Community assessment: a church community and the parish nurse

In central Massachusetts a large urban parish asked the University of Massachusetts, Amherst School of Nursing to conduct a community assessment for the church and newly employed parish nurse. The aims of the assessment were: to determine the health status of parishioners, identify their perceived health needs and perceived barriers in meeting those needs, and to assist the church and parish nurse in developing a health program for their faith community. Findings of the assessment are based on questionnaire and focus group data. Four hundred and twenty-one questionnaires were completed, and six focus groups were held to validate the data. Results showed most parishioners felt they were in good health (93%), believed faith and spiritual beliefs were important in maintaining health and well-being (91%), and thought that the church should play a role in helping parishioners meet their health needs (70%). In addition, focus group discussions revealed a need for respite care for primary caretakers of the ill and elderly, and health education programs for their teen and elderly populations. In conclusion, parishioners were positive and articulated support of the parish nurse and activities designed to address the physical, emotional, and spiritual needs of their community.     

某社区老年人抑郁状况及影响因素分析与对策

目的了解社区老年人抑郁的发生情况并探讨其影响因素，以提出相应对策。方法采用方便抽样方法，应用老年抑郁量表及自制调查表对武汉市某社区9个卫生服务站的117位老年人进行问卷调查。以抑郁与否作为应变量，以一般资料的各项目为自变量进行多元回归分析。结果本组对象中，27．4％老年人存在不同程度的抑郁症状；单因素分析结果表明，不同年龄、婚姻状况、文化程度、经济状况、有无社会保障、有无慢性病的老年人抑郁发生率差异有统计学意义（P〈0．05）；多元回归分析显示：经济状况和慢性病是抑郁发生的两大影响因素。结论抑郁症状是老年人常见的心理健康问题，受经济状况和有无慢性病的影响，应加强社区精神卫生服务，提供相应护理措施。     

Assessment of health, well-being and social connections: a survey of women living in Western Sydney

Strengthening the physical and social environment has been shown to support health and strengthen community action for health. In an attempt to improve the social factors that influence the health of individuals and the community, community interventions increasingly include strategies to build networks and social capital and develop resilience. This study was undertaken to identify the most appropriate strategies to strengthen friendships and the social support networks for women aged 18-39 years living in Villawood, an area of high disadvantage in South Western Sydney, Australia. Although the majority reported positively on their health, one-third reported feeling isolated, experienced low energy levels and felt unhappy and anxious over the past month. Women who described themselves as unemployed felt more isolated than women in home duties. Women who were employed or engaged in home duties had more contact with neighbours, and had more in common with their neighbours. Those who reported more contact with their neighbours perceived their mental health level as being higher. These results indicate that community development initiatives should include consultation with the community and consider the needs of socially isolated groups and those with the poorest health status.     

A participatory assessment of environmental health concerns in an Ojibwa community

This research employed a participatory approach to explore environmental health (EH) concerns among Lac Courte Oreilles (LCO) Ojibwa Indians in Sawyer County, Wisconsin. The project was grounded in a broad ecological conceptualization of EH and in principles of health promotion and community participation. Community participation was accomplished through a steering committee that consisted of the primary author and LCO College faculty and community members. The selected assessment methodology was a self-administered survey mailed to LCO members in Sawyer County. Concern for environmental issues was high in this tribal community, especially for future generations. Concern was higher among older members and tribal members living on rather than off the reservation. Local environmental issues of concern were motorized water vehicles, effects from global warming, aging septic systems on waterways, unsafe driving, and contaminated lakes/streams. The LCO community can use survey results to inform further data needs and program development.     

Relapse prevention as a supervision strategy for sex offenders

Relapse prevention as a supervision strategy for sex offenders is discussed. In the authors' experience, risk factors associated with the abusive acts of sex offenders differ from those of the general criminal population. A review of the information essential to effective probation or parole case planning is provided. Specific probation conditions relevant to sex offenders are suggested. Stress is placed on the importance of developing a community-based, collateral network of individuals who might assess the sex offender's self-management and supervision. An alternative form of community notification, which places responsibility on the offender to inform selected members of his daily life, is discussed.This paper is based in part on a book by Cumming, G. F., & Buell, M. M. (in press).Supervising sex offenders in the community, published jointly by Safer Society, Brandon, VT, and American Correctional Association, Lanham, MD.     

Antilogic,a new supervised machine learning software for the automatic interpretation of antibiotic susceptibility testing in clinical microbiology: proof-of-concept on three frequently isolated bacterial species

ObjectiveAntibiotic susceptibility testing (AST) is necessary in order to adjust empirical antibiotic treatment, but the interpretation of results requires experience and knowledge. We have developed a machine learning software that is capable of reading AST images without any human intervention and that automatically interprets the AST, based on a database of antibiograms that have been clinically validated with European Committee on Antimicrobial Susceptibility Testing rules.MethodsWe built a database of antibiograms that were labelled by senior microbiologists for three species: Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. We then developed Antilogic, a Python software based on an original image segmentation module and supervised learning models that we trained against the database. Finally, we blind tested Antilogic against a validation set of 5100 photos of antibiograms.ResultsWe trained Antilogic against a database of 18072 pictures of antibiograms. Overall agreement against the validation set reached 97% (16 855/17 281) regarding phenotypes. The severity rate of errors was also evaluated: 1.66% (287/17 281) were major errors and 0.80% (136/17 281) were very major errors. After implementation of uncertainty quantifications, the rate of errors decreased to 0.80% (114/13 451) and 0.42% (51/13 451) for major and very major errors respectively.DiscussionAntilogic is the first machine learning software that has been developed for AST interpretation. It is based on a novel approach that differs from the typical diameter measurement and expert system approach. Antilogic is a proof of concept that artificial intelligence can contribute to faster and easier diagnostic methods in the field of clinical microbiology.     

A national survey of community psychiatric nurses and their client care activities in Ireland

Increasingly, people with mental health problems in Ireland and in the UK are receiving mental health services in the community. The aim of this study was to identify the predominant approaches to care used by community psychiatric nurses (CPNs) and the theoretical bases of their practice. One hundred and sixteen questionnaires out of 203 sent to CPNs throughout Ireland were returned, giving a response rate of 57.1%. In addition, 33 home visits by 13 CPNs were observed. The findings showed that over 96% of the sample were in full-time employment; most (71.4%) worked a 9-5 weekday shift; 31% had a postregistration counselling qualification, and about a quarter were based in hospitals. The average caseload size was 61 and the service was predominantly a closed referral one. The main client care activities were: assessment of clients, medication management, health promotion, and client and family support. From the observations, there was no evidence of CPNs practising cognitive, behaviour therapy or family therapies to any great extent. This study provides baseline data for monitoring trends in community mental health nursing in Ireland, and for informing future policy regarding service provision and training of CPNs.     

Community‐based Residential Supports for People with Intellectual Disabilities and Challenging Behaviour: The Views of Neighbours

Background The issue of the views of neighbours of community‐based residential supports for people with intellectual disabilities and challenging behaviour has not been examined till date. This study looks at the views of neighbours of two types of community‐based residential supports: non‐congregate settings where the minority of residents have challenging behaviour; and congregate settings where the majority of residents have challenging behaviour. Materials and methods A self‐completion questionnaire was used to collect information on contact between neighbours, residents and staff, and the views of neighbours. Information was also collected by semi‐structured interview with service staff on the characteristics of settings. Results Sixty‐four questionnaires were returned. Contact between neighbours and service users was limited for both types of setting, with two‐thirds of neighbours not knowing any service users by name, and a third having had no active contact with service users. Neighbours of non‐congregate settings were more likely to think that community care was a ‘good policy’ (76%) than neighbours of congregate settings (53%) and to believe that there were benefits to the neighbourhood from having the group home in the area (46% versus 29%) but these differences were not significant. Contact with people with intellectual disabilities was associated with more positive attitudes to community care and specific characteristics of the settings. Conclusions Contact between neighbours and people with severe intellectual disabilities and challenging behaviour is limited. However, the majority of neighbours are positive about community care and the problems reported by neighbours are predominantly minor. The results point to the key role that contact plays in fostering positive attitudes. Findings regarding differences between congregate and non‐congregate settings are limited by the small number of responses from neighbours of congregate settings.