Community Health

Our study aimed to identify perceptions Latina women have about four different contraceptive methods and to investigate whether religiosity and acculturation play a role in their contraceptive choice. An observational cross-sectional study was performed at Bellevue Hospital. A questionnaire was given to women in the gynecology outpatient clinics asking about: oral contraceptive pills (OCP’s), injectable contraception (DMPA), the Intrauterine device (IUD) and the Ortho-Evra Patch (Patch). In the 102 complete surveys, self identified Latina women were not convinced of the safety of OCPs and DMPA (less than 50% perceived them to be safe) and largely uncertain about the Patch and IUD. Latinas also demonstrated more negative beliefs about the side effects of OCPs and DMPA. In particular, they were concerned about weight gain, method reversibility, and bleeding. There was no substantial correlation between religiosity and contraceptive beliefs. Low level acculturated women were more likely to believe that the IUD and OCPs were harmful, as opposed to their more acculturated counterparts who demonstrated more negative beliefs about the Patch. Overall, Latina women in this study tended to overrate the risks associated with contraceptive use, particularly OCPs and DMPA. The markedly low method confidence suggested by high rates of “unsure” answers is a possible explanation for why Latinas are less adherent with birth control than their white counterparts.

This paper identifies two distinct types of organisational arrangements, which need to be recognised to achieve effective policies and programmes for community engagement. The differences arise from the nature of relationships in the institutional and organisational world, which are primarily vertical hierarchical, as distinct from the informal community world where the relationships are primarily horizontal peer. Lack of attention to these distinctions adversely affects the interaction of the public agencies and the community, and the community’s organisational governance and working arrangements. Using a complexity perspective, the ‘social eco-system dance’ model identifies some issues and new ways of thinking about them and of handling some of the practical challenges. This is leading to a set of managerial and organisational tools to develop new ways of working for policy making, managing, operating and participating in the community engagement process across all the sectors involved.

A consensus of the Workgroup on Community and Socioeconomic Issues was that improving and sustaining healthy rural communities depends on integrating socioeconomic development and environmental protection. The workgroup agreed that the World Health ...

Adult education aims at improving the situation of people by increasing their skills, knowledge and awareness. It is the adult that could transform the nations not children. Adult education brings a great sense of dignity and self-esteem, enhanced respect of others, an ability to take control of one's life and a greater desire to participate in society. The paper examined challenges facing adult education delivery in Nigeria which include failure of the Universal Basic Education act to give adequate recognition of Adult education as a key sector in Basic education, accessibility, under funding and lack or inadequate number of qualified facilitators amongst others. The emerging perspectives are on HIV/AIDs, mainstreaming, inter-sectoral linkages and information and communication technology. The paper finally proffers suggestions as review of the Universal Basic Education act to accommodate Adult and Non-formal education, increase in funding, establishment of more centres and make them affordable, upward review of facilitators' honorarium amongst others.

Eight-hundred seventy-three Indiana high school football players were surveyed to investigate the use of anabolic-androgenic steroids (AAS). Subjects were varsity football players that were randomly selected from 27 high schools throughout Indiana. Out of a possible 1,325 subjects, 873 or 66% participated in the study. Subjects completed a 50 item questionnaire that measured demographic information, perceived use of AAS, reasons for use, and how AAS are taken. The results indicate that 6.3% of Indiana high school football players were current or former AAS users. The average age at time of first use of AAS was 14 years and 15% began taking before the age of ten. Almost half of respondents indicated they could obtain AAS if they so desired, and that other athletes, physicians, and coaches were listed as sources for AAS. Athletic trainers can play a vital role in disseminating accurate information about AAS abuse, including the long-term adverse health risks. These messages should beg...

As more evidence shows the capacity for growth
and fulfillment in the later years of life, the concept of
positive aging has value in promoting well-being and
enhancing the image of older adulthood. A paradigm
called Foray (4A) into Aging based on Awareness,
Attitude, Affiliation, and Activity demonstrates how this
new territory of positive aging can be realized.

AbstractIntroduction: To ensure that nursing education stay abreast with modern technology advances has the Schoolof Nursing (SoN) of The University of the Western Cape integrated e-learning into the curriculum. This methodarticulates well with the case-based approach adopted by the SoN. The Learning Management System,Knowledge Environment for Web-Based Learning (Kewl), Next Generation (KNG), was used to facilitate onlineteaching and learning.Objectives: The primary aim was to gather baseline data on e-learning by exploring the perceptions andexperiences of the first pilot group of undergraduate nursing students who were exposed to this strategy.Methods: A descriptive cross-sectional quantitative design was used to determine the students' understandingand valuing of e-learning, the benefits and skills gained and challenges experienced, by means of a structured,close-ended questionnaire with space for comments. Convenience sampling was used and the questionnairewas distributed to...

This study aims to examine the relationship between infant-feeding practices and American Indian infants' gut microbiome — laying the foundation of a research program aimed at identifying potential aetiologies of childhood obesity in this population. Previous studies have emphasised the high prevalence of obesity in American Indian infants, but its underlying causes remain unclear. We received funding from the University of Washington to examine attitudes towards breastfeeding and formula feeding in American Indian mothers, their dietary and physical activity habits and the yield, quality and diversity of their infants' gut microbiome. Our study combines the strengths of qualitative and quantitative data with DNA sequencing. Results will be used to propose a larger study aimed at clarifying aetiologies of childhood obesity in this population and to identify prevention strategies. This protocol describes the theoretical basis of the study, rationale for the target population, study design, participant recruitment and data analysis plan.

Modern dancers suffer a high rate of musculoskeletal injuries. Preventing injury prolongs dance careers and eases financial burden on both individual dancers and dance companies alike. A medical student partnered with Garth Fagan Dance to develop a curriculum to teach principles of injury prevention specific to preprofessional and professional modern dancers. Quantitative assessments showed a significant increase in participant injury prevention knowledge after completion of the course (P < 0.0001). Participants’ concern that injury may end their careers showed no significant change after the course (P = 0.35). Injury prevention and dance-related injuries were reported the most often as useful topics while weight management was reported the least often as a useful topic. Qualitative evaluations showed that participants’ found a course on injury prevention valuable and desired a course of longer duration that includes a greater number of topics. These findings show that modern dancers perceive an educational course on injury prevention as valuable and retain information presented in the course in the short-term. Further study is warranted to assess changes in injury rates after the course and to continue to improve curriculum content and implementation.

Objectives: To provide a framework for epidemiological research on work and health that combines classic occupational epidemiology and the consideration of work in a structural perspective focused on gender inequalities in health. Methods: Gaps and limitations in ...

A community survey was conducted in Al awayda village, one of eight villages selected for study in the rural Gezira province of Sudan. The objective of the survey was to identify the main health, social and economic problems of people in rural areas and to set priorities as a first phase in a rural development program. The results showed a

Increasing breastfeeding initiation and duration rates is one of the UK Department of Health national targets for improving the health of the population. One reason contributing to the high rates of breastfeeding discontinuation may be that primary care teams may not have sufficient knowledge to help mothers overcome problems experienced in the early days and may also give conflicting advice. Previous studies have shown that general practitioners are happy to participate in practice-based educational sessions and have expressed a need for breastfeeding education. This study was carried out as part of the training to achieve &#39;UNICEF UK Baby Friendly Initiative in a community health care setting&#39; status. It aimed to improve the breastfeeding expertise and advice about the management of breastfeeding problems within the primary care team using a CD-ROM breastfeeding learning package, and to assess the usefulness and acceptability of this educational intervention. Six UK general...

Despite limited preparation through formal and non-formal education, local people throughout the world are engaged in the common work of building healthier communities. Some core competencies-including community assessment, planning, mobilization, and evaluation-are needed to address the variety of issues that matter to local communities. This report describes an Internet-based support system for community work known as the Community Tool Box (CTB) [http://ctb.lsi.ukans.edu/]. We examine the idea and origins of the CTB and its core content, access features, and applications. We review evidence for its use, implementation and dissemination strategies, and discuss core values that guide this internet-based work.

With the lack of attention to the attrition of child participants, loss to follow up (LTFU) holds significant implications for the health of young adults in the Pediatric HIV/AIDS Cohort Study (PHACS), a multi-center cohort study with children either perinatally infected with HIV (PHIV) or HIV-exposed uninfected (HEU). Young adults (18+) face barriers to being retained in the study, including competing time demands, geographic relocation, study fatigue, stigma, and low health literacy. Formative research, Photovoice (participatory photo elicitation), and a focus group informed the design of a web-based media strategy based on the Elaboration Likelihood Model (ELM) to increase study engagement. Six members of the Young Adult and Adult Community Advisory Boards (CABs) were recruited via email and given Photovoice training via Prezi. Photos were taken around the theme of self-identity. A teleconference focus group facilitated reflections and salient themes for the video compilation exhibit. Themes included: 1) stereotypes, 2) layered-identities, 3) stigma, and 4) self-identity. Additional meta-themes were also codified. Media strategy recommendations included: 1) participatory media and photography, 2) digital story maps, 3) social media, and 4) content and topics. Based on the results of this project with a limited sample, participatory media like Photovoice may have a positive impact on participants at risk for LTFU by increasing study engagement. While some research supports this qualitative methodology, limitations must be considered. Future PHACS projects should incorporate a needs assessment and evaluation. Moreover, further research in this area of public health and health communication needs to continue overall.

Although the development in advanced medical and public health services has provided both proactive and passive postpartum care in the rural areas, the traditional practices are still influential. The objective of this study was to investigate the traditional practices and food consuming for Thai postpartum women in the rural areas. The descriptive study used both the quantitative and qualitative methods.

The efficient and reliable assessment of general community health requires the development of comprehensive and parsimonious measures of proven validity. The Nottingham Health Profile (NHP) has been demonstrated to be a reliable indicator of common expressions of discomfort and stress in the general population. The present paper describes its linguistic adaptation into French, the derivation of item weights by Thurstone&#39;s method of paired comparisons and the comparison of item weights across various sociodemographic groups. There is more similarity than variation on the valuation of the state of health explored by the NHP between the French and the British population as little inter-cultural or inter-linguistic variations were found. The differences in judgement of severity elicited across sociodemographic groups in the French sample cast some doubts on the relevance of general weights for use in population surveys.

The primary purpose of this study was to investigate influences on pharmacists&#39; over-the-counter (OTC) recommendations. A structured survey questionnaire covering medical, social, and marketing factors related to eight OTC product categories was designed and reviewed by a jury of experts and subsequently mailed to one-half of the 1440 pharmacies in Indiana. A total of 526 pharmacists responded to the questionnaire, providing a 73.1% response rate. Findings revealed that pharmacists were most likely to make favorable OTC recommendations related to nutritional supplements and smoking cessation products. Results also indicated that medical forces were significantly more important in influencing OTC product decisions than social and marketing forces. Based on the findings in this study, pharmacists are making OTC product recommendations in accordance with their health care training and expertise.

Diabetes is prevalent among African-American and Latino Detroit residents, with profound consequences to individuals, families, and communities. The REACH Detroit Partnership engaged eastside and southwest Detroit families in focus groups organized by community, age, gender, and language, to plan community-based participatory interventions to reduce the prevalence and impact of diabetes and its risk factors. Community residents participated in planning, implementing, and analyzing data from the focus groups and subsequent planning meetings. Major themes included: 1) diabetes is widespread and risk begins in childhood, with severe consequences for African Americans and Latinos; 2) denial and inadequate health care contribute to lack of public awareness about pre-symptomatic diabetes; 3) diabetes risks include heredity, high sugar, fat and alcohol intake, overweight, lack of exercise, and stress; and 4) cultural traditions, lack of motivation, and lack of affordable, accessible stores...

"Infrastructural ephemera" as a set of spontaneous affective relations critical to the success of large-scale projects of urban governance in the urban South are examined. The deep contradictions underscoring the labours of women employed as community health workers in Lyari Town, Karachi, at a time of intense gang violence, are explored. Drawing on two years of field research as a polio vaccinator in Lyari, the reach (and limits) of adaptability, skills, and labour (physical, mental, and emotional) involved in the maintenance and repair of a fragile public health infrastructure are explored. Maintaining "community health" also involves dealing mortal and aspirational death to those that provide infrastructural labour to the project of giving life. S hazia did not show up for work, and her sisters-in-law were loath to say why. A moroseness attended the group of young women assembled for the vaccination campaign that morning. Shazia, their de facto leader, was missing. Also gone was Akram, the local gang-boss, whose jokes and fl irtations were as essential to morale as his mediations were to vaccination work. News was that he had been summoned by the Army Rangers and had not been heard from since. Tacitly, all knew that the two absences were connected. Shazia and her kin were community health workers (CHWs). Together they were the backbone of the Global Polio Eradica-tion Initiative (GPEI; the campaign, henceforth) in Pakistan. Unlike her kin, Shazia had always been the picture of quiet ef-fi ciency, skillfully motivating and organising her teams. The government supervisor was completely dependent on her for managing the campaign. Shazia's absence appeared to her a personal betrayal, and she was distraught. The true locus of her dread was the World Health Organization (WHO) appointed monitor, who conducted spot-checks on their performance in the neighbourhood. Without Shazia, a misstep was inevitable , and she would hear about it from the town health offi cer. She was driven to tears anticipating the indignities to come, which clouded everyone's mood further. Buckling under these stresses, the polio drive that month was a disaster. Akram's jocular energy would have helped on such days. As a gangster of Lyari, Akram wore many hats. One of them was that of a CHW. Akram's contributions to the campaign far exceeded the purported utility of a CHW or imagined functions of a gangster. Success for the campaign in Lyari was entirely dependent on the "working relations," solidarities and affections that emerged between the CHWs and the gangs. This was ex-emplifi ed by affi nities Akram and Shazia developed for each other, and between the young sodalities they each led. This paper chronicles the import of those affi nities. The GPEI, like any large-scale project, thrives on rhythms and processes, articulating a mass of bubbling desires. Desires, for instance, that drive the WHO's imperatives from Geneva, jive with the Pakistani elite's fantasies about the city; all dovetailing with other, humbler desires for a good life. The GPEI rendered concrete these entangled desires by offering the po-liovirus as a displaced object around which to organise. The campaign thus spatialised and rationalised these libidinal investments. Thus, infrastructural to the realisation of massive transnational fantasies were tiny hopes and affi nities held by the young CHWs.