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PubMedDate not supplied

Understanding communities of neglectful parents: child caregiving networks and child neglect.

This article focuses on family social networks and the community of caregivers of neglected children. If neglect is part of family functioning, who watches over the children? Using a case study approach, this study researched 12 children and their parents. Several concepts, such as multiple caregiving and kin keepers, revealed that study children were cared for by many people. Social network mapping used in this study indicated that families were not isolated from the larger community, had various forms of negative and positive social support, were low income, and were involved in substance abuse and domestic violence. Understanding the patterns that emerge from the complex web of family, friends, social service agencies, and the larger social community in which neglected children live can result in better community building.

Adult↗
PubMed2004

Hierarchical community classification and assessment of aquatic ecosystems using artificial neural networks.

Benthic macroinvertebrate communities in stream ecosystems were assessed hierarchically through two-level classification methods of unsupervised learning. Two artificial neural networks were implemented in combination. Firstly, the self-organizing map (SOM) was used to reduce the dimension of community data, and secondly, the adaptive resonance theory (ART) was subsequently applied to the SOM to further classify the groups in different scales. Hierarchical grouping in community data efficiently reflected the impact of the environmental factors such as topographic conditions, levels of pollution, and sampling location and time across different scales. New community data not included in the training process were used to test the trained network model. The input data were appropriately grouped at different hierarchical levels by the trained networks, and correspondingly revealed the impact of environmental disturbances and temporal dynamics of communities. The hierarchical clusters based on a two-level classification method could be useful for assessing ecosystem quality and community variations caused by environmental disturbances.

Animals↗
PubMedDate not supplied

Successful turnaround of a university-owned, community-based, multidisciplinary practice network.

PURPOSE: The University of Utah purchased a 100-clinician, 9-practice multi-specialty primary care network in 1998. The university projected the network to earn a profit the first year of its ownership in a market with growing capitation; however, capitation declined and the network incurred up to a 21 million dollars operating loss per year. This case study describes the financial turnaround of the network. METHODS: In 2001, the university reconfigured the practices for a fee-for-service environment while preserving the group's multidisciplinary clinical and ancillary services. Changes included reorganization under the existing University of Utah Hospitals and Clinics system, new governance and leadership, closure of practices, creation of a billing office, new financial reporting, implementation of electronic health records, revision of physician compensation, capture of referrals, leadership and staff training, and practice reengineering. RESULTS: The network as a whole became profitable in 2004-2005. Its primary care component is projected to become profitable in 2 to 3 years. The network is opening new sites strategically important to the health system. CONCLUSIONS: This turnaround required commitment from senior university leaders, management with knowledge of primary care practice, retention of ancillary revenues, and management and business services specific to the network with support from other units within the university. Culture change within the group was essential. Our experience suggests that an academic health center can successfully operate a primary care network by attending to the unique needs of this challenging business. Doing so can strengthen the institution's overall financial and clinical performance and provide an important setting for teaching and research.

Community Health Centers↗
PubMed2004

Modeling of growing networks with directional attachment and communities.

In this paper, we propose a new network growth model and its learning algorithm to more precisely model such a real-world growing network as the Web. Unlike the conventional models, we have incorporated directional attachment and community structure for this purpose. We show that the proposed model exhibits a degree distribution with a power-law tail, which is an important characteristic of many large-scale real-world networks including the Web. Using real Web data, we experimentally show that predictive ability can be improved by incorporating directional attachment and community structure. Also, using synthetic data, we experimentally show that predictive ability can definitely be improved by incorporating community structure.

Algorithms↗
PubMed2005

Practice-based research networks: nursing centers and communities working collaboratively to reduce health disparities.

Practice-based research networks (PBRNs) can provide a range of opportunities for nurses working in primary care settings. This article reports on the early experiences of the Midwest Nursing Centers Consortium Research Network (MNCCRN), one of only two nursing PBRNs in the nation. Findings from the MNCCRN's first research study, Wellness for a Lifetime, indicate success with implementing research across geographically distant sites, and positive client outcomes related to improving nutrition and physical activity. Lessons learned in establishing a PBRN and implementing research studies in the real world are described as well as challenges for the future.

Community Health Centers↗
PubMed1997

Community experiments in action: developing community-defined models for reconfiguring health care delivery.

In the United States, health system change occurs as the interaction of politics and policies is played out and pushed forward by individuals and organizations taking action in their local communities and markets. This article provides context and descriptive information about a model of local health care reform that is being tested in twenty-five communities around the nation. We introduce a value-based model of community-responsive health system change, the Community Care Network (CCN) Vision. We briefly describe a national demonstration program that is testing this model between January 1996 and the end of 1998. We offer several ways of looking at the local and regional multisectoral partnerships that are attempting to demonstrate the CCN vision. We look at their composition, the kinds of actions in which they are engaged, several example challenges and responses to them, and we give several examples of schools becoming part of the health system of last resort. Finally, we present some early ideas on how the local actions described here may influence (and be influenced by) the political and policy contexts in which they occur.

Community Networks↗
PubMed2005

The Children's Aid Society community schools: a full-service partnership model.

In 1989, the Children's Aid Society (CAS) created an unprecedented partnership with the New York City Board of Education by developing a comprehensive response to the pressing needs of children and families in the northern Manhattan neighborhood of Washington Heights. After three years of careful planning, CAS and the New York City public schools opened the first community school at Intermediate School 218, offering a full array of supports, services, and learning opportunities. Adding, on average, one partnership school per year and remaining very flexible in adapting its model to the individual needs of each community, CAS now has thirteen community schools around New York City. The model's flexibility is seen also in the success of its national and international adaptation-an intentional part of CAS's work.

Child↗
PubMed2005

The New York City Beacons: rebuilding communities of support in urban neighborhoods.

Established in 1991 in New York City and now operating in at least seven other cities, Beacons are designed to rebuild communities of support for children and youth in urban neighborhoods. The Beacon framework is based on research findings and practitioner experience indicating that programs taking a youth development approach are more effective than those focused on "fixing" specific youth problems. Successful Beacon programs provide positive ways to meet young people's need for safety, a sense of belonging, and mastery; they also provide opportunities for decision making and contributing to others. There are currently eighty Beacons in New York City, serving about 140,000 youth and adults annually. Beacons have been replicated in several parts of the country, including Denver, Minneapolis, Oakland, Palm Beach County, Philadelphia, San Francisco, and Savannah. The Youth Development Institute of the Fund for the City of New York provides technical assistance and training to Beacons in New York City and in all seven replication sites.

Adolescent↗
PubMed2005

Anchors of the community: community schools in Chicago.

In partnership with Chicago's public and private sectors, Chicago Public Schools (CPS) has successfully implemented a citywide education reform effort, designed to transform Chicago's neighborhood schools into vibrant centers of the community. Mayor Richard M. Daley and Arne Duncan, CEO of CPS, launched the Community Schools Initiative in January 2002. What started as an idea that was developed by a local foundation has now grown into the largest-scale community school effort in the nation, with sixty-seven schools in operation and a plan to move to one hundred community schools by 2007. This initiative currently involves seventeen private funders, ten technical assistance providers, thirty-four community-based organizations that offer on-site services to children and families, and over three hundred additional community partnerships that provide one-day events such as health fairs and violence prevention workshops.

Adolescent↗
PubMed2005

The school community council: creating an environment for student success.

A model of community-school partnerships is developing within a school district in Evansville, Indiana. Based on a full-service community school philosophy, the model started in one elementary school in the Evansville-Vanderburgh School Corporation and has expanded into a districtwide initiative called the School Community Council. The council is made up of over seventy community organizations and social service agencies working together to establish full-service schools as places of community and to enhance youth and family development.

Adolescent↗
PubMed2005

Schools uniting neighborhoods: the SUN initiative in Portland, Oregon.

The SUN Community Schools Initiative is a community-driven model that allows each school community to design the programs that fit neighborhood needs in Portland, Oregon. County and city governments, local school districts, and community agencies have jointly leveraged resources to support fifty-one community schools. The program is managed by the Multnomah County Department of School and Community Partnerships. The City Parks and Recreation Bureau oversees twelve sites staffed by city employees. Strong support across political systems aligns funding and reduces the fragmentation in existing funding patterns.

Adolescent↗
PubMed2005

California's Healthy Start: A solid platform for promoting youth development.

A school in Los Angeles County reports absences down by 30 percent and disciplinary actions down by 10 percent. A town near Fresno reports having 99 percent of their new kindergartners ready to start school on the first day of class because their immunization and school readiness outreach was so thorough. A school in San Diego reports youth tobacco use down from 15 percent to 3 percent, absences down by 10 percent, and detentions down by over 50 percent. Schools in Humboldt report a 30 percent improvement in math scores and a 40 percent improvement in reading scores. Young adults report that the assistance they received as teens through their school's Healthy Start program saved their lives and enabled them to be successful parents today. These are results from one of California's most successful education mandates-SB620 1991-California's Healthy Start.

Adolescent↗
PubMed2005

Building the community school movement: vision, organization, and leadership.

On a local level, creating and sustaining community schools requires leadership from local government, schools, businesses, and nonprofit organizations. These groups must provide the fuel and direction to move the community school strategy forward along a common vision and with strategic methods for financing. At the federal level, it must continue to build constituency for community schools if it is to succeed, although the community school movement has made great strides in recent years. There is not now a coherent federal framework to support the community school vision. The proposed Full Services Community Schools legislation would build a national constituency and legislate key principles advocated by the Coalition for Community Schools: developing districtwide community school strategies, focusing on results, and improving coordination of funding streams.

Child↗
PubMed1995

The use of continuous quality improvement to achieve proper isolation of patients with suspected tuberculosis.

The infection control staff worked on their first project that used the methods of continuous quality improvement from January through July 1993. The purpose of this initial project was to achieve proper isolation of patients with suspected tuberculosis. Flowcharting revealed that appropriate clinical performance by the charge nurses was crucial, and cause and effect diagraming demonstrated the importance of good policies and procedures. The team hypothesized that the charge nurses' current knowledge of tuberculosis and isolation procedures was low and that fewer exposures would occur if a concerted effort were made to educate this particular group. A self-administered examination to test their knowledge base was completed by 87% of approximately 75 charge nurses. The average score was 48 of a possible score of 100. Eight education programs were given to the charge nurses; these included information about tuberculosis and revised policies and procedures. After the intervention, the test was readministered to a group of 20 charge nurses. Scores of this group improved by 49%. Mistakes were made and lessons were learned in this first continuous quality improvement endeavor. Despite the flaws in this project, its ultimate goal of reducing exposures to tuberculosis was achieved.

Algorithms↗
PubMed2004

Community relations and organizations.

Establishing and maintaining excellent relations with organizations in the community that have influence on the hospital ED's success can be critical to the ability of ED leaders to achieve performance objectives and satisfy customers on an ongoing basis. Relationships with public service entities,especially EMS, are particularly important. Although the relationships with other individual community organizations may be of variable importance,the collective effort dictates the impact of the ED's overall organized community relations program and could have a significant effect on the overall success or failure of the ED.

Advertising↗
PubMedDate not supplied

Outreach: targeting high-risk women through community partnerships.

The need for community-based preventive intervention is driven by the ineffectiveness and the costliness of traditional approaches. We argue that community outreach efforts should be characterized by three components: 1) careful mapping of high-risk areas, 2) developing partnerships with trusted community institutions within areas of high risk, and 3) developing a portfolio of institutional partners that maximize the penetration of high-risk populations. The analysis of these high-risk contexts redirects the focus from individuals to institutional structures. Gaining a greater understanding of how impoverished women relate to formal institutions is critical to the primary goal of reducing unnecessary deaths.

Community Health Planning↗
PubMed2001

Pneumococcal immunizations at flu clinics: the impact of community-wide outreach.

This study examined the effectiveness of a community-wide outreach campaign to promote the use of pneumococcal vaccine at public flu immunization clinics, and assessed whether this intervention was more effective than simply making pneumococcal vaccination available at such clinics. In 1997, a community-wide outreach campaign promoting pneumococcal and influenza immunizations was launched in a 17 zip code area of Dutchess County, NY. The campaign was aimed at 7,961 Medicare beneficiaries urging them to obtain pneumococcal immunization from local flu clinics. Medicare reimbursement data were used to assess the countywide pneumococcal vaccination rate, and to analyze differences between rates for beneficiaries in the target area and elsewhere in the county. Between 1996 and 1997 there was a 94% increase in pneumococcal vaccination billed to Medicare beneficiaries in Dutchess County. The 1997 annual rate of pneumococcal immunization in the target area reached 16.3% versus 12.2% elsewhere in the county (p < 0.001), with an increase over the previous year of 8.7% and 5.6%, respectively. Nearly all of the increase is accounted for by pneumococcal vaccination delivered at flu clinics. It is possible to significantly increase the use of pneumococcal immunization by linking its delivery to community-based flu clinics and by developing local outreach strategies. The outreach campaign has a significant additive effect over simply making PPV available at flu shot clinics. Additional community-wide outreach can further improve pneumococcal immunization utilization rates.

Aged↗