scholarly journals The impact of community level treatment and preventative interventions on trachoma prevalence in rural Ethiopia

2008 ◽  
Vol 37 (3) ◽  
pp. 549-558 ◽  
Author(s):  
P. Cumberland ◽  
T. Edwards ◽  
G. Hailu ◽  
E. Harding-Esch ◽  
A. Andreasen ◽  
...  
Keyword(s):  
Community Level ◽  
Rural Ethiopia ◽  
Preventative Interventions ◽  
The Impact

86 Impact of Community-Level Socioeconomic Disparities on Quality of Life After Burn Injury: A Burn Model Systems Database Study

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S59-S60
Author(s):  
Stephanie A Mason ◽  
Emma L Gause ◽  
Helena Archer ◽  
Stephen H Sibbett ◽  
Radha K Holavanahalli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Burn Injury ◽  
Well Being ◽  
Community Level ◽  
Model Systems ◽  
Socioeconomic Disparities ◽  
Injury Incidence ◽  
The Impact ◽  
Zip Code

Abstract Introduction Individual- and community-level socioeconomic disparities impact overall health and injury incidence, severity, and outcomes. However, the impact of community-level socioeconomic disparities on recovery after burn injury is unknown. We aimed to characterize the association between community-level socioeconomic disparities and health-related quality of life (HRQL) after burn injury. These findings might inform rehabilitation service delivery and policy making at administrative levels. Methods Participants with the NIDILRR Burn Model System who were ≥14 years with a zip code were included. Sociodemographic and injury characteristics and 12-item Short Form Health Survey (SF-12) and Veterans RAND (VR-12) physical (PCS) and mental (MCS) component summary scores 6 months after injury were extracted. Data were deterministically linked by zip code to the Distressed Communities Index (DCI), which combines seven census-derived metrics into a single indicator of economic well-being that ranges from 0 (lowest distress) to 100 (highest distress). Multilevel linear regression models estimated the association between DCI and HRQL. Results The 342 participants were mostly male (239, 69%) had a median age of 48 years (IQR 33–57) and sustained a median burn size of 10% TBSA (IQR 3–28%). More than one-third of participants (117, 34%) lived in a neighborhood within the two most distressed quintiles. After adjusting for age, race/ethnicity, and pre-injury HRQL, increasing neighborhood distress was negatively associated with PCS (ß-0.05, SE 0.02, p=0.01). Age and pre-injury PCS were also significantly associated with 6-month PCS. There was no association between neighborhood distress and 6-month MCS. However, pre-injury MCS was significantly associated with 6-month MCS (0.56, SE 0.07, p< 0.001). Conclusions Neighborhood distress is associated with lower PCS after burn injury but is not associated with MCS. Regardless of neighborhood distress, pre-injury HRQL is significantly associated with both PCS and MCS during recovery.

scholarly journals Impacts of fast food and the food retail environment on overweight and obesity in China: a multilevel latent class cluster approach

2011 ◽  
Vol 15 (1) ◽  
pp. 88-96 ◽  
Author(s):  
Xiaoyong Zhang ◽  
Ivo van der Lans ◽  
Hans Dagevos
Keyword(s):  
Fast Food ◽  
Latent Class ◽  
Overweight And Obesity ◽  
Community Level ◽  
Valuable Insight ◽  
Food Retail ◽  
Retail Environment ◽  
Dietary Knowledge ◽  
Food Retail Environment ◽  
The Impact

AbstractObjectiveTo simultaneously identify consumer segments based on individual-level consumption and community-level food retail environment data and to investigate whether the segments are associated with BMI and dietary knowledge in China.DesignA multilevel latent class cluster model was applied to identify consumer segments based not only on their individual preferences for fast food, salty snack foods, and soft drinks and sugared fruit drinks, but also on the food retail environment at the community level.SettingThe data came from the China Health and Nutrition Survey (CHNS) conducted in 2006 and two questionnaires for adults and communities were used.SubjectsA total sample of 9788 adults living in 218 communities participated in the CHNS.ResultsWe successfully identified four consumer segments. These four segments were embedded in two types of food retail environment: the saturated food retail environment and the deprived food retail environment. A three-factor solution was found for consumers’ dietary knowledge. The four consumer segments were highly associated with consumers’ dietary knowledge and a number of sociodemographic variables.ConclusionsThe widespread discussion about the relationships between fast-food consumption and overweight/obesity is irrelevant for Chinese segments that do not have access to fast food. Factors that are most associated with segments with a higher BMI are consumers’ (incorrect) dietary knowledge, the food retail environment and sociodemographics. The results provide valuable insight for policy interventions on reducing overweight/obesity in China. This study also indicates that despite the breathtaking changes in modern China, the impact of ‘obesogenic’ environments should not be assessed too strictly from a ‘Western’ perspective.

The Impact of Hurricane Maria on Individuals Living with Non-Communicable Disease in Puerto Rico: The experience of 10 communities

2021 ◽  
Author(s):  
Elizabeth L. Andrade ◽  
Amalis Cordova Mustafa ◽  
Courtney Riggle-vanSchagen ◽  
Megan Jula ◽  
Carlos E. Rodriguez-Diaz ◽  
...  
Keyword(s):  
Puerto Rico ◽  
Natural Hazards ◽  
Structural Damage ◽  
Communicable Disease ◽  
Community Level ◽  
Morbidity And Mortality ◽  
Health Concern ◽  
Increased Risk ◽  
The Impact ◽  
Non Communicable Disease

Abstract Background Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. Methods This investigation examined Hurricane Maria’s impact across 10 communities in Puerto Rico to determine whether and how disaster impact and community attributes affected NCD management. We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees, with 4 interviews per selected municipality. Using QSR NVivo software, we coded interview transcripts and created categorical community-level impact variables based on participant responses. We undertook thematic analysis to characterize community-level impact and consequences for NCD management, and to identify convergent and divergent themes. Using a matrix coding query, we compared NCD management experiences across communities by impact variables and community attributes. Results The delivery of healthcare, pharmacy, and dialysis services was compromised due to facility structural damage and ineffective contingencies for electrical power and water supply. The challenges resulting from power outages were immediate, and individuals who were reliant on life-sustaining medical equipment, dialysis, or the refrigeration of medications were most vulnerable. Inaccessible roadways and the need to travel greater distances to locate operational health services were major impediments to transporting patients in need of NCD care, with those requiring dialysis and living in remote, mountainous communities at highest risk due to landslides and lengthy roadway obstruction. These barriers were compounded by limited communication to locate services and coordinate care. Two weeks post-hurricane, emerging challenges to NCD management included widespread diesel fuel shortages for generators, and shortages in medications, oxygen, and medical supplies. In the weeks to months post-hurricane, the emergence or exacerbation of mental health disorders was characterized as a pressing health concern. Conclusions Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. The degree to which these impacts were experienced across communities with different characteristics is discussed, offering important lessons regarding the impact of catastrophic disasters on NCD management for improve community disaster resilience.

Restoration of pollination interactions in communities invaded by non-native plants.

2020 ◽  
pp. 377-390
Author(s):  
Christopher N. Kaiser-Bunbury ◽  
◽  
Benno I. Simmons ◽  
◽  
Keyword(s):  
Plant Species ◽  
Restoration Ecology ◽  
Invasive Plant ◽  
Ecosystem Processes ◽  
Community Level ◽  
Ecological Communities ◽  
Management Interventions ◽  
And Function ◽  
Network Metrics ◽  
The Impact

Invasive plant species degrade and homogenize ecosystems worldwide, thereby altering ecosystem processes and function. To mitigate and reverse the impact of invasive plants on pollination, a key ecosystem function, conservation scientists and practitioners restore ecological communities and study the impact of such management interventions on plant-pollinator communities. Here, we describe opportunities and challenges associated with restoring pollination interactions as part of a holistic ecosystem-based restoration approach. We introduce a few general concepts in restoration ecology, and outline best planning and evaluation practices of restoring pollination interactions on the community level. Planning involves the selection of suitable plant species to support diverse pollinator communities, which includes considerations of the benefits and disadvantages of using native vs exotic, and bridge and framework plant species for restoration. We emphasize the central role of scientific- and community-level approaches for the planning phase of pollination restoration. For evaluation purposes, we argue that appropriate network indicators have the advantage of detecting changes in species behaviour with consequences for ecosystem processes and functions before these changes show up in altered species communities. Suitable network metrics may include interaction diversity and evenness, and network measures that describe the distribution of species, such as network and species-level specialization, modularity and motifs. Finally, we discuss the usefulness of the network approach in evaluating the benefits of restoration interventions for pollination interactions, and propose that applied network ecologists take a central role in transferring theory into practice.

scholarly journals Improving Access and Adherence to Endocrine Therapy With Nurse-Based Intervention

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 15s-15s
Author(s):  
Sefonias Getachew ◽  
Adamu Addisse ◽  
Lesley Taylor ◽  
Eva J. Kantelhardt
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Nursing Intervention ◽  
Tamoxifen Therapy ◽  
Rural Ethiopia ◽  
Long Term Treatment ◽  
Nurse Navigator ◽  
The Impact

Purpose The majority of women with breast cancer from low-income countries, including Ethiopia, present with advanced clinical stage disease, which results in limited and difficult therapeutic options and high mortality rates. In Ethiopia, breast cancer is the most common cancer. We found that 70% of breast cancer cases in Ethiopia are hormone receptor positive. Endocrine therapy is one of the treatment options recommended for breast cancer but that is highly underutilized in the country. Recommendations on interventions to improve uptake and adherence to therapy exist, but studies that have assessed the feasibility of implementing these are limited. Our study (n = 107) in rural Ethiopia revealed an estimated 53% 2-year survival rate in patients who underwent surgery only. In our pilot study, of 51 eligible patients 26 initiated therapy and one half of those adhered after 1 year. Our study aims to evaluate the effectiveness of using a trained breast nurse navigator to improve patient adherence to tamoxifen therapy among patients with breast cancer in rural Ethiopia. Methods A cluster randomized intervention trial is being carried out in rural hospitals in southwestern Ethiopia from February 2018 to June 2019. We use hospitals in clusters as the units of randomization. The sample size includes four per intervention arm and control arm, with each cluster comprised of approximately 15 patients. Before intervention, all patients in the hospitals will receive tamoxifen therapy free of charge. Hormone receptor status of the breast cancer specimen will be determined before the initiation of therapy or throughout the course of therapy. The primary outcome of this trial is adherence to endocrine therapy on the basis of objective and subjective measures. Data will be collected with a prospective repeated measures approach. Analysis will be based on an intention-to-treat principle. Results The trial aims to provide evidence on the effectiveness of the breast nurse intervention to improve adherence to long-term endocrine therapy and answer the following research question: does the nursing intervention improve long-term treatment adherence by patients to endocrine therapy compared with those who receive usual care services? Conclusion These data are essential to maximize the impact of trained nurse-based interventions on adherence to endocrine (tamoxifen) therapy among patients with breast cancer on follow-up. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Eva J. Kantelhardt Travel, Accommodations, Expenses: Daiichi Sankyo Oncology Europe

scholarly journals Task-Layer Multiplicity as a Measure of Community Level Health

Complexity ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
P. Fraundorf
Keyword(s):  
Belief Systems ◽  
Well Being ◽  
Community Level ◽  
Behavioral Measure ◽  
Policy Changes ◽  
Web Searches ◽  
Individual Level ◽  
Broken Symmetries ◽  
Attention Focus ◽  
The Impact

The insights of many disciplines, and of commonsense, about individual-level well-being might be strengthened by a shift in focus to community-level well-being in a way that respects belief systems as well as the power of each individual. We start with the jargon of complex systems and the possibility that a small number of broken symmetries, marked by the edges of a hierarchical series of physical subsystem types, underlie the delicate correlation-based complexity of life on our planet’s surface. We show that an information-theory-inspired model of attention-focus on correlation layers, which looks in/out from the boundaries of skin, family, and culture, predicts that behaviorally diverse communities may tend toward a characteristic task-layer multiplicity per individual of only e29/20≅ 4.26 of the six correlation layers that comprise that community. This behavioral measure of opportunity may help us to (i) go beyond GDP in quantifying the impact of policy changes and disasters, (ii) manage electronic idea-streams in ways that strengthen community networks, and (iii) leverage our paleolithic shortcomings toward the enhancement of community-level task-layer diversity. Empirical methods for acquiring task-layer multiplicity data are in their infancy, although for human communities a great deal of potential lies in the analysis of web searches and asynchronous experience sampling similar to that used by “flu near you.”

Primary care and all-cause mortality in urban China: a mixed-level analysis

2020 ◽  
Author(s):  
Quan Zhang
Keyword(s):  
Primary Care ◽  
Mortality Risk ◽  
Health Care Access ◽  
Community Dwelling ◽  
Urban China ◽  
Community Level ◽  
Promoting Effect ◽  
Primary Care Supply ◽  
The Impact

Abstract Background There is still a lack of evidence focusing on primary care supply in developing countries where the educational achievement of primary care practitioners is relatively low. Objectives By using a nationally representative longitudinal and prospective cohort study, this study examined whether primary care supply, measured by the availability and the number of community health centres (CHCs), was associated with 4-year mortality risk among community-dwelling participants aged 45 and above in urban China. Methods Using the 2011 and 2015 waves of the China Health and Retirement Longitudinal Survey (CHARLS), we conducted a longitudinal mixed-level logistic analysis to study the impact of the availability and the number of CHC on 4-year follow-up mortality risk, after adjusting community- and individual-level covariates. Results Individuals living in communities with CHC were 31% less likely to die during the 4-year follow-up (P < 0.05) conditional on community-level characteristics, including the basic facilities availability, population size and physical area, and individuals’ socio-demographic and health characteristics and health behaviours. Also, an increased number of community-level CHC was shown to decrease residents’ 4-year mortality risk significantly (odds ratio = 0.82, P < 0.05). Furthermore, the association was more pronounced among adults aged 65 and above. Conclusion This study provides additional evidence of the health-promoting effect of primary care supply among urban residents in China. Improving primary care coverage in China should be necessary to improve health care access, thus promoting population health.

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