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Often, the missing link in managing contact cap is a profiling system that gives specialists the data they need to make educated decisions. This system focuses on reducing intra-network variation.
This paper explores the dynamics between poverty and exclusion; neighbourhood, and health and well being by considering the role of social networks and social capital in the social processes involved. It is based on qualitative research taking two deprived areas as exemplary case studies, and involving depth interviews with residents. Neighbourhood influences on networks and social capital were explored, network typologies developed reflecting structural and cultural aspects of individual's networks, and pathways implicated in health effects considered. The complexity of social capital is addressed. The role of three factors in influencing social networks and social capital are demonstrated: neighbourhood characteristics and perceptions; poverty and social exclusion, and social consciousness. Perceptions of inequality could be a source of social capital as well as demoralisation. Different network structures-dense and weak, homogeneous and heterogeneous- were involved in the creation of social capital and had implications for well being. Coping, enjoyment of life and hope are identified as benefits. Although participation in organisations was confirmed as beneficial, it is suggested that today's heterogeneous neighbourhoods also require regenerated local work opportunities to develop bridging ties necessary for the genesis of inclusive social capital and better health. Despite the capacity of social capital to buffer its harsher effects, the concept is not wholly adequate for explaining the deleterious effects of poverty on health and well being.
The mission of the Utah Cancer Action Network is to reduce cancer incidence and mortality in Utah. Established in 2003, the network selected skin and colon cancers as the first priorities in its comprehensive plan. In its first year of operation, the network planned and implemented a cancer awareness campaign that was organized along two tracks: 1) marketing research, consisting of two telephone surveys, and 2) two advertising/awareness campaigns, one for colon cancer and one for skin cancer. The first telephone survey was conducted in January 2003 to obtain a baseline measurement of the Utah population's knowledge, attitudes, and behaviors. The advertising campaigns were launched in April 2003, and the second telephone survey was conducted in May. In January 2003, 18% of survey respondents reported seeing or hearing skin cancer prevention or sun protection announcements; in May, this percentage increased to 76%. In January, 36% indicated they had seen, read, or heard colorectal cancer early detection announcements; in May, this percentage increased to 79%.
This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.
The use of economic evaluation to assess the costs and consequences of health care technologies has steadily increased in recent years. However, little is known about the influence economic studies have on health care decision makers or policy at local and national level. This paper reports the results of a survey of economic evaluations in EC countries to identify the impact of the results on decision and policy making in health care. Health service researchers in 10 EC countries were identified and asked to participate in the survey. The researchers were asked to locate economic evaluations in their country and complete a standardised questionnaire for each study. The criteria for inclusion in the survey were first, the studies should have been started or reported since 1987, second, the evaluations should include a comparison of the cost and consequences of the technologies assessed and finally, the appraisals should include a comparison of alternative health care technologies or programmes. A total of 66 studies which met the survey criteria were reported. Of these, 27% were thought to have influenced health care decision makers or policy. The results suggested that method of dissemination, source of funding and purpose of the study may be important determinants of whether an economic evaluation will be used in health care policy or decision making. The results of the survey suggest that economic evaluation currently has a relatively low impact on health care policy or decision making.(ABSTRACT TRUNCATED AT 250 WORDS)
In France, a wide range of healthcare workers provide care for pregnant women and their infants including general practitioners and specialists working in a private or public setting and midwives (again in a private or public hospital practice). The respective competencies of each category of healthcare workers is not currently evaluated and their individual actions are rarely coordinated. This raises the question of equal opportunity for future mothers. In light of this situation, we developed an innovating concept aimed at improving pregnancy follow-up in a coordinated effort implicating all the different categories of healthcare workers involved in perinatal care: the pregnancy follow-up perinatal community.
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This randomized open-label trial of human immunodeficiency virus type 1-infected persons compared safety and efficacy for 38 patients receiving hydroxyurea/didanosine combination therapy with findings in 42 persons given didanosine monotherapy for 12 weeks, followed by 12 weeks of hydroxyurea/didanosine combination therapy for all patients. Week 12 on-treatment group comparisons showed a mean decrease in virus load between hydroxyurea/didanosine versus didanosine groups of -0.93 versus -0.74 log10 copies/mL (P=.20); a higher percentage of the hydroxyurea/didanosine group below the assay's detection limit (500 copies/mL), 29% versus 7% (P=.017); and median change in CD4 cells for the hydroxyurea/didanosine versus didanosine group of 0 versus 43 cells/mm3 (P=.045), although median change in CD4 percentage was similar (0.9% vs. 1.2%, P=.64). Week 24 virus load reductions and CD4 cell changes were similar in both groups. Intent-to-treat and on-treatment analyses showed similar results. The hydroxyurea/didanosine combination was well tolerated.
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Executive nursing practice has evolved from the traditional role in a single institution to a complex role in an integrated health care network. Nurse executives are challenged to use their strengths, which traditionally served them toward promotion in the past, and add new competencies that will facilitate promotion in the new corporate structure. Executive nurses must recognize the gap that exists in these two types of competencies and be able to develop skills in communication, persuasion, networking, and decision making in order to market themselves in the corporate world. Significant contributions can be made by nurse executives to facilitate the growth of a health care network. These contributions are made by merging business and clinical knowledge to help the network standardize patient care and evaluate outcomes. Through this process the network can demonstrate a quality product to the community and payers of health care.
The problem of finding clusters in complex networks has been studied by mathematicians, computer scientists, and, more recently, by physicists. Many of the existing algorithms partition a network into clear clusters without overlap. Here we introduce a method to identify the nodes lying "between clusters," allowing for a general measure of the stability of the clusters. This is done by adding noise over the edge weights. Our method can in principle be used with almost any clustering algorithm able to deal with weighted networks. We present several applications on real-world networks using two different clustering algorithms.
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Due to certain specificities in the HIV epidemic, its spread has escaped the random transmission pattern of other infectious diseases. Observation of the epidemic has shown that individual behavior - relational patterns among individuals - plays a crucial role in HIV transmission and that strategies to prevent the epidemic's spread should take this factor into account in order to foster efficient allocation of existing resources. Mathematical and statistical models applying the behavioral approach to the epidemic have estimated interactions between groups whose characteristics and behaviors varied. However, such models have been more "post-dictive" than predictive, due to the inadequate representation of social structures in populations through which infectious agents spread. The social network methodology thus came to be applied to the approach to the HIV epidemic. This article discusses alternatives for the application of this methodology to the Brazilian epidemic, considering that sociometric risk networks structure the flow of infectious agents in communities, creating unique opportunities to interrupt their spread.
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