Referring heroin users from compulsory detoxification centers to community methadone maintenance treatment: a comparison of three models.

BACKGROUND: Both compulsory detoxification treatment and community-based methadone maintenance treatment (MMT) exist for heroin addicts in China. We aim to examine the effectiveness of three intervention models for referring heroin addicts released from compulsory detoxification centers to community methadone maintenance treatment (MMT) clinics in Dehong prefecture, Yunnan province, China. METHODS: Using a quasi-experimental study design, three different referral models were assigned to four detoxification centers. Heroin addicts were enrolled based on their fulfillment to eligibility criteria and provision of informed consent. Two months prior to their release, information on demographic characteristics, history of heroin use, and prior participation in intervention programs was collected via a survey, and blood samples were obtained for HIV testing. All subjects were followed for six months after release from detoxification centers. Multi-level logistic regression analysis was used to examine factors predicting successful referrals to MMT clinics. RESULTS: Of the 226 participants who were released and followed, 9.7% were successfully referred to MMT(16.2% of HIV-positive participants and 7.0% of HIV-negative participants). A higher proportion of successful referrals was observed among participants who received both referral cards and MMT treatment while still in detoxification centers (25.8%) as compared to those who received both referral cards and police-assisted MMT enrollment (5.4%) and those who received referral cards only (0%). Furthermore, those who received referral cards and MMT treatment while still in detoxification had increased odds of successful referral to an MMT clinic (adjusted OR = 1.2, CI = 1.1-1.3). Having participated in an MMT program prior to detention (OR = 1.5, CI = 1.3-1.6) was the only baseline covariate associated with increased odds of successful referral. CONCLUSION: Findings suggest that providing MMT within detoxification centers promotes successful referral of heroin addicts to community-based MMT upon their release.

The Decolonization of Northwest Community College

In 1996, the authors of the Canadian Royal Commission on Aboriginal Peoples concluded Canadian educational policy had been based on the false assumption of the superiority of European worldviews. The report authors recommended the transformation of curriculum and schools to recognize that European knowledge was not universal. Aboriginal researcher Battiste believes the current system of Canadian education causes Aboriginal children to face cognitive imperialism and cognitive assimilation and that this current practice of cultural racism in Canada makes educational institutions a hostile environment for Aboriginal learners. In order to counter this cultural racism, Battiste calls for the decolonization of education. In 2005, the president of Northwest Community College (NWCC), publicly committed to decolonizing the college in order to address the continuing disparity in educational attainment between Aboriginal and non-Aboriginal learners. Upon the president’s departure in 2010, the employees of NWCC were left to define for themselves the meaning of decolonization. This qualitative study was designed to build a NWCC definition of colonization and decolonization by collecting researcher observations, nine weeks of participant blog postings, and pre and post blog Word survey responses drawn from a purposeful sample of six Aboriginal and six non-Aboriginal NWCC employees selected from staff, instructor and administrator employee groups. The findings revealed NWCC employees held multiple definitions of colonization and decolonization which did not vary between employee groups, or based on participant gender; however, differences were found based on whether the participants were Aboriginal or non-Aboriginal. Both Aboriginal and non-Aboriginal participants thought decolonization was a worthy goal for the college. Aboriginal participants felt hopeful that decolonization would happen in the future and thought decolonization had to do with moving forward to a time when they would be valued, respected, empowered, unashamed, safe, and viewed as equal to non-Aboriginals. Non-Aboriginal participants were unsure if decolonization was possible because it would require going back in time to restore the Aboriginal way of life. When non-Aboriginal participants felt their thoughts were not being valued or they were being associated with colonialism, they felt angry and guarded and were uncomfortable with Aboriginal participants expressing anger towards Colonizers.

Vegetation community and geochemistry in the Uummannaq District, West Greenland

Beach and salt marsh vegetation of the Uummannaq District, northern West Greenland (c. 70°15' N - 72° N, 49° W - 54° W) was studied 1998 according to the Braun-Blanquet phytosociological approach. Habitat analyses included soil chemistry. Such vegetation locally occurs and is not developed over extensive areas. On gravely stony beaches a Mertensia maritima ssp. maritima community occurs, while a Honckenya peploides var. diffusa community is confined to sandy beaches. The association Honckenyo diffusae-Elymetum mollis Thannh. 1975 is confined to sandy shore walls and low dunes. All vegetation types are assigned to the alliance Honckenyo- Elymion arenariae Tx. 1966, which again is a unit of the order Honckenyo- Elymetalia arenariae Tx. 1966, which is sub ordered to the class Honckenyo-Elymetea arenariae Tx. 1966. On fine sediments along sheltered coasts salt marsh vegetation is locally developed mainly on fiord deltas and outwash plains of small rivers and streams. A distinct zonation pattern in vegetation can be observed from the lower to upper salt marsh: Puccinellietum phryganodis Hadac 1946 association, Caricetum subspathaceae Hadac 1946 association, Caricetum ursinae Hadac 1946 association (all assigned to the alliance Puccinellion phryganodis Hadac 1946) and Festuco-Caricetum glareosae Nordh. 1954 association (assigned to the alliance Armerion maritimae Br.-Bl. et de Leeuw 1936). Both alliances are units of the order Glauco- Puccinellietalia Beeftink et Westhoff in Beeftink 1965, which is assigned to the class Asteretea tripolii Westhoff et Beeftink in Beeftink 1962. TWINSPAN and CCA support the vegetation classification and the CCA with soil chemistry parameters shows that salinity (related to position above MHW) and Ncontent are strongly correlated with the floristical differentiation of the vegetation of the Honckenyo-Elymetea class. In the Asteretea tripolii class, position above MHW (negatively correlated with pH, conductivity and Clcontent) and fresh water supply are likely the main factors, which affect vegetation differentiation. A synoptic survey of vegetation types from Greenland based on published phytosociological tables is presented and distribution of the vegetation types is addressed, just as their position in a circumpolar context. Moreover a Cochlearia groenlandica-Melandrium triflorum community is described as a new vegetation type, occurring on shallow soil on cliffs influenced by salt spray.

Rightful Resistance in the Colombian conflict. A theoretical reflection based on a Peace Community

This article considers the opportunities of civilians to peacefully resist violent conflicts or civil wars. The argument developed here is based on a field-based research on the peace community San José de Apartadó in Colombia. The analytical and theoretical framework, which delimits the use of the term ‘resistance’ in this article, builds on the conceptual considerations of Hollander and Einwohner (2004) and on the theoretical concept of ‘rightful resistance’ developed by O’Brien (1996). Beginning with a conflict-analytical classification of the case study, we will describe the long-term socio-historical processes and the organizational experiences of the civilian population, which favoured the emergence of this resistance initiative. The analytical approach to the dimensions and aims of the resistance of this peace community leads to the differentiation of O`Brian’s concept of ‘rightful resistance’.

GPs’ and community pharmacists’ opinions on medication management at transitions of care in Ireland

Objective. The aim of this study was to survey GPs and community pharmacists (CPs) in Ireland regarding current practices of medication management, specifically medication reconciliation, communication between health care providers and medication errors as patients transition in care.
Methods. A national cross-sectional survey was distributed electronically to 2364 GPs, 311 GP Registrars and 2382 CPs. Multivariable associations comparing GPs to CPs were generated and content analysis of free text responses was undertaken.
Results. There was an overall response rate of 17.7% (897 respondents—554 GPs/Registrars and 343 CPs). More than 90% of GPs and CPs were positive about the effects of medication reconciliation on medication safety and adherence. Sixty per cent of GPs reported having no formal system of medication reconciliation. Communication between GPs and CPs was identified as good/very good by >90% of GPs and CPs. The majority (>80%) of both groups could clearly recall prescribing errors, following a transition of care, they had witnessed in the previous 6 months. Free text content analysis corroborated the positive relationship between GPs and CPs, a frustration with secondary care communication, with many examples given of prescribing errors.
Conclusions. While there is enthusiasm for the benefits of medication reconciliation there are limited formal structures in primary care to support it. Challenges in relation to systems that support inter-professional communication and reduce medication errors are features of the primary/secondary care transition. There is a need for an improved medication management system. Future research should focus on the identified barriers in implementing medication reconciliation and systems that can improve it.

Measuring children’s experience of their right to participate in school and community: a rights-based approach

This paper discusses the development of a children’s rights-based measure of participation and the findings from its use in a survey of 10 to 11 year old children (n= 3773). The measure, which was developed in collaboration with a group of children, had a high reliability (Cronbach’s alpha = .89). Findings suggest that children’s positive experience of their participation rights is higher in school than in community, and higher for girls compared to boys. It is argued that involving children in the ‘measurement’ of their own lives has the potential to generate more authentic data on children’s lived experiences.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Evaluation of a Brief Intervention to Assist Health Visitors and Community Practitioners to Engage with Fathers as Part of the Healthy Child Initiative

Aims: To improve engagement of Health Visitors and Community Practitioners delivering the Healthy Child Programme with fathers. To evaluate a one-day, father-focused workshop with a supporting handbook for Practitioners. To identify institutional and organisational barriers to engagement with fathers. Background: The UK government policy encourages health professionals to engage with fathers. This derives from robust evidence that fathers’ early involvement with their children impacts positively on emotional, behavioural and educational development. Yet, there is little evidence that the importance of engaging fathers is reflected in Health Visitor training or that primary-care services are wholly embracing father-inclusive practice. The Fatherhood Institute (FI), a UK charity, has developed a workshop for Practitioners delivering the Healthy Child Programme. Method: A ‘before and after’ evaluation study, comprising a survey followed by telephone interviews, evaluated the impact of the FI workshop on Health Visitors’ and Community Practitioners’ knowledge, attitudes and behaviour in practice. A total of 134 Health Visitors and Community Practitioners from eight NHS Trusts in England attended the workshop from November 2011 to January 2014 at 12 sites. A specially constructed survey, incorporating a validated questionnaire, was administered before the workshop, immediately afterwards and three months later. Telephone interviews further explored participants’ responses. Findings: Analysis of the questionnaire data showed that the workshop and handbook improved participants’ knowledge, attitudes and behaviour in practice. This was sustained over a three-month period. In telephone interviews, most participants said that the workshop had raised their awareness of engaging fathers and offered them helpful strategies. However, they also spoke of barriers to engagement with fathers. NHS Trusts need to review the training and education of Health Visitors and Community Practitioners and take a more strategic approach towards father-inclusive practice and extend services to meet the needs of fathers.

SURVEILLANCE OF, AND THE IMPACT OF COMMUNITY POLICING ON ARREST-RELATED DEATHS (ARDS): Exploring the surveillance of ARDs and the opportunities to prevent them in the United States

Thesis (Master's)--University of Washington, 2016-08

Motivating residents to combat invasive species on private lands: social norms and community reciprocity

Invasive species (IS) threaten biodiversity and ecosystem functioning. To achieve landscape-scale reductions in IS and the associated gains for biodiversity, IS control efforts must be expanded across private lands. Enhancing IS control across private lands requires an understanding of the factors that motivate residents to engage or prohibit residents from engaging in efforts to control IS. Drawing from the collective interest model and literature, we sought to understand how a wide range of interpersonal, intrapersonal, and contextual factors might influence resident action around combating the invasive tree albizia (Falcataria moluccana), in the Puna District of Hawaiʻi. To do so, we used a cross-sectional survey of 243 residents and elastic net regression techniques. We found that residents’ actions related to IS control were related to their perceptions of social norms and community reciprocity regarding albizia control, as well as their knowledge of effective control strategies and their risk perceptions regarding albizia. These findings suggest that, although common intervention approaches that focus on providing education or subsidies are important, they may be more effective at reducing the spread of IS if coupled with approaches that build community reciprocity and norms.

Community perceptions of collaborative processes for managing freshwater resources

Six of New Zealand’s 16 regional councils are trialling collaborative planning as a means of addressing complex challenges in freshwater management. Although some work has been undertaken to evaluate similarities and differences across those processes, the success or failure rests with the public’s acceptance of the processes and their outcomes. This is the first study to evaluate public perceptions of freshwater management in regions with collaborative processes. We surveyed 450 respondents in Hawke’s Bay, Northland, and Waikato, some of whom live in catchments in which collaborative processes are under way and some of whom do not. In addition to assessing awareness of the collaborative planning processes, the survey measured perceptions regarding the regional council’s management of freshwater resources, the extent of agreement regarding freshwater management among various interests, the fairness of freshwater management, and the extent to which respondents believe that their interests and concerns are included in freshwater management. We hypothesized that relative to respondents in parts of the region in which traditional processes are in places, respondents in catchments with collaborative management of freshwater resources would have more positive perceptions of management, agreement, fairness, and interests, even if there is low awareness that a collaborative planning process is under way. Survey results indicate that knowledge of collaborative processes is generally low and that living in catchments with collaborative processes does not impact respondents’ perceptions of management, agreement, fairness, or interests in Northland or Waikato. However, relative to Hawke’s Bay respondents living outside of the collaborative catchment, respondents living inside the collaborative catchment believe that the regional council’s freshwater management is better and fairer. Moreover, Hawke’s Bay residents living inside the collaborative catchment perceive less conflict over freshwater management than Hawke’s Bay respondents living outside the collaborative catchment. Further research is needed to identify the reasons for this regional variation.

The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil

EMOND, Alan et al. The effectiveness of community-based interventions to improve maternal and infant health in the Northeast of Brazil. Revista Panamericana de Salud Pública/ Pan American Journal of Public Health , v.12, n.2, p.101-110, 2002

Health assets and active lifestyles during preadolescence and adolescence: highlights from the HBSC/WHO health survey and implications for health promotion

The present chapter discusses the assets model as a theoretical approach to the study of health behavior and health promotion. The model emphasizes people’s talents, competences, and resources. In this chapter, a health asset is defined as any factor or resource that maximizes the opportunities for individuals, local communities, and populations to attain and maintain health and well-being. This perspective expands and complements the current medical model as it focuses on the development of a sense of empowerment in community members to prevent and manage their own health. Therefore, in this chapter we address the concepts of salutogenesis, social support, resilience, coping, self-regulation, social capital, and personal and social competence, which are central to the development of individuals’ potential to manage and savor their own health, creating the conditions for self-fulfillment. Additionally, we demonstrate how the assets model guides the study of children’s and adolescents’ health in the Portuguese Health Behaviour in School-aged Children study (www.hbsc.org), concentrating on areas such as active lifestyles and quality-of-life perception. Finally, we present a roadmap for action that emphasizes the need to identify the factors that make children and adolescents happy and healthy individuals, while minimizing risks and problems they naturally encounter throughout their development. We also argue for the need to involve young people in discussions concerning their health and health promotion practices, focusing on the development of talents, capabilities, and positive expectations for the future.

Ithaka S+R, Jisc and RLUK UK survey of academics 2015

This report is the second Ithaka S+R / Jisc / RLUK survey of UK academics. It asks of the UK research community their views on resource discovery, their use of these resources (online and digital), attitudes to research data management, and much more. It provides a powerful insight into how researchers view their own behaviour and the research environment within the UK today. It gives us pointers to how we can provide further support to researchers and first indications as to where resources should be best invested in the future.