Résumé
OBJECTIVE: To measure the progress made by the collaborative actions of multisectorial partners in a community health effort using a systematic method to document and evaluate community/system changes over time. METHODS: This was a community-based participatory research project engaging community partners of the Latino Health for All Coalition, which based on the Health for All model, addresses health inequity in a low-income neighborhood in Kansas City, Kansas, United States of America. Guided by three research questions regarding the extent to which the Coalition catalyzed change, intensity of change, and how to visually display change, data were collected on community/system changes implemented by the community partners from 2009-2012. These changes were characterized and rated according to intensity (event duration, population reach, and strategy) and by other categories, such as social determinant of health mechanism and sector. RESULTS: During the 4-year study period, the Coalition implemented 64 community/system changes. These changes were aligned with the Coalition's primary goals of healthy nutrition, physical activity, and access to health screenings. Community/system efforts improved over time, becoming longer in duration and reaching more of the population. CONCLUSIONS: Although evidence of its predictive validity awaits further research, this method for documenting and characterizing community/system changes enables community partners to see progress made by their health initiatives.
OBJETIVO:Medir el progreso alcanzado por las actividades de colaboración de los socios multisectoriales en una iniciativa de salud comunitaria mediante el empleo de un método sistemático para verificar y evaluar los cambios en la comunidad y los sistemas con el transcurso del tiempo. MÉTODOS: Se trata de un proyecto comunitario de investigación participativa en el que colaboraron los socios comunitarios de la Coalición Salud para Todos los Latinos, que, con base en el modelo de Salud para Todos, aborda las desigualdades en materia de salud en un vecindario de bajos ingresos de Kansas City, en el estado de Kansas (Estados Unidos). Adoptando como guía tres preguntas de investigación referentes a en qué medida la Coalición catalizó los cambios, qué intensidad alcanzaron y cómo mostrarlos gráficamente, se recogieron datos sobre los cambios en la comunidad y los sistemas introducidos por los socios comunitarios del 2009 al 2012. Estos cambios se describieron y evaluaron según su intensidad (la duración del acontecimiento, el porcentaje de población expuesta y la estrategia) y según otras categorías, tales como el mecanismo implicado como determinante social de la salud y el sector afectado. RESULTADOS: Durante el período de estudio de cuatro años, la Coalición había introducido 64 cambios en la comunidad y los sistemas. Estos cambios estaban alineados con las principales metas de la Coalición: nutrición sana, ejercicio físico y acceso a los tamizajes de salud. Las iniciativas de la comunidad y los sistemas mejoraron con el transcurso del tiempo, eran más duraderas y llegaban a una parte más importante de la población. CONCLUSIONES:Aunque se requieren investigaciones adicionales para establecer datos probatorios de su validez predictiva, este método para verificar y caracterizar los cambios en la comunidad y los sistemas permite a los socios comunitarios observar el progreso alcanzado por sus iniciativas en pro de la de salud.
Sujets)
Humains , Comportement coopératif , Promotion de la santé/organisation et administration , Hispanique ou Latino , Évaluation de programme/méthodes , Santé en zone urbaine , Maladies cardiovasculaires/ethnologie , Maladies cardiovasculaires/prévention et contrôle , Planification de la santé communautaire , Recherche participative basée sur la communauté , Diabète/ethnologie , Diabète/prévention et contrôle , Politique de santé , Promotion de la santé/méthodes , Disparités de l'état de santé , Disparités d'accès aux soins , Kansas , Modèles théoriques , Pauvreté , Pouvoir psychologique , Caractéristiques de l'habitat , Changement socialRésumé
During the excavations of the XIX century Meadowlark cemetery (Manhattan, Kansas, US), samples of sediments were taken from around five skeletons, and analyzed to detect intestinal parasites. No helminth eggs were found, but immunological ELISA tests for Entamoeba histolytica were positive in three samples. The immunological techniques have been successfully used in paleoparasitology to detect protozoan infections. Amoebiasis could have been a severe disease in the past, especially where poor sanitary conditions prevailed, and there is evidence that this cemetery may have been used in a situation where poor sanitary conditions may have prevailed. The presence of this protozoan in US during the late XIX century gives information on the health of the population and provides additional data on the parasite's evolution since its appearance in the New World.
Sujets)
Animaux , Histoire du 19ème siècle , Humains , Entamoeba histolytica/isolement et purification , Infection à Entamoeba/histoire , Pratique mortuaire , Funérailles , Test ELISA , Infection à Entamoeba/parasitologie , Kansas , PaléopathologieRésumé
Arcanobacterium haemolyticum is a beta-hemolytic coryneform bacillus. It has been implicated as an etiologic agent of non-streptococcal pharyngitis and less frequently a cause of skin and wound infections, osteomyelitis, pneumonia, endocarditis, sepsis, and central nervous system infections. We describe a case of A. hemolyticum sepsis reported for the first time in Korea. A 61-year-old man with a diabetic foot was admitted due to a high fever. Three sets of blood cultures taken at the emergency room yielded coryneform bacilli. The organism was beta-hemolytic on blood agar plate, catalase-negative, and non-motile. It was identified as A. haemolyticum by Rapid CB Plus (Remel, Kansas, USA) and API Coryne (BioMerieux SA, Marcy l`Etoile, France) and confirmed by CAMP inhibition reaction. It was susceptible to penicillin, ceftriaxone, erythromycin, ciprofloxacin, and vancomycin by the disk diffusion method using the breakpoint criteria of National Committee for Clinical Laboratory Standards for streptococci other than Streptococcus pneumoniae. The patient was improved with partial amputation of the right big toe and antimicrobial therapy with ampicillin/sulbactam. If Arcanobacterium is isolated from normally sterile sites or culture specimens properly collected from infected tissues, it should be identified to the species level. Commercial biochemical test kits specialized in corynebacteria and CAMP test are useful for species identification of A. haemolyticum.