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Evaluation of a discussion forum for knowledge sharing among emergency practitioners: a social network approach.

Peer to peer knowledge sharing is recognized as a key contributor to the development of expert practice for health care professionals. Emergency departments with access to extensive expertise, such as in urban hospital settings, present greater potential for rich collaborative learning opportunities as compared with rural settings where expertise is at times scarce. Collaborative technologies such as electronic discussion boards may assist in leveling the "knowledge" playing field and increase opportunities for the growth of a strong social network for emergency clinicians. A social network perspective is used to explore the effectiveness of a discussion forum to support knowledge sharing among emergency practitioners in rural and urban emergency departments in Nova Scotia.

Cooperative Behavior↗

Social-network analysis of Mycobacterium bovis transmission among captive brushtail possums (Trichosurus vulpecula).

Wild brushtail possums (Trichosurus vulpecula) are the main source of Mycobacterium bovis infection for New Zealand livestock. The disease is spread principally by infectious aerosol; therefore, social interactions determine disease transmission. In captive possums, den-sharing behaviour provided the greatest risk of tuberculosis transmission between animals. Den sharing between individual possums was used as the basic measurement for quantifying close proximity between animals over extended periods. Social-network analysis (SNA) was used to model patterns of social behaviour and to predict tuberculosis transmission. There was great diversity between groups in their social behaviour-but there were consistent trends in the SNA measures (closeness and flow-betweenness). With time, the social distance between possums in the same group increased, the social network became more homogeneous and the possums less differentiated from each other. Alteration of the physical environment of the pens (such as changing the number of dens or relocating the group to a new pen) had an inconsistent effect on social structure when comparing different groups. During the infection-transmission study, the possums that became infected had greater closeness and flow-betweenness scores than those that remained free of infection. Although standard statistical descriptive measures (such as the number of partners and the frequency of den-sharing events) were greater for the infected than the infection-free possums, the SNA-specific measures were more precise and could be compared across time and between groups.

Animal Husbandry↗

Social networks--the metaphor that became a research approach--a research approach in the field of nursing?

This article discusses whether the concept of social networks can be an effective approach for use in nursing research in Norway and Scandinavia. It also describes areas which may be especially well suited for this approach. The article does not answer the question as to whether nursing research should make use of social network studies, but it is concluded that this is one of the approaches which must be considered closely in connection with nursing research.

Humans↗

AIDS-related information exposure in the mass media and discussion within social networks among married women in Bombay, India.

Married women are at high risk of acquiring HIV infection in India and health education remains the most feasible preventive tool in their context. In a survey conducted among 350 married women in Bombay, it was found that a majority had acquired information about AIDS from the mass media, especially television. Although 87% of women who knew of AIDS had been exposed to AIDS-related information in the mass media in the past four weeks, only 57% had discussed it within their social networks. Those with more exposure to AIDS information in the mass media were significantly more likely to discuss AIDS within social networks. The women were most likely to discuss AIDS with their husbands as a general social issue, followed by friends and family members and least likely to talk to husbands about AIDS as a personal issue relating to their sexual relationship. Increased frequency and duration of AIDS messages on television will have a positive influence on AIDS knowledge in this group.

Acquired Immunodeficiency Syndrome↗

Substitution and compensation in the social networks of older widowed women.

The death of a spouse often requires widows to derive support from other people, but little is known about the adaptive significance of such substitute sources of support. Older women (N = 322) widowed 3-30 months were interviewed 7 times over 1 year to investigate social network substitution (derivation of support from alternative social ties) and compensation (derivation of psychological benefits from these alternative ties). Three forms of substitution (formation of new social ties, rekindling of dormant ties, and intensification of existing ties) varied with the duration of widowhood. Regardless of the duration of widowhood, however, greater substitution was related to worse psychological health. Social network substitution appears to occur in widowhood, but the compensatory benefits of substitute ties are more elusive.

Adaptation, Psychological↗

Social network characteristics and injecting HIV-risk behaviors among street injection drug users.

As an alternative approach to individually-focused understanding of HIV risk behavior, this study explored the relationship between social network characteristics and HIV-risk injecting behaviors. Subjects were 499 inner-city injection drug users (IDUs) recruited from the streets of Baltimore, Maryland. Analysis of structural and functional network data indicates that a substantial proportion of drug sharing network members also provided social support, often because of family and sexual partner relationships. IDUs with larger drug networks which also provided social support were more likely to share needles, while IDUs with larger drug networks which did not provide social support were more likely to inject in commercial settings. The findings suggest that social support from drug network members has differential effects on injecting HIV-risk behaviors among IDUs. HIV prevention efforts should be expanded to reach drug-sharing networks and should take into account their social support relationships.

Adult↗

Social networks among men and women: the effects of age and socioeconomic status.

OBJECTIVES: This study examines the main and interactive effects of age and socioeconomic status (SES) on social networks. METHODS: Respondents are drawn from a regional stratified probability sample aged 40 to 93 years. Hierarchical regression analysis estimates the influence of age and SES on dimensions of social networks, controlling for marital status and health among men and women. RESULTS: Among men, older age was associated with older networks. Professional men report networks that are less geographically proximal, however, occupational effects are most obvious in late life. Among women, age is associated with smaller networks that are older, less geographically proximal, and less frequently contacted. Whereas less education is associated with younger network members in midlife, among women in later life, lower levels of education are not associated with a younger network. Professional women report older networks composed of a higher proportion of friends than do homemakers. Higher levels of education are linked to larger personal networks among men and women, but not to the number of individuals considered closest. Among women, higher levels of education are also associated with less proximal networks. DISCUSSION: An examination of within-group variability reveals influences of age and SES on personal networks among men and women.

Adult↗

A social network approach and the revolving door patient.

Traditional psychiatric treatment approaches have not been very successful with the "revolving door patient." A variety of findings suggest that the social network, as opposed to the individual patient, may be a more viable locus for intervention. A conceptual review and analysis of the literature reveals two constructs salient to understanding social networks: flexibility and stability. The networks of revolving door patients are frequently characterized as inflexible and/or unstable. Assessment methods as well as strategies for balancing flexibility and stability are described. Enlarging the network, increasing multiplexity, and/or reducing the negative effects of attitudinal inflexibility encompass the strategies for increasing flexibility, while developing connections between individuals, generating spans between clusters of people in the network, and increasing multiplexity are recommended for increasing stability. The assets and liabilities of each of these strategies are discussed.

Adult↗

Social networks and work/nonwork life: action-research with nurse managers.

An action-research project with hospital nurses is reported which explores the utility of social network analysis for understanding and enhancing the quality of work life. Based on a framework for conceptualizing work stressors, we present a rationale for developing resource-support groups. These groups combine emotional support, group problem-solving, and participatory decision-making within the context of developing programs and policies to enhance the quality of working life. A workshop help for nurse managers focused on the potential for using these groups to achieve specific, prioritized goals. To study the ecology of work/nonwork life, we obtained data from workshop participants on both their work and nonwork social networks. We found these to be almost totally segmented. Personal, organizational, and sociocultural variables that may account for this pattern are examined. Implications are also discussed for developing support programs and for empowering nursing as a profession.

Humans↗

The social networks of drug abusers before and after treatment.

Changes in the social networks of a sample of 38 drug abusers are studied from pretreatment to 1 and 3 months following treatment. Overall network composition changed to include fewer drug users and fewer long-term acquaintances. While the pretreatment networks of those who used opiates and those who did not use opiates in the follow-up period were virtually the same, the posttreatment networks of opiate abusers contained greater social influence toward drug use following treatment. Implications for treatment are discussed.

Adolescent↗

Age-related patterns in social networks among European Americans and African Americans: implications for socioemotional selectivity across the life span.

Socioemotional selectivity theory contends that as people become increasingly aware of limitations on future time, they are increasingly motivated to be more selective in their choice of social partners, favoring emotionally meaningful relationships over peripheral ones. The theory hypothesizes that because age is negatively associated with time left in life, the social networks of older people contain fewer peripheral social partners than those of their younger counterparts. This study tested the hypothesis among African Americans and European Americans, two ethnic groups whose social structural resources differ. Findings confirm the hypothesis. Across a wide age range (18 to 94 years old) and among both ethnic groups, older people report as many emotionally close social partners but fewer peripheral social partners in their networks as compared to their younger counterparts. Moreover, a greater percentage of very close social partners in social networks is related to lower levels of happiness among the young age group, but not among the older age groups. Implications of findings for adaptive social functioning across the life span are discussed.

Adolescent↗

Social networks and community prevention coalitions.

This study investigates the links between community readiness and the social networks among participants in Communities That Care (CTC), community-based prevention coalitions. The coalitions targeted adolescent behavior problems through community risk factor assessments, prioritization of risk factors, and selection/implementation of corresponding evidence-based family, school, and community programs. Key leaders (n = 219) in 23 new CTC sites completed questionnaires focusing on community readiness to implement CTC and the respondents' personal, work, and social organization links to other key leaders in the community. Outside technical assistants also completed ratings of each community's readiness and early CTC functioning. Measures of network cohesion/integration were positively associated with readiness, while centralization was negatively associated. These results suggest that non-centralized networks in which ties between members are close and direct may be an indicator of community readiness. In addition, we found different associations between readiness and different domains of social relations. EDITORS' STRATEGIC IMPLICATIONS: The authors present the promising practice of using social network analysis to characterize the functioning of local prevention coalitions and their readiness to implement a community-based prevention initiative. Researchers and community planners will benefit from the lessons in this article, which capitalizes on a large sample and multiple informants. This work raises interesting questions about how to combine the promotion of coalition functioning while simultaneously encouraging diversity of coalition membership.

Adolescent↗

Comparability of information provided by elderly cancer patients and surrogates regarding health and functional status, social network, and life events.

Stressful life events may adversely affect health, but these effects may be mitigated by a strong social support network. The elderly should be a focus for investigation in this area, but epidemiologic studies in the elderly are often complicated by the need to rely upon information collected from surrogates. We assessed the degree to which 622 elderly cancer patients and surrogates agreed in their answers to questions about life events, social network, and health and functional status. We compared spouses, friends, and children as surrogates by evaluating (1) their agreement with index subjects and (2) the proportion of surrogates of each type who could not answer one or more questions. Agreement for most items on health and functional status was at least moderately good, but agreement was more inconsistent for questions about social network and major life events. Agreement was higher when factual information was solicited than when the question regarded more personal information or attitudes. For questions about health status, social network, and life events, spouses agreed more closely with index subjects than did children or friends. For questions about functional status, however, agreement did not vary consistently by respondent type. We found no consistent effects of the index subject's age or cognitive status on levels of agreement, nor did we find evidence of bias in the surrogates' responses.

Activities of Daily Living↗

The TAPS Project. 5: The structure of social-network data obtained from long-stay patients.

The Social Network Schedule was successfully completed on 489 (64%) of 770 long-stay patients in Friern and Claybury Hospitals and the data on 3774 social contacts of the patients subjected to log-linear modelling. This showed that the category 'confidant' was salient in understanding the data. Latent-class analysis highlighted the importance of the nature of the social interaction between patients and their contacts. In particular, non-verbal exchanges of goods and services emerged as important in creating social bonds.

Arousal↗

Life events and social network in relation to the onset of depression. A controlled study.

In this article we present the results of a study on the role of life events and social network in the onset of depression. We compared 24 new outpatients with major depression or a dysthymic disorder with 24 healthy matched controls. The patient group was interviewed about the year before the onset of depression; the control group about the year preceding the interview. The results show a significant difference between the 2 groups in occurrence of life events and quality of social network.

Adaptation, Psychological↗

A study of the relationship between social network, perceived ill health and utilization of emergency care. A case-control study.

Several studies have shown that persons who repeatedly turn to somatic emergency departments, besides having ailments also often have social and psychological problems. It has also been shown that this group of patients differs from the general population and can be considered a psycho-socially exposed group. In the present study a group of recurrent users (4 + yearly visits) was compared to a group of first-time visitors to the general emergency department of a middlesized metropolitan hospital. Both patient groups were asked to complete a questionnaire that contained 45 items, covering socio-demographic and social network variables, social and personal problems, perceived state of health and contacts with other care-giving institutions. The results showed that the first-time visitors were significantly younger than the recurrent users, and more often actively employed. Only 2 percent of the first-time visitors developed a behaviour of recurrent use of the ED. The recurrent users were well-known at the hospital, not only in the emergency department but also at the out-patient clinics and the social work department. The multiple Odds ratio showed that alcohol abuse, lack of close friend, general health problems and deteriorating health were important risk factors for recurrent ED use. It is suggested that an individual treatment plan including medical, social and societal measures could be one alternative in an attempt to more efficiently treat these patients.

Adolescent↗

Postpartum depression. A role for social network and life stress variables.

Depressed (N = 11) and nondepressed (N = 19) women who had recently given birth were compared on several life stress measures and indices of structural and qualitative characteristics of their social networks. We predicted that depressed subjects diagnosed on the basis of Research Diagnostic Criteria would have experienced more stressful life events since the beginning of pregnancy and since delivery. We also predicted that depressed subjects would have fewer confidants and receive less instrumental and emotional support from their network members. These predictions were largely confirmed, except that the two groups did not differ on number of confidants. The social support provided by spouses appeared to be especially important. Implications of these findings for life events and social network research are discussed.

Adult↗