Work In Community Settings Research Articles

Helicopter Dropping of 50 Free Allopathic Medicines; Prescribed by Homoeopathic Doctors at Ground: Sorry this is not Universal Health Coverage.

The provision of Universal Health Coverage (UHC) is being discussed in India. Crippled by the charges of corruption and unethical practice by media and public at large, medical professionals are largely unaware, disinterested, isolated and edged out from this debate. The traditional general practitioner is a dying breed and deficiency of doctors willing to work in community settings is rampant. Is UHC model proposed in present form good for an ordinary Indian citizen? This editorial looks into the underlying politics of health care in India in the past and how this ongoing debate could impact the future of primary care and health care of people in India.

Diversifying Information Literacy Research: An Informed Learning Perspective

This article uses the idea of informed learning, an interpretation of information literacy that focuses on people’s information experiences rather than their skills or attributes, to analyse the character of using information to learn in diverse communities and settings, including digital, faith, indigenous and ethnic communities. While researchers of information behaviour or information seeking and use have investi- AU :2 gated people’s information worlds in diverse contexts, this work is still at its earliest stages in the information literacy domain. To date, information literacy research has largely occurred in what might be considered mainstream educational and workplace contexts, with some emerging work in community settings. These have been mostly in academic libraries, schools and government workplaces. What does information literacy look like beyond these environments? How might we understand the experience of effective information use in a range of community settings, from the perspective of empirical research and other sources? The article concludes by commenting on the significance of diversifying the range of information experience contexts,for information literacy research and professional practice.

Field Assessments for Obesity Prevention in Children and Adults: Physical Activity, Fitness, and Body Composition

Nutrition and health educators work in community settings implementing lifestyle programs focused on obesity prevention and chronic disease risk reduction. These programs typically focus on improving diet and physical activity (PA) behaviors. Many nutrition educators may not be confident in their ability to select, administer, and interpret PA assessments to effectively evaluate their PA or lifestyle programs. This report will assist educators in identifying and selecting appropriate field-based assessments for measurement of PA, physical fitness, and body composition for children and adults. Specific guidelines, references, and resources are given for selecting assessment methods and test within these 3 areas.

How do hospital administrators perceive cardiac rehabilitation in a publicly-funded health care system?

BackgroundPatient and provider-related factors affecting access to cardiac rehabilitation (CR) have been extensively studied, but health-system administration factors have not. The objectives of this study were to investigate hospital administrators’ (HA) awareness and knowledge of cardiac rehabilitation (CR), perceptions regarding resources for and benefit of CR, and attitudes toward and implementation of inpatient transition planning for outpatient CR.MethodsA cross-sectional and observational design was used. A survey was administered to 679 HAs through Canadian and Ontario databases. A descriptive examination was performed, and differences in HAs’ perceptions by role, institution type and presence of within-institution CR were compared using t-tests.Results195 (28.7%) Canadian HAs completed the survey. Respondents reported good knowledge of what CR entails (mean=3.42±1.15/5). Awareness of the closest site was lower among HAs working in community versus academic institutions (3.88±1.24 vs. 4.34±0.90/5 respectively; p=.01). HAs in non-executive roles (4.77±0.46/5) perceived greater CR importance for patients’ care than executives (4.52±0.57; p=.001). HAs perceived CR programs should be situated in both hospitals and community settings (n=134, 71.7%).ConclusionsHAs value CR as part of patients’ care, and are supportive of greater CR provision. Those working in community settings and executives may not be as aware of, or less-likely to value, CR services. CR leaders from academic institutions might consider liaising with community hospitals to raise awareness of CR benefits, and advocate for it with the executives in their home institutions.

Compassion in Contemporary Social Policy: Applications of Virtue Theory

AbstractCurrent academic debate in the social sciences and humanities is revisiting the role of virtue in civic life. This debate is relevant to social policy. We argue that virtue is already an implicit component of policy debates, but that the virtue of compassion has not received sufficient emphasis. To support our argument we review classical and contemporary arguments regarding virtue and its linkage to the ‘good society’; articulate the necessity of compassion and its application to specific policies areas (e.g., domestic violence, welfare, emergency care); and assess how compassion intersects with other virtues in the policy environment. Policy implications are identified including: recognition of the realities of suffering, the need for sufficient administrative infrastructure and trained professionals and an often long-term commitment to work in community settings. Weighing the risks, and the overall challenges of virtuous action, our analysis suggests compassion remains a compelling, yet under-utilised, basis for constructing and implementing policies.

History and description of the Anni Bergman Parent-Infant Program

It is a proud occasion to have papers written by graduates of the Anni Bergman Parent-Infant Training Program published by The International Journal of Infant Observation. Our programme in New York, far younger than the Tavistock Clinic, is beginning its fourteenth year. The papers collected here reflect how the programme has facilitated psychoanalytically informed infant observation and clinical work with mothers, fathers, and infants in a variety of settings. Several years ago, Rita Reiswig, a founding director of the Anni Bergman Parent-Infant Program, contacted Lisa Miller about collaborating on an issue of Infant Observation. Gloria Demby and Susannah Falk Shopsin, graduates of the programme, took on the task of bringing the project to fruition. We are grateful to Beth Miller and the entire editorial board of Infant Observation, headed by Lisa Miller, for a rich collaboration with us over the past months that has culminated in this edition of the journal. The following introduction describes the beginning of our training programme and provides an overview of the ideas that have influenced the programme today – its areas of study, and our beginning expansion into clinical work in community settings and research.

Stuck at home: A portrayal of educational work in community spaces

This paper considers the positioning of work in community learning spaces through insights drawn from a particular case of adult community education in Victoria, Australia. Despite the rhetorical location of adult community education in Victoria as a legitimate and important sector of post compulsory education and as part of the platform on which the government's lifelong learning agenda is realised, perceptions held of it continue to devalue the significant educational work that is done within it and the outcomes it achieves.The paper draws on an analysis of a sample of qualitative interview data collected in the course of related research projects (Clemans, 2005; Billett et al., 2005; Seddon et al. 2008) to highlight the ways in which work in a community learning space is positioned, perceived and (mis)understood. These perceptions stem from those who work both within and are located outside of the community-based adult education sector. The findings demonstrate the centrality of the notion of the ‘domestic’ or home space in the ways that educational work in community settings is constructed and perceived. They suggest that a consistent emphasis on care overlays notions of unpaid, private and domestic work onto those who work in the community learning space.The paper invites readers to view the community as a spatial construction, drawing on ideas founded in feminist geographies and those within adult education. It argues that these scholarly resources are helpful in understanding the ways in which work within the adult community education space is distinctively positioned, yet consistently devalued, despite its significant impact on ‘second chance’ learners.

Hints for the Aspiring Public Health Nurse

The original article from which these excerpts were taken, "Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program," by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's "Valuable Assets."

Longitudinal Associations Between Negative Symptoms and Social Functioning in Schizophrenia: The Moderating Role of Employment Status and Setting

While research has demonstrated strong relationships between negative symptoms and social difficulties in schizophrenia, little is known about the possible role of employment status and setting in this relationship. Seventy-seven participants with a diagnosis of schizophrenia spectrum disorder, who were either unemployed (n = 34), employed within a specialty mental health setting (n = 23), or employed within a community setting (n = 20) were assessed twice, six weeks apart, as to their negative symptoms and social functioning. Work in community settings generally predicted an increase in the levels of social functioning over time. However, individuals with high levels of negative symptoms who were employed in community settings evinced substantial decline in social functioning over time compared to unemployment or to employment in specialty mental health settings. These results are consistent with action models of psychopathology and encourage heightened sensitivity to individual symptomatic profiles in the course of vocational rehabilitation.

Professional Relationships and Power Dynamics Between Urban Community-Based Nurses and Social Work Case Managers

The purpose of this study was to explore how community-based case managers interface with their clients' healthcare providers and other community organizations as a function within their advocacy efforts. Case managers previously defined advocacy as occurring at individual, organizational, and community levels. The relationships they attempt to develop and maintain are consistent with case management ideology, yet this is a complex process to ensure care for vulnerable populations with many medical and socioeconomic needs. Community-based case management settings. In-depth qualitative interviews with a total of 20 nurse and social work case managers working in public housing, university-affiliated community nursing centers, local parishes, and community ministry. The case managers in this study reflected on how they interface with their clients, other healthcare providers, and community organizations on behalf of their clients. They reflect on the importance of trust and communication to facilitate this process. The advocacy work of case managers is influenced by the setting, others' perceptions of their knowledge and expertise, and power dynamics. Their ability to effectively advocate is greatly influenced by the strength of the relationships they forge. Advocacy for vulnerable clients is influenced by the existing relationship between case managers and their clients' healthcare providers. Case managers need to be persistent in their interactions with other providers to ensure that their clients have access to valuable community resources. Clear lines of communication should be established between case managers so that there is clarity around roles and expectations in service provision. Case managers should also participate in the mentoring of future health professions students so they may learn the application of advocacy work in community settings.

Developing a University-Wide Institutional Response to Sexual Assault and Relationship Violence

SUMMARY This article presents a process case study for developing a university-wide response to sexual assault and relationship violence. Following Kelly's (1988) approach to prevention work in community-settings, we began our work with in-depth ecological reconnaissance to understand our local context. Our case study described the processes used to develop an inclusive task force, conduct an environmental scan, and carry out a quantitative-qualitative needs assessment. Our processes for developing an institutional response for both direct services interventions and prevention are discussed in the context of Kelly's (1966, 1968, 2006) ecological principles of interdependence and cycling of resources.

Public-Academic Partnerships: Core Elements of a Public Psychiatry Fellowship

As the oldest, largest, and best known program for training psychiatrists to become public-sector leaders, the Columbia University Public Psychiatry Fellowship (PPF) at New York State Psychiatric Institute has frequently been consulted by other departments of psychiatry planning public and community fellowship programs. PPF's faculty has developed seven core elements for such training programs. The fellowship's longevity and the career paths of its graduates suggest that these core elements represent a best-practices model for fellowship training in public-community psychiatry.

How to succeed as a lifelong learner

This article examines the concepts and practical applications of lifelong learning and continuing professional development. It explores the ways in which nurses working in community settings can set and achieve learning goals.

British Health System Shifts Authority to Local Agencies

Back to table of contents Previous article Next article International NewsFull AccessBritish Health System Shifts Authority to Local AgenciesChristine LehmannChristine LehmannSearch for more papers by this authorPublished Online:17 Sep 2004https://doi.org/10.1176/pn.39.18.0390020aThe idea for a robust public health system in England was born in 1942, when mass casualties were expected during World War II. When the war ended, the idea of a welfare state with cradle-to-grave social services for all became popular in the country.The National Health Service (NHS) was envisioned to be tax supported, free to all, and based on community care, with general practitioners and community health centers at its core.The NHS, which was fully established in England by 1948, has continued to grow, becoming the largest governmental organization in Europe with more than 1 million employees, according to the NHS Web site.The government has run the NHS since 1948 without national standards, patient choice of health care providers or treatment, and adequate staffing or funding, according to a Department of Health (DoH) statement. The DoH is responsible for improving the health and well-being of England's population.In his re-election campaign, Prime Minister Tony Blair promised to reform the NHS and increase its funding. His government made good on that promise and is implementing a detailed plan for reform combined with modest funding increases.In 2002 a cabinet minister was appointed secretary for health and head of the DoH.The health secretary works with five health ministers. Each minister is responsible for several, often diverse, areas. For example, the minister responsible for adult mental health services also oversees dentistry, emergency care, diabetes, and patient and public involvement, said Richard Beinecke, D.P.A., at last month's Mental Health Policy Roundtable meeting at APA headquarters (Original article: see article above). He spent three months in the United Kingdom last spring to learn about the organization and delivery of general health, mental health, and social services.A major reform within the NHS is the transfer of service planning authority and funding from the central offices in London to locally based primary care trusts (organizations). “The goal is to design services around patients and put them first,” according to a report from the NHS.Strategic planning for NHS was delegated to 28 new health authorities renamed Strategic Health Authorities (SHA). Each SHA covers about 1.5 million people and develops plans for improving local health services and ensuring that the quality of services is high and national priorities are integrated into local health service plans, according to Beinecke.The government has promised that 75 percent of the NHS budget will be transferred to local health authorities, according to the NHS.The primary care trusts also decide which secondary services to contract for. Secondary care is specialized and covers mental health, integrated care, NHS hospitals, and ambulance services, Beinecke explained.People with severe mental illnesses including severe anxiety problems or psychotic illness usually are referred by their primary care physicians to specialists for mental health treatment, according to the NHS. For milder problems including marital and bereavement concerns, patients are generally advised to seek help from primary care professionals.Mental health teams work in community settings. Specialized care is provided by crisis resolution teams, assertive outreach teams, early intervention teams, and prison-in-reach teams, which support the health staff in prisons, said Beinecke.There has been a renewed emphasis on integrating general health, mental health, and social services funded by the NHS, Beinecke said. The 1999 Health Act allowed local authorities and the NHS to set up local integrated care organizations called “care trusts” and pool budgets, according to Beinecke.A small number of these trusts have been established, but more are expected in the future.A detailed description of the reorganized NHS is posted online at<www.nhs.uk/england/aboutTheNHS/default.cmsx>. The summary of the NHS plan is posted online at<www.publications.doh.gov.uk/deliveringthenhsplan.index.htm>.▪ ISSUES NewArchived

Developing a Curriculum Module to Prepare Students for Community-Based Physiotherapy Rehabilitation in South Africa

Background and purpose With the rapid turnover and consequent demand for hospital beds and the inadequate number of physiotherapists, increasing numbers will need to work in community settings in South Africa in the future. Education of students at the University of Cape Town was required to move away from a disease-centred, hospital-based curriculum to a community-based programme in order to meet the rehabilitation needs of the majority of the disabled population in the country. The aim of this study was to identify the gaps in the undergraduate curriculum and to make the required curricular changes to ensure that, on graduation, the students would be competent and confident to work in community settings. Methods A module on community physiotherapy preceded a four-week placement in an historically disadvantaged community with no access to rehabilitation facilities. Seventy-five students provided severely disabled persons and their caregivers with rehabilitation and education programmes in their homes. The students were provided with two sessions of clinical supervision weekly. At the end of the placement they were examined on their ability to treat patients in a home environment and were also scored on their block performance over the month. Students evaluated the placement as a learning experience and the clinical supervisors kept records throughout the two years on gaps in the content of the community physiotherapy module. Findings The majority of students found the placement a valuable learning experience and suggested that it should be developed into a multi-disciplinary student rotation. The clinical supervisors identified several topics that were essential to include in the community physiotherapy module to help the students in moving from a medical model to a bio-psychosocial model in the management of their clients. Conclusion The study achieved its aim of identifying the gaps in the existing undergraduate programme that needed to be addressed in order to prepare students to be competent and confident to practise in community settings on graduation. Changes to the curriculum were done incrementally during the year and also at the beginning of each of two years. These have been in operation for the past five years. With the rapid turnover and consequent demand for hospital beds and the inadequate number of physiotherapists, increasing numbers will need to work in community settings in South Africa in the future. Education of students at the University of Cape Town was required to move away from a disease-centred, hospital-based curriculum to a community-based programme in order to meet the rehabilitation needs of the majority of the disabled population in the country. The aim of this study was to identify the gaps in the undergraduate curriculum and to make the required curricular changes to ensure that, on graduation, the students would be competent and confident to work in community settings. A module on community physiotherapy preceded a four-week placement in an historically disadvantaged community with no access to rehabilitation facilities. Seventy-five students provided severely disabled persons and their caregivers with rehabilitation and education programmes in their homes. The students were provided with two sessions of clinical supervision weekly. At the end of the placement they were examined on their ability to treat patients in a home environment and were also scored on their block performance over the month. Students evaluated the placement as a learning experience and the clinical supervisors kept records throughout the two years on gaps in the content of the community physiotherapy module. The majority of students found the placement a valuable learning experience and suggested that it should be developed into a multi-disciplinary student rotation. The clinical supervisors identified several topics that were essential to include in the community physiotherapy module to help the students in moving from a medical model to a bio-psychosocial model in the management of their clients. The study achieved its aim of identifying the gaps in the existing undergraduate programme that needed to be addressed in order to prepare students to be competent and confident to practise in community settings on graduation. Changes to the curriculum were done incrementally during the year and also at the beginning of each of two years. These have been in operation for the past five years.

The Perceptions of Experienced Community Learning Disability Nurses of their Roles and Ways of Working

In Wales, 20 experienced Community Learning Disability Nurses (CLDNs) each with over 5 years of working in community settings were interviewed in order to ascertain how they perceived their roles and ways of working. They described a diverse range of activities that included addressing the health, social, psychological and educational needs of people with learning disabilities. Whereas job satisfaction appeared high, a need to better communicate their role to others was identified, along with the need for a more targeted approach to their practice. They reported an aim to establish a stronger health identity with closer links to the Primary Health Care Team. Whereas it was felt that the CLDN role was valuable, some of those interviewed were unsure as to its long-term survival. It was also noted that there was an inconsistency across localities as to how the skills of CLDNs were being used, for example, in relation to the provision of residential services and services for children.

Singing for health: an exploration of the issues

Singing for health may be an idea whose time has come. The interest in music in relation to health is evident in medical and health‐care research. This paper reviews ways in which music and singing relate to health and healing, historically and cross‐culturally, and shows that music forms a part of the healing systems of many cultures. The paper reviews research on the links between music and health. They include studies that suggest that music has profound effects on the emotions, for example, inducing states of relaxation which are particularly useful as an antidote to depression, anxiety and fatigue. Music has also been shown to enhance physical health through improvements to breathing capacity, muscle tension and posture and the reduction of respiratory symptoms. It may also contribute to social health through the management of self‐identity and interpersonal relationships. The paper explores theories that are beginning to develop about the mechanisms that mediate music for health, including the possible connections between immuno‐suppression, stress reduction, and music. The paper goes on to discuss the role of singing with early years children and community groups of adults. A resurgence of traditional music‐making and voice work in community settings is taking place across the UK, and the paper reviews several community‐based initiatives.

Factors associated with intended staff turnover and job search behaviour in services for people with intellectual disability.

Staff turnover is a major problem in services for people with intellectual disability (ID). Therefore, understanding the reasons for staff turnover is vital for organizations seeking to improve their performance. The present study investigates the factors directly and indirectly associated with an intention to leave an organization and actual job search behaviour amongst staff in services for people with ID. As part of a large-scale survey of staff in services for people with ID, information was collected from 450 staff concerning intended turnover, job search behaviour and a wide range of factors potentially associated with these outcomes. Path analyses revealed that work satisfaction, job strain, younger staff age and easier subjective labour conditions were directly associated with intended turnover. The same factors, with the exception of younger staff age, were also directly associated with job search behaviour. Factors indirectly associated with these outcomes included wishful thinking, alienative commitment to the organization, lack of staff support, role ambiguity, working longer contracted hours, having a low-status job, a lack of influence over decisions at work and less orientation to working in community settings with people with ID. The models of staff turnover empirically derived in the present study confirm and extend previous research in this area. The implications for organizations are discussed.

WORKING IN COMMUNITIES TO PROMOTE HEALTH AND WELL-BEING

To optimize health and well-being for the entire population, interventions that have proven efficacious for enhancing physical activity and reducing cardiovascular risk in controlled, clinical settings need to be adapted and tested for effectiveness in community settings. Investigators from Johns Hopkins University have a wealth of experience in conducting interventions in community settings, demonstrating that community-based research is feasible and can be conducted with scientific integrity. Dr. Donna Wills, a media-based Medical Consultant will introduce the particular health needs of Baltimore. The other speakers will present Baltimore-based projects that have addressed improved health and well-being for community participants. These include: (1) physical activity and dietary interventions conducted among youth to reduce cardiovascular risk (Stewart) (2) lifestyle interventions conducted in churches for African Americans to improve cardiovascular health (Becker); (3) a church-based intervention to increase physical activity for African American women (Young); (4) a neighborhood health worker intervention to reduce blood pressure in a low-income, high-risk, urban neighborhood in Baltimore (Clark); and (5) an elementary school mentoring program for older adults to improve well-being and cognitive and physical function (Fried). Speakers will highlight these projects, describe their effectiveness at reaching study goals, and address challenges that are associated with working in community settings.

Exploring mental health nurses' expectations and experiences of working in the community.

As mental health care is increasingly being provided in community settings, a variety of job opportunities are becoming available to mental health nurses. The extent to which nurses' views and experiences of working in community settings have been explored, however, is limited. This paper reports on newly qualified nurses' plans in relation to taking up work in the community and, for those who thought it likely that they would take up such work, their reasons for doing so. Reasons for working in the community were diverse, and suggested that a range of satisfactions could be expected. The extent to which such expectations become a reality is considered in the light of findings from interviews with 12 nurses who were working in community settings. Satisfactions and difficulties experienced by the 12 nurses are described, and suggestions for tackling some of the difficulties are made.