Conducting a randomized trial in rural and urban safety-net health centers: Added value of community-based participatory research

Directory of Open Access Journals (Sweden)

Meera Muthukrishnan

2018-06-01

Full Text Available Background: Colorectal cancer (CRC is the second most common cancer in the US. Despite evidence that screening reduces CRC incidence and mortality, screening rates are sub-optimal with disparities by race/ethnicity, income, and geography. Rural-urban differences in CRC screening are understudied even though approximately one-fifth of the US population lives in rural areas. This focus on urban populations limits the generalizability and dissemination potential of screening interventions. Methods: Using community-based participatory research (CBPR principles, we designed a cluster-randomized trial, adaptable to a range of settings, including rural and urban health centers. We enrolled 483 participants across 11 health centers representing 2 separate networks. Both networks serve medically-underserved communities; however one is primarily rural and one primarily urban. Results: Our goal in this analysis is to describe baseline characteristics of participants and examine setting-level differences. CBPR was a critical for recruiting networks to the trial. Patient respondents were predominately female (61.3%, African-American (66.5%, and earned <$1200 per month (87.1%. The rural network sample was older; more likely to be female, white, disabled or retired, and have a higher income, but fewer years of education. Conclusions: Variation in the samples partly reflects the CBPR process and partly reflects inherent differences in the communities. This confirmed the importance of using CBPR when planning for eventual dissemination, as it enhanced our ability to work within diverse settings. These baseline findings indicate that using a uniform approach to implementing a trial or intervention across diverse settings might not be effective or efficient. Keywords: Colorectal cancer screening, Community-based participatory research, Health disparities, Medically underserved populations, Dissemination and implementation, Randomized trial

Pediatric Asthma Care Coordination in Underserved Communities: A Quasiexperimental Study.

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Janevic, Mary R; Stoll, Shelley; Wilkin, Margaret; Song, Peter X K; Baptist, Alan; Lara, Marielena; Ramos-Valencia, Gilberto; Bryant-Stephens, Tyra; Persky, Victoria; Uyeda, Kimberly; Lesch, Julie Kennedy; Wang, Wen; Malveaux, Floyd J

2016-11-01

To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical-social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino. We assessed asthma symptoms and health care utilization via parent interview at baseline and 12 months. To prevent overestimation of intervention effects, we constructed a comparison group using bootstrap resampling of matched control cases from previous pediatric asthma trials. At follow-up, intervention participants had 2.2 fewer symptom days per month (SD = 0.3; P < .01) and 1.9 fewer symptom nights per month (SD = 0.35; P < .01) than did the comparison group. The relative risk in the past year associated with the intervention was 0.63 (95% confidence interval [CI] = 0.45, 0.89) for an emergency department visit and 0.69 (95% CI = 0.47, 1.01) for hospitalization. Care coordination may improve pediatric asthma symptom control and reduce emergency department visits. Expanding third-party reimbursement for care coordination services may help reduce pediatric asthma disparities.

Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

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Hill, Caterina; Zurakowski, David; Bennet, Jennifer; Walker-White, Rainelle; Osman, Jamie L; Quarles, Aaron; Oriol, Nancy

2012-03-01

The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

Empowering underserved populations through cancer prevention and early detection.

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Rivera-Colón, Venessa; Ramos, Roberto; Davis, Jenna L; Escobar, Myriam; Inda, Nikki Ross; Paige, Linda; Palencia, Jeannette; Vives, Maria; Grant, Cathy G; Green, B Lee

2013-12-01

It is well documented that cancer is disproportionately distributed in racial/ethnic minority groups and medically underserved communities. In addition, cancer prevention and early detection represent the key defenses to combat cancer. The purpose of this article is to showcase the comprehensive health education and community outreach activities at the H. Lee Moffitt Cancer Center and Research Institute (Moffitt) designed to promote and increase access to and utilization of prevention and early detection services among underserved populations. One of Moffitt's most important conduits for cancer prevention and early detection among underserved populations is through its community education and outreach initiatives, in particular, the Moffitt Program for Outreach Wellness Education and Resources (M-POWER). M-POWER works to empower underserved populations to make positive health choices and increase screening behaviors through strengthening collaboration and partnerships, providing community-based health education/promotion, and increasing access to care. Effective, empowering, and culturally and linguistically competent health education and community outreach, is key to opening the often impenetrable doors of cancer prevention and early detection to this society's most vulnerable populations.

Sleep duration of underserved minority children in a cross-sectional study

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Short sleep duration has been shown to associate with increased risk of obesity. Childhood obesity is more prevalent among underserved minority children. The study measured the sleep duration of underserved minority children living in a large US urban environment using accelerometry and its relation...

Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

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Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

2013-06-01

To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

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Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

2015-11-01

The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

Engaging the underserved: a process model to mobilize rural community health coalitions as partners in translational research.

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Davis, Melinda M; Aromaa, Susan; McGinnis, Paul B; Ramsey, Katrina; Rollins, Nancy; Smith, Jamie; Beamer, Beth Ann; Buckley, David I; Stange, Kurt C; Fagnan, Lyle J

2014-08-01

Community engagement (CE) and community-engaged research (CEnR) are increasingly recognized as critical elements in research translation. Process models to develop CEnR partnerships in rural and underserved communities are needed. Academic partners transformed four established Community Health Improvement Partnerships (CHIPs) into Community Health Improvement and Research Partnerships (CHIRPs). The intervention consisted of three elements: an academic-community kickoff/orientation meeting, delivery of eight research training modules to CHIRP members, and local community-based participatory research (CBPR) pilot studies addressing childhood obesity. We conducted a mixed methods analysis of pre-/postsurveys, interviews, session evaluations, observational field notes, and attendance logs to evaluate intervention effectiveness and acceptability. Forty-nine community members participated; most (78.7%) attended five or more research training sessions. Session quality and usefulness was high. Community members reported significant increases in their confidence for participating in all phases of research (e.g., formulating research questions, selecting research methods, writing manuscripts). All CHIRP groups successfully conducted CBPR pilot studies. The CHIRP process builds on existing infrastructure in academic and community settings to foster CEnR. Brief research training and pilot studies around community-identified health needs can enhance individual and organizational capacity to address health disparities in rural and underserved communities. © 2014 Wiley Periodicals, Inc.

The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

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Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina

2011-10-01

One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

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Vandebroek, Ina

2013-07-30

The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of

Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

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Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

2002-07-01

infectious disease, preventive medicine, perinatal epidemiology, domestic violence, sexual assault, and disease management. Students develop increased understanding of barriers to health and personal resilience by listening to focus groups conducted with homeless men and undocumented Latino women. They participate in a resident and faculty development retreat on enhancing community medicine knowledge and skills. By August, students select an advisor and outline a project designed to expand understanding in the areas of urban population health research, community health education, professional education, or health intervention planning and evaluation. Faculty members at the Center for Urban Population Health work closely with the students throughout the year, which includes two weeks in the spring that are dedicated to intensive work on the projects. This fourth-year, urban community-based preceptorship is designed to provide students with an alternative fourth year that integrates skill development in clinical and community medicine, offers a continuity primary care experience, and showcases innovative urban health resources and role models. It is hoped that these students will pursue graduate medical education in Milwaukee, incorporate a population perspective in their practice, and choose to work in neighborhoods that are currently underserved.

A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

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Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

2018-01-01

The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.

NASA and Public Libraries: Enhancing STEM Literacy in Underserved Communities

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Dusenbery, P.; LaConte, K.; Harold, J. B.; Randall, C.

2016-12-01

NASA research programs are helping humanity understand the origin and evolution of galaxies, stars, and planets, and defining the conditions necessary to support life beyond Earth. The Space Science Institute's (SSI) National Center for Interactive Learning (NCIL) was recently funded by NASA`s Science Mission Directorate (SMD) to develop and implement a project called NASA@ My Library: A National Earth and Space Science Initiative That Connects NASA, Public Libraries and Their Communities. As places that offer their services for free, public libraries have become the "public square" by providing a place where members of a community can gather for information, educational programming, and policy discussions. Libraries are developing new ways to engage their patrons in STEM learning, and NCIL's STAR Library Education Network (STAR_Net) has been supporting their efforts for the last eight years, including through a vibrant community of practice that serves both librarians and STEM professionals. Project stakeholders include public library staff, state libraries, the earth and space science education community at NASA, subject matter experts, and informal science educators. The project will leverage high-impact SMD and library events to catalyze partnerships through dissemination of SMD assets and professional development. It will also develop frameworks for public libraries to increase STEM interest pathways in their communities (with supports for reaching underserved audiences). This presentation will summarize the key activities and expected outcomes of the 5-year project.

LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

Directory of Open Access Journals (Sweden)

Melanie Austin-McCain

2015-04-01

Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

Occupational safety and health education and training for underserved populations.

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O'Connor, Tom; Flynn, Michael; Weinstock, Deborah; Zanoni, Joseph

2014-01-01

This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers.

Leadership Advocacy: Bringing Nursing to the Homeless and Underserved.

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Porter-OʼGrady, Tim

Nurses have historically played a key role in advocacy and service for all members of the community, including those who are traditionally underserved by other providers or the health system. Nurses from a local Atlanta community health system, both clinical and administrative, have continued this tradition by developing an advocacy and service program for the downtown homeless of Atlanta. From its beginnings as a highly informal volunteer program to its current structure as a strongly integrated community health center for the underserved and homeless of Atlanta, local nurses have demonstrated their strong value of service advocacy. Their leadership, insight, discipline, and strategic development have facilitated the growth of a focused, viable health service network for marginalized people of the city of Atlanta.

The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies

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Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce

2015-01-01

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…

Pop Up/Drill Down: A Traveling Exhibit Designed to Reach Underserved Communities through Art and Geosciences

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Kurtz, N.

2017-12-01

Scientists observe the world around them in an attempt to understand it. Artists observe the world around them in an attempt to create a reflection or response to the environment. It is critical for the two fields to work together in order to engage and inform the general population. The Consortium for Ocean Leadership, the International Ocean Discovery Program and a series of collaborators are designing a traveling exhibit that will inspire underserved communities in the excitement of exploration, the process of science, and the people and tools required to get there. The project aims to learn more about how to increase access to and awareness of ocean/earth science by bringing a pop-up style museum exhibit to local libraries and public events. As an artist with a science and education background and the graphic designer for this exhibit, this author will highlight the ways this project utilizes art and design to educate underserved populations in ocean and geosciences.

Feasibility and Preliminary Outcomes of a School-Based Mindfulness Intervention for Urban Youth

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Mendelson, Tamar; Greenberg, Mark T.; Dariotis, Jacinda K.; Gould, Laura Feagans; Rhoades, Brittany L.; Leaf, Philip J.

2010-01-01

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper…

"I Am Here for a Reason": Minority Teachers Bridging Many Divides in Urban Education

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Magaldi, Danielle; Conway, Timothy; Trub, Leora

2018-01-01

Minority teachers are overwhelmingly employed in urban schools in underserved, low-income communities with large minority student populations. They receive little in the way of multicultural preparation, mentorship, and professional induction to meet the demands of teaching diverse student populations. This grounded theory study explores the…

Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: Cross-sectional analysis of data from Bangladesh, India and Nepal

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M. Neuman (Melissa); G. Alcock (Glyn); K. Azad (Kishwar); A. Kuddus (Abdul); D. Osrin (David); N. Shah More (Neena); N. Nair (Nirmala); P. Tripathy (Prasanta); C. Sikorski (Catherine); N. Saville (Naomi); A. Sen (Aman); T. Colbourn (Tim); A.J. Houweling (Tanja); N. Seward (Nadine); A. Manandhar; B. Shrestha (Bhim); A. Costello (Anthony); A. Prost (Audrey)

2014-01-01

textabstractObjectives: To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design: Cross-sectional study. Setting: 81 community-based geographical clusters in four locations in Bangladesh, India

Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

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Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

2016-05-01

Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

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

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

2017-04-01

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

Caregiver's depressive symptoms and asthma control in children from an underserved community.

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Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A

2017-12-01

Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01). Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.

Leading for Urban School Reform and Community Development

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Green, Terrance L.

2015-01-01

Purpose: Improving urban schools of color and the communities where they are located requires leadership that spans school and community boundaries. The purpose of this study is to understand how principal and community leader actions support urban school reform along with community development at two community schools in the urban Midwest and…

Factors associated with differential uptake of seasonal influenza immunizations among underserved communities during the 2009-2010 influenza season.

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Vlahov, David; Bond, Keosha T; Jones, Kandice C; Ompad, Danielle C

2012-04-01

Influenza vaccination coverage remains low and disparities persist. In New York City, a community-based participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non-traditional venues (i.e., community-based organizations). We conducted a 10 min survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during the influenza season included being US-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP's recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being US born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the US, Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.

Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

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Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

2018-01-27

With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

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Price, Morgan; Weber-Jahnke, Jens H

2009-01-01

This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.

Project Coach: A Case Study of a College-Community Partnerships as a Venture in Social Entrepreneurship

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Intrator, Sam M.; Siegel, Donald

2010-01-01

Project Coach is an after school program developed and directed by the authors. The program, which is set in a high-need urban community in Springfield, Massachusetts, teaches high school and middle school students to be sport coaches and then to run youth sport leagues for elementary-aged youth in underserved neighborhoods in their own community.…

Engaging diverse underserved communities to bridge the mammography divide

Directory of Open Access Journals (Sweden)

Cully Angelia

2011-01-01

Full Text Available Abstract Background Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2 intervention or a

Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

Science.gov (United States)

Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

2010-04-01

The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

Towards sustainable urban communities

International Nuclear Information System (INIS)

Haapio, Appu

2012-01-01

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.

How to Guide: Aggregate under-served markets into buying pools

Energy Technology Data Exchange (ETDEWEB)

None

2000-12-26

This activity promotes new opportunities to increase energy security and lower energy costs for under-served markets. It involves market analysis and collaboration with community partners, as well as outreach activities to inform target markets and technical assistance for participants.

Understanding the performance of community health volunteers involved in the delivery of health programmes in underserved areas: a realist synthesis

OpenAIRE

Vareilles, Ga?lle; Pommier, Jeanine; Marchal, Bruno; Kane, Sumit

2017-01-01

Background The recruitment of community health volunteers (CHVs) to support the delivery of health programmes is an established approach in underserved areas and in particular where there are health inequalities due to the scarcity of trained human resources. However, there is a dearth of evidence about what works to improve CHVs? performance. This review aimed to synthesise existing literature to explain why, how and under which circumstances intervention approaches to improve the performanc...

Positioning Community Art Practices in Urban Cracks

Science.gov (United States)

Verschelden, Griet; Van Eeghem, Elly; Steel, Riet; De Visscher, Sven; Dekeyrel, Carlos

2012-01-01

This article addresses the position of community art practices and the role of practitioners in urban cracks. Community art practices raise possibilities for a reconceptualisation of the concept of community and an extension of the concept of art in public space. Urban cracks are conceptualised as spatial, temporal and relational manifestations of…

Perceived impact of an interprofessional education program on community resilience: an exploratory study.

Science.gov (United States)

Slack, Marion Kimball; McEwen, Marylyn Morris

2013-09-01

The purpose of this study was to explore the perceived impact of an interprofessional education (IPE) program for health sciences students on two culturally diverse, underserved communities. A community resilience/capacity framework, consisting of catalysts (primarily the creation of awareness) and capital components: human (workforce development), social (networking and empowerment) and economic (volunteer labor and money spent by the program), provided the conceptual underpinnings for the study. Focus groups with stakeholders in two communities, one rural and one metropolitan, were audio-recorded, transcribed and analyzed by categorizing data according to each capital component. In addition to the concepts contained in the capacity framework a new category, informational capital (data specific to the community) emerged during the analysis. We suggest that by acting as a catalyst a community based interprofessional program can affect components of community resilience/capacity, primarily human, social, and informational capital. Using the community resilience/capacity framework facilitated exploration of the perceived impact of an educational program on one rural and one urban underserved community beyond assessing student outcomes or number of clients served.

Occupational Health and Sleep Issues in Underserved Populations.

Science.gov (United States)

Kalliny, Medhat; McKenzie, Judith Green

2017-03-01

Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

Exercise and Sports Medicine Issues in Underserved Populations.

Science.gov (United States)

Morelli, Vincent; Bedney, Daniel L; Eric Dadush, Arie

2017-03-01

Primary care providers can make a strong argument for exercise promotion in underserved communities. The benefits are vitally important in adolescent physical, cognitive, and psychological development as well as in adult disease prevention and treatment. In counseling such patients, we should take into account a patient's readiness for change and the barriers to exercise. Copyright © 2016 Elsevier Inc. All rights reserved.

The Inwood Astronomy Project: 100 Nights in Manhattan---An Outreach Initiative to Underserved Communities

Science.gov (United States)

Kendall, J. S.

2008-11-01

Observing the night sky in New York City is a challenge. However, there is a popular, and even club-going, interest in science in New York City. On the edges of that interest, most people that live in New York City have never had the opportunity to look through a telescope, particularly in underserved areas such as Northern Manhattan. The presenter discusses plans for frequent observing sessions utilizing the parks in New York City combined with public classes at the New York Public Library. Both observing sessions and classes will be held in the ethnically, racially and economically diverse Bronx and Manhattan neighborhoods of Washington Heights, Marble Hill and Inwood. Integration with area middle, elementary and high schools is also discussed. Particular issues surrounding publicity and the need for showmanship in an image-driven community with numerous entertainment opportunities are also discussed.

Communities and Spontaneous Urban Planning: A Toolkit for Urban ...

International Development Research Centre (IDRC) Digital Library (Canada)

State-led urban planning is often absent, which creates unsustainable environments and hinders the integration of migrants. Communities' prospects of ... This toolkit is expected to be a viable alternative for planning urban expansion wherever it cannot be carried out through traditional means. The toolkit will be tested in ...

Community Foresight for Urban Sustainability

DEFF Research Database (Denmark)

Mortensen, Jonas Egmose; Eames, Malcolm

2011-01-01

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

Breaking Barriers to Bike Share: Insights from Residents of Traditionally Underserved Neighborhoods

Science.gov (United States)

2017-06-01

Evidence has shown that higher income and white populations are overrepresented in both access to and use of bike share. Efforts to overcome underserved communities barriers to access and use of bike share have been initiated in a number of cities...

Enrolling Minority and Underserved Populations in Cancer Clinical Research.

Science.gov (United States)

Wallington, Sherrie F; Dash, Chiranjeev; Sheppard, Vanessa B; Goode, Tawara D; Oppong, Bridget A; Dodson, Everett E; Hamilton, Rhonda N; Adams-Campbell, Lucile L

2016-01-01

Research suggests that community involvement is integral to solving public health problems, including involvement in clinical trials-a gold standard. Significant racial/ethnic disparities exist in the accrual of participants for clinical trials. Location and cultural aspects of clinical trials influence recruitment and accrual to clinical trials. It is increasingly necessary to be aware of defining characteristics, such as location and culture of the populations from which research participants are enrolled. Little research has examined the effect of location and cultural competency in adapting clinical trial research for minority and underserved communities on accrual for clinical trials. Utilizing embedded community academic sites, the authors applied cultural competency frameworks to adapt clinical trial research in order to increase minority participation in nontherapeutic cancer clinical trials. This strategy resulted in successful accrual of participants to new clinical research trials, specifically targeting participation from minority and underserved communities in metropolitan Washington, DC. From 2012 to 2014, a total of 559 participants enrolled across six nontherapeutic clinical trials, representing a 62% increase in the enrollment of blacks in clinical research. Embedding cancer prevention programs and research in the community was shown to be yet another important strategy in the arsenal of approaches that can potentially enhance clinical research enrollment and capacity. The analyses showed that the capacity to acquire cultural knowledge about patients-their physical locales, cultural values, and environments in which they live-is essential to recruiting culturally and ethnically diverse population samples. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Multicultural Milky Way: Ethnoastronomy and Planetarium Shows for Under-served Arizonans

Science.gov (United States)

Knierman, Karen

2018-01-01

The astronomy outreach initiative, Multicultural Milky Way, partners the School of Earth and Space Exploration (SESE) at Arizona State University (ASU) with under-served populations in Arizona in learning about our Milky Way and other galaxies. Arizona is home to many diverse populations with rich cultural histories such as Mayan, Navajo, and Apache. Linking astronomy practiced by one’s indigenous culture to that of Western astronomy may increase the interest in science. Through multicultural planetarium shows and associated hands-on activities, under-served students and families will learn how the Milky Way is represented in different cultures and about the science of galaxies. New planetarium shows using the Mesa Community College (MCC) Digital Planetarium and STARLAB portable planetarium explore how the Milky Way is interpreted in different cultures. STARLAB shows and associated new hands-on activities have been featured during school visits, teacher trainings, and Community Astronomy Nights around Arizona. For authentic assessment, evaluation techniques and procedures were developed.

Watershed Urbanization Linked to Differences in Stream Bacterial Community Composition

Directory of Open Access Journals (Sweden)

Jacob D. Hosen

2017-08-01

Full Text Available Urbanization strongly influences headwater stream chemistry and hydrology, but little is known about how these conditions impact bacterial community composition. We predicted that urbanization would impact bacterial community composition, but that stream water column bacterial communities would be most strongly linked to urbanization at a watershed-scale, as measured by impervious cover, while sediment bacterial communities would correlate with environmental conditions at the scale of stream reaches. To test this hypothesis, we determined bacterial community composition in the water column and sediment of headwater streams located across a gradient of watershed impervious cover using high-throughput 16S rRNA gene amplicon sequencing. Alpha diversity metrics did not show a strong response to catchment urbanization, but beta diversity was significantly related to watershed impervious cover with significant differences also found between water column and sediment samples. Samples grouped primarily according to habitat—water column vs. sediment—with a significant response to watershed impervious cover nested within each habitat type. Compositional shifts for communities in urbanized streams indicated an increase in taxa associated with human activity including bacteria from the genus Polynucleobacter, which is widespread, but has been associated with eutrophic conditions in larger water bodies. Another indicator of communities in urbanized streams was an OTU from the genus Gallionella, which is linked to corrosion of water distribution systems. To identify changes in bacterial community interactions, bacterial co-occurrence networks were generated from urban and forested samples. The urbanized co-occurrence network was much smaller and had fewer co-occurrence events per taxon than forested equivalents, indicating a loss of keystone taxa with urbanization. Our results suggest that urbanization has significant impacts on the community composition

A Critique of the Application of Neighborhood Sustainability Assessment Tools in Urban Regeneration

Directory of Open Access Journals (Sweden)

Luke Boyle

2018-03-01

Full Text Available Neighbourhood Sustainability Assessment Tools (NSA tools are fast becoming the principal framework for urban planners and developers for promoting urban sustainability. The majority of NSA tools promote a specific type of urban development that effectively excludes regeneration projects from the urban sustainability conversation. Given that the world’s megacities are mostly built, it is argued that it is essential that strategies for global sustainability consider that urban development is focussed internally to address existing, under-serviced communities in particular need of meaningful intervention and sustainable redevelopment frameworks. The paper uses existing knowledge on NSA tools to highlight the shortcomings of outcomes-based approaches to urban governance and builds the case that the technocratic “one-size-fits-all” approach adopted by many tools inadequately accounts for underlying institutional, social and economic arrangements that influence urban development, making them inappropriate for application in both planned and existing communities. The paper proposes that urban redevelopment strategies need to be derived from the urban realities of a particular place or context. Such strategies must be grounded in principles of urban governance, participatory action and an understanding of market dynamics. Without these collaborative procedural frameworks, urban regeneration projects will continue to inadequately transition towards more comprehensive sustainability.

A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

Science.gov (United States)

Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

2012-01-01

Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Of 258 initially active participants, 225 (225/258=87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (pstructure, and effectiveness in improving their HIV-related knowledge and skills. This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired through the process, and could continue working within their underserved communities while participating in the online component and then implement interventions that successfully converted theoretical knowledge to action to improve integration of HIV care into primary care.

Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis.

Science.gov (United States)

Raymond Guilbault, Ryan William; Vinson, Joseph Alexander

2017-01-01

Undergraduate medical students are enrolled in clinical education programs in rural and underserved urban areas to increase the likelihood that they will eventually practice in those areas and train in a primary care specialty to best serve those patient populations. MEDLINE and Cochrane Library online databases were searched to identify articles that provide a detailed description of the exposure and outcome of interest. A qualitative review of articles reporting outcome data without comparison or control groups was completed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis of articles reporting outcome data with comparison or control groups was completed with statistical and graphical summary estimates. Seven hundred and nine articles were retrieved from the initial search and reviewed based on inclusion and exclusion criteria. Of those, ten articles were identified for qualitative analysis and five articles included control groups and thus were included in the quantitative analysis. Results indicated that medical students with clinical training in underserved areas are almost three times as likely to practice in underserved areas than students who do not train in those areas (relative risk [RR] = 2.94; 95% confidence interval [CI]: 2.17, 4.00). Furthermore, medical students training in underserved areas are about four times as likely to practice primary care in underserved areas than students who do not train in those locations (RR = 4.35; 95% CI: 1.56, 12.10). These estimates may help guide medical school administrators and policymakers to expand underserved clinical training programs to help relieve some of the problems associated with access to medical care among underserved populations.

Gender issues in urban indigenous communities in Nigeria ...

African Journals Online (AJOL)

This paper therefore attempts to examine gender issues in five indigenous communities in Port Harcourt. The communities are: Abuloma, Oroazi, Rumuadaolu, Elekahia and Ogbuna-abali. The key questions explored in the study are: how are urban indigenous women been marginalized in the process of urban growth and ...

Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

Science.gov (United States)

Mays, Keith A; Maguire, Meghan

2018-01-01

Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

Correlates of overweight and obesity among urban adolescents in Bihar, India

Directory of Open Access Journals (Sweden)

Ayan Ghosh

2015-01-01

Full Text Available Background: For better perception of adolescent overweight and obesity as a global public health problem, systematic collection of baseline data is urgently needed in India. Objective: A community-based study was undertaken for better perception of the prevalence and correlates of obesity in an adolescent urban community in Katihar, Bihar. Materials and Methods: A cross-sectional study was conducted among urban adolescents in the eastern part of India to find out prevalence of overweight and obesity and sociodemographic correlates by interview technique followed by clinical examination with ethical consideration. Results: Out of 400 adolescent study participants, 21% were overweight or obese. The study showed that there was a significant association between less consumption of vegetable foods, fruits, meals cooked outside the home, alcohol consumption, yoga practice, socioeconomic status, and the occurrence of overweight/obesity in the adolescents. Conclusions: We attempted to find out the prevalence and risk correlates of overweight and obesity among adolescents and found it quite alarming compared to developed countries. The urban underserved population in India has difficulty to access quality healthcare and not conscious enough to seek healthcare until critically ill. Community-based studies are required to highlight the problem of obesity among urban adolescents by a comprehensive approach.

Seeding Social Capital? Urban Community Gardening and Social Capital

DEFF Research Database (Denmark)

Christensen, Søren

2017-01-01

There is a continuing debate regarding urban community gardening’s benefits to local communities, and a particularly interesting branch of this debate has focused on community gardens capacity to encourage and facilitate social interaction, which may generate social capital. Social capital...... is an increasingly important concept in international research and measures of social capital have been associated with various measures of health. In a meta-analysis of literature published between 2000 and 2016 regarding community gardens’ social advantages, through the lens of the concept of social capital......, it is demonstrated that several studies substantiate that urban community gardens create social capital, both bonding and bridging, and exhibit indications of linking. It is moreover identified how there is much to be learned from future research, illuminating how urban community gardens can foster social capital...

American Dental Association White Paper Targets Dental Care for the Underserved

Science.gov (United States)

Berthold, Mark

2005-01-01

Reaffirming its leadership role toward better oral health for all Americans, the ADA has produced a white paper that also challenges policy-makers and the US to improve access to dental services. The white paper, "State and Community Models for Improving Access to Dental Care for the Underserved," was presented October 1 to the House of…

Urban Community, poverty and corruption: the case of Annaba, Algeria

Directory of Open Access Journals (Sweden)

Nadji KAHOUA

2010-01-01

Full Text Available The population in the most Mediterranean countries, particularly in Algeria, is concentrated to the urban communities, cities with more or less importance, urban and coastal regions. This trend of rapid growth of the urban communities leads to multiple consequences both economically and socially on the use of resources and their distribution. The urban is the area where cross the resources, the population and the production activities and yours management. To analyze the corruption as a phenomenon triple (economic, social and institutional through an urban community (as Annaba’s case in this research it may well prove very fruitful in terms of lessons on this central phenomenon and its impacts in the North African countries.

Capacity issues in local communities for integral urban regeneration

Directory of Open Access Journals (Sweden)

Mrđenović Tatjana

2013-01-01

Full Text Available The subject of the research in wider sense is organizational-communication capacity of local communities in Serbia in the frame of sustainable development. Along with this, the paper will explore potentialities of Faludi's model of multiplanning agencies as well as Healey's collaborative theory for better efficiency and effectiveness of planning in the process of urban regeneration. Specifically the paper will research relation between organizational structure of local communities in Serbia and their potentialities to provide adequate communication towards integral information for urban regeneration. Research is framed with a problem of efficiency and effectiveness in creating urban regeneration policies, strategies, designs, and technical solutions. The problem will be focused to Serbian context; characterized with inadequate, transitional, system of governance that is moving from centralistic towards decentralist model. This will be further explored through level and type of participation in the process of urban regeneration. The hypothesis of the research explores the nature of the relation between number and types of communication channels, provided by organizational structure of local communities that should enable effectiveness and efficiency of urban regeneration. In other words the hypothesis is: number and types of communication channels (variable A influences the effectiveness and efficiency of urban planning for sustainable urban regeneration (variable B. The aims of the paper are identification of the regulations between the variables. Expected result is establishing the model for measuring the capacity of local communities for integral urban regeneration.

Social marketing for a farmer’s market in an underserved community: A needs assessment

Directory of Open Access Journals (Sweden)

Meg Skizim

2018-01-01

Full Text Available The aim of the present paper is to assess local residents’ awareness of utilizing Supplemental Nutrition Assistance Program (SNAP benefits to purchase fresh produce at local farmers’ markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (LA, USA. The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers’ markets; 63% of low-income participants never attended a farmers’ market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.

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

Science.gov (United States)

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

2018-03-20

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

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

Science.gov (United States)

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

2015-01-01

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

Rural And Urban Youth Participation In Community Development In ...

African Journals Online (AJOL)

The focused on participation in community development activities, constraints to and benefits derived from participation. It compared rural and urban youth participation in community development activities in Ido local government area of Oyo State. Proportionate random sampling was used to select 2 rural, 1 urban ...

Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

Science.gov (United States)

Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

2016-01-01

eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

Sharing Gravity's Microscope: Star Formation and Galaxy Evolution for Underserved Arizonans

Science.gov (United States)

Knierman, Karen A.; Monkiewicz, Jacqueline A.; Bowman, Catherine DD; Taylor, Wendy

2016-01-01

Learning science in a community is important for children of all levels and especially for many underserved populations. This project combines HST research of galaxy evolution using gravitationally lensed galaxies with hands-on activities and the Starlab portable planetarium to link astronomy with families, teachers, and students. To explore galaxy evolution, new activities were developed and evaluated using novel evaluation techniques. A new set of galaxy classification cards enable inquiry-based learning about galaxy ages, evolution, and gravitational lensing. Activities using new cylinder overlays for the Starlab transparent cylinder will enable the detailed examination of star formation and galaxy evolution as seen from the viewpoint inside of different types of galaxies. These activities were presented in several Arizona venues that enable family and student participation including ASU Earth and Space Open House, Arizona Museum of Natural History Homeschooling Events, on the Salt River Pima-Maricopa Indian Community, and inner city Phoenix schools serving mainly Hispanic populations. Additional events targeted underserved families at the Phoenix Zoo, in Navajo County, and for the Pascua Yaqui Tribe. After evaluation, the activities and materials will also be shared with local teachers and nationally.

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

Directory of Open Access Journals (Sweden)

Lishan Xiao

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

Palliative Oncologic Care Curricula for Providers in Resource-Limited and Underserved Communities: a Systematic Review.

Science.gov (United States)

Xu, Melody J; Su, David; Deboer, Rebecca; Garcia, Michael; Tahir, Peggy; Anderson, Wendy; Kinderman, Anne; Braunstein, Steve; Sherertz, Tracy

2017-12-20

Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.

School as Community, Community as School: Examining Principal Leadership for Urban School Reform and Community Development

Science.gov (United States)

Green, Terrance L.

2018-01-01

For decades, reform has been a persistent issue in urban schools. Research suggests that urban school reforms that are connected to equitable community development efforts are more sustainable, and that principals play a pivot role in leading such efforts. Yet, limited research has explored how urban school principals connect school reform with…

Physician assistants as servant leaders: meeting the needs of the underserved.

Science.gov (United States)

Huckabee, Michael J; Wheeler, Daniel W

2011-01-01

The purpose of this study was to determine if the level of servant leader characteristics in clinically practicing physician assistants (PAs) in underserved populations differed from PAs serving in other locales. Five subscales of servant leadership: altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship, were measured in a quantitative study of clinically practicing PAs using a self-rating survey and a similar survey by others rating the PA. Of 777 PAs invited, 321 completed the survey. On a scale of 1 to 5, mean PA self-ratings ranged from 3.52 (persuasive mapping) to 4.05 (wisdom). Other raters' scores paired with the self-rated PA scores were comparable in all subscales except wisdom, which was rated higher by the other raters (4.32 by other raters, 4.01 by PAs, P= .002). There was no significant difference in the measures of servant leadership reported by PAs serving the underserved compared to PAs serving in other populations. Servant leader subscales were higher for PAs compared to previous studies of other health care or community leader populations. The results found that the PA population studied had a prominent level of servant leadership characteristics that did not differ between those working with underserved and nonunderserved populations.

Recruitment practices for U.S. minority and underserved populations in NRG oncology: Results of an online survey

Directory of Open Access Journals (Sweden)

Elise D. Cook

2018-06-01

Full Text Available Introduction: Cancer clinical trials (CCT provide much of the evidence for clinical guidelines and standards of care. But low levels of CCT participation are well documented, especially for minorities. Methods and materials: We conducted an online survey of 556 recruitment practices across the NRG Oncology network. Survey aims were 1 to learn how sites recruit minority/underserved populations; 2 to better understand the catchment areas of the NRG institutions; and 3 to aid in planning education programs for accrual of minority/underserved populations. Results: The survey response rate was 34.9%. The most effective methods reported for recruiting minority/underserved participants were patient navigators (44.4% and translators (38.9%. All institutions reported using a mechanism for eligibility screening and 71% of institutions reported using a screening/enrollment tracking system. CCT training was required at 78.1% and cultural competency training was required at 47.5% of responding institutions. Only 19.9% of sites used community partners to assist with minority recruitment and just 37.1% of respondents reported a defined catchment area. Sites reported very little race and ethnicity data. Conclusion: This NRG Oncology online survey provides useful data for improvements in trial enrollment and training to recruit minority/underserved populations to CCT. Areas for further investigation include web-based methods for recruitment and tracking, cultural competency training, definition of catchment areas, use of patient navigators, and community partnerships. The survey results will guide recruitment training programs.

Precommitting to Serve the Underserved

Science.gov (United States)

Eyal, Nir; Bärnighausen, Till

2014-01-01

In many countries worldwide, especially in Sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas. PMID:22548519

Precommitting to serve the underserved.

Science.gov (United States)

Eyal, Nir; Bärnighausen, Till

2012-01-01

In many countries worldwide, especially in sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas.

Mobile and Portable Dental Services Catering to the Basic Oral Health Needs of the Underserved Population in Developing Countries: A Proposed Model

Science.gov (United States)

Ganavadiya, R; Chandrashekar, BR; Goel, P; Hongal, SG; Jain, M

2014-01-01

India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model.

Science.gov (United States)

Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M

2014-05-01

India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

5 CFR 894.801 - Will benefits be available in underserved areas?

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Will benefits be available in underserved... Underserved Areas § 894.801 Will benefits be available in underserved areas? (a) Dental and vision plans under FEDVIP will include underserved areas in their service areas and provide benefits to enrollees in...

Declining urban and community tree cover in the United States

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2018-01-01

Paired aerial photographs were interpreted to assess recent changes (c. 2009–2014) in tree, impervious and other cover types within urban/community and urban land in all 50 United States and the District of Columbia. National results indicate that tree cover in urban/community areas of the United States is on the decline at a rate of about 175,000 acres per year, which...

Negative Perceptions of Urban Tourism Community in Beijing: Based on Online Comments

OpenAIRE

Ping, Li; Kaiyong, Wang; Tian, Chen; Fuyuan, Wang

2017-01-01

The development of urban tourism community (UTC) will bring new vigor and vitality into the urban sustainable development. There are abundant tourists’ comments about personal experience in UTC in online travel communities, which provide good access to the knowledge of negative perceptions of urban tourism community. Based on online comments, this paper used content analysis method to research tourists’ negative perceptions about five typical tourism communities in Beijing, whereby the common...

Quercus rubra-associated ectomycorrhizal fungal communities of disturbed urban sites and mature forests.

Science.gov (United States)

Karpati, Amy S; Handel, Steven N; Dighton, John; Horton, Thomas R

2011-08-01

The presence and quality of the belowground mycorrhizal fungal community could greatly influence plant community structure and host species response. This study tests whether mycorrhizal fungal communities in areas highly impacted by anthropogenic disturbance and urbanization are less species rich or exhibit lower host root colonization rates when compared to those of less disturbed systems. Using a soil bioassay, we sampled the ectomycorrhizal fungal (EMF) communities associating with Quercus rubra (northern red oak) seedlings in soil collected from seven sites: two mature forest reference sites and five urban sites of varying levels of disturbance. Morphological and polymerase chain reaction-restriction fragment length polymorphism analyses of fungi colonizing root tips revealed that colonization rates and fungal species richness were significantly lower on root systems of seedlings grown in disturbed site soils. Analysis of similarity showed that EMF community composition was not significantly different among several urban site soils but did differ significantly between mature forest sites and all but one urban site. We identified a suite of fungal species that occurred across several urban sites. Lack of a diverse community of belowground mutualists could be a constraint on urban plant community development, especially of late-successional woodlands. Analysis of urban EMF communities can add to our understanding of urban plant community structure and should be addressed during ecological assessment before pragmatic decisions to restore habitats are framed.

Co-Constructing Community, School, University Partnerships for Urban School Transformation

Science.gov (United States)

Gillenwaters, Jamila Najah

2009-01-01

University-school-community partnerships represent a collaborative model of urban educational reformation inclusive of all the organizations that impact urban education. Co-constructed relationships among communities, schools, and universities have the potential for redistributing hierarchical power, thereby enabling all partners to contribute to…

A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

Directory of Open Access Journals (Sweden)

Tamara Flys

Full Text Available BACKGROUND: Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs. We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. METHODS: The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. RESULTS: Of 258 initially active participants, 225 (225/258=87.2% successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85% attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001. The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001. A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. CONCLUSION: This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills

Validation of English and Spanish-language versions of a screening questionnaire for rheumatoid arthritis in an underserved community.

Science.gov (United States)

Potter, Jeffrey; Odutola, Jennifer; Gonzales, Christian Amurrio; Ward, Michael M

2008-08-01

Questionnaires to screen for rheumatoid arthritis (RA) have been tested in groups that were primarily well educated and Caucasian. We sought to validate the RA questions of the Connective Tissue Disease Screening Questionnaire (CSQ) in ethnic minorities in an underserved community, and to test a Spanish-language version. The Spanish-language version was developed by 2 native speakers. Consecutive English-speaking or Spanish-speaking patients in a community-based rheumatology practice completed the questionnaire. Diagnoses were confirmed by medical record review. Sensitivity and specificity of the questionnaire for a diagnosis of RA were computed for each language version, using 2 groups as controls: patients with noninflammatory conditions, and participants recruited from the community. The English-language version was tested in 53 patients with RA (79% ethnic minorities; mean education level 11.3 yrs), 85 rheumatology controls with noninflammatory conditions, and 82 community controls. Using 3 positive responses as indicating a positive screening test, the sensitivity of the questionnaire was 0.77, the specificity based on rheumatology controls was 0.45, and the specificity based on community controls was 0.94. The Spanish-language version was tested in 55 patients with RA (mean education level 7.8 yrs), 149 rheumatology controls, and 88 community controls. The sensitivity of the Spanish-language version was 0.87, with specificities of 0.60 and 0.97 using the rheumatology controls and community controls, respectively. The sensitivity of the English-language version of the RA questions of the CSQ was lower in this study than in other cohorts, reflecting differences in the performance of the questions in different ethnic or socioeconomic groups. The Spanish-language version demonstrated good sensitivity, and both had excellent specificity when tested in community controls.

The impact of urbanization on the community food environment in China.

Science.gov (United States)

Wu, Yang; Xue, Hong; Wang, Huijun; Su, Chang; Du, Shufa; Wang, Youfa

2017-05-01

Research on how urbanization has influenced the food environment in China is limited. The study aimed to examine the impact of urbanization on the food environment in China. Longitudinal data collected during 1989-2009 from the China Health and Nutrition Survey were used, which covered 9 provinces in China. Urbanicity index (0-10) was assessed using an urbanicity scale. Final analyses included 216 communities. Random-effect models were used in analyses. Urbanization (higher urbanicity index) increased the odds of having fast food restaurants (OR=2.78, 95% CI: 2.18-3.54) and other indoor restaurants (OR=2.93, 95% CI: 2.28-3.76) within the community, the odds of having supermarkets (OR=2.43, 95% CI: 2.04-2.89) and free markets (OR=2.56, 95% CI: 1.77-3.70) within 30 minutes' bus ride from the community. Food prices for apples (β=0.06, 95% CI: 0.04-0.08) and lean pork (β =0.02, 95% CI: 0.01-0.03) increased with urbanicity, while prices for other food did not. Urbanicity was positively associated with community norms for fast food consumption (RR=1.28, 95% CI: 1.22-1.33), fast food preferences (RR=1.09, 95% CI: 1.06-1.12) and nutrition knowledge (RR=1.02, 95% CI: 1.01-1.03). Urbanization is associated with food environment in China. The findings provide insight for future economic development and public health efforts related to urbanization.

Walking the Leadership Tightrope: Building Community Cohesiveness and Social Capital in Schools in Highly Disadvantaged Urban Communities

Science.gov (United States)

Riley, Kathryn A.

2013-01-01

School leaders in highly disadvantaged urban communities across the globe walk a tightrope, caught between the needs of communities and the requirements of national policies. This article aims to enrich our understanding of the potential of school-community relationships. It examines the policy discourse on urban schools and the practice of…

Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

Directory of Open Access Journals (Sweden)

Bärnighausen Till

2009-06-01

retention; support (programmes should prepare participants for the time in an underserved area, stay in close contact with participants throughout the different phases of enrolment and help participants by assigning them mentors, establishing peer support systems or financing education courses relevant to work in underserved areas; enforcement (programmes may use community-based monitoring or outsource enforcement to existing institutions; and evaluation (in order to broaden the evidence on the effectiveness of financial incentives in increasing the health workforce in underserved areas, programmes in developing countries should evaluate their performance; in order to improve the strength of the evidence on the effectiveness of financial incentives, controlled experiments should be conducted where feasible. In comparison to other interventions to increase the supply of health workers to medically underserved areas, financial-incentive programmes have advantages – unlike initiatives using non-financial incentives, they establish legally enforceable commitments to work in underserved areas and, unlike compulsory service policies, they will not be opposed by health workers – as well as disadvantages – unlike initiatives using non-financial incentives, they may not improve the working and living conditions in underserved areas (which are important determinants of health workers' long-term retention and, unlike compulsory service policies, they cannot guarantee that they will supply health workers to underserved areas who would not have worked in such areas without financial incentives. Financial incentives, non-financial incentives, and compulsory service are not mutually exclusive and may positively affect each other's performance.

Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

Science.gov (United States)

Bärnighausen, Till; Bloom, David E

2009-06-26

should prepare participants for the time in an underserved area, stay in close contact with participants throughout the different phases of enrolment and help participants by assigning them mentors, establishing peer support systems or financing education courses relevant to work in underserved areas); enforcement (programmes may use community-based monitoring or outsource enforcement to existing institutions); and evaluation (in order to broaden the evidence on the effectiveness of financial incentives in increasing the health workforce in underserved areas, programmes in developing countries should evaluate their performance; in order to improve the strength of the evidence on the effectiveness of financial incentives, controlled experiments should be conducted where feasible). In comparison to other interventions to increase the supply of health workers to medically underserved areas, financial-incentive programmes have advantages--unlike initiatives using non-financial incentives, they establish legally enforceable commitments to work in underserved areas and, unlike compulsory service policies, they will not be opposed by health workers--as well as disadvantages--unlike initiatives using non-financial incentives, they may not improve the working and living conditions in underserved areas (which are important determinants of health workers' long-term retention) and, unlike compulsory service policies, they cannot guarantee that they will supply health workers to underserved areas who would not have worked in such areas without financial incentives. Financial incentives, non-financial incentives, and compulsory service are not mutually exclusive and may positively affect each other's performance.

Intrinsic rewards experienced by a group of dentists working with underserved populations.

Science.gov (United States)

Gardner, S P; Roberts-Thomson, K F; Winning, T A; Peterson, R

2014-09-01

The aim of this study was to explore, using qualitative methods, the intrinsic reasons why dentists work with underserved groups. Minority and marginalized groups of Australians suffer a greater burden of dental disease than the general population due to disparities in accessing care. Recruitment and retention of dentists to care for underserved groups is problematic due to personal, professional and structural reasons. What drives dentists to work with underserved groups is not widely known. Sixteen dentists were recruited using 'snowball' purposeful sampling. Semi-structured in-depth interviews were conducted. Thematic analysis was conducted on the transcriptions to identify themes. Five key themes emerged: (1) 'tapped on the shoulder', being personally approached or invited; (2) 'dental school experience', the challenges faced as a student; (3) 'empathic concern', the non-judgemental expressions of care toward others; (4) 'resilience', the ability to bounce back after setbacks; (5) 'intrinsic reward', the personal gain and satisfaction received. This study focuses on the intrinsic rewards which were found to be simple, unexpected, and associated with relieving pain, community engagement and making a difference. Emphasizing personal fulfilment and intrinsic reward could be useful when promoting dentistry as a career and when encouraging graduates to consider working with disadvantaged groups. © 2014 Australian Dental Association.

Community Hospital Telehealth Consortium

National Research Council Canada - National Science Library

Williams, Elton

2003-01-01

.... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

Community Hospital Telehealth Consortium

National Research Council Canada - National Science Library

Williams, Jr, Elton L

2007-01-01

.... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

Community Hospital Telehealth Consortium

National Research Council Canada - National Science Library

Williams, Elton

2004-01-01

.... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

Science.gov (United States)

Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

2015-10-01

This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.

Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study.

Science.gov (United States)

Woringer, Maria; Cecil, Elizabeth; Watt, Hillary; Chang, Kiara; Hamid, Fozia; Khunti, Kamlesh; Dubois, Elizabeth; Evason, Julie; Majeed, Azeem; Soljak, Michael

2017-06-14

Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England's National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.

‘Much clearer with pictures’: using community-based participatory research to design and test a Picture Option Grid for underserved patients with breast cancer

Science.gov (United States)

Durand, Marie-Anne; Alam, Shama; Grande, Stuart W; Elwyn, Glyn

2016-01-01

Objective Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was to develop and test the usability, acceptability and accessibility of a pictorial encounter decision aid targeted at women of low SES diagnosed with early stage breast cancer. Design Community-based participatory research (CBPR) using think-aloud protocols (phases 1 and 2) and semistructured interviews (phase 3). Setting Underserved community settings (eg, knitting groups, bingo halls, senior centres) and breast clinics. Participants In phase 1, we recruited a convenience sample of clinicians and academics. In phase 2, we targeted women over 40 years of age, of low SES, regardless of breast cancer history, and in phase 3, women of low SES, recently diagnosed with breast cancer. Intervention The pictorial encounter decision aid was derived from an evidence-based table comparing treatment options for breast cancer (http://www.optiongrid.org). Outcome measures We assessed the usability, acceptability and accessibility of the pictorial decision aid prototypes using the think-aloud protocol and semistructured interviews. Results After initial testing of the first prototype with 18 academics and health professionals, new versions were developed and tested with 53 lay individuals in community settings. Usability was high. In response to feedback indicating that the use of cartoon characters was considered insensitive, a picture-only version was developed and tested with 23 lay people in phase 2, and 10 target users in phase 3. Conclusions and relevance Using CBPR methods and iterative user testing cycles improved usability and accessibility, and led to the development of the Picture Option Grid, entirely guided by multiple stakeholder feedback. All women of low SES recently diagnosed with early stage breast

Urban Climate Risk Communities

DEFF Research Database (Denmark)

Blok, Anders

2016-01-01

of Beck’s forward-looking agenda for a post-Euro-centric social science, outlines the contours of such an urban-cosmopolitan ‘realpolitik’ of climate risks, as this is presently unfolding across East Asian world cities. Much more than a theory-building endeavour, the essay suggests, Beck’s sociology......Ulrich Beck’s cosmopolitan sociology affords a much-needed rethinking of the transnational politics of climate change, not least in pointing to an emerging inter-urban geography of world cities as a potential new source of community, change and solidarity. This short essay, written in honour...... provides a standing invitation for further transnational dialogue and collaborative empirical work, in East Asia and beyond, on what are, arguably, the defining challenges for the 21st century world of global risks....

Urban violence and displacement, gender, and community ties ...

International Development Research Centre (IDRC) Digital Library (Canada)

2017-10-20

Oct 20, 2017 ... SAIC experts explored poverty, violence, and inequality in 40 cities across Latin America, South Asia, and sub-Saharan Africa. The 15 research ... Urban violence and displacement, gender, and community ties. October 20 ... in urban spaces. Return to main page: Solutions to make cities safe and inclusive.

Partnered Evaluation of a Community Engagement Intervention: Use of a “Kickoff” Conference in a Randomized Trial for Depression Care Improvement in Underserved Communities

Science.gov (United States)

Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry

2013-01-01

Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving healthcare systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is great stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This paper evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement “kickoff” conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialogue, sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community, 2) activating interest and participation in CPIC’s randomized trial of two different ways to implement evidence-based quality improvement (QI) programs for depression across diverse community agencies, and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation

Characterization of coastal urban watershed bacterial communities leads to alternative community-based indicators

Energy Technology Data Exchange (ETDEWEB)

Wu, C.H.; Sercu, B.; Van De Werhorst, L.C.; Wong, J.; DeSantis, T.Z.; Brodie, E.L.; Hazen, T.C.; Holden, P.A.; Andersen, G.L.

2010-03-01

Microbial communities in aquatic environments are spatially and temporally dynamic due to environmental fluctuations and varied external input sources. A large percentage of the urban watersheds in the United States are affected by fecal pollution, including human pathogens, thus warranting comprehensive monitoring. Using a high-density microarray (PhyloChip), we examined water column bacterial community DNA extracted from two connecting urban watersheds, elucidating variable and stable bacterial subpopulations over a 3-day period and community composition profiles that were distinct to fecal and non-fecal sources. Two approaches were used for indication of fecal influence. The first approach utilized similarity of 503 operational taxonomic units (OTUs) common to all fecal samples analyzed in this study with the watershed samples as an index of fecal pollution. A majority of the 503 OTUs were found in the phyla Firmicutes, Proteobacteria, Bacteroidetes, and Actinobacteria. The second approach incorporated relative richness of 4 bacterial classes (Bacilli, Bacteroidetes, Clostridia and a-proteobacteria) found to have the highest variance in fecal and non-fecal samples. The ratio of these 4 classes (BBC:A) from the watershed samples demonstrated a trend where bacterial communities from gut and sewage sources had higher ratios than from sources not impacted by fecal material. This trend was also observed in the 124 bacterial communities from previously published and unpublished sequencing or PhyloChip- analyzed studies. This study provided a detailed characterization of bacterial community variability during dry weather across a 3-day period in two urban watersheds. The comparative analysis of watershed community composition resulted in alternative community-based indicators that could be useful for assessing ecosystem health.

Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

Science.gov (United States)

Metz, Anneke M

2017-01-01

Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating

Urban and community forests of the Pacific region: California, Oregon, Washington

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of California, Oregon, and Washington by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry information for each state including human population characteristics and trends, changes in...

Underserved Areas and Pediatric Resident Characteristics: Is There Reason for Optimism?

Science.gov (United States)

Laraque-Arena, Danielle; Frintner, Mary Pat; Cull, William L

2016-01-01

To examine whether resident characteristics and experiences are related to practice in underserved areas. Cross-sectional survey of a national random sample of pediatric residents (n = 1000) and additional sample of minority residents (n = 223) who were graduating in 2009 was conducted. Using weighted logistic regression, we examined relationships between resident characteristics (background, values, residency experiences, and practice goals) and reported 1) expectation to practice in underserved area and 2) postresidency position in underserved area. Response rate was 57%. Forty-one percent of the residents reported that they had an expectation of practicing in an underserved area. Of those who had already accepted postresidency positions, 38% reported positions in underserved areas. Service obligation in exchange for loans/scholarships and primary care/academic pediatrics practice goals were the strongest predictors of expectation of practicing in underserved areas (respectively, adjusted odds ratio 4.74, 95% confidence interval 1.87-12.01; adjusted odds ratio 3.48, 95% confidence interval 1.99-6.10). Other significant predictors include hospitalist practice goals, primary care practice goals, importance of racial/ethnic diversity of patient population in residency selection, early plan (before medical school) to care for underserved families, mother with a graduate or medical degree, and higher score on the Universalism value scale. Service obligation and primary care/academic pediatrics practice goal were also the strongest predictors for taking a postresidency job in underserved area. Trainee characteristics such as service obligations, values of humanism, and desire to serve underserved populations offer the hope that policies and public funding can be directed to support physicians with these characteristics to redress the maldistribution of physicians caring for children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All

Re-Presenting Slavery: Underserved Questions in Museum Collections

Science.gov (United States)

Levenson, Cyra

2014-01-01

This article looks at the notion of what, not who, is underserved in museum education. The importance of looking through, in, and from objects in order to uncover underserved questions and themes is vital. A willingness to consider new ways to approach collections and display is necessary to have a dialogue with our audiences about how museums can…

Urbanization Effects on the Vertical Distribution of Soil Microbial Communities and Soil C Storage across Edge-to-Interior Urban Forest Gradients

Science.gov (United States)

Rosier, C. L.; Van Stan, J. T., II; Trammell, T. L.

2017-12-01

Urbanization alters environmental conditions such as temperature, moisture, carbon (C) and nitrogen (N) deposition affecting critical soil processes (e.g., C storage). Urban soils experience elevated N deposition (e.g., transportation, industry) and decreased soil moisture via urban heat island that can subsequently alter soil microbial community structure and activity. However, there is a critical gap in understanding how increased temperatures and pollutant deposition influences soil microbial community structure and soil C/N cycling in urban forests. Furthermore, canopy structural differences between individual tree species is a potentially important mechanism facilitating the deposition of pollutants to the soil. The overarching goal of this study is to investigate the influence of urbanization and tree species structural differences on the bacterial and fungal community and C and N content of soils experiencing a gradient of urbanization pressures (i.e., forest edge to interior; 150-m). Soil cores (1-m depth) were collected near the stem (urban pressure (i.e., forest edge). We further expect trees located on the edge of forest fragments will maintain greater surface soil (urbanization alters soil microbial community composition via reduced soil moisture and carbon storage potential via deposition gradients. Further analyses will answer important questions regarding how individual tree species alters urban soil C storage, N retention, and microbial dynamics.

Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

Directory of Open Access Journals (Sweden)

Eugene Aisenberg

2012-01-01

Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

Physical Activity in an Underserved Population: Identifying Technology Preferences.

Science.gov (United States)

Medairos, Robert; Kang, Vicky; Aboubakare, Carissa; Kramer, Matthew; Dugan, Sheila Ann

2017-01-01

This study aims to identify patterns of use and preferences related to technology platforms that could support physical activity (PA) programs in an underserved population. A 29-item questionnaire was administered at 5 health and wellness sites targeting low income communities in Chicago. Frequency tables were generated for Internet, cell phone, and social media use and preferences. Chi-squared analysis was used to evaluate differences across age and income groups. A total of 291 individuals participated and were predominantly female (69.0%). Majority reported incomes less than $30,000 (72.9%) and identified as African American/Black/Caribbean (49.3%) or Mexican/Mexican American (34.3%). Most participants regularly used smartphones (63.2%) and the Internet (75.9%). Respondents frequently used Facebook (84.8%), and less commonly used Instagram (43.6%), and Twitter (20.0%). Free Internet-based exercise programs were the most preferred method to increase PA levels (31.6%), while some respondents (21.0%) thought none of the surveyed technology applications would help. Cell phone, Internet, and social media use is common among the surveyed underserved population. Technology preferences to increase PA levels varied, with a considerable number of respondents not preferring the surveyed technology platforms. Creating educational opportunities to increase awareness may maximize the effectiveness of technology-based PA interventions.

Habitat and landscape characteristics underlying anuran community structure along an urban-rural gradient.

Science.gov (United States)

Pillsbury, Finn C; Miller, James R

2008-07-01

Urbanization has been cited as an important factor in worldwide amphibian declines, and although recent work has illustrated the important influence of broad-scale ecological patterns and processes on amphibian populations, little is known about the factors structuring amphibian communities in urban landscapes. We therefore examined amphibian community responses to wetland habitat availability and landscape characteristics along an urban-rural gradient in central Iowa, USA, a region experiencing rapid suburban growth. We conducted call surveys at 61 wetlands to estimate anuran calling activity, and quantified wetland habitat structure and landscape context. We used canonical correspondence analysis (CCA) to examine patterns in anuran community structure and identify the most important variables associated with those patterns. Urban density at the landscape scale had a significant negative influence on overall anuran abundance and diversity. While every species exhibited a decrease in abundance with increasing urban density, this pattern was especially pronounced for species requiring post-breeding upland habitats. Anurans most affected by urbanization were those associated with short hydroperiods, early breeding activity, and substantial upland habitat use. We suggest that broad-scale landscape fragmentation is an important factor underlying anuran community structure in this region, possibly due to limitations on the accessibility of otherwise suitable habitat in fragmented urban landscapes. This study underscores the importance of a regional approach to amphibian conservation in urban and urbanizing areas; in fragmented landscapes, a network of interconnected wetland and upland habitats may be more likely to support a successful, diverse anuran community than will isolated sites.

Restoring our urban communities: A model for an empowered America

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-01

This booklet tells the story of how two very different types of organizations - Bethel New Life and Argonne National Laboratory - have forged a partnership to rebuild West Garfield Park. This unique Partnership blends Bethel`s theological and sociological roots with Argonne`s scientific and technological expertise. Together they hope to offer the community fresh, transferable approaches to solving urban socio-economic and environmental problems. The Partnership hopes to address and solve the inner city`s technological problems through community participation and collaborative demonstrations - without losing sight of the community`s social needs. The key themes throughout this booklet - jobs, sustainable community development, energy efficiency, and environment - highlight challenges the partners face. By bringing people and technologies together, this Partnership will give West Garfield Park residents a better life -- and, perhaps, offer other communities a successful model for urban renewal.

Impact of urbanization and gardening practices on common butterfly communities in France.

Science.gov (United States)

Fontaine, Benoît; Bergerot, Benjamin; Le Viol, Isabelle; Julliard, Romain

2016-11-01

We investigated the interacting impacts of urban landscape and gardening practices on the species richness and total abundance of communities of common butterfly communities across France, using data from a nationwide monitoring scheme. We show that urbanization has a strong negative impact on butterfly richness and abundance but that at a local scale, such impact could be mitigated by gardening practices favoring nectar offer. We found few interactions among these landscape and local scale effects, indicating that butterfly-friendly gardening practices are efficient whatever the level of surrounding urbanization. We further highlight that species being the most negatively affected by urbanization are the most sensitive to gardening practices: Garden management can thus partly counterbalance the deleterious effect of urbanization for butterfly communities. This holds a strong message for park managers and private gardeners, as gardens may act as potential refuge for butterflies when the overall landscape is largely unsuitable.

Child gender preferences in an urban and rural community in Enugu ...

African Journals Online (AJOL)

Conclusion: Son preference exists in the rural and urban community in Enugu State however a balanced preference is also common especially in the urban area. Recommendation: Family education especially on gender equality and sensitivity was recommended. Keywords: Son preference, balanced preference, Urban, ...

Urban community gardeners' knowledge and perceptions of soil contaminant risks.

Science.gov (United States)

Kim, Brent F; Poulsen, Melissa N; Margulies, Jared D; Dix, Katie L; Palmer, Anne M; Nachman, Keeve E

2014-01-01

Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether.

Urban community gardeners' knowledge and perceptions of soil contaminant risks.

Directory of Open Access Journals (Sweden)

Brent F Kim

Full Text Available Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether.

Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities

Science.gov (United States)

Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-01-01

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. PMID:29509675

Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

Science.gov (United States)

Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-03-06

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

Research on the Model of E-commerce of China’s Urban Informatization Community

Directory of Open Access Journals (Sweden)

Yu Han

2014-02-01

Full Text Available Urban informatization e-commerce is a business model of the combination of e-commerce operators and organizational forms of community property management, and the import of people management and property management into e-commerce. This paper analyzes the current situation of Chinese urban community e-commerce and informatization community building. It puts forward the model of community e-commerce based on informatization, and its feasibility was verified by PIECE method. Finally, focusing on the application, the model of community e-commerce based on informatization community is analyzed in detail from the perspective of the role and value, supply chain and collaborative management works. Information services are most likely to succeed in the entry point of e-commerce. The study has shown that the establishment of community e-commerce on the basis of urban informatization community can be regarded as a solution of e-commerce development.

Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

Science.gov (United States)

Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

2016-01-01

We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention.

Science.gov (United States)

Burrage, Rachel L; Gone, Joseph P; Momper, Sandra L

2016-09-01

American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre-existing interview data from 15 self-identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community's knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models. © Society for Community Research and Action 2016.

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

Science.gov (United States)

Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

2017-07-01

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

Science.gov (United States)

O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

2018-01-01

To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

The Relationship between Community Violence Exposure and Mental Health Symptoms in Urban Adolescents

OpenAIRE

McDonald, Catherine C.; Richmond, Therese R.

2008-01-01

Urban adolescents are exposed to a substantial amount of community violence which has the potential to influence psychological functioning. To examine the relationship between community violence exposure and mental health symptoms in urban adolescents, a literature review using MEDLINE, CINAHL, PubMed, PsycINFO, CSA Social Services, and CSA Sociological Abstracts was conducted. Search terms included adolescent/adolescence, violence, urban, mental health, well-being, emotional distress, depres...

Can green roofs reduce urban heat stress in vulnerable urban communities: A coupled atmospheric and social modeling approach

Science.gov (United States)

Sharma, A.; Woodruff, S.; Budhathoki, M.; Hamlet, A. F.; Fernando, H. J. S.; Chen, F.

2017-12-01

Urban areas provide organized, engineered, sociological and economical infrastructure designed to provide a high quality of life, but the implementation and management of urban infrastructure has been a continued challenge. Increasing urbanization, warming climate, as well as anthropogenic heat emissions that accompany urban development generates "stress". This rapidly increasing `urban stress' affects the sustainability of cities, making populations more vulnerable to extreme hazards, such as heat. Cities are beginning to extensively use green roofs as a potential urban heat mitigation strategy. This study explores the potential of green roofs to reduce summertime temperatures in the most vulnerable neighborhoods of the Chicago metropolitan area by combining social vulnerability indices (a function of exposure, sensitivity and adaptive capacity), and temperatures from mesoscale model. Numerical simulations using urbanized version the Advanced Research Weather Research and Forecasting (WRF) model were performed to measure rooftop temperatures, a representative variable for exposure in this study. The WRF simulations were dynamically coupled with a green roof algorithm as a part of urban parameterization within WRF. Specifically, the study examines roof surface temperature with changing green roof fractions and how would they help reduce exposure to heat stress for vulnerable urban communities. This study shows an example of applied research that can directly benefit urban communities and be used by urban planners to evaluate mitigation strategies.

The association between women's self-rated health and satisfaction with environmental services in an underserved community in Lebanon.

Science.gov (United States)

Habib, Rima R; Elzein, Kareem; Hojeij, Safa

2013-01-01

This research evaluated the association between women's self-rated health and a number of socioeconomic and environmental health indicators relating to drinking water services in an underserved Lebanese community. A population-based, cross-sectional survey using interviews was adopted to obtain information from female homemakers of 2,223 households in the town of Bebnine, Lebanon. The questionnaire included indicators on self-rated health, satisfaction with water quality, source of drinking water, occurrence of diarrhea, and socioeconomic variables, such as education, occupation, and perceived economic status. Self-rated health was categorized as poor, fair, and good. Odds ratios for poor and fair compared to good self-rated health values were calculated using multinomial logistic regression. A total of 712 women (32%) reported poor self-rated health. Women who perceived their household income to be worse than others in town were four times as likely to report poor health. Compared to women who were satisfied with drinking water quality, dissatisfied women were 42% more likely to report poor health. Women living in households reporting recent episodes of diarrheal illness had poorer health ratings than those without. The findings suggest a positive relationship between individual perceptions of water quality and self-rated health. Community concerns over their surrounding environment serve as a primary guide for infrastructural development and government policy.

Aerobic and anaerobic methanotrophic communities in urban landscape wetland.

Science.gov (United States)

Chen, Sili; Chen, Jianfei; Chang, Sha; Yi, Hao; Huang, Dawei; Xie, Shuguang; Guo, Qingwei

2018-01-01

Both aerobic methane-oxidizing bacteria (MOB) and nitrite-dependent anaerobic methane oxidation (n-damo) organisms can be important methane sinks in a wetland. However, the influences of the vegetation type on aerobic MOB and n-damo communities in wetland, especially in constructed wetland, remain poorly understood. The present study investigated the influences of the vegetation type on both aerobic MOB and n-damo organisms in a constructed urban landscape wetland. Sediments were collected from eight sites vegetated with different plant species. The abundance (1.19-3.27 × 10 7 pmoA gene copies per gram dry sediment), richness (Chao1 estimator = 16.3-81.5), diversity (Shannon index = 2.10-3.15), and structure of the sediment aerobic MOB community were found to vary considerably with sampling site. In contrast, n-damo community abundance (8.74 × 10 5 -4.80 × 10 6 NC10 16S rRNA gene copies per gram dry sediment) changed slightly with the sampling site. The richness (Chao1 estimator = 1-11), diversity (Shannon index = 0-0.78), and structure of the NC10 16S rRNA gene-based n-damo community illustrated slight site-related changes, while the spatial changes of the pmoA gene-based n-damo community richness (Chao1 estimator = 1-8), diversity (Shannon index = 0-0.99), and structure were considerable. The vegetation type could have a profound impact on the wetland aerobic MOB community and had a stronger influence on the pmoA-based n-damo community than on the NC10 16S-based one in urban wetland. Moreover, the aerobic MOB community had greater abundance and higher richness and diversity than the n-damo community. Methylocystis (type II MOB) predominated in urban wetland, while no known type I MOB species was detected. In addition, the ratio of total organic carbon to total nitrogen (C/N) might be a determinant of sediment n-damo community diversity and aerobic MOB richness.

Introduction to Urban and Community Forestry in the United States of America: History, Accomplishments, Issues and Trends

Institute of Scientific and Technical Information of China (English)

Qi Yadong; Zhang Zhiqiang

2003-01-01

The urban and community forestry movement in the United States has matured over the last 20 years from managing street trees, to understanding the benefits of trees in urban ecosystems, and now to managing urban green infrastructure. This paper introduced the history, development, and major accomplishments of the urban and community forestry movement, highlighted the economic, ecological, environmental, and social values of forests and trees to communities, and discussed issues and trends of the urban and community forestry program in the United States.

Urbanization reduces and homogenizes trait diversity in stream macroinvertebrate communities.

Science.gov (United States)

Barnum, Thomas R; Weller, Donald E; Williams, Meghan

2017-12-01

More than one-half of the world's population lives in urban areas, so quantifying the effects of urbanization on ecological communities is important for understanding whether anthropogenic stressors homogenize communities across environmental and climatic gradients. We examined the relationship of impervious surface coverage (a marker of urbanization) and the structure of stream macroinvertebrate communities across the state of Maryland and within each of Maryland's three ecoregions: Coastal Plain, Piedmont, and Appalachian, which differ in stream geomorphology and community composition. We considered three levels of trait organization: individual traits, unique combinations of traits, and community metrics (functional richness, functional evenness, and functional divergence) and three levels of impervious surface coverage (low [10%]). The prevalence of an individual trait differed very little between low impervious surface and high impervious surface sites. The arrangement of trait combinations in community trait space for each ecoregion differed when impervious surface coverage was low, but the arrangement became more similar among ecoregions as impervious surface coverage increased. Furthermore, trait combinations that occurred only at low or medium impervious surface coverage were clustered in a subset of the community trait space, indicating that impervious surface affected the presence of only a subset of trait combinations. Functional richness declined with increasing impervious surface, providing evidence for environmental filtering. Community metrics that include abundance were also sensitive to increasing impervious surface coverage: functional divergence decreased while functional evenness increased. These changes demonstrate that increasing impervious surface coverage homogenizes the trait diversity of macroinvertebrate communities in streams, despite differences in initial community composition and stream geomorphology among ecoregions. Community

Community perceptions towards the establishment of an urban forest plantation: a case of Dzivaresekwa, Zimbabwe

Directory of Open Access Journals (Sweden)

A. Mureva

2014-06-01

Full Text Available The health of urban forest communities not only depend on the government and nongovernmental organizations, but also strongly rely on local community stewardship. A study was carried out to assess community perceptions on the establishment of an urban forest plantation among urban residents in Dzivaresekwa, an urban area in Harare. Randomized systematic sampling was used to select 150 households and one resident per household was interviewed using a pretested questionnaire with both closed and open-ended questions. The objectives of the study were to determine how age and gender and employment status variables, were related to the urban residents’ perceptions towards establishment of a forest plantation in an urban area. Most females (58.3% viewed the plantation as a threat while most men (51.7% viewed the plantation as a recreational area. The highest proportion (61.9% of the middle age group (21-40 years perceived the plantation as a source of employment. There was a statistically significant relationship (p = 0.040 between gender and the general perception of establishing a forest plantation in the urban area. However, there was no statistically significant relationship (p = 0.203 between age groups and the perception of establishing a forest plantation in the urban area. It is concluded that the community had diverse perceptions on urban community forestry.

Intraspecific variation shapes community-level behavioral responses to urbanization in spiders.

Science.gov (United States)

Dahirel, Maxime; Dierick, Jasper; De Cock, Maarten; Bonte, Dries

2017-09-01

Urban areas are an extreme example of human-changed environments, exposing organisms to multiple and strong selection pressures. Adaptive behavioral responses are thought to play a major role in animals' success or failure in such new environments. Approaches based on functional traits have proven especially valuable to understand how species communities respond to environmental gradients. Until recently, they have, however, often ignored the potential consequences of intraspecific trait variation (ITV). When ITV is prevalent, it may highly impact ecological processes and resilience against stressors. This may be especially relevant in animals, in which behavioral traits can be altered very flexibly at the individual level to track environmental changes. We investigated how species turnover and ITV influenced community-level behavioral responses in a set of 62 sites of varying levels of urbanization, using orb web spiders and their webs as models of foraging behavior. ITV alone explained around one-third of the total trait variation observed among communities. Spider web structure changed according to urbanization, in ways that increase the capture efficiency of webs in a context of smaller urban prey. These trait shifts were partly mediated by species turnover, but ITV increased their magnitude, potentially helping to buffer the effects of environmental changes on communities. The importance of ITV varied depending on traits and on the spatial scale at which urbanization was considered. Despite being neglected from community-level analyses in animals, our results highlight the importance of accounting for intraspecific trait variation to fully understand trait responses to (human-induced) environmental changes and their impact on ecosystem functioning. © 2017 by the Ecological Society of America.

Differences in health care seeking behaviour between rural and urban communities in South Africa

Science.gov (United States)

2012-01-01

Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

Community-acquired Pneumonia in Hospitalized Urban Young ...

African Journals Online (AJOL)

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

Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

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Effiong Ekong Akpan

2015-01-01

Full Text Available Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978 participants were recruited from rural areas and five hundred and ninety (590 from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.. The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4% versus 28.6% (95% CI 24.9–32.3%]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria.

Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

Science.gov (United States)

Malewski, David F; Ream, Aimrie; Gaither, Caroline A

2015-01-01

Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

OpenAIRE

Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

2016-01-01

Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

Responses of riparian reptile communities to damming and urbanization

Science.gov (United States)

Hunt, Stephanie D.; Guzy, Jacquelyn C.; Price, Steven J.; Halstead, Brian J.; Eskew, Evan A.; Dorcas, Michael E.

2013-01-01

Various anthropogenic pressures, including habitat loss, threaten reptile populations worldwide. Riparian zones are critical habitat for many reptile species, but these habitats are also frequently modified by anthropogenic activities. Our study investigated the effects of two riparian habitat modifications-damming and urbanization-on overall and species-specific reptile occupancy patterns. We used time-constrained search techniques to compile encounter histories for 28 reptile species at 21 different sites along the Broad and Pacolet Rivers of South Carolina. Using a hierarchical Bayesian analysis, we modeled reptile occupancy responses to a site's distance upstream from dam, distance downstream from dam, and percent urban land use. The mean occupancy response by the reptile community indicated that reptile occupancy and species richness were maximized when sites were farther upstream from dams. Species-specific occupancy estimates showed a similar trend of lower occupancy immediately upstream from dams. Although the mean occupancy response of the reptile community was positively related to distance downstream from dams, the occupancy response to distance downstream varied among species. Percent urban land use had little effect on the occupancy response of the reptile community or individual species. Our results indicate that the conditions of impoundments and subsequent degradation of the riparian zones upstream from dams may not provide suitable habitat for a number of reptile species.

A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

Science.gov (United States)

Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

2015-03-15

Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

HealthATM: personal health cyberinfrastructure for underserved populations.

Science.gov (United States)

Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

2011-05-01

There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

Urban-development-induced Changes in the Diversity and Composition of the Soil Bacterial Community in Beijing

Science.gov (United States)

Yan, Bing; Li, Junsheng; Xiao, Nengwen; Qi, Yue; Fu, Gang; Liu, Gaohui; Qiao, Mengping

2016-12-01

Numerous studies have implicated urbanization as a major cause of loss of biodiversity. Most of them have focused on plants and animals, even though soil microorganisms make up a large proportion of that biodiversity. However, it is unclear how the soil bacterial community is affected by urban development. Here, paired-end Illumina sequencing of the 16 S rRNA gene at V4 region was performed to study the soil microbial community across Beijing’s built-up area. Proteobacteria, Acidobacteria, Bacteroidetes, Actinobacteria, Gemmatimonadetes, Verrucomicrobia, Planctomycetes, and Chloroflexi were the dominant phyla in all samples, but the relative abundance of these phyla differed significantly across these concentric zones. The diversity and composition of the soil bacterial community were found to be closely correlated with soil pH. Variance partitioning analysis suggested that urban ring roads contributed 5.95% of the bacterial community variation, and soil environmental factors explained 17.65% of the variation. The results of the current work indicate that urban development can alter the composition and diversity of the soil microbial community, and showed pH to be a key factor in the shaping of the composition of the soil bacterial community. Urban development did have a strong impact on the bacterial community of urban soil in Beijing.

Community perspectives on barriers and strategies for promoting locally grown produce from an urban agriculture farm.

Science.gov (United States)

Hu, Alice; Acosta, Angela; McDaniel, Abigail; Gittelsohn, Joel

2013-01-01

Although much is understood about barriers to healthy food consumption in low-income, urban communities, knowledge regarding the crucial next step of building feasible, community-supported approaches to address those barriers remains limited. This qualitative study used in-depth interviews (n = 20), focus groups (n = 2), and participant observations (n = 3) to identify strategies to promote locally grown produce from an urban food security project, Produce From the Park (PFP), an urban farm. Informants included community organization representatives and residents from low-income neighborhoods in a mid-Atlantic city. Informants identified structural and cultural barriers to purchasing healthy food, including price, location, food culture, and lack of interest. Participants proposed a number of strategies, such as distribution through mobile food carts and farm stands, marketing new foods through taste tests and cooking demonstrations, and youth mentorship. Informants also described their perceptions of the local urban farm and suggested ways to increase community buy-in. Strategies mentioned were inexpensive and incorporated cultural norms and local assets. These community perspectives can provide insights for those promoting healthy eating in urban African American communities through urban food security projects.

Nekton community structure varies in response to coastal urbanization near mangrove tidal tributaries

Science.gov (United States)

Krebs, Justin M.; McIvor, Carole C.; Bell, Susan S.

2014-01-01

To assess the potential influence of coastal development on estuarine-habitat quality, we characterized land use and the intensity of land development surrounding small tidal tributaries in Tampa Bay. Based on this characterization, we classified tributaries as undeveloped, industrial, urban, or man-made (i.e., mosquito-control ditches). Over one third (37 %) of the tributaries have been heavily developed based on landscape development intensity (LDI) index values >5.0, while fewer than one third (28 %) remain relatively undeveloped (LDI < 3.0). We then examined the nekton community from 11 tributaries in watersheds representing the four defined land-use classes. Whereas mean nekton density was independent of land use, species richness and nekton-community structure were significantly different between urban and non-urban (i.e., undeveloped, industrial, man-made) tributaries. In urban creeks, the community was species-poor and dominated by high densities of poeciliid fishes, Poecilia latipinna and Gambusia holbrooki, while typically dominant estuarine taxa including Menidia spp., Fundulus grandis, and Adinia xenica were in low abundance and palaemonid grass shrimp were nearly absent. Densities of economically important taxa in urban creeks were only half that observed in five of the six undeveloped or industrial creeks, but were similar to those observed in mosquito ditches suggesting that habitat quality in urban and mosquito-ditch tributaries is suboptimal compared to undeveloped tidal creeks. Furthermore, five of nine common taxa were rarely collected in urban creeks. Our results suggest that urban development in coastal areas has the potential to alter the quality of habitat for nekton in small tidal tributaries as reflected by variation in the nekton community.

Effect of Active Videogames on Underserved Children's Classroom Behaviors, Effort, and Fitness.

Science.gov (United States)

Gao, Zan; Lee, Jung Eun; Pope, Zachary; Zhang, Dachao

2016-09-30

The purpose of this study was to examine the effect of active videogames (AVGs) on underserved minority children's on-task classroom behavior, academic effort, and fitness. A one group pre- and posttest repeated measures design was used. In Fall 2013, 95 fourth grade children (57 boys, 38 girls; 96% of minority) from three classes at an underserved urban elementary school participated in teacher-supervised AVG activities (e.g., Wii Sports, Xbox Just Dance). Specifically, students participated in a 50-minute weekly AVG program at school for 6 weeks. Children's academic effort was evaluated by classroom teachers using a validated scale that assessed activity, attention, conduct, and social/emotional behavior. Moreover, children's classroom behavior was observed immediately before and after each AVG session by trained researchers. Finally, cardiovascular fitness was also measured. A paired t-test was used to assess teacher-rated student effort, while one-way (gender) analysis of variance (ANOVA) with repeated measures was performed to analyze children's on-task classroom behavior. There was a significant effect on children's effort between the first (mean = 3.24, SD = 0.75) and last week (mean = 3.41, SD = 0.73) assessments, t = 2.42, P = 0.02. In addition, there was a significant effect on classroom behavior, F = 33.103, P < 0.01. In detail, children scored significantly higher on on-task behavior during the post-AVG observation (mean = 81.4, SD = 12.3) than seen during the pre-AVG observation (mean = 69.8, SD = 14.9). However, no main effect was indicated for gender, F = 0.39, P = 0.54. No significant improvement in cardiovascular fitness was observed, although slight improvements were seen. Offering an AVG program at school could improve underserved minority children's classroom on-task behavior and academic effort. Future studies may include a control group to further confirm the effectiveness of AVG

Exploring How African American Males from an Urban Community Navigate the Interracial and Intra-Racial Dimensions of Their Experiences at an Urban Jesuit High School

Science.gov (United States)

Simmons, Robert W., III

2012-01-01

African American males from urban communities have been attending Jesuit high schools in urban spaces for many years, yet little to no literature exists that explores their experiences while attending these elite private schools. This qualitative study of 10 African American males from an urban community attending a similarly positioned Jesuit…

Community Broadband Networks and the Opportunity for E-Government Services

DEFF Research Database (Denmark)

Williams, Idongesit

2017-01-01

Community Broadband Networks (CBN) facilitate Broadband connectivity in underserved areas in many countries. The lack of Broadband connectivity is one of the reasons for the slow diffusion of e-government services in many countries.This article explains how CBNs can be enabled by governments...... to facilitate the delivery of e–government services in underserved areas in the developed and developing countries.The Community Based Broadband Mobilization (CBNM) models are used as explanatory tools....

Shift in the microbial community composition of surface water and sediment along an urban river.

Science.gov (United States)

Wang, Lan; Zhang, Jing; Li, Huilin; Yang, Hong; Peng, Chao; Peng, Zhengsong; Lu, Lu

2018-06-15

Urban rivers represent a unique ecosystem in which pollution occurs regularly, leading to significantly altered of chemical and biological characteristics of the surface water and sediments. However, the impact of urbanization on the diversity and structure of the river microbial community has not been well documented. As a major tributary of the Yangtze River, the Jialing River flows through many cities. Here, a comprehensive analysis of the spatial microbial distribution in the surface water and sediments in the Nanchong section of Jialing River and its two urban branches was conducted using 16S rRNA gene-based Illumina MiSeq sequencing. The results revealed distinct differences in surface water bacterial composition along the river with a differential distribution of Proteobacteria, Cyanobacteria, Actinobacteria, Bacteroidetes and Acidobacteria (P urban water. PICRUSt metabolic inference analysis revealed a growing number of genes associated with xenobiotic metabolism and nitrogen metabolism in the urban water, indicating that urban discharges might act as the dominant selective force to alter the microbial communities. Redundancy analysis suggested that the microbial community structure was influenced by several environmental factors. TP (P urban river. These results highlight that river microbial communities exhibit spatial variation in urban areas due to the joint influence of chemical variables associated with sewage discharging and construction of hydropower stations. Copyright © 2018 Elsevier B.V. All rights reserved.

Urban and community forests of the South Central East region: Alabama, Kentucky, Mississippi, Tennessee

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of Alabama, Kentucky, Mississippi, and Tennessee by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry information for each state including human population characteristics and trends,...

Urban and community forests of the South Central West region: Arkansas, Louisiana, Oklahoma, Texas

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of Arkansas, Louisiana, Oklahoma, and Texas by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry information for each state including human population characteristics and trends, changes...

ENGINEERING INSIDE PROCESS OF URBAN RENEWAL AND COMMUNITY MANAGEMENT

Directory of Open Access Journals (Sweden)

Barrantes, K.

2015-06-01

Full Text Available This paper aims to show the community management process and interdisciplinary work involve in the Social Action project named “University social work: Calle de la Amargura towards a physical, recreational and cultural renewal” which belongs to the Civil Engineering School of Universidad de Costa Rica (UCR This initiative began in 2005 as a response to the security issue in a place known as “Calle de la Amargura”, in Costa Rica, this street has been stigmatized as an unsafe and damaged spot. Even though, this place has a negative concept, it has a huge urban potential as a meeting point for youth; this, due to closeness to Universidad de Costa Rica. Nevertheless, situations as drugs dealing and violence have created a negative perception within people all around the country. This project of urban renewal since the beginning has sought to enhance the perception of “Calle de la Amargura” from three axes: the development of educational and leisure activities, the foundation of community working networks and the improvement of physical conditions. Interdisciplinary groups were created in different areas such as engineer, arts, social sciences, health and education. Today, this plan is a recognize project, which involves a hard work on public space appropriation. Indeed, this paper seeks to expose the high content of social action and community management process of urban renewal leading by Engineering Faculty

Reducing violence in poor urban areas of Honduras by building community resilience through community-based interventions.

Science.gov (United States)

Hansen-Nord, Nete Sloth; Kjaerulf, Finn; Almendarez, Juan; Rodas, Victor Morales; Castro, Julio

2016-11-01

To examine the impact of a 3 year community-based violence prevention intervention on risk of violence and social capital in two poor urban communities in Honduras in 2011-2014. A quasi-experimental design pre and post implementation of the intervention was conducted based on data from two randomly selected samples using the same structured questionnaire in 2011 and in 2014. Community members had a 42 % lower risk of violence in 2014 compared to 2011. There was a positive relation between participation in the intervention and structural social capital, and participants had more than twice the likelihood of engaging in citizenship activities compared to the general population. The intervention contributed to decreasing violence and increasing community resilience in two urban areas in Honduras. Citizenship activities and active community participation in the violence prevention agenda rather than social trust and cohesion characteristics was affected by the intervention. This research introduces important lessons learned to future researchers aiming to retrieve very sensitive data in a similarly violent setting, and provides strong research opportunities within areas, which to this date remain undiscovered.

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

Science.gov (United States)

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

2014-01-01

This article describes a model of teaching community health nursing that evolved from a long-term partnership with a community with limited existing health programs. The partnership supported RN-BSN students' integration in the community and resulted in reciprocal gains for faculty, students and community members. Community clients accessed public health services as a result of the partnership. A blended learning approach that combines face-to-face interactions, service learning and online activities was utilized to enhance students' learning. Following classroom sessions, students actively participated in community-based educational process through comprehensive health needs assessments, planning and implementation of disease prevention and health promotion activities for community clients. Such active involvement in an underserved community deepened students' awareness of the fundamentals of community health practice. Students were challenged to view public health from a broader perspective while analyzing the impacts of social determinants of health on underserved populations. Through asynchronous online interactions, students synthesized classroom and community activities through critical thinking. This paper describes a model for teaching community health nursing that informs students' learning through blended learning, and meets the demands for community health nursing services delivery. © 2013 Wiley Periodicals, Inc.

Adolescent and parent use of new technologies for health communication: a study in an urban Latino community

Directory of Open Access Journals (Sweden)

Arlene Smaldone

2015-02-01

Full Text Available Background. Mobile communication technologies provide novel opportunities to support clinic-based health initiatives. Adoption of technologies for daily use and for health communication can differ between communities, depending upon demographic and cultural characteristics. Design and methods. A survey was administered in adolescent primary care and subspecialty clinics to assess parent-adolescent preferences in use of mobile technologies and social media to support provider-patient communication in an urban Latino community. Results. Of 130 respondents (65 parent-adolescent pairs, approximately half frequently sent and received text messages but lacked agreement regarding the other’s text messaging use. In contrast, adolescents only rarely used email compared to parents (15.4% versus 37.5%, P=0.006. Of social media, FacebookTM/MySpaceTM was most frequently used by parents and youth (60% and 55.4%, P=0.59; however, most lacked interest in using social media for health communication. Parents reported more interest than adolescents in receiving email (73.4% versus 35.9%, P<0.001 and text messages (58.5% versus 33.9%, P=0.005 for health, but had more concerns about privacy issues (26.2% versus 9.2%, P=0.01. Respondents who were American born (aOR 5.7, 95%CI 1.2-28.5 or regularly used Instant Messaging or FacebookTM/MySpaceTM (aOR 4.6, 95%CI 1.4-14.7 were more likely to be interested in using social media for health communication. Conclusions. These findings underscore the importance of targeted assessment for planning the utilization of communication technologies and social media in clinical care or research for underserved youth.

Examining Neighborhood Social Cohesion in the Context of Community-based Participatory Research: Descriptive Findings from an Academic-Community Partnership.

Science.gov (United States)

Bateman, Lori Brand; Fouad, Mona N; Hawk, Bianca; Osborne, Tiffany; Bae, Sejong; Eady, Sequoya; Thompson, Joanice; Brantley, Wendy; Crawford, Lovie; Heider, Laura; Schoenberger, Yu-Mei M

2017-01-01

The purpose of this article is to describe the process of conducting an assessment of neighborhood perceptions and cohesion by a community coalition-academic team created in the context of community-based participatory research (CBPR), to guide the design of locally relevant health initiatives. Guided by CBPR principles, a collaborative partnership was established between an academic center and a local, urban, underserved neighborhood in Birmingham, Alabama to identify and address community concerns and priorities. A cross-sectional survey was conducted in September 2016 among community residents (N=90) to examine perceptions of neighborhood characteristics, including social cohesion and neighborhood problems. The major concerns voiced by the coalition were violence and lack of neighborhood cohesion and safety. The community survey verified the concerns of the coalition, with the majority of participants mentioning increasing safety and stopping the violence as the things to change about the community and the greatest hope for the community. Furthermore, results indicated residents had a moderate level of perceived social cohesion (mean = 2.87 [.67]). The Mid-South TCC Academic and Community Engagement (ACE) Core successfully partnered with community members and stakeholders to establish a coalition whose concerns and vision for the community matched the concerns of residents of the community. Collecting data from different groups strengthened the interpretation of the findings and allowed for a rich understanding of neighborhood concerns.

Urban and community forests of the Mid-Atlantic region: New Jersey, New York, Pennsylvania

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2009-01-01

This report details how land cover and urbanization vary within the states of New Jersey, New York, and Pennsylvania by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry information for each state including human population characteristics and trends, changes in...

The Knowledge Is Power Program (KIPP): An Analysis of One Model's Efforts to Promote Achievement in Underserved Communities

Science.gov (United States)

Macey, Erin; Decker, Janet; Eckes, Suzanne

2009-01-01

Many claim that the Knowledge is Power Program has experienced success in closing the achievement gap in urban and rural communities across America. Studies suggest that KIPP charter schools enroll an overwhelming proportion of poor and minority students and often outperform their district peers. However, the purpose of this study is not to…

Grassland communities of urban open spaces in Bloemfontein, Free State, South Africa

Directory of Open Access Journals (Sweden)

Mamokete N.V. Dingaan

2013-02-01

Full Text Available Natural vegetation in urban environments is greatly impacted by human activities and it is in constant threat of degradation and destruction as a result of urbanisation. This vegetation, although fragmented, serves an important ecological function and needs to be properly managed and conserved. Studies on urban vegetation are lacking in South Africa, with only a handful having been carried out since the end of the last century. This study was initiated to identify, classify and describe the grassland communities of the urban open spaces in Bloemfontein. Relevés were compiled in 61 sample plots, where species present and habitat information were recorded. Care was taken to restrict sample plots to vegetation in pristine condition, wherever possible, and severely degraded stands were avoided. A two-way indicator species analysis (TWINSPAN classification, refined by Braun-Blanquet procedures, revealed two distinct major communities, seven communities and four sub-communities. Both detrended and canonical correspondence analyses indicated the vegetation units to be associated with soil texture and pH, although biotic factors such as overgrazing, burning and mowing also influence the composition of the vegetation. The proper management and conservation of urban open spaces requires in-depth knowledge of the spatial distribution, floristic, structural and functional compositions within the major vegetation types in this environment. The present study further contributed towards formulating ways for the proper management, utilisation and functioning of the open spaces within the Bloemfontein area.Conservation implications: The Grassland Biome of South Africa is poorly conserved, mainly because of its status as an agricultural hub of the country. The preservation of natural and semi-natural forms of urban vegetation is important because such vegetation, although often disturbed and degraded, could form dispersal corridors between peri-urban and rural

Behavioural change in an urban smart-grid community

NARCIS (Netherlands)

Milovanovic, Marko; Steg, Emmalina; Spears, Russell

2014-01-01

Achieving long term behavioral change is a challenging task, especially when it comes to changing energy use habits. In our research we explore the social route to behavioral change, and examine how people influence each other in urban communities. We explore the conditions under which individuals

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

Directory of Open Access Journals (Sweden)

G.G. Mchunu

2009-09-01

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

Distinguishing stressors acting on landbird communities in an urbanizing environment

Science.gov (United States)

Matthew D. Schlesinger; Patricia N. Manley; Marcel Holyoak

2008-01-01

Urbanization has profound influences on ecological communities, but our understanding of causal mechanisms is limited by a lack of attention to its component stressors. Published research suggests that at landscape scales, habitat loss and fragmentation are the major drivers of community change, whereas at local scales, human activity and vegetation management are the...

Reducing Disparities in Cancer Screening and Prevention through Community-Based Participatory Research Partnerships with Local Libraries: A Comprehensive Dynamic Trial.

Science.gov (United States)

Rapkin, Bruce D; Weiss, Elisa; Lounsbury, David; Michel, Tamara; Gordon, Alexis; Erb-Downward, Jennifer; Sabino-Laughlin, Eilleen; Carpenter, Alison; Schwartz, Carolyn E; Bulone, Linda; Kemeny, Margaret

2017-09-01

Reduction of cancer-related disparities requires strategies that link medically underserved communities to preventive care. In this community-based participatory research project, a public library system brought together stakeholders to plan and undertake programs to address cancer screening and risk behavior. This study was implemented over 48 months in 20 large urban neighborhoods, selected to reach diverse communities disconnected from care. In each neighborhood, Cancer Action Councils were organized to conduct a comprehensive dynamic trial, an iterative process of program planning, implementation and evaluation. This process was phased into neighborhoods in random, stepped-wedge sequence. Population-level outcomes included self-reported screening adherence and smoking cessation, based on street intercept interviews. Event-history regressions (n = 9374) demonstrated that adherence outcomes were associated with program implementation, as were mediators such as awareness of screening programs and cancer information seeking. Findings varied by ethnicity, and were strongest among respondents born outside the U.S. or least engaged in care. This intervention impacted health behavior in diverse, underserved and vulnerable neighborhoods. It has been sustained as a routine library system program for several years after conclusion of grant support. In sum, participatory research with the public library system offers a flexible, scalable approach to reduce cancer health disparities. © Society for Community Research and Action 2017.

A community in the wildland-urban interface

Science.gov (United States)

María Cecilia Ciampoli Halaman

2013-01-01

Communities located in the wildland-urban interface undergo a process of transformation until they can guard against fires occurring in the area. This study analyzed this process for the Estación neighborhood in the city of Esquel, Chubut Province, Argentina. The analysis was performed by comparing the level of danger diagnosed for each neighborhood home in 2004 with...

A small-area analysis of inequalities in chronic disease prevalence across urban and non-urban communities in the Province of Nova Scotia, Canada, 2007-2011.

Science.gov (United States)

Terashima, Mikiko; Rainham, Daniel G C; Levy, Adrian R

2014-05-13

Small-area studies of health inequalities often have an urban focus, and may be limited in their translatability to non-urban settings. Using small-area units representing communities, this study assessed the influence of living in different settlement types (urban, town and rural) on the prevalence of four chronic diseases (heart disease, cancer, diabetes and stroke) and compared the degrees of associations with individual-level and community-level factors among the settlement types. The associations between community-level and individual-level characteristics and prevalence of the chronic diseases were assessed using logistic regression (multilevel and non-multilevel) models. Individual-level data were extracted from the Canadian Community Health Survey (2007-2011). Indices of material deprivation and social isolation and the settlement type classification were created using the Canadian Census. Respondents living in towns were 21% more likely to report one of the diseases than respondents living in urban communities even after accounting for individual-level and community-level characteristics. Having dependent children appeared to have protective effects in towns, especially for males (OR: 0.49 (95% CI 0.27 to 0.90)). Unemployment had a strong association for all types of communities, but being unemployed appeared to be particularly damaging to health of males in urban communities (OR: 2.48 (95% CI 1.43 to 4.30)). The study showed that those living in non-urban settings, particularly towns, experience extra challenges in maintaining health above and beyond the socioeconomic condition and social isolation of the communities, and individual demographic, behavioural and socioeconomic attributes. Our findings also suggest that health inequality studies based on urban-only settings may underestimate the risks by some factors. Ways to devise meaningful small-area units comparable in all settlement types are necessary to help plan effective provision of chronic

Increased body size along urbanization gradients at both community and intraspecific level in macro-moths.

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Merckx, Thomas; Kaiser, Aurélien; Van Dyck, Hans

2018-05-23

Urbanization involves a cocktail of human-induced rapid environmental changes and is forecasted to gain further importance. Urban-heat-island effects result in increased metabolic costs expected to drive shifts towards smaller body sizes. However, urban environments are also characterized by strong habitat fragmentation, often selecting for dispersal phenotypes. Here, we investigate to what extent, and at which spatial scale(s), urbanization drives body size shifts in macro-moths-an insect group characterized by positive size-dispersal links-at both the community and intraspecific level. Using light and bait trapping as part of a replicated, spatially nested sampling design, we show that despite the observed urban warming of their woodland habitat, macro-moth communities display considerable increases in community-weighted mean body size because of stronger filtering against small species along urbanization gradients. Urbanization drives intraspecific shifts towards increased body size too, at least for a third of species analysed. These results indicate that urbanization drives shifts towards larger, and hence, more mobile species and individuals in order to mitigate low connectivity of ecological resources in urban settings. Macro-moths are a key group within terrestrial ecosystems, and since body size is central to species interactions, such urbanization-driven phenotypic change may impact urban ecosystem functioning, especially in terms of nocturnal pollination and food web dynamics. Although we show that urbanization's size-biased filtering happens simultaneously and coherently at both the inter- and intraspecific level, we demonstrate that the impact at the community level is most pronounced at the 800 m radius scale, whereas species-specific size increases happen at local and landscape scales (50-3,200 m radius), depending on the species. Hence, measures-such as creating and improving urban green infrastructure-to mitigate the effects of urbanization on

Spatial correlation analysis of urban traffic state under a perspective of community detection

Science.gov (United States)

Yang, Yanfang; Cao, Jiandong; Qin, Yong; Jia, Limin; Dong, Honghui; Zhang, Aomuhan

2018-05-01

Understanding the spatial correlation of urban traffic state is essential for identifying the evolution patterns of urban traffic state. However, the distribution of traffic state always has characteristics of large spatial span and heterogeneity. This paper adapts the concept of community detection to the correlation network of urban traffic state and proposes a new perspective to identify the spatial correlation patterns of traffic state. In the proposed urban traffic network, the nodes represent road segments, and an edge between a pair of nodes is added depending on the result of significance test for the corresponding correlation of traffic state. Further, the process of community detection in the urban traffic network (named GWPA-K-means) is applied to analyze the spatial dependency of traffic state. The proposed method extends the traditional K-means algorithm in two steps: (i) redefines the initial cluster centers by two properties of nodes (the GWPA value and the minimum shortest path length); (ii) utilizes the weight signal propagation process to transfer the topological information of the urban traffic network into a node similarity matrix. Finally, numerical experiments are conducted on a simple network and a real urban road network in Beijing. The results show that GWPA-K-means algorithm is valid in spatial correlation analysis of traffic state. The network science and community structure analysis perform well in describing the spatial heterogeneity of traffic state on a large spatial scale.

SENSE OF COMMUNITY AND RESIDENTIAL SPACE: CONTEXTUALIZING NEW URBANISM WITHIN A BROADER THEORETICAL FRAMEWORK

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Mohamad Kashef

2009-11-01

Full Text Available This study engages the planning and urban design literature as well as social theory to develop a nuanced understanding of issues related to neighborhood form and sense of community. The study analyzes the meaning of community from economic, social, and cultural perspectives. It contextualizes the New Urbanism use of physical design as a subtext for community within a broader theoretical context. The study revisits the New Urbanism design principle regarding the interface between the private and public realm and its relationship to the idea of place and social attachment. While questioning the relevance of the New Urbanism planning agenda to U.S. metropolitan formations, the study discussions underline the value of its design formula for the social life of residential neighborhoods. The multidisciplinary approach of this study unravels some of the confusion over sociospatial dialectics in general, and community and built environment in particular. It opens the door for further cross-disciplinary research aimed at understanding and potentially optimizing the relationship between people and their built environments.

Youth empowerment through urban agriculture: Red Hook Community Farm

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Ian Marvy

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Assessing net carbon sequestration on urban and community forests of northern New England, USA

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Daolan Zheng; Mark J. Ducey; Linda S. Heath

2013-01-01

Urban and community forests play an important role in the overall carbon budget of the USA. Accurately quantifying carbon sequestration by these forests can provide insight for strategic planning to mitigate greenhouse gas effects on climate change. This study provides a new methodology to estimate net forest carbon sequestration (FCS) in urban and community lands of...

Planning innovation for better urban communities in sub-Saharan ...

African Journals Online (AJOL)

Planning innovation for better urban communities in sub-Saharan Africa: The education ... This is at a time when Africa is urbanising faster than any other region ... management are yet to be thoroughly analysed and rethought in planning ...

Art and community health: lessons from an urban health center.

Science.gov (United States)

Siegel, Wilma Bulkin; Bartley, Mary Anne

2004-01-01

Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

Promoting Effective Parenting Practices and Preventing Child Behavior Problems in School among Ethnically Diverse Families from Underserved, Urban Communities

Science.gov (United States)

Brotman, Laurie Miller; Calzada, Esther; Huang, Keng-Yen; Kingston, Sharon; Dawson-McClure, Spring; Kamboukos, Dimitra; Rosenfelt, Amanda; Schwab, Amihai; Petkova, Eva

2011-01-01

This study examines the efficacy of "ParentCorps" among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. "ParentCorps" includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health…

Urban and community forests of the North Central East region: Illinois, Indiana, Michigan, Ohio, Wisconsin

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of Illinois, Indiana, Michigan, Ohio, and Wisconsin by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry information for each state including human population characteristics and trends,...

New forms of dwelling – sustainable urban communities

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Mojca Šašek Divjak

2000-01-01

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.

Fruit and Vegetable Intake among Urban Community Gardeners

Science.gov (United States)

Alaimo, Katherine; Packnett, Elizabeth; Miles, Richard A.; Kruger, Daniel J.

2008-01-01

Objective: To determine the association between household participation in a community garden and fruit and vegetable consumption among urban adults. Design: Data were analyzed from a cross-sectional random phone survey conducted in 2003. A quota sampling strategy was used to ensure that all census tracts within the city were represented. Setting:…

Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

Science.gov (United States)

Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

2012-03-01

The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

Incorporating Traditional Healing Into an Urban American Indian Health Organization: A Case Study of Community Member Perspectives

Science.gov (United States)

Hartmann, William E.; Gone, Joseph P.

2013-01-01

Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available for urban AI communities do not exist in the literature, this community-based project convened 4 focus groups consisting of 26 members of a midwestern urban AI community to better understand traditional healing practices of interest and how they might be integrated into the mental health and substance abuse treatment services in an Urban Indian Health Organization (UIHO). Qualitative content analysis of focus group transcripts revealed that ceremonial participation, traditional education, culture keepers, and community cohesion were thought to be key components of a successful traditional healing program. Potential incorporation of these components into an urban environment, however, yielded 4 marked tensions: traditional healing protocols versus the realities of impoverished urban living, multitribal representation in traditional healing services versus relational consistency with the culture keepers who would provide them, enthusiasm for traditional healing versus uncertainty about who is trustworthy, and the integrity of traditional healing versus the appeal of alternative medicine. Although these tensions would likely arise in most urban AI clinical contexts, the way in which each is resolved will likely depend on tailored community needs, conditions, and mental health objectives. PMID:22731113

Household transmission of leptospira infection in urban slum communities.

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Elves A P Maciel

2008-01-01

Full Text Available Leptospirosis, a spirochaetal zoonotic disease, is the cause of epidemics associated with high mortality in urban slum communities. Infection with pathogenic Leptospira occurs during environmental exposures and is traditionally associated with occupational risk activities. However, slum inhabitants reside in close proximity to environmental sources of contamination, suggesting that transmission during urban epidemics occurs in the household environment.A survey was performed to determine whether Leptospira infection clustered within households located in slum communities in the city of Salvador, Brazil. Hospital-based surveillance identified 89 confirmed cases of leptospirosis during an outbreak. Serum samples were obtained from members of 22 households with index cases of leptospirosis and 52 control households located in the same slum communities. The presence of anti-Leptospira agglutinating antibodies was used as a marker for previous infection. In households with index cases, 22 (30% of 74 members had anti-Leptospira antibodies, whereas 16 (8% of 195 members from control households had anti-Leptospira antibodies. Highest titres were directed against L. interrogans serovars of the Icterohaemorrhagiae serogroup in 95% and 100% of the subjects with agglutinating antibodies from case and control households, respectively. Residence in a household with an index case of leptospirosis was associated with increased risk (OR 5.29, 95% CI 2.13-13.12 of having had a Leptospira infection. Increased infection risk was found for all age groups who resided in a household with an index case, including children <15 years of age (P = 0.008.This study identified significant household clustering of Leptospira infection in slum communities where recurrent epidemics of leptospirosis occur. The findings support the hypothesis that the household environment is an important transmission determinant in the urban slum setting. Prevention therefore needs to target

An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

Science.gov (United States)

Santoyo-Olsson, Jasmine; Cabrera, Julissa; Freyre, Rachel; Grossman, Melanie; Alvarez, Natalie; Mathur, Deepika; Guerrero, Maria; Delgadillo, Adriana T.; Kanaya, Alka M.; Stewart, Anita L.

2011-01-01

Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors. PMID:21565823

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

Science.gov (United States)

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately

Seasonally dynamic fungal communities in the Quercus macrocarpa phyllosphere differ between urban and nonurban environments.

Science.gov (United States)

Jumpponen, A; Jones, K L

2010-04-01

*The fungal richness, diversity and community composition in the Quercus macrocarpa phyllosphere were compared across a growing season in trees located in six stands within and outside a small urban center using 454-sequencing and DNA tagging. The approaches did not differentiate between endophytic and epiphytic fungal communities. *Fungi accumulated in the phyllosphere rapidly and communities were temporally dynamic, with more than a third of the analyzed operational taxonomic units (OTUs) and half of the BLAST-inferred genera showing distinct seasonal patterns. The seasonal patterns could be explained by fungal life cycles or environmental tolerances. *The communities were hyperdiverse and differed between the urban and nonurban stands, albeit not consistently across the growing season. Foliar macronutrients (nitrogen (N), potassium (K) and sulfur (S)), micronutrients (boron (B), manganese (Mn) and selenium (Se)) and trace elements (cadmium (Cd), lead (Pb) and zinc (Zn)) were enriched in the urban trees, probably as a result of anthropogenic activities. Because of correlations with the experimental layout, these chemical elements should not be considered as community drivers without further empirical studies. *We suggest that a combination of mechanisms leads to differences between urban and nonurban communities. Among those are stand isolation and size, nutrient and pollutant accumulation plus stand management, including fertilization and litter removal.

77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

Science.gov (United States)

2012-07-23

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

Science.gov (United States)

2013-08-16

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

The Consortium for Climate Risk in the Urban Northeast: A NOAA RISA Project

Science.gov (United States)

Rosenzweig, C.

2011-12-01

urban and economic policies on the social, racial and ethnic dimensions of livelihoods and of communities in the urban Northeast corridor. Disadvantaged socio-economic groups have been particularly underserved in the area of climate change, and one of CCRUN's long-term goals is the building of adaptive capacity among such groups to current and future climate extremes.

A 5A's communication intervention to promote physical activity in underserved populations

Directory of Open Access Journals (Sweden)

Carroll Jennifer K

2012-10-01

Full Text Available Abstract Background The present study protocol describes the trial design of a clinician training intervention to improve physical activity counseling in underserved primary care settings using the 5As. The 5As (Ask, Advise, Agree, Assist, Arrange are a clinical tool recommended for health behavior counseling in primary care. Methods/Design The study is a two-arm randomized pilot pragmatic trial to examine a primary care clinician communication intervention on use of the 5As in discussion of physical activity in audio-recorded office visits in an ethnically diverse, low-income patient population. The study setting consists of two federally qualified community health centers in Rochester, NY. Eligible clinicians (n=15 are recruited and randomized into two groups. Group 1 clinicians participate in the training intervention first; Group 2 clinicians receive the intervention six months later. The intervention and its outcomes are informed by self-determination theory and principles of patient-centered communication. Assessment of outcomes is blinded. The primary outcome will be the frequency and quality of 5As discussions as judged by evaluating 375 audio-recorded patient visits distributed over baseline and in the post-intervention period (immediately post and at six months. Secondary outcomes will be changes in patients’ perceived competence to increase physical activity (Aim 2 and patients and clinicians beliefs regarding whether pertinent barriers to promoting exercise have been reduced. (Aim 3. Exploratory outcomes (Aim 4 are potential mediators of the intervention’s effect and whether the intervention affects actual enrollment in the community program recommended for exercise. The analysis will use repeated measures (in the form of recorded office visits from each clinician at each time point and aggregate measures of Groups 1 and 2 over time. Discussion Results will help elucidate the role of 5As communication training for clinicians on

Financial incentives for return of service in underserved areas: a systematic review

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Bärnighausen Till

2009-05-01

Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes

Floral abundance, richness, and spatial distribution drive urban garden bee communities.

Science.gov (United States)

Plascencia, M; Philpott, S M

2017-10-01

In urban landscapes, gardens provide refuges for bee diversity, but conservation potential may depend on local and landscape features. Foraging and population persistence of bee species, as well as overall pollinator community structure, may be supported by the abundance, richness, and spatial distribution of floral resources. Floral resources strongly differ in urban gardens. Using hand netting and pan traps to survey bees, we examined whether abundance, richness, and spatial distribution of floral resources, as well as ground cover and garden landscape surroundings influence bee abundance, species richness, and diversity on the central coast of California. Differences in floral abundance and spatial distribution, as well as urban cover in the landscape, predicted different bee community variables. Abundance of all bees and of honeybees (Apis mellifera) was lower in sites with more urban land cover surrounding the gardens. Honeybee abundance was higher in sites with patchy floral resources, whereas bee species richness and bee diversity was higher in sites with more clustered floral resources. Surprisingly, bee species richness and bee diversity was lower in sites with very high floral abundance, possibly due to interactions with honeybees. Other studies have documented the importance of floral abundance and landscape surroundings for bees in urban gardens, but this study is the first to document that the spatial arrangement of flowers strongly predicts bee abundance and richness. Based on these findings, it is likely that garden managers may promote bee conservation by managing for floral connectivity and abundance within these ubiquitous urban habitats.

76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

Science.gov (United States)

2011-06-02

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

Science.gov (United States)

2010-06-10

... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

Social connectedness is associated with food security among peri-urban Peruvian Amazonian communities.

Science.gov (United States)

Lee, Gwenyth O; Surkan, Pamela J; Zelner, Jon; Paredes Olórtegui, Maribel; Peñataro Yori, Pablo; Ambikapathi, Ramya; Caulfield, Laura E; Gilman, Robert H; Kosek, Margaret N

2018-04-01

Food insecurity is a major global public health issue. Social capital has been identified as central to maintaining food security across a wide range of low- and middle-income country contexts, but few studies have examined this relationship through sociocentric network analysis. We investigated relationships between household- and community-level social connectedness, household food security, and household income; and tested the hypothesis that social connectedness modified the relationship between income and food security. A cross-sectional census with an embedded questionnaire to capture social relationships was conducted among eleven peri-urban communities. Community connectedness was related to study outcomes of food security and per-capita income through regression models. Of 1520 households identified, 1383 were interviewed (91.0%) and 1272 (83.9%) provided complete data. Households in the youngest communities had the most total contacts, and the highest proportion of contacts outside of the community. Household income was also associated with more outside-community contacts (0.05 more contacts per standard deviation increase in income, psecure households reported more contacts nearby (0.24 increase in household food insecurity access scale (HFIAS) for each additional contact, psecurity (-0.92 decrease in HFIAS for each one-unit increase in community mean degree, p=0.008). There was no evidence that social connectedness modified the relationship between income and food security such that lower-income households benefited more from community membership than higher-income households. Although households reported networks that spanned rural villages and urban centers, contacts within the community, with whom food was regularly shared, were most important to maintaining food security. Interventions that build within-community connectedness in peri-urban settings may increase food security.

Attitudes of Community to Urban Traffic Noise in Morogoro, Tanzania

African Journals Online (AJOL)

Attitudes of Community to Urban Traffic Noise in Morogoro, Tanzania. ... which is the daytime governmentally prescribed noise limit for residential-commercial areas. ... The main impacts of exposure to noise were reported to be headache, ...

Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

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Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

2016-10-07

Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving

Why do urban communities with similar conditions of social ...

International Development Research Centre (IDRC) Digital Library (Canada)

Urban marginal territories with similar levels of social exclusion might present di erent degrees of violence because of di erences in the capacity of the community to act to confront the phenomenon of violence. Research questions. Hypothesis. The research was carried out in. Outputs. Methodology. Household survey.

URBAN DISPLACEMENT AND LOW-INCOME COMMUNITIES: THE CASE OF THE AMERICAN CITY FROM THE LATE TWENTIETH CENTURY

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Jason Knight

2016-07-01

Full Text Available How can urban redevelopment benefit existing low-income communities? The history of urban redevelopment is one of disruption of poor communities. Renewal historically offered benefits to the place while pushing out the people. In some cases, displacement is intentional, in others it is unintentional. Often, it is the byproduct of the quest for profits. Regardless of motives, traditional communities, defined by cultural connections, are often disrupted. Disadvantaged neighborhoods include vacant units, which diminish the community and hold back investment. In the postwar period, American cities entered into a program of urban renewal. While this program cleared blight, it also drove displacement among the cities’ poorest and was particularly hard on minority populations clustered in downtown slums. The consequences of these decisions continue to play out today. Concentration of poverty is increasing and American cities are becoming more segregated. As neighborhoods improve, poorer residents are uprooted and forced into even more distressed conditions, elsewhere. This paper examines the history of events impacting urban communities. It further reviews the successes and failures of efforts to benefit low-income communities.

The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations.

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Shi Ying

Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.

Community perception regarding rabies prevention and stray dog control in urban slums in India.

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Herbert, Mrudu; Riyaz Basha, S; Thangaraj, Selvi

2012-12-01

The lack of community awareness about rabies control is a major issue that thwarts efforts to prevent human deaths caused by rabies. The objectives of this study were (1) to assess community knowledge and attitudes about rabies, rabies prevention and stray dog control in an urban slum community and (2) to determine the factors that influence rabies awareness in urban slums. Using a systematic random sampling strategy, 185 participants were selected from 8 urban slums. The data were collected by direct interview using a pre-tested, structured questionnaire. In the study population, 74.1% of the participants had heard about rabies, and 54.1% knew that rabies is a fatal disease. Only 33.5% of the interviewees felt that people in the community had a role to play in controlling the stray dog population. Gender, age and educational status were significantly associated with rabies awareness. Our study indicates that there are gaps in the knowledge and attitudes of individuals living in urban slums regarding rabies prevention and control. Efforts to promote awareness should be targeted at men, older people and uneducated individuals. Copyright © 2012 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Urbanization alters communities of flying arthropods in parks and gardens of a medium-sized city.

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Lagucki, Edward; Burdine, Justin D; McCluney, Kevin E

2017-01-01

Urbanization transforms undeveloped landscapes into built environments, causing changes in communities and ecological processes. Flying arthropods play important roles in these processes as pollinators, decomposers, and predators, and can be important in structuring food webs. The goal of this study was to identify associations between urbanization and the composition of communities of flying (and floating) arthropods within gardens and parks in a medium-sized mesic city. We predicted that flying arthropod abundance and diversity would respond strongly to percent impervious surface and distance to city center, measurements of urbanization. Flying arthropods were sampled from 30 gardens and parks along an urbanization gradient in Toledo, Ohio, during July and August 2016, using elevated pan traps. A variety of potential predictor variables were also recorded at each site. We collected a total of 2,369 individuals representing nine orders. We found that flying arthropod community composition was associated with percent impervious surface and canopy cover. Overall flying arthropod abundance was negatively associated with percent impervious surface and positively associated with distance to city center. Hymenoptera (bees, wasps, ants), Lepidoptera (moths, butterflies), and Araneae (spiders) were positively associated with distance to city center. Hemiptera (true bugs), Diptera (flies), and Araneae were negatively associated with percent impervious surface. Both distance to city center and percent impervious surface are metrics of urbanization, and this study shows how these factors influence flying arthropod communities in urban gardens and city parks, including significant reductions in taxa that contain pollinators and predators important to urban agriculture and forestry. A variety of environmental factors also showed significant associations with responses (e.g. canopy cover and soil moisture), suggesting these factors may underlie or modulate the urbanization

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

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Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

Directory of Open Access Journals (Sweden)

Blessing U. Mberu

2016-12-01

Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to

Proyecto MercadoFRESCO: a multi-level, community-engaged corner store intervention in East Los Angeles and Boyle Heights.

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Ortega, Alexander N; Albert, Stephanie L; Sharif, Mienah Z; Langellier, Brent A; Garcia, Rosa Elena; Glik, Deborah C; Brookmeyer, Ron; Chan-Golston, Alec M; Friedlander, Scott; Prelip, Michael L

2015-04-01

Urban food swamps are typically situated in low-income, minority communities and contribute to overweight and obesity. Changing the food landscape in low income and underserved communities is one strategy to combat the negative health consequences associated with the lack of access to healthy food resources and an abundance of unhealthy food venues. In this paper, we describe Proyecto MercadoFRESCO (Fresh Market Project), a corner store intervention project in East Los Angeles and Boyle Heights in California that used a multi-level approach with a broad range of community, business, and academic partners. These are two neighboring, predominantly Latino communities that have high rates of overweight and obesity. Located in these two communities are approximately 150 corner stores. The project used a community-engaged approach to select, recruit, and convert four corner stores, so that they could become healthy community assets in order to improve residents' access to and awareness of fresh and affordable fruits and vegetables in their immediate neighborhoods. We describe the study framework for the multi-level intervention, which includes having multiple stakeholders, expertise in corner store operations, community and youth engagement strategies, and social marketing campaigns. We also describe the evaluation and survey methodology to determine community and patron impact of the intervention. This paper provides a framework useful to a variety of public health stakeholders for implementing a community-engaged corner store conversion, particularly in an urban food swamp.

Neurological Disease Burden in two Semi-urban Communities in ...

African Journals Online (AJOL)

BACKGROUND: Neurological disorders are a significant cause of morbidity and mortality worldwide. Urban hospital -based studies give some perspectives on the burden of neurological disease but there are no community- based studies from South East Nigeria. AIM: This study sought to screen for the scope and pattern of ...

Educational and individual factors associated with positive change in and reaffirmation of medical students' intention to practice in underserved areas.

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Boscardin, Christy K; Grbic, Douglas; Grumbach, Kevin; O'Sullivan, Patricia

2014-11-01

The projected U.S. physician shortage will disproportionately affect underserved areas. This study examined the impact of medical school educational experiences on positive changes in and reaffirmation of students' intention to practice in underserved areas (practice intention). Medical students (n = 7,361) from 113 U.S. MD-granting medical schools who graduated in 2009-2010 and responded to both the Association of American Medical Colleges' 2006 Matriculating Student Questionnaire and 2010 Graduation Questionnaire were included. Multilevel logistic regression analyses were conducted to determine factors associated with change in and reaffirmation of practice intention. After controlling for individual characteristics, community health field experience (adjusted odds ratio [OR]: 1.36; 95% CI: 1.18, 1.57), learning another language (OR: 1.41; 95% CI: 1.22, 1.63), cultural competence/awareness experience (OR: 1.38; 95% CI: 1.21, 1.58), becoming more aware of perspectives of individuals from different backgrounds (OR: 1.24; 95% CI: 1.04, 1.48), and attending schools with higher social mission scores (OR: 1.66; 95% CI: 1.28, 2.16) were all significantly associated with positive changes in practice intention from matriculation to graduation. Field experience in community health (OR: 1.24; 95% CI: 0.99, 1.53), learning another language (OR: 1.29; 95% CI: 1.01, 1.65), and attending schools with higher social mission scores (OR: 1.62; 95% CI: 1.09, 2.43) were all significantly associated with reaffirmation of practice intention at graduation. Multifaceted factors are associated with practice intention. This study suggests medical schools can play active roles in alleviating the physician shortage in underserved areas through targeted curricular interventions and recruitment.

Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

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Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

2010-01-01

Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…

Urban ecological stewardship: understanding the structure, function and network of community-based urban land management

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Erika s. Svendsen; Lindsay K. Campbell

2008-01-01

Urban environmental stewardship activities are on the rise in cities throughout the Northeast. Groups participating in stewardship activities range in age, size, and geography and represent an increasingly complex and dynamic arrangement of civil society, government and business sectors. To better understand the structure, function and network of these community-based...

Evaluation of a Coordinated School-Based Obesity Prevention Program in a Hispanic Community: Choosing Healthy and Active Lifestyles for Kids/healthy Schools Healthy Families

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Berger-Jenkins, Evelyn; Rausch, John; Okah, Ebiere; Tsao, Daisy; Nieto, Andres; Lyda, Elizabeth; Meyer, Dodi; McCord, Mary

2014-01-01

Background: Obesity is a public health concern that disproportionately affects underserved and minority communities. Purpose: To evaluate whether a comprehensive obesity prevention program that targets children and school staff in an underserved Hispanic community affects obesity related knowledge, attitudes, and behaviors among both students and…

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

Science.gov (United States)

Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

2015-07-01

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

Facilitating community information service for national development ...

African Journals Online (AJOL)

Many rural communities have continued to be underserved; hence, information becomes necessary in integrating the needs of the people for sustainable development. Librarians and libraries are charged with providing the information resources and outreaches to the communities to help build the bridge between the ...

Rapid Recovery of an Urban Remnant Reptile Community following Summer Wildfire.

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Davis, Robert A; Doherty, Tim S

2015-01-01

Reptiles in urban remnants are threatened with extinction by increased fire frequency, habitat fragmentation caused by urban development, and competition and predation from exotic species. Understanding how urban reptiles respond to and recover from such disturbances is key to their conservation. We monitored the recovery of an urban reptile community for five years following a summer wildfire at Kings Park in Perth, Western Australia, using pitfall trapping at five burnt and five unburnt sites. The reptile community recovered rapidly following the fire. Unburnt sites initially had higher species richness and total abundance, but burnt sites rapidly converged, recording a similar total abundance to unburnt areas within two years, and a similar richness within three years. The leaf-litter inhabiting skink Hemiergis quadrilineata was strongly associated with longer unburnt sites and may be responding to the loss of leaf litter following the fire. Six rarely-captured species were also strongly associated with unburnt areas and were rarely or never recorded at burnt sites, whereas two other rarely-captured species were associated with burnt sites. We also found that one lizard species, Ctenotus fallens, had a smaller average body length in burnt sites compared to unburnt sites for four out of the five years of monitoring. Our study indicates that fire management that homogenises large areas of habitat through frequent burning may threaten some species due to their preference for longer unburnt habitat. Careful management of fire may be needed to maximise habitat suitability within the urban landscape.

Districts on the Edge: The Impact of Urban Sprawl on a Rural Community.

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Theobald, Paul

1988-01-01

Portrays the controversy surrounding schools and education in a rural community experiencing both an influx of urban and suburban newcomers and the effects of urban sprawl. Reports on surveys of student educational attitudes, household information, and outside activities, and on interviews with teachers, school administrators, and residents.…

Effects of urban development on ant communities: implications for ecosystem services and management

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M.P. Sanford; Patricia N. Manley; Dennis D. Murphy

2009-01-01

Research that connects the effects of urbanization on biodiversity and ecosystem services is lacking. Ants perform multifarious ecological functions that stabilize ecosystems and contribute to a number of ecosystem services. We studied responses of ant communities to urbanization in the Lake Tahoe basin by sampling sites along a gradient...

Methodology of a diabetes prevention translational research project utilizing a community-academic partnership for implementation in an underserved Latino community

Directory of Open Access Journals (Sweden)

Ma Yunsheng

2009-03-01

Full Text Available Abstract Background Latinos comprise the largest racial/ethnic group in the United States and have 2–3 times the prevalence of type 2 diabetes mellitus as Caucasians. Methods and design The Lawrence Latino Diabetes Prevention Project (LLDPP is a community-based translational research study which aims to reduce the risk of diabetes among Latinos who have a ≥ 30% probability of developing diabetes in the next 7.5 years per a predictive equation. The project was conducted in Lawrence, Massachusetts, a predominantly Caribbean-origin urban Latino community. Individuals were identified primarily from a community health center's patient panel, screened for study eligibility, randomized to either a usual care or a lifestyle intervention condition, and followed for one year. Like the efficacious Diabetes Prevention Program (DPP, the LLDPP intervention targeted weight loss through dietary change and increased physical activity. However, unlike the DPP, the LLDPP intervention was less intensive, tailored to literacy needs and cultural preferences, and delivered in Spanish. The group format of the intervention (13 group sessions over 1 year was complemented by 3 individual home visits and was implemented by individuals from the community with training and supervision by a clinical research nutritionist and a behavioral psychologist. Study measures included demographics, Stern predictive equation components (age, gender, ethnicity, fasting glucose, systolic blood pressure, HDL-cholesterol, body mass index, and family history of diabetes, glycosylated hemoglobin, dietary intake, physical activity, depressive symptoms, social support, quality of life, and medication use. Body weight was measured at baseline, 6-months, and one-year; all other measures were assessed at baseline and one-year. All surveys were orally administered in Spanish. Results A community-academic partnership enabled the successful recruitment, intervention, and assessment of Latinos at

Continuing interprofessional education in geriatrics and gerontology in medically underserved areas.

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Toner, John A; Ferguson, K Della; Sokal, Regina Davis

2009-01-01

There is a widening gap between the health care needs of older persons and the treatment skills of the health care professionals who serve them. This gap is especially severe in rural areas, where there is a shortage of and inadequate collaboration between health care professionals and poor access to services for older persons. There is also a special opportunity in rural areas, particularly those designated as "medically underserved," for continuing interprofessional education as a vehicle for retaining health care professionals who tend to leave medically underserved areas for more lucrative professional opportunities elsewhere. In collaboration with the Consortium of New York Geriatric Education Centers, the Columbia-New York Geriatric Education Center at the Stroud Center of Columbia University has developed the Program for Outreach to Interprofessional Services and Education (POISE). The purpose of POISE is to develop, implement, evaluate, and sustain interprofessional education and training for health care learners, while emphasizing improved access to health services for the geriatric population in medically underserved areas. The POISE model was designed as an effective approach to teaching the core geriatrics and gerontology curriculum endorsed by the national (U.S. Department of Health and Human Services) network of Geriatric Education Centers to health care learners in medically underserved areas of upstate New York. This article describes the adaptation and implementation of the POISE model.

An assessment of environmental sanitation in an urban community ...

African Journals Online (AJOL)

Inadequate environmental sanitation has been recognized as a public health hazard worldwide. In some Nigerian cities, living with waste as part of the natural environment has become a way of life. This study examined the sanitary condition of an urban community in Akwa Ibom State, Nigeria. It used a cross sectional ...

THE REPRESENTATION OF URBAN UPPER MIDDLE CLASS AMERICAN WOMEN'S COMMUNITY IN SEX AND THE CITY

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Yola Damayanti Gani

2005-01-01

Full Text Available The portrayal of urban upper middle class American women's community in Sex and the City-SATC-is built upon constructed symbols related to the position of urban upper middle class American Women's community and how cosmopolitan the women are. The symbol's construction is characterized by singleness, upper middle class social status, well-established career, alienation, consumptiveness, independence, gender consciousness, and open mindedness in their sexual knowledge. Television has helped to fracture traditional conventions about how women should place themselves in the midst of their society and constructed urban upper middle class American women's image and identity.

The community health worker cultural mentoring project: preparing professional students for team work with health workers from urban communities.

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Sherwen, Laurie N; Schwolsky-Fitch, Elena; Rodriquez, Romelia; Horta, Greg; Lopez, Ivanna

2007-01-01

Community Health Workers or CHWs (also known by a variety of alternative titles) are health workers drawn from communities to provide access to care for members of their communities. CHWs have been documented as effective in delivering a variety of services in a culturally-sensitive manner, and in providing a bridge between health professionals and underserved or minority communities. Yet, CHWs have not been well incorporated into interdisciplinary health care teams. The majority of health professionals are not even aware of the possible role and skills of CHWs. Believing that the best time to educate professionals about this valuable health worker and ensure that CHWs become part of interdisciplinary health care teams is during the student years, the Hunter College Schools of the Health Professions, and the Community Health Worker Network of New York City developed a pilot project, the Community Health Worker Cultural Mentoring Project. Community Health Workers, who were members of the Network, served as "community mentors" for health professions students drawn from the programs of community health education, nursing, and nutrition. CHWs worked with faculty of selected courses in each of the professional programs, and served as panelists in these courses, presenting information about health beliefs and alternative health practices of diverse cultural groups in communities of New York City. Class sessions were first held in the fall of 2004; subsequent sessions were held in following semesters. Approximately 40 students participated in 7 classes, with 6 CHWs serving as mentors - two per class. At the end of the classroom presentations, students wrote reflections relating to their understanding of the CHW role and relevance for their future interdisciplinary practice. The majority of reflections met the goal of increasing professional students' understanding of the CHW role and skills. At this point, quantitative and qualitative data will need to be collected to

Urbanization breaks up host-parasite interactions: a case study on parasite community ecology of rufous-bellied thrushes (Turdus rufiventris) along a rural-urban gradient.

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Calegaro-Marques, Cláudia; Amato, Suzana B

2014-01-01

Urbanization drastically alters natural ecosystems and the structure of their plant and animal communities. Whereas some species cope successfully with these environmental changes, others may go extinct. In the case of parasite communities, the expansion of urban areas has a critical effect by changing the availability of suitable substrates for the eggs or free-larval stages of those species with direct life cycles or for the range of hosts of those species with complex cycles. In this study we investigated the influence of the degree of urbanization and environmental heterogeneity on helminth richness, abundance and community structure of rufous-bellied thrushes (Turdus rufiventris) along a rural-urban gradient in the metropolitan region of Porto Alegre, State of Rio Grande do Sul, Brazil. This common native bird species of southern Brazil hosts 15 endoparasite species at the study region. A total of 144 thrushes were collected with mist nets at 11 sites. The degree of urbanization and environmental heterogeneity were estimated by quantifying five landscape elements: buildings, woodlands, fields, bare lands, and water. Landscape analyses were performed at two spatial scales (10 and 100 ha) taking into account home range size and the potential dispersal distance of thrushes and their prey (intermediate hosts). Mean parasite richness showed an inverse relationship with the degree of urbanization, but a positive relationship with environmental heterogeneity. Changes in the structure of component communities along the rural-urban gradient resulted from responses to the availability of particular landscape elements that are compatible with the parasites' life cycles. We found that the replacement of natural environments with buildings breaks up host-parasite interactions, whereas a higher environmental (substrate) diversity allows the survival of a wider range of intermediate hosts and vectors and their associated parasites.

Recruiting Underserved Mothers to Medical Research: Findings from North Carolina

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Spears, Chaya R.; Sandberg, Joanne C.; O’Neill, Jenna L.; Grzywacz, Joseph G.; Howard, Timothy D.; Feldman, Steven R.; Arcury, Thomas A.

2014-01-01

Representative samples are required for ethical, valid, and useful health research. Yet, recruiting participants, especially from historically underserved communities, can be challenging. This paper presents findings from in-depth interviews with 40 mothers about factors that might influence their willingness to participate or allow their children to participate in medical research. Saliency analysis organizes the findings. Frequent and important salient themes about research participation included concerns that it might cause participants harm, hope that participants might gain a health benefit, and recognition that time and transportation resources could limit participation. Ultimately, we propose that a theoretical model, such as the Theory of Planned Behavior (TPB), will facilitate more systematic evaluation of effective methods for recruitment and retention of participants in medical research. Future research should explore the utility of such a model for development of effective recruitment and retention strategies. PMID:24185171

Biogeochemistry and community ecology in a spring-fed urban river following a major earthquake

International Nuclear Information System (INIS)

Wells, Naomi S.; Clough, Tim J.; Condron, Leo M.; Baisden, W. Troy; Harding, Jon S.; Dong, Y.; Lewis, G.D.; Lear, Gavin

2013-01-01

In February 2011 a M W 6.3 earthquake in Christchurch, New Zealand inundated urban waterways with sediment from liquefaction and triggered sewage spills. The impacts of, and recovery from, this natural disaster on the stream biogeochemistry and biology were assessed over six months along a longitudinal impact gradient in an urban river. The impact of liquefaction was masked by earthquake triggered sewage spills (∼20,000 m 3 day −1 entering the river for one month). Within 10 days of the earthquake dissolved oxygen in the lowest reaches was −1 , in-stream denitrification accelerated (attenuating 40–80% of sewage nitrogen), microbial biofilm communities changed, and several benthic invertebrate taxa disappeared. Following sewage system repairs, the river recovered in a reverse cascade, and within six months there were no differences in water chemistry, nutrient cycling, or benthic communities between severely and minimally impacted reaches. This study highlights the importance of assessing environmental impact following urban natural disasters. -- Highlights: •Earthquakes triggered sewage spills and liquefaction into an urban river. •Combined chemical, isotopic, and biological measurements to quantify stream recovery. •Sustained sewage discharge into the river drove eutrophication in lower reaches. •River function recovered in a reverse cascade, from chemical to macroinvertebrate. -- Linking stream community ecology with biogeochemical function, we provide an in-depth quantification of urban stream recovery following a catastrophic earthquake

Hierarchical filters determine community assembly of urban species pools

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Myla F.J. Aronson; Charles H. Nilon; Christopher A. Lepczyk; Tommy S. Parker; Paige S. Warren; Sarel S. Cilliers; Mark A. Goddard; Amy K. Hahs; Cecilia Herzog; Madhusudan Katti; Frank A. La Sorte; Nicholas S.G. Williams; Wayne  Zipperer

2016-01-01

The majority of humanity now lives in cities or towns, with this proportion expected to continue increasing for the foreseeable future. As novel ecosystems, urban areas offer an ideal opportunity to examine multi-scalar processes involved in community assembly as well as the role of human activities in modulating environmental drivers of biodiversity. Although...

Comparison of root-associated communities of native and non-native ectomycorrhizal hosts in an urban landscape.

Science.gov (United States)

Lothamer, K; Brown, S P; Mattox, J D; Jumpponen, A

2014-05-01

Non-native tree species are often used as ornamentals in urban landscapes. However, their root-associated fungal communities remain yet to be examined in detail. Here, we compared richness, diversity and community composition of ectomycorrhizosphere fungi in general and ectomycorrhizal (EcM) fungi in particular between a non-native Pinus nigra and a native Quercus macrocarpa across a growing season in urban parks using 454-pyrosequencing. Our data show that, while the ectomycorrhizosphere community richness and diversity did not differ between the two host, the EcM communities associated with the native host were often more species rich and included more exclusive members than those of the non-native hosts. In contrast, the ectomycorrhizosphere communities of the two hosts were compositionally clearly distinct in nonmetric multidimensional ordination analyses, whereas the EcM communities were only marginally so. Taken together, our data suggest EcM communities with broad host compatibilities and with a limited numbers of taxa with preference to the non-native host. Furthermore, many common fungi in the non-native Pinus were not EcM taxa, suggesting that the fungal communities of the non-native host may be enriched in non-mycorrhizal fungi at the cost of the EcM taxa. Finally, while our colonization estimates did not suggest a shortage in EcM inoculum for either host in urban parks, the differences in the fungi associated with the two hosts emphasize the importance of using native hosts in urban environments as a tool to conserve endemic fungal diversity and richness in man-made systems.

Application of the target fish community model to an urban river system.

Science.gov (United States)

Meixler, Marcia S

2011-04-01

Several models have been developed to assess the biological integrity of aquatic systems using fish community data. One of these, the target fish community (TFC) model, has been used primarily to assess the biological integrity of larger, mainstem rivers in southern New England with basins characterized by dispersed human activities. We tested the efficacy of the TFC approach to specify the fish community in the highly urbanized Charles River watershed in eastern Massachusetts. To create a TFC for the Charles River we assembled a list of fish species that historically inhabited the Charles River watershed, identified geomorphically and zoogeographically similar reference rivers regarded as being in high quality condition, amassed fish survey data for the reference rivers, and extracted from the collections the information needed to define a TFC. We used a similarity measurement method to assess the extent to which the study river community complies with the TFC and an inference approach to summarize the manner in which the existing fish community differed from target conditions. The five most abundant species in the TFC were common shiners (34%), fallfish (17%) redbreast sunfish (11%), white suckers (8%), and American eel (7%). Three of the five species predicted to be most abundant in the TFC were scarce or absent in the existing river community. Further, the river was dominated by macrohabitat generalists (99%) while the TFC was predicted to contain 19% fluvial specialist species, 43% fluvial dependent species, and 38% macrohabitat generalist species. In addition, while the target community was dominated by fish intolerant (37%) and moderately tolerant (39%) of water quality degradation, the existing community was dominated by tolerant individuals (59%) and lacked intolerant species expected in the TFC. Similarity scores for species, habitat use specialization, and water quality degradation tolerance categories were 28%, 35% and 66%, respectively. The clear

Spatial variation in the parasite communities and genomic structure of urban rats in New York City.

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Angley, L P; Combs, M; Firth, C; Frye, M J; Lipkin, I; Richardson, J L; Munshi-South, J

2018-02-01

Brown rats (Rattus norvegicus) are a globally distributed pest. Urban habitats can support large infestations of rats, posing a potential risk to public health from the parasites and pathogens they carry. Despite the potential influence of rodent-borne zoonotic diseases on human health, it is unclear how urban habitats affect the structure and transmission dynamics of ectoparasite and microbial communities (all referred to as "parasites" hereafter) among rat colonies. In this study, we use ecological data on parasites and genomic sequencing of their rat hosts to examine associations between spatial proximity, genetic relatedness and the parasite communities associated with 133 rats at five sites in sections of New York City with persistent rat infestations. We build on previous work showing that rats in New York carry a wide variety of parasites and report that these communities differ significantly among sites, even across small geographical distances. Ectoparasite community similarity was positively associated with geographical proximity; however, there was no general association between distance and microbial communities of rats. Sites with greater overall parasite diversity also had rats with greater infection levels and parasite species richness. Parasite community similarity among sites was not linked to genetic relatedness of rats, suggesting that these communities are not associated with genetic similarity among host individuals or host dispersal among sites. Discriminant analysis identified site-specific associations of several parasite species, suggesting that the presence of some species within parasite communities may allow researchers to determine the sites of origin for newly sampled rats. The results of our study help clarify the roles that colony structure and geographical proximity play in determining the ecology of R. norvegicus as a significant urban reservoir of zoonotic diseases. Our study also highlights the spatial variation present in urban

Ectomycorrhizal Fungal Communities in Urban Parks Are Similar to Those in Natural Forests but Shaped by Vegetation and Park Age.

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Hui, Nan; Liu, Xinxin; Kotze, D Johan; Jumpponen, Ari; Francini, Gaia; Setälä, Heikki

2017-12-01

Ectomycorrhizal (ECM) fungi are important mutualists for the growth and health of most boreal trees. Forest age and its host species composition can impact the composition of ECM fungal communities. Although plentiful empirical data exist for forested environments, the effects of established vegetation and its successional trajectories on ECM fungi in urban greenspaces remain poorly understood. We analyzed ECM fungi in 5 control forests and 41 urban parks of two plant functional groups (conifer and broadleaf trees) and in three age categories (10, ∼50, and >100 years old) in southern Finland. Our results show that although ECM fungal richness was marginally greater in forests than in urban parks, urban parks still hosted rich and diverse ECM fungal communities. ECM fungal community composition differed between the two habitats but was driven by taxon rank order reordering, as key ECM fungal taxa remained largely the same. In parks, the ECM communities differed between conifer and broadleaf trees. The successional trajectories of ECM fungi, as inferred in relation to the time since park construction, differed among the conifers and broadleaf trees: the ECM fungal communities changed over time under the conifers, whereas communities under broadleaf trees provided no evidence for such age-related effects. Our data show that plant-ECM fungus interactions in urban parks, in spite of being constructed environments, are surprisingly similar in richness to those in natural forests. This suggests that the presence of host trees, rather than soil characteristics or even disturbance regime of the system, determine ECM fungal community structure and diversity. IMPORTANCE In urban environments, soil and trees improve environmental quality and provide essential ecosystem services. ECM fungi enhance plant growth and performance, increasing plant nutrient acquisition and protecting plants against toxic compounds. Recent evidence indicates that soil-inhabiting fungal communities

Flying-foxes in the Australian urban environment—community attitudes and opinions

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Nina Y. Kung

2015-12-01

Full Text Available The urban presence of flying-foxes (pteropid bats in eastern Australia has increased in the last 20 years, putatively reflecting broader landscape change. The influx of large numbers often precipitates community angst, typically stemming from concerns about loss of social amenity, economic loss or negative health impacts from recently emerged bat-mediated zoonotic diseases such as Hendra virus and Australian bat lyssavirus. Local authorities and state wildlife authorities are increasingly asked to approve the dispersal or modification of flying-fox roosts to address expressed concerns, yet the scale of this concern within the community, and the veracity of the basis for concern are often unclear. We conducted an on-line survey to capture community attitudes and opinions on flying-foxes in the urban environment to inform management policy and decision-making. Analysis focused on awareness, concerns, and management options, and primarily compared responses from communities where flying-fox management was and was not topical at the time of the survey. While a majority of respondents indicated a moderate to high level of knowledge of both flying-foxes and Hendra virus, a substantial minority mistakenly believed that flying-foxes pose a direct infection risk to humans, suggesting miscommunication or misinformation, and the need for additional risk communication strategies. Secondly, a minority of community members indicated they were directly impacted by urban roosts, most plausibly those living in close proximity to the roost, suggesting that targeted management options are warranted. Thirdly, neither dispersal nor culling was seen as an appropriate management strategy by the majority of respondents, including those from postcodes where flying-fox management was topical. These findings usefully inform community debate and policy development and demonstrate the value of social analysis in defining the issues and options in this complex human�

Rapid Recovery of an Urban Remnant Reptile Community following Summer Wildfire.

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Robert A Davis

Full Text Available Reptiles in urban remnants are threatened with extinction by increased fire frequency, habitat fragmentation caused by urban development, and competition and predation from exotic species. Understanding how urban reptiles respond to and recover from such disturbances is key to their conservation. We monitored the recovery of an urban reptile community for five years following a summer wildfire at Kings Park in Perth, Western Australia, using pitfall trapping at five burnt and five unburnt sites. The reptile community recovered rapidly following the fire. Unburnt sites initially had higher species richness and total abundance, but burnt sites rapidly converged, recording a similar total abundance to unburnt areas within two years, and a similar richness within three years. The leaf-litter inhabiting skink Hemiergis quadrilineata was strongly associated with longer unburnt sites and may be responding to the loss of leaf litter following the fire. Six rarely-captured species were also strongly associated with unburnt areas and were rarely or never recorded at burnt sites, whereas two other rarely-captured species were associated with burnt sites. We also found that one lizard species, Ctenotus fallens, had a smaller average body length in burnt sites compared to unburnt sites for four out of the five years of monitoring. Our study indicates that fire management that homogenises large areas of habitat through frequent burning may threaten some species due to their preference for longer unburnt habitat. Careful management of fire may be needed to maximise habitat suitability within the urban landscape.

Bringing cutting-edge Earth and ocean sciences to under-served and rural audiences through informal science education

Science.gov (United States)

Cooper, S. K.; Petronotis, K. E.; Ferraro, C.; Johnson, K. T. M.; Yarincik, K.

2017-12-01

The International Ocean Discovery Program (IODP) is an international marine research collaboration that explores Earth's history and dynamics using ocean-going research platforms to recover data recorded in seafloor sediments and rocks and to monitor subseafloor environments. The JOIDES Resolution is the flagship vessel of IODP and is operated by the National Science Foundation. It is an inspirational hook for STEM Earth and ocean topics for children and the general public of all ages, but is not easily accessible due to its international travels and infrequent U.S. port calls. In response, a consortium of partners has created the Pop-Up/Drill Down Science project. The multi-year project, funded by NSF's Advancing Informal Science Learning program, aims to bring the JR and its science to under-served and rural populations throughout the country. Consisting of an inflatable walk-through ship, a multi-media experience, a giant interactive seafloor map and a series of interactive exhibit kiosks, the exhibit, entitled, In Search of Earth's Secrets: A Pop-Up Science Encounter, will travel to 12 communities throughout the next four years. In each community, the project will partner with local institutions like public libraries and small museums as hosts and to train local Girl Scouts to serve as exhibit facilitators. By working with local communities to select events and venues for pop-up events, the project hopes to bring cutting edge Earth and ocean science in creative new ways to underserved populations and inspire diverse audiences to explore further. This presentation will provide details of the project's goals, objectives and development and provide avenues to become involved.

Lifestyle risk factors in an urban South African community

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SCD Wright

2008-09-01

Full Text Available The research question addressed in the study was to determine the prevalence of the following lifestyle risk factors: obesity, waist-hip ratio, physical inactivity, high blood glucose, and hypertension in an urban community. The research objective for the study was to determine the prevalence of specific risk factors in an urban community. Based on the results, a health intervention could be planned and implemented to reduce the prevalence of the risk factors and the possibility of chronic noncommunicable diseases in later life. The design was a quantitative survey using physical measurement and a structured questionnaire. The target population of the study was black urban adults (n=218. The sampling method was convenient and purposive. The results of the study indicated that the prevalence of hypertension and obesity were higher than the national prevalence for South Africa. The waist-hip ratio revealed that 20% of the men and 49.7% of the women were at risk for cardiovascular disease. High blood glucose levels were demonstrated for 21.6% of the group. Physical activity was also shown to be inadequate. In conclusion, the potential for cardiovascular and metabolic health problems in future is high. It is recommended that an intervention, based on the results of the study, should and must be developed and implemented. The more challenging question is to know what to do and how to do it. A framework is suggested to guide the development of an intervention.

Forging University-Community Collaboration: The Agency Perspective on National Service.

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Tice, Carol H.

1994-01-01

With passage of the National and Community Service Trust Act of 1993, national service volunteers will be joining forces with community-based organizations to work with underserved populations, creating many challenges. The community agency perspective on some anticipated challenges, possible responses, and application of principles of good…

The partnership model: working with individuals, families, and communities toward a new vision of health.

Science.gov (United States)

Courtney, R; Ballard, E; Fauver, S; Gariota, M; Holland, L

1996-06-01

Increasingly, health professionals must learn to work in new partnership relationships with clients and community to promote health effectively. A partnership requires a transformation of the professional role from chief actor to partner, and the client role from passive recipient to partner. A partnership approach has particular merit in a reformed health care system that increasingly emphasizes active involvement and self-care actions of individuals and families to maintain health and prevent disease. A partnership approach is also important to professionals working with underserved, vulnerable, and/or minority populations. For too long professionals and policymakers have relegated these groups to passive roles in health decision making and action. This article will provide a description of the partnership process as it has been developed and implemented by nurse practitioners in an urban Hispanic community with emphasis on a community partnership. A partnership model is described and compared to the more traditional professional model. A definition and essential criteria for partnership are presented. Finally, a specific example of how the partnership process was implemented at the community level is discussed.

SUSTAINABLE URBAN COMMUNITY DEVELOPMENT THROUGH AGENDA 21

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Zainal Md Zan

2015-08-01

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.

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria.

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Senbanjo, Idowu O; Olayiwola, Ibiyemi O; Afolabi, Wasiu A O

2016-01-01

Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P rural communities.

Decreasing abundance, increasing diversity and changing structure of the wild bee community (Hymenoptera: Anthophila along an urbanization gradient.

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Laura Fortel

Full Text Available Wild bees are important pollinators that have declined in diversity and abundance during the last decades. Habitat destruction and fragmentation associated with urbanization are reported as part of the main causes of this decline. Urbanization involves dramatic changes of the landscape, increasing the proportion of impervious surface while decreasing that of green areas. Few studies have investigated the effects of urbanization on bee communities. We assessed changes in the abundance, species richness, and composition of wild bee community along an urbanization gradient.Over two years and on a monthly basis, bees were sampled with colored pan traps and insect nets at 24 sites located along an urbanization gradient. Landscape structure within three different radii was measured at each study site. We captured 291 wild bee species. The abundance of wild bees was negatively correlated with the proportion of impervious surface, while species richness reached a maximum at an intermediate (50% proportion of impervious surface. The structure of the community changed along the urbanization gradient with more parasitic species in sites with an intermediate proportion of impervious surface. There were also greater numbers of cavity-nesting species and long-tongued species in sites with intermediate or higher proportion of impervious surface. However, urbanization had no effect on the occurrence of species depending on their social behavior or body size.We found nearly a third of the wild bee fauna known from France in our study sites. Indeed, urban areas supported a diverse bee community, but sites with an intermediate level of urbanization were the most speciose ones, including greater proportion of parasitic species. The presence of a diverse array of bee species even in the most urbanized area makes these pollinators worthy of being a flagship group to raise the awareness of urban citizens about biodiversity.

Decreasing abundance, increasing diversity and changing structure of the wild bee community (Hymenoptera: Anthophila) along an urbanization gradient.

Science.gov (United States)

Fortel, Laura; Henry, Mickaël; Guilbaud, Laurent; Guirao, Anne Laure; Kuhlmann, Michael; Mouret, Hugues; Rollin, Orianne; Vaissière, Bernard E

2014-01-01

Wild bees are important pollinators that have declined in diversity and abundance during the last decades. Habitat destruction and fragmentation associated with urbanization are reported as part of the main causes of this decline. Urbanization involves dramatic changes of the landscape, increasing the proportion of impervious surface while decreasing that of green areas. Few studies have investigated the effects of urbanization on bee communities. We assessed changes in the abundance, species richness, and composition of wild bee community along an urbanization gradient. Over two years and on a monthly basis, bees were sampled with colored pan traps and insect nets at 24 sites located along an urbanization gradient. Landscape structure within three different radii was measured at each study site. We captured 291 wild bee species. The abundance of wild bees was negatively correlated with the proportion of impervious surface, while species richness reached a maximum at an intermediate (50%) proportion of impervious surface. The structure of the community changed along the urbanization gradient with more parasitic species in sites with an intermediate proportion of impervious surface. There were also greater numbers of cavity-nesting species and long-tongued species in sites with intermediate or higher proportion of impervious surface. However, urbanization had no effect on the occurrence of species depending on their social behavior or body size. We found nearly a third of the wild bee fauna known from France in our study sites. Indeed, urban areas supported a diverse bee community, but sites with an intermediate level of urbanization were the most speciose ones, including greater proportion of parasitic species. The presence of a diverse array of bee species even in the most urbanized area makes these pollinators worthy of being a flagship group to raise the awareness of urban citizens about biodiversity.

Estimated lead (Pb) exposures for a population of urban community gardeners.

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Spliethoff, Henry M; Mitchell, Rebecca G; Shayler, Hannah; Marquez-Bravo, Lydia G; Russell-Anelli, Jonathan; Ferenz, Gretchen; McBride, Murray

2016-08-01

Urban community gardens provide affordable, locally grown, healthy foods and many other benefits. However, urban garden soils can contain lead (Pb) that may pose risks to human health. To help evaluate these risks, we measured Pb concentrations in soil, vegetables, and chicken eggs from New York City community gardens, and we asked gardeners about vegetable consumption and time spent in the garden. We then estimated Pb intakes deterministically and probabilistically for adult gardeners, children who spend time in the garden, and adult (non-gardener) household members. Most central tendency Pb intakes were below provisional total tolerable intake (PTTI) levels. High contact intakes generally exceeded PTTIs. Probabilistic estimates showed approximately 40 % of children and 10 % of gardeners exceeding PTTIs. Children's exposure came primarily from dust ingestion and exposure to higher Pb soil between beds. Gardeners' Pb intakes were comparable to children's (in µg/day) but were dominated by vegetable consumption. Adult household members ate less garden-grown produce than gardeners and had the lowest Pb intakes. Our results suggest that healthy gardening practices to reduce Pb exposure in urban community gardens should focus on encouraging cultivation of lower Pb vegetables (i.e., fruits) for adult gardeners and on covering higher Pb non-bed soils accessible to young children. However, the common practice of replacement of root-zone bed soil with clean soil (e.g., in raised beds) has many benefits and should also continue to be encouraged.

Carbon storage and sequestration by trees in urban and community areas of the United States

International Nuclear Information System (INIS)

Nowak, David J.; Greenfield, Eric J.; Hoehn, Robert E.; Lapoint, Elizabeth

2013-01-01

Carbon storage and sequestration by urban trees in the United States was quantified to assess the magnitude and role of urban forests in relation to climate change. Urban tree field data from 28 cities and 6 states were used to determine the average carbon density per unit of tree cover. These data were applied to statewide urban tree cover measurements to determine total urban forest carbon storage and annual sequestration by state and nationally. Urban whole tree carbon storage densities average 7.69 kg C m −2 of tree cover and sequestration densities average 0.28 kg C m −2 of tree cover per year. Total tree carbon storage in U.S. urban areas (c. 2005) is estimated at 643 million tonnes ($50.5 billion value; 95% CI = 597 million and 690 million tonnes) and annual sequestration is estimated at 25.6 million tonnes ($2.0 billion value; 95% CI = 23.7 million to 27.4 million tonnes). -- Highlights: •Total tree carbon storage in U.S. urban areas (c. 2005) is estimated at 643 million tonnes. •Total tree carbon storage in U.S. urban and community areas is estimated at 1.36 billion tonnes. •Net carbon sequestration in U.S. urban areas varies by state and is estimated at 18.9 million tonnes per year. •Overlap between U.S. forest and urban forest carbon estimates is between 247 million and 303 million tonnes. -- Field and tree cover measurements reveal carbon storage and sequestration by trees in U.S. urban and community areas

Protecting the Urban Community of Cotonou from the effects of ...

International Development Research Centre (IDRC) Digital Library (Canada)

This project aims to build the capacity of populations in the urban community of Cotonou to cope with flooding. It will do so through a participatory diagnosis, analysis and planning process for sustainable flood prevention strategies. The process will involve local populations (including vulnerable groups), civil society actors, ...

Spatial analysis of falls in an urban community of Hong Kong

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Wong Wing C

2009-03-01

Full Text Available Abstract Background Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. Results This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh and Standard Deviational Ellipse (SDE techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. Conclusion The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies.

Spatial analysis of falls in an urban community of Hong Kong

Science.gov (United States)

Lai, Poh C; Low, Chien T; Wong, Martin; Wong, Wing C; Chan, Ming H

2009-01-01

Background Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. Results This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh) and Standard Deviational Ellipse (SDE) techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. Conclusion The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies. PMID:19291326

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

Science.gov (United States)

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

2017-11-16

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

Community-Based Urban Teacher Education: Theoretical Frameworks and Practical Considerations for Developing Promising Practices

Science.gov (United States)

Noel, Jana

2016-01-01

Traditional campus-based teacher education programs, located on college or university campuses, have been criticized for being removed from the "real world" of community life, and a number of programs have moved directly into urban communities in order for preservice teachers to become immersed in the life of the community. This article…

Posttraumatic stress symptoms related to community violence and children's diurnal cortisol response in an urban community-dwelling sample.

Science.gov (United States)

Suglia, Shakira Franco; Staudenmayer, John; Cohen, Sheldon; Wright, Rosalind J

2010-03-01

While community violence has been linked to psychological morbidity in urban youth, data on the physiological correlates of violence and associated posttraumatic stress symptoms are sparse. We examined the influence of child posttraumatic stress symptoms reported in relationship to community violence exposure on diurnal salivary cortisol response in a population based sample of 28 girls and 15 boys ages 7-13, 54% self-identified as white and 46% as Hispanic. Mothers' reported on the child's exposure to community violence using the Survey of Children's Exposure to Community Violence and completed the Checklist of Children's Distress Symptoms (CCDS) which captures factors related to posttraumatic stress; children who were eight years of age or greater reported on their own community violence exposure. Saliva samples were obtained from the children four times a day (after awakening, lunch, dinner and bedtime) over three days. Mixed models were used to assess the influence of posttraumatic stress symptoms on cortisol expression, examined as diurnal slope and area under the curve (AUC), calculated across the day, adjusting for socio-demographics. In adjusted analyses, higher scores on total traumatic stress symptoms (CCDS) were associated with both greater cortisol AUC and with a flatter cortisol waking to bedtime rhythm. The associations were primarily attributable to differences on the intrusion, arousal and avoidance CCDS subscales. Posttraumatic stress symptomatology reported in response to community violence exposure was associated with diurnal cortisol disruption in these community-dwelling urban children.

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....

Discerning the role of faith communities in responding to urban youth marginalisation

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Reginald W. Nel

2014-11-01

Full Text Available Urban youth marginalisation became a key consideration in scholarly and policy literature in the 1990s. This entailed a shift from an emphasis on youth in relation to activism in the struggle to overcome colonial racism – popularly known as ‘the struggle against apartheid’ – to an emphasis on youth as the object of social inquiry and social welfare programmes. Irrespective of how we valuate this shift, the question in this article is how urban faith communities and youth ministry research are to respond to the agency of youth as dialogue partners – with a focus on social cohesion. This article explores this shift in scholarship on urban youth movements, especially for the period since 1994. It draws from the perspectives of my recent doctoral studies (Nel 2013 in constructing a creative dialogue with youth movements. The ultimate aim of this article is to provide a grounded basis for constructing a methodology for a postcolonial urban theology. In addition, it aims to inform the ongoing Youth at the Margins (YOMA comparative study on the contribution of faith-based organisations to social cohesion in South Africa and Nordic Europe, with the Riverlea community, in Johannesburg, as one of the case studies.

Experiences and Challenges of Community Participation in Urban Renewal Projects: The Case of Johannesburg, South Africa

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Wellington Didibhuku Thwala

2009-11-01

Full Text Available Urban renewal and inner city regeneration have become critical efforts for the South African government, which has invested in several structures to stem the tide of decline in its nine major cities. Commitment to the alleviation of poverty is a focal point of the renewal and regeneration agenda and will remain so in the future. This effort is motivated by the fact that around 24% of the South African population currently lives on less than USD 1.00 per day, below the poverty line defined by the World Bank. The Central Government has made numerous public commitments to development, a part of which concerns extensive infrastructure investment and service delivery. Communities are expected to participate fully in the planning and implementation of these urban renewal projects. To this aim, participation is a process through which stakeholders influence and share control over development initiatives and the decisions and resources which affect them. Community participation should be aimed at empowering people by ensuring the development of skills and the creation of employment opportunities. This paper first explores the concept of community participation, and will then look at relevant past experiences in relation to community participation in urban renewal projects. Furthermore, the paper outlines the challenges and problems of community participation in urban renewal projects in Johannesburg, and finally, close with recommendations for the future.

Focus Cities : Improving the Living Environment in Underserved ...

International Development Research Centre (IDRC) Digital Library (Canada)

Papers. Urban Poverty and Environment Programme : Colombo; monitoring and evaluation component; monitoring findings as of December 2008 - April 2009; outcome mapping no. 2. 129292.pdf. Papers. Statistical handbook on baseline survey : part 1; data tables; (Focus City Programme : Community based Assessment ...

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

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-07-01

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)

Attrition of Women Business Majors in an Urban Community College.

Science.gov (United States)

Karlen, Janice M.

2004-01-01

Identified intervention protocols that could help reduce the attrition of women business majors at an urban community college. Review of academic progress data and data from student surveys which examined students' reasons for leaving the institution indicated that there was a need for support mechanisms throughout the freshman year and extending…

Employing Young Talent from Underserved Populations: Designing a Flexible Organizational Process for Assimilation and Productivity

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Arthur Mark Langer

2013-04-01

Full Text Available This article describes an ongoing 13-year-old program designed to improve the ability of organizations to assimilate young talent from underserved populations, mostly students who have recently graduated from high school. Although many firms have internship and orientation programs, few have well-tested organizational approaches for assimilating 17-20 year-olds into their organizations in an efficient and productive manner. The objective of this study is to describe and evaluate the solution introduced by Workforce Opportunity Services (WOS, a non-profit agency that provides organizations with well-trained talent from underserved local communities. The WOS model is a systemic design involving a lead agency (WOS, corporate clients, training partnerships with local colleges and universities, and underutilized human capital. Over 290 students have completed the WOS program and obtained long-term employment, mostly in IT jobs that normally are outsourced. The results of the study show that companies have success employing young talent when they follow the WOS organizational process. Companies need to have patience with WOS student employees, but within six months most members of the WOS program make positive contributions to their sponsoring firm and have a strong likelihood of becoming permanently employed. Implications of the WOS model for organization design are discussed.

A community intervention: AMBER: Arab American breast cancer education and referral program.

Science.gov (United States)

Ayash, Claudia; Axelrod, Deborah; Nejmeh-Khoury, Sana; Aziz, Arwa; Yusr, Afrah; Gany, Francesca M

2011-12-01

Although the number of Arab Americans is growing in the United States, there is very little data available on this population's cancer incidence and screening practices. Moreover, there are few interventions addressing their unique needs. This study aims to determine effective strategies for increasing breast cancer screening in at-risk underserved Arab American women. AMBER utilizes a community based participatory approach to conduct formative research and program interventions, including culturally appropriate Arabic language breast cancer education, screening coordination, and cultural competency training for healthcare professionals in New York City. In 2 years, 597 women were educated, 189 underserved women were identified as being in need of assistance, 68 were screened, one new case of breast cancer was detected, and four active cases in need of follow-up reconnected with care. The AMBER model is an important intervention for breast cancer screening and care in the underserved Arab American community.

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

Science.gov (United States)

Gomes, Sharlene L.; Hermans, Leon M.

2016-05-01

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

Evaluating distributed medical education: what are the community's expectations?

Science.gov (United States)

Lovato, Chris; Bates, Joanna; Hanlon, Neil; Snadden, David

2009-05-01

This study aimed to explore community members' perceptions of present and future impacts of the implementation of an undergraduate medical education programme in an underserved community. We conducted semi-structured interviews with eight key informants representing the health, education, business, economy, media and political sectors. A two-stage approach was used. In the first stage, the interviews were analysed to identify sector-specific impacts informants perceived as already occurring or which they hoped to see in the future. The transcripts were then re-analysed to determine any underlying themes that crossed sectors. Community leaders described impacts that were already occurring in all sectors and also described changes in the community itself. Four underlying themes emerged: an increase in pride and status; partnership development; community self-efficacy, and community development. These underlying themes appear to characterise the development of social capital in the community. The implementation of distributed undergraduate medical education programmes in rural and underserved communities may impact their host communities in ways other than the production of a rural doctor workforce. Further studies to quantify impacts in diverse sectors and to explore possible links with social capital are needed.

Effects of a psychological skills training programme for underserved ...

African Journals Online (AJOL)

Effects of a psychological skills training programme for underserved rugby ... The development of psychological skills is an important, but often neglected part of ... Repeated measures two-way ANOVAs revealed significant main time effects, ...

Community based bioremediation: grassroots responses to urban soil contamination

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Scott Kellogg

2016-12-01

Full Text Available The past 150 years of industrial processes have left a legacy of toxicity in the soils of today’s urban environments. Exposure to soil based pollutants disproportionately affects low-income communities who are frequently located within formerly industrialized zones. Both gardeners, who come into direct contact with soil, as well as those who eat the products grown in the soil, are at risk to exposure from industrial contaminants. Options for low-income communities for remediating contaminated soils are limited, with most remediation work being carried out by costly engineering firms. Even more problematic is the overall lack of awareness and available information regarding safety and best practices with soils. In response to these challenges, a grassroots movement has emerged that seeks to empower urban residents with the tools and information necessary to address residual industrial toxicity in their ecosystems. Focusing on methods that are simple and affordable, this movement wishes to remove the barriers of cost and technical expertise that may be otherwise prohibitive. This paper will give an overview of this exemplar of generative justice, looking at case studies of organizations that have been successful in implementing these strategies.

Improving Urban Minority Girls' Health Via Community Summer Programming.

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Bohnert, Amy M; Bates, Carolyn R; Heard, Amy M; Burdette, Kimberly A; Ward, Amanda K; Silton, Rebecca L; Dugas, Lara R

2017-12-01

Summertime has emerged as a high-risk period for weight gain among low-income minority youth who often experience a lack of resources when not attending school. Structured programming may be an effective means of reducing risk for obesity by improving obesogenic behaviors among these youth. The current multi-method study examined sedentary time, physical activity, and dietary intake among low-income urban minority girls in two contexts: an unstructured summertime setting and in the context of a structured 4-week community-based summer day camp program promoting physical activity. Data were analyzed using paired-sample t tests and repeated-measure analyses of variance with significance at the p time of over 2 h/day and dairy consumption when engaged in structured summer programming. All improvements were independent of weight status and age, and African-American participants evidenced greater changes in physical activity during programming. The study concludes that structured, community-based summertime programming may be associated with fewer obesogenic behaviors in low-income urban youth and may be a powerful tool to address disparities in weight gain and obesity among high-risk samples.

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

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Tayyab Ikram Shah

Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood

Living in a continuous traumatic reality: Impact on elderly persons residing in urban and rural communities.

Science.gov (United States)

Regev, Irit; Nuttman-Shwartz, Orit

2016-01-01

This study is an exploration of the contribution of exposure to the continuous threat of Qassam rocket attacks to PTSD among elderly residents of urban and rural communities. Specifically, we examined the contribution of sociodemographic variables, psychological resources, and perceived social support to PTSD, and whether this relationship is mediated by cognitive appraisals. The sample consisted of 298 residents of 2 different communities: urban (n = 190), and rural (n = 108). We examined the main research question by calculating the correlations of the sociodemographic variables, the psychological resource (self-esteem), social support, and cognitive appraisals with the dependent variable (PTSD). Our model explained the variance in PTSD (53% for urban residents, and 56% for rural residents). Higher levels of PTSD were found among the urban residents. Most of the predictors contributed to PTSD, but differences were found between each type of community with regard to the combination of components. Results indicated that the type of community is related degree of protection against stress-related triggers such as Qassam rockets. The psychological resource (self-esteem) and cognitive appraisal variables were found to be important for older people facing a continuous threat, and can serve as a basis for professional intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Urbanization alters the functional composition, but not taxonomic diversity, of the soil nematode community

Science.gov (United States)

Mitchell A. Pavao-Zuckerman; David C. Coleman

2007-01-01

We evaluated the response of riparian forest soil nematode community structure to the physico-chemical environment associated with urban land use. Soils were sampled seasonally between December 2000 and October 2002 along an urban-rural transect in Asheville, North Carolina. We characterized the taxonomic (to genus) and functional composition (trophic groups) of the...

The association between income source and met need among community mental health service users in Ontario, Canada.

Science.gov (United States)

Durbin, Anna; Bondy, Susan J; Durbin, Janet

2012-10-01

We examined income source and match between recommended and received care among users of community mental health services. We conducted a secondary analysis of needs-based planning data on adults in Ontario community mental health programs from 2000 to 2002. The outcome was whether clients were severely underserved (yes/no) based on the match between level of care recommended and received. A logistic regression model investigated if income source predicted this outcome. 13% of clients were severely underserved. Over 40% were on public assistance and they had a higher risk of being severely undeserved than the others. Men were at greater risk. One aim of mental health reform is to increase access to care for vulnerable individuals. The finding that among users of community mental health services, individuals with public assistance income support are most vulnerable to being severely underserved should be considered by service planners and providers.

Urban and community forests of the North Central West region: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2010-01-01

This report details how land cover and urbanization vary within the states of Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community...

Neighborhood Social Predictors of Weight-related Measures in Underserved African Americans in the PATH Trial.

Science.gov (United States)

McDaniel, Tyler C; Wilson, Dawn K; Coulon, Sandra M; Hand, Gregory A; Siceloff, E Rebekah

2015-11-05

African Americans have the highest rate of obesity in the United States relative to other ethnic minority groups. Bioecological factors including neighborhood social and physical environmental variables may be important predictors of weight-related measures specifically body mass index (BMI) in African American adults. Baseline data from the Positive Action for Today's Health (PATH) trial were collected from 417 African American adults. Overall a multiple regression model for BMI was significant, showing positive associations with average daily moderate-to-vigorous physical activity (MVPA) (B =-.21, Psocial interaction (B =-.13, Psocial interaction was associated with healthier BMI, highlighting it as a potential critical factor for future interventions in underserved, African American communities.

Bumble Bee Abundance in New York City Community Gardens: Implications for Urban Agriculture

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Gail A. Langellotto

2009-01-01

Full Text Available A variety of crops are grown in New York City community gardens. Although the production of many crops benefits from pollination by bees, little is known about bee abundance in urban community gardens or which crops are specifically dependent on bee pollination. In 2005, we compiled a list of crop plants grown within 19 community gardens in New York City and classified these plants according to their dependence on bee pollination. In addition, using mark-recapture methods, we estimated the abundance of a potentially important pollinator within New York City urban gardens, the common eastern bumble bee (Bombus impatiens. This species is currently recognized as a valuable commercial pollinator of greenhouse crops. However, wild populations of B. impatiens are abundant throughout its range, including in New York City community gardens, where it is the most abundant native bee species present and where it has been observed visiting a variety of crop flowers. We conservatively counted 25 species of crop plants in 19 surveyed gardens. The literature suggests that 92% of these crops are dependent, to some degree, on bee pollination in order to set fruit or seed. Bombus impatiens workers were observed visiting flowers of 78% of these pollination-dependent crops. Estimates of the number of B. impatiens workers visiting individual gardens during the study period ranged from 3 to 15 bees per 100 m2 of total garden area and 6 to 29 bees per 100 m2 of garden floral area. Of 229 B. impatiens workers marked, all recaptured individuals (45% were found in gardens where they were initially marked. These results indicate an abundance of B. impatiens workers within New York City community gardens and suggest that, at least for certain time periods, many individual workers forage within single gardens. Both findings suggest that B. impatiens may be an especially important pollinator of several common crops grown within community gardens and other urban green spaces

The Geography of Rape: Rape Victims in Urban and Rural Communities

DEFF Research Database (Denmark)

Nielsen, Louise Hjort

Little is known from research about barriers to seeking and receiving help following domestic violence, rape, attempted rape, and sexual assault in Denmark. This study examined possible regional differences in reporting rape and sexual assault in urban and rural communities in a large region...

The challenges of working in underserved areas: a qualitative exploratory study of views of policy makers and professionals.

Science.gov (United States)

AbuAlRub, Raeda F; El-Jardali, Fadi; Jamal, Diana; Iblasi, Abdulkareem S; Murray, Susan F

2013-01-01

The inadequate number of health care providers, particularly nurses, in underserved areas is one of the biggest challenges for health policymakers. There is a scarcity of research in Jordan about factors that affect nurse staffing and retention in underserved areas. To elucidate the views of staff nurses working in underserved areas, directors of health facilities in underserved areas and key informants from the policy and education arena on issues of staffing and retention of nurses in underserved areas. An exploratory study using a qualitative approach with semi-structured interviews was utilized to elucidate the views of 22 key informants from the policy and education arena, 11 directors of health centers, and 19 staff nurses on issues that contribute to low staffing and retention of nurses in underserved areas. The five stage 'framework approach' proposed by Bryman et al. (1993) was utilized for data analysis. Nursing shortage in underserved areas in Jordan are exacerbated by a lack of financial incentives, poor transportation and remoteness of these areas, bad working conditions, and lack of health education institutions in these areas, as well as by opportunities for internal and external migration. Young Jordanian male nurses usually grab any opportunity to migrate and work outside the country to improve their financial conditions; whereas, female nurses are more restricted and not encouraged to travel abroad to work. Several strategies are suggested to enhance retention in these areas, such as promoting financial incentives for staff to work there, enhancing the transportation system, and promoting continuous and academic education. Nurses' administrators and health care policy makers could utilize the findings of the present study to design and implement comprehensive interventions to enhance retention of staff in underserved areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effect of urbanization on bird community in riparian environments in Caí River, Rio Grande do Sul, Brazil

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Jaqueline Brummelhaus

2012-02-01

Full Text Available http://dx.doi.org/10.5007/2175-7925.2012v25n2p81 Urbanization produces changes in riparian environments causing effects in the structure of bird communities, which respond differently to impacts. We compare richness, abundance and composition of birds in riparian environments with different urbanization gradients in Caí River, Rio Grande do Sul. We conducted observations in woodland, grassland and urban environments, between September/2007 and August/2008. We recorded 130 bird species, 29 species unique to woodland environments, including an endangered species: Triclaria malachitacea. Bird abundance differed between woodland and urban environments (426 individuals in woodland, 721 in grassland and 939 in urban. Species composition and feeding guilds contributed significantly to differentiation of bird community structures in these three riparian environments. In open environments (grassland and urban we recorded more generalist feeding guilds and bird species, while in riparian woodland environments, we find guilds and species more sensitive to human impacts. Bird species may be biological quality indicators and contribute to natural economy. With the knowledge of bird community structure and their needs, it is possible to establish management practices for riparian restoration of degraded environments in the region.

Urban Ecological Stewardship: Understanding the Structure, Function and Network of Community-based Urban Land Management

Directory of Open Access Journals (Sweden)

Lindsay K. Campbell

2008-01-01

Full Text Available Urban environmental stewardship activities are on the rise in cities throughout the Northeast. Groups participating in stewardship activities range in age, size, and geography and represent an increasingly complex and dynamic arrangement of civil society, government and business sectors. To better understand the structure, function and network of these community-based urban land managers, an assessment was conducted in 2004 by the research subcommittee of the Urban Ecology Collaborative. The goal of the assessment was to better understand the role of stewardship organizations engaged in urban ecology initiatives in selected major cities in the Northeastern U.S.: Boston, New Haven, New York City, Pittsburgh, Baltimore, and Washington, D.C. A total of 135 active organizations participated in this assessment. Findings include the discovery of a dynamic social network operating within cities, and a reserve of social capital and expertise that could be better utilized. Although often not the primary land owner, stewardship groups take an increasingly significant responsibility for a wide range of land use types including street and riparian corridors, vacant lots, public parks and gardens, green roofs, etc. Responsibilities include the delivery of public programs as well as daily maintenance and fundraising support. While most of the environmental stewardship organizations operate on staffs of zero or fewer than ten, with small cohorts of community volunteers, there is a significant difference in the total amount of program funding. Nearly all respondents agree that committed resources are scarce and insufficient with stewards relying upon and potentially competing for individual donations, local foundations, and municipal support. This makes it a challenge for the groups to grow beyond their current capacity and to develop long-term programs critical to resource management and education. It also fragments groups, making it difficult for planners and

Wind Energy Assessment for Small Urban Communities in the Baja California Peninsula, Mexico

Directory of Open Access Journals (Sweden)

Quetzalcoatl Hernandez-Escobedo

2016-10-01

Full Text Available Mexico needs to exploit its renewable resources and many studies have determined the great renewable potential it has using wind energy. However it is necessary to calculate the amount of this resource for small urban communities, which in this country lack essential services such as electricity. This study is focused in the Baja California Peninsula, using GIS as a tool to identify small urban zones with higher wind power. For this work data was analyzed from meteorological stations and recorded every 10 min for two years (2012–2014. Weibull distribution, linear regression, kriging interpolation, power and energy output and useful hours were calculated for each station. It was found that the total energy generated is 38,603,666 kWh per year and the mean of useful hours is 5220 h per year for the whole Peninsula. Maps of Wind Power Density (WPD show a good power per square meter, GIS shows the areas with the most wind power where it can be used i.e., the state of Baja California wind power can generate electricity for 12% of those communities, meanwhile for Baja California Sur, the electric power generation could electrify almost 25% of the total of small urban communities.

Implementing Domestic Violence Gun Confiscation Policy in Rural and Urban Communities: Assessing the Perceived Risk, Benefits, and Barriers.

Science.gov (United States)

Lynch, Kellie R; Logan, T K

2017-07-01

The purpose of this study was to gain a deeper understanding of why communities differing in culture and resources are willing and able to implement gun confiscation as part of a protective order in the absence of a uniform statewide gun law. Specifically, the perceived risk of intimate partner homicide and gun violence, effectiveness of implementing gun confiscation, and the barriers to implementing gun confiscation were assessed. Interviews were conducted with key community professionals ( N = 133) who worked in victim services and the justice system in one urban community and four rural, under-resourced communities. Analyses revealed that professionals in the rural communities viewed the risk of intimate partner homicide and gun violence as lower, and the process of implementing gun confiscation as less effective than professionals in the urban community. In addition, urban justice system professionals, in comparison with all other professionals, reported fewer barriers to enforcing the gun confiscation police and were more likely to downplay law enforcement limitations in the community. The results have implications for developing more effective regional strategies in states that lack domestic violence gun laws as a means to increase a community's ability to enforce gun policies and initiatives.

Negotiating Competing Goals in the Development of an Urban Ecology Practitioner Inquiry Community

Science.gov (United States)

Piazza, Peter; McNeill, Katherine L.

2013-11-01

Teacher learning communities are hailed by many as vehicles for reforming and elevating the professional status of teaching. While much research explores teacher community as a venue for measurable gains, our research examines the orientation of practitioner inquiry toward critical debate about effective instruction. Specifically, our study focuses on a group of middle and high school teachers who worked with a nonprofit organization to engage students in urban environmental field investigations. Teachers met regularly as a community with the common goal of teaching urban ecology in an outdoor setting. We collected interview data from members of the teacher community, and we observed teacher interaction during a meeting of the practitioner inquiry group. Interview results indicated that while the nonprofit aimed to support collaborative dialogue and self-critique, participants saw the community mainly as a venue for pursuing short-term goals, such as receiving new resources or socializing with colleagues. Observation data, however, suggested that the community was taking early steps toward building an environment oriented toward critical discussion. Juxtaposing results from our interviews and observations, we discuss the challenges communities face when they seek to develop shared beliefs and deal openly with conflict. Ultimately, we suggest that organizers of collaborative learning environments should work to actively develop structures for building the organizational trust necessary to support civil critique.

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

Science.gov (United States)

Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

Science.gov (United States)

Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (Pservice utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.

Bolivia programme evaluation of a package to reach an underserved population: Community-based maternal and newborn care economic analysis.

Science.gov (United States)

Barger, Diana; Pooley, Bertha; Dupuy, Julien Roger; Cardenas, Norma Amparo; Wall, Steve; Owen, Helen; Daviaud, Emmanuelle

2017-10-01

To address inequitable access to health services of indigenous communities in the Bolivian highlands, the Bolivian Ministry of Health, with the support of Save the Children-Saving Newborn Lives, conducted operational research to identify, implement and test a package of maternal and newborn interventions using locally recruited, volunteer Community Health Workers (vCHW) between 2008 and 2010. The additional annual economic and financial costs of the intervention were estimated from the perspective of the Bolivian Ministry of Health in two municipalities. The cost of intervention-stimulated increases in facility attendance was estimated with national surveillance data using a pre-post comparison, adjusted for secular trends in facility attendance. Three scale-up scenarios were modelled by varying the levels of coverage and the number (per mother and child pair) and frequency of home visits. Average cost per mother and average cost per home visit are presented in constant 2015 US$. Eighteen per cent of expectant mothers in the catchment area were visited at least once. The annualized additional financial cost of the community-based intervention across both municipalities was $43 449 of which 3% ($1324) was intervention design, 20% ($8474) set-up and 77% ($33 651) implementation. Drivers of additional costs were additional paid staff (68%), 81% of which was for management and support by local implementing partner and 19% of which was for vCHW supervision. The annual financial cost per vCHW was $595. Modelled scale-up scenarios highlight potential efficiency gains. Recognizing local imperatives to reduce inequalities by targeting underserved populations, the observed low coverage by vCHWs resulted in a high cost per mother and child pair ($296). This evaluation raises important questions about this model's ability to achieve its ultimate goals of reducing neonatal mortality and inequalities through behaviour change and increased care seeking and has served to

A psychosocial approach to dentistry for the underserved: incorporating theory into practice.

Science.gov (United States)

Flaer, Paul J; Younis, Mustafa Z; Benjamin, Paul L; Al Hajeri, Maha

2010-01-01

Dentistry for the underserved is more than an egalitarian social issue--it is a key factor in the health and social progress of our nation. The first signs or manifestations of several diseases such as varicella (i.e., chicken pox and shingles), STDs, and influenza become apparent in the oral cavity. The value of access to quality dentistry is an immeasurable factor in maintaining general medical health of people and fulfilling their psychosocial needs of pain reduction and enhanced cosmetics. In the United States, for the most part, only the middle and upper classes receive non-extraction, restorative, and prosthetic dentistry that is economically within their ability to pay. In addition, uninsured and poverty-level individuals often must face overwhelming long waiting lists, unnecessary referrals, lack of choice, and bureaucratic hurdles when seeking primary dental care. Therefore, it seems pertinent to put forth the question: What are the critical values and beliefs of psychosocial theory that can underscore the practice of dentistry for underserved populations in the United States? The widely employed public health theory, the health belief model (HBM), is applied to evaluate psychosocial factors in dental care for the underserved. The HBM is used to predict and explain behavioral changes in dental health and associated belief patterns. The HBM as applied to dentistry for the underserved predicts self-perceptions of susceptibility and seriousness of dental disease, health status, cues to action, and self-efficacy. Furthermore, patients can make judgments about benefits, costs, and risks of dental treatment. A theoretical approach to dentistry employing the HBM, mediated by values and culture, can provide significant insights into patient thinking, beliefs, and perceptions. These insights can mediate access to and use of primary care dental services by underserved populations. Evidence-based practice (i.e., based on research using the scientific method) has been

Teaching the content in context: Preparing "highly qualified" and "high quality" teachers for instruction in underserved secondary science classrooms

Science.gov (United States)

Tolbert, Sara E.

2011-12-01

This dissertation research project presents the results of a longitudinal study that investigates the knowledge, beliefs, and practices of 13 preservice secondary science teachers participating in a science teacher credentialing/Masters program designed to integrate issues of equity and diversity throughout coursework and seminars. Results are presented in the form of three papers: The first paper describes changes in preservice teacher knowledge about contextualization in science instruction, where contextualization is defined as facilitating authentic connections between science learning and relevant personal, social, cultural, ecological, and political contexts of students in diverse secondary classrooms; the second paper relates changes in the self-efficacy and content-specific beliefs about science, science teaching, diversity, and diversity in science instruction; and the final paper communicates the experiences and abilities of four "social justice advocates" learning to contextualize science instruction in underserved secondary placement classrooms. Results indicate that secondary student teachers developed more sophisticated understandings of how to contextualize science instruction with a focus on promoting community engagement and social/environmental activism in underserved classrooms and how to integrate science content and diversity instruction through student-centered inquiry activities. Although most of the science teacher candidates developed more positive beliefs about teaching science in underrepresented classrooms, many teacher candidates still attributed their minority students' underperformance and a (perceived) lack of interest in school to family and cultural values. The "social justice advocates" in this study were able to successfully contextualize science instruction to varying degrees in underserved placement classrooms, though the most significant limitations on their practice were the contextual factors of their student teaching

Urban environment interventions linked to the promotion of physical activity. A mixed methods study applied to the urban context of Latin America

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Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana Celmira; Reis, Rodrigo; Quistberg, Alex

2015-01-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. PMID:25748111

Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America.

Science.gov (United States)

Gomez, Luis F; Sarmiento, Rodrigo; Ordoñez, Maria Fernanda; Pardo, Carlos Felipe; de Sá, Thiago Hérick; Mallarino, Christina H; Miranda, J Jaime; Mosquera, Janeth; Parra, Diana C; Reis, Rodrigo; Quistberg, D Alex

2015-04-01

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential. Copyright © 2015 Elsevier Ltd. All rights reserved.

Urban farming activity towards sustainable wellbeing of urban dwellers

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Othman, N.; Mohamad, M.; Latip, R. A.; Ariffin, M. H.

2018-02-01

In Malaysia, urban farming is viewed as a catalyst towards achieving the well-being of urban dwellers and natural environment. Urban farming is a strategy for Malaysia’s food and economic security, and as one of the foci in the agriculture transformation whereby urban dwellers are encouraged to participate in this activity. Previous study proved that urban farming can help to address social problems of food security, urban poverty and high living cost, also provides leisure and recreation among urban dwellers. Thus, this study investigates the best urban farming practices suitable for urban setting, environment and culture of urban dwellers. Data collection was done via questionnaire survey to urban farmers of a selected community garden in Subang Jaya, Selangor. Meanwhile, on-site observations were carried out on gardening activities and the gardens’ physical attributes. The study sample encompasses of 131 urban farmers of 22 community gardens in Subang Jaya. It was found that most of the community gardens practiced crops planting on the ground or soil base planting and dwellers in the lower income group with monthly low household income constitutes the majority (83.2%) of the respondents. Social and health benefits are the highest motivating factors for urban farmers. This study provides unprecedented insights on urban farming practices and motivations in a Malaysian setting.

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

Directory of Open Access Journals (Sweden)

Karina Landman

2007-09-01

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.

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

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Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a

Differentiated surface fungal communities at point of harvest on apple fruits from rural and peri-urban orchards.

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Shen, Youming; Nie, Jiyun; Li, Zhixia; Li, Haifei; Wu, Yonglong; Dong, Yafeng; Zhang, Jianyi

2018-02-01

The diverse fungal communities that colonize fruit surfaces are closely associated with fruit development, preservation and quality control. However, the overall fungi adhering to the fruit surface and the inference of environmental factors are still unknown. Here, we characterized the fungal signatures on apple surfaces by sequencing internal transcribed spacer 1 (ITS1) region. We collected the surface fungal communities from apple fruits cultivated in rural and peri-urban orchards. A total of 111 fungal genera belonging to 4 phyla were identified, showing remarkable fungal diversity on the apple surface. Comparative analysis of rural samples harboured higher fungal diversity than those from peri-urban orchards. In addition, fungal composition varied significantly across apple samples. At the genus level, the protective genera Coniothyrium, Paraphaeosphaeria and Periconia were enriched in rural samples. The pathogenic genera Acremonium, Aspergillus, Penicillium and Tilletiposis were enriched in peri-urban samples. Our findings indicate that rural samples maintained more diverse fungal communities on apple surfaces, whereas peri-urban-planted apple carried potential pathogenic risks. This study sheds light on ways to improve fruit cultivation and disease prevention practices.

A Cross-Curricular, Problem-Based Project to Promote Understanding of Poverty in Urban Communities

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Gardner, Daniel S.; Tuchman, Ellen; Hawkins, Robert

2010-01-01

This article describes the use of problem-based learning to teach students about the scope and consequences of urban poverty through an innovative cross-curricular project. We illustrate the process, goals, and tasks of the Community Assessment Project, which incorporates community-level assessment, collection and analysis of public data, and…

The Food Environment in an Urban Mexican American Community

OpenAIRE

Lisabeth, Lynda D; Sánchez, Brisa N; Escobar, James; Hughes, Rebecca; Meurer, William J; Zuniga, Belinda; Garcia, Nelda; Brown, Devin L; Morgenstern, Lewis B

2010-01-01

The objective was to determine whether ethnic composition of neighborhoods is associated with number and type of food stores in an urban, Mexican American US community. Data were from a commercial food store data source and the US Census. Multivariate count models were used to test associations with adjustment for neighborhood demographics, income, and commercialization. Neighborhoods at the 75th percentile of percent Mexican American (76%) had nearly four times the number of convenience stor...

Experiences from a community based substance use treatment centre in an urban resettlement colony in India.

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Balhara, Yatan Pal Singh; Ranjan, Rajeev; Dhawan, Anju; Yadav, Deepak

2014-01-01

Background. There are limited community based treatment services for drug dependence in India. Rural areas and urban resettlement colonies are in particular deficient in such services. Aims. The current study aimed at preliminary assessment of substance use disorder management services at a community based substance use treatment clinic in an urban resettlement colony. Methods. The study was carried out at community based substance use treatment centre in a resettlement colony in India. The records of the centre were chart reviewed. Results. A total of 754 patients were registered at the clinic during the study period. Heroin was the primary drug of abuse for 63% of the patients. The mean duration of follow-up for the patients with opioid and alcohol dependence was 13.47 (SD ± 10.37; range 0-39) months. A total of 220 patients of opioid dependence were prescribed substation or abstinence directed therapy. Buprenorphine (87), slow release oral morphine (SROM) (16), and dextropropoxyphene (98) were used for opioid substitution. Conclusion. It is possible to deliver substance use disorder treatment services in community setting. There is a need to develop area specific community based treatment services for substance abuse in socially disadvantaged populations such as urban resettlement colonies.

Mental health, well-being, and poverty: A study in urban and rural communities in Northeastern Brazil.

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Nepomuceno, Bárbara Barbosa; Cardoso, Antonio Alan Vieira; Ximenes, Verônica Morais; Barros, João Paulo Pereira; Leite, Jáder Ferreira

2016-01-01

This article analyzes the relations between mental health and well-being in urban and rural contexts marked by poverty. The analysis takes as its basis a quantitative research conducted with 417 adult inhabitants of two communities, one rural and the other urban, in Northeastern Brazil. The data were constructed using questionnaires composed of sociodemographic data, the Personal Wellbeing Index and Self Report Questionnaire (SRQ-20) scales. We found significant differences between the inhabitants of the rural and urban communities regarding well-being and the prevalence of common mental disorders (CMD), with a higher average well-being score in the rural context; the urban sample had a higher average regarding the prevalence of CMD. The variable income significantly influenced the SRQ-20 average scores; the same was not observed with well-being scores. Besides, it was observed that there is a negative correlation with well-being and CMD.

On Second Chances and Stratification: How Sociologists Think about Community Colleges

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Schudde, Lauren; Goldrick-Rab, Sara

2015-01-01

Community colleges increase college access, extending postsecondary educational opportunities to underserved students, yet, these students exhibit low rates of program completion and transfer to 4-year colleges. Sociological research on community colleges focuses on the tension between increasing educational opportunity and failing to improve…

Social perception and environmental behavior of communities close to a tropical urban river in Costa Rica

OpenAIRE

Ureña Santos, Claudio; Barrientos, Zaidett

2017-01-01

Urban green areas are important to keep balance in the cities, but few studies consider people`s perception of these areas. We evaluated and compared the environmental perception of two urban communities in San José, Costa Rica. The analyzed communities are separated by the Ocloro River; one has a low socioeconomic status and the other a medium-high level. We conducted surveys in 40 homes located less than 150 m from the river, and local government employees in charge of natural resources man...

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

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Lijun Guo

Full Text Available Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001. In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022. The urban comprehensive score also exceeded that of the suburbs (P<0.001. In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this

The Online-Counseling Debate: A View toward the Underserved

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Sanchez-Page, Delida

2005-01-01

This article responds to some important issues that Mallen, Vogel, Rochlen, and Day raise in "Online Counseling: Reviewing the Literature from a Counseling Psychology Framework." This reaction reviews the appropriateness of online counseling for underserved populations. The author provides suggestions for better serving historically undeserved…

Solidago canadensis invasion affects soil N-fixing bacterial communities in heterogeneous landscapes in urban ecosystems in East China.

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Wang, Congyan; Jiang, Kun; Zhou, Jiawei; Wu, Bingde

2018-03-12

Soil nitrogen-fixing bacterial communities (SNB) can increase the level of available soil N via biological N-fixation to facilitate successful invasion of several invasive plant species (IPS). Meanwhile, landscape heterogeneity can greatly enhance regional invasibility and increase the chances of successful invasion of IPS. Thus, it is important to understand the soil micro-ecological mechanisms driving the successful invasion of IPS in heterogeneous landscapes. This study performed cross-site comparisons, via metagenomics, to comprehensively analyze the effects of Solidago canadensis invasion on SNB in heterogeneous landscapes in urban ecosystems. Rhizospheric soil samples of S. canadensis were obtained from nine urban ecosystems [Three replicate quadrats (including uninvaded sites and invaded sites) for each type of urban ecosystem]. S. canadensis invasion did not significantly affect soil physicochemical properties, the taxonomic diversity of plant communities, or the diversity and richness of SNB. However, some SNB taxa (i.e., f_Micromonosporaceae, f_Oscillatoriaceae, and f_Bacillaceae) changed significantly with S. canadensis invasion. Thus, S. canadensis invasion may alter the community structure, rather than the diversity and richness of SNB, to facilitate its invasion process. Of the nine urban ecosystems, the diversity and richness of SNB was highest in farmland wasteland. Accordingly, the community invasibility of farmland wasteland may be higher than that of the other types of urban ecosystem. In brief, landscape heterogeneity, rather than S. canadensis invasion, was the strongest controlling factor for the diversity and richness of SNB. One possible reason may be the differences in soil electrical conductivity and the taxonomic diversity of plant communities in the nine urban ecosystems, which can cause notable shifts in the diversity and richness of SNB. Copyright © 2018 Elsevier B.V. All rights reserved.

Community-centered responses to Ebola in urban Liberia: the view from below.

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Abramowitz, Sharon Alane; McLean, Kristen E; McKune, Sarah Lindley; Bardosh, Kevin Louis; Fallah, Mosoka; Monger, Josephine; Tehoungue, Kodjo; Omidian, Patricia A

2015-04-01

The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD) and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia. This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia--one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs) and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1) prevention, (2) treatment and response, and (3) community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support. Local communities' strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial state and

Community-centered responses to Ebola in urban Liberia: the view from below.

Directory of Open Access Journals (Sweden)

Sharon Alane Abramowitz

2015-04-01

Full Text Available The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia.This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia--one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1 prevention, (2 treatment and response, and (3 community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support.Local communities' strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial

Urban Analysis and Smart Communities: An Approach to the Use of Technology in Everyday Mobility

Directory of Open Access Journals (Sweden)

Zurisaddai De la Cruz Severiche Maury

2015-01-01

Full Text Available Concentration of population in urban centers is a global problem for which different strategies in order to organize different processes in cities and improve the quality of life are required. The creation of smart communities is shown as a sustainable solution since they deal with various key aspects, such as traffic management and mobility, through the use of information technologies (ITs. This work presents a review of recent studies using information technologies for urban analysis and mobility in cities. A descriptive analysis of automated methods for collecting and analyzing citizens’ mobility patterns is performed; it is centered in smart card use, geolocation and geotagging. It is concluded that a robust communication infrastructure, supported by an efficient computational platform allowing big data management and ubiquitous computing, is a crucial aspect for urban management in a smart community

[Medication use among community-dwelling older Icelanders. Population-based study in urban and rural areas].

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Sigurdardottir, Arun K; Arnadottir, Solveig Asa; Gunnarsdottir, Elín Díanna

2011-12-01

To describe medication use among older community-dwelling Icelanders by collecting information on number of medicine, polypharmacy (>5 medications), and medications by ATC categories. Moreover, to explore the relationship between medication use and various influential factors emphasizing residency in urban and rural areas. Population-based, cross-sectional study. Participants were randomly selected from the National registry in one urban (n=118) and two rural (n=68) areas. 1) ≥ 65 years old, 2) community-dwelling, 3) able to communicate verbally. Information on medication use was obtained from each person's medication list and interviews. A questionnaire and five standardized instruments were used to assess the potential influencing factors. On average, participants used 3.9 medications and prevalence of polypharmacy was 41%. Men used 3.5 medications on average and women 4.4 (p=0.018). Compared to rural residents, urban residents had fewer medical diagnoses, better mobility, less pain, and fewer depressive symptoms. By controlling for the effects of these variables, more medications were associated with urban living (pbetter scores on health assessments.

Connecting Urban Students with Engineering Design: Community-Focused, Student-Driven Projects

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Parker, Carolyn; Kruchten, Catherine; Moshfeghian, Audrey

2017-01-01

The STEM Achievement in Baltimore Elementary Schools (SABES) program is a community partnership initiative that includes both in-school and afterschool STEM education for grades 3-5. It was designed to broaden participation and achievement in STEM education by bringing science and engineering to the lives of low-income urban elementary school…

Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

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Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

2013-10-24

Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was

Mandatory Community-Based Learning in U.S. Urban High Schools: Fair Equality of Opportunity?

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Bennett, Jeffrey V.; Alsbury, Thomas L.; Fan, Jingjing

2016-01-01

This study explores participant experiences at two contrasting high schools in a large, urban school district in crisis who implemented mandatory community-based learning (CBL) (e.g. community service, work-based internships) as a policy of reform. Rawls' theory of justice as fairness is used to examine capacity of the district formal policy to…

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

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Kanchanabhandhu, Chanchai; Woraphong, Seree

2016-01-01

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

"We can see a future here": Place attachment, professional identity, and forms of capital mobilized to deliver medical education in an underserviced area.

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Hanlon, Neil; Halseth, Greg; Snadden, David

2010-09-01

Community-integrated undergraduate medical education is becoming a more common option for students predisposed to practice in rural and small town places. One such initiative, the Northern Medical Program, has been operating since 2004 in the northern interior of British Columbia, Canada. The NMP's curriculum relies heavily on the involvement of practicing physicians in its host community, Prince George. Drawing on Bourdieu's conceptualization of capital in its different forms, the commitment of the local physician community is understood as social capital derived from cultural capital centred on a collective sense of professional identity forged by conditions of practice in an underserviced area. The findings of this study are discussed with respect to the long-term operation and success of community-integrated medical education programs. Copyright 2010 Elsevier Ltd. All rights reserved.

Case management redesign in an urban facility.

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Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

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

Development of a community-based participatory colorectal cancer screening intervention to address disparities, Arkansas, 2008-2009.

Science.gov (United States)

Yeary, Karen; Flowers, Eric; Ford, Gemessia; Burroughs, Desiree; Burton, Jackie; Woods, Delores; Stewart, Chara; Mehta, Paulette; Greene, Paul; Henry-Tillman, Ronda

2011-03-01

The death rate from colorectal cancer is high and affects poor and medically underserved populations disproportionately. In the United States, health disparities are particularly acute in the Lower Mississippi River Delta region. Because many in the region have limited access to basic health care resources, they are not screened for cancer, even though screening is one of the most effective strategies to prevent colorectal cancer. Community-based participatory research is a promising approach to prevent colorectal cancer in this population. The Empowering Communities for Life program was implemented in 2 underserved counties in the Arkansas Lower Mississippi River Delta. The program arose from a 9-year partnership between the University of Arkansas for Medical Sciences and 9 cancer councils across Arkansas. Empowering Communities for Life is a community-based participatory intervention designed to increase colorectal cancer screening in rural, underserved communities through fecal occult blood testing. Community and academic partners collaborated to develop research infrastructure, intervention materials and methods, and the assessment instrument. Project outcomes were strengthened community-academic partnerships, certification of community partners in conducting human subjects research, development of a randomized controlled design to test the intervention's efficacy, an interactive PowerPoint presentation, an informational pamphlet, the certification of 6 lay health advisors and 22 role models to provide the intervention, and an assessment tool using an audience response system. Lessons learned in working collaboratively with diverse groups include the importance of meeting face to face and listening.

A national study on nurses' retention in healthcare facilities in underserved areas in Lebanon.

Science.gov (United States)

El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F

2013-09-30

Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas. A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P job satisfaction and their intent to stay. This study reveals poor retention of nurses in rural and underserved

Habitat connectivity shapes urban arthropod communities: the key role of green roofs.

Science.gov (United States)

Braaker, S; Ghazoul, J; Obrist, M K; Moretti, M

2014-04-01

The installation of green roofs, defined here as rooftops with a shallow soil cover and extensive vegetation, has been proposed as a possible measure to mitigate the loss of green space caused by the steady growth of cities. However, the effectiveness of green roofs in supporting arthropod communities, and the extent to which they facilitate connectivity of these communities within the urban environment is currently largely unknown. We investigated the variation of species community composition (beta diversity) of four arthropod groups with contrasting mobility (Carabidae, Araneae, Curculionidae, and Apidae) on 40 green roofs and 40 extensively managed green sites on the ground in the city of Zurich, Switzerland. With redundancy analysis and variation partitioning, we (1) disentangled the relative importance of local environmental conditions, the surrounding land cover composition, and habitat connectivity on species community composition, (2) searched for specific spatial scales of habitat connectivity for the different arthropod groups, and (3) discussed the ecological and functional value of green roofs in cities. Our study revealed that on green roofs community composition of high-mobility arthropod groups (bees and weevils) were mainly shaped by habitat connectivity, while low-mobility arthropod groups (carabids and spiders) were more influenced by local environmental conditions. A similar but less pronounced pattern was found for ground communities. The high importance of habitat connectivity in shaping high-mobility species community composition indicates that these green roof communities are substantially connected by the frequent exchange of individuals among surrounding green roofs. On the other hand, low-mobility species communities on green roofs are more likely connected to ground sites than to other green roofs. The integration of green roofs in urban spatial planning strategies has great potential to enable higher connectivity among green spaces, so

Individual Breast Cancer risk assessment in Underserved Populations: Integrating empirical Bioethics and Health Disparities Research

Science.gov (United States)

Anderson, Emily E.; Hoskins, Kent

2013-01-01

Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issues that require further examination. After reviewing these issues, we will discuss how empirical bioethics research can be integrated with health disparities research to inform the translation of research findings. Our in-progress National Cancer Institute (NCI) funded study, How Do Underserved Minority Women Think About Breast Cancer?, conducted in the context of a larger study on individual breast cancer risk assessment, is presented as a model. PMID:23124498

Lack of Quality Primary Health Services: The Problems of the Underserved.

Science.gov (United States)

Hall, Daniel A.

1978-01-01

Major political and economic forces, which affect the provision of primary health services, particularly to underserved populations, are reviewed. Technological, professional, governmental, fiscal, and societal solutions are proposed. (GC)

Looking within and beyond the community: lessons learned by researching, theorising and acting to address urban poverty and health.

Science.gov (United States)

Hodgetts, Darrin; Chamberlain, Kerry; Tankel, Yadena; Groot, Shiloh

2014-01-01

Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.

Wind Energy Assessment for Small Urban Communities in the Baja California Peninsula, Mexico

OpenAIRE

Quetzalcoatl Hernandez-Escobedo

2016-01-01

Mexico needs to exploit its renewable resources and many studies have determined the great renewable potential it has using wind energy. However it is necessary to calculate the amount of this resource for small urban communities, which in this country lack essential services such as electricity. This study is focused in the Baja California Peninsula, using GIS as a tool to identify small urban zones with higher wind power. For this work data was analyzed from meteorological stations and reco...

An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

Science.gov (United States)

Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

2014-06-01

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

Correlates of Externalizing Behavior Symptoms among Youth within Two Impoverished, Urban Communities

Science.gov (United States)

Gopalan, Geetha; Cavaleri, Mary A.; Bannon, William M.; McKay, Mary M.

2009-01-01

This study examines whether risk factors associated with child externalizing behavior symptoms differ between two similar low-income, urban communities, using baseline parent data of 154 African American youth (ages 9-15) participating in the Collaborative HIV-Prevention and Adolescent Mental Health Project (CHAMP) family program. Separate…

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

Science.gov (United States)

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

2013-10-09

's Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. NIH clinical trial # NCT01881373.

Mobile Learning and Indigenous Education in Canada: A Synthesis of New Ways of Learning

Science.gov (United States)

Pulla, Siomonn

2017-01-01

M-Learning holds great potential for supporting the positive educational outcomes of underserved Indigenous communities in the Canadian North, and even in urban centers, that are at risk of exclusion from affordable, high-quality learning experiences. The technical advantages of having mobile technology to deliver educational curricula and assess…

Bioaccessibility of metals and human health risk assessment in community urban gardens.

Science.gov (United States)

Izquierdo, M; De Miguel, E; Ortega, M F; Mingot, J

2015-09-01

Pseudo-total (i.e. aqua regia extractable) and gastric-bioaccessible (i.e. glycine+HCl extractable) concentrations of Ca, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn were determined in a total of 48 samples collected from six community urban gardens of different characteristics in the city of Madrid (Spain). Calcium carbonate appears to be the soil property that determines the bioaccessibility of a majority of those elements, and the lack of influence of organic matter, pH and texture can be explained by their low levels in the samples (organic matter) or their narrow range of variation (pH and texture). A conservative risk assessment with bioaccessible concentrations in two scenarios, i.e. adult urban farmers and children playing in urban gardens, revealed acceptable levels of risk, but with large differences between urban gardens depending on their history of land use and their proximity to busy areas in the city center. Only in a worst-case scenario in which children who use urban gardens as recreational areas also eat the produce grown in them would the risk exceed the limits of acceptability. Copyright © 2015 Elsevier Ltd. All rights reserved.

Wastewater treatment plant effluent introduces recoverable shifts in microbial community composition in urban streams

Science.gov (United States)

Ledford, S. H.; Price, J. R.; Ryan, M. O.; Toran, L.; Sales, C. M.

2017-12-01

New technologies are allowing for intense scrutiny of the impact of land use on microbial communities in stream networks. We used a combination of analytical chemistry, real-time polymerase chain reaction (qPCR) and targeted amplicon sequencing for a preliminary study on the impact of wastewater treatment plant effluent discharge on urban streams. Samples were collected on two dates above and below treatment plants on the Wissahickon Creek, and its tributary, Sandy Run, in Montgomery County, PA, USA. As expected, effluent was observed to be a significant source of nutrients and human and non-specific fecal associated taxa. There was an observed increase in the alpha diversity at locations immediately below effluent outflows, which contributed many taxa involved in wastewater treatment processes and nutrient cycling to the stream's microbial community. Unexpectedly, modeling of microbial community shifts along the stream was not controlled by concentrations of measured nutrients. Furthermore, partial recovery, in the form of decreasing abundances of bacteria and nutrients associated with wastewater treatment plant processes, nutrient cycling bacteria, and taxa associated with fecal and sewage sources, was observed between effluent sources. Antecedent moisture conditions impacted overall microbial community diversity, with higher diversity occurring after rainfall. These findings hint at resilience in stream microbial communities to recover from wastewater treatment plant effluent and are vital to understanding the impacts of urbanization on microbial stream communities.

Residential building energy conservation and avoided power plant emissions by urban and community trees in the United States

Science.gov (United States)

David J. Nowak; Nathaniel Appleton; Alexis Ellis; Eric Greenfield

2017-01-01

Urban trees and forests alter building energy use and associated emissions from power plants by shading buildings, cooling air temperatures and altering wind speeds around buildings. Field data on urban trees were combined with local urban/community tree and land cover maps, modeling of tree effects on building energy use and pollutant emissions, and state energy and...

Coastal urbanization leads to remarkable seaweed species loss and community shifts along the SW Atlantic.

Science.gov (United States)

Scherner, Fernando; Horta, Paulo Antunes; de Oliveira, Eurico Cabral; Simonassi, José Carlos; Hall-Spencer, Jason M; Chow, Fungyi; Nunes, José Marcos C; Pereira, Sonia Maria Barreto

2013-11-15

Coastal urbanization is rapidly expanding worldwide while its impacts on seaweed communities remain poorly understood. We assessed the impact of urbanization along an extensive latitudinal gradient encompassing three phycogeographical regions in the SW Atlantic. Human population density, number of dwellings, and terrestrial vegetation cover were determined for each survey area and correlated with diversity indices calculated from seaweed percent cover data. Urban areas had significantly lower calcareous algal cover (-38%), and there was significantly less carbonate in the sediment off urban areas than off reference areas. Seaweed richness averaged 26% less in urban areas than in areas with higher vegetation cover. We observed a remarkable decline in Phaeophyceae and a substantial increase of Chlorophyta in urban areas across a wide latitudinal gradient. Our data show that coastal urbanization is causing substantial loss of seaweed biodiversity in the SW Atlantic, and is considerably changing seaweed assemblages. Copyright © 2013 Elsevier Ltd. All rights reserved.

Personal values of family physicians, practice satisfaction, and service to the underserved.

Science.gov (United States)

Eliason, B C; Guse, C; Gottlieb, M S

2000-03-01

Personal values are defined as "desirable goals varying in importance that serve as guiding principles in people's lives," and have been shown to influence specialty choice and relate to practice satisfaction. We wished to examine further the relationship of personal values to practice satisfaction and also to a physician's willingness to care for the underserved. We also wished to study associations that might exist among personal values, practice satisfaction, and a variety of practice characteristics. We randomly surveyed a stratified probability sample of 1224 practicing family physicians about their personal values (using the Schwartz values questionnaire), practice satisfaction, practice location, breadth of practice, demographics, board certification status, teaching involvement, and the payor mix of the practice. Family physicians rated the benevolence (motivation to help those close to you) value type highest, and the ratings of the benevolence value type were positively associated with practice satisfaction (correlation coefficient = 0.14, P = .002). Those involved in teaching medical trainees were more satisfied than those who were not involved (P = .009). Some value-type ratings were found to be positively associated with caring for the underserved. Those whose practices consisted of more than 40% underserved (underserved defined as Medicare, Medicaid, and indigent populations) rated the tradition (motivation to maintain customs of traditional culture and religion) value type significantly higher (P = .02). Those whose practices consisted of more than 30% indigent care rated the universalism (motivation to enhance and protect the well-being of all people) value type significantly higher (P = .03). Family physicians who viewed benevolence as a guiding principle in their lives reported a higher level of professional satisfaction. Likewise, physicians involved in the teaching of medical trainees were more satisfied with their profession. Family physicians

Emerging Information Literacy and Research-Method Competencies in Urban Community College Psychology Students

Science.gov (United States)

Wolfe, Kate S.

2015-01-01

This article details an assignment developed to teach students at urban community colleges information-literacy skills. This annotated bibliography assignment introduces students to library research skills, helps increase information literacy in beginning college students, and helps psychology students learn research methodology crucial in…

Designing a community-based lay health advisor training curriculum to address cancer health disparities.

Science.gov (United States)

Gwede, Clement K; Ashley, Atalie A; McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B; Wathington, Deanna; Dash-Pitts, Lolita; Green, B Lee

2013-05-01

Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. APPROACH AND STRATEGIES: Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic-community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research.

Cost-effectiveness and cost utility of community screening for glaucoma in urban India.

Science.gov (United States)

John, Denny; Parikh, Rajul

2017-07-01

Population-based screening for glaucoma has been demonstrated to be cost-effective if targeted at high-risk groups such as older adults and those with a family history of glaucoma, and through use of a technician for conducting initial assessment rather than a medical specialist. This study attempts to investigate the cost-effectiveness of a hypothetical community screening and subsequent treatment programme for glaucoma in comparison with current practice (i.e. with no screening programme but with some opportunistic case finding) in the urban areas of India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in the urban areas of India. Screening and treatment costs were obtained from an administrator of a tertiary eye hospital in India. The probabilities for the screening pathway were derived from published literature and expert opinion. The glaucoma prevalence rates for urban areas were adapted from the Chennai Glaucoma Study findings. A decision-analytical model using TreeAge Pro 2015 was built to model events, costs and treatment pathways. One-way sensitivity analyses were conducted. The introduction of a community screening programme for glaucoma is likely to be cost-effective, the estimated incremental cost-effectiveness ratio (ICER) values being 10,668.68 when compared with no screening programme and would treat an additional 4443 cases and prevent 1790 person-years of blindness over a 10-year period in the urban areas of India. Sensitivity analyses revealed that glaucoma prevalence rates across various age groups, screening uptake rate, follow-up compliance after screening, treatment costs and utility values of health states associated with medical and surgical treatment of glaucoma had an impact on the ICER values of the screening programme. In comparison with current practice (i.e. without a screening programme but with some opportunistic case finding

Holistic Admissions in the Health Professions: Strategies for Leaders

Science.gov (United States)

Artinian, Nancy T.; Drees, Betty M.; Glazer, Greer; Harris, Kevin; Kaufman, Lon S.; Lopez, Naty; Danek, Jennifer C.; Michaels, Julia

2017-01-01

In the wake of national health care reform, development of the future health care workforce has become more important than ever. Millions of newly insured patients, many from underserved urban communities, are seeking health care services. In order to provide high-quality care to rapidly diversifying patient populations, health care professionals…

Perceived Benefits of Participation and Risks of Soil Contamination in St. Louis Urban Community Gardens.

Science.gov (United States)

Wong, Roger; Gable, Leah; Rivera-Núñez, Zorimar

2018-06-01

Community gardens are credited for promoting health within neighborhoods, by increasing healthy food intake and exercise frequency. These benefits, however, are potentially undermined as urban soils are often contaminated from industrial legacies. The purpose of this study was to examine the perceived benefits of participation and risks of soil contamination within urban community gardens, and factors associated with soil contamination concerns. Ninety-three gardeners were interviewed across 20 community gardens in St. Louis, Missouri between June and August 2015. Surveys included questions on demographics, gardening practices, and perceptions of community gardening. Multilevel logistic models assessed how gardener demographics, gardening practices, and garden characteristics were associated with soil contamination concerns. Common perceived benefits of community gardening were community building (68.8%), healthy and fresh food (35.5%), and gardening education (18.3%). Most gardeners (62.4%) were not concerned about soil contamination, but nearly half (48.4%) stated concerns about heavy metals. Black race was significantly associated with soil contamination concerns (OR 5.47, 95% CI 1.00-30.15, p = .04). Community gardens offer numerous social and health benefits. Although most gardeners were not concerned about soil contamination, black gardeners were more likely to have concerns. Garden leaders should provide resources to gardeners to learn about soil contamination and methods to manage their risk, particularly in minority neighborhoods.

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

Science.gov (United States)

2013-01-01

) framework. Discussion The Children’s Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. Trial registration NIH clinical trial # NCT01881373 PMID:24107083

The Influence of Heating Mains on Yeast Communities in Urban Soils

Science.gov (United States)

Tepeeva, A. N.; Glushakova, A. M.; Kachalkin, A. V.

2018-04-01

The number and species diversity of yeasts in urban soils (urbanozems) affected by heating mains and in epiphytic yeast complexes of grasses growing above them were studied. The number of yeasts in the soil reached 103-104 CFU/g; on the plants, 107 CFU/g. Significant (by an order of magnitude) increase in the total number of soil yeasts in the zone of heating mains in comparison with the surrounding soil was found in winter period. Overall, 25 species of yeasts were isolated in our study. Yeast community of studied urbanozems was dominated by the Candida sake, an eurybiont of the temperate zone and other natural ecotopes with relatively low temperatures, but its share was minimal in the zone of heating mains. In general, the structure of soil and epiphytic yeast complexes in the zones of heating mains differed from that in the surrounding area by higher species diversity and a lower share of pigmented species among the epiphytic yeasts. The study demonstrated that the number and species structure of soil yeast communities in urban soils change significantly under the influence of the temperature factor and acquire a mosaic distribution pattern.

Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

Science.gov (United States)

Brickle, Colleen M; Self, Karl D

2017-09-01

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

77 FR 67433 - Community Advantage Pilot Program

Science.gov (United States)

2012-11-09

... comments. SUMMARY: The Community Advantage (``CA'') Pilot Program is a pilot program to increase SBA... small businesses and entrepreneurs in underserved markets, SBA is issuing this Notice to extend the term... Pilot Program was introduced to increase the number of SBA-guaranteed loans made to small businesses in...

Urban-Related Environmental Variables and Their Relation with Patterns in Biological Community Structure in the Fountain Creek Basin, Colorado, 2003-2005

Science.gov (United States)

Zuellig, Robert E.; Bruce, James F.; Evans, Erin E.; Stogner, Sr., Robert W.

2007-01-01

In 2003, the U.S. Geological Survey, in cooperation with Colorado Springs City Engineering, began a study to evaluate the influence of urbanization on stream ecosystems. To accomplish this task, invertebrate, fish, stream discharge, habitat, water-chemistry, and land-use data were collected from 13 sites in the Fountain Creek basin from 2003 to 2005. The Hydrologic Index Tool was used to calculate hydrologic indices known to be related to urbanization. Response of stream hydrology to urbanization was evident among hydrologic variables that described stormflow. These indices included one measurement of high-flow magnitude, two measurements of high-flow frequency, and one measurement of stream flashiness. Habitat and selected nonstormflow water chemistry were characterized at each site. Land-use data were converted to estimates of impervious surface cover and used as the measure of urbanization annually. Correlation analysis (Spearman?s rho) was used to identify a suite of nonredundant streamflow, habitat, and water-chemistry variables that were strongly associated (rho > 0.6) with impervious surface cover but not strongly related to elevation (rho analysis (BIO-ENV, PRIMER ver 6.1, Plymouth, UK) was used to create subsets of eight urban-related environmental variables that described patterns in biological community structure. The strongest and most parsimonious subset of variables describing patterns in invertebrate community structure included high flood pulse count, lower bank capacity, and nutrients. Several other combinations of environmental variables resulted in competing subsets, but these subsets always included the three variables found in the most parsimonious list. This study found that patterns in invertebrate community structure from 2003 to 2005 in the Fountain Creek basin were associated with a variety of environmental characteristics influenced by urbanization. These patterns were explained by a combination of hydrologic, habitat, and water

A qualitative study of recruitment barriers, motivators, and community-based strategies for increasing clinical trials participation among rural and urban populations.

Science.gov (United States)

Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D; Tanner, Andrea; Kim, Sei-Hill

2015-01-01

Participation in clinical trials (CTs) is low among rural communities. Investigators report difficulty recruiting rural individuals for CTs. The study purpose was to identify recruitment barriers, motivators, and strategies to help increase access to and participation in CTs in rural and urban communities. Qualitative focus groups/interviews. Rural and urban counties in one southeastern state. Two hundred twelve African-American and white men and women ages 21+. Nineteen focus groups and nine interviews were conducted. Audio files were transcribed and organized into NVivo10. Recurring themes were examined by geographic location. Although similar barriers, motivators, and strategies were reported by urban and rural groups, perceptions regarding their importance varied. Recruitment barriers mentioned in both rural and urban groups included fear, side effects, limited understanding, limited time, and mistrust. Rural groups were more mindful of time commitment involved. Both rural and urban participants reported financial incentives as the top motivator to CT participation, followed by personal illness (urban groups) and benefits to family (rural groups). Recruitment strategies suggested by rural participants involved working with schools/churches and using word of mouth, whereas partnering with schools, word of mouth, and media were recommended most by urban groups. Perceived recruitment barriers, motivators, and strategies did not differ considerably between rural and urban groups. Major barriers identified by participants should be addressed in future CT recruitment and education efforts. Findings can inform recruitment and communication strategies for reaching both urban and rural communities.

Sustainable Supply of Safe Drinking Water for Underserved Households in Kenya: Investigating the Viability of Decentralized Solutions

Directory of Open Access Journals (Sweden)

Pauline Chepchirchir Cherunya

2015-10-01

Full Text Available Water quality and safe water sources are pivotal aspects of consideration for domestic water. Focusing on underserved households in Kenya, this study compared user perceptions and preferences on water-service provision options, particularly investigating the viability of decentralized models, such as the Safe Water Enterprise (SWE, as sustainable safe drinking water sources. Results showed that among a number of water-service provision options available, the majority of households regularly sourced their domestic water from more than one source (86% Ngoliba/Maguguni, 98% Kangemi Gichagi. A majority of households perceived their water sources to be unsafe to drink (84% Ngoliba/Maguguni, 73% Kangemi Gichagi. For this reason, drinking water was mainly chlorinated (48% Ngoliba/Maguguni, 33% Kangemi Gichagi or boiled (42% Ngoliba/Maguguni, 67% Kangemi Gichagi. However, this study also found that households in Kenya did not apply these household water treatment methods consistently, thus indicating inconsistency in safe water consumption. The SWE concept, a community-scale decentralized safe drinking water source, was a preferred option among households who perceived it to save time and to be less cumbersome as compared to boiling and chlorination. Willingness to pay for SWE water was also a positive indicator for its preference by the underserved households. However, the long-term applicability of such decentralized water provision models needs to be further investigated within the larger water-service provision context.

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

OpenAIRE

Jiayan 　LIU

2017-01-01

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

Urban communities in analysis of the causes of low participation for example X in Wuhan City

Science.gov (United States)

Zhang, Keyong; Xu, Wenli

2011-12-01

Community governance is not only a global social development of the core issues, but also the essential requirement of social development, At present, there are still exist poor sense of involved in community awareness and participation insufficient. These constraints have become the bottleneck of China's urban community development. This paper attempts to the community perspective of participation, and the District of Wuhan, for example X, from a historical, psychological, institutional and other elements to discussed the causes of low participation, Hope benefit to the domestic community development.

MUWS (Microbiology in Urban Water Systems – an interdisciplinary approach to study microbial communities in urban water systems

Directory of Open Access Journals (Sweden)

P. Deines

2010-07-01

Full Text Available Microbiology in Urban Water Systems (MUWS is an integrated project, which aims to characterize the microorganisms found in both potable water distribution systems and sewer networks. These large infrastructure systems have a major impact on our quality of life, and despite the importance of these systems as major components of the water cycle, little is known about their microbial ecology. Potable water distribution systems and sewer networks are both large, highly interconnected, dynamic, subject to time and varying inputs and demands, and difficult to control. Their performance also faces increasing loading due to increasing urbanization and longer-term environmental changes. Therefore, understanding the link between microbial ecology and any potential impacts on short or long-term engineering performance within urban water infrastructure systems is important. By combining the strengths and research expertise of civil-, biochemical engineers and molecular microbial ecologists, we ultimately aim to link microbial community abundance, diversity and function to physical and engineering variables so that novel insights into the performance and management of both water distribution systems and sewer networks can be explored. By presenting the details and principals behind the molecular microbiological techniques that we use, this paper demonstrates the potential of an integrated approach to better understand how urban water system function, and so meet future challenges.

The association between income inequality and all-cause mortality across urban communities in Korea.

Science.gov (United States)

Park, Jong; Ryu, So-Yeon; Han, Mi-ah; Choi, Seong-Woo

2015-06-20

Korea has achieved considerable economic growth more rapidly than most other countries, but disparities in income level have increased. Therefore, we sought to assess the association between income inequality and mortality across Korean cities. Data on household income were obtained from the 2010-2012 Korean Community Health Survey and data on all-cause mortality and other covariates were obtained from the Korean Statistical Information Service. The Gini coefficient, Robin Hood index, and income share ratio between the 80th and 20th percentiles of the distribution were measured for each community. After excluding communities affected by changes in administrative districts between 2010 and 2012, a total of 157 communities and 172,398 urban residents were included in the analysis. When we graphed income inequality measures versus all-cause mortality as scatter plots, the R square values of the regression lines for GC, RHI, and 80/20 ratios relative to mortality were 0.230, 0.238, and 0.152, respectively. After adjusting for other covariates and median household income, mean all-cause mortality increased significantly with increasing GC (P for trend = 0.014) and RHI (P for trend = 0.031), and increased marginally with 80/20 ratio (P for trend = 0.067). Our data demonstrate that income inequality measures are significantly associated with all-cause mortality rate after adjustment for covariates, including median household income across urban communities in Korea.

Producing "science/fictions" about the rural and urban poor: Community-based learning at a medical college in South India

Science.gov (United States)

Arur, Aditi Ashok

This dissertation is an ethnographic case study of a community-based teaching program (CBTP) in public health at a medical college in South India that explored how the CBTP produced particular ways of seeing and understanding rural and urban poor communities. Drawing from critical, feminist, and postcolonial scholars, I suggest that the knowledge produced in the CBTP can be understood as "science/fictions", that is, as cultural texts shaped by transnational development discourses as well as medical teachers' and students' sociospatial imaginations of the rural and urban poor. I explored how these science/fictions mediated medical students' performative actions and interactions with a rural and an urban poor community in the context of the CBTP. At the same time, I also examined how knowledge produced in students' encounters with these communities disrupted their naturalized understandings about these communities, and how it was taken up to renarrativize science/fictions anew. Data collection and analyses procedures were informed by critical ethnographic and critical discourse analysis approaches. Data sources includes field notes constructed from observations of the CBTP, interviews with medical teachers and students, and curricular texts including the standardized national textbook of public health. The findings of this study illustrate how the CBTP staged the government and technology as central actors in the production of healthy bodies, communities, and environments, and implicitly positioned medical teachers and students as productive citizens of a modern nation while rural and urban poor communities were characterized sometimes as empowered, and at other times as not-yet-modern and in need of reform. However, the community also constituted an alternate pedagogical site of engagement in that students' encounters with community members disrupted students' assumptions about these communities to an extent. Nevertheless, institutionalized practices of assessment

Temporal dynamics influenced by global change: bee community phenology in urban, agricultural, and natural landscapes.

Science.gov (United States)

Leong, Misha; Ponisio, Lauren C; Kremen, Claire; Thorp, Robbin W; Roderick, George K

2016-03-01

Urbanization and agricultural intensification of landscapes are important drivers of global change, which in turn have direct impacts on local ecological communities leading to shifts in species distributions and interactions. Here, we illustrate how human-altered landscapes, with novel ornamental and crop plant communities, result not only in changes to local community diversity of floral-dependent species, but also in shifts in seasonal abundance of bee pollinators. Three years of data on the spatio-temporal distributions of 91 bee species show that seasonal patterns of abundance and species richness in human-altered landscapes varied significantly less compared to natural habitats in which floral resources are relatively scarce in the dry summer months. These findings demonstrate that anthropogenic environmental changes in urban and agricultural systems, here mediated through changes in plant resources and water inputs, can alter the temporal dynamics of pollinators that depend on them. Changes in phenology of interactions can be an important, though frequently overlooked, mechanism of global change. © 2015 John Wiley & Sons Ltd.

Interactive web-based portals to improve patient navigation and connect patients with primary care and specialty services in underserved communities.

Science.gov (United States)

Highfield, Linda; Ottenweller, Cecelia; Pfanz, Andre; Hanks, Jeanne

2014-01-01

This article presents a case study in the redesign, development, and implementation of a web-based healthcare clinic search tool for virtual patient navigation in underserved populations in Texas. It describes the workflow, assessment of system requirements, and design and implementation of two online portals: Project Safety Net and the Breast Health Portal. The primary focus of the study was to demonstrate the use of health information technology for the purpose of bridging the gap between underserved populations and access to healthcare. A combination of interviews and focus groups was used to guide the development process. Interviewees were asked a series of questions about usage, usability, and desired features of the new system. The redeveloped system offers a multitier architecture consisting of data, business, and presentation layers. The technology used in the new portals include Microsoft .NET Framework 3.5, Microsoft SQL Server 2008, Google Maps JavaScript API v3, jQuery, Telerik RadControls (ASP.NET AJAX), and HTML. The redesigned portals have 548 registered clinics, and they have averaged 355 visits per month since their launch in late 2011, with the average user visiting five pages per visit. Usage has remained relatively constant over time, with an average of 142 new users (40 percent) each month. This study demonstrates the successful application of health information technology to improve access to healthcare and the successful adoption of the technology by targeted end users. The portals described in this study could be replicated by health information specialists in other areas of the United States to address disparities in healthcare access.

Predicting delay to treatment of urinary incontinence among urban community-dwelling women in China

Directory of Open Access Journals (Sweden)

Chen Wu

2015-03-01

Conclusion: Women who were older, had lower subjective UI severity, and who reported only stress or urgency UI tended to delay treatment longer; such patients should be targeted for health education and intervention regarding UI in urban communities.

Diet and Obesity Issues in the Underserved.

Science.gov (United States)

Mejia de Grubb, Maria C; Levine, Robert S; Zoorob, Roger J

2017-03-01

The goal of this article is to inform new directions for addressing inequalities associated with obesity by reviewing current issues about diet and obesity among socioeconomically vulnerable and underserved populations. It highlights recent interventions in selected high-risk populations, as well as gaps in the knowledge base. It identifies future directions in policy and programmatic interventions to expand the role of primary care providers, with an emphasis on those aimed at preventing obesity and promoting healthy weight. Copyright © 2016 Elsevier Inc. All rights reserved.

Pedestrian Zones As Important Urban Strategies in Redeveloping the Community - Case Study: Alba Iulia Borough Park

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Oana Elena BLAGA

2013-02-01

Full Text Available The pedestrian zone issue is by far an important matter in the context of urban regeneration. Cities which adopted this strategy – the pedestrian zones – have recorded better urban attitudes regarding the urban environment, a continuous growth of the urban quality, an improved urban ecosystem  and continuous attractiveness for investment and  tourism. This article explores the evolution of the pedestrian zones as ideas in utopian urban models in the early 1900 and later as efficient environmental friendly strategies adopted by cities. After identifying the path this concept followed, from a simple idea to an important strategy of urban development, the paper focuses on the major characteristics and benefits of the pedestrian precincts. Next, the article focuses on the newest pedestrian zone in one of the Romanian cities, Alba Iulia and it tries to identify the types of impact this area has so far on the community and entire city.

A multiple criteria analysis for household solid waste management in the urban community of Dakar.

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Kapepula, Ka-Mbayu; Colson, Gerard; Sabri, Karim; Thonart, Philippe

2007-01-01

Household solid waste management is a severe problem in big cities of developing countries. Mismanaged solid waste dumpsites produce bad sanitary, ecological and economic consequences for the whole population, especially for the poorest urban inhabitants. Dealing with this problem, this paper utilizes field data collected in the urban community of Dakar, in view of ranking nine areas of the city with respect to multiple criteria of nuisance. Nine criteria are built and organized in three families that represent three classical viewpoints: the production of wastes, their collection and their treatment. Thanks to the method PROMETHEE and the software ARGOS, we do a pair-wise comparison of the nine areas, which allows their multiple criteria rankings according to each viewpoint and then globally. Finding the worst and best areas in terms of nuisance for a better waste management in the city is our final purpose, fitting as well as possible the needs of the urban community. Based on field knowledge and on the literature, we suggest applying general and area-specific remedies to the household solid waste problems.

Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

NARCIS (Netherlands)

Havenaar, Juhan; Geerlings, Mirjan; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

2007-01-01

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were

Persistence at an Urban Community College: The Implications of Self-Efficacy and Motivation

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Liao, Hsiang-Ann; Edlin, Margot; Ferdenzi, Anita Cuttita

2014-01-01

This study examined how self-efficacy and motivation affected student persistence at an urban community college. Self-efficacy was studied at two dimensions: self-regulated learning efficacy and self-efficacy for academic achievement. Motivation was also investigated at two levels: intrinsic motivation and extrinsic motivation. Results show that…

Participatory Rural Appraisal as an Approach to Environmental Education in Urban Community Gardens.

Science.gov (United States)

Doyle, Rebekah; Krasny, Marianne

2003-01-01

Describes the Cornell University Garden Mosaics program in which youth learn about ethnic gardening practices in urban community gardens using research methods adapted from the Participatory Rural Appraisal (PRA). Conducts a study to determine whether youth could effectively facilitate PRA activities with gardeners and to document any social and…

The Issue of Poverty in the Urban and Rural Communities in Romania

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ELISA PARASCHIV

2008-03-01

Full Text Available The main objective of this work is to answer questions which are relevant for the process of preparing anti-poverty strategies.The major discrepancy between the rural and urban environment with respect to the aspects mentioned above is one of the main conclusions. However, the residence environment usually represents only one of the dimensions or one of the influential factors of poverty in Romania, without any systematic study of the differences/resemblances between urban and rural poverty. In this respect, the study represents a complementary study for the previous analyses, a synthesis of the existent knowledge of resemblances between urban poverty and rural poverty and, implicitly, of the adequate political instruments for combating each of these aspects. According to the arguments presented by the author, in Romania, poverty is territorially concentrated, at the level of both the communities and the households, from the perspective of consumerism, and rural poverty is the key issue of poverty in Romania.

Modeling the heterogeneous traffic correlations in urban road systems using traffic-enhanced community detection approach

Science.gov (United States)

Lu, Feng; Liu, Kang; Duan, Yingying; Cheng, Shifen; Du, Fei

2018-07-01

A better characterization of the traffic influence among urban roads is crucial for traffic control and traffic forecasting. The existence of spatial heterogeneity imposes great influence on modeling the extent and degree of road traffic correlation, which is usually neglected by the traditional distance based method. In this paper, we propose a traffic-enhanced community detection approach to spatially reveal the traffic correlation in city road networks. First, the road network is modeled as a traffic-enhanced dual graph with the closeness between two road segments determined not only by their topological connection, but also by the traffic correlation between them. Then a flow-based community detection algorithm called Infomap is utilized to identify the road segment clusters. Evaluated by Moran's I, Calinski-Harabaz Index and the traffic interpolation application, we find that compared to the distance based method and the community based method, our proposed traffic-enhanced community based method behaves better in capturing the extent of traffic relevance as both the topological structure of the road network and the traffic correlations among urban roads are considered. It can be used in more traffic-related applications, such as traffic forecasting, traffic control and guidance.

Determinants of late antenatal care presentation in rural and peri-urban communities in South Africa: A cross-sectional study.

Science.gov (United States)

Ebonwu, Joy; Mumbauer, Alexandra; Uys, Margot; Wainberg, Milton L; Medina-Marino, Andrew

2018-01-01

To investigate and compare determinates for delayed first presentation to antenatal care (ANC) services. A cross-sectional study was conducted amongst pregnant women attending their first ANC visit in rural Capricorn District and peri-urban Tlokwe sub-district communities in South Africa. Data collection included questionnaires and medical record abstraction. Bivariate and multivariate analyses assessed factors associated with late ANC presentation. We recruited 807 pregnant women. Of these, 51% of rural women and 28% of peri-urban women presented late for first ANC. Rural women were more likely to present late for first ANC (AOR = 2.65; 95% CI 1.98-3.55) and report barriers to accessing ANC services (PANC presentation in rural communities was associated with being married (AOR = 2.36; 95% CI 1.33-4.19), employed (AOR = 1.90; 95% CI 1.03-3.50), ANC after presenting early (AOR 0.51; 95% CI 0.30-0.89) and being pregnant for the first time (AOR = 0.56; 95% CI 0.34-0.94). Both rural and peri-urban women had high rates of late presentation for first ANC. However, women in the rural communities were more likely to present late. Unplanned pregnancy was an independent risk factor in both rural and peri-urban communities. Interventions around family planning, especially for adolescent girls and young women, are needed to improve early presentation for ANC.

Insights into nasal carriage of Staphylococcus aureus in an urban and a rural community in Ghana

DEFF Research Database (Denmark)

Egyir, Beverly; Guardabassi, Luca; Esson, Joseph

2014-01-01

of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353) and in a rural community situated in the Dangme-West district (n = 234). The overall prevalence of nasal carriage was 21...

The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England.

Science.gov (United States)

Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

2014-08-12

To: (1) determine the percentage of the population in England that have access to a community pharmacy within 20 min walk; (2) explore any relationship between the walking distance and urbanity; (3) explore any relationship between the walking distance and social deprivation; and (4) explore any interactions between urbanity, social deprivation and community pharmacy access. This area level analysis spatial study used postcodes for all community pharmacies in England. Each postcode was assigned to a population lookup table and lower super output area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Access to a community pharmacy within 20 min walk. Overall, 89.2% of the population is estimated to have access to a community pharmacy within 20 min walk. For urban areas, that is 98.3% of the population, for town and fringe, 79.9% of the population, while for rural areas, 18.9% of the population. For areas of lowest deprivation (deprivation decile 1) 90.2% of the population have access to a community pharmacy within 20 min walk, compared to 99.8% in areas of highest deprivation (deprivation decile 10), a percentage difference of 9.6% (8.2, 10.9). Our study shows that the majority of the population can access a community pharmacy within 20 min walk and crucially, access is greater in areas of highest deprivation--a positive pharmacy care law. More research is needed to explore the perceptions and experiences of people--from various levels of deprivation--around the accessibility of community pharmacy services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

Science.gov (United States)

Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

2017-06-01

Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

NARCIS (Netherlands)

Havenaar, J.M.; Geerlings, M.I.; Vivian, L.; Collinson, M.; Robertson, B.

2008-01-01

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

Common mental health problems in historically disadvantaged urban and rural communities in South Africa : prevalence and risk factors

NARCIS (Netherlands)

Havenaar, Juhan M.; Geerlings, Mirjan I.; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.

Conceptualizing age-friendly community characteristics in a sample of urban elders: an exploratory factor analysis.

Science.gov (United States)

Smith, Richard J; Lehning, Amanda J; Dunkle, Ruth E

2013-01-01

Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing US Environmental Protection Agency policy framework. From a sample of urban elders (n = 1,376), we identified 6 factors associated with demographic and health characteristics: access to business and leisure, social interaction, access to health care, neighborhood problems, social support, and community engagement. Future research should explore the effects of these factors across contexts and populations.

Web usability testing with a Hispanic medically underserved population.

Science.gov (United States)

Moore, Mary; Bias, Randolph G; Prentice, Katherine; Fletcher, Robin; Vaughn, Terry

2009-04-01

Skilled website developers value usability testing to assure user needs are met. When the target audience differs substantially from the developers, it becomes essential to tailor both design and evaluation methods. In this study, researchers carried out a multifaceted usability evaluation of a website (Healthy Texas) designed for Hispanic audiences with lower computer literacy and lower health literacy. METHODS INCLUDED: (1) heuristic evaluation by a usability engineer, (2) remote end-user testing using WebEx software; and (3) face-to-face testing in a community center where use of the website was likely. Researchers found standard usability testing methods needed to be modified to provide interpreters, increased flexibility for time on task, presence of a trusted intermediary such as a librarian, and accommodation for family members who accompanied participants. Participants offered recommendations for website redesign, including simplified language, engaging and relevant graphics, culturally relevant examples, and clear navigation. User-centered design is especially important when website developers are not representative of the target audience. Failure to conduct appropriate usability testing with a representative audience can substantially reduce use and value of the website. This thorough course of usability testing identified improvements that benefit all users but become crucial when trying to reach an underserved audience.

Determination of sex-ratio by birth order in an urban community in Manipur.

Science.gov (United States)

Brogen, Akoijam S; Shantibala, K; Rajkumari, Bishwalata; Laishram, Jalina

2009-01-01

To determine the sex ratio by birth order and to assess the sex preference of the couples in an urban community. A cross sectional study, in an urban community in Manipur, was conducted among the currently married couples. Data on background characteristics of the couple, family pedigree chart (of the offspring) including history of abortion, stillbirth, death of child of the couple, sex preference and Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act [PNDT Act] were collected through a structured interview. Data were analyzed using descriptive and chi-square statistics. There were a total of 1777 births to the 855 couples interviewed. There were 900 females per 1000 males for the 1st birth order but the sex ratio was favorable towards females in the 2nd, 3rd and 4th birth orders. Among both the husbands and wives, being more educated was significantly associated (p<0.05) with preferring lesser number of children, using new technology for sex selection and having heard of the PNDT Act. Majority of those who wanted to use new technology for sex selection (128, 56.6%) preferred to have male child. Sex ratio in this community was favorable towards females, though it was less among the first born babies.

Adaptation of copper community tolerance levels after biofilm transplantation in an urban river.

Science.gov (United States)

Fechner, Lise C; Versace, François; Gourlay-Francé, Catherine; Tusseau-Vuillemin, Marie-Hélène

2012-01-15

The Water Framework Directive requires the development of biological tools which can act as early-warning indicators of a sudden increase (accidental pollution) or decrease (recovery due to prevention) of the chemical status of aquatic systems. River biofilms, which respond quickly to modifications of environmental parameters and also play a key part in the functioning of aquatic ecosystems, are therefore good candidates to monitor an increase or a decrease of water pollution. In the present study, we investigated the biological response of biofilms transplanted either upstream (recovery) or downstream (deterioration of exposure levels) the urban area of Paris (France). Both modifications of Cu community tolerance levels and of global bacterial and eukaryotic community structure using automated ribosomal intergenic spacer analysis (ARISA) fingerprints were examined 15 and 30 days after the transplantation. Cu tolerance levels of the heterotrophic component of biofilms were assessed using a short-term toxicity test based on β-glucosidase (heterotrophic) activity. Cu tolerance increased for biofilms transplanted upstream to downstream Paris (5-fold increase on day 30) and conversely decreased for biofilms transplanted downstream to upstream (8-fold decrease on day 30). ARISA fingerprints revealed that bacterial and eukaryotic community structures of transplanted biofilms were closer to the structures of biofilms from the transplantation sites (or sites with similar contamination levels) than to biofilms from their sites of origin. Statistical analysis of the data confirmed that the key factor explaining biofilm Cu tolerance levels is the sampling site and not the site of origin. It also showed that Cu tolerance levels are related to the global urban contamination (both metals and nutrients). The study shows that biofilms adapt fast to modifications of their surroundings. In particular, community tolerance varies quickly and reflects the new exposure levels only 15

What explains the Rural-Urban Gap in Infant Mortality — Household or Community Characteristics?

NARCIS (Netherlands)

E. Van de Poel (Ellen); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)

2007-01-01

textabstractThe rural-urban gap in infant mortality rates is explained using a new decomposition method that permits identification of the ontribution of unobserved heterogeneity at the household and the community level. Using Demographic and Health Survey data for six Francophone countries in

Unintentional Childhood Injuries in Urban and Rural Ujjain, India: A Community-Based Survey

Directory of Open Access Journals (Sweden)

Aditya Mathur

2018-02-01

Full Text Available Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India. The objective of this cross-sectional, community-based survey was to identify the incidence, type, and risk factors of unintentional childhood injuries. The study was done in seven villages and ten contiguous urban slums in Ujjain, India. World Health Organization (WHO tested tools and definitions were used for the survey, which included 2518 households having 6308 children up to 18 years of age, with 2907 children from urban households and 3401 from rural households. The annual incidence of all injuries was 16.6%, 95% Confidence Interval 15.7–17.5%, (n = 1049. The incidence was significantly higher among boys compared to girls (20.2% versus 12.7%, respectively, was highest in age group 6–10 years of age (18.9%, and in urban locations (17.5%. The most commonly identified injury types were: physical injuries (71%, burns (16%, poisonings (10%, agriculture-related injuries (2%, near drowning (2%, and suffocations (2%. The most common place of injury was streets followed by home. The study identified incidence of different types of unintentional childhood injuries and factors associated with increased risk of unintentional injuries. The results can help in designing injury prevention strategies and awareness programs in similar settings.

The roles of mosquito and bird communities on the prevalence of West Nile virus in urban wetland and residential habitats

Science.gov (United States)

Johnson, Brian J.; Munafo, Kristin; Shappell, Laura; Tsipoura, Nellie; Robson, Mark; Ehrenfeld, Joan; Sukhdeo, Michael V. K.

2014-01-01

This study investigated the impacts of urban wetlands and their adjacent residential environments on the transmission dynamics of West Nile virus (WNV) within the state of New Jersey (USA). A working hypothesis was that urban wetlands decrease the local prevalence of WNV through the dilution effect from increased bird diversity, and through relative reductions in the numbers of competent avian host and mosquito species commonly associated with WNV. Surveys of mosquito and bird communities were undertaken at six urban wetlands and their adjacent residential environments over two seasons (2009, 2010). The community compositions of both avian and mosquito species differed significantly across habitats, and over relatively short geographical distances. Residential areas contained significantly higher proportions of WNV-competent mosquito species (31.25±5.3 %; e.g. Culex pipiens and Culex restuans), and WNV-competent avian host species (62.8±2.3 %, e.g. House Sparrow and American Robin) when compared to adjacent urban wetlands (13.5±2.1 %; 35.4±2.1 % respectively). Correspondingly, WNV infection rates within local Culex spp. populations indicate that WNV was more prevalent within residential areas (28.53/1000) compared to wetlands (16.77/1000). Large urban wetlands (>100 ha) produced significantly lower weekly WNV infection rates in local Culex spp. (6.67±2.84/1000) compared to small (urban wetlands contained significantly more species than small wetland patches. These results confirm that the community compositions of mosquito and avian hosts are important drivers in WNV infections, and that the ecological conditions that favor transmission are more strongly associated with urban residential environments than with adjacent urban wetlands. PMID:25484570

Epidemiology of Hymenolepis nana infections in primary school children in urban and rural communities in Zimbabwe.

Science.gov (United States)

Mason, P R; Patterson, B A

1994-04-01

Fecal specimens were obtained on 3 occasions at 10-12 wk intervals from 315 children in 3 rural villages in Zimbabwe and from 351 children in the high-density suburbs of an adjacent small town. Specimens were examined qualitatively and quantitatively for eggs of Hymenolepis nana, and these were found in 142 (21%) children. Infections occurred more frequently in younger children in the urban area but in older children in rural areas. The prevalence in urban areas (24%) was higher than in rural areas (18%), and in urban areas infection correlated with low "hygiene scores" (determined by observation) and with the presence in the household of an infected sibling. The prevalence of infection in the 3 rural communities did not correlate with availability of water, number of households per toilet, with low "hygiene scores," or with the presence of an infected sibling. Treatment with a single oral dose of 15 mg/kg praziquantel cured 84% of the infected children. New or reinfections occurred more frequently in households that had an infected sibling in an urban but not rural setting. The study demonstrates distinct differences in the transmission of H. nana infection in rural and urban communities. The data suggest intrafamily transmission in urban areas, particularly in households with poor hygiene behavior, leading to primary infection early in life. In rural areas, the prevalence of infection and the incidence of reinfection were highest in children of school age, and there was little evidence for intrafamily transmission of the parasite.

The impact of coastal urbanization on the structure of phytobenthic communities in southern Brazil.

Science.gov (United States)

Martins, Cintia D L; Arantes, Noele; Faveri, Caroline; Batista, Manuela B; Oliveira, Eurico C; Pagliosa, Paulo R; Fonseca, Alessandra L; Nunes, José Marcos C; Chow, Fungyi; Pereira, Sonia B; Horta, Paulo A

2012-04-01

The anthropogenic pressures on coastal areas represent important factors affecting local, regional, and even global patterns of distribution and abundance of benthic organisms. This report undertakes a comparative analysis of the community structure of rocky shore intertidal phytobenthos in both pristine like environments (PLE) and urbanized environments (UBE) in southern Brazil, characterizing variations on different spatial scales. Multivariate analysis of variance indicated that the PLE is characterized by a larger number of taxa and an increased occurrence of Rhodophyta species in relation to UBE. In contrast, UBE were dominated by opportunistic algae, such as Cladophora and Ulva spp. Significance tests further indicated higher species richness and Shannon-Wiener diversity on the PLE in relation to UBE. Here we provide data showing the magnitude of seaweed biodiversity loss and discuss direct and indirect consequences of unplanned urbanization on these communities. Copyright © 2012 Elsevier Ltd. All rights reserved.

Pavement and riparian forest shape the bird community along an urban river corridor

Directory of Open Access Journals (Sweden)

Christopher J.W. McClure

2015-07-01

Full Text Available Knowledge of habitat use by animals within urban-riparian corridors during the breeding season is important for conservation, yet remains understudied. We examined the bird community along an urban-riparian corridor through metropolitan Boise, Idaho and predicted that occupancy of individual species and species richness would be greater in forested areas than in urbanized areas. We surveyed birds throughout the summers of 2009 and 2010 and quantified the m2 of each cover-type within 50-m, 100-m, and 200-m buffers surrounding each survey location using satellite imagery. Occupancy modeling revealed that eight of 14 species analyzed were positively associated with riparian forest, and no species avoided forest. Species richness was negatively associated with the amount of paved surface within 100 m of a survey site with richness declining by more than two species for every hectare of paved surface. Most associations with cover-types–especially riparian forest–were at ⩾100 m. Therefore, the riparian forest within 100 m of a given site along an urban-riparian corridor should be the most important for maintaining species richness.

Urban Development for Whom? Changing Forms of Urbanization in Chengdu, China

DEFF Research Database (Denmark)

Zeuthen, Jesper Willaing

is on the institutions regulating changed use of land when communities shift from rural to urban. In the current phase of urbanization far from the city centre, politically decided plans bargained far from rural communities play a much larger role than they did in earlier phases of urbanization closer to the city. China...... process means more formal regulations than in the past, it also means less credible institutions, because regulations may change almost over night as a result of political decisions on which local communities have no influence. In the current situation, the paper argues, the high degree of state control...

Web-based tree crown condition evaluation training tool for urban and community forestry

Science.gov (United States)

Neil Clark; Matthew Winn; Philip Araman

2009-01-01

Volunteers are getting involved more and more, particularly in monitoring applications within the context of urban and community forestry. Training numerous volunteers becomes a substantial task given the numbers of people, time available, and a multitude of other projects. Hundreds of different individuals may be involved in a single field season. These individuals...

Epidemiological patterns of mental disorders and stigma in a community household survey in urban slum and rural settings in Kenya

NARCIS (Netherlands)

Mutiso, Victoria N.; Musyimi, Christine W.; Tomita, Andrew; Loeffen, Lianne; Burns, Jonathan K.; Ndetei, David M.

Purpose: This study investigated the epidemiological patterns of mental illness and stigma in community households in Kenya using a cross-sectional community household survey among 846 participants. Methods: A cross-sectional community household survey was conducted around urban slum (Kangemi) and

Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

Science.gov (United States)

Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

2013-01-01

In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

Urban and community forests of the Southern Atlantic region: Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia

Science.gov (United States)

David J. Nowak; Eric J. Greenfield

2009-01-01

This report details how land cover and urbanization vary within the states of Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, and West Virginia; and the District of Columbia by community (incorporated and census designated places), county subdivision, and county. Specifically this report provides critical urban and community forestry...

Urban bat communities are affected by wetland size, quality, and pollution levels.

Science.gov (United States)

Straka, Tanja Maria; Lentini, Pia Eloise; Lumsden, Linda Faye; Wintle, Brendan Anthony; van der Ree, Rodney

2016-07-01

Wetlands support unique biota and provide important ecosystem services. These services are highly threatened due to the rate of loss and relative rarity of wetlands in most landscapes, an issue that is exacerbated in highly modified urban environments. Despite this, critical ecological knowledge is currently lacking for many wetland-dependent taxa, such as insectivorous bats, which can persist in urban areas if their habitats are managed appropriately. Here, we use a novel paired landscape approach to investigate the role of wetlands in urban bat conservation and examine local and landscape factors driving bat species richness and activity. We acoustically monitored bat activity at 58 urban wetlands and 35 nonwetland sites (ecologically similar sites without free-standing water) in the greater Melbourne area, southeastern Australia. We analyzed bat species richness and activity patterns using generalized linear mixed-effects models. We found that the presence of water in urban Melbourne was an important driver of bat species richness and activity at a landscape scale. Increasing distance to bushland and increasing levels of heavy metal pollution within the waterbody also negatively influenced bat richness and individual species activity. Areas with high levels of artificial night light had reduced bat species richness, and reduced activity for all species except those adapted to urban areas, such as the White-striped free-tailed bat (Austronomus australis). Increased surrounding tree cover and wetland size had a positive effect on bat species richness. Our findings indicate that wetlands form critical habitats for insectivorous bats in urban environments. Large, unlit, and unpolluted wetlands flanked by high tree cover in close proximity to bushland contribute most to the richness of the bat community. Our findings clarify the role of wetlands for insectivorous bats in urban areas and will also allow for the preservation, construction, and management of wetlands

Somatic symptoms, peer and school stress, and family and community violence exposure among urban elementary school children.

Science.gov (United States)

Hart, Shayla L; Hodgkinson, Stacy C; Belcher, Harolyn M E; Hyman, Corine; Cooley-Strickland, Michele

2013-10-01

Somatic symptoms are a common physical response to stress and illness in childhood. This study assessed 409, primarily African American (85.6 %), urban elementary school children to examine the association between: (1) somatic symptoms and potential external stressors (school and peer stress, family conflict, and community violence) and (2) parent and child agreement on children's self-report of somatic symptoms. The odds of self-report of somatic complaints were significantly associated with family conflict, school and peer stress, and community violence exposure (OR = 1.26, 95 % CI: 1.05-1.50; OR = 1.18, 95 % CI 1.08-1.28; and OR = 1.02, 95 % CI: 1.00-1.05, respectively). Identifying the associations between social, family, and community based stress and somatic symptoms may improve the quality of life for children living in urban environments through early identification and treatment.

Effect of urbanization on bird community in riparian environments in Caí River, Rio Grande do Sul, Brazil

OpenAIRE

Brummelhaus, Jaqueline; Bohn, Márcia Sueli; Petry, Maria Virginia

2012-01-01

http://dx.doi.org/10.5007/2175-7925.2012v25n2p81 Urbanization produces changes in riparian environments causing effects in the structure of bird communities, which respond differently to impacts. We compare richness, abundance and composition of birds in riparian environments with different urbanization gradients in Caí River, Rio Grande do Sul. We conducted observations in woodland, grassland and urban environments, between September/2007 and August/2008. We recorded 130 bird species, 29...

Breast Cancer Outreach for Underserved Women: A Randomized Trial and Cost-Effectiveness Analysis

National Research Council Canada - National Science Library

Pasick, Rena

1999-01-01

The current study, BACCIS-II, is a randomized controlled trial of an outreach intervention model designed to increase the rate of periodic mammography and clinical breast exam among underserved women...

An Exploratory Assessment of the Validity of the Community College Survey of Men (CCSM): Implications for Serving Veteran Men

Science.gov (United States)

De La Garza, Thomas; Wood, J. Luke; Harris, Frank, III

2015-01-01

The Community College Survey of Men (CCSM) assesses predictors of student success for historically underrepresented and underserved men in community colleges. The instrument is designed to inform programming and service-delivery for male students (Wood & Harris, 2013). While the instrument was designed for community college men in general,…

URBAN COMMUNITY RESPONSES TO VISUAL APPROPRIATE THEMATIC DESIGN, SUPER HERO PARK BANDUNG

Directory of Open Access Journals (Sweden)

Dian Duhita

2017-06-01

Full Text Available Parks is one of city public area that serves as a communal place for city community. On another perspective, parks is an architectural design that is designed with an aesthetic element to attract. Bandung, since a few years was to make improvements in various sectors, especially in the public space. Through the slogan Creative City, Bandung City Government revived communities part of the citizens by providing place for a activities, creation and production. Thematic Parks became one of the alternative approaches responsive design as part of creative cities development. Object of research study object is Super Hero park. The purpose of research is to analyzing the response of communities to design a thematic park. The study was conducted with a qualitative approach through participation observation method. The scope of the research includes visual appropriate and city community response. The conclussion obtain that visual appropriate are in accordance with the theme. Urban Community was able to respond well the identity of Super Hero park with visual appropriate design.

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

Science.gov (United States)

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Predictors of Faculty-Student Engagement for Black Men in Urban Community Colleges: An Investigation of the Community College Survey of Men

Science.gov (United States)

Wood, J. Luke; Newman, Christopher B.

2017-01-01

This research focuses on factors predicting faculty-student engagement for Black male collegians. In this study, the authors investigated whether students' perceptions of racial/gender stereotypes had a moderating effect on the determinants of engagement with faculty. The sample population was derived from 16 urban community colleges located…

Urban forest management in New England: Towards a contemporary understanding of tree wardens in Massachusetts communities

Science.gov (United States)

Harper, Richard W.; Bloniarz, David V.; DeStefano, Stephen; Nicolson, Craig

2017-01-01

In the New England states, tree wardens are local officials responsible for the preservation, maintenance and stewardship of municipal public trees. This study explores the emerging professional challenges, duties and responsibilities of tree wardens, from the subject’s point of view, by conducting in-person, semi-structured qualitative research interviews with 50 tree wardens throughout Massachusetts. Many of the findings corroborate previous literature, including that tree wardens are typically housed in a municipal department (often public works or highway), that tree wardens routinely interact with a wide variety of local organisations (representatives from other municipal departments, community volunteer associations) and that as community size increases, tree wardens typically have access to a greater pool of resources to carry out urban forest management. A newer finding is that the subject of urban forest health arose as a topic of great importance for tree wardens, as nearly all interviewees (n = 49) indicated that they monitor for urban forest pests and that they would like further continuing education concerning this subject.

ITEAMS: Increasing the Self-Identification for Girls and Underserved Youth in Pursuing STEM Careers

Directory of Open Access Journals (Sweden)

R. Bruce Ward

2012-02-01

Full Text Available We report early findings on the efficacy of a technology-based project in increasing self-identification for girls and underserved youth to self-select STEM (science, technology, engineering, and mathematics careers. ITEAMS (Innovative Technology- Enabled Astronomy for Middle Schools – an out-of-schooltime program with online, robotic telescopes as its central focus – targets girls and minority students underrepresented in STEMrelated vocations. The participating students attend urban schools in Eastern Massachusetts. ITEAMS’ twofold goal is to: a provide inspiration for the participants to pursue STEM careers, and b increase the students’ mastery of foundational subject matter so they are prepared for the rigor of further STEM study. We use an online system for surveys and assessments, the former to capture attitudinal changes about career choices, and the latter to assess the students’ subject matter knowledge. Participating students take pre-, intermediate, and post subject-matter tests and career-interest surveys. While we find statistically significant gains in subject matter knowledge free of gender, race, or school bias, we also find girls profess less interest than boys in STEM careers as early as grades five and six, although other attitudinal indicators suggest ways to reverse that trend.

Promising Practices: A Literature Review of Technology Use by Underserved Students

Science.gov (United States)

Zielezinski, Molly B.; Darling-Hammond, Linda

2016-01-01

How can technologies and digital learning experiences be used to support underserved, under-resourced, and underprepared students? For many years, educators, researchers, and policy makers looking for strategies to close the achievement gap and improve student learning have sought solutions involving new uses of technology, especially for students…

Depression among the urban poor in Peninsular Malaysia: a community based cross-sectional study.

Science.gov (United States)

Tan, Kok Leong; Yadav, Hematram

2013-01-01

This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.

The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations

OpenAIRE

Ying, Shi; Zeng, Dan-Ning; Chi, Liang; Tan, Yuan; Galzote, Carlos; Cardona, Cesar; Lax, Simon; Gilbert, Jack; Quan, Zhe-Xue

2015-01-01

Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urba...

Urinary Schistosomiasis in Urban and Semi-Urban Communities in South-Eastern Nigeria

Directory of Open Access Journals (Sweden)

Ogochukwu Caroline Okeke

2013-09-01

Full Text Available Background: In view of the massive rural-to-urban migration in Nigeria, investiga­tions on transmission of urinary schistosomiasis were carried out in ur­ban and semi-urban communities in Nike Lake area of Enugu State, Nigeria.Methods: Urine samples of school children were tested for micro-haematuria using reagent strips followed by microscopic examination for Schistosoma haemato­bium eggs. Water contact sites were also identified and sampled for snails.Results: The overall prevalence of S. haematobium eggs in school children was 4.64%. The mean intensity of infection was 1.14 + 0.41 eggs/10ml urine. Males had insignificantly higher prevalence and intensity of S. haematobium infec­tion than females. The youngest age group (4-7 years had no infection. The preva­lence of micro-haematuria (6.2% was higher than that of microscopy, and this correlated positively with prevalence (r=0.65, P < 0.01 and intensity (r=0.50, P < 0.01 of the infection. Potential intermediate host of human shistosome collected were: Bulinus globosus, B. senegalensis and Biomphalaria pfeifferi. How­ever, only B. globosus shed cercariae of S. haematobium, with a snail infection rate of 0.73%. Transmission was in the dry season coinciding with the drying of wells.Conclusion: The results revealed that urinary schistosomiasis is prevalent, and that B. globosus and not B. truncatus as previously reported is the main interme­diate host of urinary schistosomiasis in this part of Enugu State

Austin Community College District's P-16 Initiative Graduates America

Science.gov (United States)

Hensley, Mary; Madsen, Gary

2010-01-01

Austin Community College (ACC) District's P-16 Initiative supports partnerships with 30 school districts--reaching traditionally underserved students and bridging the gap between high school and college--so more Texas students can reach their educational goals. The P-16 Initiative is a constellation of efforts designed to provide broad-based…

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment.

Science.gov (United States)

Ward Thompson, Catharine; Aspinall, Peter; Roe, Jenny; Robertson, Lynette; Miller, David

2016-04-22

Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people's stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant's home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments.

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment

Directory of Open Access Journals (Sweden)

Catharine Ward Thompson

2016-04-01

Full Text Available Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant’s home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments.

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment

Science.gov (United States)

Ward Thompson, Catharine; Aspinall, Peter; Roe, Jenny; Robertson, Lynette; Miller, David

2016-01-01

Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant’s home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments. PMID:27110803

Species composition of forested natural communities near freshwater hydrological features in an urbanizing watershed of west-central Florida

Science.gov (United States)

Melissa H Friedman; Michael G.  Andreu; Wayne Zipperer; Rob J.  Northrop; Amr  Abd-Elrahman

2015-01-01

Natural communities near freshwater hydrological features provide important ecosystem functions and services. As human populations increase, forested landscapes become increasingly fragmented and deforested, which may result in a loss of the functions and services they provide. To investigate the current state of forested natural communities in the rapidly urbanizing...

Understanding Loan Use and Debt Burden among Low-Income and Minority Students at a Large Urban Community College

Science.gov (United States)

Luna-Torres, Maria; McKinney, Lyle; Horn, Catherine; Jones, Sara

2018-01-01

This study examined a sample of community college students from a diverse, large urban community college system in Texas. To gain a deeper understanding about the effects of background characteristics on student borrowing behaviors and enrollment outcomes, the study employed descriptive statistics and regression techniques to examine two separate…

Low prevalence of methicillin-resistant Staphylococcus aureus nasal carriage in urban and rural community settings in Bolivia and Peru.

Science.gov (United States)

Bartoloni, Alessandro; Pallecchi, Lucia; Fernandez, Connie; Mantella, Antonia; Riccobono, Eleonora; Magnelli, Donata; Mannini, Dario; Strohmeyer, Marianne; Bartalesi, Filippo; Segundo, Higinio; Monasterio, Joaquin; Rodriguez, Hugo; Cabezas, César; Gotuzzo, Eduardo; Rossolini, Gian Maria

2013-05-01

To investigate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage in rural and urban community settings of Bolivia and Peru. MRSA nasal carriage was investigated in 585 individuals living in rural and urban areas of Bolivia and Peru (one urban area, one small rural village, and two native communities, one of which was highly isolated). MRSA isolates were subjected to molecular analysis for the detection of virulence genes, characterization of the staphylococcal cassette chromosome mec (SCCmec), and genotyping (multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)). An overall very low prevalence of MRSA nasal carriage was observed (0.5%), with MRSA carriers being detected only in a small rural village of the Bolivian Chaco. The three MRSA isolates showed the characteristics of community-associated MRSA (being susceptible to all non-beta-lactam antibiotics and harboring the SCCmec type IV), were clonally related, and belonged to ST1649. This study provides an insight into the epidemiology of MRSA in community settings of Bolivia and Peru. Reliable, time-saving, and low-cost methods should be implemented to encourage continued surveillance of MRSA dissemination in resource-limited countries. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Effects of dance on depression, physical function, and disability in underserved adults.

Science.gov (United States)

Murrock, Carolyn J; Graor, Christine Heifner

2014-07-01

This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest-posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

Community access networks: how to connect the next billion to the ...

International Development Research Centre (IDRC) Digital Library (Canada)

Community access networks: how to connect the next billion to the Internet. Despite recent progress with mobile technology diffusion, more than four billion people worldwide are unconnected and have limited access to global communication infrastructure. The cost of implementing connectivity infrastructure in underserved ...

Phylogenetic and Functional Diversity of Total (DNA) and Expressed (RNA) Bacterial Communities in Urban Green Infrastructure Bioswale Soils.

Science.gov (United States)

Gill, Aman S; Lee, Angela; McGuire, Krista L

2017-08-15

New York City (NYC) is pioneering green infrastructure with the use of bioswales and other engineered soil-based habitats to provide stormwater infiltration and other ecosystem functions. In addition to avoiding the environmental and financial costs of expanding traditional built infrastructure, green infrastructure is thought to generate cobenefits in the form of diverse ecological processes performed by its plant and microbial communities. Yet, although plant communities in these habitats are closely managed, we lack basic knowledge about how engineered ecosystems impact the distribution and functioning of soil bacteria. We sequenced amplicons of the 16S ribosomal subunit, as well as seven genes associated with functional pathways, generated from both total (DNA-based) and expressed (RNA) soil communities in the Bronx, NYC, NY, in order to test whether bioswale soils host characteristic bacterial communities with evidence for enriched microbial functioning, compared to nonengineered soils in park lawns and tree pits. Bioswales had distinct, phylogenetically diverse bacterial communities, including taxa associated with nutrient cycling and metabolism of hydrocarbons and other pollutants. Bioswale soils also had a significantly greater diversity of genes involved in several functional pathways, including carbon fixation ( cbbL-R [ cbbL gene, red-like subunit] and apsA ), nitrogen cycling ( noxZ and amoA ), and contaminant degradation ( bphA ); conversely, no functional genes were significantly more abundant in nonengineered soils. These results provide preliminary evidence that urban land management can shape the diversity and activity of soil communities, with positive consequences for genetic resources underlying valuable ecological functions, including biogeochemical cycling and degradation of common urban pollutants. IMPORTANCE Management of urban soil biodiversity by favoring taxa associated with decontamination or other microbial metabolic processes is a

Implementing a Healthy Food Distribution Program: A Supply Chain Strategy to Increase Fruit and Vegetable Access in Underserved Areas.

Science.gov (United States)

DeFosset, Amelia R; Kwan, Allison; Rizik-Baer, Daniel; Gutierrez, Luis; Gase, Lauren N; Kuo, Tony

2018-05-24

Increasing access to fresh produce in small retail venues could improve the diet of people in underserved communities. However, small retailers face barriers to stocking fresh produce. In 2014, an innovative distribution program, Community Markets Purchasing Real and Affordable Foods (COMPRA), was launched in Los Angeles with the aim of making it more convenient and profitable for small retailers to stock fresh produce. Our case study describes the key processes and lessons learned in the first 2 years of implementing COMPRA. Considerable investments in staff capacity and infrastructure were needed to launch COMPRA. Early successes included significant week-to-week increases in the volume of produce distributed. Leveraging partnerships, maintaining a flexible operational and funding structure, and broadly addressing store owners' needs contributed to initial gains. We describe key challenges and next steps to scaling the program. Lessons learned from implementing COMPRA could inform other jurisdictions considering supply-side approaches to increase access to healthy food.

Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study

OpenAIRE

Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

2015-01-01

Objectives \\ud \\ud To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. \\ud \\ud Design\\ud \\ud Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. \\ud \\ud \\ud Setting \\ud \\ud Urban disadvantaged communities in the East Midlands of the UK. \\ud \\ud \\ud Participants \\...

Big Pharma on the Farm: Students Are Exposed to Pharmaceutical Marketing More Often in Rural Clinics.

Science.gov (United States)

Evans, David V; Keys, Toby; Desnick, Laurel; A Andrilla, C Holly; Bienz, Danielle; Rosenblatt, Roger

2016-07-01

Pharmaceutical marketing techniques are effective in changing the behavior of health care providers in ways that deviate from evidence-based practices. To mitigate the influence of pharmaceutical marketing on learners, academic medical centers (AMCs) have adopted policies to limit student/industry interaction. Many clinical experiences occur outside of the AMC. The purpose of this study was to compare medical students' exposure to pharmaceutical marketing in off-campus rural and urban underserved clinical sites. The University of Washington School of Medicine Rural and Underserved Opportunities Program (RUOP) places rising second-year medical students in underserved clinical sites in five northwestern states. We surveyed RUOP students to evaluate their exposure to pharmaceutical marketing. Of 120 students, 86 (72%) completed surveys. Sixty-five (76%) did their RUOP rotation in rural areas. Students in rural locations were more likely to report exposure to pharmaceutical marketing. Distribution of free drug samples was reportedly three times higher in rural than urban sites (54% versus 15%). Doctors meeting with sales representatives were reported as four times higher in rural clinics (40% versus 10%). Students at rural sites reported exposure to pharmaceutical marketing more than those in urban settings. Rural medical educators should provide faculty development for community clinicians on the influences of pharmaceutical marketing on learners. Medical schools must review local clinic and institution-wide policies to limit pharmaceutical marketing exposure to learners in the rural learning environment.

Smartphone threshold audiometry in underserved primary health-care contexts.

Science.gov (United States)

Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

2016-01-01

To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Area-level risk factors for adverse birth outcomes: trends in urban and rural settings.

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Kent, Shia T; McClure, Leslie A; Zaitchik, Ben F; Gohlke, Julia M

2013-06-10

Significant and persistent racial and income disparities in birth outcomes exist in the US. The analyses in this manuscript examine whether adverse birth outcome time trends and associations between area-level variables and adverse birth outcomes differ by urban-rural status. Alabama births records were merged with ZIP code-level census measures of race, poverty, and rurality. B-splines were used to determine long-term preterm birth (PTB) and low birth weight (LBW) trends by rurality. Logistic regression models were used to examine differences in the relationships between ZIP code-level percent poverty or percent African-American with either PTB or LBW. Interactions with rurality were examined. Population dense areas had higher adverse birth outcome rates compared to other regions. For LBW, the disparity between population dense and other regions increased during the 1991-2005 time period, and the magnitude of the disparity was maintained through 2010. Overall PTB and LBW rates have decreased since 2006, except within isolated rural regions. The addition of individual-level socioeconomic or race risk factors greatly attenuated these geographical disparities, but isolated rural regions maintained increased odds of adverse birth outcomes. ZIP code-level percent poverty and percent African American both had significant relationships with adverse birth outcomes. Poverty associations remained significant in the most population-dense regions when models were adjusted for individual-level risk factors. Population dense urban areas have heightened rates of adverse birth outcomes. High-poverty African American areas have higher odds of adverse birth outcomes in urban versus rural regions. These results suggest there are urban-specific social or environmental factors increasing risk for adverse birth outcomes in underserved communities. On the other hand, trends in PTBs and LBWs suggest interventions that have decreased adverse birth outcomes elsewhere may not be reaching

The rural community care gerontologic nurse entrepreneur: role development strategies.

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Caffrey, Rosalie A

2005-10-01

Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.

Prevalence Of Hypertension And Awareness Of The Causes And Effects Of Hypertension In Rural And Urban Communities Of Enugu State Nigeria

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Chinyere Okeke

2017-12-01

Full Text Available Developing countries face the double burden of communicable and non-communicable diseases and of the later hypertension is the most common. It is a major public health challenge with an ever increasing global prevalence which inherently increases the global disease burden whereas awareness of this disease and its determinants are poor. It contributes to about 500000 deaths every year. This was a cross-sectional descriptive community survey carried out in urban and rural communities of Enugu southeast Nigeria. A multi-staged sampling technique was used to recruit 260 participants and data was collected by administering questionnaires. Blood pressure measurement and weight of all the subjects were done. These were analysed using EPI info statistical software version 6.04. The result shows that the prevalence of hypertension in urban and rural areas was 15.4 and 13.8 respectively but was not statistically significantly different. About 17.6 and 23 were perceived hypertensives for urban and rural areas respectively. From the study 17 and 44.5 of urban and rural respondents respectively have suffered from hypertension related illnesses stroke kidney disease heart disease and eye problem. Approximately 45 of urban respondents and 83.7 of rural respondents believed that hypertension can be cured. The source of information and general knowledge of hypertension in urban and rural area was statistically significant pamp88040.05. In the urban area their method of cure include drugs and lifestyle modification while in the rural areas drugs and spiritual means was their way of curing the disease. Prevalence and awareness of hypertension is higher in the urban areas however both communities are grossly unaware of the hypertensive associated diseases. Proper health education is recommended to reduce the prevalence of complications of the disease change the trend and ultimately reduce the death in our environment.

Multi-scale factors influencing the characteristics of avian communities in urban parks across Beijing during the breeding season

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Xie, Shilin; Lu, Fei; Cao, Lei; Zhou, Weiqi; Ouyang, Zhiyun

2016-07-01

Understanding the factors that influence the characteristics of avian communities using urban parks at both the patch and landscape level is important to focus management effort towards enhancing bird diversity. Here, we investigated this issue during the breeding season across urban parks in Beijing, China, using high-resolution satellite imagery. Fifty-two bird species were recorded across 29 parks. Analysis of residence type of birds showed that passengers were the most prevalent (37%), indicating that Beijing is a major node in the East Asian-Australasian Flyway. Park size was crucial for total species abundance, but foliage height diversity was the most important factor influencing avian species diversity. Thus, optimizing the configuration of vertical vegetation structure in certain park areas is critical for supporting avian communities in urban parks. Human visitation also showed negative impact on species diversity. At the landscape level, the percentage of artificial surface and largest patch index of woodland in the buffer region significantly affected total species richness, with insectivores and granivores being more sensitive to the landscape pattern of the buffer region. In conclusion, urban birds in Beijing are influenced by various multi-scale factors; however, these effects vary with different feeding types.

Distinct responses of bacterial communities to agricultural and urban impacts in temperate southern African estuaries

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Matcher, G. F.; Froneman, P. W.; Meiklejohn, I.; Dorrington, R. A.

2018-01-01

Worldwide, estuaries are regarded as amongst the most ecologically threatened ecosystems and are increasingly being impacted by urban development, agricultural activities and reduced freshwater inflow. In this study, we examined the influence of different human activities on the diversity and structure of bacterial communities in the water column and sediment in three distinct, temperate permanently open estuarine systems within the same geographic region of southern Africa. The Kariega system is freshwater-deprived and is considered to be relatively pristine; the Kowie estuary is marine-dominated and impacted by urban development, while the Sundays system is fresh-water dominated and impacted by agricultural activity in its catchment. The bacterial communities in all three systems comprise predominantly heterotrophic species belonging to the Bacteroidetes and Proteobacteria phyla with little overlap between bacterioplankton and benthic bacterial communities at the species level. There was overlap between the operational taxonomic units (OTUs) of the Kowie and Kariega, both marine-influenced estuaries. However, lower species richness in the Kowie, likely reflects the impact of human settlements along the estuary. The dominant OTUs in the Sundays River system were distinct from those of the Kariega and Kowie estuaries with an overall decrease in species richness and evenness. This study provides an important snapshot into the microbial population structures of permanently open temperate estuarine systems and the influence of anthropogenic impacts on bacterial diversity and community structure.

Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

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Vivi Maketa

Full Text Available In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health

How Do Low-Income Urban African Americans and Latinos Feel about Telemedicine? A Diffusion of Innovation Analysis

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Sheba George

2012-01-01

Full Text Available Introduction. Telemedicine is promoted as a means to increase access to specialty medical care among the urban underserved, yet little is known about its acceptability among these populations. We used components of a diffusion of innovation conceptual framework to analyze preexperience perceptions about telemedicine to assess its appeal among urban underserved African Americans and Latinos. Methods. Ten focus groups were conducted with African American (=43 and Latino participants (=44 in both English and Spanish and analyzed for key themes. Results. Both groups perceived increased and immediate access to multiple medical opinions and reduced wait time as relative advantages of telemedicine. However, African Americans expressed more concerns than Latinos about confidentiality, privacy, and the physical absence of the specialist. This difference may reflect lower levels of trust in new health care innovations among African Americans resulting from a legacy of past abuses in the US medical system as compared to immigrant Latinos who do not have this particular historical backdrop. Conclusions. These findings have implications for important issues such as adoption of telemedicine, patient satisfaction, doctor-patient interactions, and the development and tailoring of strategies targeted to each of these populations for the introduction, marketing, and implementation of telemedicine.

A Smart Partnership: Integrating Educational Technology for Underserved Children in India

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Charania, Amina; Davis, Niki

2016-01-01

This paper explores the evolution of a large multi-stakeholder partnership that has grown since 2011 to scale deep engagement with learning through technology and decrease the digital divide for thousands of underserved school children in India. Using as its basis a case study of an initiative called integrated approach to technology in education…

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities

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Jenny Roe

2016-07-01

Full Text Available Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523 to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin, to ”good” health (white British, and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups, labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities

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Roe, Jenny; Aspinall, Peter A.; Ward Thompson, Catharine

2016-01-01

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities.

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Roe, Jenny; Aspinall, Peter A; Ward Thompson, Catharine

2016-07-05

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from "very good" health (people of Indian origin), to "good" health (white British), and "poor" health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled "Mixed BME" in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in "Mixed BME". Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an

Workplace physical violence among hospital nurses and physicians in underserved areas in Jordan.

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AbuAlRub, Raeda Fawzi; Al Khawaldeh, Abdullah Talal

2014-07-01

To: (1) examine the incidence, frequency and contributing factors to workplace violence among nurses and physicians in underserved areas in Jordan, and (2) identify the existing policies and the management modalities to tackle workplace violence. Workplace violence is a major problem in healthcare organisations. An understanding of the nature of violence is essential to implementing successful management. A descriptive exploratory research design. The questionnaire that was developed in 2003 by the International Labor Office, the International Council of Nurses, the World Health Organization, and the Public Services International was used to collect data from a convenience sample of 521 Jordanian physicians and nurses (396 nurses, 125 physicians) who worked in hospitals located in underserved areas. Around 15% of the participants were exposed to physical violence. The factors that contributed to workplace violence were related to absence of policies, inadequate staffing and lack of communication skills. Only 16·9% of participants indicated that there were specific policies available for dealing with physical workplace violence. Strengthening security and providing training were some of the important factors indicated by participants for decreasing violence in the workplace. Workplace violence is a problem in underserved areas that needs attention from administrators. Most participants were very dissatisfied with the way the administrators dealt with the incidents. Instituting firm policies against perpetrators and developing protective violence guidelines to support healthcare staff in managing workplace violence are paramount to tackle the problem of workplace violence. © 2013 John Wiley & Sons Ltd.

Impervious Surfaces Alter Soil Bacterial Communities in Urban Areas: A Case Study in Beijing, China

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Yinhong Hu

2018-02-01

Full Text Available The rapid expansion of urbanization has caused land cover change, especially the increasing area of impervious surfaces. Such alterations have significant effects on the soil ecosystem by impeding the exchange of gasses, water, and materials between soil and the atmosphere. It is unclear whether impervious surfaces have any effects on soil bacterial diversity and community composition. In the present study, we conducted an investigation of bacterial communities across five typical land cover types, including impervious surfaces (concrete, permeable pavement (bricks with round holes, shrub coverage (Buxus megistophylla Levl., lawns (Festuca elata Keng ex E. Alexeev, and roadside trees (Sophora japonica Linn. in Beijing, to explore the response of bacteria to impervious surfaces. The soil bacterial communities were addressed by high-throughput sequencing of the bacterial 16S rRNA gene. We found that Proteobacteria, Actinobacteria, Acidobacteria, Bacteroidetes, Chloroflexi, and Firmicutes were the predominant phyla in urban soils. Soil from impervious surfaces presented a lower bacterial diversity, and differed greatly from other types of land cover. Soil bacterial diversity was predominantly affected by Zn, dissolved organic carbon (DOC, and soil moisture content (SMC. The composition of the bacterial community was similar under shrub coverage, roadside trees, and lawns, but different from beneath impervious surfaces and permeable pavement. Variance partitioning analysis showed that edaphic properties contributed to 12% of the bacterial community variation, heavy metal pollution explained 3.6% of the variation, and interaction between the two explained 33% of the variance. Together, our data indicate that impervious surfaces induced changes in bacterial community composition and decrease of bacterial diversity. Interactions between edaphic properties and heavy metals were here found to change the composition of the bacterial community and

Higher Education and Urban Migration for Community Resilience: Indigenous Amazonian Youth Promoting Place-Based Livelihoods and Identities in Peru

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Steele, Diana

2018-01-01

This paper offers an ethnographic analysis of indigenous Peruvian Amazonian youth pursuing higher education through urban migration to contribute to the resilience of their communities, place-based livelihoods, and indigenous Amazonian identities. Youth and their communities promoted education and migration as powerful tools in the context of…

[Assessment on the short-term impact regarding the community-based interventions to improve physical activities in three urban areas of Hangzhou city].

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Gao, Fang; Liu, Qing-min; Ren, Yan-jun; He, Ping-ping; LV, Jun; Li, Li-ming

2013-06-01

To evaluate the short-term impact of comprehensive community based intervention on physical activity (PA) of adults living in the three urban communities of Hangzhou city. Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two urban areas (Xiacheng district and Gongshu district)and an urban area(Xihu district)as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the short-term impact of the intervention program. A total of 2016 adults at baseline and 2016 adults at follow-up stages, completed the survey, including 1016 adults from the intervention areas and 1000 from the comparison area. Over the two-year intervention period, the cognitive level on benefits of physical activity in the intervention areas were trending downward. The changes observed in the comparison area did not show statistical significance. Intervention areas showed a statistically significant increase (1204 vs. 1386, P = 0.023) in the level of physical activity(metabolic equivalent, MET-minutes/week)compared with the comparison area(918 vs. 924, P = 0.201). And results remained the same after eliminating the possible effects of age factor. After a two-year intervention, beneficial changes were noted in the intervention areas with respect to the level of physical activity. A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou.

History of community health center affiliations with The New England College of Optometry.

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Wilson, Roger; Sharda, Vandhana

2008-10-01

Since the 1970s, The New England College of Optometry (NECO) has been a leader in community-based educational programming. This was accomplished through the development of affiliation agreements with health care facilities that care for the underserved, notably community health centers (CHCs). The college's clinical system, the New England Eye Institute (NEEI), develops CHC programs, manages professional services agreements, initiates teaching affiliation agreements, and leads staff recruitment and retention efforts. CHC collaborations, which effectively address disparities in access to health care and visual health status, represent a significant component of the college's primary care clinical training venues. Since their inception in 1972, these CHC academic-community partnerships have provided more than 650,000 eye examinations to the underserved and have trained more than 3,200 graduates in community-based eye care, interdisciplinary care management environment, clinical prevention strategies, and population health. This report describes NECO's longstanding success with CHCs, explains the scope of practice at CHCs, explains how students are involved in the CHCs' eye care services, and discusses the various management and business arrangements. The benefits and challenges of CHC affiliations with optometry schools and colleges are also discussed.

Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

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Shah, Megha K.; Kieffer, Edith C.; Choi, Hwajung; Schumann, Christina; Heisler, Michele

2015-01-01

Background. Pregnancy is an opportune time to initiate diabetes prevention strategies for minority and underserved women, using culturally tailored interventions delivered by community health workers. A community-partnered randomized controlled trial (RCT) with pregnant Latino women resulted in significantly improved vegetable, fiber, added sugar,…

Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

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Ekúndayò, Olúgbémiga T; Tataw, David B

2013-01-01

This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi.

Examining community and consumer food environments for children: An urban-suburban-rural comparison in Southwestern Ontario.

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DuBreck, Catherine M; Sadler, Richard C; Arku, Godwin; Gilliland, Jason A

2018-05-08

The aim of this study is to evaluate how retail food environments for children in the City of London and Middlesex County, Ontario, Canada, vary according to level of urbanicity and level of socioeconomic distress. Urbanicity in this study is defined as a neighbourhood's designation as urban, suburban, or rural. We assessed community food environments (e.g., the type, location, and accessibility of food outlets) using 800m and 1600m network buffers (school zones) around all public and private elementary schools, and we calculated and compared density of junk food opportunities (JFO) (e.g., fast food and full-service restaurants, grocery stores, and convenience stores) within each school zone in urban, suburban and rural settings. The study also assessed consumer food environments (e.g., the price, promotion, placement, and availability of healthy options and nutrition information) through restaurant children's menu audits using the Children's Menu Assessment tool. Results suggest JFO density is greater around elementary schools in areas with higher levels of socioeconomic distress and urbanicity, while urbanicity is also associated with greater use of branded marketing and inclusion of an unhealthy dessert on children's menus. Copyright © 2018 Elsevier Ltd. All rights reserved.

Diversity analysis of bacterial community compositions in sediments of urban lakes by terminal restriction fragment length polymorphism (T-RFLP).

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Zhao, Dayong; Huang, Rui; Zeng, Jin; Yan, Wenming; Wang, Jianqun; Ma, Ting; Wang, Meng; Wu, Qinglong L

2012-11-01

Bacteria are crucial components in lake sediments and play important role in various environmental processes. Urban lakes in the densely populated cities are often small, shallow, highly artificial and hypereutrophic compared to rural and natural lakes and have been overlooked for a long time. In the present study, bacterial community compositions in surface sediments of three urban lakes (Lake Mochou, Lake Qianhu and Lake Zixia) in Nanjing City, China, were investigated using the terminal restriction fragment length polymorphism (T-RFLP) of PCR-amplified 16S rRNA gene and clone libraries. Remarkable differences in the T-RFLP patterns were observed in different lakes or different sampling stations of the same lake. Canonical correspondence analysis indicated that total nitrogen (TN) had significant effects on bacterial community structure in the lake sediments. Chloroflexi were the most dominant bacterial group in the clone library from Lake Mochou (21.7 % of the total clones) which was partly associated with its higher TN and organic matters concentrations. However, Bacteroidetes appeared to be dominated colonizers in the sediments of Lake Zixia (20.4 % of the total clones). Our study gives a comprehensive insight into the structure of bacterial community of urban lake sediments, indicating that the environmental factors played a key role in influencing the bacterial community composition in the freshwater ecosystems.

Preparing Historically Underserved Students for STEM Careers: The Role of an Inquiry-based High School Science Sequence Beginning with Physics

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Bridges, Jon P.

Improving the STEM readiness of students from historically underserved groups is a moral and economic imperative requiring greater attention and effort than has been shown to date. The current literature suggests a high school science sequence beginning with physics and centered on developing conceptual understanding, using inquiry labs and modeling to allow students to explore new ideas, and addressing and correcting student misconceptions can increase student interest in and preparation for STEM careers. The purpose of this study was to determine if the science college readiness of historically underserved students can be improved by implementing an inquiry-based high school science sequence comprised of coursework in physics, chemistry, and biology for every student. The study used a retrospective cohort observational design to address the primary research question: are there differences between historically underserved students completing a Physics First science sequence and their peers completing a traditional science sequence in 1) science college-readiness test scores, 2) rates of science college-and career-readiness, and 3) interest in STEM? Small positive effects were found for all three outcomes for historically underserved students in the Physics First sequence.

Evaluating Michigan's community hospital access: spatial methods for decision support

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Varnakovida Pariwate

2006-09-01

Full Text Available Abstract Background Community hospital placement is dictated by a diverse set of geographical factors and historical contingency. In the summer of 2004, a multi-organizational committee headed by the State of Michigan's Department of Community Health approached the authors of this paper with questions about how spatial analyses might be employed to develop a revised community hospital approval procedure. Three objectives were set. First, the committee needed visualizations of both the spatial pattern of Michigan's population and its 139 community hospitals. Second, the committee required a clear, defensible assessment methodology to quantify access to existing hospitals statewide, taking into account factors such as distance to nearest hospital and road network density to estimate travel time. Third, the committee wanted to contrast the spatial distribution of existing community hospitals with a theoretical configuration that best met statewide demand. This paper presents our efforts to first describe the distribution of Michigan's current community hospital pattern and its people, and second, develop two models, access-based and demand-based, to identify areas with inadequate access to existing hospitals. Results Using the product from the access-based model and contiguity and population criteria, two areas were identified as being "under-served." The lower area, located north/northeast of Detroit, contained the greater total land area and population of the two areas. The upper area was centered north of Grand Rapids. A demand-based model was applied to evaluate the existing facility arrangement by allocating daily bed demand in each ZIP code to the closest facility. We found 1,887 beds per day were demanded by ZIP centroids more than 16.1 kilometers from the nearest existing hospital. This represented 12.7% of the average statewide daily bed demand. If a 32.3 kilometer radius was employed, unmet demand dropped to 160 beds per day (1