotion programmes are designed to support community health initiatives taking a bottom-up approach. This is a long-term and complex process. The aim of this study was to try to empirically identify factors that promote sustainability in the structures of programmes that are managed and coordinated by the local government. Methods Four focus group sessions with local government politicians and administrators in designated Safe Communities were conducted and analyzed using qualitative content analysis. Results Collaboration was found to be the basis for sustainability. Networks, enabling municipalities to exchange ideas, were reported to positively influence the programmes. Personal contacts rather than organizations themselves, determine whether collaboration is sustained. Participants reported an increase in cross-disciplinary collaboration among staff categories. Administrators and politicians were reported to collaborate well, which was perceived to speed up decision-making and thus to facilitate the programme work. Support from the politicians and the county council was seen as a prerequisite. Participants reported an increased willingness to share information between units, which, in their view, supports sustainability. A structure in which all local authorities' offices were located in close proximity to one another was considered to support collaboration. Appointing a public health coordinator responsible for the programme was seen as a way to strengthen the relational resources of the programme. Conclusion With a public health coordinator, the 'external' negotiating power was concentrated in one person. Also, the 'internal' programme strength increased when the coordination was based on a bureaucratic function rather than on one individual

  20. Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity. (United States)

    Markle-Reid, Maureen; Ploeg, Jenny; Fraser, Kimberly D; Fisher, Kathryn A; Bartholomew, Amy; Griffith, Lauren E; Miklavcic, John; Gafni, Amiram; Thabane, Lehana; Upshur, Ross


    To compare the effect of a 6-month community-based intervention with that of usual care on quality of life, depressive symptoms, anxiety, self-efficacy, self-management, and healthcare costs in older adults with type 2 diabetes mellitus (T2DM) and 2 or more comorbidities. Multisite, single-blind, parallel, pragmatic, randomized controlled trial. Four communities in Ontario, Canada. Community-dwelling older adults (≥65) with T2DM and 2 or more comorbidities randomized into intervention (n = 80) and control (n = 79) groups (N = 159). Client-driven, customized self-management program with up to 3 in-home visits from a registered nurse or registered dietitian, a monthly group wellness program, monthly provider team case conferences, and care coordination and system navigation. Quality-of-life measures included the Physical Component Summary (PCS, primary outcome) and Mental Component Summary (MCS, secondary outcome) scores of the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12). Other secondary outcome measures were the Generalized Anxiety Disorder Scale, Center for Epidemiologic Studies Depression Scale (CES-D-10), Summary of Diabetes Self-Care Activities (SDSCA), Self-Efficacy for Managing Chronic Disease, and healthcare costs. Morbidity burden was high (average of eight comorbidities). Intention-to-treat analyses using analysis of covariance showed a group difference favoring the intervention for the MCS (mean difference = 2.68, 95% confidence interval (CI) = 0.28-5.09, P = .03), SDSCA (mean difference = 3.79, 95% CI = 1.02-6.56, P = .01), and CES-D-10 (mean difference = -1.45, 95% CI = -0.13 to -2.76, P = .03). No group differences were seen in PCS score, anxiety, self-efficacy, or total healthcare costs. Participation in a 6-month community-based intervention improved quality of life and self-management and reduced depressive symptoms in older adults with T2DM and comorbidity without increasing total healthcare costs.

  1. Educating the Engineer for Sustainable Community Development (United States)

    Munoz, D. R.


    More than ever before, we are confronting the challenges of limited resources (water, food, energy and mineral), while also facing complex challenges with the environment and related social unrest. Resource access problems are exacerbated by multi-scale geopolitical instability. We seek a balance that will allow profit but also leave a world fit for our children to inherit. Many are working with small groups to make positive change through finding solutions that address these challenges. In fact, some say that in sum, it is the largest human movement that has ever existed. In this talk I will share our experiences to alleviate vulnerabilities for populations of humans in need while working with students, corporate entities and non governmental organizations. Our main focus is to educate a new cadre of engineers that have an enhanced awareness of and better communication skills for a different cultural environment than the one in which they were raised and are hungry to seek new opportunities to serve humanity at a basic level. The results of a few of the more than forty humanitarian engineering projects completed since 2003 will be superimposed on a theoretical framework for sustainable community development. This will be useful information to those seeking a social corporate position of responsibility and a world that more closely approaches a sustainable equilibrium.

  2. Community Gardens as a Platform for Education for Sustainability (United States)

    Corkery, Linda


    Community gardens fulfil many roles, including the reclamation of public space, community building, and the facilitation of social and cultural expression. This paper discusses a nexus between research and education for sustainability that evolved out of an examination of the role of community gardens in fostering community development and…

  3. Ties That Bind: Creating and sustaining community-academic partnerships

    Directory of Open Access Journals (Sweden)

    Kynna N. Wright


    Full Text Available Growing interest among academics and health professionals in finding new ways to study and address complex health and social problems has manifested in recent years with increasing community demands for research and program implementation that is community-based, rather than merely community placed. In the United States, community-based participatory research (CBPR, with its emphasis on the creation and use of community-university or community-academic partnerships, is the prevailing paradigm to address these complex problems, especially those concerning racial/ethnic disparities in health and health care. While the need to strengthen the relationship between researchers and the community has been recognised, often from the viewpoint of the university partner, discussions on sustainability of partnerships have been few. The aim of this paper is to share reflections, through the eyes of the community members, on the core elements that tie community and academic members together and the challenges in understanding and nurturing those ties so that the community-academic partnership is sustained over time, and to offer possible recommendations for sustainability. This article speaks from the community’s perspective and reflects on the vital elements/components that tie together community-university partnerships and the challenges that may occur when trying to sustain and grow the partnership. It is based on a research CBPR study that was conducted to (1 evaluate the functioning and future sustainability of the community-university partnership of the Community Child Health Network Study Los Angeles (CCHN-LA community-university partnership, and (2 evaluate the experience and beliefs of the current CCHN-LA community-university partnership members in their understanding of current functioning. Keywords Community-academic partnerships; sustainability; challenges; solutions

  4. Species succession and sustainability of the Great Lakes fish community (United States)

    Eshenroder, Randy L.; Burnham-Curtis, Mary K.; Taylor, William W.; Ferreri, C. Paola


    This article concentrates on the sustainability of the offshore pelagic and deepwater fish communities that were historically dominated by lake trout (Salvelinus namaycush). The causes of alteration in these fish communities (i.e., overfishing, introductions, and cultural eutrophication) were identified by Loftus and Regier (1972). Here we look at the ecology of these altered communities in relation to sustainability and discuss the need for restoration.

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

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


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

  6. Community-Based Rural Tourism: A Proposed Sustainability Framework

    Directory of Open Access Journals (Sweden)

    Kayat Kalsom


    Full Text Available Many tourism projects run by community in the rural areas are labelled as Community-based Rural Tourism (CBRT, a type of a more ‘responsible’ tourism that contributes to sustainable development. However, a framework is needed to enable planners and managers to understand its criteria thus ensuring that the CBRTs fulfil the sustainability requirement. This paper presents findings from a literature review on previous writings in this topic. Findings from an analysis on the criteria of a sustainable CBRT product are discussed. It is found that in order for it to play a role in sustainable development, a CBRT product must focus on competitive management, resource conservation, and benefit creation to the community. The three elements need to be supported, in turn, by community involvement and commitment. As the proposed conceptual framework of sustainable CBRT product can be a basis for further research in CBRT, it offers producing theoretical and practical implications.

  7. Contributions to Sustainability by Communities and Individuals: Problems and Prospects

    Energy Technology Data Exchange (ETDEWEB)

    MacGregor, D.; Tonn, B.E.


    This report examines relationships between a comprehensive set of definitions of and viewpoints on the concept of Sustainability and the abilities of communities and individuals in the United States to meet the behavioral prescriptions inherent in these definitions and viewpoints. This research is timely because sustainability is becoming a cornerstone of national and international environmental strategies designed to simultaneously achieve environmental, economic, and social goals. In the United States, many communities have adopted sustainability principles as the foundation for both their environmental protection efforts and their socioeconomic development initiatives. This research is important because it highlights serious problems communities and inviduals may have in achieving sustainability expectations, and illustrates how much work is needed to help communities and individuals overcome numerous considerable and complex constraints to sustainability.

  8. What role could community pharmacists in Malaysia play in diabetes self-management education and support? The views of individuals with type 2 diabetes. (United States)

    Lee, E Lyn; Wong, Pei Se; Tan, Ming Yeong; Sheridan, Janie


    This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia. A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively. Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services. This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia. © 2017 Royal Pharmaceutical Society.

  9. Network-Based Community Brings forth Sustainable Society (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.

  10. planning peoples' participaion in sustainable community ...

    African Journals Online (AJOL)


    COMMUNITY DEVELOPMENT AT THE GRASSROOT. LEVELS IN ... development strategy is predicated on the capacity ..... energies and satisfaction which are central to the growth of .... intelligent members of the community must be involved.

  11. Creating A Sustainable Model of Spine Care in Underserved Communities

    DEFF Research Database (Denmark)

    Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff


    The world lacks sustainable models of care to manage spinal disorders in poor and underserved communities. The purpose of this article is to: (1) review the rationale and importance of developing a sustainable evidence-based model of care at low cost for people with spinal disorders in underserved...... adequate care, World Spine Care (WSC) was established to "improve lives in underserved communities through sustainable, integrated, evidence-based, spinal care." WSC is comprised of volunteers and institutions from 6 continents and several countries, and incorporates a Board of Directors, an executive...... are adapted to and integrated within each community in collaboration with local decision makers, existing health care workers and traditional healers. Cornerstones of WSC's emphasis on long-term sustainability are (1) education of community partners, governments and local health professionals, and (2...

  12. Communities in Action: Lifelong Learning for Sustainable Development (United States)

    Noguchi, Fumiko; Guevara, Jose Roberto; Yorozu, Rika


    This handbook identifies principles and policy mechanisms to advance community-based learning for sustainable development based on the commitments endorsed by the participants of the "Kominkan-CLC International Conference on Education for Sustainable Development," which took place in Okayama City, Japan, in October 2014. To inform…

  13. Green Richland: Building Sustainable Local and World Community (United States)

    Lester, Carole N.


    This article shares the college's experiences and the lessons learned in the creation of the GREENRichland Program and the other approaches to building sustainability. These programs directly support the college's vision to be the best place to learn, teach, and build sustainable local and world community. This discussion features details…

  14. Partnership for Sustainable Communities: Five Years of Learning from Communities and Coordinating Federal Investments (United States)

    This report commemorating the fifth anniversary of the HUD-DOT-EPA Partnership for Sustainable Communities shows how the three agencies are changing their policies and removing barriers to help communities.

  15. Patients' views and experiences of technology based self-management tools for the treatment of hypertension in the community: A qualitative study. (United States)

    Glynn, Liam; Casey, Monica; Walsh, Jane; Hayes, Patrick S; Harte, Richard P; Heaney, David


    Patients with hypertension in the community frequently fail to meet treatment goals. The optimal way to organize and deliver care to hypertensive patients has not been clearly identified. The powerful on-board computing capacity of mobile devices, along with the unique relationship individuals have with newer technologies, suggests that they have the potential to influence behaviour. However, little is known regarding the views and experiences of patients using such technology to self-manage their hypertension and associated lifestyle behaviours. The aim of this study was to explore patients' views and experiences of using technology based self-management tools for the treatment of hypertension in the community. This focus group study was conducted with known hypertensive patients over 45 years of age who were recruited in a community setting in Ireland. Taped and transcribed semi-structured interviews with a purposeful sample involving 50 participants in six focus groups were used. Framework analysis was utilized to analyse the data. Four key inter-related themes emerged from the analysis: individualisation; trust; motivation; and communication. The globalisation of newer technologies has triggered many substantial and widespread behaviour changes within society, yet users are unique in their use and interactions with such technologies. Trust is an ever present issue in terms of its potential impact on engagement with healthcare providers and motivation around self-management. The potential ability of technology to influence motivation through carefully selected and tailored messaging and to facilitate a personalised flow of communication between patient and healthcare provider was highlighted. Newer technologies such as mobile devices and the internet have been embraced across the globe despite technological challenges and concerns regarding privacy and security. In the design and development of technology based self-management tools for the treatment of

  16. Enhancing Sustainable Communities With Green Infrastructure (United States)

    This publication aims to help local governments, water utilities, nonprofit organizations, neighborhood groups, and other stakeholders integrate green infrastructure strategies into plans that can transform their communities.

  17. Where Is "Community"?: Engineering Education and Sustainable Community Development (United States)

    Schneider, J.; Leydens, J. A.; Lucena, J.


    Sustainable development initiatives are proliferating in the US and Europe as engineering educators seek to provide students with knowledge and skills to design technologies that are environmentally sustainable. Many such initiatives involve students from the "North," or "developed" world building projects for villages or…

  18. Unveiling scientific communities about sustainability and innovation. A bibliometric journey around sustainable terms

    DEFF Research Database (Denmark)

    Franceschini, Simone; Faria, Lourenco; Jurowetzki, Roman


    innovation), and they concluded that such terms are mostly interchangeable. These findings surprise in light of the different positions shown in the innovation for sustainability debate. Our bibliometric analysis tracks meanings and communities associated with these four terms and indicates some overlaps......, especially between eco-innovation and environmental innovation. However, we found relevant differences of meanings and communities that reflect the different positions in the innovation for sustainability debate....

  19. Community participatory sustainable land management byelaw ...

    African Journals Online (AJOL)

    Widespread adoption of sustainable land management (SLM) innovations by land users is considered key in addressing the rampant land degradation in the high rainfall and densely populated highlands of eastern and southern Africa. However, absence of enabling policy environments hamperes massive adoption of SLM ...

  20. Classifying Adoption of Sustainability Policies and Programs: Quantitative and Qualitative Methods for the Development of a Community Sustainability Typology (United States)

    Understanding how and why different communities engage with sustainability policies and actions is of critical importance for furthering implementation of innovative and conventional sustainability strategies. Despite this importance, an understanding of how and why communities a...

  1. Community capacity building and sustainability: outcomes of community-based participatory research. (United States)

    Hacker, Karen; Tendulkar, Shalini A; Rideout, Catlin; Bhuiya, Nazmim; Trinh-Shevrin, Chau; Savage, Clara P; Grullon, Milagro; Strelnick, Hal; Leung, Carolyn; DiGirolamo, Ann


    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.

  2. Pump Management Committees and sustainable community water ...

    African Journals Online (AJOL)

    PMCs), technically known as Water and Sanitation Committees (WATSAN) in the water sector, are institutionalized organs for community water management. A survey of twenty-seven (27) of these institutions in six districts across the Upper ...

  3. Sustaining health education research programs in Aboriginal communities. (United States)

    Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra


    Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

  4. Role of community acceptance in sustainable bioenergy projects in India

    International Nuclear Information System (INIS)

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


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


    Directory of Open Access Journals (Sweden)

    Monika Skorek


    Full Text Available The paper presents an explanation of the essence of creation of consumer communities that have been developing for several years on the marketing market. A hypothesis was made that says that the mechanism of interdependence existing in the consumer community can be used to create sustainable consumption on the market. The method of literature study was used in the article. In the introduction it was proved that regardless of whether a community is formed independently around the brand or not, its existence is initiated by a company and its members interact by providing one another with the patterns of consumption. The reasons for consumers’ belonging to communities around the brand were described. The presented literature analysis revealed that the appropriate management of the community around the brand can serve the company to create a sustainable product consumption. 

  6. Incredible Edible: How to Grow Sustainable Communities (United States)

    Clarke, Paul


    This article seeks to provide an outline of the basic ideas and approaches used by the Incredible Edible programme, a community enterprise that is based in the United Kingdom. To do this the author briefly (1) defines the context for the programme, (2) defines the concepts that inform the programme, (3) and illustrates some of the action of the…

  7. Sustainable school development: professional learning communities

    NARCIS (Netherlands)

    Prof.Dr. E. Verbiest


    In this contribution we report about a project about Professional Learning Communities.This project combines development and research. In this contribution we pay attention to the effect of the organisational capacity of a school on the personal and interpersonal capacity and to the impact of a

  8. Development and application of a community sustainability visualization tool through integration of US EPA’s Sustainable and Health Community Research Program tasks (United States)

    Maintaining a harmonious balance between economic, social, and environmental well-being is paramount to community sustainability. Communities need a practical/usable suite of measures to assess their current position on a "surface" of sustainability created from the interaction ...

  9. Towards a Community-led Agenda for Urban Sustainability Research

    DEFF Research Database (Denmark)

    Eames, Malcolm; Mortensen, Jonas Egmose; Adebowale, Maria

    This report describes the findings from the Citizens Science for Sustainability (SuScit) Project. The report provides an overview of the innovative ‘bottom-up' public engagement and foresight process developed through the SuScit Project, before setting out a ten point agenda for urban...... sustainability research developed through our work with the local community in the Mildmay area of Islington, North London....

  10. Sustainable communities: Opportunities for integrated infrastructure

    International Nuclear Information System (INIS)

    Panetta, D.


    The world's holistic and interconnected relationships are becoming more evident on a daily basis. Areas of concern, previously thought of as independent, are being revealed as interdependent. The choice of technological systems for use in such an interconnected system can often have unforeseen consequences. We have understood that wastewater treatment (WT) effects water quality since the 19th century. However, other important, although less evident relationships exist concerning wastewater treatment. This paper explores some of the impacts that the choice of waste-water treatment technology has on energy, ecology and the community's ability to afford housing, parks and open space. It concludes that the choice and implementation of wastewater treatment systems is of paramount concern to the quality of our lives. Many alternatives currently exist to conventional treatment processes. One of the more successful alternatives is discussed along with its potential to mitigate potential adverse impacts and to function as an amenity in the community rather than simply an expensive requirement

  11. Community Vitality: The Role of Community-Level Resilience Adaptation and Innovation in Sustainable Development

    Directory of Open Access Journals (Sweden)

    Lenore Newman


    Full Text Available Community level action towards sustainable development has emerged as a key scale of intervention in the effort to address our many serious environmental issues. This is hindered by the large-scale destruction of both urban neighbourhoods and rural villages in the second half of the twentieth century. Communities, whether they are small or large, hubs of experimentation or loci of traditional techniques and methods, can be said to have a level of community vitality that acts as a site of resilience, adaptation and innovation in the face of environmental challenges. This paper outlines how community vitality acts as a cornerstone of sustainable development and suggests some courses for future research. A meta-case analysis of thirty-five Canadian communities reveals the characteristics of community vitality emerging from sustainable development experiments and its relationship to resilience, applied specifically to community development.

  12. A Case Study in Organizing for Livable and Sustainable Communities

    Directory of Open Access Journals (Sweden)

    Jerry Marx


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

  13. New forms of dwelling – sustainable urban communities

    Directory of Open Access Journals (Sweden)

    Mojca Šašek Divjak


    Full Text Available Various new forms of settlements composed of sustainable communities are emerging all around the World as answers to the urban crises in great cities. These settlements differ, especially when comparing the countries where they appear. However they also have many common features, such as the humane scale and social community cohesion, public participation in their management, enforcing new societal values and sustainable orientation of activities. These settlements where developed following development of information and communication technology and correspond to the introduction of new styles of life and employment.

  14. Sustaining knowledge in the neutron generator community and benchmarking study.

    Energy Technology Data Exchange (ETDEWEB)

    Barrentine, Tameka C.; Kennedy, Bryan C.; Saba, Anthony W.; Turgeon, Jennifer L.; Schneider, Julia Teresa; Stubblefield, William Anthony; Baldonado, Esther


    In 2004, the Responsive Neutron Generator Product Deployment department embarked upon a partnership with the Systems Engineering and Analysis knowledge management (KM) team to develop knowledge management systems for the neutron generator (NG) community. This partnership continues today. The most recent challenge was to improve the current KM system (KMS) development approach by identifying a process that will allow staff members to capture knowledge as they learn it. This 'as-you-go' approach will lead to a sustainable KM process for the NG community. This paper presents a historical overview of NG KMSs, as well as research conducted to move toward sustainable KM.

  15. Tourism policies and sustainability in traditional communities: conceptual perspectives

    Directory of Open Access Journals (Sweden)

    Paulo Moreira Pinto


    Full Text Available The public policies of tourism in Brazil and in the Amazon, analyzing its implications in the political and administrative reality of traditional communities and its relationship with the historical sustainability of those populations in relation to the natural environment. It is an exploratory research, and in order to achieve its goal, describes the trajectory of the public policies of tourism in Brazil and, particularly, in the Amazon confronting them with theoretical background that support the formation of public policies, specially of sustainable tourism, which permeates the new programs of tourism and foresees the inclusion of community participation as an important element to carry out the public policies of tourism.

  16. Teen Advocates for Community and Environmental Sustainability (United States)

    Wunar, B.


    The Museum of Science and Industry, Chicago (MSI) is in the early stages of a NOAA supported Environmental Literacy Grant project that aims to engage high school age youth in the exploration of climate and Earth systems science. Participating youth are positioned as teen advocates for establishing resilient communities in the Midwest. The project utilizes a variety of resources, including NOAA Science On a Sphere® (SOS) technology and datasets, Great Lakes and local climate assets, and local municipal resiliency planning guides to develop museum-based youth programming. Teen participants in the project will share their learning through regular facilitated interactions with public visitors in the Museum and will bring learning experiences to Chicago Public Library sites throughout the city's neighborhoods. Project content will also be adapted for use in 100+ after-school science clubs to engage younger students from diverse communities across the Chicago area. Current strategies for supporting teen facilitation of public experiences, linkages to out of school time and summer learning programs, and connections to local resiliency planning agencies will be explored.

  17. Integrating community health workers into a patient-centered medical home to support disease self-management among Vietnamese Americans: lessons learned. (United States)

    Wennerstrom, Ashley; Bui, Tap; Harden-Barrios, Jewel; Price-Haywood, Eboni G


    There is evidence that patient-centered medical homes (PCMHs) and community health workers (CHWs) improve chronic disease management. There are few models for integrating CHWs into PCMHs in order to enhance disease self-management support among diverse populations. In this article, we describe how a community-based nonprofit agency, a PCMH, and academic partners collaborated to develop and implement the Patient Resource and Education Program (PREP). We employed CHWs as PCMH care team members to provide health education and support to Vietnamese American patients with uncontrolled diabetes and/or hypertension. We began by conducting focus groups to assess patient knowledge, desire for support, and availability of community resources. Based on findings, we developed PREP with CHW guidance on cultural tailoring of educational materials and methods. CHWs received training in core competencies related to self-management support principles and conducted the 4-month intervention for PCMH patients. Throughout the program, we conducted process evaluation through structured team meetings and patient satisfaction surveys. We describe successes and challenges associated with PREP delivery including patient recruitment, structuring/documenting visits, and establishing effective care team integration, work flow, and communication. Strategies for mitigating these issues are presented, and we make recommendations for other PCMHs seeking to integrate CHWs into care teams. © 2014 Society for Public Health Education.

  18. Teacher-Community Cooperation to Promote Sustainability of ...

    African Journals Online (AJOL)

    This study was undertaken with 83 teachers from 54 primary schools in Kenya. Its purpose was to establish how teachers relate with the local community and how they harness this interaction to promote sustainability of wetlands within their locality. Data were collected using questionnaires, interviews and observation.

  19. Community management and sustainability of rural water facilities in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.; Butijn, C.A.A.; Niehof, Anke


    This paper addresses the question of whether community management in water service delivery affects the sustainability of rural water facilities (RWFs) at village level, in terms of their technical and managerial aspects, and what role capacity building of users and providers plays in this process.

  20. An Informatics Approach to Establishing a Sustainable Public Health Community (United States)

    Kriseman, Jeffrey Michael


    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  1. Reciprocity as Sustainability in Campus-Community Partnership (United States)

    Bloomgarden, Alan


    The concept of reciprocity permeates the literature on campus-community partnership as a matter of principle, aspiration, and--ideally--best practice. More recently, principles and practices of sustainability have pervaded scholarly and popular discourse, emerging from and applying to environmental studies, economic development, and social justice…

  2. Partnering for a greener community, Virginia Tech, the Town of Blacksburg, and Sustainable Blacksburg present Sustainability Week 2008


    Harris, Jennifer


    Virginia Tech, the Town of Blacksburg and Sustainable Blacksburg have partnered to present Sustainability Week 2008, Oct. 20 through 25. During Sustainability Week more than 20 activities, events and tours, focused on building and sustaining a greener community, have been scheduled.

  3. Community Disaster and Sustainability Teams for Civil Protection (United States)

    Kelman, I.; Cordonnier, B.


    Many examples of community-based teams for civil protection and disaster risk reduction exist. Turkey has a Community Disaster Volunteer Training Program while the USA has Community Emergency Response Teams which have been extended into secondary schools as Teen School Emergency Response Training. The principles and practices of these teams further apply directly to other development and sustainability endeavours, all of which are intricately linked to disaster risk reduction and civil protection. An example is keeping local water courses and storm drains clear from rubbish. That improves community health and cleanliness while assisting rainfall drainage to reduce flood risk. The "community teams" concept, as implemented for civil protection and disaster risk reduction, therefore connects with day-to-day living, such as ensuring that all community members have adequate access to water, food, waste management, shelter, health care, education, and energy. Community teams should be based on the best science and pedagogy available to ensure that concepts, training, skills, and implementation are effective and are maintained over the long-term. That entails going beyond the interest that is commonly generated by highlighting high-profile events, such as hurricanes and earthquakes, or high-profile concerns, such as climate change or terrorism. When community teams are focused on high-profile challenges, maintaining interest can be difficult without specific manifestations of the perceived "number one threat". Incorporating day-to-day concerns into civil protection can overcome that. For example, the community teams' talents and energy could be used for picking up rubbish, for educating about health and waste disposal, and for conducting vulnerability assessments in order to inspire action for continual vulnerability reduction. In addition to the examples given above, Japan's Jishu-bosai-soshiki community activities and Asia's "Townwatch" initiative adopt wider and deeper

  4. Factors influencing perceived sustainability of Dutch community health programs. (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K


    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email:

  5. Pediatric obesity community programs: barriers & facilitators toward sustainability. (United States)

    Po'e, Eli K; Gesell, Sabina B; Lynne Caples, T; Escarfuller, Juan; Barkin, Shari L


    Our current generation of young people could become the first generation to live shorter lives than their parents. Families need resources in their community to address this issue. Identifying barriers and facilitators of community organizations to offer obesity-related services is a first step in understanding sustainable community programs. The objective of this study is to identify common barriers and facilitators in community organizational programs designed to prevent or reduce pediatric obesity. We conducted an exploratory qualitative research study based on grounded theory. Thirty-six community organizations were identified based on self-descriptions of goals involving pediatric obesity. Semi-structured, systematic, face-to-face interviews among program directors (n = 24) were recorded, transcribed, and coded for recurrent themes. Relevant themes were abstracted from interviews by a standardized iterative process by two independent reviewers between December 2007 and November 2008. Theme discordance was reconciled by a third reviewer. Seventy percent of organizations indicated that obesity prevention/treatment was their explicit goal with remaining groups indicating healthy lifestyles as a more general goal. Facilitators to provision of these programs included: programmatic enhancements such as improved curriculums (73%), community involvement such as volunteers (62.5%), and partnerships with other programs (54.2%). Barriers that threatened sustainability included lack of consistent funding (43.8%), lack of consistent participation from the target population (41.7%) and lack of support staff (20.8%). New approaches in fostering partnerships between organizations need to be developed. Building coalitions and engaging community members in developing community based programs may be a helpful strategy to strengthen community-based programs to address the pediatric obesity epidemic.

  6. Community Strategic Relationship and Marketing to Foster the Development of communities and the sustainability of organizations

    Directory of Open Access Journals (Sweden)

    Fernando Juárez


    Full Text Available The purpose of this study was to define community strategic relationship and marketing (CSRM as a relevant tool to foster the development of communities and the sustainability of organizations. The method was rationalist, theoretical, and conceptual; it comprised the analysis of a propositional structure. Articulated propositions provided a framework for analysis, discussion, and conclusions. After giving a definition of CSRM, several analyses were conducted that determined the uniqueness and usefulness of this approach. These analyses were: 1 the usefulness of the community concepts and strategies in CSRM, 2 the existence of a community approach to different strategic areas or marketing, and 3 the relevance of the use of community concepts and strategies to foster the development of communities and the sustainability of organizations. The conclusion was that CSRM and the use of these concepts and strategies have the potential to be a fruitful research and strategic approach in marketing and in all of organization activities

  7. The new district energy : building blocks for sustainable community development

    International Nuclear Information System (INIS)


    The price of energy is expected to rise as world demand for fossil fuels increases and energy supplies become harder to access. Governments and businesses are interested in the role of energy in the design, development and operation of buildings and whole communities. In addition to contributing to community economic development, district energy (DE) systems can assist communities in meeting their goals for sustainable growth and in managing the changing nature of risk in the generation and delivery of energy. This handbook was developed in order to encourage information sharing and provide ideas on how to advance district energy development in communities across Canada. The handbook identified those who could use DE and listed the benefits provided by DE. These included community, environmental, and business benefits. The handbook also offered suggestions for overcoming common challenges experienced by communities initiating a DE system and provided a checklist to help accelerate the uptake of DE systems in a community. These challenges included working with the community; using integrated design; building knowledge, know-how and technical skills; and partnering to improve project financing and reducing development risk. 50 refs., 8 tabs., 11 figs

  8. Perceived sustainability of community telepharmacy in North Dakota. (United States)

    Scott, David M; Friesner, Daniel L; Undem, Teri; Anderson, Gabrielle; Sem, Kelli; Peterson, Charles D

    To assess the sustainability of the business model underlying the North Dakota Telepharmacy Project (NDTP). Of the 38 community pharmacy organizations (14 central, 24 remote), 27 organizations (11 central and 16 remote sites) in North Dakota provided a useable set of responses (71.1% response rate). A twelfth organization (a community pharmacy) ceased operations over the study's time frame and was not included in the data analysis. Emphasis is placed on NDTP community telepharmacies, because the community telepharmacy business model is more established than hospital telepharmacies. Yet little is known about the long-run financial viability of telepharmacies. Originally funded by a series of federal grants, the goal of the NDTP was to create the infrastructure necessary to support the development of telepharmacy sites. A 48-item questionnaire assessed the self-reported operational, financial, and community impacts of a community telepharmacy. The questionnaire was administered from December 2015 to February 2016 to all NDTP community telepharmacy owners-managers. Thus, 1 participant (owner-manager) addressed both central and remote-site locations served by a pharmacy. Most respondents reported that their telepharmacy sites (especially remote sites) generate small positive financial returns for the organization. Respondents also reported that the closure of their remote sites would significantly harm the communities they serve. NDTP aims of restoration and retention have been achieved via the investment and shared decision making with pharmacy owners in North Dakota. The telepharmacy model is sustainable, even if it does not generate significant economic profit. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  9. Social education, human rights and sustainability in community development

    Directory of Open Access Journals (Sweden)

    José Antonio CARIDE GÓMEZ


    Full Text Available The article places its contributions in a reflection of a pedagogical and social nature about the links that are established between social education, human rights and sustainability in community development. In this regard, in a historical and prospective key, it places emphasis on the need to promote educational actions that, being consistent with the principles of equity and justice, make it possible to build a more democratic, inclusive and cohesive local-global society.A future expectation that must be confined to educational theories and practices where local communities assume the role they play in their own development processes, with an alternative vision to the ways of educating people and themselves on a daily basis, respectful of human and ecological rights. A line of action that coincides with the commitments made at the Global Action Programme on Education for Sustainable Development, adopted by UNESCO, and Resolution A/70/1 adopted by the General Assembly in 2015, Transform our world: the 2030 Agenda for Sustainable Development, guaranteeing lifelong learning for all.In this objective beats a decisive, although not explicit, of a pedagogical-social vocation: to train citizens that, individually and collectively being aware of their role in socio-environmental changes, assume the responsibilities inherent to the values that sustain life in all its diversity. Social education and community development that, by projecting initiatives in different times and social spaces, allows formative opportunities to be expanded beyond the school system and its curricular practices. The Environmental Education and the Local Agenda 21 continue being two references main for the reflection-action educational and community.

  10. Sustainability Assessment: Energy Efficiency in Buildings at a Community University

    Directory of Open Access Journals (Sweden)

    Stephane Louise Bocasanta


    Full Text Available This research aims to analyze the degree of sustainability of a building in a community university (object of analysis, as regards its energy efficiency. Therefore, it seeks out to contribute to the literature, provide a basis for the application of SICOGEA system in other buildings and contribute to the consolidation of an effective and consistent environmental management system. The research can be classified, as to its technical procedures, as a case study. As to its objectives it is descriptive, with a qualitative approach. The literature on environmental management and sustainability assessment of buildings was used to support the research. As to the results found, the overall University sustainability rate was 48%, which can be classified as regular, that is, it aims to deal with the legislation only. Therefore, it is believed that the institution can make improvements to achieve a more efficient index. By taking into consideration the deficit items, the following is suggested: to introduce sustainable procurement; to strive for stamps and certifications; to avoid environmental fines and indemnity; and to implement environmental auditing. However, it is clarified that these are suggestions that should be taken into consideration along with financial matters and within the institution planning questions. The analysis of financial sustainability was considered good and, ideally, it will go on.

  11. ISABEL Triggering Sustainable Biogas Energy Communities through Social Innovation (United States)

    Baumgarten, Wibke; Piedra Garcia, Diego


    The Horizon 2020 funding project ISABEL (Triggering Sustainable Biogas Energy Communities through Social Innovation) is all about promoting, supporting and developing community biogas in Europe. The project is set on providing all the framework conditions for biogas communities to shape, develop and thrive. It works on all angles to pave the way for the transition from traditional supply chains to community ownership and take full advantage of the ample societal benefits of regional community-driven biogas systems, fuelled and inspired by Social Innovation principles. The biogas communities emerge in three targeted ISABEL regions, Baden-Württemberg in Germany, Central and Eastern Macedonia and Thrace in Greece and Yorkshire, Lincolnshire and the Humber in UK. To realize this vision ISABEL is employing its "5E strategy" with the following objectives: Educate: Re-position biogas energy by re-branding it as a "public good". Engage: Enable the development of regional Biogas Communities. Empower: Utilize the created momentum through Social Innovation and Public Participation Evaluate: Assess the local interventions and drafting lessons and guidelines Expand: Maximise impact through transfer and replication

  12. 77 FR 10543 - Announcement of Funding Awards for the Capacity Building for Sustainable Communities Program for... (United States)


    ... Awards for the Capacity Building for Sustainable Communities Program for Fiscal Year 2011 AGENCY: Office... INFORMATION: The Capacity Building for Sustainable Communities Program identifies intermediary organizations... announces the allocation total of $5.65 million for Capacity Building for Sustainable Communities grants, of...

  13. Are community-based nurse-led self-management support interventions effective in chronic patients? Results of a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Azzurra Massimi

    Full Text Available The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context. The aim of this systematic review and meta-analysis is to assess the efficacy of the nurse-led self-management support versus usual care evaluating patient outcomes in chronic care community programs. Systematic review was carried out in MEDLINE, CINAHL, Scopus and Web of Science including RCTs of nurse-led self-management support interventions performed to improve observer reported outcomes (OROs and patients reported outcomes (PROs, with any method of communication exchange or education in a community setting on patients >18 years of age with a diagnosis of chronic diseases or multi-morbidity. Of the 7,279 papers initially retrieved, 29 met the inclusion criteria. Meta-analyses on systolic (SBP and diastolic (DBP blood pressure reduction (10 studies-3,881 patients and HbA1c reduction (7 studies-2,669 patients were carried-out. The pooled MD were: SBP -3.04 (95% CI -5.01--1.06, DBP -1.42 (95% CI -1.42--0.49 and HbA1c -0.15 (95% CI -0.32-0.01 in favor of the experimental groups. Meta-analyses of subgroups showed, among others, a statistically significant effect if the interventions were delivered to patients with diabetes (SBP or CVD (DBP, if the nurses were specifically trained, if the studies had a sample size higher than 200 patients and if the allocation concealment was not clearly defined. Effects on other OROs and PROs as well as quality of life remain inconclusive.

  14. A center for self-management of chronic illnesses in diverse groups. (United States)

    Inouye, Jillian; Boland, Mary G; Nigg, Claudio R; Sullivan, Kathleen; Leake, Anne; Mark, Debra; Albright, Cheryl L


    Prevention and successful treatment of chronic disease require a scientific understanding of the impacts and interactions of ethnicity, culture, and illness on self-management interventions. This article presents one approach to developing effective methods to address the needs of ethnic minorities living with chronic illnesses. Described is the University of Hawaii Center for Ohana Self-Management of Chronic Illnesses (COSMCI) located in the School of Nursing & Dental Hygiene and funded by the National Institute of Nursing Research (Award Number P20NR010671). The interdisciplinary center focuses on family and community self-management interventions in ethnically diverse populations with chronic illnesses. Areas discussed are: 1) the operational structure for creating an environment conducive to interdisciplinary ohana self-management chronic illness research in ethnically diverse populations; and 2) the development of sustainable interdisciplinary, biobehavioral research capacity. The COSMCI uses a social cognitive theory framework to guide the application of established self-management interventions to Asian and Pacific Island populations (API) through three conceptually linked research projects on HIV infection, type 2 diabetes, and chronic obstructive pulmonary disease. COSMI addresses the feasibility of sharing of lessons learned among the approaches taken. The interdisciplinary nature of COSMCI increases the potential success of the intervention efforts. Hawaii Medical Journal Copyright 2010.

  15. Editorial: Creating, Supporting, Sustaining and Evaluating Virtual Learning Communities

    Directory of Open Access Journals (Sweden)

    Xun Ge


    Full Text Available This special issue is dedicated to creating, building, supporting, sustaining and evaluating virtual learning communities (VLCs using emerging technologies. The contributors from diverse disciplines have come together to share their valuable experiences and findings through their research in the following themes: (a instructional models, strategies, approaches for building, supporting and evaluating VLCs, (b designing effective use of tools to promote discourse and scaffold peer interactions among members, (c iterative processes and models of designing and evaluating VLCs; and (d various variables concerning VLCs, such as virtual community behaviors, cultural factors, adoption patterns of tools. It is hoped that these articles will provide practical guidance and offer valuable experience to both educators and researchers who are interested in designing effective VLCs and examining various aspects of VLCs to advance our understanding of VLCs.

  16. Toward a Sustained, Multi-disciplinary Socioeconomic Community (United States)

    Pearlman, J.; Pearlman, F.


    Over the last several years the availability of geospatial data has evolved from a scarce and expensive resource, primarily provided by governmental organizations to an abundant resource, often sourced at no or minimum charge by a much broader community including citizen scientists. In an upcoming workshop (October 28/29, 2014), the consequences of the changing technology, data, and policy landscape will be examined thus evaluating the emerging new data-driven paradigms, and advancing the state-of-the-art methodologies to measure the resulting socioeconomic impacts. Providers and users of geospatial data span a broad range of multi-disciplinary areas include policy makers and analysts, financial analysts, economists, geospatial practitioners and other experts from government, academia and the private sector. This presentation will focus on the emerging plan for a sustained, multi-disciplinary community to identify and pursue exemplary use cases for further research and applications. Considerations will include the necessary outreach enablers for such a project.

  17. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity]. (United States)

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M


    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Promoting Community Socio-Ecological Sustainability through Technology: A Case Study from Chile (United States)

    Aguayo, Claudio; Eames, Chris


    The importance of community learning in effecting social change towards ecological sustainability has been recognised for some time. More recently, the use of Information and Communication Technology (ICT) tools to promote socio-ecological sustainability has been shown to have potential in community education for sustainable development (ESD). The…

  19. Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data. (United States)

    Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick


    Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

  20. Social support systems as determinants of self-management and quality of life of people with diabetes across Europe: study protocol for an observational study. (United States)

    Koetsenruijter, Jan; van Lieshout, Jan; Vassilev, Ivaylo; Portillo, Mari Carmen; Serrano, Manuel; Knutsen, Ingrid; Roukova, Poli; Lionis, Christos; Todorova, Elka; Foss, Christina; Rogers, Anne; Wensing, Michel


    Long-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much research on self-management focuses on individual competencies, while the social systems of support that facilitate self-management are underexplored. The presented study aims to explore the role of social systems of support for self-management and quality of life, focusing on the social networks of people with diabetes and community organisations that serve them. The protocol concerns a cross-sectional study in 18 geographic areas in six European countries, involving a total of 1800 individuals with diabetes and 900 representatives of community organisations. In each country, we include a deprived rural area, a deprived urban area, and an affluent urban area. Individuals are recruited through healthcare practices in the targeted areas. A patient questionnaire comprises measures for quality of life, self-management behaviours, social network and social support, as well as individual characteristics. A community organisations' survey maps out interconnections between community and voluntary organisations that support patients with chronic illness and documents the scope of work of the different types of organisations. We first explore the structure of social networks of individuals and of community organisations. Then linkages between these social networks, self-management and quality of life will be examined, taking deprivation and other factors into account. This study will provide insight into determinants of self-management and quality of life in individuals with diabetes, focusing on the role of social networks and community organisations.

  1. Four Stories: People, Communities and Sustainability. Environments for Life Conservation Issues Forum Series. (United States)

    Pearson, Andrew

    Education about sustainability is the foundation of conservation efforts. This publication was designed to inform and inspire individuals and communities that may be contemplating or already undertaking efforts to promote community sustainability. The four stories in this booklet are: (1) "Coastal Community Connections"; (2) "Cultivating Farm…

  2. Sustaining diversity in trait-based models of phytoplankton communities

    Directory of Open Access Journals (Sweden)

    Agostino eMerico


    Full Text Available It is well-established that when equilibrium is attained for two species competing for the same limiting resource in a stable, uniform environment, one species will eliminate the other due to competitive exclusion. While competitive exclusion is observed in laboratory experiments and ecological models, the phenomenon seems less common in nature, where static equilibrium is prevented by the fluctuating physical environment and by other factors that constantly change species abundances and the nature of competitive interactions. Trait-based models of phytoplankton communities appear to be useful tools for describing the evolution of large assemblages of species with aggregate group properties such as total biomass, mean trait, and trait variance, the latter representing the functional diversity of the community. Such an approach, however, is limited by the tendency of the trait variance to unrealistically decline to zero over time. This tendency to lose diversity, and therefore adaptive capacity, is typically solved by fixing the variance or by considering exogenous processes such as immigration. Exogenous processes, however, cannot explain the maintenance of adaptive capacity often observed in the closed environment of chemostat experiments. Here we present a new method to sustain diversity in adaptive trait-based models of phytoplankton communities based on a mechanism of trait diffusion through subsequent generations. Our modeling approach can therefore account for endogenous processes such as rapid evolution or transgenerational trait plasticity.

  3. The Effects and Costs of a Group-Based Education Programme for Self-Management of Patients with Type 2 Diabetes. A Community-Based Study (United States)

    Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole


    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…

  4. Dimensions of osteoarthritis self-management. (United States)

    Prior, Kirsty N; Bond, Malcolm J


    Our aims were to determine whether a taxonomy of self-management strategies for osteoarthritis could be identified, and whether the resultant dimensions of such a taxonomy demonstrate predictable relationships with health status indices. Participants (n = 117) from community-based self-help groups and a general rheumatology outpatient clinic completed a self-management inventory consisting of 11 items, answered for both the past 7 days and a day on which symptoms were worse than usual. Duration of symptoms, level of pain, perceived functional ability and self-rated health were recorded as indicators of health status. Three essentially identical factors were obtained for both past 7 days and worse day items. Resultant scales were labeled passive, complementary and active, respectively. Correlations with health status measures provided modest evidence for the construct validity of these self-management scales. Compared with a simple aggregate score based on the total number of strategies used, the scales provided a clearer understanding of the relationship between self-management and health. The study provided a useful extension to existing research, addressing a number of shortcomings identified by previous researchers. The identified self-management dimensions offered a greater insight into the self-management choices of patients. Suggestions for further improvements to the measurement of self-management are outlined.

  5. Who is Next? Identifying Communities with the Potential for Increased Implementation of Sustainability Policies and Programs (United States)

    Understanding the system of connections between societal contexts and policy outcomes in municipal governments provides important insights into how community sustainability happens, and why it happens differently in various communities. A growing body of research in recent years ...

  6. Social Sustainability through Social Interaction—A National Survey on Community Gardens in Germany

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    Nicole Rogge


    Full Text Available Community gardening has become a growing movement in cities all over the world, where these diverse collectively managed spaces provide various economic, ecological, and social benefits for urban residents. Particularly in developed countries such as Germany, social benefits are the motivation to participate in community gardens more so than the harvests. Although research on community gardens has grown, including the question of their benefits to a sustainable development, there is little literature studying the social importance and social sustainability of community gardens. Therefore, the purpose of this paper is to examine social interaction, participation, and perceived success as a concept to assess social sustainability. The paper further aims to examine the conditions influencing social sustainability within community gardens. With the help of an online survey, we collect data from 123 community gardens throughout Germany, with which we assess diverse degrees of social sustainability. Causalities of gardens’ social sustainability are analyzed with a multiple linear regression model. Results indicate that there is no significant relationship between size of community and social sustainability, rather aspects of trust and management have a strong effect on social sustainability. Findings like these lead to a better understanding of social interaction in urban communities that contribute to more social sustainability.

  7. An internet survey of the characteristics and physical activity of community-dwelling Australian adults with acquired brain injury: Exploring interest in an internet-delivered self-management program focused on physical activity. (United States)

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


    Individuals with acquired brain injury (ABI) are more likely to be physically inactive and experience barriers to accessing services to address inactivity. This study was designed to guide the development of an internet-delivered self-management program to increase physical activity after ABI. The aims of this study were to examine the current physical activity status of community-dwelling Australian adults with ABI, the barriers to physical activity they experience and to explore interest an internet-delivered self-management program aimed at increasing physical activity. An online survey of Australian adults with ABI was used to collect information about demographic characteristics; general health; emotional well-being; mobility and physical activity status, and satisfaction; barriers to physical activity; confidence in overcoming barriers, and; interest in an internet self-management program. Data were analyzed descriptively and correlational analyses examined relationships between variables. Data were analyzed from 59 respondents. Over half were not satisfied with their current physical activity status. The most frequently reported barriers were pain/discomfort, fatigue and fear, and confidence to overcome these barriers was very low. Interest in an internet-delivered self-management program was high (74%) and not related to the amount of physical activity, satisfaction with physical activity and mobility status or total number of barriers. Australian adults with ABI are not satisfied with their activity levels and experience barriers in maintaining their physical activity levels. Participants were interested in accessing an internet-delivered self-management program aimed at improving physical activity levels. Therefore such a program warrants development and evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. [Establishing self-management for chronic spinal cord injury patients: a qualitative investigation]. (United States)

    Okochi, Ayako; Tadaka, Etsuko


    Self-management is essential for individuals with chronic cervical spinal cord injury, but some cases of self-neglect have been reported. The objective of this study was to examine the establishment of self-management in order to help inform community care practice. This was a qualitative study applying a grounded theory approach with semi-structured home interviews. We interviewed 29 individuals with cervical spinal cord injuries (aged 26-77 years) who were members of each of the three branches of the nationwide self-help group, or the clients of a home-visit nursing care station. Qualitative analysis was implemented from a time transition perspective consisting of the faint awareness period, the seeking period, and the adaptation period. The analysis included the perceptions and methods of self-management. The process of establishing self-management was abstracted into a core category of "continuous adaptation to minimize the extent to which the individual's life was disrupted and to allow them to continue to live within the community". This in turn consisted of seven categories. In the faint awareness period, subjects perceived that they "hardly recognized health maintenance needs", that they had difficulties in acknowledging the necessity of controlling physical conditions, and that they were dependent on caregivers. In the seeking period, they were "driven by handling uncontrollable changes" and they coped with those changes in their own way and sometimes did not consider it necessary to see a doctor. In this period, a process of "searching for the methods of being healthy somehow" begun and they started to understand the degree to which they could cope without medication, together with their own responsibilities, and searched for the best coping methods and acted on advice. In the adaptation period, individuals were "struggling to continue the established health methods"; "managing stress"; "prioritizing their own beliefs over medical regimens"; and

  9. Enhancing patient engagement in chronic disease self-management support initiatives in Australia: the need for an integrated approach. (United States)

    Jordan, Joanne E; Briggs, Andrew M; Brand, Caroline A; Osborne, Richard H


    Although emphasis on the prevention of chronic disease is important, governments in Australia need to balance this with continued assistance to the 77% of Australians reported to have at least one long-term medical condition. Self-management support is provided by health care and community services to enhance patients' ability to care for their chronic conditions in a cooperative framework. In Australia, there is a range of self-management support initiatives that have targeted patients (most notably, chronic disease self-management education programs) and health professionals (financial incentives, education and training). To date, there has been little coordination or integration of these self-management initiatives to enhance the patient-health professional clinical encounter. If self-management support is to work, there is a need to better understand the infrastructure, systems and training that are required to engage the key stakeholders - patients, carers, health professionals, and health care organisations. A coordinated approach is required in implementing these elements within existing and new health service models to enhance uptake and sustainability.

  10. Online extremism and the communities that sustain it: Detecting the ISIS supporting community on Twitter (United States)

    Joseph, Kenneth; Carley, Kathleen M.


    The Islamic State of Iraq and ash-Sham (ISIS) continues to use social media as an essential element of its campaign to motivate support. On Twitter, ISIS’ unique ability to leverage unaffiliated sympathizers that simply retweet propaganda has been identified as a primary mechanism in their success in motivating both recruitment and “lone wolf” attacks. The present work explores a large community of Twitter users whose activity supports ISIS propaganda diffusion in varying degrees. Within this ISIS supporting community, we observe a diverse range of actor types, including fighters, propagandists, recruiters, religious scholars, and unaffiliated sympathizers. The interaction between these users offers unique insight into the people and narratives critical to ISIS’ sustainment. In their entirety, we refer to this diverse set of users as an online extremist community or OEC. We present Iterative Vertex Clustering and Classification (IVCC), a scalable analytic approach for OEC detection in annotated heterogeneous networks, and provide an illustrative case study of an online community of over 22,000 Twitter users whose online behavior directly advocates support for ISIS or contibutes to the group’s propaganda dissemination through retweets. PMID:29194446

  11. Renewable energy and sustainable communities: Alaska's wind generator experience†

    Directory of Open Access Journals (Sweden)

    R. Steven Konkel


    villages, b. impacts associated with climate change on human health, c. progress in better understanding wind energy potential through resource assessments and new tools for detailed feasibility and project planning, d. need for comprehensive monitoring and data analysis, and e. state funding requirements and opportunity costs. Conclusion . The energy policy choices ahead for Alaska will have important implications for Arctic population health, especially for those villages whose relatively small size and remote locations make energy a key component of subsistence lifestyles and community sustainability. Wind generation can contribute to meeting renewable energy goals and is a particularly important resource for rural and remote Alaskan communities currently dependent on diesel fuel for generating electricity and heat.

  12. Renewable energy and sustainable communities: Alaska's wind generator experience. (United States)

    Konkel, R Steven


    better understanding wind energy potential through resource assessments and new tools for detailed feasibility and project planning, need for comprehensive monitoring and data analysis, and state funding requirements and opportunity costs. The energy policy choices ahead for Alaska will have important implications for Arctic population health, especially for those villages whose relatively small size and remote locations make energy a key component of subsistence lifestyles and community sustainability. Wind generation can contribute to meeting renewable energy goals and is a particularly important resource for rural and remote Alaskan communities currently dependent on diesel fuel for generating electricity and heat.

  13. Renewable energy and sustainable communities: Alaska's wind generator experience† (United States)

    Konkel, R. Steven


    with climate change on human health,progress in better understanding wind energy potential through resource assessments and new tools for detailed feasibility and project planning,need for comprehensive monitoring and data analysis, andstate funding requirements and opportunity costs. Conclusion The energy policy choices ahead for Alaska will have important implications for Arctic population health, especially for those villages whose relatively small size and remote locations make energy a key component of subsistence lifestyles and community sustainability. Wind generation can contribute to meeting renewable energy goals and is a particularly important resource for rural and remote Alaskan communities currently dependent on diesel fuel for generating electricity and heat. PMID:23971014

  14. Sustainable energy communities: a study contrasting Spain and Germany

    International Nuclear Information System (INIS)

    Romero-Rubio, Carmen; Andrés Díaz, José Ramón de


    In recent years, several governments and organisations in the developed world have encouraged the creation of sustainable energy communities (SECs) as a strategy for achieving their energy and environmental targets. However, whereas in some of these countries (e.g., Germany), numerous SECs have been founded, there are other countries, such as Spain, where the creation and growth of SECs has been much slower. The purpose of this article is to analyse the case of Spain, to determine the causes of the lack of SECs in this country, and to propose actions adapted to the Spanish context aimed at accelerating the creation of SECs. To facilitate these tasks, we have taken the German case as a reference. The key finding is that, in contrast to Germany, in Spain, SECs have scarcely contributed to the development of RE (Renewable energy) infrastructures, despite having similar incentives for renewable electricity (until recently). Moreover, in Spain, these incentives have been drastically cut recently. Therefore, it has become even more difficult to finance a renewable electricity generation plant. That is why strategies in sectors other than renewable electricity have been suggested for the encouragement of SECs in Spain. -- Highlights: •Collective-ownership models for RE (Renewable energy) infrastructures are very widespread in Germany. •Approximately 22% of the installed renewable electricity capacity in Germany is owned by SECs. •In contrast, collective ownership of RE infrastructures is rare in Spain. •In Spain, incentives for renewable electricity have been drastically cut recently. •To encourage SECs, energy activities other than renewable electricity production are proposed

  15. Evaluating the engagement of universities in capacity building for sustainable development in local communities. (United States)

    Shiel, Chris; Leal Filho, Walter; do Paço, Arminda; Brandli, Luciana


    Universities have the potential to play a leading role in enabling communities to develop more sustainable ways of living and working however, sustainable communities may only emerge with facilitation, community learning and continual efforts to build their capacities. Elements of programme planning and evaluation on the one hand, and capacity building on the other, are needed. The latter entails approaches and processes that may contribute to community empowerment; universities may either lead such approaches, or be key partners in an endeavour to empower communities to address the challenges posed by the need for sustainable development. Although capacity building and the promotion of sustainable development locally, are on the agenda for universities who take seriously regional engagement, very little is published that illustrates or describes the various forms of activities that take place. Further, there is a paucity of studies that have evaluated the work performed by universities in building capacity for sustainable development at the local level. This paper is an attempt to address this need, and entails an empirical study based on a sample of universities in the United Kingdom, Germany, Portugal and Brazil. The paper examines the extent to which capacity building for sustainable development is being undertaken, suggests the forms that this might take and evaluates some of the benefits for local communities. The paper concludes by reinforcing that universities have a critical role to play in community development; that role has to prioritise the sustainability agenda. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. The effectiveness of a Supported Self-management task-shifting intervention for adult depression in Vietnam communities: study protocol for a randomized controlled trial. (United States)

    Murphy, Jill; Goldsmith, Charles H; Jones, Wayne; Oanh, Pham Thi; Nguyen, Vu Cong


    Depressive disorders are one of the leading causes of disease and disability worldwide. In Vietnam, although epidemiological evidence suggests that depression rates are on par with global averages, services for depression are very limited. In a feasibility study that was implemented from 2013 to 2015, we found that a Supported Self-management (SSM) intervention showed promising results for adults with depression in the community in Vietnam. This paper describes the Mental Health in Adults and Children: Frugal Innovations (MAC-FI) trial protocol that will assess the effectiveness of the SSM intervention, delivered by primary care and social workers, to community-based populations of adults with depression in eight Vietnamese provinces. The MAC-FI program will be assessed using a stepped-wedge, randomized controlled trial. Study participants are adults aged 18 years and over in eight provinces of Vietnam. Study participants will be screened at primary care centres and in the community by health and social workers using the Self-reporting Questionnaire-20 (SRQ-20). Patients scoring >7, indicating depression caseness, will be invited to participate in the study in either the SSM intervention group or the enhanced treatment as usual control group. Recruited participants will be further assessed using the World Health Organization's Disability Assessment Scale (WHODAS 2.0) and the Cut-down, Annoyed, Guilty, Eye-opener (CAGE) Questionnaire for alcohol misuse. Intervention-group participants will receive the SSM intervention, delivered with the support of a social worker or social collaborator, for a period of 2 months. Control- group participants will receive treatment as usual and a leaflet with information about depression. SRQ-20, WHODAS 2.0 and CAGE scores will be taken by blinded outcome assessors at baseline, after 1 month and after 2 months. The primary analysis method will be intention-to-treat. This study has the potential to add to the knowledge base about

  17. The Illinois Community College Sustainability Network--A Successful Model (United States)

    Jacobson, Bert


    In 2008, the Illinois Department of Commerce and Economic Opportunity (DCEO), Bureau of Energy and Recycling, funded a pilot project creating a network of Sustainability Centers. The pilot project demonstrated that networked campus sustainability centers are an efficient mechanism to reach consumers, business, and industry. All 48 community…

  18. Defining sustainable practice in community-based health promotion: a Delphi study of practitioner perspectives. (United States)

    Harris, Neil; Sandor, Maria


    Sustainability of practice must be a central imperative in the practice of community-based health promotion to achieve population health and attract a greater share of public health spending. Although there has been some consideration of sustainability at the project or program levels, often understood as intervention longevity, very limited attention has been given to understanding sustainable practice. The present study develops a definition and features of sustainable practice in community-based health promotion through a Delphi method with health promotion practitioners in Queensland, Australia. The study presents a consensus definition and features of sustainable practice. The definition highlights the importance of collaboration, health determinants and aspirations, processes and outcomes. The four features of sustainable practice identified in the study are: (1) effective relationships and partnerships; (2) evidence-based decision making and practice; (3) emphasis on building community capacity; and (4) supportive context for practice. The definition and features are, to a large extent, consistent with the limited literature around sustainability at the project and program levels of health promotion. Together, they provide insight into a form of community-based health promotion that will be both viable and productive. So what? This consensus understanding of sustainable practice articulates the foundations of working effectively with local communities in achieving improved population health within global limits.

  19. How and why do patients with Type 1 diabetes sustain their use of flexible intensive insulin therapy? A qualitative longitudinal investigation of patients' self-management practices following attendance at a Dose Adjustment for Normal Eating (DAFNE) course. (United States)

    Rankin, D; Cooke, D D; Clark, M; Heller, S; Elliott, J; Lawton, J


    Conventional insulin therapy requires patients with Type 1 diabetes to adhere to rigid dietary and insulin injection practices. Recent trends towards flexible intensive insulin therapy enable patients to match insulin to dietary intake and lifestyle; however, little work has examined patients' experiences of incorporating these practices into real-life contexts. This qualitative longitudinal study explored patients' experiences of using flexible intensive insulin therapy to help inform the development of effective long-term support. Semi-structured interviews were conducted with 30 adult patients with Type 1 diabetes following participation in a structured education programme on using flexible intensive insulin therapy, and 6 and 12 months post-course. Longitudinal data analysis used an inductive, thematic approach. Patients consistently reported feeling committed to and wanting to sustain flexible intensive insulin therapy. This regimen was seen as a logical and effective method of self-management, as patients experienced improved blood glucose readings and/or reported feeling better. Implementing and sustaining flexible intensive insulin therapy was enhanced when patients had stable routines, with more challenges reported by those working irregular hours and during weekends/holidays. Some patients re-crafted their lives to make this approach work for them; for instance, by creating dietary routines or adjusting dietary choices. Clinical data have shown that flexible intensive insulin therapy can lead to improvement in glycaemic control. This study, drawing on patients' perspectives, provides further endorsement for flexible intensive insulin therapy by demonstrating patients' liking of, and their motivation to sustain, this approach over time. To help patients implement and sustain flexible intensive insulin therapy, follow-up support should encourage them to identify routines to better integrate this regimen into their lives. © 2011 The Authors. Diabetic

  20. Sustainability. (United States)

    Chang, Chein-Chi; DiGiovanni, Kimberly; Mei, Ying; Wei, Li


    This review on Sustainability covers selected 2015 publications on the focus of Sustainability. It is divided into the following sections : • Sustainable water and wastewater utilities • Sustainable water resources management • Stormwater and green infrastructure • Sustainability in wastewater treatment • Life cycle assessment (LCA) applications • Sustainability and energy in wastewater industry, • Sustainability and asset management.

  1. 76 FR 2406 - Notice of Proposed Information Collection: Comment Request Sustainable Communities Regional Grant... (United States)


    ... Information Relay Service (1-800-877-8339). FOR FURTHER INFORMATION CONTACT: Zuleika Morales-Romero, Grants.... Shelley R. Poticha. Director, Office of Sustainable Housing and Communities. [FR Doc. 2011-657 Filed 1-12...

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

    NARCIS (Netherlands)

    Damastuti, Ekaningrum; Groot, de Dolf


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

  3. Unveiling scientific communities about sustainability and innovation. A bibliometric journey around sustainable terms

    DEFF Research Database (Denmark)

    Franceschini, Simone; Faria, Lourenco; Jurowetzki, Roman


    Literature about the relationship between innovation and sustainability has skyrocketed in the last two decades and new terms have appeared. However, only very few bibliometric analyses have reviewed some of these terms (eco-innovation, environmental innovation, green innovation, and sustainable ...

  4. Greener on the Other Side: Cultivating Community and Improvement through Sustainability Practices (United States)

    Sterrett, William L.; Kensler, Lisa; McKey, Tania


    Sustainability practices that lead to greener schools are often overlooked in leadership preparation programs and in school improvement efforts. An urban middle school principal recognizes the potential to build community, foster a healthy learning environment, and redefine her school through focusing on sustainability practices in a collaborative…

  5. Evaluating School-Community Participation in Developing a Local Sustainability Agenda (United States)

    Eilam, Efrat; Trop, Tamar


    Increasingly, international and national statements are calling for the development of local sustainability scenarios within partnerships between schools and their communities. The present study addresses the question of reciprocity in such partnerships, by comparing the sustainability agendas underlying schools' educational programs to the…

  6. Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan. (United States)

    Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn


    The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Sustaining Community-University Partnerships: Lessons learned from a participatory research project with elderly Chinese

    Directory of Open Access Journals (Sweden)

    XinQi Dong


    Full Text Available The strength of community-engaged research has been well documented in public health literature. It is recognised as a useful approach for eliminating health disparities by linking research and practice. While the framework of community-engaged research encompasses a broad range of research collaborations, community-based participatory research (CBPR places most emphasis on involving the community as a full, equitable partner throughout the collaboration. Despite growing interest in and demand for community-university partnerships, less attention is given to the issue of partnership sustainability. The purpose of this article is to present the challenges faced in sustaining a community-university partnership when conducting a CBPR project with an elderly Chinese population in Chicago’s Chinatown. Lessons and strategies learned from the cultural and linguistic complexities of the Chinese community are also detailed. In addition, based on a well-accepted sustainability conceptual framework, we reflect on the initial stage, mid-term actions and long-term goals of developing partnership sustainability. Working with the Chinese community required trust and respect for its unique cultural values and diversity. The cultural, social and environmental contexts within which the partnership operated served as critical forces for long-term sustainability: a culturally sensitive approach is instrumental in sustaining community-university partnership. Also discussed are the significant implications for evidence-based, impact-driven partnerships to develop culturally appropriate strategies to meet the needs of diverse populations. Keywords Community-based participatory research, community health partnerships, health promotion, Chinese Americans, ageing

  8. Development of a capacity building program for village health volunteers to support self-management in a high risk population for diabetes in a rural community in northeast Thailand

    Directory of Open Access Journals (Sweden)

    Pakinee Srisarakham


    Full Text Available Similar to other parts of the world, the prevalence of type 2 diabetes mellitus (T2DM in the Asia-Pacific Region has rapidly increased during the last few decades. The purposes of this pilot study were to determine the feasibility and the effects of a capacity building program for Village Health Volunteers (VHVs to support self-management in a T2DM high risk population from a rural subdistrict in Northeast Thailand. Both quantitative and qualitative data were collected using surveys, focus group discussions, and in-depth interviews. Data were analyzed and used to develop a 12-week capacity building program for VHVs. This program was then implemented on 60 subjects at high risk of T2DM in the selected community. According to the paired t-test and Wilcoxon-signed rank test, VHVs had higher scores on knowledge and self-efficacy of T2DM prevention after a 12 week intervention (p = .03 and p = .02, respectively. Study participants at risk for T2DM also had a significant increase in T2DM knowledge and self-management (p < .001. Implementation of the capacity building program for VHVs in Northeast Thailand was feasible. The key successes were strong community bonding, community empowerment, and support from family and public health nurses. Effects of the program should be examined with those in other Asia-Pacific countries.

  9. Sustaining Open Source Communities through Hackathons - An Example from the ASPECT Community (United States)

    Heister, T.; Hwang, L.; Bangerth, W.; Kellogg, L. H.


    The ecosystem surrounding a successful scientific open source software package combines both social and technical aspects. Much thought has been given to the technology side of writing sustainable software for large infrastructure projects and software libraries, but less about building the human capacity to perpetuate scientific software used in computational modeling. One effective format for building capacity is regular multi-day hackathons. Scientific hackathons bring together a group of science domain users and scientific software contributors to make progress on a specific software package. Innovation comes through the chance to work with established and new collaborations. Especially in the domain sciences with small communities, hackathons give geographically distributed scientists an opportunity to connect face-to-face. They foster lively discussions amongst scientists with different expertise, promote new collaborations, and increase transparency in both the technical and scientific aspects of code development. ASPECT is an open source, parallel, extensible finite element code to simulate thermal convection, that began development in 2011 under the Computational Infrastructure for Geodynamics. ASPECT hackathons for the past 3 years have grown the number of authors to >50, training new code maintainers in the process. Hackathons begin with leaders establishing project-specific conventions for development, demonstrating the workflow for code contributions, and reviewing relevant technical skills. Each hackathon expands the developer community. Over 20 scientists add >6,000 lines of code during the >1 week event. Participants grow comfortable contributing to the repository and over half continue to contribute afterwards. A high return rate of participants ensures continuity and stability of the group as well as mentoring for novice members. We hope to build other software communities on this model, but anticipate each to bring their own unique challenges.

  10. Community Participation for Sustainable Tourism Model in Manado Coastal Area (United States)

    Warouw, F. F.; Langitan, F. W.; Alamsyah, A. T.


    Manado city with the potential for coastal tourism which is at the center of the world’s coral triangle is developing a tourism development policy. Tourism that is being developed should certainly be able to adapt to changing conditions of today’s dynamic environment. The extent to which the adaptation process is determined by the communities involved in the development of tourism. Based on data from the population in the city of Manado, there are currently 410 481 thousand inhabitants. This study tried to reveal the extent of community participation in the city of Manado in particular involvement in the development of tourism in coastal Bay of Manado. Level of community participation in the development of tourism in the city of Manado is measured in the form of quantitative research in the form of questionnaires to the community based on the level of community participation developed by Arnstein Sheery by purposive sampling technique. The level of participation was developed by Arnstein Sheery row of low level ketinggi namely: Manipulation, Therapy, informing, Consultation, placation, partnership, Delegaten Power, Citizen Control. Findings community level participation in the development of coastal tourism on Manado bay civilized level of consultation. Consultation rate shows that the government invite the public opinion after the given information to the public and has been a two-way dialogue between government and society. Community has provided input and active discussion by way of the two-way dialogue. Although there has been a two-way dialogue, but the successful rate is low because there is no guarantee that the concerns and ideas of the community will be considered. This requires the development of community-based programs in order to increase the degree of participation so that community participation will increase. To conclude, the program needs to be based on input from the community’s needs and it has to involve the public directly to tourism

  11. Community Participation and Project Sustainability in Rural Nigeria ...

    African Journals Online (AJOL)

    Other goals include improved governance through building stronger community institutions and increased community capacity, empowerment and voice, which can in turn provide a vehicle for strengthening local governance in other spheres of social and economic development. Thus, participation has now become an ...

  12. Assessment of the potential for sustainable community tourism ...

    African Journals Online (AJOL)

    The Nandoni Dam was constructed amidst much fanfare regarding the social and economic benefits that would accrue to the local communities. Although not specifically stated, tourism was implied, which could lead to employment and the general upliftment of these communities. The potential for tourism enterprises, such ...

  13. Using Social Impact Assessment to Strengthen Community Resilience in Sustainable Rural Development in Mountain Areas

    NARCIS (Netherlands)

    Imperiale, Angelo Jonas; Vanclay, Frank

    Building community resilience is an important topic in the current debate about achieving positive community development outcomes from sustainable place-based policies, especially in mountain regions and less-favored areas. At the practical, grassroots level, however, it remains unclear how

  14. Toward Sustainable Communities: A Resource Book for Municipal and Local Governments. (United States)

    Roseland, Mark

    This book is intended as a resource for elected officials, municipal staff, and citizens who would like to apply the concept of sustainable development in their communities through an ecosystems approach to human settlements management. The subcomponents of human community life and its impact on the environment are explored. Included are tested,…

  15. Using Social Impact Assessment to Strengthen Community Resilience in Sustainable Rural Development in Mountain Areas

    NARCIS (Netherlands)

    Imperiale, Angelo Jonas; Vanclay, Frank


    Building community resilience is an important topic in the current debate about achieving positive community development outcomes from sustainable place-based policies, especially in mountain regions and less-favored areas. At the practical, grassroots level, however, it remains unclear how

  16. Qualitative and Quantitative Methods for Developing a Typology of Community Engagement with Sustainability Programs (United States)

    Identifying the needs that a community must satisfy to implement sustainability programs is complex, with interplay between geographic, environmental and social influences. Helping communities meet these needs is a focus of the U.S. Environmental Protection Agency’s (U.S. E...

  17. 75 FR 6689 - Sustainable Communities Planning Grant Program Advance Notice and Request for Comment (United States)


    ... final NOFA will be broadly announced through appropriate and familiar means and will provide further... sustainability, and social equity in metropolitan regions and rural communities. Recognizing the fundamental role... way in reshaping the role of the Federal government in helping communities obtain the capacity to...

  18. Sustaining Research Innovations in Educational Technology through Communities of Practice (United States)

    Hung, David; Lee, Shu-Shing; Lim, Kenneth Y. T.


    The diffusion of innovation is critical to societal progression. In the field of education, such diffusion takes on added significance because of the many stakeholders and accountabilities involved. This article presents the argument that efforts at diffusion which are designed from a top-down perspective are not sustainable over the long term…

  19. Resolving community conflicts and problems: public deliberation and sustained dialogue

    National Research Council Canada - National Science Library

    Lohmann, Roger A; Van Til, Jon


    ... into eventual dialogue the disparate leaders of Israel and Egypt. Saunders's work continued through the 1980s and 1990s with the Dartmouth Seminar, developing public conversation between Soviet and American citizen leaders, and has since spread to many other nations under the rubric of "sustained dialogue." During the same period, the Kettering Fo...

  20. Community Gardening Project: Meredith College Students Explore Sustainability, Organics (United States)

    Roubanis, Jody L.; Landis, William


    Consuming locally grown foods promotes sustainable development and individual wellness (Waters, 2006). In the United States, the average food product travels 2,000 miles before reaching the consumer (Schlosser, 2001). This distance between producer and consumer is one reason that today's youth lack an understanding of the origin of the food they…

  1. Sustaining Community Partnership across Transition in District Leadership (United States)

    LeChasseur, Kimberly


    This case of district turnover was developed as part of a project with state leaders and funders supporting local early education systems development. Understanding strategic and reactive activities during district leadership transition can be useful in assisting educators and their partners to prepare for sustainability. In this case, early…

  2. Sustaining Community-University Collaborations: The Durham University Model

    Directory of Open Access Journals (Sweden)

    Andrew Russell


    Full Text Available Durham University has initiated a community outreach and engagement program based on an evolving multifaceted model. This article analyses the components of the model and looks at how our work at Durham has become increasingly embedded in the structures and processes of the university as it has developed. The strengths and weaknesses in what has been achieved are highlighted, as is the future vision for the further development of this innovative community-university program. Keywords Public engagement; community partnerships; employer supported volunteering; corporate social responsibility

  3. Sustainable and Healthy Communities 2015 Research Accomplishments (Annual Report) (United States)

    Program scientists—together with input from their partners from EPA program and regional offices, state environmental management agencies, community decision-makers, and the scientific community—are embracing a truly cross-disciplinary research portfolio.

  4. Finding the community in sustainable online community engagement: Not-for-profit organisation websites, service-learning and research


    Dodd, Alice


    This article explores the use of action research (2008–2014) based on a case study of the Sustainable Online Community Engagement (SOCE) Project, a service-learning project in which University of South Australia students build websites for not-for-profit (NFP) organisations, to demonstrate that effective teaching, public service and research are interdependent. A significant problem experienced in the SOCE project was that, despite some training and ongoing assistance, the community organisat...

  5. Institutional Sustainability Barriers of Community Conservation Agreement as a Collaboration Management in Lore Lindu National Park

    Directory of Open Access Journals (Sweden)

    Sudirman Daeng Massiri


    Full Text Available The main problem of forest institutional arrangement is the issue of institutional sustainability in achieving sustainable forest ecosystem. This study aimed to explain the barriers of institutional sustainability Community Conservation Agreement (CCA designed in Lore Lindu National Park (LLNP, in Indonesia, as a collaborative management of national parks. This study is of descriptive which used qualitative approach, i.e. asking open-ended questions, reviewing documentation and analyzing textual of community conservation agreements. We found that the institutional sustainability barriers of CCA were the local decisions on collective-choice level and that the rules at operational level arranged in CCA were not in line with formal rules of national park management at the constitutional level. Furthermore, the low capacity of local institutions in heterogeneous villages with many migrants in controlling and regulating the forest use, especially in rehabilitation zone areas, also became a barrier to institutional sustainability of CCA. Therefore, institutional sustainability of CCA requires support of national park management policy that accommodates the sustainability of livelihoods of local communities in national parks, strengthening local institution's capacity, and ultimately integrating institution of CCA as part of LLNP management.

  6. Building sustainable health and education partnerships: stories from local communities. (United States)

    Blank, Martin J


    Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. © 2015 Institute for Educational Leadership. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

  7. Sustainable value chains for bamboo working communities : Integrating the tenets of sustainability through the Rhizome Approach

    NARCIS (Netherlands)

    Reubens, R.R.R.; Brezet, J.C.; Christiaans, H.H.C.M.


    There is a growing demand globally for products which impact sustainability positively. Bamboo fulfills these criteria, since it is a highly renewable timber replacement material which does not cause deforestation. It simultaneously has the potential to create livelihood opportunities for both the

  8. The effects and costs of a group-based education programme for self-management of patients with Type 2 diabetes. A community-based study

    DEFF Research Database (Denmark)

    Mølsted, Stig; Tribler, Jane; Poulsen, Peter B.


    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type...... training in its use. Glycemic control (HbA1c) was found to improve from 7.34 ± 1.34 to 6.88 ± 1.09%, P ... pressure, female waist circumference, lipid profile, quality of life, physical activity and the patients' knowledge of diabetes whilst the number of visits to GPs declined. This study supports the use of an empowerment vision as a basis for an interdisciplinary group-based education programme...

  9. The Sustainability of Community-Based Adaptation Projects in the Blue Nile Highlands of Ethiopia

    Directory of Open Access Journals (Sweden)

    Belay Simane


    Full Text Available Climate resilience in subsistence agricultural communities depends strongly on the robustness and effective management of the agricultural natural resource base. For this reason, adaptation planning efforts frequently focus on natural resource conservation as the primary motivation for and primary outcome of adaptation activities. Here, we present an analysis of the sustainability of community based adaptation (CBA activities in 20 community based organizations (CBO that were established in the Blue Nile Highlands of Ethiopia in order to promote resilience to climate change. CBA sustainability was assessed through multi-criteria analysis using the Analytic Hierarchy Process (AHP. Sustainability was considered for social, institutional, technical, financial, and environmental dimensions, with second-order indicators or factors defined for each dimension. According to this analysis, CBA efforts of two thirds of the COBs studied were found to be unsustainable in all dimensions and CBA efforts of the remaining CBOs were found to be at risk of unsustainability. A number of barriers to CBA sustainability were identified, including inadequacies in community participation, training of local community members, local government commitment, farmer capacity, and bureaucratic efficiency. Participatory evaluation of CBA, however, revealed that many of these barriers can be attributed to the decision to use conservation of natural resources as the primary framework for CBA activities. Based on this evaluation, new efforts have been developed that use markets as the entry and exit points for sustainability activities. Lessons learned in this project are relevant for CBA efforts in other agricultural regions of the developing world.

  10. Social Networks, the ‘Work’ and Work Force of Chronic Illness Self-Management: A Survey Analysis of Personal Communities (United States)

    Vassilev, Ivaylo; Rogers, Anne; Blickem, Christian; Brooks, Helen; Kapadia, Dharmi; Kennedy, Anne; Sanders, Caroline; Kirk, Sue; Reeves, David


    Self-management support forms a central aspect of chronic Illness management nationally and globally. Evidence for the success of self-management support has mainly focussed on individually-centred outcomes of behavioural change. While it is recognised that social network members play an important role there is currently a gap in knowledge regarding who provides what type of support and under what circumstances. This is relevant for understanding the division of labour and the meeting of needs for those living with a long-term condition. We therefore took a network approach to explore self-management support conceptualising it as types of illness ‘work’ undertaken within peoples’ social networks. 300 people from deprived areas and with chronic illnesses took part in a survey conducted in 2010 in the North West of England. A concentric circles diagram was used as a research tool with which participants identified 2,544 network members who contributed to illness management. The results provide an articulation of how social network members are substantially involved in illness management. Whilst partners and close family make the highest contributions there is evidence of inputs from a wide range of relationships. Network member characteristics (type of relationship, proximity, frequency of contact) impact on the amount of illness work undertaken in peoples’ networks. In networks with ‘no partner’ other people tend to contribute more in the way of illness related work than in networks with a partner. This indicates a degree of substitutability between differently constituted networks, and that the level and type of input by different members of a network might change according to circumstances. A network perspective offers an opportunity to redress the balance of an exclusively individual focus on self-management because it addresses the broader set of contributions and resources available to people in need of chronic illness management and support. PMID

  11. Self-management education and support in chronic disease management. (United States)

    McGowan, Patrick T


    With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Toward smart governance and social sustainability for Chinese migrant communities

    NARCIS (Netherlands)

    Lin, Yanliu; Zhang, Xiaoling; Geertman, Stan|info:eu-repo/dai/nl/072392924


    In the regeneration of Chinese migrant communities, which are usually referred to as "villages in the city," various modes of governance have been formed based on the relationships between the three key actors (state, market, and society). These modes of governance are characterized by problems

  13. Towards a sustainable community database: taking advantage of ...

    African Journals Online (AJOL)

    This study aimed to assess whether the magnitude of possession and retention of RTH cards is adequate to serve as a community database for monitoring and evaluating health interventions targeting under fives. ... database. This paper discusses some of the strategies to increase retention of the cards by caretakers.

  14. Beyond the ivory tower: service-learning for sustainable community ...

    African Journals Online (AJOL)

    Teaching, research and community service have since earliest times been regarded as the three core functions of the university. The concept and practice of service-learning has succeeded in uniting these core functions. Whereas the quality of student learning resulting from service-learning experiences is of crucial ...

  15. Virtual Rural Community Development: Human Links That Sustain Web Links. (United States)

    Bright, Larry K.; Evans, Wayne H.; Marmet, Kathy

    Outmigration in the rural Upper Midwest prompted a group of citizens and University of South Dakota faculty to form the Center for the Advancement of Rural Communities (ARC). ARC considers how to stimulate traditionally competitive and isolated South Dakota peoples to collaborate for economic, social, educational, political, and cultural gains. As…

  16. Social Work with Religious Volunteers: Activating and Sustaining Community Involvement (United States)

    Garland, Diana R.; Myers, Dennis M.; Wolfer, Terry A.


    Social workers in diverse community practice settings recruit and work with volunteers from religious congregations. This article reports findings from two surveys: 7,405 congregants in 35 Protestant congregations, including 2,570 who were actively volunteering, and a follow-up survey of 946 volunteers. It compares characteristics of congregation…


    Energy Technology Data Exchange (ETDEWEB)

    Downing, Melinda; Rosenthall, John; Hudson, Michelle


    Capacity building programs help poor and disadvantaged communities to improve their ability to participate in the environmental decision-making processes. They encourage citizen involvement, and provide the tools that enable them to do so. Capacity building enables communities that would otherwise be excluded to participate in the process, leading to better, and more just decisions. The Department of Energy (DOE) continues to be committed to promoting environmental justice and involving its stakeholders more directly in the planning and decision-making process for environmental cleanup. DOE's Environmental Management Program (EM) is in full support of this commitment. Through its environmental justice project, EM provides communities with the capacity to effectively contribute to a complex technical decision-making process by furnishing access to computers, the Internet, training and technical assistance. DOE's Dr. Samuel P. Massie Chairs of Excellence Program (Massie Chairs) function as technical advisors to many of these community projects. The Massie Chairs consist of nationally and internationally recognized engineers and scientists from nine Historically Black Colleges and Universities (HBCUs) and one Hispanic Serving Institution (HIS). This paper will discuss capacity building initiatives in various jurisdictions.

  18. Building Sustainable Health and Education Partnerships: Stories from Local Communities (United States)

    Blank, Martin J.


    Background: Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high…

  19. Sustainability of rainwater catchment systems for small island communities (United States)

    Bailey, Ryan T.; Beikmann, Alise; Kottermair, Maria; Taboroši, Danko; Jenson, John W.


    Communities living on atolls and similar low-lying islands in the tropical Pacific rely on rainwater and shallow groundwater to meet domestic water needs. Rainwater, generally captured and stored using rooftop rainwater catchment systems, is the preferred water source due to higher quality and convenience of access. This study assesses the performance of rainwater catchment systems (RWCS) on Ifalik Atoll, located in Yap State, Federated States of Micronesia in the western Pacific. A field survey was conducted in August 2015 to evaluate RWCS features (guttered roof area, storage tank size, gutter leakage conditions), determine numbers of users, and estimate daily water use via household surveys. All 152 RWCS were surveyed. Water balance modeling was applied to the RWCS to estimate end-of-day stored rainwater volumes for each day of the 1997-1999 time period, during which an El Niño-induced drought occurred. Results indicate that the community is resilient to drought, although the majority of RWCS were depleted of rainwater and hence community sharing was required. Scenario testing indicates that increasing guttered roof area is the optimal strategy for enhancing system reliability. For example, the volume of water maintained at the peak of a drought can be tripled if the available roof areas for the RWCS are guttered. Design curves, which provide a set of roof area - tank volume combinations that achieve specified levels of reliability, were created and can be used to plan new RWCS. Besides offering insights into community-wide water storage and usage patterns and resiliency for Ifalik Atoll, this study presents methods that can be applied to other atoll island communities throughout the Indo-Pacific region.

  20. A Systematic Review of the Literature on the Sustainability of Community Health Collaboratives. (United States)

    Hearld, Larry R; Bleser, William K; Alexander, Jeffrey A; Wolf, Laura J


    Recent interest in community health collaboratives has been driven by the potential of these types of organizations to solve complex health problems at the local level by bringing together stakeholders that have traditionally operated independently, and often at cross-purposes. Much of the work that is central to the mission of collaboratives can take years to reach fruition, however, and there are a number of challenges to sustaining their activities. In this article, we systematically reviewed the theoretical and empirical literature on health care collaborative sustainability, focusing on definitions and antecedents of sustainability. Given the diversity and fragmentation of this literature, we used this review as a foundation to develop a synthesized definition, conceptual groups of antecedents, and potential research propositions to help guide future research, planning, and practice of sustainable community health collaboratives. © The Author(s) 2015.

  1. Community knowledge and sustainable natural resources management: learning from the Monpa of Arunachal Pradesh

    Directory of Open Access Journals (Sweden)

    Ranjay K. Singh


    Full Text Available Community knowledge and local institutions play a significant role in sustainable comanagement, use and conservation of natural resources. Looking to the importance of these resources, a project, funded by the National Innovation Foundation (NIF, Ahmedabad, India was implemented to document the community knowledge associated with agriculture and natural resources in few selected Monpa tribe dominating villages of West Kameng and Tawang Districts of Arunachal Pradesh, India. Dynamics of various indigenous practices, gender role, culture and informal rural social institutions, cultural edges significantly contribute in managing and using the natural resources sustainably. Experiential learning and location specific knowledge play a pivotal role in ecosystem sustainability. Study also indicates the synergistic relation existing between local knowledge and ecological edges, thereby helping in sustaining livelihood in high altitude. Indigenous resource management systems are not mere traditions but adaptive responses that have evolved over time.

  2. Are forest incomes sustainable? Firewood and timber extraction and productivity in community managed forests in Nepal

    DEFF Research Database (Denmark)

    Meilby, Henrik; Smith-Hall, Carsten; Byg, Anja


    community managed forests in Nepal, using data from 240 permanent sample plots and a structured household survey conducted in 2006 and 2009 (n = 507 and 558, respectively). We find that analyses of sustainability need to recognize the complexity of forest stand utilization, and that there is considerable...... scope, by altering how existing local forest management rules are implemented, for increasing rural household forest incomes while keeping harvesting levels sustainable....

  3. Finding the community in sustainable online community engagement: Not-for-profit organisation websites, service-learning and research

    Directory of Open Access Journals (Sweden)

    Alice Dodd


    Full Text Available This article explores the use of action research (2008–2014 based on a case study of the Sustainable Online Community Engagement (SOCE Project, a service-learning project in which University of South Australia students build websites for not-for-profit (NFP organisations, to demonstrate that effective teaching, public service and research are interdependent. A significant problem experienced in the SOCE project was that, despite some training and ongoing assistance, the community organisations reported that they found it difficult to make effective use of their websites. One of the proposed solutions was to develop an online community of the participating organisations that would be self-supporting, member-driven and collaborative, and enable the organisations to share information about web-based technology. The research reported here explored the usefulness of developing such an online community for the organisations involved and sought alternative ways to assist the organisations to maintain an effective and sustainable web presence. The research used a three-phase ethnographic action research approach. The first phase was a content analysis and review of the editing records of 135 organisational websites hosted by the SOCE project. The second phase was an online survey sent to 145 community organisation members responsible for the management of these websites, resulting in 48 responses. The third phase consisted of semi-structured, in-depth interviews with 18 of the website managers from 12 of these organisations. The research revealed the extent to which organisations were unable to manage their websites and found that the proposed solution of an online community would not be useful. More importantly, it suggested other useful strategies which have been implemented. In Furco’s (2010 model of the engaged campus, public engagement can be used to advance the public service, teaching and research components of higher education’s tripartite

  4. Space for innovation for sustainable community-based biofuel production and use: Lessons learned for policy from Nhambita community, Mozambique

    International Nuclear Information System (INIS)

    Schut, Marc; Paassen, Annemarie van; Leeuwis, Cees; Bos, Sandra; Leonardo, Wilson; Lerner, Anna


    This paper provides insights and recommendations for policy on the opportunities and constrains that influence the space for innovation for sustainable community-based biofuel production and use. Promoted by the Mozambican government, Nhambita community established jatropha trials in 2005. Initial results were promising, but crop failure and the absence of organized markets led to scepticism amongst farmers. We start from the idea that the promotion of community-based biofuel production and use requires taking interactions between social-cultural, biophysical, economic, political and legal subsystems across different scales and levels of analysis through time into account. Our analysis demonstrates that heterogeneous farming strategies and their synergies at community level should be carefully assessed. Furthermore, national and international political and legal developments, such as the development of biofuel sustainability criteria, influence the local space in which community-based biofuel developments take place. We conclude that ex-ante integrated assessment and creating an enabling environment can enhance space for sustainable community-based biofuel production and use. It may provide insights into the opportunities and constraints for different types of smallholders, and promote the development of adequate policy mechanisms to prevent biofuels from becoming a threat rather than an opportunity for smallholders. - Highlights: → This paper explores space for innovation for community-based biofuel production and use. → Heterogeneous farming strategies and their synergies at community level are key. → Farmers have little trust in jatropha due to crop failure and absence of markets. → (Inter)national biofuel policies influence space for local biofuel production and use. → Policies should focus on ex-ante integrated assessment and creating an enabling environment.

  5. What Can Rural Communities Do to Be Sustained?

    Directory of Open Access Journals (Sweden)

    Rachel J. C. Chen


    Full Text Available Since the Appalachian Regional Commission (ARC was founded in 1965, various reports have been presented to summarize the progress in terms of economic development, strengths, weaknesses, opportunities, and threats among studied communities in the Appalachian region. The purposes of this study were to investigate (1 the condition and usage of facilities and services in the studied communities; (2 what factors contribute to local growth in improving areas; and (3 what barriers deter growth in the studied communities based on the perceptions of study participants. Ten studied counties were categorized based on their topography, demographics, and economics. Each sub-region has two selected counties (non-distressed and distressed to represent and compare their similar topography and various stages of demographic opportunities and economic development and challenges. Location is recognized as one of the significant factors that affect communities’ development. Counties perform better when they are adjacent to urban areas, own major transportation corridors, and have more supplies of natural resources than those located in more rural areas with fewer resources. This study noted the need to improve communication infrastructure (such as Internet access, broadband, and mobile communications that impact local development opportunities and public safety.

  6. A Qualitative Exploration of Motivation to Self-Manage and Styles of Self-Management amongst People Living with Type 2 Diabetes. (United States)

    Newton, Paul; Asimakopoulou, Koula; Scambler, Sasha


    The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (N = 25), focus groups (3 × N = 12 participants), and open-ended questionnaires (N = 6), people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+) and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients' motives for self-management included (i) concern about the anticipative effects of T2D; (ii) wishing to "stay well"; (iii) maintaining independence; (iv) reducing the need for healthcare professionals; and (v) improving quality of life. Six self-management styles were found and pertained to self-managing: (i) through routinisation; (ii) as a burden; (iii) as maintenance; (iv) through delegation; (v) through comanagement; and (vi) through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D.

  7. A Qualitative Exploration of Motivation to Self-Manage and Styles of Self-Management amongst People Living with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Paul Newton


    Full Text Available The study examined the motives that people living with type 2 diabetes (T2D had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (N=25, focus groups (3 ×  N=12 participants, and open-ended questionnaires (N=6, people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+ and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients’ motives for self-management included (i concern about the anticipative effects of T2D; (ii wishing to “stay well”; (iii maintaining independence; (iv reducing the need for healthcare professionals; and (v improving quality of life. Six self-management styles were found and pertained to self-managing: (i through routinisation; (ii as a burden; (iii as maintenance; (iv through delegation; (v through comanagement; and (vi through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D.

  8. Promoting community socio-ecological sustainability through technology: A case study from Chile (United States)

    Aguayo, Claudio; Eames, Chris


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

  9. Sustainable childhood obesity prevention through community engagement (SCOPE) program: evaluation of the implementation phase. (United States)

    McIntosh, Bonnie; Daly, Amelia; Mâsse, Louise C; Collet, Jean-Paul; Higgins, Joan Wharf; Naylor, Patti-Jean; Amed, Shazhan


    Childhood obesity rates are steadily rising. Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) is a community-based participatory action research (PAR) program aimed at preventing childhood obesity. This study aimed to describe community perspectives on, and elicit feedback about, SCOPE's first phase of implementation in two pilot cities in British Columbia, Canada. A case study was implemented using interviews and questionnaires to obtain feedback about SCOPE from two groups: SCOPE coordinators and stakeholders (i.e., individuals and organizations that were a member of the community and engaged with SCOPE coordinators). Participants were recruited via email and (or) by telephone. Coordinators completed a telephone interview. Stakeholders completed a questionnaire and (or) a telephone interview. Thematic analysis was conducted. Participants included 2 coordinators and 15 stakeholders. Participants similarly interpreted SCOPE as a program focused on raising awareness about childhood obesity prevention, while engaging multiple community sectors. Overall, participants valued the program's role in facilitating networking and partnership development, providing evidence-based resources, technical expertise, and contributing funding. Participants felt that SCOPE is sustainable. However, participants felt that barriers to achieving healthy weights among children included those related to the built environment, and social, behavioral, and economic obstacles. Perspectives on factors that facilitated and acted as barriers to SCOPE's first phase of implementation were obtained from the SCOPE communities and may be used to enhance the sustainability of SCOPE and its applicability to other BC communities.

  10. Diabetes: Christian Worldview, Medical Distrust & Self-Management (United States)

    Newlin Lew, Kelley; Arbuah, Nancy; Banach, Paul; Melkus, Gail


    To inform development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members (N=44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical mistrust, and self-management as prominent themes. Findings suggest diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African American community to improve health outcomes. PMID:25735754

  11. Community action for sustainable housing: Building a low-carbon future

    International Nuclear Information System (INIS)

    Seyfang, Gill


    This paper presents a new analytical framework of 'grassroots innovations' which views community-led initiatives for sustainable development as strategic green niches with the potential for wider transformation of mainstream society. This framework is applied to a low-carbon, low-impact, community-based sustainable housing initiative in the USA that pioneers straw bale housing techniques within a strong community-building ethos. The project is evaluated according to New Economics criteria of sustainable consumption, and is found to be successful at localising the construction supply chain, reducing ecological footprints, community-building, enabling collective action and building new institutions and systems of provision around housebuilding. However, viewing it as a strategic niche with aim to influence wider society, it is clear that it faces significant challenges in diffusing its ideas and practices beyond the niche. Its model is not necessarily suitable for scaling up or widespread replication; however, the scope for niche lessons to be adopted by mainstream builders is greater, given a supportive policy environment. Recognising the innovative nature of green niches at the policy level could lead to new approaches to governance of bottom-up community action for sustainable development.

  12. Transgressing the norm: Transformative agency in community-based learning for sustainability in southern African contexts (United States)

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


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

  13. Towards a sustainable knowledge management and development perspective approach: The sustainable rural community development portal

    CSIR Research Space (South Africa)

    Chakwizira, J


    Full Text Available development. The philosophy and thinking behind the rural community planning portal is that it will act as a seed for the generation of an inclusive and dynamic rural development agenda that is sensitive and relevant to contemporary issues and challenges...

  14. eBikes and sustainable communities : a new opportunity

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, J. [Magna Marque, Aurora, ON (Canada)


    Recent studies have shown that more than half of all commute trips and 3 out of 4 shopping trips are under 5 miles in length. Recent polls have also suggested that nearly 20 per cent of all adults would cycle to work if safe routes, and workplace facilities were provided. This presentation suggested that funding bicycle facilities and program is a cost-effective means of reducing motor vehicle emissions and reducing congestion. Several municipalities have placed an emphasis on the provision of safe travel lanes and traffic signals for cyclists. The Velib program in Paris includes 20,600 bicycles. Velib riders are currently taking 120,000 trips per day. Bike infrastructure and bike share programs will encourage community members to participate in active transportation. Over 23 million electric bicycles were sold in 2008. It is expected that eBike sales will double in 4 years. New electric bike systems incorporate a battery-powered electric motor to supplement pedalling efforts. The hybrid technology uses a torque sensor to measure how much pressure the rider is exerting with each stroke. The electric batteries can assist riders for up to 113 km. Use of the bikes may encourage members of the community to leave their cars at home for shorter trips. tabs., figs.

  15. Improving energy sustainability for public buildings in Italian mountain communities. (United States)

    Mutani, Guglielmina; Cornaglia, Mauro; Berto, Massimo


    The objective of this work is to analyze and then optimize thermal energy consumptions of public buildings located within the mountain community of Lanzo, Ceronda and Casternone Valleys. Some measures have been proposed to reduce energy consumption and consequently the economic cost for energy production, as well as the harmful GHG emissions in the atmosphere. Initially, a study of the mountain territory has been carried out, because of its vast extension and climatic differences. Defined the communities and the buildings under investigation, energy dependant data were collected for the analysis of energy consumption monitoring: consumption data of three heating seasons, geometric buildings characteristics, type of opaque and transparent envelope, heating systems information with boiler performance and climatic data. Afterward, five buildings with critical energy performances were selected; for each of these buildings, different retrofit interventions have been hypothesized to reduce the energy consumption, with thermal insulation of vertical or horizontal structures, new windows or boiler substitution. The cost-optimal technique was used to choose the interventions that offered higher energy performance at lower costs; then a retrofit scenario has been planned with a specific financial investment. Finally, results showed possible future developments and scenarios related to buildings energy efficiency with regard to the topic of biomass exploitation and its local availability in this area. In this context, the biomass energy resource could to create a virtuous environmental, economic and social process, favouring also local development.

  16. Community pharmacy minor ailment services in England: Pharmacy stakeholder perspectives on the factors affecting sustainability. (United States)

    Nazar, Hamde; Nazar, Zachariah


    Self-care advice and management of minor ailments have long been provided in community pharmacies across England. However, formal pharmacy minor ailment service provision is geographically variable and has yet to gain recognition and political support as a valued sustainable service for nationwide adoption and commissioning. To investigate the sustainability potential of pharmacy minor ailment services from the perspective of community pharmacy stakeholders within the North East of England. A mixed methods approach was adopted to survey and interview stakeholders from the North East of England who commission; provide; and/or represent groups influencing the design, delivery and investment in community pharmacy clinical and public health services. The 40-item Programme Sustainability Assessment Tool, a validated instrument to assess a public health programme's capacity for sustainability across eight domains, was administered to fifty-three stakeholders, identified from a pharmacy minor ailments showcase event. The same stakeholders were invited for a semi-structured interview to explore issues further. Interviews were audio-recorded, transcribed verbatim, and underwent framework analysis. Forty-two (79.2% response rate) stakeholders representing commissioning, provider and influencing (e.g. Local Professional Network) organisations completed the assessment tool. Pharmacy minor ailment services were rated as unsustainable across the majority of the domains. Elements within the domain 'Partnerships' demonstrated potential for sustainability. Stakeholder interviews provided detailed explanation for the low scoring sustainability domains, highlighting the multifaceted challenges threatening these services. The Programme Sustainability Assessment Tool allowed stakeholders to evaluate the potential of pharmacy minor ailment services in England. Follow-up interviews highlighted that initial design and implementation of services was poorly conceived and lacked evidence

  17. Dark Side of Development: Modernity, Disaster Risk and Sustainable Livelihoods in Two Coastal Communities in Fiji


    Per Becker


    The world is changing rapidly, as are the remotest rural communities. Modernity is spreading across the world under the guise of development and it is transforming disaster risk. This raises issues concerning how disaster risk is changing in such milieus. Using a sustainable livelihood approach, this article investigates access to different types of capital that central to the vulnerability of two coastal communities in Fiji that are affected by modernity to different extents. This comparativ...

  18. Community Tourism Entrepreneurship for Sustainable Tourism Management in Southern Africa: Lessons from Zimbabwe


    Simon Chiutsi; Boycen Kumira Mudzengi


    Zimbabwe tourism development has suffered the pitfalls of uneven development often producing disproportionate distribution of returns. While tourism has been promulgated as a panacea to the socio-economic development challenges Zimbabwe is facing, local and often marginalized rural communities have not meaningfully reaped the benefits through tourism income. In this paper community tourism entrepreneurship is suggested as a viable option to promote sustainable tourism as it places the local c...

  19. Complementary crops and landscape features sustain wild bee communities. (United States)

    Martins, Kyle T; Albert, Cécile H; Lechowicz, Martin J; Gonzalez, Andrew


    Wild bees, which are important for commercial pollination, depend on floral and nesting resources both at farms and in the surrounding landscape. Mass-flowering crops are only in bloom for a few weeks and unable to support bee populations that persist throughout the year. Farm fields and orchards that flower in succession potentially can extend the availability of floral resources for pollinators. However, it is unclear whether the same bee species or genera will forage from one crop to the next, which bees specialize on particular crops, and to what degree inter-crop visitation patterns will be mediated by landscape context. We therefore studied local- and landscape-level drivers of bee diversity and species turnover in apple orchards, blueberry fields, and raspberry fields that bloom sequentially in southern Quebec, Canada. Despite the presence of high bee species turnover, orchards and small fruit fields complemented each other phenologically by supporting two bee genera essential to their pollination: mining bees (Andrena spp.) and bumble bees (Bombus spp.). A number of bee species specialized on apple, blueberry, or raspberry blossoms, suggesting that all three crops could be used to promote regional bee diversity. Bee diversity (rarefied richness, wild bee abundance) was highest across crops in landscapes containing hedgerows, meadows, and suburban areas that provide ancillary nesting and floral resources throughout the spring and summer. Promoting phenological complementarity in floral resources at the farmstead and landscape scales is essential to sustaining diverse wild bee populations. © 2018 by the Ecological Society of America.

  20. Sustainable Community Sanitation for a Rural Hospital in Haiti

    Directory of Open Access Journals (Sweden)

    Jason Jawidzik


    Full Text Available A fully sustainable sanitation system was developed for a rural hospital in Haiti. The system operates by converting human waste into biogas and fertilizer without using external energy. It is a hybrid anaerobic/aerobic system that maximizes methane production while producing quality compost. The system first separates liquid and solid human waste at the source to control carbon to nitrogen ratio and moisture content to facilitate enhanced biodegradation. It will then degrade human waste through anaerobic digestion and capture the methane gas for on-site use as a heating fuel. For anaerobic decomposition and methane harvesting a bioreactor with two-stage batch process was designed. Finally, partially degraded human waste is extracted from the bioreactor with two-stage batch process and applied to land farming type aerobic composter to produce fertilizer. The proposed system is optimized in design by considering local conditions such as waste composition, waste generation, reaction temperature, residence time, construction materials, and current practice. It is above ground with low maintenance requirements.


    Directory of Open Access Journals (Sweden)

    Gukurume Simbarashe


    Full Text Available This article explores the impact of climate change and variability on agricultural productivity in the communal area of Bikita. The article further examines the adaptation and mitigation strategies devised by farmers to deal with the vagaries of climate change and variability. The sustainability of these is also interrogated in this article. This study juxtaposed qualitative and quantitative methodologies albeit with more bias on the former. A total of 40 farmers were sampled for unstructured interviews and focus group discussions. This article argues that the adverse impacts of climate change and variability are felt heavily by the poor communal farmers who are directly dependent on agriculture for livelihood. From the study, some of the widely reported signs of climate variability in Bikita included late and unpredictable rains, high temperatures (heat waves, successive drought, shortening rainfall seasons and seasonal changes in the timing of rainfall. The paper argues that climate change has compounded the vulnerability of peasant farmers in the drought - prone district of Bikita plunging them into food insecurity and abject poverty. It emerged in the study that some of effects of climate variability felt by communal farmers in Bikita included failure of crops, death of livestock and low crop yields, all of which have led to declining agricultural productivity. Findings in this study however established that communal farmers have not been passive victims of the vagaries of climate change and variability. They have rationally responded to it through various adaptation and mitigation strategies both individually and collectively.

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

    Directory of Open Access Journals (Sweden)

    Christina Valeska Sager-Klauss


    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

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

    Directory of Open Access Journals (Sweden)

    Vera H Hausner

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

  4. Turning construction of a sustainable community into business; Kestaevaen yhdyskunnan rakentaminen. Naekoekulmia ja liiketoimintamahdollisuuksia

    Energy Technology Data Exchange (ETDEWEB)

    Vainio, T.; Nissinen, K.; Moettoenen, V.; Vainio, S. [VTT Technical Research Centre of Finland, Espoo (Finland); Herrala, M.; Haapasalo, H. [Univ. of Oulu (Finland)


    The aim of the project was to increase understanding about what a sustainable community is like and how one can be built. The report describes briefly the theoretical backgrounds of all three dimensions sustainability and presents assessment methods as well as tests two of them on Hiukkavaara, Oulu. The crucial decisions regarding building a sustainable community are made already before planning starts during goal setting. Zoning, planning and construction for their part meet set goals. During the life cycle, the use phase has a decisive influence especially on the dimension of socially and ecologically sustainable development. The built environment may either waste or generate energy during the life cycle. In principle, socially sustainable development is considered more of a process than an achieved status. If successful, it increases the status and value of an area which is part of economically sustainable development. The aspects of sustainable development are not separate but merge with each other. Considering the viewpoint of sustainable development in construction creates new and expands existing business opportunities at all phases of the building process. In addition to life-cycle projects suitable for large companies with riskbearing capacity, or building of novel networks, sustainable construction offers opportunities also for small, local companies. In the design of a one- and two-family house dominated residential area the value chain from general design to finished residential area is long time-wise. Thus, in the early phase it is important to retain the possibility to make changes instead of meeting exact client needs. A concrete example of that is the improvement of the energy efficiency of one- and two-family houses which calls into question the profitability of building a district heating system. The value chains of construction must be able to develop solutions for the changing operating environment. Uses must be found for buildings throughout

  5. An Integrated Approach to “Sustainable Community-Based Tourism”

    Directory of Open Access Journals (Sweden)

    Tek B. Dangi


    Full Text Available Two rich knowledge domains have been evolving along parallel pathways in tourism studies: sustainable tourism (ST and community-based tourism (CBT. Within both lie diverse definitions, principles, criteria, critical success factors and benefits sought or outcomes desired, advocated by different stakeholders ranging from quasi-governmental and non-profit organizations to public-private sector and academic interests. This poses significant challenges to those interested in theory building, research and practice in the sustainable development and management of tourism. The paper builds on a previous article published in Sustainability by presenting an integrated framework based on a comprehensive, in-depth review and analysis of the tourism-related literature. The study reveals not just common ground and differences that might be anticipated, but also important sustainability dimensions that are lagging or require much greater attention, such as equity, justice, ethical and governance issues. A preliminary framework of “sustainable community-based tourism” (SCBT is forwarded that attempts to bridge the disparate literature on ST and CBT. Critical directions forward are offered to progress research and sustainability-oriented practices towards more effective development and management of tourism in the 21st century.

  6. Interdependence and Sustainable Collective Action: : The case of four collective housing communities in Mexico City

    NARCIS (Netherlands)

    Montelongo Arana, Marina; Wittek, Rafael


    We study under which conditions collective action breaks down into some communities but keeps sustainable in others. The main purpose of our explorative qualitative study is to identify the micro-level pathways that lead to the maintenance and decay of collective action. Drawing on sharing group

  7. Sustainability Transdisciplinary Education Model: Interface of Arts, Science, and Community (STEM) (United States)

    Clark, Barbara; Button, Charles


    Purpose: The purpose of this paper is to describe the components of a sustainability transdisciplinary education model (STEM), a contemporary approach linking art, science, and community, that were developed to provide university and K-12 students, and society at large shared learning opportunities. The goals and application of the STEM curriculum…

  8. Transition Communities and the Glass Ceiling of Environmental Sustainability Policies at Three Universities (United States)

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


    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…

  9. Team Factors that Predict to Sustainability Indicators for Community-Based Prevention Teams (United States)

    Perkins, Daniel F.; Feinberg, Mark E.; Greenberg, Mark T.; Johnson, Lesley E.; Chilenski, Sarah Meyer; Mincemoyer, Claudia C.; Spoth, Richard L.


    Because they often set out with a guarantee of only short-term funding, many community partnerships will face a threat to their sustainability almost as soon as the first money runs out. Research into the factors that enable some coalitions and partnerships to meet the challenge when others fail is limited. This study begins to fill this gap in…

  10. Greening Social Work Education: Teaching Environmental Rights and Sustainability in Community Practice (United States)

    Androff, David; Fike, Chris; Rorke, John


    Green issues such as protecting environmental rights and promoting sustainability are growing in importance to social work practice but are largely ignored in social work curricula. This article uses comparative case studies of three student-led community practice projects to demonstrate how environmental rights can be incorporated into social…

  11. Mapping a sustainable future: Community learning in dialogue at the science-society interface (United States)

    Barth, Matthias; Lang, Daniel J.; Luthardt, Philip; Vilsmaier, Ulli


    In 2015, the German Federal Ministry of Education and Research (BMBF) announced that the Science Year 2015 would focus on the "City of the Future". It called for innovative projects from cities and communities in Germany dedicated to exploring future options and scenarios for sustainable development. Among the successful respondents was the city of Lüneburg, located in the north of Germany, which was awarded funding to establish a community learning project to envision a sustainable future ("City of the Future Lüneburg 2030+"). What made Lüneburg's approach unique was that the city itself initiated the project and invited a broad range of stakeholders to participate in a community learning process for sustainable development. The authors of this article use the project as a blueprint for sustainable city development. Presenting a reflexive case study, they report on the process and outcomes of the project and investigate community learning processes amongst different stakeholders as an opportunity for transformative social learning. They discuss outputs and outcomes (intended as well as unintended) in relation to the specific starting points of the project to provide a context-sensitive yet rich narrative of the case and to overcome typical criticisms of case studies in the field.

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

    Directory of Open Access Journals (Sweden)

    Mike White


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

  13. Sustainable cultivation of broadleaved trees in a recycling community

    International Nuclear Information System (INIS)

    Christersson, L.


    In the future, with problems of global warming and acidification and with an increasing need to recirculate wastes of the community in an ecologically acceptable and economically sound manner, the cultivation of broadleaved species (birch, aspen, poplar, alder and willow in particular) on suitable forest land and on former agricultural land is of utmost interest if following the recycling philosophy. The wood produced could be used primarily for short fibres and for energy. Also of interest is the production of methanol, biogas and electricity, chipboard and laminates, in the context of a forest industry concerned with the further development of the raw materials. The main advantages of cultivating fast-growing, broadleaved trees on former agricultural land are that: * in Sweden it has been shown possible to produce 10-12 tonnes of dry matter of woody biomass per hectare and year by cultivating willows and hybrid poplars, * in such plantations, the energy efficiency ratio will be 1 to 15-20, meaning that for every energy unit used, 15-20 can be harvested, and * some residual products from society, such as sludges, ashes, and wastewaters can be used as fertilizers in such plantations. 16 refs

  14. Earth Science Informatics Community Requirements for Improving Sustainable Science Software Practices: User Perspectives and Implications for Organizational Action (United States)

    Downs, R. R.; Lenhardt, W. C.; Robinson, E.


    Science software is integral to the scientific process and must be developed and managed in a sustainable manner to ensure future access to scientific data and related resources. Organizations that are part of the scientific enterprise, as well as members of the scientific community who work within these entities, can contribute to the sustainability of science software and to practices that improve scientific community capabilities for science software sustainability. As science becomes increasingly digital and therefore, dependent on software, improving community practices for sustainable science software will contribute to the sustainability of science. Members of the Earth science informatics community, including scientific data producers and distributers, end-user scientists, system and application developers, and data center managers, use science software regularly and face the challenges and the opportunities that science software presents for the sustainability of science. To gain insight on practices needed for the sustainability of science software from the science software experiences of the Earth science informatics community, an interdisciplinary group of 300 community members were asked to engage in simultaneous roundtable discussions and report on their answers to questions about the requirements for improving scientific software sustainability. This paper will present an analysis of the issues reported and the conclusions offered by the participants. These results provide perspectives for science software sustainability practices and have implications for actions that organizations and their leadership can initiate to improve the sustainability of science software.

  15. Modeling Sustainability of Water, Environment, Livelihood, and Culture in Traditional Irrigation Communities and Their Linked Watersheds

    Directory of Open Access Journals (Sweden)

    Kenneth Boykin


    Full Text Available Water scarcity, land use conversion and cultural and ecosystem changes threaten the way of life for traditional irrigation communities of the semi-arid southwestern United States. Traditions are strong, yet potential upheaval is great in these communities that rely on acequia irrigation systems. Acequias are ancient ditch systems brought from the Iberian Peninsula to the New World over 400 years ago; they are simultaneously gravity flow water delivery systems and shared water governance institutions. Acequias have survived periods of drought and external shocks from changing economics, demographics, and resource uses. Now, climate change and urbanization threaten water availability, ecosystem functions, and the acequia communities themselves. Do past adaptive practices hold the key to future sustainability, or are new strategies required? To explore this issue we translated disciplinary understanding into a uniform format of causal loop diagrams to conceptualize the subsystems of the entire acequia-based human-natural system. Four subsystems are identified in this study: hydrology, ecosystem, land use/economics, and sociocultural. Important linkages between subsystems were revealed as well as variables indicating community cohesion (e.g., total irrigated land, intensity of upland grazing, mutualism. Ongoing work will test the conceptualizations with field data and modeling exercises to capture tipping points for non-sustainability and thresholds for sustainable water use and community longevity.

  16. Measuring the Social Sustainability of Urban Communities: The Role of Local Authorities

    Directory of Open Access Journals (Sweden)

    Bogdana NEAMŢU


    Full Text Available The paper explores the topic of social sustainability which in the last years has attracted interest from both the academia and political decision-makers and analyzes emerging issues on the social sustainability agenda such as urban governance, citizens’ empowerment and participation, sense of place, urban livability etc. The article focuses on how social sustainability of a community can be evaluated: it looks at existing methodologies, metrics and tools and uses the indicators from the Egan report (UK to illustrate the shifts currently taking place in the realm of sustainability assessment. The empirical research strives to determine whether public servants working in urban planning or in other areas that are closely related to planning are in favor of introducing at the local level a sustainability assessment system (research carried out in medium and large municipalities from the North-Western region of Romania. The main conclusion which can be derived from both literature and practice is that the themes under the umbrella of social sustainability are changing and that sustainability assessment is currently in the process of being better understood and used at the local level.

  17. The storm that rocks the boat: the systemic impact of gated communities on urban sustainability

    Directory of Open Access Journals (Sweden)

    Karina Landman


    Full Text Available This paper is concerned with the impact and implications of gated communities on urban sustainability. This is investigated making use of an overarching methodological framework based on the internationally accepted Driver-Pressure-State-Impact-Response (DPSIR model, developed by the OECD. Additional to the simple causal flow from drivers to responses are the dynamic relationships between these five aspects. The paper discusses each of these issues and the relationships between them as they pertain to gated communities in South Africa. Gated communities, as complex systems, necessitate the consideration of a multiplicity of feedback loops with internal rates of flow that are determined by non-linear relationships. Only in this way can the full extent of their impact and implications on urban sustainability be assessed.

  18. Building a design community for sustainable homes through configuration and open innovation

    DEFF Research Database (Denmark)

    Thuesen, Christian Langhoff; Jespersen, Kristina Risom


    . Furthermore will an idea space collect and rate ideas from the users. Through a combination of technical and user driven innovation the design community will act as a learning tool for the users and producers and thereby facilitate the development of a market for sustainable homes.......This paper presents a development project which aims to create a market place for sustainable homes – around a design community where the uses and producers collectively can develop new energy efficient solutions and thereby reduce the emmisson of CO2. The core functionality of the design community...... is a configurator where the users based on the produceres templates can design their own home at a selected address visualizing and estimating the energy consumption, total cost, CO2 emission etc. All the designs will be collected and rated in a design space creating transparency over the market and technologies...

  19. Actions Environmental Sustainability Measures for Producers and Local Communities in a Coastal Area

    Directory of Open Access Journals (Sweden)

    María Elena Zequeira-Álvarez


    Full Text Available In this work, the area of study is defined as the producers and communities of the northern coastal zone, up to the 5-meter level curve of the province of Camagüey, Cuba. It is composed of four municipalities and is very rich in natural values but also identifies itself as a very fragile ecosystem. The methodological procedure consists of three stages that respond to their respective objectives: General characteristics of the study area, environmental problems in the area of study and general measures of sustainability for producers and coastal communities, The general objective of the work is to propose general measures of Environmental sustainability for producers and local communities in the northern coastal zone of Camagüey, Cuba in order to contribute to the use and conservation of the ecosystem. These are aimed at the producers and settlers of the study area but may be interesting for other ecosystems.

  20. Neoliberal governance, sustainable development and local communities in the Barents Region

    Directory of Open Access Journals (Sweden)

    Monica Tennberg


    Full Text Available There are currently high hopes in the Barents Region for economic growth, higher employment and improved well-being, encouraged by developments in the energy industry, tourism and mining. The article discusses these prospects from the perspective of local communities in five locations in the region, which spans the northernmost counties of Finland, Norway, Sweden and Northwest Russia. The communities studied are remote, relatively small, multicultural, and dependent on natural resources. The salient dynamic illuminated in the research is how ideas of sustainability and neoliberal governance meet in community development. While the two governmentalities often conflict, they sometimes also complement one another, posing a paradox that raises concerns over the social aspect of sustainable development in particular. The article is based on international, multidisciplinary research drawing on interviews as well as statistical and documentary analysis.

  1. The Managing Epilepsy Well Network:: Advancing Epilepsy Self-Management. (United States)

    Sajatovic, Martha; Jobst, Barbara C; Shegog, Ross; Bamps, Yvan A; Begley, Charles E; Fraser, Robert T; Johnson, Erica K; Pandey, Dilip K; Quarells, Rakale C; Scal, Peter; Spruill, Tanya M; Thompson, Nancy J; Kobau, Rosemarie


    Epilepsy, a complex spectrum of disorders, affects about 2.9 million people in the U.S. Similar to other chronic disorders, people with epilepsy face challenges related to management of the disorder, its treatment, co-occurring depression, disability, social disadvantages, and stigma. Two national conferences on public health and epilepsy (1997, 2003) and a 2012 IOM report on the public health dimensions of epilepsy highlighted important knowledge gaps and emphasized the need for evidence-based, scalable epilepsy self-management programs. The Centers for Disease Control and Prevention translated recommendations on self-management research and dissemination into an applied research program through the Prevention Research Centers Managing Epilepsy Well (MEW) Network. MEW Network objectives are to advance epilepsy self-management research by developing effective interventions that can be broadly disseminated for use in people's homes, healthcare providers' offices, or in community settings. The aim of this report is to provide an update on the MEW Network research pipeline, which spans efficacy, effectiveness, and dissemination. Many of the interventions use e-health strategies to eliminate barriers to care (e.g., lack of transportation, functional limitations, and stigma). Strengths of this mature research network are the culture of collaboration, community-based partnerships, e-health methods, and its portfolio of prevention activities, which range from efficacy studies engaging hard-to-reach groups, to initiatives focused on provider training and knowledge translation. The MEW Network works with organizations across the country to expand its capacity, help leverage funding and other resources, and enhance the development, dissemination, and sustainability of MEW Network programs and tools. Guided by national initiatives targeting chronic disease or epilepsy burden since 2007, the MEW Network has been responsible for more than 43 scientific journal articles, two

  2. Building sustainable community partnerships into the structure of new academic public health schools and programs. (United States)

    Gaughan, Monica; Gillman, Laura B; Boumbulian, Paul; Davis, Marsha; Galen, Robert S


    We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.

  3. Sodium Restriction in Patients With CKD : A Randomized Controlled Trial of Self-management Support

    NARCIS (Netherlands)

    Meuleman, Yvette; Hoekstra, Tiny; Dekker, Friedo W.; Navis, Gerjan; Vogt, Liffert; van der Boog, Paul J. M.; Bos, Willem Jan W.; van Montfrans, Gert A.; van Dijk, Sandra

    Background: To evaluate the effectiveness and sustainability of self-managed sodium restriction in patients with chronic kidney disease. Study Design: Open randomized controlled trial. Setting & Participants: Patients with moderately decreased kidney function from 4 hospitals in the Netherlands.

  4. School-community learning partnerships for sustainability: Recommended best practice and reality (United States)

    Wheeler, Leone; Guevara, Jose Roberto; Smith, Jodi-Anne


    Effective partnerships across different stakeholders are essential to the collaboration required for learning cities to contribute to sustainable development. Through partnerships, formal educational institutions, such as schools and universities, play a vital role in establishing and sustaining learning cities, often by facilitating the meaningful participation of different local community members. The research presented in this article examines the characteristics of effective school-community partnerships in the literature and compares it to the results of a three-year research study which examined 16 case studies of school-community partnerships in the state of Victoria in Australia. Using participatory action research, the researchers identified four approaches to implementing partnerships for sustainability, explored challenges to achieving an idealised partnership, and made recommendations for establishing successful partnership networks. The researchers propose that partnerships be viewed as a dynamic resource rather than merely a transactional arrangement that addresses the identified challenges of time, funding, skills and personnel. Furthermore, the use of "partnership brokers", such as local government or non-government organisations, is recommended to expand the current school-centred approach to partnerships. These insights aim to contribute to providing quality education and lifelong learning through partnerships - outcomes crucial for establishing and sustaining learning cities.

  5. Sustainable capacity building among immigrant communities: the raising sexually healthy children program in Canada. (United States)

    Narushima, Miya; Wong, Josephine Pui-Hing; Li, Anda; Sutdhibhasilp, Noulmook


    The Raising Sexually Healthy Children (RSHC) program is a peer-to-peer leadership training program for immigrant parents in Toronto, Canada. It was established in 1998 with the goal of promoting family sex education and parent-child communication. This evaluative study examined the developmental processes and outcomes of the RSHC program to identify the strengths, challenges and insights that can be used to improve the program. It employed a multi-case study approach to compare the RSHC programs delivered in the Chinese, Portuguese and Tamil communities. Data collection methods included focus groups, individual interviews and document analysis. The cross-case analysis identified both common and unique capacity building processes and outcomes in the three communities. In this paper, we report factors that have enhanced and hindered sustainable capacity building at the individual, group/organizational and community levels, and the strategies used by these communities to address challenges common to immigrant families. We will discuss the ecological and synergetic, but time-consuming processes of capacity building, which contributed to the sustainability of RSHC as an empowering health promotion program for immigrant communities. We conclude the paper by noting the implications of using a capacity building approach to promote family health in ethno-racial-linguistic minority communities.

  6. A pilot study of a Community Health Agent-led type 2 diabetes self-management program using Motivational Interviewing-based approaches in a public primary care center in São Paulo, Brazil. (United States)

    do Valle Nascimento, Thais Moura Ribeiro; Resnicow, Ken; Nery, Marcia; Brentani, Alexandra; Kaselitz, Elizabeth; Agrawal, Pooja; Mand, Simanjit; Heisler, Michele


    Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptability, and outcomes of training community health agents (CHAs) in Motivational Interviewing (MI)-based counseling for patients with poorly controlled diabetes in a primary care center in São Paulo, Brazil. Nineteen salaried CHAs participated in 32 h of training in MI and behavioral action planning. With support from booster training sessions, they used these skills in their regular monthly home visits over a 6 month period with 57 diabetes patients with baseline HbA1cs > 7.0%. The primary outcome was patients' reports of the quality of diabetes care as measured by the Portuguese version of the Patient Assessment of Chronic Illness Care (PACIC) scale. Secondary outcomes included changes in patients' reported diabetes self-management behaviors and in A1c, blood pressure, cholesterol and triglycerides. We also examined CHAs' fidelity to and experiences with the intervention. Patients reported improvements over the 6 month period in quality of diabetes care received (PACIC score improved 33 (+/-19) to 68 (+/-21) (p < .001)). They reported increases in physical activity (p = .001), consumption of fruits and vegetables (p < .001) and medication adherence (p = .002), but no decreases in consumption of high-fat foods (p = .402) or sweets (p = .436). Participants had mean 6-month A1c levels 0.34% points lower than at baseline (p = .08) and improved mean LDL (-16.1 mg/dL, p = .005) and triglyceride levels (-38.725 mg/dL, p = .002). Of the 16 CHAs observed in fidelity assessments, 13 were categorized as medium- or high-performing on MI skills, while 3 were low-performing. CHAs expressed enthusiasm about learning new skills, and many

  7. Enviromental indicators in Amazonian Kichwa Communities from Ecuador for the ellaboration of a sustainable development strategy

    Directory of Open Access Journals (Sweden)

    Ruth Irene Arias Gutiérrez


    Full Text Available An environmental diagnosis is made in the Amazonian Kichwa region (Napo and Pastaza provinces, Ecuador for the ellaboration of a sustainable development strategy. The environmental indicators such as the number of cultivated plant species and their use. The use of forest and agricultural products were measured, as well. Qualitative and quantitative research methods, most appropriate for this study, were used. The quantitative methodology consisted in surveying to the residents, the leaders of the six communities and the heads of 64 households scattered around five rural parishes. The main results are collected in a strategic agenda that would boost the ecological sustainability. The communities employ a high number of species directly as food, and a fewer for medical, flavoring and cosmetic use. However, a single use of resources as raw materials is observed. With no the application of science and technology, there is not an orderly and efficient use of resources, which is achieved by establishing links with other universities research projects. It is necessary to replenish and enhance native renewable resources used by the communities, and add value and work on human capital formation for the protection of these resources. Local resources are not reasonably used with a focus on the protection of the environment and the extensive Amazonian biodiversity. There are high rates of illiteracy in the communities. That’s why it is important the development of bio-knowledge through public interventions, which will help sustain the national competitive advantage, based on its natural and biological richness, supported by the development of local production networks and technology generation. A proposed strategy for a sustainable agro-ecological community development was made.

  8. Sustainable Schools, Sustainable Communities: The View from the West. CAE Spring 2001 Conference [Proceedings] (San Diego, California, March 22-24, 2001). (United States)

    Malone, Sara

    This paper presents summary conclusions reached by discussion panels that participated in the Committee on Architecture for Education's conference. The conference explored the symbiotic relationship between schools and communities and the ways that schools and communities sustain one another. Panel titles were: "City Heights Urban Village"; "High…

  9. Future energy communities : How community norms shape individual adoption and acceptability of sustainable energy systems

    NARCIS (Netherlands)

    Milovanovic, Marko; Steg, Emmalina; Spears, Russell


    Most research on factors influencing the acceptability and adoption of sustainable energy systems is focused on individual-level factors such as personal norms, values, and attitudes. Some researchers have considered the effects of social factors such as descriptive and injunctive norms, but little

  10. Impact of an occupation-based self-management programme on chronic disease management.

    LENUS (Irish Health Repository)

    O'Toole, Lynn


    There is a need for the development and evaluation of occupational therapy interventions enabling participation and contributing to self-management for individuals with multiple chronic conditions. This pilot study aimed to assess the feasibility and potential impact of an occupation-based self-management programme for community living individuals with multiple chronic conditions.

  11. Gascoyne Growers Market: a sustainable health promotion activity developed in partnership with the community. (United States)

    Payet, Jennifer; Gilles, Marisa; Howat, Peter


    To explore the social, health and economic impact of a farmers' market on a small rural community in the north of Western Australia. Qualitative and quantitative research using a random structured intercept survey, and focus group interviews around four domains of social capital: economic impact, governance and capacity building, healthy public places and social and civic participation. The Gascoyne Growers Markets in Carnarvon. One hundred consumers and 28 market stallholders. Consumers demonstrated community pride and an increase in fruit and vegetable consumption since they commenced shopping at the markets. The stallholders appear to have gained economically, professionally and socially from the market experience. The Gascoyne Growers Markets demonstrate a sustainable health promotion activity developed in partnership with the community. It has contributed to the local economy, providing local quality fruit and vegetables directly to the community while also increasing social capital and creating a healthy public space.

  12. Analysis of the sustainability of tourism: a study in indigenous communities of Roraima state, Brazil

    Directory of Open Access Journals (Sweden)

    Cristiane do Nascimento Brandao


    Full Text Available This survey was conducted in three indigenous communities in the state of Roraima. They found in tourism a way of achieving local sustainable development. This activity can bring positive and negative consequences, so the aim of this study is to analyze the social, cultural, economic and environmental impacts of tourism in indigenous communities. We used the quantitative method with questionnaires. The units of analysis were the indigenous inhabitants of the surveyed communities. The survey sample consisted of 210 valid responses. In the data analysis, we used descriptive statistics and multivariate analysis. The study found that tourism can bring economic, social, cultural and environmental benefits for communities. Must develop actions that aim to transform existing initiatives in destinations of excellence in Indigenous tourism.

  13. Affordable Exploration of Mars: Recommendations from a Community Workshop on Sustainable Initial Human Missions (United States)

    Thronson, Harley; Carberry, Chris; Cassady, R. J.; Cooke, Doug; Hopkins, Joshua; Perino, Maria A.; Kirkpatrick, Jim; Raftery, Michael; Westenberg, Artemis; Zucker, Richard


    There is a growing consensus that within two decades initial human missions to Mars are affordable under plausible budget assumptions and with sustained international participation. In response to this idea, a distinguished group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December, 2013. Participants reviewed and discussed scenarios for affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station over the coming decade as the essential early step toward humans to Mars, possible "bridge" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and a usable definition of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop.

  14. Actualizing Communities of Practice (COPs and Situated Learning for A Sustainable Eco-Village

    Directory of Open Access Journals (Sweden)

    Maria Victoria Pineda


    Full Text Available An eco-village as defined by Robert Gilman is a “human-scale, full-featured settlement where you feel you know the others, and human activities are integrated with natural, biological systems.” Roland Mayerl argued that this maybe ideal, but there are huge challenges. He claims the challenges are at different levels—there is the physical layer that constitutes food production, animals, water and wastewater treatment. Other layers will be the built environment, the economic system and the governance in the village.This paper argues that one of the challenging layers is the human layer that was excluded in the modeling of many eco-village works. While there are many good models of an eco-village, sustainability will primarily be laid on the shoulders of the members of the community or the village for that matter. Sustainability should be espoused by the members of the eco-village. But how can sustainability be attained? What sustainability approach or strategy can be employed?“Communities of practice (COP are formed by people who engage in a process of collective learning in a shared domain of human endeavor.“ (Wenger, 2004 COPs are concepts commonly applied in organizations and virtual communities. Using this approach together with periphery participation and situated learning, this paper presents a human-based model of a sustainable eco-village and some useful examples.The paper also argues that an eco-village necessitates the support of technology in enhancing and preserving the shared practices. Hence, use of social media deployed in the web is one of the recommended ways that also permit collective action among members of the eco-village.

  15. A new approach to conservation: using community empowerment for sustainable well-being

    Directory of Open Access Journals (Sweden)

    Alaka Wali


    Full Text Available The global environmental conservation community recognizes that the participation of local communities is essential for the success of conservation initiatives; however, much work remains to be done on how to integrate conservation and human well-being. We propose that an assets-based approach to environmental conservation and human well-being, which is grounded in a biocultural framework, can support sustainable and adaptive management of natural resources by communities in regions adjacent to protected areas. We present evidence from conservation and quality of life initiatives led by the Field Museum of Natural History over the past 17 years in the Peruvian Amazon. Data were derived from asset mapping in 37 communities where rapid inventories were conducted and from 38 communities that participated in longer term quality of life planning. Our main findings are that Amazonian communities have many characteristics, or assets, that recent scholarship has linked to environmental sustainability and good natural resource stewardship, and that quality of life plans that are based on these assets tend to produce priorities that are more consistent with environmental conservation. Importantly, we found that validating social and ecological assets through our approach can contribute to the creation of protected areas and to their long-term management. As strategies to engage local communities in conservation expand, research on how particular methodologies, such as an assets-based approach, is needed to determine how these initiatives can best empower local communities, how they can be improved, and how they can most effectively be linked to broader conservation and development processes.

  16. Community support for campus approaches to sustainable energy use: The role of 'town-gown' relationships

    International Nuclear Information System (INIS)

    McComas, Katherine A.; Stedman, Richard; Sol Hart, P.


    Across the United States, universities are grappling with challenges associated with adopting approaches to more sustainable energy use. One approach has been to develop energy-related projects in their local, host communities. Because host communities can play a major role in the successful planning and implementation of these projects, understanding the factors relating to their support is important. Building on research that suggests that procedural fairness is one such key factor, this study examines community members' support of six approaches a local university could implement to work towards a goal of carbon neutrality. The results of a mail survey (N=677) found that perceived fairness of campus decision makers was significantly related to community support for the proposed approaches; however, beliefs about the efficacy of the different approaches to address challenges associated with climate change had the strongest relationship with support. The results also suggest that residents prefer changes in the energy infrastructure, such as the development of wind power, over the purchase of carbon offsets. We discuss the results in terms of actions that universities may take to foster community engagement in decision-making for university-sponsored sustainable energy projects. - Research highlights: → Residents were surveyed about support of a local university's energy choices. → Perceived fairness of campus authorities related to local support. → Beliefs about ability of energy choices to address climate change predicted support.

  17. Establishment of a Hub for the Light Water Reactor Sustainability Online Monitoring Community

    International Nuclear Information System (INIS)

    Lybeck, Nancy J.; Tawfik, Magdy S.; Pham, Binh T.


    Implementation of online monitoring and prognostics in existing U.S. nuclear power plants will involve coordinating the efforts of national laboratories, utilities, universities, and private companies. Internet-based collaborative work environments provide necessary communication tools to facilitate interaction between geographically diverse participants. Available technologies were considered, and a collaborative workspace was established at INL as a hub for the light water reactor sustainability online monitoring community.

  18. Methodology for Monitoring Sustainable Development of Isolated Microgrids in Rural Communities

    Directory of Open Access Journals (Sweden)

    Claudia Rahmann


    Full Text Available Microgrids are a rapidly evolving and increasingly common form of local power generation used to serve the needs of both rural and urban communities. In this paper, we present a methodology to evaluate the evolution of the sustainability of stand-alone microgrids projects. The proposed methodology considers a composite sustainability index (CSI that includes both positive and negative impacts of the operation of the microgrid in a given community. The CSI is constructed along environmental, social, economic and technical dimensions of the microgrid. The sub-indexes of each dimension are aggregated into the CSI via a set of adaptive weighting factors, which indicate the relative importance of the corresponding dimension in the sustainability goals. The proposed methodology aims to be a support instrument for policy makers especially when defining sound corrective measures to guarantee the sustainability of small, isolated microgrid projects. To validate the performance of the proposed methodology, a microgrid installed in the northern part of Chile (Huatacondo has been used as a benchmarking project.

  19. Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members

    Directory of Open Access Journals (Sweden)

    Flynn SJ


    practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group and uncontrolled (one group hypertension, as well as their family members (two groups. Trained moderators used open-ended questions to assess participants’ perceptions regarding patient, family, clinic, and community-level factors influencing patients’ effective hypertension self-management. Results: Patient participants identified several facilitators (including family members’ support and positive relationships with doctors and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients’ doctor’s visits and discussions with patients’ doctors outside of visits and barriers (including their own limited health knowledge and patients’ lack of motivation to sustain hypertension self-management behaviors that affect their efforts to support patients’ hypertension self-management. Conclusion: African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients’ hypertension self-management. Patients’ and their family members’ views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations. Keywords: hypertension, patient perspective, qualitative research, health disparities

  20. Sustainable energy and development in disadvantaged communities: New approaches from Bosnia and Herzegovina, Hungary, and Slovakia

    Energy Technology Data Exchange (ETDEWEB)

    Legro, Susan [Eco Ltd (Czech Republic)


    This paper examines two community projects implemented by the United Nations Development Programme (UNDP). The first, Promoting Access to Energy Services to Foster Integration and Human Development for Disadvantaged Communities in Hungary and Slovakia with a Special Focus on the Roma, built on regional development work with isolated communities without reliable access to heat and electricity. The second, Energy Efficiency in Housing in Bosnia and Herzegovina (BiH), focused on a network of communities where rebuilding was underway following the Balkans conflict. While the projects took place in different environments, both shared common approaches. First, they focused on community energy planning in areas where infrastructure was severely deficient. Planning was designed so that current investments in building stock would not have to be retrofitted later for efficiency. Second, they linked energy agencies and NGOs with institutions outside of the energy/environment community, such as the National Minority Self Government in Hungary and the Ministry of Refugees in BiH . The projects thus leveraged funds and expertise from new sources while raising awareness of sustainable energy issues in organizations already funding infrastructure.While time and funding were limited by the terms of the grants, both projects established a foundation of information, planning, and partnerships. Both projects included baseline energy studies, training workshops, and practical guides for local leaders. In addition, there were tangible community benefits in education (reliable heat supply for a new kindergarten), jobs creation (wood-chipping in a municipal forest), and business development (contracts for efficient construction)

  1. Factors in creating sustainable intersectoral community mobilization for prevention of heart and lung disease. (United States)

    Bourdages, Josée; Sauvageau, Lyne; Lepage, Céline


    This paper describes factors facilitating and working against successful community mobilization in the implementation of an integrated prevention programme for cardiovascular disease and lung cancer in four community settings in Québec, Canada. Implementation evaluation data from several sources showed that over the 3-year period, mobilization was partly achieved in all four communities, although the degree of success varied. The data support those of previous studies showing that several factors are key to effective intersectoral community mobilization: (i) involvement of concerned and influential community members with a commitment to shared goals and a visible community focus; (ii) formation of multi-organization systems among appropriate organizations, recognizing their strengths, resources and competencies, and preserving both their autonomy and interdependence with an appreciation of divergent perspectives; (iii) development of decision-making mechanisms through the setting up of formal structural arrangements to facilitate decisions with clear leadership; (iv) clear definition of objectives, tasks, roles and responsibilities; and (v) official support and legitimization from participating agencies, government authorities, and organizations with adequate resources devoted to partnership building. This study also replicated a number of barriers to the creation of sustainable intersectoral community mobilization, notably the potentially destructive role of power conflicts among the key institutional partners.

  2. The Sustainable and Healthy Communities Research Program: The Environmental Protection Agency’s Research Approach to Assisting Community Decision-Making

    Directory of Open Access Journals (Sweden)

    Kevin Summers


    Full Text Available A sustainable world is one in which human needs are met equitably and without sacrificing the ability of future generations to meet their needs on environmental, economic, and social fronts. The United States (U.S. Environmental Protection Agency’s Sustainable and Healthy Communities Research Program aims to assist communities (large and small to make decisions for their long term sustainability with respect to the three pillars of human well-being—environmental, economic and social—and are tempered in a way that ensures social equity, environmental justice and intergenerational equity. The primary tool being developed by the Sustainable and Healthy Communities (SHC research program to enhance sustainable decision making is called TRIO (Total Resources Impacts and Outcomes. The conceptual development of this tool and the SHC program attributes are discussed.

  3. Social and Solidarity Economy, Sustainable Development Goals, and Community Development: The Mission of Adult Education & Training

    Directory of Open Access Journals (Sweden)

    Catalina Quiroz-Niño


    Full Text Available A utopia of sustainable development is becoming established on the international stage. To get there, varied and complementary strategies must come into play—among them education. This trend is turning to the “Social and Solidarity Economy” (SSE, especially since the approval by the United Nations (UN of the 2030 Agenda; the fulfilment of which demands adult education strategies and programs in line with the principles and values of sustainability. This article offers a response to that demand. It aims to carry out a reflective analysis that reveals the similarities between the principles and values of the SSE and those guiding the UN’s 2030 Agenda, with its 17 Sustainable Development Goals (SDGs. Based on the results of this analysis, we will argue that training in the competencies for sustainability, essential in achieving the SDGs, is among the main functions of education within the SSE framework. Further, in order to make educational programs more sustainable, such training must be included in their operating objectives. The work uses a hermeneutic methodology based on the existing literature and gives particular attention to UNESCO’s directives on training in key competencies for sustainability. The significant contribution the results make is to show: (a the emphases of each approach and their similarities; (b how the two are complementary; and (c the potential, and need, for creating synergies based on their respective strengths. A further original contribution is a proposed basic guide for the design of training activities geared towards gaining the normative competency that UNESCO has identified as key to sustainability. This innovative proposal will be useful for improving the quality of adult training programs, thereby contributing to the achievement of the SDGs in communities.

  4. Multidimensional Scaling Approach to Evaluate the Level of Community Forestry Sustainability in Babak Watershed, Lombok Island, West Nusa Tenggara

    Directory of Open Access Journals (Sweden)

    Ryke Nandini


    Full Text Available Community forestry in Babak watershed is one of the efforts to reduce critical land area. The aim of this research was to evaluate the level of community forestry sustainability in both of community forest (HKm and private forest in Babak watershed. Multidimensional scaling (MDS was used to analyse the level of community forest sustainability based on the five dimensions of ecology, economy, social, institutional, and technology as well as 29 attributes. Leverage analysis was used to know the sensitive attributes of sustainability, while Monte Carlo analysis and goodness of fit was used to find the accuracy of MDS analysis. The result shows that HKm was in moderate sustainability level (sustainability index 54.08% and private forest was in less sustainability level (sustainability index 48.53%. Furthermore, the ecology and technology in HKm were classified as less sustainable, while the institution and technology in private forest were considered less sustainable. There were 11 sensitive attributes of HKm and 19 sensitive attributes of private forest. The priorities of attribute improvement in HKm include land recovering (the dimension of ecology and cooperative development (the dimension of technology. In private forest, the priorities of attribute improvement include leadership capacity building (the institutional dimension and also the use of silviculture intensive and soil conservation (the dimension of technology.

  5. Stakeholder engagement in diabetes self-management: patient preference for peer support and other insights. (United States)

    Kwan, Bethany M; Jortberg, Bonnie; Warman, Meredith K; Kane, Ilima; Wearner, Robyn; Koren, Romona; Carrigan, Thomas; Martinez, Vincent; Nease, Donald E


    Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR). Twenty-seven diabetes care stakeholders, including patients and providers from a local network of federally qualified health centres participated. Stakeholders met in-person and by conference call over the course of 8 months. Subject matter experts provided education on the diabetes SMS evidence. Facilitators engaged the group in discussions about barriers to self-management and opportunities for improving delivery of SMS. BCT participants identified lack of social support, personal resources, trust, knowledge and confidence as barriers to diabetes self-management. Intervention opportunities emphasized peer support, use of multidisciplinary care teams and centralized systems for sharing information about community and practice resources. BCT informed new services and a PCOR study proposal. Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient's health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail:

  6. Self-management through shame

    DEFF Research Database (Denmark)

    Staunæs, Dorthe; Bjerg, Helle


    of management of self-management in two ways. Firstly, by thinking management of self-management trough concepts from what has become known as the affective turn. Secondly, by illustrating the precise mechanisms of management of self-management in every day life and thereby pointing to how management of self...... to recognition, but is also linked to the production of shame or at least potential shame. This argument is developed theoretically from Brian Massumi's theory on affectivity and intensity combined with Silvan Tomkins's theory of shame as the most self-reflexive affect of all affects. In order to exemplify......  Critical studies on management of self-management and governmentality have primarily been occupied with the production of identities, subject positions and the reflexive elements of self-management. The aim of this article is to challenge and contribute to the field of critical studies...

  7. Creating the sustainable conditions for knowledge information sharing in virtual community. (United States)

    Wang, Jiangtao; Yang, Jianmei; Chen, Quan; Tsai, Sang-Bing


    Encyclopedias are not a new platform for the distribution of knowledge, but they have recently drawn a great deal of attention in their online iteration. Peer production in particular has emerged as a new mode of providing information with value and offering competitive advantage in information production. Large numbers of volunteers actively share their knowledge by continuously editing articles in Baidu encyclopedias. Most articles in the online communities are the cumulative and integrated products of the contributions of many coauthors. Email-based surveys and objective data mining were here used to collect analytical data. Critical mass theory is here used to analyze the characteristics of these collective actions and to explain the emergence and sustainability of these actions in the Baidu Encyclopedia communities. These results show that, based on the collective action framework, the contributors group satisfied the two key characteristics that ensure the collective action of knowledge contribution will both take place and become self-sustaining. This analysis not only facilitates the identification of collective actions related to individuals sharing knowledge in virtual communities, but also can provide an insight for other similar virtual communities' management and development.


    Directory of Open Access Journals (Sweden)

    Kapinos N.


    Full Text Available Land Fund in Ukraine is experiencing excessive human impact, which is reflected in its performance exceeding the allowable agricultural development and land structure imbalance. The environmental condition of land resources close to critical. Among the largest land area occupied by agricultural land (71% of which - 76% is arable land. Violation environmentally acceptable ratio of arable land, natural grasslands and forests negatively affected the sustainability of agricultural landscapes. Throughout the widespread land degradation processes, among which the most ambitious is the erosion (about 57.5% of the territory, pollution (20% of the territory, flooding (about 12% of the territory. Sustainable (balanced land is one of the key factors of sustainable nature of territorial entities and may be formed of a priority, taking into account environmental factors. In ecological optimization based on value criteria ekolohostabilizuyuchyh and anthropogenic pressures lands should necessarily provide for withdrawal of intensive land use, which in its modal properties can not ensure sustainability of land use. However, today in Ukraine within the territories of communities no project development to optimize land use on the basis of sustainable development. Accordingly, the purpose of the article was the study of certain aspects of Land Management sustainable development of agricultural land within the territories of local communities. The current structure of the land fund of Ukraine was actually formed in the Soviet period, under the influence of policies of extensive agricultural development. Violation environmentally acceptable ratio of arable land, natural grasslands and forests negatively affected the stability and condition of land, which is confirmed by relevant research. In such circumstances, balancing the land proposed to carry out in two stages - the ecological and economic. In ecological optimization criteria based on land value necessarily

  9. Seaweeds: an opportunity for wealth and sustainable livelihood for coastal communities. (United States)

    Rebours, Céline; Marinho-Soriano, Eliane; Zertuche-González, José A; Hayashi, Leila; Vásquez, Julio A; Kradolfer, Paul; Soriano, Gonzalo; Ugarte, Raul; Abreu, Maria Helena; Bay-Larsen, Ingrid; Hovelsrud, Grete; Rødven, Rolf; Robledo, Daniel


    The European, Canadian, and Latin American seaweed industries rely on the sustainable harvesting of natural resources. As several countries wish to increase their activity, the harvest should be managed according to integrated and participatory governance regimes to ensure production within a long-term perspective. Development of regulations and directives enabling the sustainable exploitation of natural resources must therefore be brought to the national and international political agenda in order to ensure environmental, social, and economic values in the coastal areas around the world. In Europe, Portugal requires an appraisal of seaweed management plans while Norway and Canada have developed and implemented coastal management plans including well-established and sustainable exploitation of their natural seaweed resources. Whereas, in Latin America, different scenarios of seaweed exploitation can be observed; each country is however in need of long-term and ecosystem-based management plans to ensure that exploitation is sustainable. These plans are required particularly in Peru and Brazil, while Chile has succeeded in establishing a sustainable seaweed-harvesting plan for most of the economically important seaweeds. Furthermore, in both Europe and Latin America, seaweed aquaculture is at its infancy and development will have to overcome numerous challenges at different levels (i.e., technology, biology, policy). Thus, there is a need for regulations and establishment of "best practices" for seaweed harvesting, management, and cultivation. Trained human resources will also be required to provide information and education to the communities involved, to enable seaweed utilization to become a profitable business and provide better income opportunities to coastal communities.

  10. Assessing Good-Practice Frameworks for the Development of Sustainable Energy Communities in Europe: Lessons from Denmark and Ireland

    Directory of Open Access Journals (Sweden)

    Eimear Heaslip


    Full Text Available This paper presents findings from initial fieldwork studies of sustainable energy community development methodologies in two islands in Denmark and one rural village in Ireland. The main goals of this study were to determine the enablers and barriers to their successful development and to assess the successful elements of these previously implemented sustainable energy community development methodologies. The study involved extensive semi-structured interviews with the managers of the sustainable energy community projects and comprehensive site visits of each project. The evidence presented in this paper indicates that social barriers are interconnected and often reinforce each other. This article suggests that a comprehensive understanding of how barriers can be transformed into enablers supports the successful development of sustainable energy communities at local level in Europe. The findings in this research indicate that although each of the sustainable energy communities studied did not have any specific implementation framework developed for their projects, many of the successful tools and methodologies used across all communities were similar. The significant contribution of this work is the illumination of key factors influencing the successful development of sustainable energy communities in Ireland and Europe.

  11. Social – Cultural Sustainability of a Local Community through Visual Identification on the Example of the Town of Zabok

    Directory of Open Access Journals (Sweden)

    Dončić Siniša Hajdaš


    Full Text Available In order for a local community to set up mechanisms for shaping and enforcing public politics which strengthen local communities, historical research that would lead to the identity of a local community must be conducted thus enabling the identification of the community as a tourist destination. Analytical-synthetic method will be used to define the concept of a local community, that is the sustainability of a local community as one element of sustainability in general, as well as the concept of a tourist destination. The identity of a local community may be presented using basic means of visual communication (graphic design, typography, photography, illustration, which if defined and applied appropriately, will improve the distinguished identity of a local community.

  12. Collaboration Between Universities: An effective way of sustaining community-university partnerships?

    Directory of Open Access Journals (Sweden)

    Jonathan Pratt


    Full Text Available This article highlights some of the opportunities and challenges that collaboration between higher education institutions (HEIs can bring to the development of sustainable community-university partnerships. In particular, it explores the potential for universities to collaborate on building effective engagement mechanisms (such as helpdesks, ‘hub and spoke’ contact models, and research groups to review ideas for activities that will support an ongoing flow of new projects and partnerships over time. It draws on evidence gathered from the evaluation and coordination of the South East Coastal Communities (SECC program, an almost unique experiment in collaboration between English universities. In an ‘age of austerity’, opportunities to reduce costs without damaging core services are of particular interest to public funding bodies. The article suggests that collaboration between universities may be an efficient and effective way of engaging with local communities, but that it is not cost-free, and high-level strategic buy-in within HEIs is required if community-university partnerships are to thrive in the current higher education funding environment. The article also suggests that there may be a geographic dimension to effective collaboration between universities in both community-university partnership work and the mechanisms that support community engagement. Inter-university collaboration across the whole region covered by the SECC program has been much weaker than collaboration at a subregional level and within ‘city-regions’ in particular. This raises a key question: does the natural geography for effective collaboration between universities need to reflect, at least in part, the geographies of communities themselves, in terms of lived experiences and/or community representation? Such a debate has interesting and timely parallels in the United Kingdom, where the new coalition government is bringing about a fundamental shift in the

  13. 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.


    -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

  14. A Community-based Partnership for a Sustainable GNSS Geodetic Network (United States)

    Dokka, R. K.


    Geodetic networks offer unparalleled opportunities to monitor and understand many of the rhythms of the Earth most vital to the sustainability of modern and future societies, i.e., crustal motions, sea-level, and the weather. For crustal deformation studies, the advantage is clear. Modern measurements allow us to document not only the permanent strains incurred over a seismic cycle, for example, but also the ephemeral strains that are critical for understanding the underlying physical mechanism. To be effective for science, however, geodetic networks must be properly designed, capitalized, and maintained over sufficient time intervals to fully capture the processes in action. Unfortunately, most networks lack interoperability and lack a business plan to ensure long term sustainability. The USA, for example, lacks a unified nation-wide GNSS network that can sustain its self over the coming years, decades, and century. Current federal priorities do not yet envision such a singular network. Publicly and privately funded regional networks exist, but tend to be parochial in scope, and optimized for a special user community, e.g., surveying, crustal motions, etc. Data sharing is common, but the lack of input at the beginning limits the functionality of the system for non-primary users. Funding for private networks depend heavily on the user demand, business cycle, and regulatory requirements. Agencies funding science networks offer no guarantee of sustained support. An alternative model (GULFNet) developed in Louisiana is meeting user needs, is sustainable, and is helping engineers, surveyors, and geologists become more spatially enabled. The common denominator among all participants is the view that accurate, precise, and timely geodetic data have tangible value for all segments of society. Although operated by a university (LSU), GULFNet is a community-based partnership between public and private sectors. GULFNet simultaneously achieves scientific goals by providing

  15. Feasibility and Sustainability of Community Based Health Insurance in Rural Areas Case Study of Musana, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Lazarus MUCHABAIWA


    Full Text Available The Zimbabwe Demographic Health Survey (ZDHS 2010-11 showed that only 6 percent of the population is covered by health insurance in Zimbabwe. This study investigated the feasibility, acceptability and sustainability of Community Based Health Insurance (CBHI as an alternative to pooling risk and financing social protection in Zimbabwe. Willingness to Pay (WTP for health insurance and socioeconomic data were collected through interviews with 121 household heads selected using a 2-stage sampling procedure on 14 villages in Musana and Domboshava rural areas, a population which is largely unemployed and reliant on subsistence agriculture. A CBHI scheme was established and followed up for 3 years documenting data on visits made, financial contributions from recruited households and their actual health expenditures. Findings indicate that CBHI is generally accepted as a means of health insurance in rural communities. The median willingness to pay for health insurance was $5.43 against monthly expenditures ranging of up to $180. The low WTP is attributable to low incomes as only 3.4 percent of the respondents relied on formal employment. Trust issues, adverse selection, moral hazard, and administration costs were challenges threatening sustainability of CBHI. A financial gap averaging 42% was generally on a downward trend and was closed by the end of the follow-up study as contributions were equivalent to medical expenses. We conclude that CBHI is feasible, has potential for sustainability and should be considered as a springboard for the planned Zimbabwean National Health Insurance.

  16. Can you model growth of trust? A study of the sustainability of a rural community health centre in North India


    Smith, H. K.; Harper, Paul Robert


    Trust in the service provided by any health facility is of vital importance to its sustainability, whether it is a community clinic in a rural area of a developing country or an international telemedicine service. Community health centres can be used as a means of delivering highly accessible, low-cost health service in the developing world. A major strategic issue for planners of such centres is the expected level of uptake of services throughout a region and its effect on sustainability of ...

  17. Developing a sustainable community tourism strategy for townships : the case of Soshanguve / Paul Nkemngu Acha-Anyi


    Acha-Anyi, Paul Nkemngu


    The goal of this study is to develop a sustainable tourism strategy for the Soshanguve Township. The motivation for this study arose out of the acute developmental challenges facing many township communities in South Africa, mainly due to the absence of economic opportunities. This results in a high unemployment rate, poverty and an elevated number of crime incidences. A sustainable community tourism strategy could alleviate this situation by availing itself of the opportunities presented by ...

  18. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda. (United States)

    Russell, Steve; Martin, Faith; Zalwango, Flavia; Namukwaya, Stella; Nalugya, Ruth; Muhumuza, Richard; Katongole, Joseph; Seeley, Janet


    The health of people living with HIV (PLWH) and the sustained success of antiretroviral therapy (ART) programmes depends on PLWH's motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH's self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH's self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH's self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men) were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new 'self': they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management which ART

  19. Finding Meaning: HIV Self-Management and Wellbeing among People Taking Antiretroviral Therapy in Uganda.

    Directory of Open Access Journals (Sweden)

    Steve Russell

    Full Text Available The health of people living with HIV (PLWH and the sustained success of antiretroviral therapy (ART programmes depends on PLWH's motivation and ability to self-manage the condition over the long term, including adherence to drugs on a daily basis. PLWH's self-management of HIV and their wellbeing are likely to be interrelated. Successful self-management sustains wellbeing, and wellbeing is likely to motivate continued self-management. Detailed research is lacking on PLWH's self-management processes on ART in resource-limited settings. This paper presents findings from a study of PLWH's self-management and wellbeing in Wakiso District, Uganda. Thirty-eight PLWH (20 women, 18 men were purposefully selected at ART facilities run by the government and by The AIDS Support Organisation in and around Entebbe. Two in-depth interviews were completed with each participant over three or four visits. Many were struggling economically, however the recovery of health and hope on ART had enhanced wellbeing and motivated self-management. The majority were managing their condition well across three broad domains of self-management. First, they had mobilised resources, notably through good relationships with health workers. Advice and counselling had helped them to reconceptualise their condition and situation more positively and see hope for the future, motivating their work to self-manage. Many had also developed a new network of support through contacts they had developed at the ART clinic. Second, they had acquired knowledge and skills to manage their health, a useful framework to manage their condition and to live their life. Third, participants were psychologically adjusting to their condition and their new 'self': they saw HIV as a normal disease, were coping with stigma and had regained self-esteem, and were finding meaning in life. Our study demonstrates the centrality of social relationships and other non-medical aspects of wellbeing for self-management

  20. Sustaining knowledge in the neutron generator community and benchmarking study. Phase II.

    Energy Technology Data Exchange (ETDEWEB)

    Huff, Tameka B.; Stubblefield, William Anthony; Cole, Benjamin Holland, II; Baldonado, Esther


    This report documents the second phase of work under the Sustainable Knowledge Management (SKM) project for the Neutron Generator organization at Sandia National Laboratories. Previous work under this project is documented in SAND2008-1777, Sustaining Knowledge in the Neutron Generator Community and Benchmarking Study. Knowledge management (KM) systems are necessary to preserve critical knowledge within organizations. A successful KM program should focus on people and the process for sharing, capturing, and applying knowledge. The Neutron Generator organization is developing KM systems to ensure knowledge is not lost. A benchmarking study involving site visits to outside industry plus additional resource research was conducted during this phase of the SKM project. The findings presented in this report are recommendations for making an SKM program successful. The recommendations are activities that promote sharing, capturing, and applying knowledge. The benchmarking effort, including the site visits to Toyota and Halliburton, provided valuable information on how the SEA KM team could incorporate a KM solution for not just the neutron generators (NG) community but the entire laboratory. The laboratory needs a KM program that allows members of the workforce to access, share, analyze, manage, and apply knowledge. KM activities, such as communities of practice (COP) and sharing best practices, provide a solution towards creating an enabling environment for KM. As more and more people leave organizations through retirement and job transfer, the need to preserve knowledge is essential. Creating an environment for the effective use of knowledge is vital to achieving the laboratory's mission.

  1. The concept of community poverty reduction in coastal area of Surabaya based on sustainable livelihood approach (United States)

    Gai, A. M.; Soewarni, I.; M, M., Sir


    Multidimensional poverty becomes a trademark of fisherman community including the community in Surabaya. The fishermen in Surabaya belong to a society with quite apprehensive welfare in all aspects covering economy, social, and environment. Therefore, this research aims to organize poverty reduction concept in coastal area of Surabaya based on sustainable livelihood which assesses poverty through 5 (five) livelihood assets i.e. human asset, natural asset, social asset, physical asset, and financial asset. This research is a qualitative research using rationalistic approach with explorative, descriptive, and perspective nature. Primary data collected using Participatory Poverty Assessment (PPA) and secondary data collected through agency and literature survey. Purposive sampling was employed in getting the sample. Then, the data were analyzed using content analysis, statistics descriptive analysis, and delphi analysis. The results show that sustainable livelihood level in coastal area of Surabaya indicates the human asset is 65% at the SLA level and the lowest is social asset which is 20%, and financial asset is the most affecting factors of poverty in coastal area of Surabaya since the expense for fuel cannot be compared to the fish catched. Community empowerment is the concept proposed to overcome the poverty problems in coastal area of Surabaya.

  2. Sustaining knowledge in the neutron generator community and benchmarking study. Phase II

    International Nuclear Information System (INIS)

    Huff, Tameka B.; Stubblefield, William Anthony; Cole, Benjamin Holland II; Baldonado, Esther


    This report documents the second phase of work under the Sustainable Knowledge Management (SKM) project for the Neutron Generator organization at Sandia National Laboratories. Previous work under this project is documented in SAND2008-1777, Sustaining Knowledge in the Neutron Generator Community and Benchmarking Study. Knowledge management (KM) systems are necessary to preserve critical knowledge within organizations. A successful KM program should focus on people and the process for sharing, capturing, and applying knowledge. The Neutron Generator organization is developing KM systems to ensure knowledge is not lost. A benchmarking study involving site visits to outside industry plus additional resource research was conducted during this phase of the SKM project. The findings presented in this report are recommendations for making an SKM program successful. The recommendations are activities that promote sharing, capturing, and applying knowledge. The benchmarking effort, including the site visits to Toyota and Halliburton, provided valuable information on how the SEA KM team could incorporate a KM solution for not just the neutron generators (NG) community but the entire laboratory. The laboratory needs a KM program that allows members of the workforce to access, share, analyze, manage, and apply knowledge. KM activities, such as communities of practice (COP) and sharing best practices, provide a solution towards creating an enabling environment for KM. As more and more people leave organizations through retirement and job transfer, the need to preserve knowledge is essential. Creating an environment for the effective use of knowledge is vital to achieving the laboratory's mission.

  3. Self-management of Hybrid Networks: Introduction, Pros and Cons

    NARCIS (Netherlands)

    Fioreze, Tiago; Pras, Aiko; Lehnert, Ralf

    In the last decade ‘self-management’ has become a popular research theme within the networking community. While reading papers, one could get the impression that self-management is the obvious solution to solve many of the current network management problems. There are hardly any publications,

  4. Gulf of Mexico and Caribbean Community Sustainability Study Focuses on Tying the Science of Ecosystem Services and Human Health Directly to Community Decision Making (United States)

    The Community-based Sustainability Research Program in EPA’s Office of Research and Development is studying how the availability of ecosystem goods and services (EGS) is impacted by community decision making and how this relationship alters human wellbeing. We also seek ‘common g...

  5. Resilience and receptivity worked in tandem to sustain a geothermal mat community amidst erratic environmental conditions. (United States)

    Ghosh, Wriddhiman; Roy, Chayan; Roy, Rimi; Nilawe, Pravin; Mukherjee, Ambarish; Haldar, Prabir Kumar; Chauhan, Neeraj Kumar; Bhattacharya, Sabyasachi; Agarwal, Atima; George, Ashish; Pyne, Prosenjit; Mandal, Subhrangshu; Rameez, Moidu Jameela; Bala, Goutam


    To elucidate how geothermal irregularities affect the sustainability of high-temperature microbiomes we studied the synecological dynamics of a geothermal microbial mat community (GMMC) vis-à-vis fluctuations in its environment. Spatiotemporally-discrete editions of a photosynthetic GMMC colonizing the travertine mound of a circum-neutral hot spring cluster served as the model-system. In 2010 a strong geyser atop the mound discharged mineral-rich hot water, which nourished a GMMC continuum from the proximal channels (PC) upto the slope environment (SE) along the mound's western face. In 2011 that geyser extinguished and consequently the erstwhile mats disappeared. Nevertheless, two relatively-weaker vents erupted in the southern slope and their mineral-poor outflow supported a small GMMC patch in the SE. Comparative metagenomics showed that this mat was a relic of the 2010 community, conserved via population dispersal from erstwhile PC as well as SE niches. Subsequently in 2012, as hydrothermal activity augmented in the southern slope, ecological niches widened and the physiologically-heterogeneous components of the 2011 "seed-community" split into PC and SE meta-communities, thereby reclaiming either end of the thermal gradient. Resilience of incumbent populations, and the community's receptiveness towards immigrants, were the key qualities that ensured the GMMC's sustenance amidst habitat degradation and dispersal to discrete environments.

  6. Community Markets for Conservation (COMACO) links biodiversity conservation with sustainable improvements in livelihoods and food production. (United States)

    Lewis, Dale; Bell, Samuel D; Fay, John; Bothi, Kim L; Gatere, Lydiah; Kabila, Makando; Mukamba, Mwangala; Matokwani, Edwin; Mushimbalume, Matthews; Moraru, Carmen I; Lehmann, Johannes; Lassoie, James; Wolfe, David; Lee, David R; Buck, Louise; Travis, Alexander J


    In the Luangwa Valley, Zambia, persistent poverty and hunger present linked challenges to rural development and biodiversity conservation. Both household coping strategies and larger-scale economic development efforts have caused severe natural resource degradation that limits future economic opportunities and endangers ecosystem services. A model based on a business infrastructure has been developed to promote and maintain sustainable agricultural and natural resource management practices, leading to direct and indirect conservation outcomes. The Community Markets for Conservation (COMACO) model operates primarily with communities surrounding national parks, strengthening conservation benefits produced by these protected areas. COMACO first identifies the least food-secure households and trains them in sustainable agricultural practices that minimize threats to natural resources while meeting household needs. In addition, COMACO identifies people responsible for severe natural resource depletion and trains them to generate alternative income sources. In an effort to maintain compliance with these practices, COMACO provides extension support and access to high-value markets that would otherwise be inaccessible to participants. Because the model is continually evolving via adaptive management, success or failure of the model as a whole is difficult to quantify at this early stage. We therefore test specific hypotheses and present data documenting the stabilization of previously declining wildlife populations; the meeting of thresholds of productivity that give COMACO access to stable, high-value markets and progress toward economic self-sufficiency; and the adoption of sustainable agricultural practices by participants and other community members. Together, these findings describe a unique, business-oriented model for poverty alleviation, food production, and biodiversity conservation.

  7. The Effectiveness of Self-Management Mobile Phone and Tablet Apps in Long-term Condition Management: A Systematic Review. (United States)

    Whitehead, Lisa; Seaton, Philippa


    Long-term conditions and their concomitant management place considerable pressure on patients, communities, and health care systems worldwide. International clinical guidelines on the majority of long-term conditions recommend the inclusion of self-management programs in routine management. Self-management programs have been associated with improved health outcomes; however, the successful and sustainable transfer of research programs into clinical practice has been inconsistent. Recent developments in mobile technology, such as mobile phone and tablet computer apps, could help in developing a platform for the delivery of self-management interventions that are adaptable, of low cost, and easily accessible. We conducted a systematic review to assess the effectiveness of mobile phone and tablet apps in self-management of key symptoms of long-term conditions. We searched PubMed, Embase, EBSCO databases, the Cochrane Library, and The Joanna Briggs Institute Library for randomized controlled trials that assessed the effectiveness of mobile phone and tablet apps in self-management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 2005-2016. We searched registers of current and ongoing trials, as well as the gray literature. We then checked the reference lists of all primary studies and review papers for additional references. The last search was run in February 2016. Of the 9 papers we reviewed, 6 of the interventions demonstrated a statistically significant improvement in the primary measure of clinical outcome. Where the intervention comprised an app only, 3 studies demonstrated a statistically significant improvement. Interventions to address diabetes mellitus (5/9) were the most common, followed by chronic lung disease (3/9) and cardiovascular disease (1/9). A total of 3 studies included multiple intervention groups using permutations of an intervention involving an app. The duration of the intervention ranged from 6 weeks to 1 year, and

  8. Empowering the village communities for sustained observation of permafrost-related environmental changes, Upper Kuskokwim, Alaska (United States)

    Panda, S. K.; Kholodov, A. L.; Hanson, T.


    A suite of environmental changes are underway in the North directly affecting the socio-economic state of native communities in remote Arctic villages. We cannot possibly have enough scientists and professionals on the ground to timely predict and effectively respond to the major changes. We believe the most cost-effective and possibly sustainable approach to cover more ground for monitoring and prediction of changes is by building community capacity for monitoring and research, and supporting communities to use resulting data and new findings to address emerging environmental issues and ensuing socio-economic challenges. The goal of this project is to help the communities of Upper Kuskokwim region take the lead in assessing and responding to the environmental changes that are coming with warmer climate and thawing permafrost. The permafrost related societal impacts that the communities are aware of are a) drying of lakes which affect their fishing and trapping, b) lower water level in Rivers due to bank erosion which affect their main mode of transportation in summer, c) appearance of sinkholes that pose threat to the safety of the community members and their properties, and d) eruption of a sand dune in the middle of the Telida village air strip. In August 2016 we will spend ten days in the Nikolai and Telida communities to understand the community need for monitoring through a community survey. We will offer training workshop on climate science and landscape change, and in making scientific observation and data collection. Also, we will install sensors to monitor air temperature, soil temperature, soil moisture, and snow at 12 sites spread across different ecotypes and topographic settings. Also, we will survey sites of major change to help develop a geo-hazard map for the region to facilitate safe subsistence practices and land use. As broader impact, the project will offer the traditionally-underserved native communities of the Upper Kuskokwim region an

  9. Operationalizing Surveillance of Chronic Disease Self-Management and Self-Management Support. (United States)

    Brady, Teresa J; Sacks, Jeffrey J; Terrillion, Albert J; Colligan, Erin M


    Sixty percent of US adults have at least one chronic condition, and more than 40% have multiple conditions. Self-management (SM) by the individual, along with self-management support (SMS) by others, are nonpharmacological interventions with few side effects that are critical to optimal chronic disease control. Ruiz and colleagues laid the conceptual groundwork for surveillance of SM/SMS at 5 socio-ecological levels (individual, health system, community, policy, and media). We extend that work by proposing operationalized indicators at each socio-ecologic level and suggest that the indicators be embedded in existing surveillance systems at national, state, and local levels. Without a robust measurement system at the population level, we will not know how far we have to go or how far we have come in making SM and SMS a reality. The data can also be used to facilitate planning and service delivery strategies, monitor temporal changes, and stimulate SM/SMS-related research.

  10. Community electricity for sustainable livelihoods through public-private partnership (Ethiopia, Nepal, Sri Lanka and Uganda)

    Energy Technology Data Exchange (ETDEWEB)



    In the past, public-private partnerships have been developed in all four countries involved in the project with varying levels of success. There are clear lessons to be learned from these approaches, and much potential to develop models which build on their success factors. Models that will be developed within the course of this research will address the inequalities and social exclusion within existing public-private partnership models in order to broaden access to electricity services. Fieldwork will be carried out in communities, using a sustainable livelihoods approach to assess existing approaches and develop the most promising models through a series of pilot projects in each country. The objective of this work was to define and test models for public-private partnerships to deliver electricity services to rural and under-served urban communities, to enable the provision of electricity for communal and domestic access. (author)

  11. PKU Self-Management Timeline (United States)

    ... about pku UW PKU Clinic News & Events PKU Self-Management Timeline This timeline is also available as an ... Acrobat file. Click here to download. The PKU Self- Management timeline is included to provide long-term view ...

  12. A chronic care ostomy self-management program for cancer survivors. (United States)

    Krouse, Robert S; Grant, Marcia; McCorkle, Ruth; Wendel, Christopher S; Cobb, Martha D; Tallman, Nancy J; Ercolano, Elizabeth; Sun, Virginia; Hibbard, Judith H; Hornbrook, Mark C


    Individuals with ostomies experience extensive changes in health-related quality of life (HRQOL) and daily routine. Patients and families are typically forced to use trial and error to improve self-management. This is a longitudinal one-group design pilot study of a five-session ostomy self-care curriculum based on the Chronic Care Model to improve HRQOL and self-management for cancer survivors with ostomies. Participants were surveyed to evaluate each session. Multiple instruments were administered to examine outcomes at baseline, post-intervention, and at 6-month follow-up (Patient Activation Measure, self-efficacy, Hospital Anxiety and Depression Scale, Ways of Coping, Group Health Association of America Satisfaction with ostomy care survey, and the City of Hope Quality of Life Ostomy). Changes from pre-intervention to post-intervention and pre-intervention to follow-up were evaluated with paired t-tests. Text responses were coded and evaluated for important themes and recommendations. Thirty-eight subjects participated in the study. Most had a history of rectal cancer (60.5%) or bladder cancer (28.9%). Participants rated the overall program high (4.4-4.8 on 5-point scale). Text feedback indicated that participants enjoyed the group forums, wanted more participants, and more hands-on training. Scores on multiple surveys were shown to be improved and sustained, including patient activation (p = 0.0004), self-efficacy (p = 0.006), total HRQOL (p = 0.01), physical well-being (p = 0.005), and social well-being (p = 0.002). Survivor anxiety was significantly reduced by follow-up (p = 0.047). This self-management ostomy program can help cancer survivors with ostomies adapt to their stoma. Initiating this program in the community setting would be beneficial to many cancer survivors. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Comprehensive Self-Management Strategies. (United States)

    Bourbeau, J; Lavoie, K L; Sedeno, M


    In this article, we provide a review of the literature on self-management interventions and we are giving some thought to how, when, and by whom they should be offered to patients. The present literature based on randomized clinical trials has demonstrated benefits (reduced hospital admissions and improved health status) for chronic obstructive pulmonary disease (COPD) patients undergoing self-management interventions, although there are still problems with the heterogeneity among interventions, study populations, follow-up time, and outcome measures that make generalization difficult in real life. Key to the success, self-management intervention has to target behavior change. Proper self-management support is a basic prerequisite, for example, techniques and skills used by health care providers "case manager" to instrument patients with the knowledge, confidence, and skills required to effectively self-manage their disease. To improve health behaviors and engagement in self-management, self-management interventions need to target enhancing intrinsic motivation to change. This will best be done using client-centered communication (motivational communication) that encourages patients to express what intrinsically motivates them (e.g., consistent with their values or life goals) to adopt certain health behavior, with the goal of helping them overcome their ambivalence about change. Finally, if we want to be able to design and implement self-management interventions that are integrated, coherent, and have a strong likelihood of success, we need to take a more careful look and give more attention at the case manager, the patient (patient evaluation), and the quality assurance. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. Dark Side of Development: Modernity, Disaster Risk and Sustainable Livelihoods in Two Coastal Communities in Fiji

    Directory of Open Access Journals (Sweden)

    Per Becker


    Full Text Available The world is changing rapidly, as are the remotest rural communities. Modernity is spreading across the world under the guise of development and it is transforming disaster risk. This raises issues concerning how disaster risk is changing in such milieus. Using a sustainable livelihood approach, this article investigates access to different types of capital that central to the vulnerability of two coastal communities in Fiji that are affected by modernity to different extents. This comparative case study is based on semi-structured interviews, focus groups and observation. The results indicate that modernity transforms access to and use of key capitals (natural, physical, financial, human, and social capital on both community and household levels, increasing dependence on external resources that are unequally distributed, while undermining social cohesion and support. Although disaster risk might be of a similar magnitude across the board at the community level, modernity transforms vulnerability significantly and skews the distribution of disaster risk, to the detriment of the households left behind by development.

  15. Identifying Effective and Sustainable Measures for Community-Based Environmental Monitoring (United States)

    McKay, Ariana J.; Johnson, Chris J.


    Resource development projects typically result in monitoring programs that fail to fully consider the values and participation of surrounding communities. Also, monitoring protocols for single environmental values can be insufficient for addressing the cumulative impacts of resource development. Community-based environmental monitoring (CBEM) has emerged as a way to meaningfully include local citizens in the decision-making process and assessment of the development of natural resources. Our research explored how to develop effective and sustainable CBEM. Interviews were conducted with staff from 15 CBEM programs established across Canada to identify criteria of what constitutes effective CBEM. Results demonstrate that CBEM offers an effective, locally adapted, and culturally applicable approach to facilitate community participation in natural resource management and to track environmental change. Benefits of CBEM include: locally relevant monitoring protocols, inclusion of cumulative impacts, better informed decision-making, and increased awareness and collaboration amongst community, governments, and proponents. Challenges associated with CBEM are cost, capacity, longevity, distribution of results, and establishing credibility. This research validates the use of CBEM for improving resource management.

  16. Integration of treatment wetlands as sustainable wastewater management systems for small communities

    Energy Technology Data Exchange (ETDEWEB)

    Dahab, M.F.; Surampalli, R.Y. [Univ. of Nebraski-Lincoln, Dept. of Civil Engineering, Lincoln, NE (United States)


    This paper discuses the applicability as well as the integration of the constructed wetlands technology within the environmental infrastructure in small communities. To that end, a case study involving the use of Constructed wetlands (CW) for waste management in the Nebraska plains is presented. CW systems have been shown to be effective treatment alternatives in resource-limited small communities; and hence, can contribute to improving the economic well-being and the sustainability of many small communities. The paper specifically discusses the performance of subsurface-flow constructed wetlands systems used as the wastewater treatment process for a small community in eastern Nebraska and outlines operational experience gained through five years of plant operation. The results show that effective and sufficient CW seasonal removals of TSS, VSS, CBOD{sub 5}, COD, and fecal coliform were achieved. Wastewater temperatures seemed to affect CBOD{sub 5} and COD removal rates. Nitrogen and phosphorus reductions were not as effective and varied seasonally, as well as with wastewater temperature. The addition of a sand filter, to aid in further nitrification and disinfection following CW treatment, markedly improved the performance of the wetlands system. After a few years of operation, the performance of the system was dampened by apparent clogging and subsequent eruption of wastewater at the head-end of the treatment cells. While clogging was partially caused by biomass build-up in the wetlands substrate, visual observations suggest that excessive vegetation and relaxed maintenance may also be responsible. (author)

  17. Integration of treatment wetlands as sustainable wastewater management systems for small communities

    International Nuclear Information System (INIS)

    Dahab, M.F.; Surampalli, R.Y.


    This paper discuses the applicability as well as the integration of the constructed wetlands technology within the environmental infrastructure in small communities. To that end, a case study involving the use of Constructed wetlands (CW) for waste management in the Nebraska plains is presented. CW systems have been shown to be effective treatment alternatives in resource-limited small communities; and hence, can contribute to improving the economic well-being and the sustainability of many small communities. The paper specifically discusses the performance of subsurface-flow constructed wetlands systems used as the wastewater treatment process for a small community in eastern Nebraska and outlines operational experience gained through five years of plant operation. The results show that effective and sufficient CW seasonal removals of TSS, VSS, CBOD 5 , COD, and fecal coliform were achieved. Wastewater temperatures seemed to affect CBOD 5 and COD removal rates. Nitrogen and phosphorus reductions were not as effective and varied seasonally, as well as with wastewater temperature. The addition of a sand filter, to aid in further nitrification and disinfection following CW treatment, markedly improved the performance of the wetlands system. After a few years of operation, the performance of the system was dampened by apparent clogging and subsequent eruption of wastewater at the head-end of the treatment cells. While clogging was partially caused by biomass build-up in the wetlands substrate, visual observations suggest that excessive vegetation and relaxed maintenance may also be responsible. (author)

  18. Augmented Reality: Sustaining Autonomous Way-Finding in the Community for Older Persons with Cognitive Impairment. (United States)

    Sejunaite, K; Lanza, C; Ganders, S; Iljaitsch, A; Riepe, M W


    Impairment of autonomous way-finding subsequent to a multitude of neurodegenerative and other diseases impedes independence of older persons and their everyday activities. It was the goal to use augmented reality to aid autonomous way-finding in a community setting. A spatial map and directional information were shown via head-up display to guide patients from the start zone on the hospital campus to a bakery in the nearby community. Hospital campus and nearby community. Patients with mild cognitive impairment (age 63 to 89). A head-up display was used to help patients find their way. Time needed to reach goal and number of assists needed. With use of augmented reality device, patients preceded along the correct path in 113 out of 120 intersections. Intermittent reassurance was needed for most patients. Patients affirmed willingness to use such an augmented reality device in everyday life if needed or even pay for it. Augmented reality guided navigation is a promising means to sustain autonomous way-finding as a prerequisite for autonomy of older persons in everyday activities. Thus, this study lays ground for a field trial in the community using assistive technology for older persons with cognitive impairment.

  19. Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants

    NARCIS (Netherlands)

    van Middelaar, Tessa; Beishuizen, Cathrien R. L.; Guillemont, Juliette; Barbera, Mariagnese; Richard, Edo; Moll van Charante, Eric P.; van Gool, Willem A.; Soininen, Hilkka; Kivipelto, Miia; Andrieu, Sandrine; Brayne, Carol; Jongstra, Susan; van Wanrooij, Lennard L.; Hoevenaar-Blom, Marieke P.; Ngandu, Tiia; Mangialasche, Francesca; Coley, Nicola; Meiller, Yannick; van de Groep, Bram


    To study older peoples' experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care. Qualitative semistructured interview study, with thematic

  20. Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants

    NARCIS (Netherlands)

    Middelaar, T. van; Beishuizen, C.R.; Guillemont, J.; Barbera, M.; Richard, E.; Charante, E.P.M. van


    OBJECTIVES: To study older peoples' experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care. DESIGN: Qualitative semistructured interview study,

  1. Development of Rural Communities by Diversification of Rural Economy in the Context of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Manuela Dora Orboi


    Full Text Available The sustainable development is a process taking place at the same time with the complex and sustainable agricultural development; agriculture and the rural area being interdependent sides specific to rural communities. When analysing economic activity in the rural area we should pay a particular attention to the identification of such alternative activities that have a real chance for development and create new jobs that compensate the diminution of labour occupancy degree in agriculture. Opportunities of rural economy represent a source of having alternative income for the population from rural communities in order to escape from poverty and in order to accelerate the social progress in the rural area. Alternative activities with economic, social and cultural impact, providers of jobs and incomes are: the development of agro tourism and rural tourism, processing and promoting foodstuff, local traditional drinks, ecological foodstuff, handicraft and silviculture. Improving the conditions for business in the rural area is a main condition for the generation of economic activities generating jobs in the rural area.

  2. Technological solution for vulnerable communities: Questioning the sustainability of Appropriate Technology

    International Nuclear Information System (INIS)

    Sianipar, C P M; Dowaki, K; Yudoko, G


    Vulnerability eradication has become an emerging concern in today's society following the increasing uncertainties in achieving societal resilience, particularly in vulnerable communities. Furthermore, incorporating technological solution, especially appropriate technology (AT), into such concern requires interdisciplinary understandings to achieve a holistic eradication based on the particularities of each community. This study aims to briefly reveal existing scholarly discourses and investigate potential gap(s) between previous researches. Literatures, particularly consisting meta-analysis on previous scholarly discussions, are surveyed. The findings reveal three progress among scientific discourses. The first one is the paradigm shift of developmental purposes from typical development to empowerment. Next, concerns in technology development indicate the parallel movement toward empowerment. Then, previous methodological developments, including approach in sustaining AT, indicate the needs to assess the future based on sustainability. Therefore, a new research is proposed to develop an assessment framework on AT for vulnerability eradication on the basis of empowerment paradigm, extended focuses in technology development, and extended coverage of future changes in dynamic matter. The framework needs to be developed based on the combination of positivist-deductive-qualitative research paradigms. This is intended to generalize the framework for being used in different cases, to build an applicative framework as an integral part of existing body of knowledge, and to develop an enriched and flexible construction of framework. Looking at existing researches, this brief study proposes insights to move scientific progress toward a more holistic vulnerability eradication using AT solution both in conceptual and practical levels

  3. The sustainability of a community pharmacy intervention to improve the quality use of asthma medication. (United States)

    Bereznicki, B; Peterson, G; Jackson, S; Walters, E H; Gee, P


    A previously published asthma intervention used a software application to data mine pharmacy dispensing records and generate a list of patients with potentially suboptimal management of their asthma; in particular, a high rate of provision of reliever medication. These patients were sent educational material from their community pharmacists and advised to seek a review of their asthma management from their general practitioner. The intervention resulted in a 3-fold improvement in the ratio of dispensed preventer medication (inhaled corticosteroids) to reliever medication (short-acting beta-2 agonists). This follow-up study aimed to determine the long-term effects of the intervention programme on the preventer-to-reliever (P:R) ratio. The same data mining software was modified so that it could re-identify patients who were originally targeted for the intervention. Community pharmacists who participated in the previous intervention installed the modified version of the software. The dispensing data were then de-identified, encrypted and transferred via the Internet to a secure server. The follow-up dispensing data for all patients were compared with their pre- and post-intervention data collected originally. Of the 1551 patients who were included in the original study, 718 (46·3%) were eligible to be included in the follow-up study. The improved P:R ratio was sustained for at least 12 months following the intervention (P < 0·01). The sustained increase in the P:R ratio was attributed to significant decreases in the average daily usage of reliever medication (P < 0·0001). The follow-up study demonstrated a sustained improvement in the ratio of dispensed preventer medication to reliever medication for asthma. The intervention has the potential to show long-lasting and widespread improvements in asthma management, improved health outcomes for patients, and ultimately, a reduced burden on the health system. © 2010 Blackwell Publishing Ltd.

  4. [Effects of Self-management Program applying Dongsasub Training on Self-efficacy, Self-esteem, Self-management Behavior and Blood Pressure in Older Adults with Hypertension]. (United States)

    Kim, Myoungsuk; Song, Misoon


    The purpose of this study was to develop a self-management program applying Dongsasub training based on self-efficacy theory, and to verify the program effectiveness on self-esteem as well as self-efficacy, self-management behaviors, and blood pressure. The study design was a non-equivalent, pre-post controlled quasi-experiment study. Thirty-eight patients aged 65 and older from a senior welfare center in Seoul participated in this study (20 patients in the experimental group and 18 patients in the control group). The self-management program applying Dongsasub training consisted of eight sessions. After development was complete the program was used with the experimental group. Outcome variables included self-efficacy, self-esteem, self-management behaviors measured by questionnaires, and blood pressure measured by electronic manometer. Self-efficacy (t=2.42, p=.021), self-esteem (t=2.57, p=.014) and self-management behaviors (t=2.21, p=.034) were significantly higher and systolic blood pressure (t=-2.14, p=.040) was significantly lower in the experimental group compared to the control group. However, diastolic blood pressure (t=-.85, p=.400) was not significantly different between the two groups. The results indicate that the self-management program applying Dongsasub training can be used as a nursing intervention in community settings for improving self-management behaviors for older adults with hypertension.

  5. Scientific Coverage in Community-Based Tourism: Sustainable Tourism and Strategy for Social Development

    Directory of Open Access Journals (Sweden)

    José Álvarez-García


    Full Text Available In the last decades in developing countries, the tourism sector has been immersed in an intense process of strengthening the participation of local communities through the so-called community tourism initiatives, whose main objective is to improve the quality of life of the inhabitants of host communities, ensuring the subsistence of traditional culture. Its growing momentum as a means for sustainable tourism and a strategy for social development has generated a large amount of academic literature, and it is necessary to analyze its presence in the main multidisciplinary databases. Thus, the main purpose of our article is to show the current state of scientific production on community tourism through a bibliometric comparative study of the documents indexed in the WoS and Scopus databases, dealing with aspects such as their coverage, correlation between both bases, overlapping of documents and journals, growth, dispersion or concentration of articles, among others. For this purpose, and by means of an advanced search by terms, a representative set of 115 articles in WoS and 185 in Scopus were selected, with the time limit set in 2017. These form the ad-hoc basis of the analysis. In view of the results, it is concluded that, although WoS and Scopus databases differ in terms of scope, volume of data, and coverage policies, both information systems are complementary but not exclusive. Although the documents and the results of their analysis are in many aspects similar, Scopus has a better coverage in the specific area of community tourism due to collecting a greater number of articles, journals and signatures, and its articles receiving a greater number of citations.


    Hickman, Ronald L; Clochesy, John M; Pinto, Melissa D; Burant, Christopher; Pignatiello, Grant


    Most Americans will acquire a chronic disease during their lifetime. One of the most prevalent chronic diseases that affect Americans is hypertension (HTN). Despite the known comorbidities and increased mortality rate associated with uncontrolled HTN, most community dwelling adults with HTN do not have sufficient blood pressure control Therefore, the aim of this article is to report the preliminary efficacy of a serious game for health to enhance blood pressure control among community dwelling adults with HTN. A nonprobability sample of 116 community dwelling adults with HTN participated in this nonblinded, randomized controlled trial. Participants were randomly assigned to: (1) an intervention arm that consisted of four exposures to a serious game for health known as eSMART-HD; or (2) an attentional control arm that compromised of four exposures to screen-based HTN education. The primary outcome measure for this trial was blood pressure reduction over a four month observational period. In this study, baseline characteristics and blood pressure measurements were similar between participants in each study arm. There was no significant between-group difference in blood pressure reduction over time. However, there were significant within-group reductions in systolic and diastolic blood pressures across time among favoring participants exposed to eSMART-HD. This study establishes the preliminary efficacy of eSMART-HD that can be easily administered to community dwelling adults and facilitate clinically significant reductions in systolic and diastolic blood pressures. Future studies should assess the influential components of this promising serious game for health (eSMART-HD) combined with medication management in larger and more diverse samples of community dwelling adults with HTN.

  7. Sustainable local development in citizen and community spheres. Implications for the governance of natural resources

    Directory of Open Access Journals (Sweden)

    Javier Carreón Guillén


    Full Text Available The economic, political, citizen, and community spheres, whether global or local, are regulated by systems of governance, which create public interest agendas including tariffs for public services derived from the use of natural resources. In this regard, this paper presents the agreements and disagreements between entrepreneurial, municipal, citizen, and community organizations to establish local development scenarios in reference to the global market. This discussion will create a series of representations that symbolize the dissonance between prosperity and austerity in order to contrast lifestyles oriented towards globalization and livelihoods aimed at sustainability. In this context, different identities have emerged from the alliances between civil and business organizations, in which development is not necessarily a priority; however, such vicissitudes provide central themes for the discussion of economic models.  This paper is important because it envisages a governance scheme that permits including natural resources in the civil, political, and business agenda.  In other words, governance regulates the intrusion of transnational corporations in communities and the inclusion of SMEs in the international market.

  8. Challenges to achieving sustainable community health development within a donor aid business model. (United States)

    Ashwell, Helen; Barclay, Lesley


    This paper explores the paradox of donor aid being delivered through a business model through a case study in Papua New Guinea. A retrospective review of project implementation and an outcome evaluation provided an opportunity to examine the long-term results and sustainability of a large project. Analysis was informed by data collected from 175 interviews (national, provincial, district and village), 93 community discussions and observations across 10 provinces. Problems with the business model of delivering aid were evident from implementation data and in an evaluation conducted two years after project completion (2006). Compounding the business model effect were challenges of over-ambitious project goals with limited flexibility to adapt to changing circumstances, a donor payment system requiring short-term productivity and excessive reporting requirements. An overly ambitious project design, donor dominance within the business model and limited local counterpart capacity created problems in the community initiatives component of the project. Contractual pressures can negatively influence long-term outcomes that require development of local leadership and capacity. Future planning for donor project designs needs to be flexible, smaller in scope and have a longer timeframe of seven to 10 years. Donor-funded projects need to be sufficiently flexible to apply proven principles of community development, build local ownership and allow adequate time to build counterpart knowledge and skills.

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

    Directory of Open Access Journals (Sweden)

    Diego Matsvange


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

  10. Contested modernities in an indigenous domain: Community self-management of forest in post-independence Meghalaya, a state of India


    Kumar, Sanjeeva


    textabstractThe study examines the fate of community forestry in the real-world context of pressures through the state and from the market, by using a combination of discourse analysis, actor analysis and net-work analysis.It deals with the views and interactions of a wide range of groups, including attention to important divisions of genders and class. It identifies and characterises eight relevant discourses, and examines, including from interviews, how these have been used by diverse users...

  11. Sustainable Products and the PPMs Dilemma: How the international community can help in resolving developing countries' concerns

    Energy Technology Data Exchange (ETDEWEB)

    Borregaard, Nicola [RIDES (Chile); Dufey, Annie


    Sustainable Products have been identified as having significant potential for win-win-win outcomes from trade for developing countries. However, several barriers are preventing developing countries from exploiting these opportunities. While the international community could play a key role in resolving some constraints, national governments need also to take a more proactive and coherent approach to promote sustainable products if they want to keep abreast with a highly dynamic and rapidly evolving market.

  12. Water protection measures and community involvement increase sustainability of uranium mining in Tanzania

    International Nuclear Information System (INIS)

    Gaspar, Miklos


    The stage is set for uranium mining in the United Republic of Tanzania, following recent changes to the country’s regulatory framework that brought it in line with IAEA recommendations. Environmental considerations and the involvement of the local community in monitoring the licensing process and future operations will contribute to the sustainability of the project, said Tanzanian officials and IAEA experts. Tanzania, which has identified uranium resources of about 60 000 tonnes, looks to begin mining in 2016 in order to exploit its uranium deposits as part of the country’s plans to increase the contribution of the mining sector from 3.3% of the gross domestic product in 2013 to 10% by the end of the decade. With its gold and diamond reserves nearing depletion, the country is shifting its focus to uranium.

  13. Building a sustainable academic-community partnership: focus on fall prevention. (United States)

    Gray, Betsey; Macrae, Nancy


    To create an interprofessional/interdisciplinary education (IPE), pilot course that provided a representative group of students the opportunity to develop a 6 week fall reduction program for a group of elder volunteers who were independently living in the community. The authors describe the processes that occurred for the course and student-led program to be developed. This pilot course provided opportunities for interprofessional student learning, faculty practice and development, and a program to improve the health of the participants. Sustaining interprofessional collaboration is challenging, primarily due to scheduling difficulties and faculty workloads. More time needs to be devoted to developing the team skills of students, as well as building their knowledge of the contributions each discipline can make to a holistic view of elders. The next phase of this project needs to include pre and post measurement of students' readiness for IPE and elders to more adequately assess the components and effects of the course and program for fall prevention.

  14. Creating and Sustaining University-Community Partnerships in Science Education (Invited) (United States)

    Finkelstein, N.


    Despite years of research and investment, we have yet to see the widespread implementation of a myriad research-proven instructional strategies in STEM education[1]. To address this challenge, we present and analyze one such strategy, a theoretically-grounded model of university-community partnership [2] that engages university students and children in a collective enterprise that has the potential to improve the participation and education of all. We document the impact of this effort on: university participants who learn about education, the community and science; children in the community who learn about science, the nature of science and develop their identities and attitudes towards science; and, shifts in institutional structures which may allow these programs to be part of standard practice. This project is designed to be sustained and scaled, and is analyzed through the application of a new framework [3] which brings together theories of STEM change that come from studies in higher education, faculty development and disciplinary-based education research in STEM. [1] National Research Council. (2003). Improving Undergraduate Instruction in Science, Technology, Engineering, and Mathematics: Report of A Workshop. Washington, D.C.: The National Academies Press. [2] Finkelstein, N. and Mayhew, L. (2008). Acting in Our Own Self-Interest: Blending University and Community. Proceedings of the 2008 Physics Education Research Conf, AIP Press. Melville NY, 1064, 19-22. [3] Henderson, C., Finkelstein, N. & Beach A. (to appear). Beyond Dissemination in College science teaching: An Introduction to Four Core Change Strategies. Accepted May 2009 in Journal of College Science Teaching.

  15. Comprehensive assessment of Kichwa Ecuadorian Amazon communities for the elaboration of the Strategy for Sustainable Development. II . Socioeconomic indicators

    Directory of Open Access Journals (Sweden)

    Ruth Irene Arias Gutiérrez


    Full Text Available A social and economical diagnosis was made in the Amazonian Kichwa region (Napo and Pastaza Provinces for the ellaboration of a sustainable development strategy. Six communities from Anzu river valley, on the eastern slopes of the central Andes in Ecuador, were studied. The quantitative methodology consisted in surveying the residents, managers of the six communities and the heads of 64 households, scattered around five rural parishes. The measured social and economic indicators were annual dependence on local forest and cultivated resources in percentage; the indicators of education, health services and housing conditions for a proposed strategy in order to enhance a sustainable local rural development in the Ecuadorian Amazonian indigenous communities under study. Qualitative and quantitative methods were appropriately used. There are high rates of illiteracy in the communities. Kichwa families depend on local resources. The difference between the satisfaction degree of mestizo and Kichwa families is related to its population weight. There are high illiteracy rates in Boayaku, Union de Llandia and 24 de Mayo. Primary education is low in the communities, and secondary education is very low in all communities. A proposed strategy for sustainable agro-ecological community development is made.

  16. Sustainability of market-based community distribution of Sprinkles in western Kenya. (United States)

    Suchdev, Parminder S; Shah, Ami; Jefferds, Maria Elena D; Eleveld, Alie; Patel, Minal; Stein, Aryeh D; Macdonald, Barbara; Ruth, Laird


    To evaluate the sustainability of market-based community distribution of micronutrient powders (Sprinkles(®), Hexagon Nutrition, Mumbai, India.) among pre-school children in Kenya, we conducted in August 2010 a follow-up survey, 18 months after study-related marketing and household monitoring ended. We surveyed 849 children aged 6-35 months randomly selected from 60 study villages. Nutritional biomarkers were measured by fingerstick; demographic characteristics, Sprinkles purchases and use were assessed through household questionnaires. We compared Sprinkles use, marketing efforts and biomarker levels with the data from surveys conducted in March 2007, March 2008 and March 2009. We used logistic regression to evaluate associations between marketing activities and Sprinkles use in the 2010 survey. At the 2010 follow-up, 21.9% of children used Sprinkles in the previous 7 days, compared with 64.9% in 2008 (P Factors associated with recent Sprinkles use in 2010 included young age [6-23 months vs. 24-35 months, adjusted odds ratio (aOR) = 1.5, P = 0.02], lowest 2 quintiles of socio-economic status (aOR = 1.7, P = 0.004), household attendance at trainings or launches (aOR = 2.8, P marketing activities. Continued promotion and monitoring of Sprinkles usage may be important components to sustain the programme. © 2012 Blackwell Publishing Ltd.

  17. Sustainable poverty amelioration through early life education in a peri-urban community of Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olayinka A. Abosede


    Objectives: The aim of the study was to examine early life education for under-fives as a means of economic empowerment of mothers and sustainable poverty amelioration. Method: The methodology included a non-randomised selection of 34 disadvantaged mothers by criteria, a prospective intervention utilising community resources to organise early childhood education, an in-depth interview of mothers, and observation of the outcomes over a 5-year period. Results: The result of the study showed that no mother preferred keeping a child older than three years at home. Access to early childhood education gave mothers opportunity to undergo vocational training (1, 2.8% and take up new/additional jobs (12, 35.3%. All mothers and 32 (80% of the participating families more than doubled their income, earning up to twenty thousand Naira (approximately $182 per month from the first year of participation. Finally, selection criteria and periodic assessment of immunisation/growth monitoring records of participants’ children improved compliance with primary health care service utilisation. Conclusion: Organisation of early childhood education had the potential for sustainable poverty amelioration through economic empowerment of mothers.

  18. Tailoring Self-Management in Chronic Care

    NARCIS (Netherlands)

    Touwen, ID


    Self-management is nowadays seen as an important element in chronic care and therefore, self-management is increasingly embedded in chronic care guidelines; however, implementation in clinical practice is a slow and difficult process. Evidence, from research on self-management interventions, shows

  19. Advancing understanding of the sustainability of lay health advisor (LHA) programs for African-American women in community settings. (United States)

    Shelton, Rachel C; Charles, Thana-Ashley; Dunston, Sheba King; Jandorf, Lina; Erwin, Deborah O


    Lay health advisor (LHA) programs have made strong contributions towards the elimination of health disparities and are increasingly being implemented to promote health and prevent disease. Developed in collaboration with African-American survivors, the National Witness Project (NWP) is an evidence-based, community-led LHA program that improves cancer screening among African-American women. NWP has been successfully disseminated, replicated, and implemented nationally in over 40 sites in 22 states in diverse community settings, reaching over 15,000 women annually. We sought to advance understanding of barriers and facilitators to the long-term implementation and sustainability of LHA programs in community settings from the viewpoint of the LHAs, as well as the broader impact of the program on African-American communities and LHAs. In the context of a mixed-methods study, in-depth telephone interviews were conducted among 76 African-American LHAs at eight NWP sites at baseline and 12-18 months later, between 2010 and 2013. Qualitative data provides insight into inner and outer contextual factors (e.g., community partnerships, site leadership, funding), implementation processes (e.g., training), as well as characteristics of the intervention (e.g., perceived need and fit in African-American community) and LHAs (e.g., motivations, burnout) that are perceived to impact the continued implementation and sustainability of NWP. Factors at the contextual levels and related to motivations of LHAs are critical to the sustainability of LHA programs. We discuss how findings are used to inform (1) the development of the LHA Sustainability Framework and (2) strategies to support the continued implementation and sustainability of evidence-based LHA interventions in community settings.

  20. Cultural Identities in Sustaining Religious Communities in the Arctic Region: An Ethnographic Analysis on Religiosity from the Northern Viewpoint

    Directory of Open Access Journals (Sweden)

    Nafisa Yeasmin


    Full Text Available Northern countries are facing the challenges of declining human capital, and admitting immigrants, many of whom belong to religious minorities, to satisfy the demand for labour. If northern societies accept multiculturalism and immigrants, they should not disregard the cultures and religious practices (for example, ritual slaughter of immigrants, as they need to survive and integrate as a minority community in a secular society. However, there is clash between secularism and religions permitting animal slaughter, which is prohibited by some and allowed by other European countries. Community viability and sustainability depend partly on the exercise of community beliefs and ideology that support identity behaviour. This study will present an ethnographic analysis of the religiosity related to ritual slaughter and Muslim cultural identity in the European Arctic region and explore how religious relativism and practice sustain the community and support the overall integration of the Muslim minority in the North.

  1. Sustainable flood memories, lay knowledges and the development of community resilience to future flood risk

    Directory of Open Access Journals (Sweden)

    McEwen Lindsey


    Full Text Available Shifts to devolved flood risk management in the UK pose questions about how the changing role of floodplain residents in community-led adaptation planning can be supported and strengthened. This paper shares insights from an interdisciplinary research project that has proposed the concept of ‘sustainable flood memory’ in the context of effective flood risk management. The research aimed to increase understanding of whether and how flood memories from the UK Summer 2007 extreme floods provide a platform for developing lay knowledges and flood resilience. The project investigated what factors link flood memory and lay knowledges of flooding, and how these connect and disconnect during and after flood events. In particular, and relation to flood governance directions, we sought to explore how such memories might play a part in individual and community resilience. The research presented here explores some key themes drawn from semi-structured interviews with floodplain residents with recent flood experiences in contrasting demographic and physical settings in the lower River Severn catchment. These include changing practices in making flood memories and materialising flood knowledge and the roles of active remembering and active forgetting.

  2. Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD. (United States)

    Young, Hannah M L; Apps, Lindsay D; Harrison, Samantha L; Johnson-Warrington, Vicki L; Hudson, Nicky; Singh, Sally J


    In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses' and allied health professionals' (AHPs') understanding and provision of self-management in clinical practice. This study explores nurses' and AHPs' understanding and implementation of supported COPD self-management within routine clinical practice. Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach. A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients' perceived self-management abilities. Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.

  3. Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives

    Directory of Open Access Journals (Sweden)

    Wong Eliza LY


    condition to participate in self-management in order to prevent health deterioration and to save healthcare costs. The role of pharmacists should not be limited to drugs and should be extended in the primary healthcare system. Pharmacist-led patient self-management could be developed gradually with the support of government by enhancing pharmacists' responsibilities in health services and developing public-private partnership with community pharmacists. Developing facilitating measures to enhance the implementation of the pharmacist-led approach should also be considered, such as allowing pharmacists to access electronic health records, as well as deregulation of more prescription-only medicines to pharmacy-only medicines.

  4. British-Pakistani women's perspectives of diabetes self-management: the role of identity. (United States)

    Majeed-Ariss, Rabiya; Jackson, Cath; Knapp, Peter; Cheater, Francine M


    To explore the effects of type 2 diabetes on British-Pakistani women's identity and its relationship with self-management. Type 2 diabetes is more prevalent and has worse outcomes among some ethnic minority groups. This may be due to poorer self-management and an inadequate match of health services to patient needs. The influence that type 2 diabetes has on British-Pakistani women's identity and subsequent self-management has received limited attention. An explorative qualitative study. Face-to-face semi-structured English and Urdu language interviews were conducted with a purposively selected heterogeneous sample of 15 British-Pakistani women with type 2 diabetes. Transcripts were analysed thematically. Four themes emerged: Perceived change in self emphasised how British-Pakistani women underwent a conscious adaptation of identity following diagnosis; Familiarity with ill health reflected women's adjustment to their changed identity over time; Diagnosis improves social support enabled women to accept changes within themselves and Supporting family is a barrier to self-management demonstrated how family roles were an aspect of women's identities that was resilient to change. The over-arching theme Role re-alignment enables successful self-management encapsulated how self-management was a continuous process where achievements needed to be sustained. Inter-generational differences were also noted: first generation women talked about challenges associated with ageing and co-morbidities; second generation women talked about familial and work roles competing with self-management. The complex nature of British-Pakistani women's self-identification requires consideration when planning and delivering healthcare. Culturally competent practice should recognise how generational status influences self-identity and diabetes self-management in ethnically diverse women. Health professionals should remain mindful of effective self-management occurring alongside, and being

  5. Dynamics of sustained use and abandonment of clean cooking systems: study protocol for community-based system dynamics modeling. (United States)

    Kumar, Praveen; Chalise, Nishesh; Yadama, Gautam N


    More than 3 billion of the world's population are affected by household air pollution from relying on unprocessed solid fuels for heating and cooking. Household air pollution is harmful to human health, climate, and environment. Sustained uptake and use of cleaner cooking technologies and fuels are proposed as solutions to this problem. In this paper, we present our study protocol aimed at understanding multiple interacting feedback mechanisms involved in the dynamic behavior between social, ecological, and technological systems driving sustained use or abandonment of cleaner cooking technologies among the rural poor in India. This study uses a comparative case study design to understand the dynamics of sustained use or abandonment of cleaner cooking technologies and fuels in four rural communities of Rajasthan, India. The study adopts a community based system dynamics modeling approach. We describe our approach of using community based system dynamics with rural communities to delineate the feedback mechanisms involved in the uptake and sustainment of clean cooking technologies. We develop a reference mode with communities showing the trend over time of use or abandonment of cleaner cooking technologies and fuels in these communities. Subsequently, the study develops a system dynamics model with communities to understand the complex sub-systems driving the behavior in these communities as reflected in the reference mode. We use group model building techniques to facilitate participation of relevant stakeholders in the four communities and elicit a narrative describing the feedback mechanisms underlying sustained adoption or abandonment of cleaner cooking technologies. In understanding the dynamics of feedback mechanisms in the uptake and exclusive use of cleaner cooking systems, we increase the likelihood of dissemination and implementation of efficacious interventions into everyday settings to improve the health and wellbeing of women and children most affected

  6. A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity. (United States)

    Turyk, Mary; Banda, Elizabeth; Chisum, Gay; Weems, Dolores; Liu, Yangyang; Damitz, Maureen; Williams, Rhonda; Persky, Victoria


    Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations. A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression. Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity. This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.

  7. Optimizing delivery of recovery-oriented online self-management strategies for bipolar disorder: a review. (United States)

    Leitan, Nuwan D; Michalak, Erin E; Berk, Lesley; Berk, Michael; Murray, Greg


    Self-management is emerging as a viable alternative to difficult-to-access psychosocial treatments for bipolar disorder (BD), and has particular relevance to recovery-related goals around empowerment and personal meaning. This review examines data and theory on BD self-management from a recovery-oriented perspective, with a particular focus on optimizing low-intensity delivery of self-management tools via the web. A critical evaluation of various literatures was undertaken. Literatures on recovery, online platforms, and self-management in mental health and BD are reviewed. The literature suggests that the self-management approach aligns with the recovery framework. However, studies have identified a number of potential barriers to the utilization of self-management programs for BD and it has been suggested that utilizing an online environment may be an effective way to surmount many of these barriers. Online self-management programs for BD are rapidly developing, and in parallel the recovery perspective is becoming the dominant paradigm for mental health services worldwide, so research is urgently required to assess the efficacy and safety of optimization methods such as professional and/or peer support, tailoring and the development of 'online communities'. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Is an environmentally sustainable future for the European Community compatible with continued growth - carbon dioxide and the management of greed

    International Nuclear Information System (INIS)

    Slesser, M.


    The search for sustainability creates moral and economic dilemmas for politicians seeking to match public aspirations with environmental integrity. The paper explores a method for computing the longer term outcome of policies, considering the case of the European Community as a single economy and taking the specific problem of carbon dioxide

  9. Use of renewable sources of energy in function of the sustainable development of rural communities: Sierra del Escambray, Cuba

    International Nuclear Information System (INIS)

    Olalde Font, Raul; Quintana, Candido; Martinez Yon, Idielin; Cherni, Judilh


    This paper shows preliminary results of the result project. Theoretical aspects related to sustainable development of the communities are discussed. The likely success or failure of renewable energy solutions in isolated rural areas is assessed. The methodology is based on interviews with experts and political actors

  10. Use of renewable sources of energy in function of the sustainable development of rural communities: Sierra del Escambray, Cuba

    International Nuclear Information System (INIS)

    Olalde Font, Raul; Quintana, Candido; Martinez Yon, Idielin; Cherni, Judith


    This paper shows preliminary results of the RESUR Project. Theoretical aspects related to sustainable development of the communities are discussed. The likely success or failure of renewable energy solutions in isolated rural areas is assessed. The methodology is based on interviews with experts and political actors

  11. Going Green Doesn't Have to Be Sexy: Lakeland Community College's Practical Approach to Addressing Energy Conservation and Sustainability (United States)

    Mayher, Michael E.


    Lakeland Community College is recognized for its energy conservation leadership in Ohio and nationally. The college's program will detail the practical, incremental approach taken in Lakeland's "Energy Journey." Setting the standard statewide, that journey recently resulted in a sustainable, guaranteed reduction of energy use by 40%.

  12. The Influence of Community Health Resources on Effectiveness and Sustainability of Community and Lay Health Worker Programs in Lower-Income Countries: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Daniel H de Vries

    Full Text Available Despite the availability of practical knowledge and effective interventions required to reduce priority health problems in low-income countries, poor and vulnerable populations are often not reached. One possible solution to this problem is the use of Community or Lay Health Workers (CLHWs. So far, however, the development of sustainability in CLHW programs has failed and high attrition rates continue to pose a challenge. We propose that the roles and interests which support community health work should emerge directly from the way in which health is organized at community level. This review explores the evidence available to assess if increased levels of integration of community health resources in CLHW programs indeed lead to higher program effectiveness and sustainability.This review includes peer-reviewed articles which meet three eligibility criteria: 1 specific focus on CLHWs or equivalent; 2 randomized, quasi-randomized, before/after methodology or substantial descriptive assessment; and 3 description of a community or peer intervention health program located in a low- or middle-income country. Literature searches using various article databases led to 2930 hits, of which 359 articles were classified. Of these, 32 articles were chosen for extensive review, complemented by analysis of the results of 15 other review studies. Analysis was conducted using an excel based data extraction form. Because results showed that no quantitative data was published, a descriptive synthesis was conducted. The review protocol was not proactively registered. Findings show minimal inclusion of even basic community level indicators, such as the degree to which the program is a community initiative, community input in the program or training, the background and history of CLHW recruits, and the role of the community in motivation and retention. Results show that of the 32 studies, only one includes one statistical measure of community integration. As a result

  13. Enabling and sustaining the activities of lay health influencers: lessons from a community-based tobacco cessation intervention study. (United States)

    Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra


    The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.

  14. Promoting and supporting self-management for adults living in the community with physical chronic illness: A systematic review of the effectiveness and meaningfulness of the patient-practitioner encounter. (United States)

    Rees, Sally; Williams, Anne

    There has been a reported rise in the number of people with chronic illness (also referred to as long-term disease) in the Western world. One hundred million people in the United States have at least one chronic condition and in the United Kingdom (UK) as many as 17.5 million adults may be living with chronic disease. New models of care have been developed which recognise the complexities of managing care where there is overlap between the wider community, the health care system and provider organisations, for example, the Chronic Care Model and the Expert Patient Programme. These new models herald a shift away from the idea of chronically ill patients as passive recipients of care towards active engagement, in partnership with health professionals, in managing their own care.Partnership, ideally, involves collaborative care and self-management education. This may support self-care alongside medical, preventative and health maintenance interventions. In this context the nature of the patient-practitioner consultation in promoting self-care takes on a new importance. The overall objective of the review was to determine the best available evidence regarding the promotion and support of self-care management for adults living in the community with chronic illness during the patient-practitioner encounter. Specifically the review sought to determine: What is the effectiveness of the patient-practitioner encounter in promoting and supporting self-care management of people with chronic illness? What are the individual and organisational factors which help or hinder recognition, promotion and support of chronic disease self-care management strategies? What are the similarities and differences between how 'effectiveness' is defined in this context by patients and different practitioners? The review focussed on self-caring adults aged nineteen years and older living in the community, with a physical chronic illness, and not currently being treated as an in-patient. For

  15. Challenges and opportunities for implementing sustainable energy strategies in coastal communities of Baja California Sur, Mexico (United States)

    Etcheverry, Jose R.

    This dissertation explores the potential of renewable energy and efficiency strategies to solve the energy challenges faced by the people living in the biosphere reserve of El Vizcaino, which is located in the North Pacific region of the Mexican state of Baja California Sur. This research setting provides a practical analytical milieu to understand better the multiple problems faced by practitioners and agencies trying to implement sustainable energy solutions in Mexico. The thesis starts with a literature review (chapter two) that examines accumulated international experience regarding the development of renewable energy projects as a prelude to identifying the most salient implementation barriers impeding this type of initiatives. Two particularly salient findings from the literature review include the importance of considering gender issues in energy analysis and the value of using participatory research methods. These findings informed fieldwork design and the analytical framework of the dissertation. Chapter three surveys electricity generation as well as residential and commercial electricity use in nine coastal communities located in El Vizcaino. Chapter three summarizes the fieldwork methodology used, which relies on a mix of qualitative and quantitative research methods that aim at enabling a gender-disaggregated analysis to describe more accurately local energy uses, needs, and barriers. Chapter four describes the current plans of the state government, which are focused in expanding one of the state's diesel-powered electricity grids to El Vizcaino. The Chapter also examines the potential for replacing diesel generators with a combination of renewable energy systems and efficiency measures in the coastal communities sampled. Chapter five analyzes strategies to enable the implementation of sustainable energy approaches in El Vizcaino. Chapter five highlights several international examples that could be useful to inform organizational changes at the federal

  16. Sustainability Factor Related with the Implementation of Community Mental Health Nursing (CMHN in South and West Jakarta

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    Esti Winahayu


    Full Text Available The aim of this study was to determine the sustainability factor related with the implementation of CMHN in South and West Jakarta. The method of the study was cross sectional, data of the nurses was collected by questionnaire of CMHN and pearson correlation was used to analyzed the data. Interviews conducted on stakeholder to get stakeholder perceptions about the sustainability factor of CMHN. The ability of nurse in the implementation of CMHN is 45,86%. The nurse perception toward sustainability factor of CMHN is 67,49%. The result of study shows the significant relationship between the sustainability factor with the implementation of CMHN. The result of analysis interviews with stakeholder about 8 sustainability factors is obtained into several themes: the positive opinion of stakeholder toward the CMHN (the existence of nursing care to the patients, detecting of new case, and reducing stigma and the effort for the sustainability of CMHN (increasing the perception, budget planning, and socialization. The result of the study is recomended to improve the community mental health nursing service in other region. Keywords: CMHN nurses, stakeholder, sustainability, the implementation of CMHN

  17. "This does my head in". Ethnographic study of self-management by people with diabetes

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    Hinder Susan


    Full Text Available Abstract Background Self-management is rarely studied 'in the wild'. We sought to produce a richer understanding of how people live with diabetes and why self-management is challenging for some. Method Ethnographic study supplemented with background documents on social context. We studied a socio-economically and ethnically diverse UK population. We sampled 30 people with diabetes (15 type 1, 15 type 2 by snowballing from patient groups, community contacts and NHS clinics. Participants (aged 5-88, from a range of ethnic and socio-economic groups were shadowed at home and in the community for 2-4 periods of several hours (total 88 visits, 230 hours; interviewed (sometimes with a family member or carer about their self-management efforts and support needs; and taken out for a meal. Detailed field notes were made and annotated. Data analysis was informed by structuration theory, which assumes that individuals' actions and choices depend on their dispositions and capabilities, which in turn are shaped and constrained (though not entirely determined by wider social structures. Results Self-management comprised both practical and cognitive tasks (e.g. self-monitoring, menu planning, medication adjustment and socio-emotional ones (e.g. coping with illness, managing relatives' input, negotiating access to services or resources. Self-management was hard work, and was enabled or constrained by economic, material and socio-cultural conditions within the family, workplace and community. Some people managed their diabetes skilfully and flexibly, drawing on personal capabilities, family and social networks and the healthcare system. For others, capacity to self-manage (including overcoming economic and socio-cultural constraints was limited by co-morbidity, cognitive ability, psychological factors (e.g. under-confidence, denial and social capital. The consequences of self-management efforts strongly influenced people's capacity and motivation to continue them

  18. A diabetes self-management program designed for urban American Indians. (United States)

    Castro, Sarah; O'Toole, Mary; Brownson, Carol; Plessel, Kimberly; Schauben, Laura


    Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

  19. Sustainable energy for all? Linking poor communities to modern energy services

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Emma; Godfrey Wood, Rachel; Garside, Ben


    This paper explores energy delivery models that provide sustainable and clean energy services to the poor. Four key building blocks are: the implementation process, including finance, resource sourcing, conversion and end use; support services (additional services such as training or micro-finance facilities); the enabling environment of policies, regulations and incentives; and the socio-cultural context including local norms and preferences, decision-making structures and levels of social cohesion. A range of products and services targeted at communities located in diverse socio-cultural and geographical contexts are covered. Useful experiences are shared that can help to replicate or scale up successful models that link the poor to modern energy markets. The case studies were selected to illustrate a range of energy products and services, diverse socio-cultural contexts, various business models and partnerships, and varying degrees of formality in the markets under consideration. All of the case studies reveal the challenges of reaching the very poorest even with pro-poor innovations put in place. The four case studies explored in the paper are: The Project for Renewable Energy in Rural Markets (PERMER), Argentina; Portable solar product companies (Tough Stuff and d.light) in southern Asia and sub-Saharan Africa; The Anagi stove in Sri Lanka; and, Micro-hydro development in Nepal (the Rural Energy Development Programme). Lessons learned are highlighted.

  20. Community-based observations on sustainable development in southern Hudson Bay

    International Nuclear Information System (INIS)

    Arragutainaq, L.; Fleming, B.


    Inuit residents of the Belcher Islands in Hudson Bay practice sustainable development over a wide region, and are heavily dependent on fish and wildlife for food. Large-scale hydroelectric developments on rivers emptying into Hudson Bay and James Bay threaten both the environment and the traditional economy and culture of those residents. The main focus of concern is the James Bay hydroelectric project, part 1 of which (La Grande) is now operational. In addition, hydroelectric projects in Manitoba and Ontario may also affect the region. The residents feel that the subdivision of each project into components, each subject to a separate environmental review and assessment, works in favor of the project proponents and does not address the issues of interest to those affected by the project. Neither does such a review process address questions related to the cumulative development of many projects over a long term. The Belcher Islands are remote from the territorial and national governments, neither of which seem to be giving the James Bay developments as much attention as seems necessary. The island community has identified its primary ecological concerns on part 2 of the James Bay project and presented them at a public hearing. These concerns include the long-term impacts of the project on the marine environment and the kinds of compensation, if any, for such impacts. 7 refs., 2 figs

  1. Eco-Self-Build Housing Communities: Are They Feasible and Can They Lead to Sustainable and Low Carbon Lifestyles?

    Directory of Open Access Journals (Sweden)

    Steffie Broer


    Full Text Available This paper concerns how sustainable and low carbon living can be enabled in new housing developments in the UK. It is here recognized that consumption of energy and resources is not just what goes into the building, but also long-term through occupancy and activities. Current approaches, which require housing developers to reduce the carbon emissions of the homes they build through a mixture of energy efficiency and renewable energy systems, do not sufficiently contribute to the carbon emission reductions which are necessary for meeting UK Government targets and to avoid dangerous climate change. Purchasing a home ties people in to not just direct consumption of energy (heating, hot water, electricity, but also effects other areas of consumption such as the embedded energy in the building and activities associated with the location and the type of development. Conventional business models for new housing development, operating under current government regulations, policies and targets have failed to develop housing which encourages the adoption of sustainable lifestyles taking whole life consumption into account. An alternative business model of eco-self-build communities is proposed as a way to foster desired behavior change. The feasibility of eco-self-build communities and their scope for supporting low carbon sustainable lifestyles is assessed through stakeholder interviews, and through quantitative assessment of costs, carbon emission reduction potential, and other sustainability impacts of technical and lifestyle options and their combinations. The research shows that eco-self-build communities are both feasible and have the ability to deliver low carbon lifestyles. In comparison to conventional approaches to building new housing, they have further advantages in terms of delivering wider social, environmental as well as economic sustainability objectives. If implemented correctly they could succeed in making sustainable lifestyles

  2. Using Exploratory Focus Groups to Inform the Development of Targeted COPD Self-Management Education DVDs for Rural Patients

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    Michael Stellefson


    Full Text Available This exploratory study assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. A purposive, homogeneous sample of COPD patients participated in focus group interviews. Data from these interviews were referenced to edit a library of Rvision COPD self-management DVDs into a single condensed DVD containing only the most pertinent self-management topics. Patients reported a lack of knowledge and skill development related to purse lipped breathing, controlled coughing, and stress management; while medication management skills were found to be quite adequate. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs for self-management may lead to future use of educational technologies aimed at improving quality of life for these rural, hard to reach populations.

  3. “I’ll Be Home for Christmas”: The Role of International Maasai Migrants in Rural Sustainable Community Development

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    Caroline S. Archambault


    Full Text Available While the Maasai have to be among sub-Saharan Africa’s most mobile population due to their traditional transhumant pastoral livelihood strategy, compared with other neighboring ethnic groups they have been relatively late to migrate in substantial numbers for wage labour opportunities. In the community of Elangata Wuas in Southern Kenya, international migration for employment abroad has been very rare but promises to increase in significant numbers with the dramatic rise in education participation and diversification of livelihoods. Drawing on long-term ethnographic research and the specific experiences of the few international migrant pioneers in Elangata Wuas, this paper explores how community members assess the impacts of international migration on community sustainable development. It appears that international migration facilitates, and even exacerbates, inequality, which is locally celebrated, under an ethic of inter-dependence, as sustainable development. Particular attention is paid to the mechanisms of social control employed by community members to socially maintain their migrants as part of the community so that these migrants feel continued pressure and commitment to invest and develop their communities. Such mechanisms are importantly derived from the adaptability and accommodation of culture and the re-invention of tradition.

  4. Gamifying Self-Management of Chronic Illnesses: A Mixed-Methods Study. (United States)

    AlMarshedi, Alaa; Wills, Gary; Ranchhod, Ashok


    Self-management of chronic illnesses is an ongoing issue in health care research. Gamification is a concept that arose in the field of computer science and has been borrowed by many other disciplines. It is perceived by many that gamification can improve the self-management experience of people with chronic illnesses. This paper discusses the validation of a framework (called The Wheel of Sukr) that was introduced to achieve this goal. This research aims to (1) discuss a gamification framework targeting the self-management of chronic illnesses and (2) validate the framework by diabetic patients, medical professionals, and game experts. A mixed-method approach was used to validate the framework. Expert interviews (N=8) were conducted in order to validate the themes of the framework. Additionally, diabetic participants completed a questionnaire (N=42) in order to measure their attitudes toward the themes of the framework. The results provide a validation of the framework. This indicates that gamification might improve the self-management of chronic illnesses, such as diabetes. Namely, the eight themes in the Wheel of Sukr (fun, esteem, socializing, self-management, self-representation, motivation, growth, sustainability) were perceived positively by 71% (30/42) of the participants with P value gamification in the self-management of diabetes.

  5. Gamifying Self-Management of Chronic Illnesses: A Mixed-Methods Study (United States)

    Wills, Gary; Ranchhod, Ashok


    Background Self-management of chronic illnesses is an ongoing issue in health care research. Gamification is a concept that arose in the field of computer science and has been borrowed by many other disciplines. It is perceived by many that gamification can improve the self-management experience of people with chronic illnesses. This paper discusses the validation of a framework (called The Wheel of Sukr) that was introduced to achieve this goal. Objective This research aims to (1) discuss a gamification framework targeting the self-management of chronic illnesses and (2) validate the framework by diabetic patients, medical professionals, and game experts. Methods A mixed-method approach was used to validate the framework. Expert interviews (N=8) were conducted in order to validate the themes of the framework. Additionally, diabetic participants completed a questionnaire (N=42) in order to measure their attitudes toward the themes of the framework. Results The results provide a validation of the framework. This indicates that gamification might improve the self-management of chronic illnesses, such as diabetes. Namely, the eight themes in the Wheel of Sukr (fun, esteem, socializing, self-management, self-representation, motivation, growth, sustainability) were perceived positively by 71% (30/42) of the participants with P value gamification in the self-management of diabetes. PMID:27612632

  6. Building Sustainable Neighborhoods through Community Gardens: Enhancing Residents' Well-Being through University-Community Engagement Initiative (United States)

    Siewell, Nicholas; Aguirre, Stephanie; Thomas, Madhavappallil


    Building communities through creative community garden projects is increasingly common and seems to create beneficial effects for participants. This study recognizes the need to understand the impact of gardens on low socioeconomic neighborhoods. By conducting a needs assessment study and establishing a community garden, we were able to study its…

  7. Teaching Sustainability and Resource Management Using NOAA's Voices Of The Bay Community Fisheries Education Curriculum (United States)

    Hams, J. E.; Uttal, L.; Hunter-Thomson, K.; Nachbar, S.


    This presentation highlights the implementation of the NOAA VOICES OF THE BAY education curriculum at a two-year college. The VOICES OF THE BAY curriculum provides students with an understanding of the marine ecology, economy, and culture of fisheries through three interdisciplinary modules that use hands-on activities while meeting a wide range of science, math, social science, and communications standards. In the BALANCE IN THE BAY module, students use critical-thinking skills and apply principles of ecosystem-based management to analyze data, debate and discuss their findings, and make decisions that recognize the complex dynamics associated with maintaining a balance in fisheries. Through role-playing, teamwork, and a little fate, the FROM OCEAN TO TABLE module provides students with an opportunity to get an insider’s view of what it takes to be an active stakeholder in a commercial fishery. In the CAPTURING THE VOICES OF THE BAY module, students research, plan, and conduct personal interviews with citizens of the local fishing community and explore the multiple dimensions of fisheries and how they inter-connect through the lives of those who live and work in the region. The VOICES OF THE BAY modules were introduced into the curriculum at Los Angeles Valley College during the Fall 2009 semester and are currently being used in the introductory Oceanography lecture, introductory Oceanography laboratory, and Environmental Science laboratory courses. Examples of curriculum materials being used (power point presentations, module worksheets and simulated fishing activities) will be presented. In addition, samples of completed student worksheets for the three interdisciplinary modules are provided. Students commented that their overall awareness and knowledge of the issues involved in sustainable fishing and managing fishery resources increased following completion of the VOICES OF THE BAY education curriculum. Students enrolled in the laboratory sections commented

  8. Teaching Self-Management: The Design and Implementation of Self-Management Tutorials (United States)

    Gerhardt, Megan


    Learning the skills of self-management is an essential task for students in the 21st century. A total of 223 undergraduate students participated in 4 self-management tutorials that presented the components of understanding and mastering self-management skills including (a) self-assessment, (b) goal setting, (c) time management, and (d)…

  9. Self-management and creativity (United States)

    Medvedev, B. A.; Skaptsov, A. A.; Polikarpov, M. A.


    How to improve physicist's creativity? How one can make himself an instrument for creativity? What is the role of the humanities in initiation of intuitive moments in thinking? The problems are discussed in terms of such modern conception as Self-management, in context of the dialogue between nature and human being by Prigogine, "Farther reaches of human nature" by Maslow, and mathematical approach for modeling of mental structure elements.

  10. Do Community Based Initiatives foster sustainability transitions? Towards a unique Environmental Impact Assessment. (United States)

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


    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

  11. Starting early: integration of self-management support into an acute stroke service. (United States)

    Mäkelä, Petra; Gawned, Sara; Jones, Fiona


    work is required to evaluate sustainability of the Bridges stroke SMP, to understand the barriers and opportunities involved in engaging all professional groups in integrated self-management support in acute stroke settings, and to assess patient reported outcomes.

  12. The Role of Conflict Identification and Management in Sustaining Community Collaboration: Report on a Four-Year Exploratory Study. (United States)

    Blanch, Andrea K; Boustead, Robyn; Boothroyd, Roger A; Evans, Mary E; Chen, Huey-Jen


    Community collaboration has become increasingly common in behavioral health services. Conflict is likely to occur in any community coalition bringing together organizations with differing mandates, missions, and histories. However, research on how coalitions identify and handle conflict, and on the impact of conflict on sustainability is scarce. An exploratory study examined conflict in two federally funded children's "systems of care" using site visits and concept mapping to describe differences in how sites conceptualize and respond to conflict. Results suggest that unacknowledged and unaddressed conflict can negatively affect the development and sustainability of sites, and that focusing on cooperation may, paradoxically, make it more difficult to acknowledge conflict and to implement conflict transformation processes. Implications for behavioral health administrators are discussed, including potential interventions that could address these issues.

  13. A prescription for sustaining community engagement in malaria elimination on Aneityum Island, Vanuatu: an application of Health Empowerment Theory. (United States)

    Watanabe, Noriko; Kaneko, Akira; Yamar, Sam; Taleo, George; Tanihata, Takeo; Lum, J Koji; Larson, Peter S; Shearer, Nelma B C


    Community engagement has contributed to disease control and elimination in many countries. Community engagement in malaria elimination (ME) on Aneityum Island has been sustained since its introduction in the early 1990s. Capacity developed within this population has led to a health empowered community response. Health Empowerment Theory (HET) can account for the innovative community actions and capacity development efforts taken to realize and sustain meaningful changes in well-being. This study used the HET framework to investigate participant perceptions of ME efforts on the island focusing on two HET elements, personal and social-contextual resources. The purpose of this study was to explore the role of empowerment as a critical element of community engagement. Six focus group discussions, ten key informant interviews and 17 in-depth interviews were conducted in July 2012 on Aneityum. Both deductive and inductive approaches to qualitative content analysis were used to identify themes, which were condensed, coded and classified based on the HET elements above. Awareness and use of personal and social-contextual resources played an important role in ME efforts. Most participants shared their knowledge to prevent malaria reintroduction. Many participants reported their skills needed for behavioral maintenance, problem-solving or leadership. Participants who perceived a threat took preventive actions even in the dry season. Community leaders focused on second generation capacity development. A local health coalition provided ME services. Members of networks were sources of information and assistance. Face-to-face was the preferred method of communication. Barriers to engagement (e.g., financial difficulties, health literacy issues and underdeveloped infrastructure) were minimized through active collaboration and mutual assistance. In the community engagement continuum, health empowerment develops incrementally overtime as people gain their knowledge and skills, form

  14. The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study.

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    David Reeves

    Full Text Available Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective.To determine how the social networks of people with long-term conditions (diabetes and heart disease are associated with health-related outcomes and changes in outcomes over time.Patients with chronic heart disease (CHD or diabetes (n = 300 randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline.Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks.Findings indicated that: (1 social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2 support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3 network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01 reduced for patients receiving greater levels of illness work through their networks.Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community

  15. Local natural resource curse and sustainable socio-economic development in a Russian mining community of Kovdor


    Tuomas Kristian Suutarinen


    Natural resource extraction forms the backbone of the Russian economy and characterizes the majority of regions and communities in the Russian North. The long-term socio-economic sustainability of natural resource extraction in resource abundant countries has been questioned and discussed in various social sciences with the resource curse theory, which, however, is understudied on the local level. This study creates a local resource curse theory that is based on the basic idea that there are ...

  16. Healthy and sustainable diets: Community concern about the effect of the future food environments and support for government regulating sustainable food supplies in Western Australia. (United States)

    Harray, Amelia J; Meng, Xingqiong; Kerr, Deborah A; Pollard, Christina M


    To determine the level of community concern about future food supplies and perception of the importance placed on government regulation over the supply of environmentally friendly food and identify dietary and other factors associated with these beliefs in Western Australia. Data from the 2009 and 2012 Nutrition Monitoring Survey Series computer-assisted telephone interviews were pooled. Level of concern about the effect of the environment on future food supplies and importance of government regulating the supply of environmentally friendly food were measured. Multivariate regression analysed potential associations with sociodemographic variables, dietary health consciousness, weight status and self-reported intake of eight foods consistent with a sustainable diet. Western Australia. Community-dwelling adults aged 18-64 years (n = 2832). Seventy nine per cent of Western Australians were 'quite' or 'very' concerned about the effect of the environment on future food supplies. Respondents who paid less attention to the health aspects of their diet were less likely than those who were health conscious ('quite' or 'very' concerned) (OR = 0.53, 95% CI [0.35, 0.8] and 0.38 [0.17, 0.81] respectively). The majority of respondents (85.3%) thought it was 'quite' or 'very' important that government had regulatory control over an environmentally friendly food supply. Females were more likely than males to rate regulatory control as 'quite' or 'very' important' (OR = 1.63, 95% CI [1.09, 2.44], p = .02). Multiple regression modeling found that no other factors predicted concern or importance. There is a high level of community concern about the impact of the environment on future food supplies and most people believe it is important that the government regulates the issue. These attitudes dominate regardless of sociodemographic characteristics, weight status or sustainable dietary behaviours. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador. (United States)

    Spiegel, Jerry M; Breilh, Jaime; Beltran, Efrain; Parra, Jorge; Solis, Fernanda; Yassi, Annalee; Rojas, Alejandro; Orrego, Elena; Henry, Bonnie; Bowie, William R; Pearce, Laurie; Gaibor, Juan; Velasquez, Patricio; Concepcion, Miriam; Parkes, Margot


    The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: "Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?" To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. By 2009, train-the-trainer project initiation involved 27 participatory action research Master's theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master's and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Strengthening capabilities for producing and applying knowledge through direct engagement with affected populations and

  18. Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

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    Henry Bonnie


    Full Text Available Abstract Background The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. Methods In implementing curriculum and complementary innovations through application of an ecosystem approach to health, our interdisciplinary international team focused on the question: “Can strengthening of institutional capacities to support a community of practice of researchers, practitioners, policy-makers and communities produce positive health outcomes and improved capacities to sustainably translate knowledge?” To assess progress in achieving desired outcomes, we review results associated with the logic framework analysis used to guide the project, focusing on how a community of practice network has strengthened implementation, including follow-up tracking of program trainees and presentation of two specific case studies. Results By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Discussion Strengthening capabilities for producing and

  19. Quality and Usability of Arthritic Pain Self-Management Apps for Older Adults: A Systematic Review. (United States)

    Bhattarai, Priyanka; Newton-John, T R O; Phillips, Jane L


    To appraise the quality and usability of currently available pain applications that could be used by community-dwelling older adults to self-manage their arthritic pain. A systematic review. Searches were conducted in App Store and Google Play to identify pain self-management apps relevant to arthritic pain management. English language pain management apps providing pain assessment and documentation function and pain management education were considered for inclusion. A quality evaluation audit tool based on the Stanford Arthritis Self-Management Program was developed a priori to evaluate app content quality. The usability of included apps was assessed using an established usability evaluation tool. Out of the 373 apps that were identified, four met the inclusion criteria. The included apps all included a pain assessment and documentation function and instructions on medication use, communication with health professionals, cognitive behavioral therapy-based pain management, and physical exercise. Management of mood, depression, anxiety, and sleep were featured in most apps (N = 3). Three-quarters (N = 3) of the apps fell below the acceptable moderate usability score (≥3), while one app obtained a moderate score (3.2). Few of the currently available pain apps offer a comprehensive pain self-management approach incorporating evidence-based strategies in accordance with the Stanford Arthritis Self-Management Program. The moderate-level usability across the included apps indicates a need to consider the usability needs of the older population in future pain self-management app development endeavors.

  20. Strategies of Building a Stronger Sense of Community for Sustainable Neighborhoods: Comparing Neighborhood Accessibility with Community Empowerment Programs

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    Te-I Albert Tsai


    Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.

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

    Directory of Open Access Journals (Sweden)

    Christabelle S. Moyo


    Full Text Available Abstract Background Researchers involved in biomedical community-based projects rarely seek the perspectives of community fieldworkers, who are the ‘foot soldiers’ in such projects. Understanding the effect of biomedical research on community-based field workers could identify benefits and shortfalls that may be crucial to the success of community-based studies. The present study explored the perceptions of community-based field workers on the effect of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project" (MAL-ED South Africa on their tangible and intangible capital which together comprise sustainable livelihoods. Methods The study was conducted in Dzimauli community in Limpopo Province of South Africa between January-February 2016. The sustainable livelihoods framework was used to query community-based field workers’ perspectives of both tangible assets such as income and physical assets and intangible assets such as social capital, confidence, and skills. Data were collected through twenty one individual in-depth interviews and one focus group discussion. Data were analysed using the Thematic Content Analysis approach supported by ATLAS.ti, version 7.5.10 software. Results All the field workers indicated that they benefitted from the MAL-ED South Africa project. The benefits included intangible assets such as acquisition of knowledge and skills, stronger social capital and personal development. Additionally, all indicated that MAL-ED South Africa provided them with the tangible assets of increased income and physical assets. Observations obtained from the focus group discussion and the community-based leaders concurred with the findings from the in-depth interviews. Additionally, some field workers expressed the desire for training in public relations, communication, problem solving and confidence building. Conclusions The MAL-ED South Africa

  2. Recommendations of Common Data Elements to Advance the Science of Self-Management of Chronic Conditions. (United States)

    Moore, Shirley M; Schiffman, Rachel; Waldrop-Valverde, Drenna; Redeker, Nancy S; McCloskey, Donna Jo; Kim, Miyong T; Heitkemper, Margaret M; Guthrie, Barbara J; Dorsey, Susan G; Docherty, Sharron L; Barton, Debra; Bailey, Donald E; Austin, Joan K; Grady, Patricia


    Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. The use of CDEs can facilitate generalizability of research findings across diverse population and interventions. © 2016 Sigma Theta Tau International.

  3. Twelve evidence-based principles for implementing self-management support in primary care. (United States)

    Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H


    Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.

  4. Keep Talking & Monitoring: the importance of longitudinal research & community-based monitoring to support sustainable land management in southern Africa (United States)

    Dougill, Andrew; Stringer, Lindsay


    Projects come and go with researchers, development practioners and government staff initiating new forms of community engagement in environmental monitoring and land management practices. We analyse interventions from Botswana and Swaziland and highlight that for benefits to be long-lived and lead to sustainable land management, requires community engagement in project design, implementation and for project outputs to be used in developing community-led environmental monitoring tools that can then help to guide local decision-making systems. We stress the vital importance of continued participatory engagement of researchers with community leaders and key government staff beyond the timeframe of their initial research such that longitudinal research approaches can realise significant benefits to all concerned. In dynamic (non-equilibrium) dryland environments, it is vitally important that research approaches address temporal and spatial variability by mapping patterns of change, using a range of participatory tools to enhance understandings of the causes of land degradation and the opportunities for shifts towards more sustainable land management. Decision-support tools, such as rangeland assessment guides produced for various Kalahari rangeland settings in Botswana (via a UNEP project and affiliated research), provide opportunities to support more sustainable land management. However, at present benefits are not being fully realised as project and research staff move on after projects end. Similarly, findings from mixed farming systems in Swaziland (assessing a JICA-funded project) show problems in maintaining new institutional structures to manage rangeland degradation, whilst issues on arable areas associated with parasitic weeds (Striga asiatica) remain problematic. Findings from longitudinal research in Swaziland also show that community understandings of environmental problems have evolved over 10 years and identify new problems associated with intensified

  5. Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy? (United States)

    Chilundo, Baltazar Gm; Cliff, Julie L; Mariano, Alda Re; Rodríguez, Daniela C; George, Asha


    In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded 'old' CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Our analysis represents a nuanced assessment of the various domains that influence CHW programme

  6. Aligning Needs, Expectations, and Learning Outcomes to Sustain Self-Efficacy through Transfer Learning Community Programs (United States)

    Leptien, Jennifer R.


    This chapter addresses strengths and difficulties encountered in implementing transfer learning community models and how efficacy is supported through transfer learning community programming. Transfer programming best practices and recommendations for program improvements are presented.

  7. Daily self-management and work engagement

    NARCIS (Netherlands)

    Breevaart, K.; Bakker, A.B.; Demerouti, E.


    The present study adopts a bottom-up approach to work engagement by examining how self-management is related to employees' work engagement on a daily basis. Specifically, we hypothesized that on days that employees use more self-management strategies, they report higher resources at work and in

  8. Successful implementation of self-managing teams

    NARCIS (Netherlands)

    Weerheim, Wilke; Van Rossum, Lisa; Ten Have, Wouter Dirk


    Purpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is crucial to

  9. Successful implementation of self-managing teams

    NARCIS (Netherlands)

    Weerheim, W. (Wilke); Van Rossum, L. (Lisa); Ten Have, W.D. (Wouter Dirk)


    textabstractPurpose: Following health-care organisations, many mental health-care organisations nowadays consider starting to work with self-managing teams as their organisation structure. Although the concept could be effective, the way of implementing self-managing teams in an organisation is

  10. Self-management of vascular risk factors

    NARCIS (Netherlands)

    Sol-de Rijk, B.G.M.


    Summary The aim of this thesis was to provide insight into the potential of a self-management approach in treatment of vascular risk factors and to develop a self-management intervention. Furthermore to examine if this intervention, based on self-efficacy promoting theory, is effective in reducing

  11. Self-management education for cystic fibrosis.

    LENUS (Irish Health Repository)

    Savage, Eileen


    Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted.

  12. The role of cooperatives in sustaining the livelihoods of rural communities: The case of rural cooperatives in Shurugwi District, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Smart Mhembwe


    Full Text Available The main focus of the research was to analyse the role of cooperatives in sustaining the livelihoods of local rural communities in Shurugwi District in Zimbabwe. Descriptive survey design was used in this mixed method approach to the study. A questionnaire, interviews and observation methods were employed as the main research instruments. Purposive sampling technique was adopted and data were collected from government officials and from members of the six cooperatives in Shurugwi District. A total of 50 research participants were involved in the study. It was found that cooperatives were established as a strategy to sustain livelihoods of rural communities. With the adoption of cooperatives, people in the rural communities managed to generate employment, boost food production, empower the marginalised, especially women, and promote social cohesion and integration, thereby improving their livelihoods and reducing poverty. Most cooperatives face a number of challenges that include lack of financial support, poor management and lack of management skills, and lack of competitive markets to sell their produce. The study recommends that the government and the banking sector render financial support to cooperatives in rural communities to allow them to expand and diversify their business operations; constant training on leadership and management skills is provided to cooperatives’ members. There is also a need for cooperatives, especially those in the agricultural sector, to form some producer associations so as to easily market their produce. Lastly, the study recommends that future research should focus on investigating issues that hinder the growth of the cooperative movement in rural communities of Zimbabwe. It is hoped that policy-makers, the academia and communities would benefit from the study.

  13. Enabling Factors for Sustaining Open Defecation-Free Communities in Rural Indonesia: A Cross-Sectional Study. (United States)

    Odagiri, Mitsunori; Muhammad, Zainal; Cronin, Aidan A; Gnilo, Michael E; Mardikanto, Aldy K; Umam, Khaerul; Asamou, Yameha T


    Community Approaches to Total Sanitation (CATS) programmes, like the Sanitasi Total Berbasis Masyarakat (STBM) programme of the Government of Indonesia, have played a significant role in reducing open defecation though still little is known about the sustainability of the outcomes. We assessed the sustainability of verified Open Defecation Free (ODF) villages and explored the association between slippage occurrence and the strength of social norms through a government conducted cross-sectional data collection in rural Indonesia. The study surveyed 587 households and held focus group discussions (FGDs) in six ODF villages two years after the government's ODF verification. Overall, the slippage rate (i.e., a combination of sub-optimal use of a latrine and open defecation at respondent level) was estimated to be 14.5% (95% CI 11.6-17.3). Results of multivariate logistic regression analyses indicated that (1) weaker social norms, as measured by respondents' perceptions around latrine ownership coverage in their community, (2) a lack of all-year round water access, and (3) wealth levels (i.e., not being in the richest quintile), were found to be significantly associated with slippage occurrence. These findings, together with qualitative analysis, concluded that CATS programmes, including a combination of demand creation, removal of perceived constraints through community support mechanisms, and continued encouragement to pursue higher levels of services with post-ODF follow-up, could stabilize social norms and help to sustain longer-term latrine usage in study communities. Further investigation and at a larger scale, would be important to strengthen these findings.

  14. Sustainable Materials Management (SMM) Web Academy Webinar: Cupertino CA and Cambridge MA: Tips for How Communities Can Successfully Engage Businesses to Divert Food Scraps (United States)

    This is a webinar page for the Sustainable Management of Materials (SMM) Web Academy webinar titled Let’s WRAP (Wrap Recycling Action Program): Best Practices to Boost Plastic Film Recycling in Your Community

  15. Factors influencing self-management in chronic obstructive pulmonary disease: an integrative review. (United States)

    Disler, R T; Gallagher, R D; Davidson, P M


    Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g., personal) and external (e.g., health service) factors. This paper seeks to define self-management, identify the determinants which influence the individual's ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research. Integrative review. Medline, Embase, PubMed, CINAHL, Google Scholar. Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care. Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management. Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. The Role of Local Community in the Marketing Planning for Sustainable Tourism National Park Skadar Lake (Montenegro

    Directory of Open Access Journals (Sweden)

    Darko Lacmanović


    Full Text Available The relationship between local community and tourism sector is an important issue in the marketing management of tourist destinations in theoretical and practical terms. It is especially important to consider specific issues relating to sustainable tourism marketing process and the participation of local people in the process. The subject of this work is to determine the existence of significant differences in the local community attachment and involment that may affect the marketing plan in offering different types of sustainable tourism in the National Park “Skadar Lake”.The research was conducted using a survey on a sample of 51 households in the stated area, using few statistical method for processing data (The T-test for independent samples; ANOVA.Examined: the perceived importance of the supply of sustainable forms of tourism; attitude towards tourists / visitors and the perception level of tourism marketing trends.Testing the validity of the hypotheses noted the following. Rejection of Hypothesis 1 clearly states that men and women do not have clear differences of opinions regarding the development of sustainable tourism offers. Partially confirmed Hypothesis 2 showed a more significant difference in the positive attitudes of the middle-aged group, which indicates the need for careful marketing communication in relation to other age groups. Confirming the Hypothesis 3 has highlighted the clearer perception of local residents who are employed in the tourism sector about the advantages and disadvantages of tourism development. The Hypothesis 4 regarding significant monitoring of the developments in the tourism market of highly educated residents and resident-employees in the tourism sector, public services, culture and education in relation to other comparable groups has been confirmed. The rejection of the Hypothesis 5 shows that the place of residence does not significantly affect the views of local residents about the development of

  17. A GIS-based performance measurement system for assessing transportation sustainability and community livability : final report. (United States)


    Sustainability and livability in transportation, as the concepts referring to the capability of transportation systems to maintain the well being of our society, have been widely : accepted as the critical principles to improve quality of life and he...

  18. Relevance of national and local government policy to sustainable community natural resource management in South Africa

    CSIR Research Space (South Africa)

    Musvoto, Constansia D


    Full Text Available Development in South Africa is guided by the principle of sustainability, and this is underpinned by integration, which is the consideration of social, economic and environmental factors in decision making. Policies are in place at national...

  19. Evaluation of criteria for sustainability of community-based rural homestay programs via a modified pairwise comparison method (United States)

    Ramli, Rohaini; Kasim, Maznah Mat; Ramli, Razamin; Kayat, Kalsom; Razak, Rafidah Abd


    Ministry of Tourism and Culture Malaysia has long introduced homestay programs across the country to enhance the quality of life of people, especially those living in rural areas. This type of program is classified as a community-based tourism (CBT) as it is expected to economically improve livelihood through cultural and community associated activities. It is the aspiration of the ministry to see that the income imbalance between people in the rural and urban areas is reduced, thus would contribute towards creating more developed states of Malaysia. Since 1970s, there are 154 homestay programs registered with the ministry. However, the performance and sustainability of the programs are still not satisfying. There are only a number of homestay programs that perform well and able to sustain. Thus, the aim of this paper is to identify relevant criteria contributing to the sustainability of a homestay program. The criteria are evaluated for their levels of importance via the use of a modified pairwise method and analyzed for other potentials. The findings will help the homestay operators to focus on the necessary criteria and thus, effectively perform as the CBT business initiative.

  20. A systems approach for the development of a sustainable community--the application of the sensitivity model (SM). (United States)

    Chan, Shih-Liang; Huang, Shu-Li


    Corresponding to the concept of 'Think globally, act locally and plan regionally' of sustainable development, this paper discusses the approach of planning a sustainable community in terms of systems thinking. We apply a systems tool, the sensitivity model (SM), to build a model of the development of the community of Ping-Ding, located adjacent to the Yang-Ming-Shan National Park, Taiwan. The major issue in the development of Ping-Ding is the conflict between environmental conservation and the development of a local tourism industry. With the involvement of local residents, planners, and interest groups, a system model of 26 variables was defined to identify characteristics of Ping-Ding through pattern recognition. Two scenarios concerning the sustainable development of Ping-Ding are simulated with interlinked feedbacks from variables. The results of the analysis indicate that the development of Ping-Ding would be better served by the planning of agriculture and the tourism industry. The advantages and shortfalls of applying SM in the current planning environment of Taiwan are also discussed to conclude this paper.

  1. Sustainable Tourism Development: the Adaptation and Resilience of the Rural Communities in (the Tourist Villages of Karimunjawa, Central Java

    Directory of Open Access Journals (Sweden)

    Budi Setiawan


    Full Text Available From 2009 to 2015, the growth of tourism in the tourist villages (desa wisata of Karimunjawa underwent rapid progress. However, the level of poverty in Karimunjawa remained high. Nevertheless, the involvement of rural people in the sustainable development of tourism has received only limited discussion. Therefore, this article discusses the rural communities’ adaptation and resilience in Karimunjawa with the support of sustainable development planning in tourist villages. It covers the background of sustainable development, the elements of the communities’ adaptive capacity and resilience, and the role of the regional government. Empirical evidence of variations in the capacity to respond to changes of socioeconomic and ecological environments due to tourism development is presented. In addition, a case study is used in this article to describe how the people learned from their experience, knowledge, and past efforts. To obtain the necessary information, in-depth interviews were conducted with a number of key informants in the tourist villages of Karimunjawa, which were selected via purposive and snowball sampling. The results of the research show that social resilience will increase among those communities that are capable of accessing flexible social networks. These social networks are practical tools that open up the dissemination of new information and knowledge. This is a key element for a stronger process of transformation. Furthermore, communities that have capital and financial access as well as skills will also be capable of adaptation to the transformation process.

  2. Community Development to Feed the Family in Northern Manitoba Communities: Evaluating Food Activities based on Their Food Sovereighnty, Food Security, and Sustainable Livelihood Outcomes

    Directory of Open Access Journals (Sweden)

    Mohammad Ashraful Alam


    Full Text Available This article explores food-related activities and their impacts on sustainable livelihood assets, food sovereignty, and food security, and provides insight for future food-related community development. Analysis is based on community food assessments conducted in 14 Northern Manitoba communities and included a food security survey, price survey, and interviews. The lack of community control over development in First Nation and other Northern remote and rural communities in Northern Manitoba is found to undermine both food sovereignty and sustainable livelihoods, while creating high levels of food insecurity. According to logit models, sharing country foods increases food sovereignty and sustainable livelihoods, and has a stronger relationship to food security than either road access to retail stores in urban centres or increased competition between stores. The model predicts that rates of food insecurity for a community with a country foods program and with access to public transit and roads at 95% would be lower than the Canadian average of 92%.RÉSUMÉCet article explore les activités relatives à l’alimentation et leur impact sur les biens durables ainsi que sur la souveraineté et la sécurité alimentaires tout en ouvrant des perspectives sur le développement communautaire futur relatif à l’alimentation. L’analyse se fonde sur une recherche menée dans quatorze communautés du nord du Manitoba et comprend un premier sondage sur la sécurité alimentaire, un second sondage sur les prix, et des entrevues. Le manque de contrôle du développement dans les communautés reculées du nord du Manitoba, tant autochtones que non-autochtones, mine à la fois la souveraineté alimentaire et les moyens d’existence durables tout en provoquant de hauts niveaux d’insécurité alimentaire. Selon un modèle Logit, le partage d’aliments locaux permet une souveraineté alimentaire et une autonomie durable tout en ayant un meilleur impact sur la

  3. Bringing the integrative aspect of sustainable development into community natural resource management: the case of agricultural land use in Limpopo, South Africa

    CSIR Research Space (South Africa)

    Musvoto, Constansia D


    Full Text Available policies to facilitate integrated decision making, which is pivotal to sustainable development. Sustainable development is an integrative concept with a basis in a ‘whole systems approach’. There are no tools tailored to facilitate integration in community...

  4. Assessing the Impact of a Program Designed to Develop Sustainability Leadership amongst Staff Members in Higher Education Institutes: A Case Study from a Community of Practice Perspective (United States)

    Alkaher, Iris; Avissar, Ilana


    This study focuses on the impact of a sustainability leadership development program (SLDP) designed to develop staff members as leaders who encourage sustainability practices within institutions of higher education (IHE). Using the framework of community of practice (CoP), we explored the program's contribution by interviewing 16 staff members who…

  5. Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review. (United States)

    Tung, James Y; Stead, Brent; Mann, William; Ba'Pham; Popovic, Milos R


    Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

  6. Sustaining Scientist-Community Partnerships that are Just, Equitable, and Trustworthy (United States)

    Sheats, N.


    Communities of color, indigenous people, and low income communities throughout the United States are on the front lines of environmental and health impacts from polluting sources, and yet don't fully benefit from public policies that are intended to reduce or prevent those impacts. Many of the challenges faced by environmental justice communities can and should be addressed, in part, through science-based public policies. Community-relevant scientific information and equal access to this information is needed to protect people from public health and environmental hazards. Too often, however, the scientific community has failed to work collaboratively with environmental justice communities. This session will explore the challenges and opportunities faced by environmental justice advocates and scientists in working with one another. This talk will share findings from a recently-held forum, specifically discussing a formal set of principles and best practices for community-scientist partnerships to guide future collaborations between scientists and communities. When community members and scientists collaborate, they bring together unique strengths and types of knowledge that can help address our most pressing challenges, inform decision making, and develop solutions that benefit all people. The speaker will address institutional and historic barriers that hinder such collaboration, potential pitfalls to avoid, and share how institutional systems of scientific research can incorporate equity analyses into their work to ensure solutions that are truly effective.

  7. Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study. (United States)

    Van den Heuvel, S C G H; Goossens, P J J; Terlouw, C; Van Achterberg, T; Schoonhoven, L


    Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face

  8. Citizen Science for Post-disaster Sustainable Community Development in Ecologically Fragiel Regions - A Case from China (United States)

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


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

  9. Sustained benefits of a community dietetics intervention designed to improve oral nutritional supplement prescribing practices.

    LENUS (Irish Health Repository)

    Kennelly, S


    Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later.

  10. Collaboration for Transformation: Community-Campus Engagement for Just and Sustainable Food Systems (United States)

    Levkoe, Charles Z.; Andrée, Peter; Bhatt, Vikram; Brynne, Abra; Davison, Karen M.; Kneen, Cathleen; Nelson, Erin


    This article focuses on the collaborations between academics and community-based organizations seeking to fundamentally reorganize the way food is produced, distributed, and consumed as well as valued. The central research question investigates whether and how the growth of community--campus engagement (CCE) can strengthen food movements. Drawing…

  11. "Low-Impact Communities" and Their Value to Experiential Education for Sustainability in Higher Education (United States)

    Cook, Robert; Cutting, Roger


    This paper reports on a year-long research project that investigated the value of experiential engagement with "alternative" communities which derive a high degree of self-reliance from working closely with their own local natural resources. Opportunities for higher education students to explore these communities were developed and the…

  12. Towards Sustainable Performance Measurement Frameworks for Applied Research in Canadian Community Colleges and Institutes (United States)

    Williams, Keith


    Applied Research (AR) in Canadian community colleges is driven by a mandate, via the collective voice of Colleges and Institutes Canada--a national voluntary membership association of publicly supported colleges and related institutions--to address issues of interest to industry, government, and/or community. AR is supported through significant…

  13. An intercultural educational paradigm to promote peace and development of local indigenous communities. Sustainable development program of the intercultural university of the state of México (UIEM.

    Directory of Open Access Journals (Sweden)

    Mindahi Crescencio Bastida Muñoz


    Full Text Available The problems in indigenous communities Otomi and Mazahuas in Toluca, and Ixtlahuaca-Atlacomulco valleys are various. In this region there is mainly cultural, ethnic and economic violence. It is due to lack of access to infrastructure, access to education and access to justice. Education is one of the best ways to reduce these problems.The presence of the Intercultural University and the Bachelor of Sustainable Development in the Mazahua region has begun to impact positively in some communities and civil society organizations. This has been through intercultural education model and the principles of Sustainable Development. This paper describes some experiences of the Division of Sustainable Development in some communities. At the end we argue on how sustainability is a path to peace building.

  14. Building beyond the Evaluation Of Environmental Education and Sustainable Development in African Schools and Communities: The Women Global Green Action Network (WGGAN) Africa Perspective (United States)

    Enie, Rosemary Olive Mbone


    This article describes the Community Health Education and School Sanitation (CHESS) Project, an initiative by the Women Global Green Action Network International to support community-based environmental projects in Africa. The CHESS Project uses women, children and youth to develop more sustainable health and sanitation systems in urban and rural…

  15. The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies (United States)

    Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce


    Many community-based sport and physical activity programs take a positive youth development approach when operating in underserved communities around the world (Forneris, Whitley, & Barker, 2013). However, one of the biggest challenges for these programs is sustainability (Lindsey, 2008). The purpose of this article is to present the 3…

  16. Social Ecology and Diabetes Self-Management among Pacific Islanders in Arkansas. (United States)

    McElfish, Pearl Anna; Moore, Ramey; Woodring, David; Purvis, Rachel S; Maskarinec, Gregory G; Bing, Williamina Ioanna; Hudson, Jonell; Kohler, Peter O; Goulden, Peter A


    Chronic diseases disproportionately affect ethnic and racial minorities. Pacific Islanders, including the Marshallese, experience some of the highest documented rates of type 2 diabetes. Northwest Arkansas is home to the largest population of Marshallese outside of the Republic of the Marshall Islands, and many migrants are employed by the local poultry industry. This migrant population continues to increase because of climate change, limited health care and educational infrastructure in the Marshall Islands, and the ongoing health effects of US nuclear testing. The US nuclear weapons testing program had extensive social, economic, and ecological consequences for the Marshallese and many of the health disparities they face are related to the nuclear fallout. Beginning in 2013, researchers using a community-based participatory (CBPR) approach began working with the local Marshallese community to address diabetes through the development and implementation of culturally appropriate diabetes self-management education in a family setting. Preliminary research captured numerous and significant environmental barriers that constrain self-management behaviors. At the request of our CBPR stakeholders, researchers have documented the ecological barriers faced by the Marshallese living in Arkansas through a series of qualitative research projects. Using the Social Ecological Model as a framework, this research provides an analysis of Marshallese health that expands the traditional diabetes self-management perspective. Participants identified barriers at the organizational, community, and policy levels that constrain their efforts to achieve diabetes self-management. We offer practice and policy recommendations to address barriers at the community, organizational, and policy level.

  17. Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative. (United States)

    Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.


    In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican…

  18. New Tools to Estimate Runoff, Soil Erosion, and Sustainability of Rangeland Plant Communities (United States)

    Rangelands are the largest land cover type in the world. Degradation from mismanagement, desertification, and drought impact more than 50% of rangelands across the globe. The USDA Agricultural Research Service has been evaluating sustainability of rangeland for over 40-years by conducted rangeland r...

  19. The Influences of Leaders and Organizational Cultures in Sustained Multi-Agency Community College Partnerships (United States)

    Vidotto, Julie


    Multi-agency partnerships can be a key element in sustaining growth and outreach in higher education, and the literature clearly indicates the increasing number and diversity of collaborative structures occurring on today's college campuses. However, partnership construction is a complex endeavor and attempts often fail for many reasons, including…

  20. Community Theories of Change: Linking Environmental Justice to Sustainability through Stakeholder Perceptions in Milwaukee (WI, USA

    Directory of Open Access Journals (Sweden)

    Kaitlyn Hornik


    Full Text Available Environmental justice and sustainability are compatible lenses, yet action toward equity is often missing from urban sustainability initiatives. This study aims to assess the cohesion of these frameworks in practice. To do this, we parse individuals’ theories of change, or how they identify and propose to resolve environmental injustices in the pursuit of sustainability. We posit that these theories of change are comprised of three main components: (1 perceived environmental benefits and burdens; (2 the causal pathways of environmental and social injustice; and (3 visions for positive change. Drawing from 35 stakeholder interviews in Milwaukee (WI, USA we examine individual and institutional perspectives on environmental and social change and their links to the production of injustice. Our findings reveal that participants do not distinguish between environmental and social injustices. Instead, both social and environmental factors are implicated in injustice. Furthermore, we identify two mental maps for how social and economic change reproduce injustice. These findings suggest the need to reorient how urban injustice is considered and make efforts to acknowledge how a diversity of operational theories of change could either be divisive or could bring environmental justice and sustainability initiatives together.

  1. Sustainability in Teaching, Research, and Community Practice: The FCS Department at California State University, Northridge (United States)

    Pontikis, Kyriakos; Martin, Allen; Cai, Yi; Kim, Jongeun; Cao, Wei; Giordano, Angie; Torabian-Riasati, Setareh


    The purpose of this article is to demonstrate how a large comprehensive family and consumer sciences unit has incorporated sustainability into its curriculum and research agenda. It summarizes how each area within the department (Interior Design, Apparel Design and Merchandising, Consumer Affairs, Family Studies, Nutrition, Dietetics, and Food…

  2. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.

    Directory of Open Access Journals (Sweden)

    Hannah L Parke

    Full Text Available There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients.Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services.We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings.From 12,400 titles we selected 13 systematic reviews (published 2003-2012 representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death. There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community.Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.

  3. Iron released from ilmenite mineral sustains a phytoplankton community in microcosms

    Digital Repository Service at National Institute of Oceanography (India)

    Fernandes, C.E.G.; Velip, D.; Mourya, B.S.; Shaikh, S.; Das, A.; LokaBharathi, P.A.

    Natural biotic communities from Kalbadevi Bay were monitored in microcosms (1-l glass flasks) to test the hypothesis that iron released from ilmenite through microbial action contributes to proliferation of phytoplankton. Microcosms containing...

  4. Biomass energy for the economic sustain ability of isolated communities in the Amazon region

    International Nuclear Information System (INIS)

    Lascio, Marco Alfredo di; Freitas, Marcos Aurelio V.; Marques, Ana Claudia S.


    This work evaluates the use of forestry biomass as energy source for dispersed communities in the Amazon region. The photovoltaic alternative is also presented, including the experience obtained with two demonstration photovoltaic installations in the state of Rondonia, Brazil

  5. Local governments and climate change: sustainable energy planning and implementation in small and medium sized communities

    National Research Council Canada - National Science Library

    Van Staden, Maryke; Musco, Francesco


    The focus of 'Local governments and climate change' is on how small and medium-sized communities in Europe are effectively responding to climate change, with a particular focus on different approaches...

  6. Sustaining Louisiana's Freshwater Aquifers - A Case Study Brining Community and Industry Together (United States)

    For wells in the Haynesville Shale, operators use ground water for fracking. Since it requires a lot of water, the Louisiana Office of Conservation pursued alternatives to satisfy the water needs of fracking, but avoiding water impacts for the community.

  7. Community Solar: An Opportunity to Enhance Sustainable Development on Landfills and Other Contaminated Sites (United States)

    This discussion paper describes the linkage between the need for solar access for some sites, the mechanism of community solar and the opportunities for using formerly contaminated lands, landfills and mine sites for renewable energy.

  8. Multi criteria analysis for sustainability assessments of electricity generation systems in a rural community in South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Amigun, B.; Mehlwana, M. [Council for Scientific and Industrial Research, Pretoria (South Africa). Sustainable Energy Futures, Natural Resources and the Environment; Musango, J.K. [Department of Energy (DoE), Pretoria (South Africa); Brent, A.C. [Stellenbosch Univ. (South Africa). Centre for Renewable and Sustainable Energy Studies


    One of the key challenges of the energy policy in South Africa is to ensure that rural areas have access to electricity. This is reflected in the key energy policy documents (the 1998 Energy White Paper and the 2002 Renewable Energy White Paper). Both these documents identified renewable energy resources as immediate alternatives to grid electricity in especially remote rural communities that are characterised by low population densities. Centralised energy generation and transmission is very costly and inefficient in these areas due to greater transmission and distribution losses. While the cost of electricity in South Africa is relatively cheaper, it is not accessible for many rural households. There are still over two million households in rural areas without access to electricity. This paper presents a multi-criteria decision analysis (MCDA) using the Analytical Hierarchy Process (AHP) technique to compare various electricity technologies (mainly renewables) in a specific rural community of South Africa using social, economic, environment and technical indicators. These technologies were than ranked against each indicator assuming that the high-level criteria have equal importance for sustainable development. It is demonstrated that energy from wind is the most sustainable, followed by photovoltaic, anaerobic digestion (biogas) and then gasification. A sensitivity analysis was also performed to verify the stability of the priority ranking. The outcome of this study will specifically assist energy planners and decision-makers to choose the best alternative from a range of technology alternatives in a milieu of conflicting and competing criteria. (orig.)

  9. Predictors of sustainability for community-managed handpumps in sub-Saharan Africa: evidence from Liberia, Sierra Leone, and Uganda. (United States)

    Foster, Tim


    Rural water supply sustainability has remained an enduring policy challenge in sub-Saharan Africa for decades. Drawing on the largest data set assembled on rural water points in sub-Saharan Africa to date, this paper employs logistic regression analyses to identify operational, technical, institutional, financial, and environmental predictors of functionality for over 25 000 community-managed handpumps in Liberia, Sierra Leone, and Uganda. Risk factors significantly associated with nonfunctionality across all three countries were (a) system age, (b) distance from district/county capital, and (c) absence of user fee collection. In at least one of the three countries, other variables found to have significant multivariable adjusted associations with functionality status included well type, handpump type, funding organization, implementing organization, spare parts proximity, availability of a handpump mechanic, regular servicing, regular water committee meetings, women in key water committee positions, rainfall season, and perceived water quality. While the findings reinforce views that a multifaceted range of conditions is critical for the sustainability of community-managed handpumps, they also demonstrate that these factors remain absent from a high proportion of cases. Governments and development partners must significantly strengthen postconstruction support for operation and maintenance systems, and greater efforts are needed to test and evaluate alternative models for managing handpump water supplies.

  10. Online self-management interventions for chronically ill patients: cognitive impairment and technology issues. (United States)

    Archer, Norm; Keshavjee, Karim; Demers, Catherine; Lee, Ryan


    As the fraction of the population with chronic diseases continues to grow, methods and/or technologies must be found to help the chronically ill to take more responsibility to self-manage their illnesses. Internet based and/or mobile support for disease self-management interventions have often proved effective, but patients with chronic illnesses may have co-occurring cognitive impairment, making it more difficult for them to cope with technologies. Many older patients are also not familiar with technologies or they may have cognitive disabilities or dementia that reduce their ability to self-manage their healthcare. On-line solutions to the needs of chronically ill patients must be investigated and acted upon with care in an integrated manner, since resources invested in these solutions will be lost if patients do not adopt and continue to use them successfully. To review the capabilities of online and mobile support for self-management of chronic illnesses, and the impacts that age and disease-related issues have on these interventions, including cognitive impairment and lack of access or familiarity with Internet or mobile technologies. This study includes a review of the co-occurrence of cognitive impairment with chronic diseases, and discusses how cognitive impairment, dyadic caregiver patient support, patient efficacy with technology, and smart home technologies can impact the effectiveness and sustainability of online support for disease self-management. Disease self-management interventions (SMIs) using online patient centered support can often enable patients to manage their own chronic illnesses. However, our findings show that cognitive impairment often co-occurs in patients with chronic disease. This, along with age-related increases in multiple chronic illnesses and lack of technology efficacy, can be obstacles to Internet and mobile support for chronic disease self-management. Patients with chronic diseases may have greater than expected difficulties

  11. Managing Epilepsy Well: Emerging e-Tools for epilepsy self-management. (United States)

    Shegog, Ross; Bamps, Yvan A; Patel, Archna; Kakacek, Jody; Escoffery, Cam; Johnson, Erica K; Ilozumba, Ukwuoma O


    The Managing Epilepsy Well (MEW) Network was established in 2007 by the Centers for Disease Control and Prevention Epilepsy Program to expand epilepsy self-management research. The network has employed collaborative research strategies to develop, test, and disseminate evidence-based, community-based, and e-Health interventions (e-Tools) for epilepsy self-management for people with epilepsy, caregivers, and health-care providers. Since its inception, MEW Network collaborators have conducted formative studies (n=7) investigating the potential of e-Health to support epilepsy self-management and intervention studies evaluating e-Tools (n=5). The MEW e-Tools (the MEW website, WebEase, UPLIFT, MINDSET, and PEARLS online training) and affiliated e-Tools (Texting 4 Control) are designed to complement self-management practices in each phase of the epilepsy care continuum. These tools exemplify a concerted research agenda, shared methodological principles and models for epilepsy self-management, and a communal knowledge base for implementing e-Health to improve quality of life for people with epilepsy. © 2013.

  12. Towards Self-Managed Executable Petri Nets

    DEFF Research Database (Denmark)

    Hansen, Klaus Marius; Zhang, Weishan; Ingstrup, Mads


    An issue in self-managed systems is that different abstractions and programming models are used on different architectural layers, leading to systems that are harder to build and understand. To alleviate this, we introduce a self-management approach which combines high-level Petri nets...... with the capability of distributed communication among nets. Organized in a three-layer goal management, change management, and component control architecture this allows for self-management in distributed systems. We validate the approach through the Flamenco/CPN middleware that allows for self-management of service......-oriented pervasive computing systems through the runtime interpretation of colored Petri nets. The current work focuses on the change management and component control layers....

  13. Ecotourism in Mount Maculot as assessed by the Host Community: Basis for Sustainable Development


    Romer Castillo Castillo; Phoebe Dian C. Dimaano; Ericka A. Macaspac; Norilyn A. Asilo; Jeedalyn C. Amaro


    This paper assesses the ecotourism in Mount Maculot, Philippines and outlines the directions for sustainable development. The study is descriptive in nature and uses a survey questionnaire for gathering data. A major result of the study is the general agreement of the age-, sex-, and education-disaggregated respondents on all items presented to them for assessment in relation to environmental, economic and socio-cultural aspects of ecotourism. Areas of immediate concern however, include the i...

  14. Tracking and unpacking rapid Arctic change: Indicators of community health and sustainability in northern Alaska and links to cryospheric change (United States)

    Eicken, H.; Sam, J. M.; Mueller-stoffels, M.; Lovecraft, A. L.; Fresco, N. L.


    Tracking and responding to rapid Arctic change benefits from time series of indicator variables that describe the state of the system and can inform anticipatory action. A key challenge is to identify and monitor sets of indicators that capture relevant variability, trends, and transitions in social-environmental systems. We present findings from participatory scenarios focused on community health and sustainability in northern Alaska. In a series of workshops in 2015 and 2016 (Kotzebue workshop photo shown below), over 50 experts, mostly local, identified determinants of community health and sustainability by 2040 in the Northwest Arctic and North Slope Boroughs, Alaska. Drawing on further research, an initial set of factors and uncertainties was refined and prioritized into a total of 20 key drivers, ranging from governance issues to socio-economic and environmental factors. The research team then developed sets of future projections that describe plausible outcomes by mid-century for each of these drivers. A plausibility and consistency analysis of all pairwise combinations of these projections (following Mueller-Stoffels and Eicken, In: North by 2020 - Perspectives on Alaska's Changing Social-Ecological Systems, University of Alaska Press, 2011) resulted in the identification of robust scenarios. The latter were further reviewed by workshop participants, and a set of indicator variables, including indicators of relevant cryospheric change, was identified to help track trajectories towards plausible future states. Publically accessible recorded data only exist for a subset of the more than 70 indicators, reaching back a few years to several decades. For several indicators, the sampling rate or time series length are insufficient for tracking of and response to change. A core set of variables has been identified that meets indicator requirements and can serve as a tool for Alaska Arctic communities in adapting to or mitigating rapid change affecting community

  15. Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care. (United States)

    Alzubaidi, H; Mc Namara, K; Browning, C


    The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. Two qualitative methods were used: face-to-face semi-structured individual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a diverse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change. © 2016 Diabetes UK.

  16. Tourism and environmental sustainability in the community of Barra Grande, Cajueiro da Praia, Piauí (PI

    Directory of Open Access Journals (Sweden)

    Anderson Fontenele Vieira


    Full Text Available The community of Barra Grande, tourist destination located in Cajueiro da Praia, Piauí (PI, was the object of investigation of this study. Tourism, in this region, increased creating structural, social and environmental change. The aim of the research was to analyze the environmental impacts of tourism in Barra Grande considering the Environmental Sustainability Indicators of BIGS (Brazilian Institute of Geography and Statistics. It was conducted a bibliographic and documentary survey about public politics for tourism and environment, besides the application of semi-structured interviews with eighteen hotels diagnosing three indicators: water supply, sewage disposal, and collection and disposal of solid waste which measure pressure parameters (impacts to the natural environment, qualified the state of that environment and the existence of response mechanisms to minimize the impacts. The scientific relevance consists in the analysis of sustainability through indicators based on Model PER (Pressure-State-Response, adopted by OECD (Organization for Economic Cooperation and Development, in order to conduct strategic actions to solve environmental problems. Regarding the preliminary results, it realizes that the policies have part of their normalizations not carried out in practice. Concerning the field collection in the hotels it was identified that they agree with two of evaluated qualitative parameters, proving that the destination needs to improve as sustainability. Finally, it is expected that data may contribute to tourism planning, as well as building elements to support discussions, new research approaches on the viability and adherence of sustainable tourism segments in Piauí context or in other regions of Brazil.

  17. Experiences and Challenges in Software Sustainability for a Large Scientific Community

    Directory of Open Access Journals (Sweden)

    Lynn Zentner


    Full Text Available The science gateway, funded by the National Science Foundation (NSF, serves a large scientific community dedicated to research and education in nanotechnology with community-contributed simulation codes as well as a vast repository of other materials such as recorded presentations, teaching materials, and workshops and courses. Nearly 330,000 users annually access over 4400 items of content on nanoHUB, including 343 simulation tools. Arguably the largest nanotechnology facility in the world, nanoHUB has led the way not only in providing open access to scientific code in the nanotechnology community, but also in lowering barriers to the use of that code, by providing a platform where developers are able to easily and quickly deploy code written in a variety of languages with user-friendly graphical user interfaces and where users can run the latest versions of codes transparently on the grid or other powerful resources without ever having to download or update code. Being a leader in open access code deployment provides nanoHUB with opportunities and challenges as it meets the current and future needs of its community. This paper discusses the experiences of nanoHUB in addressing and adapting to the changing landscape of scientific software in ways that best serve its community and meet the needs of the largest portion of its user base.

  18. Diabetes self-management education in South Auckland, New Zealand, 2007-2008. (United States)

    Silva, Martha; Clinton, Janet; Appleton, Sarah; Flanagan, Pat


    Self-management education programs seek to help patients realize that they are their own principal caregivers and that health care professionals are consultants who support them in this role. The aim of this study was to evaluate a diabetes self-management education program implemented as part of a district-wide approach in South Auckland, New Zealand, which has some of the highest prevalence rates for diabetes and is one of the most ethnically diverse and deprived regions of New Zealand. Self-management attitudes and behaviors were monitored with the use of questionnaires before and after program implementation. Clinical outcomes such as hemoglobin A1c, body mass index, and blood pressure were also tracked before the program began and 3 months after the program ended. Participant focus groups and facilitator interviews were conducted to explore perceptions of the program. Participants showed improvement in attitudes toward their own ability to manage their diabetes; in diet, physical activity, and foot care; and in hemoglobin A1c levels 3 months after the end of participation. Participants also reduced their sense of isolation when dealing with their diabetes. However, catering to the needs of a multiethnic community is extremely resource-intensive because of the need to provide adequate language and cultural interpretation. Self-management education can work in multiethnic, high-needs communities in New Zealand. Programs must ensure they enable the appropriate mechanisms and have appropriate resources to support the community's needs.

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

    Directory of Open Access Journals (Sweden)

    William Munoz Marticorena


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

  20. Sustainable Tourism Experiences in Ecuador; Implementing knowledge’ Social Construction process in a rural community

    Directory of Open Access Journals (Sweden)

    Johanna Rodriguez


    Full Text Available This work aims to socialize a successful experience for Social Knowledge Construction in the field of Environmental Literacy. This work takes place at the rural Afro-Ecuadorian community “San Miguel”, located in Ecuador, South America. The participants are 35 women and men, who installed a communitarian tourism project with the support of national and international rural development programs in 2005. However, any study had been executed in the location to determine the impacts on the natural and cultural heritage, since the touristic project began; in consequence, the community has not information to take decisions about their entrepreneurship. This work applied the ethnographic social research method and the techniques of semi-structured interview and community surveys to collect data. It was applied the Model of Echavarren for Assessing the Tourism Impacts on Natural and Cultural Resources. The results show that the economical contribution from the touristic project is still low but, necessary in the community. There are no relevant impacts on the natural and cultural heritage. However, an Environmental Literacy Plan based on Mendonça and the Social Knowledge Construction approach is introduced by the authors to strengthen local people environmental behavior. This plan can be adapted and applied in other communities. It is concluded that environmental literacy plans can be more efficient when are applied as transversal topics during formal and informal communitarian activities. This community members respect their agreement for keeping their natural and cultural resources for the enjoying of the future generations; even when, this represents a limited economic retribution.

  1. Community rating and sustainable individual health insurance markets in New Jersey. (United States)

    Monheit, Alan C; Cantor, Joel C; Koller, Margaret; Fox, Kimberley S


    The New Jersey Individual Health Coverage Program (IHCP) was implemented in 1993; key provisions included pure community rating and guaranteed issue/renewal of coverage. Despite positive early evaluations, the IHCP appears to be heading for collapse. Using unique administrative and survey data, we examined trends in IHCP enrollment and premiums. We found the stability of the IHCP to be fragile in light of improving opportunities for job-related health insurance. We also found that it is retaining high-risk enrollees. Institutional realities and the difficulty of identifying a control group preclude attributing causality to the plan's pure community rating and open enrollment provisions.

  2. Shortcuts to sustainable Nordic communities. Experiences from Nordic Climate Festival (at) Aalto

    Energy Technology Data Exchange (ETDEWEB)

    Haanpaa, S. (ed.)


    Nordic Climate Festival (at) Aalto gathered some 90 Nordic Master's and PhD students to Helsinki and Espoo in late August 2011, to search for shortcuts to sustainable Nordic societies. The students worked in 7 workshop tracks, covering all key fields of sustainable societies, under the guidance of researchers from Aalto University. The workshop turned out to be a success with enthusiastic contribution from dedicated students. The real value of the workshop lies not only in the results however, but also in new ways of thinking about sustainability - both for the students and Aalto staff. Most of all, the event helped to build individual connections and networks people engaged in the topic. In the end, the festival was much more than just a Nordic event; the participants represented over 30 countries in total. This can only be seen as a richness in ways of looking at climate change related challenges and especially solutions that, although always being operationalized on a local level and in a local context, in the end are common challenges to all countries in one form or another. The core challenge in dealing with climate change, especially on mitigation, is time. As the level of global greenhouse gas emissions keeps on growing, we desperately need new policies and practices to turn this trend around. At the same time inertia both in natural phenomena and in changing our lifestyles means that global temperatures based on current emissions only will keep on rising for decades to come. This forces us to think of ways to adapt to unavoidable consequences of climate change and adaptation to them, despite the success of mitigation policies. Both aspects of managing climate change require forward oriented thinking already today, so that we can avoid being locked into unsustainable development pathways at the very least - a thing one might argue in many cases is already slowing mitigation efforts down. Therefore the key question the workshop set to study was: can we

  3. Shortcuts to sustainable Nordic communities. Experiences from Nordic Climate Festival (at) Aalto

    Energy Technology Data Exchange (ETDEWEB)

    Haanpaa, S [ed.


    Nordic Climate Festival (at) Aalto gathered some 90 Nordic Master's and PhD students to Helsinki and Espoo in late August 2011, to search for shortcuts to sustainable Nordic societies. The students worked in 7 workshop tracks, covering all key fields of sustainable societies, under the guidance of researchers from Aalto University. The workshop turned out to be a success with enthusiastic contribution from dedicated students. The real value of the workshop lies not only in the results however, but also in new ways of thinking about sustainability - both for the students and Aalto staff. Most of all, the event helped to build individual connections and networks people engaged in the topic. In the end, the festival was much more than just a Nordic event; the participants represented over 30 countries in total. This can only be seen as a richness in ways of looking at climate change related challenges and especially solutions that, although always being operationalized on a local level and in a local context, in the end are common challenges to all countries in one form or another. The core challenge in dealing with climate change, especially on mitigation, is time. As the level of global greenhouse gas emissions keeps on growing, we desperately need new policies and practices to turn this trend around. At the same time inertia both in natural phenomena and in changing our lifestyles means that global temperatures based on current emissions only will keep on rising for decades to come. This forces us to think of ways to adapt to unavoidable consequences of climate change and adaptation to them, despite the success of mitigation policies. Both aspects of managing climate change require forward oriented thinking already today, so that we can avoid being locked into unsustainable development pathways at the very least - a thing one might argue in many cases is already slowing mitigation efforts down. Therefore the key question the workshop set to study was: can we find

  4. Gated communities and urban sustainability: taking a closer look at the future

    CSIR Research Space (South Africa)

    Landman, K


    Full Text Available residents and to be detrimental to long-term urban sustainability and political stability. It could just be that the very measure that is implemented to address crime and instability after a while becomes a major source of conflict20. • Urban... impact on the quality of life in an area and on building a liveable and vibrant city. It could also lead to the formation of political pressure groups and attempts to pressurise the local government into making certain decisions. It could not only...

  5. Building Sustainable Futures: Emerging Understandings of the Significant Contribution of the Professional Learning Community (United States)

    Andrews, Dorothy; Lewis, Marian


    This article draws on the experiences of a range of Australian schools engaging with a teacher-centred process of whole-school renewal known as IDEAS (Innovative Designs for Enhancing Achievement in Schools). IDEAS enhances the professional capacity of teachers to improve school outcomes such as student learning, relationships with the community,…

  6. Growing Our Own: A Sustainable Approach to Teacher Education at Turtle Mountain Community College (United States)

    Lamb, Carmelita


    Through its teacher education program, Turtle Mountain Community College (TMCC) is meeting the Anishinaabe of North Dakota's educational needs, strengthening tribal sovereignty and self-determination, and positively affecting people's lives. Pivotal to the success of the teacher education program are strongly committed faculty, supportive staff,…

  7. New Interoperable Tools to Facilitate Decision-Making to Support Community Sustainability (United States)

    Communities, regional planning authorities, regulatory agencies, and other decision-making bodies do not currently have adequate access to spatially explicit information crucial to making decisions that allow them to consider a full accounting of the costs, benefits, and trade-of...

  8. Space technology, sustainable development and community applications: Internet as a facilitator (United States)

    Peter, Nicolas; Afrin, Nadia; Goh, Gérardine; Chester, Ed


    Among other approaches, space technologies are currently being deployed for disaster management, environmental monitoring, urban planning, health applications, communications, etc. Although space-based applications have tremendous potential for socioeconomic development, they are primarily technology driven and the requirements from the end-users (i.e. the development community) are rarely taken into consideration during the initial development stages. This communication gap between the "space" and "development" communities can be bridged with the help of the web-based knowledge sharing portal focused on space applications for development. This online community uses the development gateway foundation's sophisticated content management system. It is modeled after the development gateway's knowledge sharing portals ( and draws from their expertise in knowledge management, partnership building and marketing. These types of portal are known to facilitate broad-based partnerships across sectors, regions and the various stakeholders but also to facilitate North-South and South-South cooperation. This paper describes the initiative "Space for Development" ( started in 2004 which aims to demonstrate how such a web-based portal can be structured to facilitate knowledge sharing in order to bridge the gap between the "space" and "development" communities in an innovative and global manner.

  9. Sustaining Partnerships between Community Colleges and the Extended Healthcare Industry in Massachusetts (United States)

    Correia, Tamika


    "Nationwide employers invest nearly $30 billion annually in employee training. Community colleges can provide training more cost effectively than many other public and private organizations, because most already have the capacity to provide technical training or can develop it at a lower cost" (Drury, 2001, p. 2). This study investigated…

  10. Food governance transformation : aligning food security with sustainable farming practices in developing communities

    NARCIS (Netherlands)

    Otsuki, K.


    Conventional approaches used to improve farming practices and access to food in developing communities are underpinned by policy, technology, and the science of modernization. The focus has been on securing a sufficient quantity of food derived from extensive monocultures. This quantity focus is

  11. Community Wildfire Protection Planning: The Importance of Framing, Scale, and Building Sustainable Capacity (United States)

    Daniel R. Williams; Pamela J. Jakes; Sam Burns; Antony S. Cheng; Kristen C. Nelson; Victoria Sturtevant; Rachel F. Brummel; Emily Staychock; Stephanie G. Souter


    Community wildfire protection planning has become an important tool for engaging wildland-urban interface residents and other stakeholders in efforts to address their mutual concerns about wildland fire management, prioritize hazardous fuel reduction projects, and improve forest health. Drawing from 13 case studies from across the United States, this article describes...

  12. Collaborating while competing? The sustainability of community-based integrated care initiatives through a health partnership

    NARCIS (Netherlands)

    Plochg, Thomas; Delnoij, Diana M. J.; Hoogedoorn, Nelleke P. C.; Klazinga, Niek S.


    BACKGROUND: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health

  13. Collaborating while competing? The sustainability of community-based integrated care initiatives through a health partnership

    NARCIS (Netherlands)

    Plochg, T.; Delnoij, D.M.J.; Hoogedoorn, N.P.C.; Klazinga, N.S.


    Background: To improve health-care delivery, care providers must base their services on community health needs and create a seamless continuum of care in which these needs can be met. Though, it is not obvious that providers apply this vision. Experiments with regulated competition in the health

  14. Community Energy Companies in the UK: A Potential Model for Sustainable Development in “Local” Energy?

    Directory of Open Access Journals (Sweden)

    Séverine Saintier


    Full Text Available The rise of renewable energy sources (RES comes with a shift in attention from government and market energy governance to local community initiatives and self-regulation. Although this shift is generally welcome at domestic and EU level, the regulatory dimension, at both levels, is nevertheless not adapted to this multi-actor market since prosumers are not empowered and energy justice is far from achieved. The rise, in the UK, of Community Interest Companies (consumers and local actors’ collectives in the energy sector provides an interesting perspective as it allows a whole system’s view. Research was conducted with six energy community organizations in the South West of England in order to evaluate their role and identity and assess whether this exemplar of “the rise of a social sphere in regulation” could be used as a model for a more sustainable social approach to the governance of economic relations. Findings illustrate that such organizations undoubtedly play an important role in the renewable energy sector and they also help to alleviate some aspects of “energy injustice”. Yet, the failure to recognize, in terms of energy policy, at domestic and EU level, the importance of such actors undermines their role. The need to embed and support such organizations in policy is necessary if one is to succeed to put justice at the core of the changing energy landscape.

  15. How NASA is building and sustaining a community of scientist-communicators through virtual technology, graphic facilitation and other community-building tools (United States)

    DeWitt, S.; Bovaird, E.; Stewart, N.; Reaves, J.; Tenenbaum, L. F.; Betz, L.; Kuchner, M. J.; Dodson, K. E.; Miller, A.


    In 2013 NASA launched its first agency-wide effort to cultivate and support scientist-communicators. The multiple motivations behind this effort are complex and overlapping, and include a desire to connect the agency's workforce to its mission and to each other in the post-Space Shuttle era; a shift in how the agency and the world communicates about science; the current public perception of science and of NASA, and a desire to share the stories of the real people behind the agency's technical work. Leaders in the NASA science, communications and public outreach communities partnered with the agency's training and leadership development organization to: identify and fully characterize the need for training and development in science communication, experiment with various learning models, and invite early-adopter scientists to evaluate these models for future agency investment. Using virtual collaboration technology, graphic facilitation, and leadership development methods, we set out to create an environment where scientist-communicators can emerge and excel. First, we asked scientists from across the agency to identify their motivations, opportunities, barriers and areas of interest in science communication. Scientists identified a need to go beyond traditional media training, a need for continuous practice and peer feedback, and a need for agency incentives and sustained support for this kind of work. This community-driven approach also uncovered a serious need for communication support in the wake of diminishing resources for travel and conference attendance. As a first step, we offered a series of virtual learning events - highly collaborative working sessions for scientists to practice their communication technique, develop and apply new skills to real-world situations, and gain valuable feedback from external subject matter experts and fellow scientists from across the agency in a supportive environment. Scientists from ten NASA centers and a broad range of

  16. Present status and approaches for the sustainable development of community based fish culture in seasonal floodplains of Bangladesh. (United States)

    Rahman, M F; Jalal, K C A; Jahan, Nasrin; Kamaruzzaman, B Y; Ara, R; Arshad, A


    Coordination among the different stakeholders at policy planning, implementation and target beneficiary level, particularly among the agencies responsible for development and management of water resources, agriculture and fisheries, is essential for overall sustainable development. Stocking of larger fingerlings at suitable stocking densities of endemic (rohu, catla, mrigal) and exotic (silver carp, bighead carp, common carp/mirror carp) species should be stocked at varying proportion. Floodplain fish production depends only on the natural fertility of the water bodies. Technological interventions should include the installation of low cost bamboo fencing at water inlet and outlet points and setting of ring culverts for maintaining suitable levels of water for fish culture without hampering the production of rice and other crops in the intervention areas, selective stocking with native and exotic carps, restricted fishing for certain period of time and guarding. It is expected to exert positive influences in enhancing the standing crop and biodiversity of non-stocked species of fishes in the intervention seasonal floodplain. Entry of fish larvae, hatchlings and young fry of wild non-stocked fishes into the seasonal floodplains because of large fence spacing (approximately 1.0 cm), could restrict fishing for certain period, undisturbed habitat and guarding could contribute to higher productivity and enhancement of fish biodiversity in the seasonal floodplains. Proper motivation and effective cooperation of the beneficiaries are extremely important to culture fish in the seasonal floodplains under community based management system. Institutional support and constant vigilance from the Department of Fisheries (DoF) and local administrations are indispensable to ensure the sustainability of fish culture initiatives in the seasonal floodplains. Active participation and involvement of the local community people in all stages of fish culture operation beginning from

  17. Sustainable Benefits of a Community Hospital-Based Paediatric Asthma Clinic. (United States)

    Kuzik, Brian A; Chen, Chee P; Hansen, Miriam J; Montgomery, Paula L


    In 2011, we reported that our paediatric asthma clinic (PAC) appeared to significantly reduce the burden of paediatric asthma in our community. Supported by these results, the PAC underwent a gradual threefold expansion while maintaining the same model of care. We now report on the outcome of that expansion and demonstrate that our PAC continues to significantly reduce the burden of paediatric asthma in our community. As previously, newly enrolled PAC patients continue to show a 12-month reduction in asthma-related emergency department (ED) visits and admissions exceeding 60% and 80%, respectively. This consistent short-term benefit, coupled with clinic expansion, has contributed to a significant improvement in our rate of paediatric asthma-related ED visits or hospitalizations when compared to other Ontario hospitals.

  18. (Un)Sustainable Community Projects: An Urban Ethnography in a Barrio in Las Vegas


    Castrejón, J. Adrian


    This essay and the accompanying study are part of a broader project, Southern Nevada Strong (SNS), which seeks to improve housing, safety, transportation, and employment opportunities in areas of high need in the Las Vegas, Nevada metropolitan area. The study examined the living conditions for Chicanx/Latinx residents in Barrio 28th Street, employing urban ethnographic methods as part of the community-input phase of SNS. Although barrios are cultural and historical places of solidar...

  19. Challenges for Sustainable Communities in the Solomon Islands: Food Security in Honiara and Livelihoods on Savo Island

    Directory of Open Access Journals (Sweden)

    Nichole Georgeou


    Full Text Available This article highlights the challenges of community sustainability in the emerging market economy of Solomon Islands as it grows increasingly reliant on imported foodstuffs. It examines the ways in which Solomon Islanders from neighbouring Savo Island engage with HCM and the opportunities it brings. Using Renzaho and Mellor’s (2010 conceptual framework for analysis of food security assessment we explore the symbiotic relationship that provides food security for those living in and around Honiara city, and income for the mostly subsistence farmers who supply Honiara’s growing population with fresh agricultural produce. Data from five focus groups from three villages on Savo Island reveals the critical importance of income from market sales at the HCM. The article demonstrates the mix of logistical and environmental challenges that confront people when trying to earn money through farming and sales of surplus food.

  20. The Jurisprudence and Legal Review of the Effect of Promise Fulfillment in Sustainable Development of Islamic Community with Comparative Study

    Directory of Open Access Journals (Sweden)

    Nasser Hasan Delgoshamehr


    Full Text Available One of the problems in different countries including Iran is contracts breach and termination of securities contrary to the ethics. If this process is not resolved via trust and negotiation, two parties refer to legal courts and this increases the legal cases and costly operation, legal procedure, different social problems, property loss that are sold by paltry price in the bids and this is not compensated sometimes. This study evaluates promise fulfillment from jurisprudence and legal aspects and its effect is explained in the sustainable development of Islamic community. Also, promise fulfillment shows high level of human character and ignoring this element leads to loss and this is evaluated with a comparative evaluation in this study.

  1. Community-Based Rural Tourism in Inter-Organizational Collaboration: How Does It Work Sustainably? Lessons Learned from Nglanggeran Tourism Village, Gunungkidul Regency, Yogyakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Asnawi Manaf


    Full Text Available In recent years, socio-economic disparities, especially between rural and urban areas (Gini index up to 0.4 have attracted significant concern from the Government of Indonesia, which developed a community-based rural tourism program as one of the attempts to overcome this problem. Though the program seems quite promising, the implementation was challenging, especially regarding sustainability. Therefore, successful and sustainable practical examples are needed. This paper analyzes the results of a case study from the experiences of community-based tourism implementation in Nglanggeran Tourism Village, Gunungkidul Regency, Yogyakarta, Indonesia, which was considered as successful and sustainable. The main focus of this research is on how the collaboration and involvement of the related inter-organizational stakeholders, initiated by the local community, particularly the youth, has contributed to the program sustainability. Data and information for this study were obtained through in-depth interviews, observation, and documents review. This study found that the local community has a major role in implementing the program, among those various entities of stakeholders. Hence, the paper states this is the key to the success and sustainability of the program.

  2. Rebuilding northern foodsheds, sustainable food systems, community well-being, and food security. (United States)

    Gerlach, S Craig; Loring, Philip A


    Multiple climatic, environmental and socio-economic pressures have accumulated to the point where they interfere with the ability of remote rural Alaska Native communities to achieve food security with locally harvestable food resources. The harvest of wild foods has been the historical norm, but most Alaska Native villages are transitioning to a cash economy, with increasing reliance on industrially produced, store-bought foods, and with less reliable access to and reliance on wild, country foods. While commercially available market foods provide one measure of food security, the availability and quality of market foods are subject to the vagaries and vulnerabilities of the global food system; access is dependent on one's ability to pay, is limited to what is available on the shelves of small rural stores, and, store-bought foods do not fulfill the important roles that traditional country foods play in rural communities and cultures. Country food access is also constrained by rising prices of fuel and equipment, a federal and state regulatory framework that sometimes hinders rather than helps rural subsistence users who need to access traditional food resources, a regulatory framework that is often not responsive to changes in climate, weather and seasonality, and a shifting knowledge base in younger generations about how to effectively harvest, process and store wild foods. The general objective is to provide a framework for understanding the social, cultural, ecological and political dimensions of rural Alaska Native food security, and to provide information on the current trends in rural Alaska Native food systems. This research is based on our long-term ethnographic, subsistence and food systems work in coastal and interior Alaska. This includes research about the land mammal harvest, the Yukon River and coastal fisheries, community and village gardens, small livestock production and red meat systems that are scaled appropriately to village size and capacity

  3. Rebuilding northern foodsheds, sustainable food systems, community well-being, and food security

    Directory of Open Access Journals (Sweden)

    S. Craig Gerlach


    Full Text Available Background . Multiple climatic, environmental and socio-economic pressures have accumulated to the point where they interfere with the ability of remote rural Alaska Native communities to achieve food security with locally harvestable food resources. The harvest of wild foods has been the historical norm, but most Alaska Native villages are transitioning to a cash economy, with increasing reliance on industrially produced, store-bought foods, and with less reliable access to and reliance on wild, country foods. While commercially available market foods provide one measure of food security, the availability and quality of market foods are subject to the vagaries and vulnerabilities of the global food system; access is dependent on one's ability to pay, is limited to what is available on the shelves of small rural stores, and, store-bought foods do not fulfill the important roles that traditional country foods play in rural communities and cultures. Country food access is also constrained by rising prices of fuel and equipment, a federal and state regulatory framework that sometimes hinders rather than helps rural subsistence users who need to access traditional food resources, a regulatory framework that is often not responsive to changes in climate, weather and seasonality, and a shifting knowledge base in younger generations about how to effectively harvest, process and store wild foods. Objective . The general objective is to provide a framework for understanding the social, cultural, ecological and political dimensions of rural Alaska Native food security, and to provide information on the current trends in rural Alaska Native food systems. Design . This research is based on our long-term ethnographic, subsistence and food systems work in coastal and interior Alaska. This includes research about the land mammal harvest, the Yukon River and coastal fisheries, community and village gardens, small livestock production and red meat systems that

  4. Sustainability of current agriculture practices, community perception, and implications for ecosystem health: an Indian study. (United States)

    Sarkar, Atanu; Patil, Shantagouda; Hugar, Lingappa B; vanLoon, Gary


    In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.

  5. Building a community of practice for sustainability: strengthening learning and collective action of Canadian biosphere reserves through a national partnership. (United States)

    Reed, Maureen G; Godmaire, Hélène; Abernethy, Paivi; Guertin, Marc-André


    Deliberation, dialogue and systematic learning are now considered attributes of good practice for organizations seeking to advance sustainability. Yet we do not know whether organizations that span spatial scales and governance responsibilities can establish effective communities of practice to facilitate learning and action. The purpose of this paper is to generate a framework that specifies actions and processes of a community of practice designed to instill collective learning and action strategies across a multi-level, multi-partner network. The framework is then used to describe and analyze a partnership among practitioners of Canada's 16 UNESCO biosphere reserves, and additional researchers and government representatives from across Canada. The framework is a cycle of seven action steps, beginning and ending with reflecting on and evaluating present practice. It is supported by seven characteristics of collaborative environmental management that are used to gauge the success of the partnership. Our results show that the partnership successfully built trust, established shared norms and common interest, created incentives to participate, generated value in information sharing and willingness to engage, demonstrated effective flow of information, and provided leadership and facilitation. Key to success was the presence of a multi-lingual facilitator who could bridge cultural differences across regions and academia-practitioner expectations. The project succeeded in establishing common goals, setting mutual expectations and building relations of trust and respect, and co-creating knowledge. It is too soon to determine whether changes in practices that support sustainability will be maintained over the long term and without the help of an outside facilitator. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Ranking the criteria for sustainability of community-based rural homestay programmes from the perspective of the operators (United States)

    Ramli, Rohaini; Kasim, Maznah Mat; Ramli, Razamin; Kayat, Kalsom; Razak, Rafidah Abd


    Homestay is one of the government's products that promote the cultural tourism of country around the world. Homestay in Malaysia is not only thriving, but also its operation is moving gradually toward development of economic growth. Many homestays have been built throughout the country and this will give tourists an opportunity to enjoy the different and interesting environment in Malaysia. However, most of them receive less support from tourists and only certain numbers of homestays have operated consistently. This paper examines eleven sustainability criteria for homestay programme in Malaysia covering environmental, economic and sociocultural dimensions. The required data were collected through a survey of 246 homestay operators using a structured questionnaire. Data obtained was analyzed by utilizing percentage and arithmetic average. The findings revealed that the three most important criteria for homestay to remain sustained in this business area are ability and capacity, leadership and conservation of community resources. In order to improve the business performance of homestays in this country, homestay operators should focus on improving their ability and capacity and focus on enhancing their leadership skills.

  7. Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data. (United States)

    Mamykina, Lena; Heitkemper, Elizabeth M; Smaldone, Arlene M; Kukafka, Rita; Cole-Lewis, Heather J; Davidson, Patricia G; Mynatt, Elizabeth D; Cassells, Andrea; Tobin, Jonathan N; Hripcsak, George


    serve as a driving engine for personal discovery that may lead to sustainable behavior changes. Enabling personal discovery is a promising new approach to enhancing chronic disease self-management with informatics interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. The local communities and its relation with the sustainable use of forest resources in Argentina

    International Nuclear Information System (INIS)

    Minaverry, Clara Maria


    The indigenous communities (mainly the tobas), inhabiting the Gran Chaco area, northern Argentina, keep valuable cultural, social and environmental traditions that must be protected. In this paper we analyze the present status of national and international law and case law, which could impact in the mentioned area. The two main items to be considered here are the high level of deforestation and the recent enactment of the national law for the protection of native forests, which means a really important improvement in the region.

  9. Renewables and CHP with District Energy in Support of Sustainable Communities

    Energy Technology Data Exchange (ETDEWEB)

    Snoek, Chris


    This paper addresses the powerful idea of connecting many energy users to environmentally optimum energy sources through integrated community energy systems. Such systems require piping networks for distributing thermal energy, i.e., district heating and cooling (DHC) systems. The possibilities and advantages of the application of integrated energy concepts are discussed, including the economic and environmental benefits of integrating localized electrical generating systems (CHP), transportation systems, industrial processes and other thermal energy requirements. Examples of a number of operating systems are provided. Some of the R and D carried out by the IEA Implementing Agreement on District Heating and Cooling is also described.

  10. Self-management strategies in overweight and obese Canadians with arthritis. (United States)

    Bernatsky, S; Rusu, C; O'Donnell, S; Mackay, C; Hawker, G; Canizares, M; Badley, E


    To estimate the prevalence of overweight and obese Canadians with arthritis and to describe their use of arthritis self-management strategies, as well as explore the factors associated with not engaging in any self-management strategies. Respondents to the 2009 Survey on Living with Chronic Diseases in Canada, a nationally representative sample of 4,565 Canadians age ≥20 years reporting health professional-diagnosed arthritis (including more than 100 rheumatic diseases and conditions), were asked about the impact of their arthritis and how it was managed. Among the overweight (body mass index [BMI] 25-29.9 kg/m(2)) and obese (BMI ≥30 kg/m(2)) individuals with arthritis (n = 2,869), the use of arthritis self-management strategies (i.e., exercise, weight control/loss, classes, and community-based programs) were analyzed. Log binomial regression analyses were used to examine factors associated with engaging in none versus any (≥1) of the 4 strategies. More than one-quarter (27.4%) of Canadians with arthritis were obese and an additional 39.9% were overweight. The overweight and obese individuals with arthritis were mostly female (59.5%), age ≥45 years (89.7%), and reported postsecondary education (69.0%). While most reported engagement in at least 1 self-management strategy (84.9%), less than half (45.6%) engaged in both weight control/loss and exercise. Factors independently associated with not engaging in any self-management strategies included lower education, not taking medications for arthritis, and no clinical recommendations from a health professional. Fewer than half of the overweight and obese Canadians with arthritis engaged in both weight control/loss and exercise. The provision of targeted clinical recommendations (particularly low in individuals that did not engage in any self-management strategies) may help to facilitate participation. Copyright © 2012 by the American College of Rheumatology.

  11. Self-management interventions for adults with chronic kidney disease: a scoping review. (United States)

    Donald, Maoliosa; Kahlon, Bhavneet Kaur; Beanlands, Heather; Straus, Sharon; Ronksley, Paul; Herrington, Gwen; Tong, Allison; Grill, Allan; Waldvogel, Blair; Large, Chantel A; Large, Claire L; Harwood, Lori; Novak, Marta; James, Matthew T; Elliott, Meghan; Fernandez, Nicolas; Brimble, Scott; Samuel, Susan; Hemmelgarn, Brenda R


    To systematically identify and describe self-management interventions for adult patients with chronic kidney disease (CKD). Community-based. Adults with CKD stages 1-5 (not requiring kidney replacement therapy). Self-management strategies for adults with CKD. Using a scoping review, electronic databases and grey literature were searched in October 2016 to identify self-management interventions for adults with CKD stages 1-5 (not requiring kidney replacement therapy). Randomised controlled trials (RCTs), non-RCTs, qualitative and mixed method studies were included and study selection and data extraction were independently performed by two reviewers. Outcomes included behaviours, cognitions, physiological measures, symptoms, health status and healthcare. Fifty studies (19 RCTs, 7 quasi-experimental, 5 observational, 13 pre-post intervention, 1 mixed method and 5 qualitative) reporting 45 interventions were included. The most common intervention topic was diet/nutrition and interventions were regularly delivered face to face. Interventions were administered by a variety of providers, with nursing professionals the most common health professional group. Cognitions (ie, changes in general CKD knowledge, perceived self-management and motivation) were the most frequently reported outcome domain that showed improvement. Less than 1% of the interventions were co-developed with patients and 20% were based on a theory or framework. There was a wide range of self-management interventions with considerable variability in outcomes for adults with CKD. Major gaps in the literature include lack of patient engagement in the design of the interventions, with the majority of interventions not applying a behavioural change theory to inform their development. This work highlights the need to involve patients to co-developed and evaluate a self-management intervention based on sound theories and clinical evidence. © Article author(s) (or their employer(s) unless otherwise stated in the

  12. Improvement characteristics shown in holistic regeneration of Ballymun toward sustainable community

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeunsook; Lim, Soohyun; Kim, Gunhyoung [Department of Housing and Interior Design, Yonsei University, Seoul (Korea)


    Substantial numbers of urban and residential environments constructed in the 20th century are experiencing degeneration and the importance of challenging to revitalize community holistically is getting more seriously recognized. There, however, has been limitation in grasping the holistic regeneration information as urban regeneration usually goes through a long-term and complicated procedure. Yet, the urban and housing regeneration's direction is required to be holistic in the 21st Century. Any precedent case that had tried the holistic regeneration needs to be checked thoroughly and thereby the result needs to be applied to the future attempts as a reference and knowledge base. The purpose of this study was to delineate improvement characteristics that appeared during the course of holistic regeneration in Ballymun of Ireland. This research is an archival research in nature which also used content analysis technique since it deals with reports and newsletters as archival records that were accumulated on a regular base throughout the whole process. The leading projects continued over ten years of improvement were scrutinized in the perspective of physical, social, economic, cultural, and environmental dimensions of regeneration. The main results were, first, a series of improvement activities and projects to regenerate each of five dimensions were delineated for comprehensive understanding. Second, connected patterns for synergistic improvement were identified and patterns were described to show the detailed contents as examples. This study would provide communities that face holistic regeneration, an insight, planning skills, creative and realistic ideas for implementation, thereby empowers planning capability toward holistic regeneration. (author)

  13. Defining thresholds of sustainable impact on benthic communities in relation to fishing disturbance. (United States)

    Lambert, G I; Murray, L G; Hiddink, J G; Hinz, H; Lincoln, H; Hold, N; Cambiè, G; Kaiser, M J


    While the direct physical impact on seabed biota is well understood, no studies have defined thresholds to inform an ecosystem-based approach to managing fishing impacts. We addressed this knowledge gap using a large-scale experiment that created a controlled gradient of fishing intensity and assessed the immediate impacts and short-term recovery. We observed a mosaic of taxon-specific responses at various thresholds. The lowest threshold of significant lasting impact occurred between 1 and 3 times fished and elicited a decrease in abundance of 39 to 70% for some sessile epifaunal organisms (cnidarians, bryozoans). This contrasted with significant increases in abundance and/or biomass of scavenging species (epifaunal echinoderms, infaunal crustaceans) by two to four-fold in areas fished twice and more. In spite of these significant specific responses, the benthic community structure, biomass and abundance at the population level appeared resilient to fishing. Overall, natural temporal variation in community metrics exceeded the effects of fishing in this highly dynamic study site, suggesting that an acute level of disturbance (fished over six times) would match the level of natural variation. We discuss the implications of our findings for natural resources management with respect to context-specific human disturbance and provide guidance for best fishing practices.

  14. Appropriate Model for Zoning Local Fish Conservation in front of Buddhist Temple on the Bank of the Chi River by Sustainable Community Participation


    Somchob Poo-Inna; Song-Koon Jantakajon; Terdthai Pantachai


    Problem statement: The fresh water fish in The Chi River was a major source of food of people living in this area. The objectives of this research were: (1) to study the historical background, current situation and problems of local fish conservation in front of The Chi River by community participation and (2) to find the opriate model for zoning the local fish conservation on the bank of The Chi River by sustainable community participation. Approach: The research area in Esan Reg...

  15. Proceedings of the 4. annual international greening rooftops for sustainable communities conference, awards and trade show

    International Nuclear Information System (INIS)


    Green roof technologies represent opportunities for significant social, economic and environmental benefits, particularly in urban areas. This conference, awards and trade show provided a forum to discuss the integration of nature with architecture and demonstrated the possibilities of applying advanced green roof technology to residential, institutional, industrial and commercial buildings. Sustainable landscaping principles were reviewed along with methods and techniques of urban ecology. Green roofs have proven to filter polluted air, reduce energy demands, and assist in stormwater management. The additional benefits of green roof technology in urban settings include moderation of the urban heat island effect, creation of green spaces, and preservation of habitat and biodiversity. It was noted that the widespread adoption of green roof technology in North America lags behind Europe due to a lack of effective policy instruments and standards. The conference was divided into the following 3 main sessions: (1) policy and program development, (2) case studies and design, and (3) research on technical performance benefits. The conference featured 40 presentations, of which 36 have been catalogued separately for inclusion in this database. refs., tabs., figs

  16. The mining industry and the community: Joining forces for sustainable social development

    International Nuclear Information System (INIS)

    Labonne, B.


    This article joins the continuing policy debate over the social responsibility of corporations, particularly in the mining industry. The author argues that the 'old school mining orthodoxy' - approaching the exploitation of mineral deposits solely from the technical and economic points of view-is long dead. Mining companies must also encompass the social dimension. New policies for the mining industry are discussed in terms of recent worldwide trends and movements, e.g. globalization, economic interdependence and decentralization of governmental authority, and the rise of civil society as a political factor. These trends, together with the United Nations policies in quest of sustainable development and the consensus expressed at international conferences during the last decade, have deepened social awareness and set the stage for enhanced social responsiveness from the private sector. Socially responsible corporate policies include decentralization of decision-making to the field level, reaching out to stake holders and shareholders, supporting governments which provide official development assistance for good governance and building broad partnerships to reduce social exposures. (author)

  17. Assessing Sustainable Rural Community Tourism Using the AHP and TOPSIS Approaches under Fuzzy Environment

    Directory of Open Access Journals (Sweden)

    Mujiya Ulkhaq M.


    Full Text Available Tourism is currently a sector that is growing into an important and significant world activity. The development of an area where the tourist destination located in affects the growth of the tourism. In addition, the success of tourist destinations are influenced by their relative competitiveness; hence, they do compete each other to offer the best service to satisfy their customers. Rural tourism in Indonesia is believed as emerging business since there are abundant sites located in rural area that offers fascinating attractions to the visitors. This study aims to evaluate the rural tourism using sustainable indicators, namely, service quality, facilities, management system, and outcome. A combination of fuzzy AHP and TOPSIS are employed to select five rural tourism in Central Java Province. Result shows that service quality is considered as the most important attribute with weight of 28.6%, while Dieng is named for the excellent rural tourism. This finding might offer the service providers with valuable insights into the attribute that reflects customers’ perceptions about rural tourism; also to position their services based on their competitors.

  18. Civic engagement and local government strategies for sustainable local community development

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    Across Europe more and more citizens involve in voluntary grassroots and NGO activity. Concurrently, more local and national governments express an interest in increasing collaboration with voluntary organisations. The curiosity and interest as regards voluntary labour from public bodies seems...... to have grown as the financial crisis puts more and more pressure on municipal and national budgets. As such, the contribution of voluntary associations is seem as a supplement to more and more reduced public services, particularly within the social services field, care for the elderly, etc. but even...... in local communities and in relation to social capital, the diversity within the world of voluntary organisations, and the difference in views between public planners and volunteers of the role of volunteers. Three cases illustrate this as well as the need for capacity building of VCOs and the urban...

  19. Proceedings of the 3. annual international greening rooftops for sustainable communities conference, awards and trade show

    International Nuclear Information System (INIS)


    Green roofs are gaining momentum as a viable technology to support sustainable development in urban areas. Although the green roof industry is well-established in many European countries, the industry has not yet fully emerged in North America. Many municipalities in both the United States and Canada are now exploring the potential of green roofs within urban stormwater and heat island management plans. While there are now green roofs that demonstrate their efficacy in reducing energy consumption and retaining precipitation, a lack of standards and effective policy instruments continues to constrain widespread market penetration. Many building owners and architects are unaware of the positive economic benefits of green roofs. This conference examined ways to improve the uptake of green roof technology in North America. Federal policies and standards supporting green roof technology were reviewed, as well as various initiatives to promote green roofs at the municipal level. Innovative research programs and demonstration programs were examined. Important policy developments in countries where green roof technology has been widely implemented were reviewed. Issues concerning public outreach, training and education were explored. Methods of negotiating with the varied disciplines and contractors involved with the installation of green roofs were investigated. New techniques in quantifying the benefits of green roofs using economic analyses and mathematical models were also presented. The conference was divided into 3 tracks: (1) policy and program development; (2) case studies and design; and (3) research on technical performance benefits. The conference featured 62 presentations, of which 49 have been catalogued separately for inclusion in this database. refs., tabs., figs

  20. Attitude of Academic Community towards Physically Challenged Students in the University of Maiduguri: Implications for Financing Inclusive Education for Sustainable Development (United States)

    Bamiteko, Racheal Modupe; Ibi, Mustapha Baba; Bukar, Ibrahim Bulama


    This study examined the attitude of academic community towards physically challenged students in the University of Maiduguri as it affect the financing of inclusive education for sustainable development in Nigeria. Four objectives, two research questions and two hypotheses were set and tested for the study. Descriptive survey was adopted as a…

  1. “The problem is ours, it is not CRAIDS’ ”. Evaluating sustainability of Community Based Organisations for HIV/AIDS in a rural district in Zambia

    Directory of Open Access Journals (Sweden)

    Walsh Aisling


    Full Text Available Abstract Background While sustainability of health programmes has been the subject of empirical studies, there is little evidence specifically on the sustainability of Community Based Organisations (CBOs for HIV/AIDS. Debates around optimal approaches in community health have centred on utilitarian versus empowerment approaches. This paper, using the World Bank Multi-Country AIDS Program (MAP in Zambia as a case study, seeks to evaluate whether or not this global programme contributed to the sustainability of CBOs working in the area of HIV/AIDS in Zambia. Lessons for optimising sustainability of CBOs in lower income countries are drawn. Methods In-depth interviews with representatives of all CBOs that received CRAIDS funding (n = 18 and district stakeholders (n= 10 in Mumbwa rural district in Zambia, in 2010; and national stakeholders (n=6 in 2011. Results Funding: All eighteen CBOs in Mumbwa that received MAP funding between 2003 and 2008 had existed prior to receiving MAP grants, some from as early as 1992. This was contrary to national level perceptions that CBOs were established to access funds rather than from the needs of communities. Funding opportunities for CBOs in Mumbwa in 2010 were scarce. Health services: While all CBOs were functioning in 2010, most reported reductions in service provision. Home visits had reduced due to a shortage of food to bring to people living with HIV/AIDS and scarcity of funding for transport, which reduced antiretroviral treatment adherence support and transport of patients to clinics. Organisational capacity and viability: Sustainability had been promoted during MAP through funding Income Generating Activities. However, there was a lack of infrastructure and training to make these sustainable. Links between health facilities and communities improved over time, however volunteers’ skills levels had reduced. Conclusions Whilst the World Bank espoused the idea of sustainability in their plans, it remained

  2. Socio-ecological resources for diabetes self-management. (United States)

    O'Dell, Kristi; O'Dell, Michael


    This study describes the utility of the brief Chronic Illness Resources Survey (CIRS) in a family medicine clinic. The brief CIRS is a 22-item scale that assesses support for self-management tasks common to chronic illnesses. The scale is based on socio-ecological theory and measures seven levels of socio-environmental support. The sample included 31 males and females aged 38 - 86 years with a diagnosis of diabetes who presented for care at a family medicine residency clinic. After scheduled office visits, patients completed the brief CIRS, demographic indicators, and brief medical information. The health care team, personal support, and media/policy subscales were rated the highest followed by family and friends, neighborhood, workplace, and community organizations. There were no significant differences in the t-tests between select demographic variables (gender, race, age, marital status, and work status) and CIRS total score. Females' higher total CIRS score was nearly statistically significant as compared to males' total CIRS score. The health care team is of primary importance in diabetic patient self-management, and so, the brief CIRS may be a useful rapid assessment instrument in a medical clinic setting where additional resources may be identified and recommended as indicated by the physician.

  3. Why Did Zika Not Explode in Cuba? The Role of Active Community Participation to Sustain Control of Vector-Borne Diseases. (United States)

    Castro, Marta; Pérez, Dennis; Guzman, Maria G; Barrington, Clare


    As the global public health community develops strategies for sustainable Zika prevention and control, assessment of the Cuban response to Zika provides critical lessons learned. Cuba's early and successful response to Zika, grounded in the country's long-standing dengue prevention and control program, serves as a model of rapid mobilization of intersectoral efforts. Sustaining this response requires applying the evidence generated within the Cuban dengue program that active community participation improves outcomes and is sustainable and cost-effective. There is also a need for implementation science efforts to assess the transferability of lessons learned from Zika prevention and control to other pathogens and from one context to another in addition to how to take these efforts to scale.

  4. Plant species richness sustains higher trophic levels of soil nematode communities after consecutive environmental perturbations. (United States)

    Cesarz, Simone; Ciobanu, Marcel; Wright, Alexandra J; Ebeling, Anne; Vogel, Anja; Weisser, Wolfgang W; Eisenhauer, Nico


    The magnitude and frequency of extreme weather events are predicted to increase in the future due to ongoing climate change. In particular, floods and droughts resulting from climate change are thought to alter the ecosystem functions and stability. However, knowledge of the effects of these weather events on soil fauna is scarce, although they are key towards functioning of terrestrial ecosystems. Plant species richness has been shown to affect the stability of ecosystem functions and food webs. Here, we used the occurrence of a natural flood in a biodiversity grassland experiment that was followed by a simulated summer drought experiment, to investigate the interactive effects of plant species richness, a natural flood, and a subsequent summer drought on nematode communities. Three and five months after the natural flooding, effects of flooding severity were still detectable in the belowground system. We found that flooding severity decreased soil nematode food-web structure (loss of K-strategists) and the abundance of plant feeding nematodes. However, high plant species richness maintained higher diversity and abundance of higher trophic levels compared to monocultures throughout the flood. The subsequent summer drought seemed to be of lower importance but reversed negative flooding effects in some cases. This probably occurred because the studied grassland system is well adapted to drought, or because drought conditions alleviated the negative impact of long-term soil waterlogging. Using soil nematodes as indicator taxa, this study suggests that high plant species richness can maintain soil food web complexity after consecutive environmental perturbations.

  5. Opportunities and challenges for a sustainable energy policy in SE Europe: SE European Energy Community Treaty

    International Nuclear Information System (INIS)

    Mihajlov, Andjelka


    Energy demand continues to increase in turn raising concerns about energy supply. In this paper, the author has tried to systematize the role of the energy sector in South Eastern (SE) Europe in the context of the European energy policy process. This should make the energy sector in SE Europe more visible and open to substantial activities and appropriate funding. This is important to assure its full alignment with the European energy policy process, and in so doing, make it less fragile. According to the SE European Energy Community Treaty, parties to the Treaty are obliged to implement reforms in the energy and environmental sector in accordance with the European Union's respective policy. This paper raises awareness of the environmental requirements that have been set, of renewable energy and its implementation, at the same time pointing out that the response in SE Europe has been at a low level. It is believed that this paper could draw attention to the existing problems and could contribute to the establishment of a common integrated energy market in SE Europe and the EU. (author)

  6. Interprofessional Communities of Practice in Continuing Medical Education for Promoting and Sustaining Practice Change: A Prospective Cohort Study. (United States)

    Barker, Megan; Lecce, Julia; Ivanova, Anna; Zawertailo, Laurie; Dragonetti, Rosa; Selby, Peter


    Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enhancement in Applied Counselling and Health [TEACH] Project) to promote and sustain practice change. A prospective cohort design was utilized to examine the long-term impact of the TEACH CoP on practice change. An online survey was administered to TEACH-trained practitioners to assess perceived feasibility, importance, and confidence related to course competencies, involvement in TEACH CoP activities, engagement in knowledge transfer (KT), and implementation of new programming. Chi-square tests were used to detect differences in KT and program development associated with CoP participation. Course competency scores from immediate postcourse surveys and long-term follow-up surveys were compared. No significant differences in participant characteristics were found between those who did (n = 300) and did not (n = 122) participate in the TEACH CoP. Mean self-perceived competency scores were greater immediately after course than at long-term follow-up; however, self-ratings of competency in pharmacological interventions and motivational interviewing were higher at follow-up. TEACH CoP participation was associated with significantly greater engagement in KT and implementation of new programming after training. The findings from this evaluation suggest the value of interprofessional CoPs offered posttraining as a mechanism to enhance practice. CME providers should consider offering CoPs as a component of training programs to promote and sustain practice change.

  7. Assessment of mammal reproduction for hunting sustainability through community-based sampling of species in the wild. (United States)

    Mayor, Pedro; El Bizri, Hani; Bodmer, Richard E; Bowler, Mark


    Wildlife subsistence hunting is a major source of protein for tropical rural populations and a prominent conservation issue. The intrinsic rate of natural increase. (r max ) of populations is a key reproductive parameter in the most used assessments of hunting sustainability. However, researchers face severe difficulties in obtaining reproductive data in the wild, so these assessments often rely on classic reproductive rates calculated mostly from studies of captive animals conducted 30 years ago. The result is a flaw in almost 50% of studies, which hampers management decision making. We conducted a 15-year study in the Amazon in which we used reproductive data from the genitalia of 950 hunted female mammals. Genitalia were collected by local hunters. We examined tissue from these samples to estimate birthrates for wild populations of the 10 most hunted mammals. We compared our estimates with classic measures and considered the utility of the use of r max in sustainability assessments. For woolly monkey (Lagothrix poeppigii) and tapir (Tapirus terrestris), wild birthrates were similar to those from captive populations, whereas birthrates for other ungulates and lowland-paca (Cuniculus paca) were significantly lower than previous estimates. Conversely, for capuchin monkeys (Sapajus macrocephalus), agoutis (Dasyprocta sp.), and coatis (Nasua nasua), our calculated reproductive rates greatly exceeded often-used values. Researchers could keep applying classic measures compatible with our estimates, but for other species previous estimates of r max may not be appropriate. We suggest that data from local studies be used to set hunting quotas. Our maximum rates of population growth in the wild correlated with body weight, which suggests that our method is consistent and reliable. Integration of this method into community-based wildlife management and the training of local hunters to record pregnancies in hunted animals could efficiently generate useful information of life

  8. Interactive Digital e-Health Game for Heart Failure Self-Management: A Feasibility Study (United States)

    Toprac, Paul; O'Hair, Matt; Bias, Randolph; Kim, Miyong T.; Bradley, Paul; Mackert, Michael


    Abstract Objective: To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology. Materials and Methods: The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest–post-test design, validated instruments—the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index—were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game. Results: During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information. Conclusion: It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge. PMID:27976955

  9. Traditional uses of plants in a rural community of Mozambique and possible links with Miombo degradation and harvesting sustainability. (United States)

    Bruschi, Piero; Mancini, Matteo; Mattioli, Elisabetta; Morganti, Michela; Signorini, Maria Adele


    building materials. However, over-exploitation and destructive collection seem to threaten the survival of some of the woody species used. A sustainable approach including the involvement of local communities in the management of woody species is recommended.

  10. Chronic condition self-management support for Aboriginal people: Adapting tools and training. (United States)

    Battersby, Malcolm; Lawn, Sharon; Kowanko, Inge; Bertossa, Sue; Trowbridge, Coral; Liddicoat, Raylene


    Chronic conditions are major health problems for Australian Aboriginal people. Self-management programs can improve health outcomes. However, few health workers are skilled in self-management support and existing programs are not always appropriate in Australian Aboriginal contexts. The goal was to increase the capacity of the Australian health workforce to support Australian Aboriginal people to self-manage their chronic conditions by adapting the Flinders Program of chronic condition self-management support for Australian Aboriginal clients and develop and deliver training for health professionals to implement the program. Feedback from health professionals highlighted that the Flinders Program assessment and care planning tools needed to be adapted to suit Australian Aboriginal contexts. Through consultation with Australian Aboriginal Elders and other experts, the tools were condensed into an illustrated booklet called 'My Health Story'. Associated training courses and resources focusing on cultural safety and effective engagement were developed. A total of 825 health professionals  across Australia was trained and 61 people qualified as accredited trainers in the program, ensuring sustainability. The capacity and skills of the Australian health workforce to engage with and support Australian Aboriginal people to self-manage their chronic health problems significantly increased as a result of this project. The adapted tools and training were popular and appreciated by the health care organisations, health professionals and clients involved. The adapted tools have widespread appeal for cultures that do not have Western models of health care and where there are health literacy challenges. My Health Story has already been used internationally. © 2018 National Rural Health Alliance Ltd.

  11. Experience of hypertensive patients with self-management of health care. (United States)

    Balduino, Anice de Fátima Ahmad; Mantovani, Maria de Fátima; Lacerda, Maria Ribeiro; Marin, Maria José Sanches; Wal, Marilene Loewen


    The aim of this study was to interpret how hypertensive patients experience health care self-management. Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. Qualitative study. Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities. © 2016 John Wiley & Sons Ltd.

  12. Making diabetes self-management education culturally relevant for Filipino Americans in Hawaii. (United States)

    Finucane, Melissa L; McMullen, Carmit K


    The purpose of this study was to identify the cultural values, traditions, and perceptions of diabetes risk and self-care among Filipino Americans in Hawaii with type 2 diabetes that facilitate or impede engagement in diabetes self-management behaviors and education classes. This qualitative study used 2 rounds of semistructured focus groups and interviews. Participants included 15 patients with type 2 diabetes recruited from a large health-maintenance organization in Hawaii and 7 health care and cultural experts recruited from the community. The taped and transcribed focus groups and interviews were coded thematically. Participants evaluated example materials for diabetes self-management education (DSME) with Filipino Americans. Several aspects of Filipino American culture were identified as central to understanding the challenges of engaging in self-management behaviors and DSME: (1) undertaking self-management while prioritizing the family and maintaining social relationships, (2) modifying diet while upholding valued symbolic and social meanings of food, (3) participating in storytelling in the face of stigma associated with diabetes, and (4) reconciling spiritual and biomedical interpretations of disease causality and its management. Respondents also emphasized the role of several qualitative aspects of perceived risk (eg, dread, control) in moderating their behaviors. Participants suggested ways to make DSME culturally relevant. Awareness of cultural values and qualitative aspects of perceived risk that influence Filipino Americans' engagement in diabetes self-care behaviors and classes may help to improve teaching methods, materials, and recruitment strategies.

  13. Using the D-DANP-mV Model to Explore the Continuous System Improvement Strategy for Sustainable Development of Creative Communities. (United States)

    Xiong, Lei; Teng, Cheng-Lein; Zhu, Bo-Wei; Tzeng, Gwo-Hshiung; Huang, Shan-Lin


    With globalization, the notion of "creative city" has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV) model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP), and Shen-Ji New Village (SJNV), are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP), and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives). Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of resource allocation

  14. Using the D-DANP-mV Model to Explore the Continuous System Improvement Strategy for Sustainable Development of Creative Communities (United States)

    Xiong, Lei; Teng, Cheng-Lein; Zhu, Bo-Wei; Tzeng, Gwo-Hshiung; Huang, Shan-Lin


    With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV) model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP), and Shen-Ji New Village (SJNV), are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP), and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives). Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of resource

  15. Using the D-DANP-mV Model to Explore the Continuous System Improvement Strategy for Sustainable Development of Creative Communities

    Directory of Open Access Journals (Sweden)

    Lei Xiong


    Full Text Available With globalization, the notion of “creative city” has become a core concept of many cities in the world development policies, with real properties being upgraded or used to change, renewal is being conducted, and creative industries are emerging. This trend has reached its peak in the past decade, with different forms and scales gathering global development momentum among the creative communities to promote the development of creative economies. In recent years, however, there was still skepticism about the sustainability of the current creative communities. Many scholars have pointed out that signs of unsustainability have begun to appear in many creative communities. To overcome these obstacles, the development of rational and highly effective improvement strategy requires a dynamic thinking process. Therefore, this study employs the DEMATEL-based ANP with modified VIKOR (D-DANP-mV model in presenting an assessment framework for the sustainability of creative communities. This system is used to assess the sustainability of current creative communities and determine how to solve their problems. Thus, continuous and systemic improvement strategies can be developed to achieve the aim of sustainable development. Two creative communities in Taiwan, Taichung Cultural and Creative Industries Park (TCCIP, and Shen-Ji New Village (SJNV, are used as case studies in this study. Based on the concept of systematic improvement from fundamental issues, the results indicate that the improvement priorities can be determined by applying the D-DANP-mV model. This approach is different from those found by a conventional method with the hypothesis of independent criteria (e.g., diversification of creative talents in TCCIP, and cannot use for performance improvement (e.g., only can be used for ranking and selection among alternatives. Considering these points, unreasonable premises, biased errors, and lack of some real application functions in the process of

  16. Creating Affordable Housing through self-management:

    DEFF Research Database (Denmark)

    Jensen, Jesper Ole; Stensgaard, Anne Gro

    The paper presents a case on self-management in the Danish social housing sector as a way of providing affordable housing. It is based on an evaluation of a Danish concept for affordable housing, Social Housing Plus (“AlmenBolig+”). The concept was introduced in 2007, and so far app 1.400 housing...

  17. Beyond Quality Circles: Self-Managing Teams. (United States)

    Sims, Henry P., Jr.; Dean, James W., Jr.


    This article reviews the quality circle concept, shows why its characteristics appeal to American executives, and examines some of its limitations. It looks at self-managing teams and discusses the reasons that adoptions have been relatively few. It then shows what organizational conditions are necessary for quality circles to evolve into teams.…

  18. Recruiting seniors with chronic low back pain for a randomized controlled trial of a self-management program. (United States)

    Groupp, Elyse; Haas, Mitchell; Fairweather, Alisa; Ganger, Bonnie; Attwood, Michael


    To identify recruitment challenges and elucidate specific strategies that enabled recruitment of seniors for a randomized trial on low back pain comparing the Chronic Disease Self-management Program of the Stanford University to a 6-month wait-list control group. Recruitment for a randomized controlled trial. Community-based program offered at 12 locations. Community-dwelling seniors 60 years and older with chronic low back pain of mechanical origin. Passive recruitment strategies included advertisement in local and senior newspapers, in senior e-mail newsletters and listservs, in local community centers and businesses. Active strategies included meeting seniors at health fairs, lectures to the public and organizational meetings, and the help of trusted professionals in the community. A total of 100 white and 20 African American seniors were recruited. The program seemed to have the most appeal to white, middle-class older adults, educated through high school level. Advertisement failed to attract any participants to the program. Successful strategies included interaction with seniors at health fairs and lectures on health care, especially when the program was endorsed by a trusted community professional. Generating interest in the self-management program required keen communication skills because the idea of "self-management" was met with a myriad of responses, ranging from disinterest to disbelief. Generating interest also required active participation within the communities. Initial contacts had to be established with trusted professionals, whose endorsement enabled the project managers to present the concept of self-management to the seniors. More complex recruitment strategies were required for this study involving the self-management approach to back pain than for studies involving treatment.

  19. Coastal Mapping for Baseline Geoscience Knowledge to Support Community Hazard Assessment and Sustainable Development, Eastern Baffin Island, Nunavut (United States)

    Forbes, D. L.; Bell, T.; Campbell, D. C.; Cowan, B.; Deering, R. L.; Hatcher, S. V.; Hughes Clarke, J. E.; Irvine, M.; Manson, G. K.; Smith, I. R.; Edinger, E.


    reversal from falling to rising relative sea levels. Overall, the coastal mapping results constitute baseline geoscience knowledge infrastructure for navigation, fisheries, port engineering, municipal planning, and informing sustainability initiatives in the isolated coastal communities of this Arctic region.

  20. Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability. (United States)

    Daviaud, Emmanuelle; Besada, Donnela; Leon, Natalie; Rohde, Sarah; Sanders, David; Oliphant, Nicholas; Doherty, Tanya


    Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduced to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level scale-up implications. The paper focuses on costs to provider (health system and donors) to inform planning and budgeting, and does not cover cost-effectiveness. The analysis combines annualised set-up costs and 1 year implementation costs to calculate incremental economic and financial costs per treatment from a provider perspective. Affordability is assessed by calculating the per capita financial cost of the program as a percentage of the public health expenditure per capita. Time and financial implications of a 30% increase in utilization were modeled. Country scale-up is modeled for all children under 5 in rural areas. Utilization of iCCM services varied from 0.05 treatment/y/under-five in Ethiopia to over 1 in Niger. There were between 10 and 603 treatments/community health worker (CHW)/y. Consultation cost represented between 93% and 22% of economic costs per treatment influenced by the level of utilization. Weighted economic cost per treatment ranged from US$ 13 (2015 USD) in Ghana to US$ 2 in Malawi. CHWs spent from 1 to 9 hours a week on iCCM. A 30% increase in utilization would add up to 2 hours a week, but reduce cost per treatment (by 20% in countries with low utilization). Country scale up would amount to under US$ 0.8 per capita total population (US$ 0.06-US$0.74), between 0.5% and 2% of public health expenditure per capita but 8% in Niger. iCCM addresses unmet needs and impacts on under 5 mortality. An

  1. Self-Management Interventions to Prevent the Secondary Condition of Pain in People with Disability Due to Mobility Limitations

    Directory of Open Access Journals (Sweden)

    Katherine Froehlich-Grobe


    Full Text Available Introduction This focused review examines the use and effectiveness of self-management strategies in preventing or managing pain, which is among the most common secondary conditions faced by individuals with a mobility disability. Methods This focused review was part of a two-phase comprehensive scoping review. Phase I was a comprehensive scoping review of the literature targeting multiple outcomes of self-management interventions for those with mobility impairment, and Phase II was a focused review of the literature on self-management interventions that target pain as a primary or secondary outcome. Two authors searched CINAHL, PubMed, and PsyclNFO for papers published from January 1988 through August 2014 using specified search terms. Following the scoping review, the authors independently screened and selected the studies and reviewed the eligible studies, and the first author extracted data from the included studies. Results The scoping review yielded 40 studies that addressed pain self-management interventions for those living with mobility impairment. These 40 accumulated papers revealed a heterogeneous evidence base in terms of setting (clinic, community, and online, target populations, intervention duration (3 weeks to 24 months, and mode (health-care providers and lay leaders. Most of the reviewed studies reported that the self-management intervention led to significant reduction of pain over time, suggesting that self-management may be a promising approach for addressing pain experienced by people who live with mobility limitations. Discussion This review also reveals moderate-to-high bias across studies, and findings indicate that future research should enhance the methodological quality to provide stronger evidence about the effectiveness of self-management strategies for reducing pain among those with mobility impairments.

  2. Afterschool Sustainability

    Directory of Open Access Journals (Sweden)

    Hilary D. Joyce


    Full Text Available Youth participation in quality extended learning opportunities (ELOs results in positive academic, physical, mental health, and social/emotional outcomes. Funding is essential to implementing and sustaining quality ELOs; however multiple funding barriers and challenges exist. Understanding the types of funds available for ELOs and the factors that influence sustainability is critical. Through surveys and telephone interviews of ELO providers, this descriptive study identified and examined ELO funding streams, the ways ELO providers use these funding streams, and the barriers and challenges to sustainability. ELO programs often relied on one major funding stream coupled with nutrition supports as well as in-kind resources. Barriers to sustainability included year-to-year funding, transportation costs, reducing community partnerships, and difficulty in diversifying funds. Recommendations to enhance ELO sustainability are offered, particularly in relation to overcoming the challenges to diversification of funding resources and establishing mutually supportive partnerships and collaboration.

  3. Sustainable Cities

    DEFF Research Database (Denmark)

    Georg, Susse; Garza de Linde, Gabriela Lucía

    Judging from the number of communities and cities striving or claiming to be sustainable and how often eco-development is invoked as the means for urban regeneration, it appears that sustainable and eco-development have become “the leading paradigm within urban development” (Whitehead 2003....../assessment tool. The context for our study is urban regeneration in one Danish city, which had been suffering from industrial decline and which is currently investing in establishing a “sustainable city”. Based on this case study we explore how the insights and inspiration evoked in working with the tool...

  4. Barriers and facilitators to implementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review. (United States)

    Fadlallah, Racha; El-Jardali, Fadi; Hemadi, Nour; Morsi, Rami Z; Abou Samra, Clara Abou; Ahmad, Ali; Arif, Khurram; Hishi, Lama; Honein-AbouHaidar, Gladys; Akl, Elie A


    Community-based health insurance (CBHI) has evolved as an alternative health financing mechanism to out of pocket payments in low- and middle-income countries (LMICs), particularly in areas where government or employer-based health insurance is minimal. This systematic review aimed to assess the barriers and facilitators to implementation, uptake and sustainability of CHBI schemes in LMICs. We searched six electronic databases and grey literature. We included both quantitative and qualitative studies written in English language and published after year 1992. Two reviewers worked in duplicate and independently to complete study selection, data abstraction, and assessment of methodological features. We synthesized the findings based on thematic analysis and categorized according to the ecological model into individual, interpersonal, community and systems levels. Of 15,510 citations, 51 met the eligibility criteria. Individual factors included awareness and understanding of the concept of CBHI, trust in scheme and scheme managers, perceived service quality, and demographic characteristics, which influenced enrollment and sustainability. Interpersonal factors such as household dynamics, other family members enrolled in the scheme, and social solidarity influenced enrollment and renewal of membership. Community-level factors such as culture and community involvement in scheme development influenced enrollment and sustainability of scheme. Systems-level factors encompassed governance, financial and delivery arrangement. Government involvement, accountability of scheme management, and strong policymaker-implementer relation facilitated implementation and sustainability of scheme. Packages that covered outpatient and inpatient care and those tailored to community needs contributed to increased enrollment. Amount and timing of premium collection was reported to negatively influence enrollment while factors reported as threats to sustainability included facility

  5. Implementation of a diabetes self-management education program in primary care for adults using shared medical appointments. (United States)

    Sanchez, Iris


    The purpose of this study was to implement diabetes self-management education in primary care using the Chronic Care Model and shared medical appointments (SMA) to provide evidence-based interventions to improve process and measure outcomes. A quality improvement project using the Plan-Do-Check-Act cycle was implemented in a primary care setting in South Texas to provide diabetes self-management education for adults. Biological measures were evaluated in 70 patients at initiation of the project and thereafter based on current practice guidelines. The results of the project were consistent with the literature regarding the benefits, sustainability, and viability of SMA. As compared with that in studies presented in the literature, the patient population who participated in SMA had similar outcomes regarding improvement in A1C, self-management skills, and satisfaction. SMA are an innovative system redesign concept with the potential to provide comprehensive and coordinated care for patients with multiple and chronic health conditions while still being an efficient, effective, financially viable, and sustainable program. As the incidence and prevalence of diabetes increase, innovative models of care can meet the growing demand for access and utilization of diabetes self-management education programs. Programs focusing on chronic conditions to improve outcomes can be replicated by health care providers in primary care settings. SMA can increase revenue and productivity, improve disease management, and increase provider and patient satisfaction.

  6. Implementing a self-management strategy in inflammatory bowel disease (IBD): patient perceptions, clinical outcomes and the impact on service. (United States)

    Squires, Seth Ian; Boal, Allan John; Lamont, Selina; Naismith, Graham D


    Patient self-management and its service integration is not a new concept but it may be a key component in the long-term sustainability of inflammatory bowel disease (IBD) service provision, when considering growing disease prevalence and limited resources. The IBD team at the Royal Alexandra and Vale of Leven Hospitals in the Clyde Valley region developed a self-management tool, called the 'flare card'. Patients were asked to complete a questionnaire which reflected their opinion on its viability as a self-management intervention. In addition, its utility in terms of service use over a 10-month period in 2016 was compared with a similar cohort of patients over 10 months in 2015. Patients overall felt that the 'flare card' was a viable self-management tool. Positive feedback identified that the intervention could help them aid control over their IBD, improve medication adherence, reduce symptoms and reflected a feeling of patient-centred IBD care. The comparison between 2015 and 2016 service use revealed a significant reduction in IBD and non-IBD service usage, Steroid prescribing and unscheduled IBD care in the flare card supported cohort. IBD services must continue to adapt to changes within the National Health Service bearing in mind long-term sustainability and continued care provision. The 'flare card' goes further in an attempt to optimise Crohn's disease and ulcerative colitis management by harmonising clinician evaluation and patient's self-initiation of therapy and investigation.

  7. Neighbourhood facilities for sustainability

    CSIR Research Space (South Africa)

    Gibberd, Jeremy T


    Full Text Available . In this paper these are referred to as ‘Neighbourhood Facilities for Sustainability’. Neighbourhood Facilities for Sustainability (NFS) are initiatives undertaken by individuals and communities to build local sustainable systems which not only improve...

  8. Self-management for obesity and cardio-metabolic fitness: Description and evaluation of the lifestyle modification program of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Coates Alison M


    Full Text Available Abstract Background Sustainable lifestyle modification strategies are needed to address obesity and cardiovascular risk factors. Intensive, individualised programs have been successful, but are limited by time and resources. We have formulated a group-based lifestyle education program based upon national diet and physical activity (PA recommendations to manage obesity and cardio-metabolic risk factors. This article describes the content and delivery of this program, with information on compliance and acceptability. Methods Overweight/obese adults (n = 153 with metabolic syndrome were recruited from the community and randomly allocated to intervention (INT or control (CON. Written copies of Australian national dietary and PA guidelines were provided to all participants. INT took part in a 16-week lifestyle program which provided a curriculum and practical strategies on 1 dietary and PA information based on national guidelines, 2 behavioural self-management tools, 3 food-label reading, supermarkets tour and cooking, 4 exercise sessions, and 5 peer-group support. Compliance was assessed using attendance records and weekly food/PA logs. Participants' motivations, perceived benefits and goals were assessed through facilitated discussion. Program acceptability feedback was collected through structured focus groups. Results Although completion of weekly food/PA records was poor, attendance at information/education sessions (77% overall and exercise participation (66% overall was high, and compared with CON, multiple markers of body composition and cardio-metabolic health improved in INT. Participants reported that the most useful program components included food-label reading, cooking sessions, and learning new and different physical exercises, including home-based options. Participants also reported finding self-management techniques helpful, namely problem solving and short-term goal setting. The use of a group setting and supportive 'peer' leaders

  9. First responder resuscitation teams in a rural Norwegian community: sustainability and self-reports of meaningfulness, stress and mastering

    Directory of Open Access Journals (Sweden)

    Meland Eivind


    Full Text Available Abstract Background Training of lay first responder personnel situated closer to the potential victims than medical professionals is a strategy potentially capable of shortening the interval between collapse and start of cardiopulmonary resuscitation (CPR in cases of out-of-hospital cardiac arrest. In this study we trained lay first responders personnel in basic life support (BLS and defibrillation for cases of cardiac arrest and suspected acute myocardial infarction (AMI. Methods Forty-two lay first responders living in remote areas or working in industries in the island community of Austevoll, Western Norway, were trained in CPR and defibrillation. We placed particular emphasis on the first responders being able to defibrillate a primary ventricular fibrillation (PVF in patients with AMI. The trainees were organised in four teams to attend victims of AMI and cardiac arrest while awaiting the arrival of the community emergency medical services. The purpose of the study was to find out whether the teams were able to function during the five-year study project, and to examine whether lives could be saved. The first responders completed questionnaires each year on their experiences of participation. Data on the medical actions of the teams were also collected. Results By the end of the project all groups were functioning. The questionnaires evidenced a reasonable degree of motivation and self-evaluated competence in both types of group organisation, but in spite of this attrition effects in the first responders were considerable. The first responders were called out on 24 occasions, for a total of 17 patients. During the study period no case of PVF occurred after the arrival of the first responders, and the number of AMIs was very low, strongly deviating from what was anticipated. No lives were saved by the project. Conclusions The teams were sustained for almost five years without any significant deterioration of self-reported stress or mastering

  10. A Study on the Relationship between Design Elements of Outdoor Leisure Spaces and Types of Leisure Activities in Sustainable Community Development - A Case Study on Tainan, Taiwan (United States)

    Chang, J. H.; Zhang, H.


    Sustainable community development encompasses three aspects: “Lifestyle”, “Production” and “Ecology”. Among them, “Lifestyle” is closest to people and reflects basic human needs. Creating outdoor spaces that encourage residents to engage in leisure activities will not only provide them with spiritual sustenance but also fulfil one of the key criteria in sustainable community development. This study explores the relationship between design elements of outdoor leisure spaces and types of leisure activities from residents' perspective with the goal to inform future spatial planning. The study collected 365 valid questionnaires from Tainan residents. Factor analysis was used to extract factors from design elements of outdoor leisure spaces, and regression analysis was applied to understand the effect level. The result shows design elements have positive effect on the types of leisure activities. In addition, different elements exert different influences on the choice of activities.

  11. Important, misunderstood, and challenging: a qualitative study of nurses’ and allied health professionals’ perceptions of implementing self-management for patients with COPD

    Directory of Open Access Journals (Sweden)

    Young HML


    Full Text Available Hannah ML Young,1 Lindsay D Apps,1 Samantha L Harrison,1 Vicki L Johnson-Warrington,1 Nicky Hudson,2 Sally J Singh1,3 1National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, 2School of Applied Social Sciences, De Montfort University, Leicester, 3Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK Background: In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses’ and allied health professionals’ (AHPs’ understanding and provision of self-management in clinical practice. This study explores nurses’ and AHPs’ understanding and implementation of supported COPD self-management within routine clinical practice. Materials and methods: Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach. Results: A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients’ perceived self-management abilities. Conclusion: Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding

  12. Silicate:nitrate ratios of upwelled waters control the phytoplankton community sustained by mesoscale eddies in sub-tropical North Atlantic and Pacific

    Directory of Open Access Journals (Sweden)

    T. S. Bibby


    Full Text Available Mesoscale eddies in sub-tropical gyres physically perturb the water column and can introduce macronutrients to the euphotic zone, stimulating a biological response in which phytoplankton communities can become dominated by large phytoplankton. Mesoscale eddies may therefore be important in driving export in oligotrophic regions of the modern ocean. However, the character and magnitude of the biological response sustained by eddies is variable. Here we present data from mesoscale eddies in the Sargasso Sea (Atlantic and the waters off Hawai'i (Pacific, alongside mesoscale events that affected the Bermuda Atlantic Time-Series Study (BATS over the past decade. From this analysis, we suggest that the phytoplankton community structure sustained by mesoscale eddies is predetermined by the relative abundance of silicate over nitrate (Si* in the upwelled waters. We present data that demonstrate that mode-water eddies (MWE in the Sargasso Sea upwell locally formed waters with relatively high Si* to the euphotic zone, and that cyclonic eddies in the Sargasso Sea introduce waters with relatively low Si*, a signature that originated in the iron-limited Southern Ocean. We propose that this phenomenon can explain the observed dominance of the phytoplankton community by large-diatom species in MWE and by small prokaryotic phytoplankton in cyclonic features. In contrast to the Atlantic, North Pacific Intermediate Water (NPIW with high Si* may influence the cyclonic eddies in waters off Hawai'i, which also appear capable of sustaining diatom populations. These observations suggest that the structure of phytoplankton communities sustained by eddies may be related to the chemical composition of the upwelled waters in addition to the physical nature of the eddy.

  13. From Myth to Reality: The Experience of Sustainable Tourism in The Vale Encantado Community in Tijuca Forest, Rio de Janeiro, Brazil


    Barros, Otávio Alves; Melo, Maria Emília


    Considered one of the largest urban forests in the world and the third largest in Brazil, the Tijuca Forest, in the city of Rio de Janeiro, faces the great challenge of living harmoniously and sustainably with the 46 slums located around it. One of these communities, Vale Encantado, whose occupation dates from the mid-eighteenth century, experienced the various production cycles that developed in the area, through logging, farming, livestock production, ornamental plants and black granite min...

  14. Toward Food System Sustainability through School Food System Change: Think&EatGreen@School and the Making of a Community-University Research Alliance

    Directory of Open Access Journals (Sweden)

    Yael Harlap


    Full Text Available This paper describes the theoretical and conceptual framework and the research and practice model of Think&EatGreen@School, a community-based action research project aiming to foster food citizenship in the City of Vancouver and to develop a model of sustainable institutional food systems in public schools. The authors argue that educational and policy interventions at the school and school board level can drive the goals of food system sustainability, food security, and food sovereignty. The complex relationship between food systems, climate change and environmental degradation require that international initiatives promoting sustainability be vigorously complemented by local multi-stakeholder efforts to preserve or restore the capacity to produce food in a durable manner. As a step towards making the City of Vancouver green, we are currently involved in attempts to transform the food system of the local schools by mobilizing the energy of a transdisciplinary research team of twelve university researchers, over 300 undergraduate and graduate students, and twenty community-based researchers and organizations working on food, public health, environmental and sustainability education.

  15. Self-managing teams in manufacturing companies: implications for the engineering function

    NARCIS (Netherlands)

    Leede, de Jan; Stoker, Janka

    Reports on an explanatory multiple case-study of companies with self-managing teams. Reasons for introducing self-managing teams; Cooperation between self-managing teams and engineering development; Conclusion.

  16. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. (United States)

    Norris, S L; Engelgau, M M; Narayan, K M


    To systematically review the effectiveness of self-management training in type 2 diabetes. MEDLINE, Educational Resources Information Center (ERIC), and Nursing and Allied Health databases were searched for English-language articles published between 1980 and 1999. Studies were original articles reporting the results of randomized controlled trials of the effectiveness of self-management training in people with type 2 diabetes. Relevant data on study design, population demographics, interventions, outcomes, methodological quality, and external validity were tabulated. Interventions were categorized based on educational focus (information, lifestyle behaviors, mechanical skills, and coping skills), and outcomes were classified as knowledge, attitudes, and self-care skills; lifestyle behaviors, psychological outcomes, and quality of life; glycemic control; cardiovascular disease risk factors; and economic measures and health service utilization. A total of 72 studies described in 84 articles were identified for this review. Positive effects of self-management training on knowledge, frequency and accuracy of self-monitoring of blood glucose, self-reported dietary habits, and glycemic control were demonstrated in studies with short follow-up (studies demonstrated the effectiveness of self-management training on cardiovascular disease-related events or mortality; no economic analyses included indirect costs; few studies examined health-care utilization. Performance, selection, attrition, and detection bias were common in studies reviewed, and external generalizability was often limited. Evidence supports the effectiveness of self-management training in type 2 diabetes, particularly in the short term. Further research is needed to assess the effectiveness of self-management interventions on sustained glycemic control, cardiovascular disease risk factors, and ultimately, microvascular and cardiovascular disease and quality of life.

  17. Sustainable Buildings

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Elle, Morten

    The scientific community agrees that: all countries must drastically and rapidly reduce their CO2 emissions and that energy efficient houses play a decisive role in this. The general attitude at the workshop on Sustainable Buildings was that we face large and serious climate change problems...

  18. Using health trainers to promote self-management of chronic pain: can it work? (United States)

    Harris, Janet; Williams, Tim; Hart, Ollie; Hanson, Chris; Johnstone, Gareth; Muthana, Aziz; Nield, Chris


    In 2011, the Sheffield Primary Care Trust piloted a Health Trainer (HT) programme targeted specifically to people with chronic pain. The programme aimed to determine whether patients presenting to primary care with chronic pain would benefit from self-management support, thereby reducing the burden on primary care and secondary care services. We conducted a formative mixed-methods evaluation of the pilot programme, focusing on four aspects of implementation: general practitioner (GP) referral to the programme, HT's ability to use cognitive behavioural (CB) approaches, short-term outcomes for clients and adequacy of resources. Qualitative data were collected via interviews with GPs, HTs and the chronic pain team; supervision sessions with HTs; and client case studies. Quantitative data were collected on satisfaction with training, HT's self-reported confidence to implement CB and clients' self-rated well-being before and after participation. A total of 143 clients with pain for 1 year or more were referred, exceeding the projected 90 referrals by over 50%. A total of 70% of the clients came from the most deprived areas of Sheffield, 40% were listed as permanently sick/disabled and only 20% were working. Qualitative analysis indicated that the CB training was delivered as intended. Clients reported that 75% of their goals were either achieved or partly achieved, and at follow-up 43% of them reported maintaining strategies for self-management. Financial resources were supplemented by indirect resources, including GP 'champions' with a special interest in pain, and a multidisciplinary chronic pain team. The prior history of working with community organizations was critical in ensuring credibility in client communities and addressing client needs. A HT programme promoting self-management of chronic pain can be successfully implemented when supported by community organisations. Preliminary data indicate that the programme can be instrumental in helping clients to

  19. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

    NARCIS (Netherlands)

    Warner, G.; Packer, T.L.; Villeneuve, M.; Audulv, A.; Versnel, J.


    PURPOSE: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing

  20. Sustainable Management of Food (United States)

    To provide information to organizations to help them implement sustainable food management, including joining the Food Recovery Challenge. To provide education and information to communities and concerned citizens.

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

    Directory of Open Access Journals (Sweden)

    Thulani Dube


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

  2. An Early Look at Building a Social Learning for Sustainability Community of Practice: RCE Grand Rapids' Flagship Project (United States)

    Glasser, Harold


    Grand Rapids is the first United Nations University (UNU) Regional Centre of Expertise (RCE) on education for sustainable development (ESD) in the United States. It builds on the region's long history and deep foundation in research, planning and problem solving to build a sustainable future. This article explores the concept of RCEs as social…

  3. Creating the Urban Village: Teaching Pre-Service Teachers about Sustainable Design in Architecture and Community Planning (United States)

    Vande Zande, Robin


    Sustainable design is a philosophy adopted by people concerned with the health of society and the natural environment. The practice of sustainable design works toward the improvement of the quality of the built environment, while reducing or eradicating the negative impact on the natural environment (McLennan 2004). It is a philosophical approach…

  4. Social support systems as determinants of self-management and quality of life of people with diabetes across Europe: study protocol for an observational study

    NARCIS (Netherlands)

    Koetsenruijter, J.; Lieshout, J. van; Vassilev, I.; Portillo, M.C.; Serrano, M.; Knutsen, I.; Roukova, P.; Lionis, C.; Todorova, E.; Foss, C.; Rogers, A.; Wensing, M.


    BACKGROUND: Long-term conditions pose major challenges for healthcare systems. Optimizing self-management of people with long-term conditions is an important strategy to improve quality of life, health outcomes, patient experiences in healthcare, and the sustainability of healthcare systems. Much

  5. A review of mobile apps for epilepsy self-management. (United States)

    Escoffery, Cam; McGee, Robin; Bidwell, Jonathan; Sims, Christopher; Thropp, Eliana Kovitch; Frazier, Cherise; Mynatt, Elizabeth D


    Mobile health app developers increasingly are interested in supporting the daily self-care of people with chronic conditions. The purpose of this study was to review mobile applications (apps) to promote epilepsy self-management. It investigates the following: 1) the available mobile apps for epilepsy, 2) how these apps support patient education and self-management (SM), and 3) their usefulness in supporting management of epilepsy. We conducted the review in Fall 2017 and assessed apps on the Apple App Store that related to the terms "epilepsy" and "seizure". Inclusion criteria included apps (adult and pediatric) that, as follows, were: 1) developed for patients or the community; 2) made available in English, and 3) less than $5.00. Exclusion criteria included apps that were designed for dissemination of publications, focused on healthcare providers, or were available in other languages. The search resulted in 149 apps, of which 20 met the selection criteria. A team reviewed each app in terms of three sets of criteria: 1) epilepsy-specific descriptions and SM categories employed by the apps and 2) Mobile App Rating Scale (MARS) subdomain scores for reviewing engagement, functionality, esthetics, and information; and 3) behavioral change techniques. Most apps were for adults and free. Common SM domains for the apps were treatment, seizure tracking, response, and safety. A number of epilepsy apps existed, but many offered similar functionalities and incorporated few SM domains. The findings underline the need for mobile apps to cover broader domains of SM and behavioral change techniques and to be evaluated for outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Sustainable projects of MHP for the isolated small communities in the Amazon; Projetos sustentaveis de CGH para pequenas comunidades isoladas da Amazonia

    Energy Technology Data Exchange (ETDEWEB)

    Quintas, Marlus C. [Universidade Federal do Para (PPGEM/ITEC/UFPA), Belem, PA (Brazil). Instituto de Tecnologia. Programa de Pos-graduacao em Engenharia Mecanica], E-mails:,; Blanco, Claudio J.C. [Universidade Federal do Para (FAESA/ITEC/UFPA), Belem, PA (Brazil). Instituto de Tecnologia. Faculdade Engenharia Naval], E-mail:; Mesquita, Andre L.A. [Universidade Federal do Para (FEM/ITEC/UFPA), Belem, PA (Brazil). Instituto de Tecnologia. Faculdade de Engenharia Mecanica], E-mail:


    A major problem for sustainable development in the Amazon is the difficulty of supplying electric power to isolated communities. This problem has been a major obstacle to the productive activities of such communities, especially extractive and agricultural. One way to solve this problem would be to use the small rivers in the region by implementing Micro Hydroelectric Power Plants. In this paper, it was suggested a run-of-river scheme, based on a survey of energy demand and the local hydrological and topographical characteristics. Assessments of environmental, hydropower and economic aspects were developed. Also, the power supply option existing in the community - diesel generator - was analyzed. By comparing the analyses of the Micro hydroelectric power plants (MHP) to those of the diesel generator, the environmental and economic advantage of the MHP was confirmed, thus demonstrating that these can be considered for solving, in a sustainable manner, the problem of shortage of electric power supply verified in the small communities in the Amazon. (author)

  7. Telehealth--an effective delivery method for diabetes self-management education? (United States)

    Fitzner, Karen; Moss, Gail


    Diabetes is a chronic disease that is often comorbid with cardiovascular disease, hypertension, kidney disease, and neuropathy. Its management is complex, requiring ongoing clinical management, lifestyle changes, and self-care. This article examines recent literature on telehealth and emerging technological tools for supporting self-management of diabetes and identifies best practices. The authors conducted a PubMed search (January 2008-2012) that was supplemented by review of meeting materials and a scan of the Internet to identify emerging technologies. Fifty-eight papers were reviewed; 12 were selected for greater analysis. This review supports earlier findings that the delivery of diabetes self-management and training (DSME/T) via telehealth is useful, appropriate, and acceptable to patients and providers. Best practices are emerging; not all technology is appropriate for all populations--interactive technology needs to be appropriate to the patient's age, abilities, and sensitivities. Telehealth is scalable and sustainable provided that it adds value, does not add to the provider's workload, and is fairly reimbursed. However, there are multiple barriers (patient, provider, health system) to remotely provided DSME/T. DSME/T delivered via telehealth offers effective, efficient, and affordable ways to reach and support underserved minorities and other people with diabetes and related comorbidities. The new generation of smartphones, apps, and other technologies increase access, and the newest interventions are designed to meet patient needs, do not increase workloads, are highly appropriate, enhance self-management, and are desired by patients.

  8. Self-management support at the end of life: Patients', carers' and professionals' perspectives on managing medicines. (United States)

    Campling, N; Richardson, A; Mulvey, M; Bennett, M; Johnston, B; Latter, S


    Pain is a frequently reported symptom by patients approaching the end of life and well-established that patients and carers hold fears relating to opioids, and experience side effects related to their use. The management of medicines is intrinsic to achieving effective pain relief. The concept of self-management support whilst well characterised in the context of chronic illness has not been elaborated with respect to end of life care. To identify patient, carer and professional views on the concept of self-management support at end of life, specifically in relation to analgesia and related medicines (for side-effect management) in order to describe, characterise and explain self-management support in this context. Qualitative design, data collection methods involved focus groups and interviews. Topics included the meaning of self-management support in this context, roles and behaviours adopted to manage pain-related medicines, and factors that influence these. A largely deductive approach was used, involving verification and validation of key frameworks from the literature, but with capacity for new findings to emerge. Participants were drawn from two different localities in England, one North, the other South. Interviews with patients and carers took place in their own homes and focus groups with healthcare professionals were held at local hospices. 38 individuals participated. 15 patients, in the last year of life, and 4 carers under the care of community-based specialist palliative care services and 19 specialist palliative care health professionals (predominantly community palliative care nurses). The concept of self-management support had salience for patients, carers and specialist nurses alongside some unique features, specific to the end of life context. Specifically self-management was identified as an ever-changing process enacted along a continuum of behaviours fluctuating from full to no engagement. Disease progression, frequent changes in symptoms and

  9. Mindfulness-based lifestyle programs for the self-management of Parkinson's disease in Australia. (United States)

    Vandenberg, Brooke E; Advocat, Jenny; Hassed, Craig; Hester, Jennifer; Enticott, Joanne; Russell, Grant


    Despite emerging evidence suggesting positive outcomes of mindfulness training for the self-management of other neurodegenerative diseases, limited research has explored its effect on the self-management of Parkinson's disease (PD). We aimed to characterize the experiences of individuals participating in a facilitated, group mindfulness-based lifestyle program for community living adults with Stage 2 PD and explore how the program influenced beliefs about self-management of their disease. Our longitudinal qualitative study was embedded within a randomized controlled trial exploring the impact of a 6-week mindfulness-based lifestyle program on patient-reported function. The study was set in Melbourne, Australia in 2012-2013. We conducted semi-structured interviews with participants before, immediately after, and 6 months following participation in the program. Sixteen participants were interviewed prior to commencing the program. Of these, 12 were interviewed shortly after its conclusion, and 9 interviewed at 6 months. Prior to the program, participants felt a lack of control over their illness. A desire for control and a need for alternative tools for managing the progression of PD motivated many to engage with the program. Following the program, where participants experienced an increase in mindfulness, many became more accepting of disease progression and reported improved social relationships and self-confidence in managing their disease. Mindfulness-based lifestyle programs have the potential for increasing both participants' sense of control over their reactions to disease symptoms as well as social connectedness. Community-based mindfulness training may provide participants with tools for self-managing a number of the consequences of Stage 2 PD.

  10. Strategies for enhancing information, motivation, and skills for self-management behavior changes: a qualitative study of diabetes care for older adults in Korea. (United States)

    Choi, Suyoung; Song, Misoon; Chang, Sun Ju; Kim, Se-An


    To describe strategies for enhancing information, motivation, and skills related to changes in diabetes self-management behavior among community-dwelling older adults in Korea. A total of five focus group interviews (three separate focus groups) were conducted with 12 older adults with type 2 diabetes and five diabetes educators. Qualitative content analysis was used. "One's own willingness and ability" emerged as a fundamental belief about the strategies for diabetes self-management. Six major themes under three categories were identified. Under the information category, the recurrent themes were: 1) repeatedly offering detailed knowledge regarding self-management, 2) providing information about current health status, and 3) identifying experiential knowledge of blood glucose control. The recurrent themes in the motivation category were: 1) ensuring a positive attitude regarding self-management, and 2) encouragement or feedback from significant others. Furthermore, in the skills category, we found that the following theme emerged: hands-on skills training with numerical standards. This study identified six tailored strategies for enhancing information, motivation, and skills for diabetes self-management behavior changes. These strategies can be used in the development of a culturally sensitive diabetes self-management program for older adults.

  11. African American community members sustain favorable blood pressure outcomes through 12-month telephone motivational interviewing (MI) maintenance (United States)

    Community approaches offer promise for addressing disparities experienced by African Americans in hypertension prevalence, treatment, and control. HUB City Steps, a community-based participatory research lifestyle intervention, tracked participants through a 12-month MI maintenance phase following a...

  12. Developing sustainable transportation performance measures for ALDOT. (United States)


    Sustainable transportation is generally used to refer to transportation that contributes to the sustainable development of the community that owns and uses the system. The Transportation Research Board defines sustainability as: Sustainability is ...

  13. Designing, Supporting, and Sustaining an Online Community of Practice: NASA EPO Workspace as an Ongoing Exploration of the Value of Community (United States)

    Davey, B.; Davis, H. B.


    Increasingly, geographically diverse organizations, like NASA's Science Mission Directorate Education and Public Outreach personnel (SMD EPO), are looking for ways to facilitate group interactions in meaningful ways while limiting costs. Towards this end, of particular interest, and showing great potential are communities of practice. Communities of practice represent relationships in real-time between and among people sharing a common practice. They facilitate the sharing of information, building collective knowledge, and growing of the principles of practice. In 2010-11, SMD EPO established a website to support EPO professionals, facilitate headquarters reporting, and foster a community of practice. The purpose of this evaluation is to examine the design and use of the workspace and the value created for both individual community members and SMD EPO, the sponsoring organization. The online workspace was launched in 2010-11 for the members of NASA's SMDEPO community. The online workspace was designed to help facilitate the efficient sharing of information, be a central repository for resources, help facilitate and support knowledge creation, and ultimately lead to the development of an online community of practice. This study examines the role of the 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. Additionally, we look at the outcomes of housting the online community for these past years in respect to knowledge building and personal and organizational value, the affects on professional dvelopment opportunities, how community members have benefited, and how the workspace has evolved to better serve the community.

  14. The impact of cognitive impairment on self-management in chronic obstructive pulmonary disease: A systematic review. (United States)

    Baird, Chelsea; Lovell, Janaka; Johnson, Marilyn; Shiell, Kerrie; Ibrahim, Joseph E


    To determine the characteristics of persons with cognitive impairment being able to self-manage in chronic obstructive pulmonary disease (COPD). In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance this systematic review examined all studies in English from 1st January 2000 to 20 February 2016, describing the relationship between cognition and COPD self-management domains in older community dwelling persons with dementia or cognitive impairment. Of 4474 studies identified, thirteen studies were eligible for inclusion. No studies differentiated populations into recognized dementia subtypes. Study aims were variable; most (n = 7) examined inhaler competency alone. Studies identified a link between worsening cognition and the need for assistance in activities of daily living. Only one study evaluated the impact of cognition on overall self-management and found no association between cognitive impairment and self-rated self-management. Mild degrees of cognitive impairment were associated with reduced symptom recall. Cognitive impairment in COPD was associated with high degrees of inhaler incompetency. Basic cognitive screening tests were able to predict inhaler incompetence with reduced overall cognitive function, dyspraxia, and/or executive function identified as predictors of incompetency. Multiple measures of disability consistently demonstrated that cognitive impairment in COPD significantly increased the need for assistance in many aspects of daily living, treatment adherence, and effective self-management. Given the nature of neuropsychological deficits seen in COPD, dedicated screening tools are required. Future research should investigate the impact of cognitive dysfunction in COPD and identify how to support those that lack capacity to self-manage. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Optimal Decision Model for Sustainable Hospital Building Renovation—A Case Study of a Vacant School Building Converting into a Community Public Hospital (United States)

    Juan, Yi-Kai; Cheng, Yu-Ching; Perng, Yeng-Horng; Castro-Lacouture, Daniel


    Much attention has been paid to hospitals environments since modern pandemics have emerged. The building sector is considered to be the largest world energy consumer, so many global organizations are attempting to create a sustainable environment in building construction by reducing energy consumption. Therefore, maintaining high standards of hygiene while reducing energy consumption has become a major task for hospitals. This study develops a decision model based on genetic algorithms and A* graph search algorithms to evaluate existing hospital environmental conditions and to recommend an optimal scheme of sustainable renovation strategies, considering trade-offs among minimal renovation cost, maximum quality improvement, and low environmental impact. Reusing vacant buildings is a global and sustainable trend. In Taiwan, for example, more and more school space will be unoccupied due to a rapidly declining birth rate. Integrating medical care with local community elder-care efforts becomes important because of the aging population. This research introduces a model that converts a simulated vacant school building into a community public hospital renovation project in order to validate the solutions made by hospital managers and suggested by the system. The result reveals that the system performs well and its solutions are more successful than the actions undertaken by decision-makers. This system can improve traditional hospital building condition assessment while making it more effective and efficient. PMID:27347986

  16. Optimal Decision Model for Sustainable Hospital Building Renovation-A Case Study of a Vacant School Building Converting into a Community Public Hospital. (United States)

    Juan, Yi-Kai; Cheng, Yu-Ching; Perng, Yeng-Horng; Castro-Lacouture, Daniel


    Much attention has been paid to hospitals environments since modern pandemics have emerged. The building sector is considered to be the largest world energy consumer, so many global organizations are attempting to create a sustainable environment in building construction by reducing energy consumption. Therefore, maintaining high standards of hygiene while reducing energy consumption has become a major task for hospitals. This study develops a decision model based on genetic algorithms and A* graph search algorithms to evaluate existing hospital environmental conditions and to recommend an optimal scheme of sustainable renovation strategies, considering trade-offs among minimal renovation cost, maximum quality improvement, and low environmental impact. Reusing vacant buildings is a global and sustainable trend. In Taiwan, for example, more and more school space will be unoccupied due to a rapidly declining birth rate. Integrating medical care with local community elder-care efforts becomes important because of the aging population. This research introduces a model that converts a simulated vacant school building into a community public hospital renovation project in order to validate the solutions made by hospital managers and suggested by the system. The result reveals that the system performs well and its solutions are more successful than the actions undertaken by decision-makers. This system can improve traditional hospital building condition assessment while making it more effective and efficient.

  17. Collaboration in Action: Working with Indigenous peoples and Tribal communities to navigate climate decision support organizations and programs to assist Tribal communities in addressing climate resilience and sustainability efforts (United States)

    Caldwell, C. M.


    Creating opportunities and appropriate spaces with Tribal communities to engage with western scientists on climate resiliency is a complex endeavor. The shifting of seasons predicted by climate models and the resulting impacts that climate scientists investigate often verify what Traditional knowledge has already revealed to Indigenous peoples as they continue to live on, manage, and care for the environment they have been a part of for thousands of years. However, this convergence of two ways of knowing about our human environmental relationships is often difficult to navigate because of the ongoing impacts of colonialism and the disadvantage that Tribes operate from as a result. Day to day priorities of the Tribe are therefore reflective of more immediate issues rather than specifically considering the uncertainties of climate change. The College of Menominee Nation Sustainable Development Institute has developed a climate resilience program aimed at combining western science methodologies with indigenous ways of knowing as a means to assist Tribes in building capacity to address climate and community resiliency through culturally appropriate activities led by the Tribes. The efforts of the Institute, as guided by the SDI theoretical model of sustainability, have resulted in a variety of research, education and outreach projects that have provided not only the Menominee community, but other Tribal communities with opportunities to address climate resiliency as they see fit.

  18. Self-Management: Taking Charge of Your Health (United States)

    ... method of taking control is called “self-management.” What is self-management of chronic illness? Self-management of chronic illness means that you take responsibility for doing what it takes to manage your illness effectively. It’s ...

  19. The complexity of shaping self-management in daily practice

    NARCIS (Netherlands)

    H.M. van de Bovenkamp (Hester); J. Dwarswaard (Jolanda)


    markdownabstract_Background and context:_ Many countries are giving patients a more active role in health care, on both the individual and collective level. This paper focuses on one aspect of the participation agenda on the individual level: self-management. The paper explores self-management in

  20. Self-Management Patient Education and Weight Loss (United States)

    Stombaugh, Angela M.


    Self-management of a disease is defined as "having or being able to obtain, the skills and resources necessary to best accommodate to the chronic disease and its consequences" (Holman & Lorig, 1992, p. 309). Self-management has been used in the management of several chronic conditions and this model may be useful in the management of weight loss.…