'Your Heart Can't Wait'---A worksite program: Increasing the effectiveness of worksite coordinators to implement a community-wide health education program

A worksite health education program called “Your Heart Can't Wait,” was designed by the American Heart Association Gulf Coast Area (AHA). The objectives were to educate individuals about the signs and symptoms of heart attacks and the actions they should take to improve heart attack victims' chances for survival. AHA volunteers agreed to serve as mentors for this program. ^ A study was designed to determine if worksite coordinators who had the assistance of experienced AHA volunteers had higher rates of program adoption and implementation than worksite coordinators without assistance. Ninety-seven companies participated in the study. Twelve AHA volunteers were randomly assigned to work with forty-three of the worksite coordinators. Mentor/mentee contact forms were used to assess the mentoring process during the course of the study. Program adoption forms were used to measure rates of program adoption and follow-up questionnaires were used to measure rates of program implementation after the study was completed. The twelve mentors were interviewed to provide information for improving future mentoring efforts. ^ Thirty-eight companies completed program adoption forms and fifty-one companies reported using YHCW program components. For the most part, the volunteer mentors did not spend a significant amount of time contacting or working with their assigned worksite coordinators. As a result, the planned analysis comparing the implemented programs between worksite coordinators with and without assistance could not be completed. ^ Additional analyses were performed comparing the implemented programs based upon whether the companies had existing health education/health promotion programs and whether the worksite coordinators had experience using AHA Heart At Work program components. ^ Recommendations based on the mentor interviews were made to improve the success of volunteer assistance programs in the future. ^

The mark of a good healer: Examining health care behaviors in the Vietnamese community

The purpose of this study was to conduct a descriptive, exploratory analysis of the utilization of both traditional healing methods and western biomedical approaches to health care among members of the Vietnamese community in Houston, Texas. The first goal of the study was to identify the type(s) of health care that the Vietnamese use. The second goal was to highlight the numerous factors that may influence why certain health care choices are made. The third goal of this study was to examine the issue of preference to determine which practices would be used if limiting factors did not exist. ^ There were 81 participants, consisting of males and females who were 18 years or older. The core groups of participants were Vietnamese students from the University of Houston-Downtown and volunteer staff members from VN TeamWork. Asking the students and staff members to recommend others for the study used the snowball method of recruiting additional participants. ^ Surveys and informed consents were in English and Vietnamese. The participants were given the choice to take the surveys face-to-face or on their own. Surveys consisted of structured questions with predetermined choices, as well as, open-ended questions to allow more detailed information. The quantitative and qualitative data were coded and entered into a database, using SPSS software version 15.0. ^ Results indicated that participants used both traditional (38.3%) and biomedical (59.3%) healing, with 44.4% stating that it depended on the illness as to treatment. Coining was the most used traditional healing method, clearly still used by all ages. Coining was also the method most used when issues regarding fear and delayed western medical treatment were involved. It was determined that insurance status, more than household income, guided health care choices. A person's age, number of years spent in the United States, age at migration, and the use of certain traditional healing methods like coining all played a role in the importance of the health care practitioner speaking Vietnamese. The most important finding was that 64.2% of the participants preferred both traditional and western medicine because both methods work. ^

Liberation of hope: An ethnographic study of community-based initiatives in Houston, Texas

This is an ethnographic study about the worldview of community-based initiatives in Houston, Texas, and the people who work in them. People who participated in this study recognize that their direct constructive action is at the heart of authentic social change in their minority communities. Through qualitative data analysis, a constellation of relationships and process patterns were found to constitute themselves into the system of the community-based initiative. The predominant patterns identified from the findings in this study are: the pervasiveness of place, the importance of people, unique initiatory patterns, the concrete local sustainability, the ever-present action orientation, the resourceful use of networks and inter-relationships, the significance of church influence, the core sense of spirituality and the essence of hope. These patterns emerged out of the local knowledge, which is acutely sensitive to the elements of history and lived experience, embedded in the distinctive moral and visionary patterns of meaning and expression. Findings from the research reveal that these community-based initiatives are not programs--they are people--people who keep hope alive in their communities and who, by their daily practice, liberate others. ^

THE POTENTIAL EFFECTS OF A COMMUNITY DEVELOPMENT PROGRAM ON DEMOGRAPHIC VARIABLES IN HIMALAYAN INDIAN VILLAGES

A community development program operating in the mountains of North India was studied to assess its potential effects on mortality, fertility and migration patterns in the community which it served. The development program operated in Jaunpur Block, Tehri-Garhwal District, Uttar Pradesh State. Two comparable villages in the district were studied. The development program had been working in one for two years, and the other was completely untouched by the program.^ Since not enough time had elapsed since the beginning of the development program's work for any effects on demographic patterns to be visable in Jaunpur Block, this study looked to attitudes of village residents as indicators of future demographic trends. Existing demographic patterns and their interrelationship with socio-religious customs were examined in the test village. A questionnaire was then administered to ascertain attitudinal differences between the residents of the test village and the control village.^ The primary work of the community development program was to train women as village health workers. The results of the attitudinal comparison of the residents of the two villages showed a marked difference in attitudes relating to the position of women in society. The data showed a higher esteem for women in the test village than in the control village, and it is argued that this difference may be attributable to the work of the development program.^ Predicting future demographic trends in Jaunpur Block on the basis of the observed difference in villagers' attitudes toward the status of women is speculatory. Jaunpur Block appears to be in the demographic stage of pre-transition, maintaining relatively high rates of both mortality and fertility. Based on demographic transition theory the next significant change in demographic patterns in Jaunpur is predicted to be a decline in mortality, and an increase in the status of women is unrelated to this prediction.^ The community development program which was studied terminated unexpectedly during the time of this study. A case study of the program's final months is presented, and speculation on the future course of demographic trends in Jaunpur Block is related to the possible alternatives for future development in the area. ^

Better together: Addressing maternal and child health outcomes through community health worker continuing education curricula

Background. The incidence of birth defects is a significant public health issue in the United States, adversely affecting the quality of life for parents as well as children born with these defects. Minority populations face a greater burden of birth defects and associated health problems. Prenatal practices can have a large impact on infant health outcomes. Several behaviors during pregnancy, including the intake of folic acid, can greatly influence the likelihood of a child being born with a birth defect. Community Health Workers have been shown to be effective agents at improving prenatal practices, especially when they facilitate support groups that feature pregnant women. ^ Methods. A continuing education curriculum has been created for Community Health Workers that provides content in the area of Maternal and Child Health. Content was selected after conducting a review of relevant literature and theory. Materials for conducting a training for Community Health Workers have been created in addition to materials that were designed for the population with whom the CHWs work. ^ Results. A description of each "key point" of the curriculum and a justification how it relates to the literature of the prevention of birth defects is given here. Additionally, the process of creating the curriculum using the platform delineated in the methods is described. ^ Discussion. Insights for future curriculum development are discussed along with next steps in the process of certifying the curriculum at the state level. A framework for future evaluation of the curriculum is given.^

Use of empowerment evaluation to determine a sustainability plan for a community-based preconception care program

Women With IMPACT (WWI) is a community-based preconception care educational intervention. WWI is being implemented by the Impacting Maternal and Prenatal Care Together (IMPACT) Collaborative and targets zip codes in Harris County, Texas at high risk for infant mortality, low birthweight, and preterm birth. WWI started March 2012 and continues through August 2013. Three workshop series are planned. This study was conducted with participants and facilitators from the first workshop series. This study aimed to 1) evaluate the WWI program using empowerment evaluation, 2) engage all WWI stakeholders in an empowerment evaluation so the method could be adopted as a participatory evaluation process for future IMPACT activities, and 3) develop recommendations for sustainability of the WWI intervention, based on empowerment evaluation findings and results from the pre/post program evaluation completed by WWI participants. Study participants included WWI participants and facilitators and IMPACT Collaborative Steering Committee members. WWI participants were female, 18-35 year-old, non-pregnant residents of zip codes at high risk of adverse birth outcomes. All other study participants were 18 years or older. A two-phased empowerment evaluation (EE) was utilized in this study. Sessions 1-4 were conducted independently of one another – 3 with participants at different sites and one with the facilitators. The fifth session included WWI participant and facilitator representatives, and IMPACT Steering Committee members. Session 5 built upon the work of the other sessions. Observation notes were recorded during each session. Thematic content analysis was conducted on all EE tables and observation notes. Mission statements drafted by each group focused on improvement of physical and mental health through behavior change and empowerment of all participants. The top 5 overall program components were: physical activity, nutrition, self-worth, in-class communication, and stress. Goals for program improvement were set by EE participants for each of these components. Through thematic content analysis of the tables and observation notes, social support emerged as an important theme of the program among all participant groups. Change to a healthy lifestyle emerged as an important theme in terms of program improvement. Two-phased EE provided an opportunity for all program stakeholders to provide feedback regarding important program components and provide suggestions for program improvement. EE, thematic content analysis, pre/post evaluation results, and inherent program knowledge were triangulated to make recommendations to sustain the program once the initial funding ends. ^

Perceptions of institutional support of community -based participatory research within prevention research centers

The Institute of Medicine (IOM) report on the future of health care states that the focus on health needs to shift to the management and prevention of chronic illnesses and that academic health centers (AHCs) should play an active role in this process through community partnerships (IOM, 2002). Grant funding from the National Institutes of Health and the creation of the Centers for Disease Control and Prevention (CDC) Prevention Research Centers (PRC) across the county represent a transition toward more proactively seeking out community partnerships to better design and disseminate health promotion programs (Green, 2001). ^ The focus of the PRCs is to conduct rigorous, community-based, prevention research, to seek outcomes applicable to public health programs and policies. The PRCs work is to create and foster partnerships among public health and community organizations, to address health promotion and disease prevention issues (CDC, 2003). ^ The W.K. Kellogg Foundation defines CBPR as "a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health." ^ In 1995, CDC asked the IOM to review the PRC program to examine the extent to which the program is providing the public health community with strategies to address public health problems in disease prevention and health promotion (IOM, 1997). No comprehensive evaluation n of the individual PRCs had ever been done (IOM, 1997). ^ The CDC was interested in understanding how it could better support the PRC program through improved management and oversight to influence the program's success. The CDC only represents one of the entities that influence the success of a PRC. Another key entity to consider is the support of and influence of the Schools of Public Health in which the PRCs reside. Using evaluation criteria similar to those that were developed by the IOM, this study examined how aspects of structural capacity of the Schools of Public Health in which the PRCs reside are perceived to influence PRC community-based research activities. ^

Seawater carbonate chemistry, nutrients, growth rate and phytoplnkton community response to increasing CO2 concentration during experiments, 2011

This paper reports for the first time upon the effects of increasing CO2 concentrations on a natural phytoplankton assemblage in a tropical estuary (the Godavari River Estuary in India). Two short-term (5-day) bottle experiments were conducted (with and without nutrient addition) during the pre-monsoon season when the partial pressure of CO2 in the surface water is quite low. The results reveal that the concentrations of total chlorophyll, the phytoplankton growth rate, the concentrations of particulate organic matter, the photosynthetic oxygen evolution rates, and the total bacterial count were higher under elevated CO2 treatments, as compared to ambient conditions (control). delta13C of particulate organic matter (POM) varied inversely with respect to CO2, indicating a clear signature of higher CO2 influx under the elevated CO2 levels. Whereas, delta13CPOM in the controls indicated the existence of an active bicarbonate transport system under limited CO2 supply. A considerable change in phytoplankton community structure was noticed, with marker pigment analysis by HPLC revealing that cyanobacteria were dominant over diatoms as CO2 concentrations increased. A mass balance calculation indicated that insufficient nutrients (N, P and Si) might have inhibited diatomgrowth compared to cyanobacteria, regardless of increased CO2 supply. The present study suggests that CO2 concentration and nutrient supply could have significant effects on phytoplankton physiology and community composition for natural phytoplankton communities in this region. However, this work was conducted during a non-discharge period (nutrient-limited conditions) and the responses of phytoplankton to increasing CO2 might not necessarily be the same during other seasons with high physicochemical variability. Further investigation is therefore needed.

Shallow water marine sediment bacterial community shifts along a natural CO2 gradient in the Mediterranean Sea Off vulcano, Italy

The effects of increasing atmospheric CO(2) on ocean ecosystems are a major environmental concern, as rapid shoaling of the carbonate saturation horizon is exposing vast areas of marine sediments to corrosive waters worldwide. Natural CO(2) gradients off Vulcano, Italy, have revealed profound ecosystem changes along rocky shore habitats as carbonate saturation levels decrease, but no investigations have yet been made of the sedimentary habitat. Here, we sampled the upper 2 cm of volcanic sand in three zones, ambient (median pCO(2) 419 µatm, minimum Omega (arag) 3.77), moderately CO(2)-enriched (median pCO(2) 592 µatm, minimum Omega (arag) 2.96), and highly CO(2)-enriched (median pCO(2) 1611 µatm, minimum Omega (arag) 0.35). We tested the hypothesis that increasing levels of seawater pCO(2) would cause significant shifts in sediment bacterial community composition, as shown recently in epilithic biofilms at the study site. In this study, 454 pyrosequencing of the V1 to V3 region of the 16S rRNA gene revealed a shift in community composition with increasing pCO(2). The relative abundances of most of the dominant genera were unaffected by the pCO(2) gradient, although there were significant differences for some 5 % of the genera present (viz. Georgenia, Lutibacter, Photobacterium, Acinetobacter, and Paenibacillus), and Shannon Diversity was greatest in sediments subject to long-term acidification (>100 years). Overall, this supports the view that globally increased ocean pCO(2) will be associated with changes in sediment bacterial community composition but that most of these organisms are resilient. However, further work is required to assess whether these results apply to other types of coastal sediments and whether the changes in relative abundance of bacterial taxa that we observed can significantly alter the biogeochemical functions of marine sediments.

Community Structure in Soil Porous System

Diffusion controls the gaseous transport process in soils when advective transport is almost null. Knowledge of the soil structure and pore connectivity are critical issues to understand and modelling soil aeration, sequestration or emission of greenhouse gasses, volatilization of volatile organic chemicals among other phenomena. In the last decades these issues increased our attention as scientist have realize that soil is one of the most complex materials on the earth, within which many biological, physical and chemical processes that support life and affect climate change take place. A quantitative and explicit characterization of soil structure is difficult because of the complexity of the pore space. This is the main reason why most theoretical approaches to soil porosity are idealizations to simplify this system. In this work, we proposed a more realistic attempt to capture the complexity of the system developing a model that considers the size and location of pores in order to relate them into a network. In the model we interpret porous soils as heterogeneous networks where pores are represented by nodes, characterized by their size and spatial location, and the links representing flows between them. In this work we perform an analysis of the community structure of porous media of soils represented as networks. For different real soils samples, modelled as heterogeneous complex networks, spatial communities of pores have been detected depending on the values of the parameters of the porous soil model used. These types of models are named as Heterogeneous Preferential Attachment (HPA). Developing an exhaustive analysis of the model, analytical solutions are obtained for the degree densities and degree distribution of the pore networks generated by the model in the thermodynamic limit and shown that the networks exhibit similar properties to those observed in other complex networks. With the aim to study in more detail topological properties of these networks, the presence of soil pore community structures is studied. The detection of communities of pores, as groups densely connected with only sparser connections between groups, could contribute to understand the mechanisms of the diffusion phenomena in soils.

A multinational SDI-based system to facilitate disaster risk management in the Andean Community

A useful strategy for improving disaster risk management is sharing spatial data across different technical organizations using shared information systems. However, the implementation of this type of system requires a large effort, so it is difficult to find fully implemented and sustainable information systems that facilitate sharing multinational spatial data about disasters, especially in developing countries. In this paper, we describe a pioneer system for sharing spatial information that we developed for the Andean Community. This system, called SIAPAD (Andean Information System for Disaster Prevention and Relief), integrates spatial information from 37 technical organizations in the Andean countries (Bolivia, Colombia, Ecuador, and Peru). SIAPAD was based on the concept of a thematic Spatial Data Infrastructure (SDI) and includes a web application, called GEORiesgo, which helps users to find relevant information with a knowledge-based system. In the paper, we describe the design and implementation of SIAPAD together with general conclusions and future directions which we learned as a result of this work.

The technofusion project for fusion technology development: opportunities for the inertial community

The new Spanish installation for fusion research (Technofusion) has been approved by both the national and regional governments. Funding up to 80-100 M€ will be invested in the construction of seven laboratories to cover many aspects relevant to fusion technology development. This work discusses their utility for inertial fusion research.

Optimal water allocation in shortage situations as applied to an irrigation community.

This work studies the most beneficial way of allocating water in an irrigation community in water shortage situations. Therefore, it proposes that the irrigation surface area be divided into homogeneous zones, each with a beneficial relationship with respect to the water applied. The mathematical formula that enables one to obtain the optimal quota for the users or irrigation community as a whole has been found for individual relations of a quadratic or power type, and these have yielded different and complementary characteristics. Dimensionless variables have been used to display the results, and to compare with other alternative allocation rules such as the proportional rule, referencing the situation without water restrictions. As a result, for each water shortage situation, the water that is allocated to each user is obtained, together with the losses in individual income and the losses for the community as a whole. Furthermore, a proposal is put forth for establishing the marginal benefit from the water available, which could be of interest in enabling each community to analyze whether it is in its best interest to invest in increasing the resource, or to sell the resource to other users. Finally, an example is given to demonstrate how the method works and to show that, when the differences between the production schemes are considered, the differences in benefit reduction between the proportional allocation and the optimal allocation are also sizeable. Read More: http://ascelibrary.org/doi/abs/10.1061/(ASCE)IR.1943-4774.0000667

Planning and community development: case studies

Planning and Comunity Development: Case Studies, presents the findings of the inter-university Seminar held on 28?29 July 2011 and organized by researchers from the Technical University of Madrid and the University of California, Berkeley, who were fortunate to have the presence of the renowned Professor John Friedmann. Professors, researchers and PhD students from our research groups presented their works as scientific communications that were enriched by the debate among the different researches who attended the Seminar. All of them appear in the picture below in front of the gate of Haviland Hall at UC Berkeley. This book analyses the concept of planning and its evolution so far, leading to the conceptualization of governance as an expression of the planning practice. It also studies the role of social capital and cooperation as tools for the community development. The conceptual analysis is complemented by the development of six case studies that put forward experiences of planning and community development carried out in diverse social and cultural contexts of Latin-America, Europe and North America. This publication comes after more than 20 years of work of the researchers that met at the seminar. Through their work in managing development initiatives, they have learned lessons and have contribute to shape their own body of teaching that develops and analyses the role of planning in public domain to promote community development. This knowledge is synthesized in the model Planning as Working With People, that shows that development is not effective unless is promoted in continuous collaboration with all the actors involved in the process.