The reach and rationale for community health fairs

Latinos living in the USA account for one third of the uninsured population and face numerous cultural, linguistic, and financial barriers to accessing healthcare services. Community health fairs have developed to address the unmet need for no- and low-cost services that target prevention and education among underserved communities. The current research describes an ongoing effort in a community in Southern California and examines the barriers to health care among participants registering to receive free breast health screenings, one of the major services offered at a 2010 health fair. A total of 186 adult Latina women completed a brief questionnaire assessing their healthcare utilization and self-reported barriers to engaging in preventive and screening services. Approximately two thirds of the participants reported never receiving or having more than 2 years passing since receiving a preventive health check-up. Participants identified cost (64.5 %) and knowledge of locations for services (52.3 %) as the primary barriers to engaging in routine healthcare services. Engaging with health professionals represents a leading way in which adults obtain health information; health fairs offering cancer health screenings represent a culturally appropriate venue for increased cancer health equity. Implications of the current research for future health fairs and their role in community cancer education are discussed.

A Submission to the Senate Community Affairs Committee Inquiry into gene patents

Inquiry into Gene Patents Submissions Received by the Committee during the 42nd Parliament

Cost-effectiveness of hospital infection control interventions in resource-limited settings

The aim of this project was to evaluate the cost-effectiveness of hand hygiene interventions in resource-limited hospital settings. Using data from north-east Thailand, the research found that such interventions are likely to be very cost-effective in intensive care unit settings as a result of reduced incidence of methicillin-resistant Staphylococcus aureus bloodstream infection alone. This study also found evidence showing that the World Health Organization's (WHO) multimodal intervention is effective and when adding either goal-setting, reward incentives, or accountability strategies to the WHO intervention, compliance could be further improved.

Comparison of sustainable community rating tools in Australia

The community is the basic unit of urban development, and appropriate assessment tools are needed for communities to evaluate and facilitate decision making concerning sustainable community development and reduce the detrimental effects of urban community actions on the environment. Existing research into sustainable community rating tools focuses primarily on those that are internationally recognized to describe their advantages and future challenges. However, the differences between rating tools due to different regional conditions, situations and characteristics have yet to be addressed. In doing this, this paper examines three sustainable community rating tools in Australia, namely Green Star-Communities PILOT, EnviroDevelopment and VicUrban Sustainability Charter (Master Planned Community Assessment Tool). In order to identify their similarities, differences and advantages these are compared in terms of sustainability coverage, prerequisites, adaptation to locality, scoring and weighting, participation, presentation of results, and application process. These results provide the stakeholders of sustainable community development projects with a better understanding of the available rating tools in Australia and assist with evaluation and decision making.

Nursing care of children in general practice settings: roles and responsibilities

Aims. To examine roles and responsibilities of Practice Nurses in the area of child health and development and in advising parents about child health issues. Background. As the focus of Australia’s health care system shifts further towards the primary health care sector, governmental initiatives require that Practice Nurses are knowledgeable, confident and competent in providing care in the area of child health and development. Little is known about roles and responsibilities of Practice Nurses in this area. Design. Cross-sectional survey design. Methods. Practice Nurses completed a national online survey examining the roles and responsibilities in child health and development, professional development needs and role satisfaction. Data were collected from June 2010–April 2011. Results. Respondents (N = 159) reported having a significant role in well and sick child care and were interested in extending their role. Frequent activities included immunization, phone triage/advice, child health/development advice, wound care and Healthy Kids Checks. However, few had paediatric/child nursing backgrounds or postgraduate qualifications in paediatric nursing and they reported limited preparation for the role. Practice Nurses reported difficulties with keeping up-to-date with child health information and advising parents confidently. Satisfaction was relatively low regarding opportunities and encouragement to undertake professional development and expand scope of practice. Conclusion. Practice Nurses are largely unprepared to meet the demands of their child health role and need support to develop and maintain the skills and knowledge base necessary for high-quality, evidence-based practice. Both financial and time support is needed to enable Practice Nurses to access child health professional development.

Community Resilience: Fostering Recovery, Sustainability, and Growth

In this chapter, the authors define community resilience and identify the components that predict it will occur. Three dimensions are highlighted: recovery, sustainability, and growth. Their discussion focuses on communities like those of Sudanese refugees who have experienced forced migration, emphasizing the importance that community plays to future adaptation. They show through their report on their research that community collaboration, shared identity, and empowerment increase bonding and bridging capital that promote the well-being of people under stress. They argue that an emphasis on community resilience places value on the social connections, policies, programs, and community context necessary for resilience in different cultures and contexts.

Community development and community resilience: An integrative approach

Throughout history, communities and civilizations have sought to enhance the quality of community life and the well-being of its people. However, more recently there has been greater interest in attending to the details of community development by capitalizing on the improved ability to capture community well-being and successes scientifically. That interest invites greater attention to the development of indicators that can quantify those qualities of life that lead to strong and healthy communities. The selection of meaningful indicators is dependent upon several factors including a process that stimulates meaningful involvement of community stakeholders, but the single most important is the identification of an underlying model to guide the work. Indicators do not have meaning in themselves. For these measures to provide a coherent assessment of the community, an integrative approach to understanding what constitutes a healthy and strong community in a dynamic environment is required. A resilience perspective serves that purpose and provides a framework that is broad, neutral, and conceptually strong enough to structure development of significant sets of indicators. Exemplary community indicator processes across the nation, particularly recent efforts in the Phoenix, Arizona region, provide evidence supporting the value of indicator development for community building.

Community Service Charities

Using the first Annual Information Statements (AIS) filed with the Australian Charities and Not-for-profits Commission (ACNC), this factsheet describes community service charities that are based in QLD. They have been selected from charities that have a main activity of either aged care activities; civic and advocacy activities; economic, social and community development; emergency and relief; employment and training; housing activities; income support and maintenance; law and legal activities; mental health and crisis intervention; or social services.

Commercial friendships between gay sales associates and straight female customers in luxury settings: A proposed theoretical framework

This study investigates friendships between gay sales associates and heterosexual female customers in luxury retail settings. By employing grounded theory methodology, the study integrates theories and findings from diverse literature streams into an original conceptual framework to illustrate the resources gay sales associates and straight female customers receive from and provide to each other during retail exchanges. The study explains why gay male–straight female friendships are uniquely suited for luxury consumption settings. Female customers characterize their friendships with gay sales associates as providing honesty, security, trust, and comfort, which stems from the absence of sexual interest and a lack of inter-female competition. Gay sales associates receive acceptance for who they are and for their displays of unconventional masculinity in retail settings. They also obtain a temporary rite from their female customers, a so-called mandate of privacy, which permits both parties to ignore the bounds of modesty and accept a degree of intimacy. Such intimacy facilitates transactions that require both personalization and customer–employee closeness, such as the selling of high-end apparel, accessories, and jewelry.

Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Background Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language. Methods/Design Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation. Discussion Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

Community Controlled Health Services: What They Are and How They Work

This chapter provides an overview of the role of community controlled health services and health sector and the role of the nurse.

The gut microbial community of midas cichlid fish in repeatedly evolved limnetic-benthic species pairs

Gut bacterial communities are now known to influence a range of fitness related aspects of organisms. But how different the microbial community is in closely related species, and if these differences can be interpreted as adaptive is still unclear. In this study we compared microbial communities in two sets of closely related sympatric crater lake cichlid fish species pairs that show similar adaptations along the limnetic-benthic axis. The gut microbial community composition differs in the species pair inhabiting the older of two crater lakes. One major difference, relative to other fish, is that in these cichlids that live in hypersaline crater lakes, the microbial community is largely made up of Oceanospirillales (52.28%) which are halotolerant or halophilic bacteria. This analysis opens up further avenues to identify candidate symbiotic or co-evolved bacteria playing a role in adaptation to similar diets and life-styles or even have a role in speciation. Future functional and phylosymbiotic analyses might help to address these issues.

Envisaging change: Supporting grassroots efforts in Colombia with agonistic design processes

Design has become increasingly engaged with bringing about social change. Shifting domains and perspectives to conflict stricken contexts yield opportunities to explore emerging forms of design that enable the expression and articulation of difference in productive ways, which can contribute positively to efforts related to civic issues and struggles in urban settings from developing countries. We explore the recently developed notion of Adversarial Design to support the integration of diverging perspectives and grassroots voices in the design process. This paper presents the findings and design insights from our study with two grassroots organisations in Bogota, Colombia. We present three themes that expose ways in which conflict motivates bringing about change, the importance of the social and physical features of the urban landscape, and the way in which social change acts as catalyst for acquiring new knowledge. To finalise, we discuss two design areas and how design could be used to integrate dissimilar worldviews.

A novel serogenetic approach determines the community prevalence of celiac disease and informs improved diagnostic pathways

Background: Changing perspectives on the natural history of celiac disease (CD), new serology and genetic tests, and amended histological criteria for diagnosis cast doubt on past prevalence estimates for CD. We set out to establish a more accurate prevalence estimate for CD using a novel serogenetic approach.Methods: The human leukocyte antigen (HLA)-DQ genotype was determined in 356 patients with 'biopsy-confirmed' CD, and in two age-stratified, randomly selected community cohorts of 1,390 women and 1,158 men. Sera were screened for CD-specific serology.Results: Only five 'biopsy-confirmed' patients with CD did not possess the susceptibility alleles HLA-DQ2.5, DQ8, or DQ2.2, and four of these were misdiagnoses. HLA-DQ2.5, DQ8, or DQ2.2 was present in 56% of all women and men in the community cohorts. Transglutaminase (TG)-2 IgA and composite TG2/deamidated gliadin peptide (DGP) IgA/IgG were abnormal in 4.6% and 5.6%, respectively, of the community women and 6.9% and 6.9%, respectively, of the community men, but in the screen-positive group, only 71% and 75%, respectively, of women and 65% and 63%, respectively, of men possessed HLA-DQ2.5, DQ8, or DQ2.2. Medical review was possible for 41% of seropositive women and 50% of seropositive men, and led to biopsy-confirmed CD in 10 women (0.7%) and 6 men (0.5%), but based on relative risk for HLA-DQ2.5, DQ8, or DQ2.2 in all TG2 IgA or TG2/DGP IgA/IgG screen-positive subjects, CD affected 1.3% or 1.9%, respectively, of females and 1.3% or 1.2%, respectively, of men. Serogenetic data from these community cohorts indicated that testing screen positives for HLA-DQ, or carrying out HLA-DQ and further serology, could have reduced unnecessary gastroscopies due to false-positive serology by at least 40% and by over 70%, respectively.Conclusions: Screening with TG2 IgA serology and requiring biopsy confirmation caused the community prevalence of CD to be substantially underestimated. Testing for HLA-DQ genes and confirmatory serology could reduce the numbers of unnecessary gastroscopies. © 2013 Anderson et al.; licensee BioMed Central Ltd.

Identifying opportunity spaces for design research in South America: Working with grassroots and community groups

As design research continues to gain momentum in South America, design researchers and practitioners in the region have begun to consider how to the field may address regionally-specific issues, including on-going political struggles. By bringing approaches such as Participatory Design and Adversarial Design that consider political aspects of design, local researchers have explored various forms that these two approaches could take that are tailored to the needs and values of different communities across the region. This paper focuses on identifying opportunities for developing design research projects in community-based and grassroots-oriented contexts. The paper presents the findings of our study about the understanding and experience of design researchers and experts who have been working closely with community groups and grassroots organisations in South America. Five themes emerged, highlighting opportunities and challenges related to positioning contemporary design research in the region, integration of adversarial perspectives into design processes, leveraging local obstacles through creativity, and the potential of building capacity within community groups and grassroots organisations for sustainability and autonomy.