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PubMed1997

HIV prevention and community-based organizations in Japan.

The first AIDS-related community-based organizations (CBOs) in Japan emerged in the 1980s for persons who contracted HIV through infected blood products. Since then, more than 50 CBOs have been established to reach out to all HIV-infected persons. Most are centered in Tokyo. CBO activities include telephone hotlines, "buddy services," support groups, lobbying efforts, and outreach and prevention activities. Adequate funding continues to be a challenge, although progress has been made in soliciting funds from corporations (often foreign) and, increasingly, from the government. Networking of CBOs has allowed consolidation of funds and efforts, resulting in greater efficiency. Among the tasks that lie ahead for AIDS CBOs are linking family, medical, and social services into a comprehensive care network.

Community Networks↗
PubMed2002

Feedback with soil biota contributes to plant rarity and invasiveness in communities.

Understanding the relative abundance of species in plant communities is an unsolved problem. Mechanisms such as competition, resource partitioning, dispersal ability and predation tolerance do not adequately explain relative abundance under field conditions. Recent work suggests that interactions between plants and soil microbes is important. Here I show that such interaction explains a significant proportion of the variance in the relative abundance of species in plant communities. Rare plants exhibited a relative decrease in growth on 'home' soil in which pathogens had had a chance to accumulate, whereas invasive plants benefited from interactions with mycorrhizal fungi. Some plant species accumulate pathogens quickly and maintain low densities as a result of the accumulation of species-specific pathogens, whereas others accumulate species-specific pathogens more slowly and do not experience negative feedback until plant densities reach high levels. These results indicate that plants have different abilities to influence their abundance by changing the structure of their soil communities, and that this is an important regulator of plant community structure.

Canada↗
PubMed2006

Process evaluation of a Dutch community intervention to improve health related behaviour in deprived neighbourhoods.

OBJECTIVES: To assess whether a community intervention on health related behaviour in deprived neighbourhoods was delivered as planned and the extent of exposure to the intervention programme. METHODS: Data were gathered throughout the intervention period using minutes of meetings, registration forms and a postal questionnaire among residents in intervention and comparison neighbourhoods. RESULTS: Overall, the intervention was delivered according to the key principles of a "community approach", although community participation could have been improved. Neighbourhood coalitions organized more than 50 health related activities in the neighbourhoods over a two-year period. Most activities were directed at attracting attention, providing information, and increasing awareness and knowledge, and at changing behaviours. Programme awareness and programme participation were 24% respectively 3% among residents in the intervention neighbourhoods. CONCLUSIONS: The process evaluation indicated that it was feasible to implement a community intervention according to the key principles of the "community approach" in deprived neighbourhoods. However, it is unlikely that the total package of intervention activities had enough strength and sufficient exposure to attain community-wide health behaviour change.

Adolescent↗
PubMed2004

Emergency room injury presentations as an indicator of alcohol-related problems in the community: a multilevel analysis of an international study.

OBJECTIVE: This study describes and examines the development of surrogate measures of acute alcohol-related injury for use in the evaluation of community-based prevention initiatives. METHOD: An international collaborative study of alcohol and injury, the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), provided a subset of data on 8580 emergency room (ER) presentations from five countries and 28 ER facilities. RESULTS: Presentations most likely to be alcohol related were those made between 12:00 AM and 4:59 AM (56%), on Fridays, Saturdays or Sundays (26%); and those among injured persons who were male (28%), who were aged between 18 and 45 years (24%) or who were unmarried (24%). Multilevel logistic regression models confirmed the significance of the above variables as predictors of alcohol involvement prior to the injury event. The strongest predictor variable was presentation between 12 midnight and 4:59 AM with an odds ratio of 4.92 (Wald Test chi2 = 397.6, p < .001). Being male had an odds ratio of 3.01 (Wald Test chi2 = 247.25, p < .001), and presenting on a Friday, Saturday or Sunday night had an odds ratio of 1.50 (Wald Test chi2 = 49.6, p < .001), whereas being under 45 (odds ratio [OR] = 1.20, p < .05) and being unmarried (OR = 1.2, p < .01) were less strong predictors. Combining all these values for variables raised the probability of prior alcohol involvement in such injury presentations to 0.65, although only 3.37% of all cases met these criteria, limiting applicability of this combined variable as a surrogate measure for intervention studies. Probabilities of prior alcohol involvement are presented with other combinations of values for the predictor variables. CONCLUSIONS: Frequency of nighttime injury presentations to ER facilities, particularly by men, can be used as a reliable surrogate measure of alcohol-related injuries for various epidemiological and evaluation purposes.

Accidents↗
PubMed2004

[Seasonal dynamics of arthropod community diversity, evenness and relative stability in peach orchards].

This study showed that the diversity index of total arthropod community in peach orchards was significantly correlated to the diversity index of both phytophages (r = 0.9480) and predators sub-communities (r = 0.7855), and the two sub-communities were correlative (r = 0.6741). It was also significantly correlated to the evenness index of total community (r = 0.7870), but not correlated to the evenness index of both sub-communities. The diversity index (H') of total community was significantly correlated to the ratio of predators individuals (Sd) and phytophages individuals (Sz) (r = 0.8112) and of species (Ss) and individuals (Si) (r = 0.9188), but not correlated to the ratio of predators (Spl) and phytophages (Szl).

Animals↗
PubMed2004

Direct costs of schizophrenia and related disorders in Italian community mental health services: a multicenter, prospective 1-year followup study.

The behavior that accompanies schizophrenia and related disorders interferes with professional and social activities. As a result, schizophrenia is one of the most costly psychiatric illnesses. Direct medical costs associated with schizophrenia were estimated from the Italian National Health Service perspective. This was a multicenter observational 1-year study conducted in 14 Italian community mental health centers (CMHCs). Eligible patients were those with a diagnosis of schizophrenia or schizoaffective or schizophreniform disorder who had been followed by the CMHCs for at least 2 years at study entry. Exactly 643 patients were enrolled in the study. The mean direct cost per year was 6,964 (27,025 for schizophrenia and 6,587 for patients with related psychotic disorders) (1998 exchange rate U.S.$1 = 1.121). The present study provides further estimates of the cost of schizophrenia treatment in Italian mental health services and highlights the variability in the single cost components across clinically defined subgroups of patients.

Adult↗
PubMed2004

Drug related problems identified by European community pharmacists in patients discharged from hospital.

INTRODUCTION: Drug related problems (DRPs) are perceived to occur frequently when patients are discharged from the hospital. Community pharmacists' interventions to detect, prevent and solve DRPs in this population are scarcely studied. OBJECTIVE: To examine the nature and frequency of DRPs in community pharmacies among patients discharged from hospitals in several countries, and to examine several variables related to these drug related problems. METHOD: The study was performed in 112 community pharmacies in Europe: Austria, Denmark, Germany, The Netherlands, Portugal and Spain. Community pharmacists asked patients with a prescription after discharge from hospital between February and April 2001 to participate in the study. A patient questionnaire was used to identify drug related problems. Pharmacists documented drug related problems, pharmacy interventions, type of prescriber and patient and pharmacy variables. RESULTS: 435 patients were included in the study. Drug related problems were identified in 277 patients (63.7%). Uncertainty or lack of knowledge about the aim or function of the drug (133; 29.5%) and side effects (105; 23.3%) were the most common DRPs. Practical problems were reported 56 times (12.4%) by patients. Pharmacists revealed 108 problems (24.0%) concerning dosage, drug duplication, drug interactions and prescribing errors. Patients with more changes in their drug regimens (drugs being stopped, new drugs started or dosage modifications) and using more drugs were more likely to develop DRPs. Community pharmacists recorded 305 interventions in 205 patients with DRPs. Pharmacists intervened mostly by patient medication counselling (39.0%) and practical instruction to the patient (17.7%). In 26.2% the intervention was directed towards the prescriber. In 28 cases (9.2%) the pharmacists' intervention led to a change of the drug regimen. CONCLUSION: This study shows that a systematic intervention by community pharmacists in discharged patients, or their proxies, is able to reveal a high number of DRPs that might be relevant for patient health outcomes. There should be more initiatives to insure continuity of care, since DRPs after discharge from hospital seem to be very common.

Aged↗
PubMed2006

A novel model of organic waste composting in Taiwan military community.

The relatively large quantities of waste generated daily in military barracks pose a significant impact on environments in this small island of Taiwan due to limited land and crowded populations. In order to find a suitable handling method to the barracks' characteristics in Taiwan, a comprehensive selection model for various barracks carrying out waste composting was established through personal interviews and questionnaire data analyses on the military barracks. From this, the basic data for this research was also built, to evaluate the experiences and management practices in these facilities. This study found that environmental responsibility and expertise are the primary concerns and considerations among all of the military units when doing waste composting. Support of the commander, organizational image and human resource/facilities are also concerns. To offer the military barracks a selection model and policy guidelines for the waste composting treatment, an itemized score evaluation standard and a selecting chart of composting recycling methods were designed by combining the practical experimental results with economic considerations, waste classification, and Delphi expert technique.

Conservation of Natural Resources↗
PubMed2002

Soy and fish oil intake and mortality in a Japanese community.

The relation between intake of fish and soy products and subsequent all-cause and cause-specific mortality was examined in a cohort of 13,355 male and 15,724 female residents of Takayama, Gifu, Japan. A diet that included soy and fish intake was assessed in 1992 by using a validated semiquantitative food frequency questionnaire. Over 7 years of follow-up, 2,062 participants (1,163 men and 899 women) died. For men, the highest compared with the lowest quintile of total soy product intake was marginally significantly inversely associated with total mortality after adjustment for total energy and nondietary covariates (hazard ratio = 0.83, 95% confidence interval: 0.69, 1.01; p for trend = 0.07). After adjustment for nondietary covariates, a decreased hazard ratio for the highest compared with the lowest quintile of total soy product intake was also observed for women (hazard ratio = 0.83, 95% confidence interval: 0.68, 1.02; p for trend = 0.04). Additional adjustment for dietary factors significantly associated with total mortality did not attenuate these associations. For women but not for men, n-3 fatty acids from fish were significantly inversely associated with total mortality. Results showed that soy intake may have moderate but beneficial effects on total mortality.

Adult↗
PubMed2005

Health protection and age-related legislation.

Community children's nurse Debbie James has developed an innovative scheme to allow secondary school children to obtain health advice by texting her service using mobile phones. As well as general advice about spots and rubella immunization, Sister James is also receiving inquiries about children's legal rights that also have a health protection purpose, such how old a child has to be before owning a pet or have an alcoholic drink. This article looks at how the law seeks to protect children by incrementally giving them legal rights as they develop to mature adults and how legal awareness can help inform community health practitioners' advice to their child clients.

Adolescent↗
PubMed1990

Aspects of community-based nutritional intervention.

A number of aspects are discussed in relation to community-based nutrition intervention projects. This includes the application of different intervention measures, the used of anthropometric indicators, and the methods of immediate and final data evaluation.

Child↗
PubMed2000

A campus-community coalition to control alcohol-related problems off campus: an environmental management case study.

The authors report on the effects of a university and community coalition in preventing problems related to college students' off-campus drinking. The Albany, New York, Committee on University and Community Relations used strategies based on an environmental-management approach that focuses on changing the environment in which individuals make decisions about alcohol consumption and related behaviors. Committee initiatives included improving enforcement of local laws and ordinances, creating a safety-awareness campaign for off-campus students, and developing a comprehensive advertising and beverage-service agreement with local tavern owners. The initiatives were associated with a decline in the number of alcohol-related problems in the community, as indicated by decreases in the number of off-campus noise ordinance reports filed by police and the number of calls to a university-maintained hotline for reporting off-campus problems. An environmental management approach, the authors suggest, has promise as an effective means of preventing alcohol-related problems among college students.

Alcoholic Intoxication↗
PubMed1981

Occurrence of four types of growth hormone-related dwarfism in Israeli communities.

Data are presented on 121 dwarfed patients belonging to 98 Israeli families with 4 types of dwarfism related to deficiency or in activity of human growth hormone (hGH): isolated growth hormone deficiency (IGHD), partial hGH deficiency (pIGHD), multiple pituitary hormone deficiencies (MPHD) and Laron-type dwarfism (LTD). These series are believed to comprise most of the dwarfs of these types in Israel; however, their distribution among the various ethnic communities varies greatly: LTD (15 families) is confined to a few communities of Oriental Jews; only 3 of 30 families with IGHD, but 7 of 10 families with pIGHD, are Ashkenazi, whereas the clinic distribution of 42 families with MPHD corresponds roughly to that of the general population. These data seem to reflect the role of genetic factors in the etiology of the various types of dwarfism: the stronger the genetic component, the greater is its deviation from random occurrence among the various communities.

Dwarfism, Pituitary↗
PubMed2000

[Functional changes in one-year and related factors among community-dwelling frail elderly].

PURPOSE: The purpose of this study was to investigate physical and psychosocial characteristics together with life activities related to functional changes among frail elderly, including J-rank individuals able to walk outdoors and take a bus as well as people of A-rank capable of moving around inside the house but incapable of going outside. METHODS: The study design was of longitudinal type. Participants were community-dwelling frail elderly, 61 J-rank and 90 A-rank individuals aged over 65-years and caregivers. Nurses conducted home interviews as Wajima City, Ishikawa Prefecture in Japan, in 1998 at the baseline and 1999 at follow-up, and evaluated the degree of independence of the frail elderly. With the baseline survey, physical function, psychosocial characteristics, and life activities were assessed. RESULTS: At the follow-up survey, 3.3% people of J-rank elderly had died and 83.6% were at home. Among the A-rank elderly, 11.1% had died and 80.6% were at home. Functional change in one-year was as follows: 31.4% people of J-rank had declined and 68.6% remained the same. 19.4% people of A-rank improved, 65.3% unchanged, and 15.3% declined. Among J-rank elderly, functional decline was significantly related to low ADL level and less verbal contact with their caregivers. Life activities such as getting out to the garden or around the house, worshipping at a temple, doing house chores, shopping, and gardening, related to maintained function. Among A-rank elderly with the low ADL, function similarity declined. Life activities such as visiting friends, gardening, and performing self-care chores were significantly linked to improvement. CONCLUSIONS: The results suggest that the degree of independence of frail elderly may easily change. ADL is related to functional change among frail elderly of both A and J rank. It is recommended that facilitating activities like house chores or getting out the house for J-rank individuals and self-care for A-rank elderly is important to prevent functional decline. Preventive community-based care for frail elderly should therefore be directed of supporting their active life.

Activities of Daily Living↗
PubMed2006

Age and racial/ethnic differences in drinking and drinking-related problems in a community sample of lesbians.

OBJECTIVE: Although research on alcohol use among women has increased dramatically during the past several decades, relatively few studies have focused on lesbians, and almost none have included sufficient numbers of older lesbians or lesbians of color to permit comparative analyses. Using data from the Chicago Health and Life Experiences of Women Study (CHLEW), we examined drinking patterns and problems in a large and diverse sample of lesbians. METHOD: Structured interviews were conducted with 447 community-residing adult women (ages 18-83) who self-identified as lesbians (48% non-Hispanic white, 28% non-Hispanic black, and 20% Hispanic/Latina; the remainder were in the "other" category). We used multivariate logistic regressions to examine and compare the prevalence of lifetime and 12-month problem-drinking indicators across four age and three racial/ethnic groups. RESULTS: Unlike findings from general population surveys, in which women's rates of drinking tend to decrease with age, we found relatively few differences across the four age groups of CHLEW respondents. We also found no significant differences between Hispanic and white lesbians on any of the lifetime or 12-month problem-drinking indicators and only a few significant differences between white and black lesbians. CONCLUSIONS: As with heterosexual women, patterns of drinking and drinking-related problems among lesbians vary by age and race/ ethnicity. However, given our findings of substantially smaller variations among lesbians than among women in the general population, research is needed that examines in greater depth the intersections between age, race/ethnicity, sexual orientation, and drinking. Understanding how these sociocultural factors interact with each other and with other known risk factors is important for identifying population groups at greatest risk for developing alcohol-related problems.

Adolescent↗