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PubMed2006

Building social capital in first-time parents through a group-parenting program: a questionnaire survey.

BACKGROUND: Parents who are connected into strong family and community networks are said to have high social capital enabling them to provide a positive context where their children's social, emotional and educational needs are met. OBJECTIVES: To identify parent satisfaction with, strengths and weaknesses of, opportunities to build social capital, and the impact of a two-course pilot health and relationship focused Parenting Education Program-PEPE, designed for first-time parents, on the core work of the well-child nurse/health visitor. DESIGN: Retrospective descriptive survey using postal questionnaires. SETTING: Twelve pilot parenting courses facilitated across five regions of New Zealand. PARTICIPANTS: All parents (n = 105) and clinical nursing staff (n = 12) involved in the pilot parenting courses were invited to participate. Overall response rate was 82%. METHODS: Questionnaires developed by investigators were mailed to the eligible population. Numerical data was analysed using PC-SAS. Narrative data was subjected to thematic content analysis. RESULTS: Attendance at both parenting courses positively correlated with an increase in measures of social capital: development of strong social networks (82% Your New Baby course respondents: 95% CI, 75-89, and 98% Your Growing Baby course respondents: 95% CI, 96-100), and positive relationships with others (93% Your New Baby course respondents: 95% CI, 88-98, and 86% Your Growing Baby course respondents: 95% CI, 83-89). Increased confidence in respondent's parenting ability was also identified (96% Your New Baby course respondents: 95% CI, 92-100; 96% Your Growing Baby course respondents: 95% CI 93-99). CONCLUSIONS: The PEPE programme was well accepted by first-time parents leading to significant improvements in development of social capital and parenting confidence. Well-child health nurses are in a prime position to foster social capital and help rebuild communities within which they work to enhance parenting outcomes.

Adolescent↗
PubMed1989

Family and personal networks in international migration: recent developments and new agendas.

Family, friendship, and community networks underlie much of the recent migration to industrial nations. Current interest in these networks accompany the development of a migration system perspective and the growing awareness of the macro and micro determinants of migration. This article presents an overview of research findings on the determinants and consequences of personal networks. In addition, it calls for greater specification of the role of networks in migration research and for the inclusion of women in future research.

Communication↗
PubMed1992

"Chronicity," "nervios" and community care: a case study of Puerto Rican psychiatric patients in New York City.

The role of ethnicity, community structure, and folk concepts of mental illness in facilitating the adaptation of long term psychiatric patients to community living has received little attention. This article examines the cultural concepts of mental illness and the community involvement of 30 Puerto Rican psychiatric patients participating in a New York City treatment program. It is shown that many of the attributes usually associated with chronic mental illness do not apply to this population. It is argued that the folk concept of nervios helps to foster the integration of these patients in a wide range of community networks. The impact of gentrification on these patients' community integration is also discussed.

Adaptation, Psychological↗
PubMed2004

Finding and evaluating community structure in networks.

We propose and study a set of algorithms for discovering community structure in networks-natural divisions of network nodes into densely connected subgroups. Our algorithms all share two definitive features: first, they involve iterative removal of edges from the network to split it into communities, the edges removed being identified using any one of a number of possible "betweenness" measures, and second, these measures are, crucially, recalculated after each removal. We also propose a measure for the strength of the community structure found by our algorithms, which gives us an objective metric for choosing the number of communities into which a network should be divided. We demonstrate that our algorithms are highly effective at discovering community structure in both computer-generated and real-world network data, and show how they can be used to shed light on the sometimes dauntingly complex structure of networked systems.

Journal Article↗
PubMed1993

Using integration technology as a strategic advantage.

The underlying premise of the Managed Competition Act previously cited is that through managed competition providers will be forced to lower care costs while increasing the level of positive care outcomes. Because it may also be that tomorrow's hospitals will find a severe rationing of technology, what can they do to prepare? Most of the systems in place today already have built within them all the necessary potential to address this premise and technology requirement with no change, no conversion, no expense for new equipment and software, and no disruption in day-to-day operations, just a little re-engineering. Today, however, these systems are similar to a 20-mule team pulling in different directions: all the power is there, but the wagon remains motionless and totally unable to reach its objective. It takes a skilled wagonmaster to bring them together, to make the mules work as a cohesive unit, to make the power of 20 mules greater than the sum of 20 mules. So it is and will be for the hospital of tomorrow. System integration is no longer a question of whether but of when. Those hospitals that use it today as a strategic advantage will be in a better position tomorrow to use it as a competitive strategic advantage in an environment that will reward low cost and high positive care outcomes and will penalize those that cannot compete. The technology is already here and economically within reach of nearly every hospital, just waiting to be used. The question that must nag all of us who want to make the health care system of America better is, Why not make the when now? Rich Helppie, president of Superior Consultant Company, summarized the solution well: The old ways will not give way to the new overnight. The re-engineering process in healthcare must evolve. Compared to the last 20 years, however, such evolution may appear to be a massive, forthright, complete, comprehensive, drastic and rapid revolution. Survival is the name of the game, and for healthcare organizations to survive, they must join the re-engineering revolution. When that happens, the "Americanized" health care system might look like the community network shown in Figure 7, which is a networked integration of all the systems used in the community working together and exchanging information, with hospitals exchanging information with other hospitals and sharing it with physicians, clinics, laboratories, radiology centers, universities, employers, payors, and governmental agencies.(ABSTRACT TRUNCATED AT 400 WORDS)

Computer Communication Networks↗
PubMed2001

Global predictive real-time control of Quebec Urban Community's westerly sewer network.

Quebec Urban Community (QUC) has selected Global Predictive Real-Time Control (GP-RTC) as the most efficient approach to achieve environmental objectives defined by the Ministry of Environment. QUC wants to reduce combined sewer overflows (CSOs) frequency to the St Lawrence river to two events per summer period in order to reclaim the use of Jacques-Cartier Beach for recreational activities and sports of primary contact. QUC's control scheme is based on the Certainty Equivalent Control Open Loop Feedback (CEOLF) strategy which permits one to introduce, at each control period, updated measurements and meteorological predictions. A non-linear programming package is used to find the flow set points that minimise a multi-objective (cost) function, subjected to linear equality and inequality constraints representing the physical and operational constraints on the sewer network. Implementation of GP-RTC on QUC's westerly network was performed in the summer of 1999 and was operational by mid-August. Reductions in overflow volumes with GP-RTC compared to static control are attributed to the optimal use of two existing tunnels as retention facilities as well as the maximal use of the wastewater treatment plant (WWTP) capacity.

Computer Systems↗
PubMed1998

Adoption of security and confidentiality features in an operational community health information network: the Comox Valley experience--case example.

Since 1993, a budding community health information network (CHIN) has been in operation in the Comox Valley in Canada. A general hospital and three multi-doctor clinics are linked electronically. The clinics operate without paper charts using a comprehensive clinic information system. The link is provided by RSALink, a commercial message exchange service, based on Health Link, a system developed at the University of Victoria (McDaniel et al., Can. Med. Inform. 1 (1994) 40-41; McDaniel, Dissertation, University of Victoria, Canada, 1994). Health Link is a highly adaptable message exchange service with rich functionality. Despite this, the system is used exclusively to receive laboratory results transmitted by the hospital's laboratory system (RSAStat). The results are deposited in the patient data base of a commercial clinic information system (CliniCare). This case is instructive because the users' selection of services available through Health Link allows us to observe the preferences in this informational sophisticated environment. Laboratory data transmission is appreciated as highly beneficial. The reliability, security and ample privacy protection and authentication features of Health Link, in contrast, are used in a black box mode and are not consciously exploited. This is consistent with our experience of the use of other systems which have operated for a substantial time, essentially without serious protection features. Our experience suggests that security and confidentiality features are exploited only to the extent that they do not require additional effort or conscientious intervention. This puts the system provider in the difficult position of either offering interactive systems that nobody will use, or providing automated features that nobody is aware of and that are therefore not used to full advantage--if at all.

British Columbia↗
PubMed2001

WORKSAFE IOWA Occupational Medicine Associates Network: a university--community partnership in occupational safety and health.

The WORKSAFE IOWA Occupational Medicine Associates Network is a unique health care model for dispensing regional occupational medicine services in the state of Iowa, USA. WORKSAFE IOWA is an educational, informational, and consultation service of the College of Public Health at The University of Iowa. WORKSAFE IOWA includes a fee-for-service industrial hygiene program, the Occupational Medicine Associates Network, and educational and informational services. The Associates Network provides education, information, and consultation in exchange for an annual fee paid by each Associate to the university-based network. The Associates clinics provide comprehensive occupational medicine services to up to 1,500 clients through 66,000 annual clinic visits in their respective communities. The Associates Network has been financially self-sustaining over a period of 10 years, and has proven to provide valuable services to the community-based Associates, and to provide excellent training opportunities for the University students in several occupational safety and health disciplines.

Community Networks↗
PubMed2007

Gaps in the family networks of older people in three Indonesian communities.

Family networks are widely assumed to be a key source of support for older people in Indonesia and Southeast Asia more generally, although empirical study of their composition and functioning is in its infancy. This paper draws on ethnographic and survey data collected in longitudinal research of ageing in three rural Indonesian communities, in order to identify demographic and social factors limiting the size of elders' networks. Gaps in networks commonly emerge as a result of childlessness, migration and alienation, but their implications for older people's vulnerability are shaped by socio-economic status, reputation and cultural norms.

Adoption↗
PubMedDate not supplied

Gains from public-private collaborations to improve community health.

In several disciplines there exists theoretical and empirical evidence to show that community affects health and behaviors; but to date such evidence has remained largely outside the health services field. In this article, the authors introduce and contribute to this evidence and then discuss how those in the healthcare sector can work to increase public-private collaborations. Telephone survey data collected in 1995 from 1,826 randomly selected residents of a Northwest urban county were used in multivariate analysis to assess the relationship between community quality and health status. Community quality was measured by residents' perceptions of community problems. Findings indicate that individual ratings of community problems predicted mental health functioning. This effect was found overall and for men and women separately. These results suggest that health is dependent on how people perceive the quality of their community. Leadership and vision can make an enormous difference in the quality of a community health system and in the cost-effectiveness of the care provided. Healthcare leaders can develop their understanding of their community and the impact of community characteristics on health through consultation with experts, input from community leaders, and visits to the neighborhoods that surround the delivery services. Community networks can be developed with the common focus of improving the community's health. Collaborative efforts between the private health sector, the public health sector, and community members can enhance social relationships and thus promote the health of residents.

Adult↗
PubMed1995

Building the CHIN (community health information network) organization.

This article presents a template for establishing a community health information network (CHIN) and focuses primarily on the most popular organizational model for a CHIN, the community coalition model. Additionally, practical solutions to the challenges facing these organizations are presented, based on experiences with CHIN initiatives across the country.

Catchment Area, Health↗
PubMed2002

Feature decomposition architectures for neural networks: algorithms, error bounds, and applications.

In recent years, systems consisting of multiple modular neural networks have attracted substantial interest in the neural networks community because of various advantages they offer over a single large monolithic network. In this paper, we propose two basic feature decomposition models (namely, parallel model and tandem model) in which each of the neural network modules processes a disjoint subset of the input features. A novel feature decomposition algorithm is introduced to partition the input space into disjoint subsets solely based on the available training data. Under certain assumptions, the approximation error due to decomposition can be proved to be bounded by any desired small value over a compact set. Finally, the performance of feature decomposition networks is compared with that of a monolithic network in real world bench mark pattern recognition and modeling problems.

Algorithms↗