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PubMed1989

Community care workers in rural southern Illinois: job satisfaction and implications for employee retention.

This study examined factors related to community care worker job satisfaction, as a method of assessing problems related to employee turnover, based on data collected from 393 community care workers who worked with elderly clients from the 13 southernmost rural counties in Illinois in 1987. Results suggested that the majority of workers were satisfied with their job; however, there was a difference in the mean scores of those employed for more than one year and those employed for less than one year (those employed for longer than one year had significantly lower satisfaction scores than those employed for less than one year). Although only 19 individuals indicated they were intending to quit within the year, 88 respondents answered "no opinion." Reasons given why new employees quit were: low wages, no benefits, no raises or promotions, cannot cope with the elderly, do not like the elderly, or not well-suited for this type of work. Also, many of the workers responded that people quit because the job was not what they expected, they did not give it a chance, they did not receive the proper training, and that the job was too stressful or frustrating. Recommendations made on the basis of these study data include the development of a new job hierarchy (which will increase the probability of being promoted) and more detailed pre-service training program which covers in detail what new employees can expect from the job. Health education training programs are recommended as a major tool for reducing the problem of employee turnover by helping the worker manage the high levels of stress experienced on the job.

Adult↗
PubMed1993

The growth of Chinese minority populations.

This is a review of recent demographic trends among the 55 recognized minority ethnic groups in China, which have a total population of 91.2 million. Reasons for the rapid growth among many of these populations since the 1960s are analyzed. They include "the significant improvement of public health in the 1950s and 1960s, the leniency in the implementation of the birth control policies in minority communities, the relatively high birth and fertility rates in these communities, and the reaffirmation of racial identity in the 1980s."

Asia↗
PubMed2003

Temporal patterns in bacterial communities in three temperate lakes of different trophic status.

Despite considerable attention in recent years, the composition and dynamics of lake bacterial communities over annual time scales are poorly understood. This study used automated ribosomal intergenic spacer analysis (ARISA) to explore the patterns of change in lake bacterial communities in three temperate lakes over 2 consecutive years. The study lakes included a humic lake, an oligotrophic lake, and a eutrophic lake, and the epilimnetic bacterial communities were sampled every 2 weeks. The patterns of change in bacterial communities indicated that seasonal forces were important in structuring the behavior of the bacterial communities in each lake. All three lakes had relatively stable community composition in spring and fall, but summer changes were dramatic. Summertime variability was often characterized by recurrent drops in bacterial diversity. Specific ARISA fragments derived from these lakes were not constant among lakes or from year to year, and those fragments that did recur in lakes in different years did not exhibit the same seasonal pattern of recurrence. Nonetheless, seasonal patterns observed in 2000 were fairly successful predictors of the rate of change in bacterial communities and in the degree of autocorrelation of bacterial communities in 2001. Thus, seasonal forces may be important structuring elements of these systems as a whole even if they are uncoupled from the dynamics of the individual system components.

Bacteria↗
PubMed1984

Natural history of borderline hypertension in the Hisayama community, Japan--I. The relative prognostic importance of transient variability in blood pressure.

Long-term prognosis of borderline hypertensives was studied in a prospective population survey carried on since 1961 in the town of Hisayama, Japan. Five consecutive BP recordings on 1621 subjects aged 40 and over were obtained at entry, and the variability in BP between the first and fifth readings was taken into account when classifying the subject into categorical groups. Even with an estimated variability in BP in several measurements on one occasion, a large fluctuation in BP was observed in both the borderline hypertensives and the normotensives. Borderline hypertensives with a transient elevation in BP more frequently died from cardiovascular disease than did those without BP elevation, as estimated by the long-term cumulative mortality. However, there was no difference in the frequency of hypertension-related organ damage between these two groups at entry.

Adult↗
PubMed1989

Knowledge, attitudes and practices among rural communities in Zimbabwe in relation to Phytolacca dodecandra--a plant molluscicide.

Questionnaires about schistosomiasis and Phytolacca dodecandra, a plant molluscicide with potential to control schistosomiasis transmitting snails, were administered to 271 women and 168 men in two communal areas where the plant grows naturally, and in a further two areas where no records of the plant exist. 78.9% of the respondents thought that schistosomiasis was a dangerous disease with blood in urine being the most recognised symptom. 11.8% said that snails were involved in the transmission of the disease, although their role in sustaining the life cycle of the schistosome parasite was not understood. Knowledge about P. dodecandra was restricted to people resident in areas where the plant grows naturally and to immigrants from areas where it is known to grow. The most common use of the plant was as a floor polish. Knowledge of uses of the plant were found to be related to the sex of the respondents. Seventy-seven percent of the people interviewed were prepared to cultivate the plant for self-help schistosomiasis control programmes. Of the 23% that were not willing to cultivate P. dodecandra, 47.7% cited scarcity of land as the main obstacle. Other reasons were lack of knowledge about the plant (21%), lack of confidence in the success of such self-help programmes (11.2%) and indifference due to old age (20%).

Animals↗
PubMed2002

Impact of acid mine drainage on benthic communities in streams: the relative roles of substratum vs. aqueous effects.

Restoration of streams impacted by acid mine drainage (AMD) focuses on improving water quality, however precipitates of metals on the substrata can remain and adversely affect the benthos. To examine the effects of AMD precipitates independently of aqueous effects, four substrata treatments, clean sandstone, clean limestone, AMD precipitate-coated sandstone and coated limestone, were placed in a circumneutral stream of high water quality for 4 weeks. Iron and Al were the most abundant metals on rocks with AMD precipitate. and significantly decreased after the exposure. Precipitate on the substrata did not significantly affect macroinvertebrate or periphyton density and species composition. In an additional experiment, percent survival of caged live caddisflies was significantly lower when exposed in situ for 5 days in an AMD affected stream than in a reference stream. Caddisfly whole-body concentrations of all combined metals and Fe alone were significantly higher in the AMD stream. Whole-body metal concentrations were higher in killed caddisflies than in live, indicating the importance of passive uptake. The results suggest the aqueous chemical environment of AMD had a greater affect on organisms than a coating of recent AMD precipitate on the substrata (ca. 0.5 mm thick), and treatment that improves water quality in AMD impacted streams has the potential to aid in recovery of the abiotic and biotic benthic environment.

Animals↗
PubMed1996

Managing dementia-related behavior in the community.

Inappropriate use or insufficient monitoring of psychotropic agents can have deleterious effects in dementia patients. HCFA regulations serve as a useful guide to the appropriate use of psychotropic agents for dementia patients in the community. A sizeable portion of caregivers are not trained to correctly identify the adverse effects of psychotropic agents. Acting in an advisory role, the pharmacist is a key member of the patient management team.

Anti-Anxiety Agents↗
PubMed1975

A community study of the relation of alpha1-antitrypsin levels to obstructive lung diseases.

Since it is still uncertain whether moderate degrees of alpha1-antitrypsin deficiency predispose to the development of lung disease, data obtained from a stratified random sample of white households in Tucson, Arizona, consisting of 2586 subjects over five years of age, were analyzed. No relation was found between serum alpha1-antitrypsin levels, measured as trypsin inhibitory capacity, and ventilatory function, respiratory symptomatology, or frequency of diagnosed pulmonary diseases even among cigarette smokers. The data indicate that an intermediate level of alpha1-antitrypsin deficiency (i.e., inhibitory capacity between 20 and 62 per cent of the population's mean value) is not an important risk factor for the development of chronic obstructive lung diseases. The data militate strongly against the use of any quantitative determination of alpha1-antitrypsin as a test to identify subjects with moderate deficiency for the purpose of predicting later development of chronic respiratory disorders. The rate of severe deficiency is so low as to make population screening for such subjects impractical.

Adolescent↗
PubMed1996

Multiple infection with Plasmodium and helminths in communities of low and relatively high socio-economic status.

A study was conducted in the city of Lubumbashi, Zaire: (1) to survey parasitic infections and clinical conditions in the local children and their mothers; (2) to identify combinations of parasites and clinical conditions that commonly occurred together in individuals; and (3) to determine whether single- and/or multiple-species infections were risk determinants of the observed clinical conditions. Overall, 1100 children and mothers from three subdivisions, two of low socio-economic status (LSES) and one of relatively high socio-economic status (HSES), provided stool and blood samples and were clinically examined. Plasmodium prevalence was higher in the two LSES subdivisions than in the HSES subdivision. Prevalence and intensity of Ascaris lumbricoides infection were low in the HSES subdivision and one of the two LSES subdivisions. In contrast, prevalence and intensity of Trichuris trichiura and of hookworms were similar in all subdivisions. Plasmodium and A. lumbricoides were the most frequently found single-species infections. The combination of A. lumbricoides and Plasmodium was the most frequent double-species infection and that of A. lumbricoides, Plasmodium and T. trichiura was the most frequent triple-species infection. Significant positive associations between parasite species were detected in the HSES subdivision, and in one of the two LSES subdivisions. Because the relationships were not consistently detected, it is hypothesized that the associations are determined by environmental conditions rather than synergy between the parasites in the host. The most commonly observed clinical conditions were abdominal pain, diarrhoea, fever, and low packed-cell volume (PCV). The occurrence of each was significantly lower in the HSES subdivision than in at least one of the two LSES subdivisions. Abdominal pain and low PCV were most common in individuals presenting with only a single clinical condition, and the combination of this symptom and sign was the most commonly observed pair of conditions. Abdominal pain, low PCV and diarrhoea was the most common combination in individuals with three clinical conditions. Logistic regression revealed that hookworm infection, T. trichiura infection, young age and residence in an LSES subdivision were determinants of diarrhoea. Trichuris trichiura infection, young age and living in an LSES subdivision were risk factors for abdominal pain. Plasmodium infection and young age were risk factors for fever. LSES was the only predictor of low PCV. Infection with A. lumbricoides did not enter any of the models. No significant interactions were detected among parasites, indicating that there was no synergism or antagonism among parasites in the induced disease.

Adolescent↗
PubMed2004

A tale of two cities: community psychobehavioral surveillance and related impact on outbreak control in Hong Kong and Singapore during the severe acute respiratory syndrome epidemic.

OBJECTIVES: To compare the public's knowledge and perception of SARS and the extent to which various precautionary measures were adopted in Hong Kong and Singapore. DESIGN: Cross-sectional telephone survey of 705 Hong Kong and 1,201 Singapore adults selected by random-digit dialing. RESULTS: Hong Kong respondents had significantly higher anxiety than Singapore respondents (State Trait Anxiety Inventory [STAI] score, 2.06 vs 1.77; P < .001). The former group also reported more frequent headaches, difficulty breathing, dizziness, rhinorrhea, and sore throat. More than 90% in both cities were willing to be quarantined if they had close contact with a SARS case, and 70% or more would be compliant for social contacts. Most respondents (86.7% in Hong Kong vs 71.4% in Singapore; P < .001) knew that SARS could be transmitted via respiratory droplets, although fewer (75.8% in Hong Kong vs 62.1% in Singapore; P < .001) knew that fomites were also a possible transmission source. Twenty-three percent of Hong Kong and 11.9% of Singapore respondents believed that they were "very likely" or "somewhat likely" to contract SARS during the current outbreak (P < .001). There were large differences between Hong Kong and Singapore in the adoption of personal precautionary measures. Respondents with higher levels of anxiety, better knowledge about SARS, and greater risk perceptions were more likely to take comprehensive precautionary measures against the infection, as were older, female, and more educated individuals. CONCLUSION: Comparative psychobehavioral surveillance and analysis could yield important insights into generic versus population-specific issues that could be used to inform, design, and evaluate public health infection control policy measures.

Adolescent↗
PubMedDate not supplied

Wheeling walks: evaluation of a media-based community intervention.

Mass media community-wide physical activity intervention to promote and sustain changes in walking was assessed using a 2-community longitudinal design. The intervention targeted sedentary 50- to 65-year-old residents of Wheeling, West Virginia. Telephone surveys of a probability sample followed cohorts at baseline and at 3-, 6-, and 12-month post-intervention with comparison communities. The intervention, consisting of paid advertisements, public relations, and community participatory planning, attained high levels of awareness and effected significant sustained population-wide changes among the most sedentary in Wheeling.

Cohort Studies↗
PubMed2004

Prevention of falls and fall-related fractures in community-dwelling older adults: a meta-analysis of estimates of effectiveness based on recent guidelines.

BACKGROUND: Two recent falls prevention guidelines have been published but did not include quantitative estimates of effectiveness based on the published reports that were reviewed to support their recommendations. AIM: To produce quantitative estimates of effectiveness of falls prevention programs from the randomised controlled trials cited in the guidelines together with an updated search of the available published reports to August 2002. METHODS: A meta-analysis of randomised controlled trials cited in falls guidelines and studies identified by an updated search of the available published reports was carried out. Randomised controlled trials were identified from the falls guidelines and a search, which met the following criteria: trials in community-dwelling older people; 1-year follow up; and outcome measures reported as the number of subjects with at least one fall or the number of subjects with a fracture. RESULTS: The guidelines identified four studies of 'exercise as a sole intervention', which when combined with one further study identified in a search of the published reports, gave a fixed effects odds ratio (OR) favouring this strategy of 0.81 (95% confidence interval (CI) 0.58-1.14); the number of patients needed to be treated to prevent one person having a fall was 19.5. The guidelines identified seven studies of a 'multiple intervention' strategy that gave a random effects OR favouring this strategy of 0.64 (95% CI 0.47-0.88). Four further studies were identified by the search of the published reports. The updated OR favouring this intervention strategy was 0.65 (95% CI 0.52-0.81); the number of patients needed to be treated to prevent one person having a fall was 9.8. Only two studies had data for fracture and a fixed effects OR favouring falls interventions for fracture prevention was 0.50 (95% CI 0.18-1.40); the number of patients needed to be treated to prevent one person having a fracture was 45.5. CONCLUSION: Semiquantitative statements of evidence can both understate and overstate the effectiveness of falls prevention strategies. There is moderate evidence of efficacy for falls prevention particularly for multiple intervention strategies.

Accidental Falls↗
PubMed1995

Community empowerment in rural health care.

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.

Arizona↗
PubMed2000

Species diversity and biological invasions: relating local process to community pattern.

In a California riparian system, the most diverse natural assemblages are the most invaded by exotic plants. A direct in situ manipulation of local diversity and a seed addition experiment showed that these patterns emerge despite the intrinsic negative effects of diversity on invasions. The results suggest that species loss at small scales may reduce invasion resistance. At community-wide scales, the overwhelming effects of ecological factors spatially covarying with diversity, such as propagule supply, make the most diverse communities most likely to be invaded.

Asteraceae↗