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Community youth development is a challenging approach to youth work that focuses on the incorporation of new values at the practice, management, and community levels. This article explores the implementation of a community youth development approach within the context of learning organization theory, and describes the experiences of three youth-focused agencies making the transition to a community youth development approach.
A programme of community health development is reported from two villages in Haiti. It involves close cooperation between a district hospital, a local dispensary, and, most importantly, the inhabitants themselves. The programme is simple, financially realistic, adapted to local conditions, and linked to activities designed to meet basic requirements, such as those of food production and water supply.
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In South Africa, early lessons in primary health care were lost to sight and have been rediscovered only recently. Priorities need to be reassessed in order to better allocate resources to community needs. Developing and developed communities require different primary care services. Simple and effective epidemiological methods should be used to gather information required for planning and evaluation of services. In developing communities, where there is a shortage of doctors, trained nurses operate local clinics with the help of community workers. Community participation and the cooperation of the traditional healers are necessary. Appropriate training of personnel for an effective role in public health care is essential.
Oral rehydration therapy (ORT) has now been used successfully in many countries. The best indication of its effectiveness is a decrease in mortality, and this has been demonstrated in a number of studies in developing communities. In developed communities where mortality from acute diarrhoea is already low, ORT has been underutilised. Here, the general practitioner has a key role, and it is vitally important to appreciate that ORT is first-line treatment, with no place for drug therapy in most cases.
A collaborative effort of the Catholic Health Association (CHA) and the American Association of Homes for the Aging, The Social Accountability Program: Continuing the Community Benefit Tradition of Not-for-Profit Homes and Services for the Aging helps long-term care organizations plan and report community benefit activities. The program takes long-term care providers through five sequential tasks: reaffirming commitment to the elderly and others in the community; developing a community service plan; developing and providing community services; reporting community services; and evaluating the community service role. To help organizations reaffirm commitment, the Social Accountability Program presents a process facilities can use to review their historical roots and purposes and evaluate whether current policies and procedures are consistent with the organizational philosophy. Once this step is completed, providers can develop a community service plan by identifying target populations and the services they need. For facilities developing and implementing such services, the program suggests ways of measuring and monitoring them for budgetary purposes. Once they have implemented services, not-for-profit healthcare organizations must account for their impact on the community. The Social Accountability Program lists elements to be included in community service reports. It also provides guidelines for evaluating these services' effectiveness and the organization's overall community benefit role.
OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.
The Department of Health in Taiwan initiated community health development (CHD), a new approach to national community health care. Community-based research and evaluation approaches have recently been shifting from 'traditional' research to 'participatory' research. However, there is vagueness about the theoretical foundation of CHD and the appropriateness of using participatory action research (PAR) to evaluate CHD. This article explores theoretical concepts of CHD and discusses the compatibility of PAR and CHD in the theoretical and philosophical foundations. Community health development is a developing and changing process that involves both the social and the health contexts. It operates on the basis of three approaches to care: primary care, health promotion and community development. Partnership and empowerment between community health nurses and the community are concurrently involved in the entire process of CHD practice. The fundamental tenet of PAR focuses on the development of knowledge through partnership and empowerment between the researcher and the community, and the creation of critical consciousness leading to necessary action and effective change. Unlike empirical community-based research, PAR is flexible enough to capture an understanding of the complex social and health phenomena in the CHD framework. Furthermore, utilizing the PAR approach is appropriate not only for the methodological framework of the CHD evaluation, but also for the enhancement of the CHD actualization.
Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases self-reliance, self-awareness and confidence in self-examination of problems and seeking solutions for them. Behavioural changes are promoted and utilisation and support of services is facilitated, which are of great importance to all community health efforts, especially in areas where the incidence of HIV/AIDS is high or increasing. The purpose of this article is to explore community participation strategies adopted in different countries for providing community health care services. Recommendations are provided for enhancing community participation in developing countries.
The Healthy Communities 2000 mandate calls for public health leaders to involve community members in setting health priorities and implementing programs in response to the national health objectives for the year 2000 (American Public Health Association, 1991). This paper describes community involvement through a community empowerment nursing intervention and evaluates its application in a rural community. A community health nursing project (AHCPR, Grant No. HS06801) with three interventions, one of which was community empowerment, was designed to address the health needs of small, rural, underserved, primarily Mexican American communities in Arizona. Community empowerment in this project was based on the community-development approach to community organization, and involved community health nurses and lay health workers, called promotoras, who are key persons in community development. The implementation of two health fairs, one the result of the community-empowerment intervention, is described and evaluated in relation to community health. The community-empowerment intervention was based on community participation and responsibility, hallmarks of the second health fair, reflecting lay expertise and cooperation among various levels of the community. Successes and limitations of the health fairs provide feedback for developing a community-empowerment intervention.
This paper reports on a collaborative process to create an "aging prepared community" in a four county region. The process benefited from a generous grant from the John A. Hartford Foundation that supported an 18 month planning period which included input from service providers and a vast array of aging persons and their families, including particular efforts to reach underserved populations from multicultural, inner- city and rural communities. Under the umbrella of the Elder Network of the Capital Region, the process is now beginning its implementation period with foci on the following: linking health, social service and faith communities; developing accessible health education and wellness programs; creating and implementing a regional system of information and assistance; and mounting a media campaign.
The composition of animal communities developing from planktonic larvae in aquariums. A marked increase in the abundance of the annelid Polydora ligni in aquariums containing sand and flowing estuarine water was altered in the presence of the carbamate insecticide Sevin (carbaryl). Treatments were control and concentrations of Sevin that averaged 1.1, 11.1, and 103 micrograms/l; each treatment was replicated 8 times. Animals that colonized aquarium sand were collected in a 1-mm mesh sieve after 10 wk of exposure. Mollusks' arthropods, annelids, and nemerteans were the numerically dominant phyla. The average number of species per aquarium was significantly less (alpha = 0.05) in aquariums containing 11.1 or 103 micrograms/l than in those containing 1.1 micrograms/l or in control aquariums. The abundant clam Ensis minor grew significantly less in length at the higher concentrations of Sevin. The amphipod Corophium acherusicum was particularly affected; significantly fewer were found at all concentrations than in the control aquariums containing 103 micrograms/l corresponded to a marked decrease in the number of other annelids and to a significant absence of nemerteans.
Although continuing education in the health professions is an important endeavor, it has been largely neglected in the professional literature. Few studies have been done on (a) conceptual models to guide the design and implementation of continuing education and (b) the use of such models in continuing education. To fill this gap, two such models are described in this article: (a) instructional development and (b) community development. Combining and using these models can lead to more effective continuing education with more enduring effects. Principles to guide the implementation of these models are presented. An arthritis continuing education project based on the instructional and community development models is used to illustrate these principles. This continuing education project focused on occupational and physical therapists in clinical practice.
This article seeks to contribute to the debate about participation and health by presenting a framework for psychosocial interventions in primary health care. It highlights the social psychological dimensions of participation and the role it plays in improving conditions of living and thus health. The Freirean concepts of dialogue, recognition and conscientization, combined with understanding of local knowledge are suggested as guiding notions for psychosocial interventions seeking to enhance community participation and develop the local level. The article discusses the challenges as well as the potential gains experienced in the process of participation presented. It concludes by reaffirming the importance of participation and empowerment in health interventions struggling against health inequalities and seeking health for all.
The alliance of social work and theater is a natural and powerful coalition. The cooperation of two undergraduate programs to produce a preventive program on sexual abuse education reached over 4,000 children. Social work was the catalyst in terms of identifying the need, obtaining grant money, and developing community support. Theater provided the talent to produce an outstanding performance. Communities planning to develop successful prevention programs must develop community support, clear goals, a well-trained follow-up team, education for professionals who work with children daily, a clear channel for reporting abuse, and an evaluation process. The use of volunteers keeps the cost of the project to a minimum.
In this paper the author argues that the development of community psychiatric nursing can be understood as a professional project. However, the case of community psychiatric nursing cannot be adequately understood from mainstream literature on the subject of professionalization within the health care division of labour. The inadequacy of such literature is that it either concentrates upon the pre-eminent case of medicine or regards nursing's professionalization as being unitary. The author posits that the professional projects of general nursing and community psychiatric nursing have different and even opposing interests. To contextualize community psychiatric nurses' (CPNs') professional project the author examines: the history of mental nursing, from which community psychiatric nursing evolved; the development of community mental health care, which allowed for the inception of community psychiatric nursing; CPNs' relationships with both psychiatrists, whose patronage assisted CPNs' initial growth as para-professionals, and general practitioners, who later assisted a more functionally autonomous role for CPNs in primary care; and social policy towards community care that enhanced CPNs' growth. In conclusion the author argues that recent government-led changes in the management of community mental health care now impel CPNs to change the direction of their strategy for occupational survival and advancement.
Seasonal shifts in bacterioplankton community composition in Toolik Lake, a tundra lake on the North Slope of Alaska, were related to shifts in the source (terrestrial versus phytoplankton) and lability of dissolved organic matter (DOM). A shift in community composition, measured by denaturing gradient gel electrophoresis (DGGE) of 16S rRNA genes, occurred at 4 degrees C in near-surface waters beneath seasonal ice and snow cover in spring. This shift was associated with an annual peak in bacterial productivity ([(14)C]leucine incorporation) driven by the large influx of labile terrestrial DOM associated with snow meltwater. A second shift occurred after the flux of terrestrial DOM had ended in early summer as ice left the lake and as the phytoplankton community developed. Bacterioplankton communities were composed of persistent populations present throughout the year and transient populations that appeared and disappeared. Most of the transient populations could be divided into those that were advected into the lake with terrestrial DOM in spring and those that grew up from low concentrations during the development of the phytoplankton community in early summer. Sequencing of DNA in DGGE bands demonstrated that most bands represented single ribotypes and that matching bands from different samples represented identical ribotypes. Bacteria were identified as members of globally distributed freshwater phylogenetic clusters within the alpha- and beta-Proteobacteria, the Cytophaga-Flavobacteria-Bacteroides group, and the ACTINOBACTERIA:
With the growing consumer participation movement and the emphasis in health care shifting from hospital to community, the term community development is cropping up more and more. Yet the concept of community development has always been integral to public health nursing. Simply put, community development is a process by which a community identifies its needs and assumes ownership of decision-making and subsequent action surrounding those needs. By integrating community development principles into their work with two neighboring communities, nurses with Calgary Health Services facilitated the establishment of a much-needed parent support group.