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PubMed2005

Uncovering the overlapping community structure of complex networks in nature and society.

Many complex systems in nature and society can be described in terms of networks capturing the intricate web of connections among the units they are made of. A key question is how to interpret the global organization of such networks as the coexistence of their structural subunits (communities) associated with more highly interconnected parts. Identifying these a priori unknown building blocks (such as functionally related proteins, industrial sectors and groups of people) is crucial to the understanding of the structural and functional properties of networks. The existing deterministic methods used for large networks find separated communities, whereas most of the actual networks are made of highly overlapping cohesive groups of nodes. Here we introduce an approach to analysing the main statistical features of the interwoven sets of overlapping communities that makes a step towards uncovering the modular structure of complex systems. After defining a set of new characteristic quantities for the statistics of communities, we apply an efficient technique for exploring overlapping communities on a large scale. We find that overlaps are significant, and the distributions we introduce reveal universal features of networks. Our studies of collaboration, word-association and protein interaction graphs show that the web of communities has non-trivial correlations and specific scaling properties.

Community Networks↗
PubMed2004

Finding community structure in very large networks.

The discovery and analysis of community structure in networks is a topic of considerable recent interest within the physics community, but most methods proposed so far are unsuitable for very large networks because of their computational cost. Here we present a hierarchical agglomeration algorithm for detecting community structure which is faster than many competing algorithms: its running time on a network with n vertices and m edges is O (md log n) where d is the depth of the dendrogram describing the community structure. Many real-world networks are sparse and hierarchical, with m approximately n and d approximately log n, in which case our algorithm runs in essentially linear time, O (n log(2) n). As an example of the application of this algorithm we use it to analyze a network of items for sale on the web site of a large on-line retailer, items in the network being linked if they are frequently purchased by the same buyer. The network has more than 400 000 vertices and 2 x 10(6) edges. We show that our algorithm can extract meaningful communities from this network, revealing large-scale patterns present in the purchasing habits of customers.

Journal Article↗
PubMed1995

Fitting the CHIN (community health information network) to the customer: three case studies.

Each of the case studies described above is typical of many health care organizations in the northeastern United States. The reasons each of these three organizations seeks to form or participate in a CHIN varies-from establishing the loyalty of practicing physicians in a community hospital's struggle to survive, through sharing of real-time patient care data in a successful community-wide effort to avoid expensive duplication of services, to driving the transition from a multihospital integrated delivery system to a full-risk accountable health plan. While the need to reduce costs, by taking advantage of economies of scale and prospectively monitoring utilization, is common to all three organizations, selecting the type of CHIN that best fits each scenario, with particular emphasis on aspects of control, is the key success factor.

Community Health Planning↗
PubMed1985

More than a gateway: the role of the emergency psychiatry service in the community mental health network.

The authors describe how an emergency psychiatry service in an inner-city general hospital has been able to expand its functions and strengthen its ties to community mental health agencies. A major factor in helping the emergency unit build closer relationships with community agencies is its contract with the state to perform evaluations of all admissions to the state hospital psychiatric unit serving the catchment area. The emergency unit performs triage and provides backup for the agencies, coordinates the management of multi-agency cases, and holds weekly educational conferences for agency staff. Using case examples, the authors illustrate how unit and agency staff collaborate to ensure continuity of patient care.

Adult↗
PubMed2003

Community membership and social networks in mental health self-help agencies.

This article explores community membership among self-help agency (SHA) participants. It is suggested that SHAs foster the enhancement of peer-oriented social networks, leading to the experience of shared community. Social network analysis was used to examine the structure of support mechanisms, and to assess levels of community membership through peer inclusion. Results indicate that both individual and organizational characteristics play roles in predicting peer presence in social networks. Organizational empowerment is a key factor, with the SHA emerging as a promising locus for peer support development through enhanced social networks. Implications for the organization of consumer-based services are discussed.

Adult↗
PubMed1987

Enlarging the caring capacity of the community: informal support networks and the welfare state.

In common with most modern industrial societies, Great Britain is facing the unique late 20th century phenomenon of rapidly increasing numbers of people, especially very elderly people, requiring health and social care. The response in Britain has been to search for ways to enlarge the caring capacity of the "community" and, thereby, reduce the demands on public health and social services. Similar policy responses have been developed in other capitalist societies such as Canada, France, and the United States. Although a policy of "community care"--the provision of state services in people's own homes--was followed by governments of both major British political parties over the postwar period, under the right wing neo-monetarist regime of the present Thatcher administration the locus of policy has shifted toward encouraging greater reliance on the informal support networks of kin, friends, and neighbors. The reasons for this sea-change are explored and the assumptions that these networks are "natural" and necessarily the proper matrix of care are examined critically. This analysis draws on the results of recent research which indicates that informal support networks have significant limitations and that a policy based on withdrawing public services in the hope that these networks will fill the growing care gap is likely to be counterproductive. In conclusion, the author indicates the areas where further research is required to provide a sound basis for policy.

Aged↗
PubMed1995

Assessing your CHIN (community health information network) readiness.

Whether your health care organization is considering developing a CHIN, an enterprise network, or an integrated delivery system, the CHIN readiness assessment process is a valuable one. Bringing together the information technology staff, managed care and strategic planners, clinical staff, and executive management in a forum for open exchange of ideas and plans is, in itself, a critical activity. A formal assessment will provide your health care organization with a baseline measure of where you are today, and where you need to focus your efforts over the next months and years to achieve your organization's goals.

Community Health Planning↗
PubMed2003

Using network analysis to understand community-based programs: a case study from highland Madagascar.

CONTEXT: Programs using community-based distribution (CBD) of family planning services have had mixed success in Sub-Saharan Africa. Knowledge about why these programs succeed or fail is limited. METHODS: In 1999, a total of 159 women and men of reproductive age were interviewed in a village in highland Madagascar with an active community-based family planning program. Network analysis informed by chi-square tests and multiple regression analysis was used to test whether respondents' communication with CBD agents and the location of their discussion partners were associated with their knowledge and use of family planning. RESULTS: The CBD agents were highly central in the village's family planning network; 35% of women and 19% of men directly communicated with a CBD agent about family planning or were indirectly linked to an agent. Knowledge of family planning was associated with having either a direct or an indirect link to a CBD agent; use of a modern method was associated with discussing family planning only with someone outside the village (odds ratio, 12.6) or with discussing it in the village and communicating directly with a CBD agent (10.8). CONCLUSIONS: Network analysis can improve the understanding of community-based program functioning by providing a way to examine who receives information from and is influenced by CBD agents.

Adolescent↗
PubMed2004

Detecting fuzzy community structures in complex networks with a Potts model.

A fast community detection algorithm based on a q-state Potts model is presented. Communities (groups of densely interconnected nodes that are only loosely connected to the rest of the network) are found to coincide with the domains of equal spin value in the minima of a modified Potts spin glass Hamiltonian. Comparing global and local minima of the Hamiltonian allows for the detection of overlapping ("fuzzy") communities and quantifying the association of nodes with multiple communities as well as the robustness of a community. No prior knowledge of the number of communities has to be assumed.

Journal Article↗
PubMed2003

The structure of lay consultation networks: managing illness in community settings.

OBJECTIVE: We examined the structure of lay consultation networks among elderly people. METHODS: Data were gathered through interviews with 548 elderly adults living in Florida retirement communities and in Cleveland. Respondents identified people they consulted about symptom or disease information, health worries, what the doctor said, and consulting health providers. Network size, composition, geographic dispersion, gender homogeneity, and division of labor were assessed. RESULTS: Eighty percent identified at least one network member (range = 1 to 7 consultants). Networks largely consisted of family members, particularly spouses and women. Older adults talked most frequently with network members about physician visits. Widowed individuals were more likely to rely on children and friends and have networks outside their neighborhoods than married elders. Women's networks included a broader range of relationships than men's networks. DISCUSSION: Results reaffirmed the importance of gender in structuring networks in late life. The low prevalence of friends supports Cartensen's Selectivity Theory.

Aged↗
PubMed2005

Community detection in complex networks using extremal optimization.

We propose a method to find the community structure in complex networks based on an extremal optimization of the value of modularity. The method outperforms the optimal modularity found by the existing algorithms in the literature giving a better understanding of the community structure. We present the results of the algorithm for computer-simulated and real networks and compare them with other approaches. The efficiency and accuracy of the method make it feasible to be used for the accurate identification of community structure in large complex networks.

Journal Article↗
PubMed2004

Assessing interorganizational networks as a dimension of community capacity: illustrations from a community intervention to prevent lead poisoning.

Network analysis is often cited as a method for assessing collaboration among organizations as an indicator of community capacity. The purpose of this study was to (1) document patterns of collaboration in organizational networks related to lead poisoning prevention in a Native American community and (2) examine measurement issues in using organizational network analysis to assess community capacity. Interviews were conducted with representatives from 22 tribes, government agencies, schools, and community-based organizations in northeastern Oklahoma. Intensity, density, and reliability were assessed for several stages of collaboration. Intensity and density were greater for similar types of organizations than for the network as a whole and decreased as stage of collaboration increased. Network data were more reliable when responses were dichotomized than when intensities were compared. Mean reliability scores across two respondents from the same organization ranged from 60% to 90%. Results from network studies may help communities learn how to strengthen organizational networks to enhance community capacity.

Community Networks↗
PubMed1997

A clinical trial to evaluate the effect of vitamin C supplementation on in vitro mutagen sensitivity. The University of Texas M. D. Anderson Clinical Community Oncology Program Network.

Mutagen sensitivity, as measured by an in vitro assay, has been described as a risk factor for the development of several tobacco-related epithelial cancers. In vitro studies have indicated that sensitivity to the clastogenic effects of bleomycin on chromosomes was reduced with the introduction of ascorbic acid in a dose-dependent relationship. We report the results of a randomized clinical trial to determine whether increasing levels of oral ascorbic acid could reduce the levels of mutagen sensitivity. For this study, we recruited 228 healthy smokers from 21 centers around the country through the Clinical Community Oncology Program. Each individual was randomly assigned to one of four daily regimens: placebo, 1 g of ascorbic acid, 2 g of ascorbic acid, or 4 g of ascorbic acid. Treatments were administered for 16 weeks. Assessment of mutagen sensitivity was made at baseline and at weeks 4, 16, and 20 (4 weeks after cessation of treatment). Serum ascorbic acid levels were measured at baseline and at weeks 4 and 16. Demographic and risk factor data were collected at baseline and at each-measurement point. Analyses measured the differences of mutagen sensitivity levels across the four treatment arms, as well as investigating the correlation between serum ascorbic acid level and mutagen sensitivity levels in individuals. We did not find a dose-response relationship between ascorbic acid intake and mutagen sensitivity. Additionally, we did not find an association between serum ascorbic acid levels and mutagen sensitivity.

Administration, Oral↗
PubMed2004

Associate degree nursing in a community-based health center network: lessons in collaboration.

This exemplar highlights the ability of community experiences to enhance nursing students' understanding of the principles of community-based care: advocating self-care; focusing on prevention, family, culture, and community; providing continuity of care; and collaborating. An innovative teaching-practice model (i.e., a nurse-managed "network" of clinics), incorporating service-learning, was created. The Network's purposes are to provide practice sites in community-based primary care settings for student clinical rotations, increasing the awareness of the civic and social responsibility to provide quality health care for disadvantaged populations; and to reduce health disparities by increasing access to free primary health care, including health promotion and disease prevention, for disadvantaged individuals. Network clients receive free health care, referrals, and guidance to effectively obtain additional health care resources for themselves and their families. The Network is a national pioneer in modeling the delivery of primary care services through a faculty-student practice plan, with leadership emanating from a community college.

Attitude of Health Personnel↗
PubMed2005

Evaluating the effectiveness of community-based dementia care networks: the Dementia Care Networks' Study.

PURPOSE: The Dementia Care Networks' Study examined the effectiveness of four community-based, not-for-profit dementia networks. The study involved assessing the relationship between the types of administrative and service-delivery exchanges that occurred among the networked agencies and the network members' perception of the effectiveness of these exchanges. DESIGN AND METHODS: With the use of a case-study method, the evolution, structure, and processes of each network were documented. Social network analysis using a standardized questionnaire completed by member agencies identified patterns of administrative and clinical exchanges among networked agencies. RESULTS: Differences were found between the four networks in terms of their perceptions of service-delivery effectiveness; perceptions of administrative effectiveness did not factor significantly. Exchanges between groups of agencies (cliques) within each of the four networks were found to be more critical than those between individual agencies within each network. IMPLICATIONS: Integration-measured by the types of exchanges within as opposed to across networks-differentiated the four networks studied. This research contributes to our understanding of the use of multiple measures to evaluate the inner workings of service delivery and their impact on elder health and elder health care.

Aged↗
PubMed1996

The challenge of managing laboratory information in a managed care environment.

This article considers some of the major changes that are occurring in pathology and pathology informatics in response to the shift to managed care in the United States. To better understand the relationship between information management in clinical laboratories and managed care, a typology of integrated delivery systems is presented. Following this is a discussion of the evolutionary trajectory for the computer networks that serve these large consolidated healthcare delivery organizations. The most complex of these computer networks is a community health information network. Participation in the planning and deployment of community health information networks will be important for pathologists because information management within pathology will be inexorably integrated into the larger effort by integrated delivery systems to share clinical, financial, and administrative data on a regional basis. Finally, four laboratory information management challenges under managed care are discussed, accompanied by possible approaches to each of them. The challenges presented are (1) organizational integration of departmental information systems such as the laboratory information system; (2) weakening of the best-of-breed approach to laboratory information system selection; (3) the shift away from the centralized laboratory paradigm; and (4) the development of rule-based systems to monitor and control laboratory utilization.

Community Networks↗
PubMed2005

Antimicrobial susceptibilities of potential bacterial pathogens in adults with acute respiratory tract infections Prospective Epidemiological Network Investigating Community-acquired Infection SurveiLLance In Nagasaki (PENICILLIN) Study.

The prevalence and the antimicrobial susceptibilities of bacterial pathogens in acute upper respiratory tract infections (AURTIs) is not clear. We conducted a prospective community-based multicenter study in 45 centers across Nagasaki, Japan, between December 2001 and April 2002. We examined the nasopharyngeal or throat isolates in 930 adult outpatients with AURTIs. Potential bacterial pathogens, including Streptococcus pyogenes (from 6.8% patients), S. pneumoniae (5.3%), S. milleri group (2.0%), Staphylococcus aureus (26.0%), Moraxella catarrhalis (7.4%), Haemophilus influenzae (17.6%), and Klebsiella pneumoniae (1.2%), were isolated from 51.8% of the patients. Penicillin nonsusceptible phenotype accounted for 44.9% of S. pneumoniae isolates. Among Staphylococcus aureus isolates, 9.1% were methicillin-resistant. In H. influenzae isolates, 6.7% produced beta-lactamase and 23.2% were beta-lactamase-negative ampicillin-resistant. The results indicated that the potential bacterial pathogens were detected in the remarkable population of the adults with AURTIs and the current antimicrobial susceptibilities of such pathogens.

Acute Disease↗