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Better sales networks.

Anyone in sales will tell you that social networks are critical. The more contacts you have, the more leads you'll generate, and, ultimately, the more sales you'll make. But that's a vast oversimplification. Different configurations of networks produce different results, and the salesperson who develops a nuanced understanding of social networks will outshine competitors. The salesperson's job changes over the course of the selling process. Different abilities are required in each stage of the sale: identifying prospects, gaining buy-in from potential customers, creating solutions, and closing the deal. Success in the first stage, for instance, depends on the salesperson acquiring precise and timely information about opportunities from contacts in the marketplace. Closing the deal requires the salesperson to mobilize contacts from prior sales to act as references. Managers often view sales networks only in terms of direct contacts. But someone who knows lots of people doesn't necessarily have an effective network because networks often pay off most handsomely through indirect contacts. Moreover, the density of the connections in a network is important. Do a salesperson's contacts know all the same people, or are their associates widely dispersed? Sparse networks are better, for example, at generating unique information. Managers can use three levers--sales force structure, compensation, and skills development--to encourage salespeople to adopt a network-based view and make the best possible use of social webs. For example, the sales force can be restructured to decouple lead generation from other tasks because some people are very good at building diverse ties but not so good at maintaining other kinds of networks. Companies that take steps of this kind to help their sales teams build better networks will reap tremendous advantages.

Commerce↗

Psychosocial processes and general susceptibility to chronic disease.

The concept of general susceptibility to disease has developed as a unifying explanation for the findings that a variety of diseases are associated with certain social and cultural situations. This hypothesis was tested in a prospective study of 4251 men of Japanese ancestry in Hawaii who answered a psychosocial questionnaire in 1971. The seven-year incidence rates of coronary heart disease, stroke, cancer, and all deaths during the period December 1971-January 1979 were analyzed for association with individual questions and five summary scores measuring geographic and generational mobility, sociocultural and spousal inconsistency, and social networks. Among all questions and summary scores measuring mobility and inconsistency, there was only one statistically significant association with any disease, and this association was in the opposite direction to that predicted by the hypothesis. The measures of social networks were not associated with either the incidence of stroke, cancer, or all diseases combined, but were associated with coronary heart disease, as reported in detail earlier. The authors examined the joint interaction of the postulated stressful processes of mobility and inconsistency with the protective effects of social networks, with special attention to the men in the highest levels of mobility and inconsistency. They found no significant associations, and thus there was no support for the hypothesis that social networks are especially protective among persons in the highest levels of mobility and inconsistency. The inclusion of known health hazards, cigarette smoking, and high systolic blood pressure levels did not alter these findings.

Aged↗

Effects of stress and social supports on mother-child interactions in single- and two-parent families.

Social networks, coping abilities, life stresses, and mother-child interaction were studied in 28 mother-child pairs--14 single mothers and their preschool children and 14 matched married women and children. Questionnaires were used to measure the mothers' social network, coping abilities, and life stress; a mother-child interaction situation was used to measure maternal control, maternal maturity demands, maternal nurturance, mother-child communication, and child compliance. Single parents tended to be more socially isolated than married parents. They worked longer hours and received less emotional and less parental support. They tended to have less stable social networks and experience more potentially stressful life changes. Only in the household area did single mothers report more difficulties coping than 2-parent mothers. No significant differences were found in any of the 5 mother-child interaction variables. Different variables predicted mother-child interaction in the 2 samples. Predicting optimal mother-child interaction in single-parent families were fewer stressful life events, reduced social contact, increased parenting support, and hours maternal employment. Predicting optimal interaction in 2-parent families were fewer stressful life events, satisfaction with emotional support, and the availability of household help. Social contacts, household help, and employment differentially predicted mother-child interactions in the 2 groups. Implications of these differences for descriptions of the effect of social networks and maternal adjustment on child development are considered, as are implications for intervention.

Child Rearing↗

Physicians as clinical directors: working conditions, psychosocial resources and self-rated health.

BACKGROUND: Physicians in clinical directors' positions fulfil their commitments in demanding work environments characterized by organizational changes and economic cutbacks. Little is known about the self-rated health of this group. AIM: To investigate whether self-rated health was associated with psychosocial working conditions, professional networks, job support, social networks and social support, sick leave and salary in Swedish physicians working as clinical directors. METHODS: A self-reported questionnaire was sent to 373 clinical directors. Odds ratios (ORs) were used for estimating the bivariate association between self-rated health and psychosocial resources. RESULTS: A total of 274 clinical directors agreed to participate in the study. The response rate was 73%. The clinical directors exposed to high job demands had a significantly higher probability of low self-rated health [OR = 3.4 and 95% confidence interval (CI) = 1.6-7.0] than those who were not in this situation. Furthermore, participants who were exposed to high job demands had an increased risk of low self-rated health (OR = 3.8 and 95% CI = 1.8-8.1) irrespective of available social support inside or outside work. High average working hours more than doubled the risk of low self-rated health (OR = 2.2 and 95% CI = 1.1-4.4). CONCLUSION: The job demands on physicians in clinical directors' positions may exceed ordinary means of support with consequent adverse effects on self-rated health. More research is needed to investigate the interaction between job demands and support systems in this group of health care workers.

Administrative Personnel↗

Effect of specific aspects of community social environment on the mortality of individuals diagnosed with serious illness.

The purpose of this study was to examine the prospective and contextual effects of urban community environment on mortality among Medicare beneficiaries who were 67 years old or older in 1993, lived in the city of Chicago, and were hospitalized for one of 13 serious diseases. As expected, we found that advantageous socioeconomic context helps lower mortality risk among elderly patients over and above individual demographic and health background. We also found that collective efficacy was a health-enhancing social resource whereas criminal and violent activities in the community appeared to be deleterious. Inconsistent with our hypotheses, community social network density (measured by the size of social network and frequency of social interaction) was not protective but detrimental. Moreover, social support and the civic involvement of residents in the community do not seem to affect mortality. The complex relationship between community social environment and health found in this study may suggest that community-level social interventions based on social capital/social cohesion models are not likely to achieve fruitful results without concomitant effort in the economic and health care realm, at least in terms of influences on the health of older people once they are already ill.

Acute Disease↗

First-episode schizophrenia with long duration of untreated psychosis. Pathways to care.

BACKGROUND: The early course of illness in first-episode schizophrenia was examined with special emphasis on the duration of untreated psychosis and pathways to care. METHOD: The consecutively admitted individuals (n = 34) were assessed on premorbid functioning, duration of untreated psychosis, global functioning, symptoms and social network. To clarify the obstacles for receiving earlier treatment, 17 case histories with long duration of untreated psychosis were intensively studied. RESULTS: The duration of untreated psychosis was on average very long (130 weeks), the median value was 54 weeks. The long duration of untreated psychosis group (> 54 weeks) had greater deterioration in the premorbid phase, a weaker social network and were more withdrawn than the short duration of untreated psychosis group (< 54 weeks). The main obstacles for receiving treatment were withdrawal and poor social network. CONCLUSIONS: In order to identify people earlier, a system of detection must be mobile, easily accessible and attentive to early symptoms of psychosis. It seems to be important to educate the social network related to the individual about the importance of early treatment.

Adolescent↗

Getting by with a little help from your friends: the impact of peer networks on criminality in a cohort of treatment-seeking drug users.

This study investigates the links between social networks of drug users and criminal activity. Opiate misusers (n=128) receiving in-patient treatment were interviewed about substance use, social networks, and crime in the month before treatment. Almost 60% of participants reported an average of more than 70 crimes each. Less than one-fifth of the subjects spent no time with other users, while just over half spent either "quite a lot" or "a lot" of time with drug users. Time with users increased the risk of crime. Spending no time with users provided a protective effect. Time with criminally involved drug users was associated with greater levels of crime. Social networks represent an important marker for integration in criminal networks in treatment-seeking drug users and a long-term barrier to rehabilitation.

Adult↗

Intention to have a mammogram in the future among women who have underused mammography in the past.

This study investigated associations between confidence in one's ability to discuss mammography with health providers and to obtain regular mammograms (self-efficacy), social network members' attitudes toward mammograms (social influence), mammography experiences, and intention to have a mammogram in the next 1 to 2 years among women who were not in adherence with screening guidelines. Data were collected as part of a baseline assessment for a work site intervention study. Women 52 years and older completed a self-administered survey. Those not in compliance with screening guidelines (n = 194) were included in the analyses. Logistic regression revealed that self-efficacy and strong supportive social influences were significantly associated with mammography intention (odds ratio [OR] = 2.50, OR = 2.22, respectively), adjusting for prior mammography use. Findings suggest that interventions designed to promote mammography should build women's confidence in their ability to discuss mammography with health providers and to obtain regular mammograms. Intervention among social networks may also be an effective means of promoting mammography.

Adult↗

Coronary artery bypass grafting: social support for patients and their significant others.

BACKGROUND: Patients and significant others may experience physical and psychological stress symptoms during the recovery time from coronary artery bypass surgery. It has been shown that social support is associated with health and well-being in various situations. It is important to study how patients and significant others describe the social support received. AIM AND OBJECTIVE: To describe social support for bypass surgery patients and their significant others from the social network and nurses during hospitalization and the association between demographic variables and support received from nurses. DESIGN: A descriptive study using a questionnaire. This was a pilot study. METHOD: Questionnaires were mailed to 146 subjects and 103 responded. The questionnaires included background variables, the Social Support from the Social Network Scale and the Support from Nurses during Hospitalization Scale. RESULTS: In most cases, the spouse, children and friends were the major sources of support for patients and significant others. Patients reported equal amounts of both affect and aid or concrete support while significant others reported the highest level of affect and the lowest level of affirmation from the social network. Patients and significant others reported the highest level of affirmation and the lowest level of aid from nurses during hospitalization. CONCLUSIONS: Relatives are important sources of support for bypass surgery patients and their significant others. Patients reported higher levels of all types of social support from both the social network and nurses than did significant others. RELEVANCE TO CLINICAL PRACTICE: The provision of nursing support for significant others can be enhanced by focusing nursing care on the whole family. This would promote the health of the whole family.

Aged↗

Quality and costs of supported living residences and group homes in the United Kingdom.

Information was collected on 63 adults in supported living residences, 55 adults in small group homes, and 152 adults in large group homes. Results indicated that (a) there were no statistically significant differences in service costs once these had been adjusted to take account of participant characteristics; (b) compared with participants living in small group homes, those in supported living residences had greater choice, participated in more community-based activities, experienced fewer scheduled activities, were more likely to have had their home vandalized, and were considered at greater risk of exploitation; (c) compared with participants living in large group homes, those in small group homes had larger social networks, more people in their social networks who were not staff, not family, and did not have mental retardation. These residents were considered at less risk of abuse.

Adult↗

Screening African-American elderly for the presence of depressive symptoms: a preliminary investigation.

Several authors have reported that older African-Americans with multiple medical problems and decreased activities of daily living are at an increased risk of reporting symptoms of depression. African-Americans were more likely to report symptoms of anger, irritability, denial of illness, and to spontaneously report symptoms that did not reflect a change in mood, but rather forbearance of a difficult time or somatic complaints. This paper describes the results of a study to assess the presence of depressive symptoms in older African-American community residents. A new instrument, the Baker Belief Scale, is compared with the Center for Epidemiologic Studies-Depression Scale (CES-D) and the association of medical illnesses, social network, and level of physical function in activities of daily living (ADL). Ninety-six African-American men and women, aged 60 years or older, with equal representation from urban and rural counties in western Tennessee comprised the sample. The sample was stratified, in each of the two counties, into three age categories; 60-69, 70-79, and 80 years and older. A screening battery consisting of the Short Portable Mental Status Questionnaire, the CES-D, the Lubben Social Network Scale, and the Katz ADL were administered to the sample. Current medical illnesses were recorded with demographic data. There was a significant association between the CES-D score and the BBS score for those who screened positive for symptoms of depression. In addition there was a significant relationship between CES-D score and specific medical illnesses, social network, physical function in ADL, and residence (urban vs. rural). Residents who screened positive (N = 19) for depressive symptomatology with CES-D scores of 16 or higher exhibited a higher frequency of hypertension, arteriosclerosis, and circulatory problems than those who tested negative (N = 77). More urban residents (N = 13) than rural residents (N = 6) screened positive for symptoms of depression. Approximately 21% (N = 20) of the 96 respondents had scores of 20 or less on the Lubben Social Network Scale, suggesting a group of "at risk" for social isolation.

Black or African American↗

Family burden in long-term diseases: a comparative study in schizophrenia vs. physical disorders.

This study explored burden and social networks in families of patients with schizophrenia or a long-term physical disease. It was carried out in 169 specialised units (mental health department, and units for the treatment of chronic heart, brain, diabetes, kidney, lung diseases) recruited in 30 randomly selected geographic areas of Italy. The study sample consisted of 709 key relatives of patients with a DSM-IV diagnosis of schizophrenia and 646 key relatives of patients with physical diseases. Each relative was asked to fill in the Family Problems Questionnaire (FPQ) and the Social Network Questionnaire (SNQ). In all selected pathologies, the consequences of caregiving most frequently reported as always present in the past 2 months were constraints in social activities, negative effects on family life, and a feeling of loss. Objective burden was higher in brain diseases, and subjective burden was higher in schizophrenia and brain diseases than in the other groups. Social support and help in emergencies concerning the patient were dramatically lower among relatives of patients with schizophrenia than among those of patients with physical diseases. In the schizophrenia group, both objective and subjective burden were significantly higher among relatives who reported lower support from their social network and professionals. The results of this study highlight the need to provide the families of those with long-term diseases with supportive interventions, including: (a) the management of relatives' psychological reactions to patient's illness; (b) the provision of information on the nature, course and outcome of patient's disease; (c) training for the relatives in the management of the patient's symptoms; and (d) the reinforcement of relatives' social networks, especially in the case of schizophrenia.

Adolescent↗

Formal and informal network factors as sources of morale in a senior center population.

This study examined the relative effects of senior center factors and social network attributes on the morale of a sample of senior center participants in Israel (N = 85), controlling for respondents' background characteristics. The multivariate model accounted for 56 percent of the variance in morale scores. Respondents' health was the primary explanatory factor, followed by selected attributes of participants' informal social networks. The formal network factors had a minor and partly negative effect. The findings suggest that participants' morale was shaped more by the configuration of their interpersonal social networks than by factors related to the senior center environment.

Aged↗

Are there 'casual users' of cocaine?

Medical and public opinion about cocaine use have shifted dramatically over the past decade. New research methodologies and definitions to evaluate the impact of cocaine are needed. This paper presents a theoretical definition and empirical analysis of the 'casual user' of cocaine. Data have been drawn from a subsample of 58 cocaine users and their cocaine-using contacts in Rotterdam. The methodology of the study presents a novel approach to patterns of cocaine use involving the integration of social network variables with 'snowball' sampling data collection techniques. The theoretical definition is systematically related to two social context variables: (1) the scope of settings where contacts use cocaine; (2) the degree of involvement in social network relations of actual cocaine use. Scope of settings has been defined in terms of the number of cocaine-using social circuits contacts are drawn from: i.e. 'narrow' setting where all contacts originate from one circuit while a 'wide' setting indicates contacts come from two or more circuits. Involvement has been defined in terms of the percentage of contacts where the relation with study participants is characterized by cocaine use most or all of the time. Additional social network variables measuring the mean duration (in years) of contacts' cocaine use and the use of cocaine with contacts in the last six months are subsequently related to the scope and involvement variables. The implications of the analysis for a new cross-classification of cocaine use patterns are discussed with special reference to public health policy issues.

Analysis of Variance↗

Age differences in the effects of network composition on psychological distress.

The main goal of this research is to better understand age differences in the effects of social networks on mental health. Using a social network approach to revise the convoy of social support model (Kahn and Antonucci, 1980), we examine specifically how two aspects of social support networks (kin composition and convoy dimensions) influence psychological distress for older and younger samples (18-59 and 60+). We hypothesize that kin composition will influence distress in general but especially for the younger sample, while two competing hypotheses for the convoy of social support model are tested. Using data from a three-wave panel health study, structural equation models (LISREL 8.20) indicate that a greater proportion of kin in the perceived support network and the presence of family members in the inner circle of the convoy significantly reduce distress, primarily for the younger sample. Implications for the convoy model are discussed.

Adolescent↗

Social ties and susceptibility to the common cold.

OBJECTIVE: To examine the hypothesis that diverse ties to friends, family, work, and community are associated with increased host resistance to infection. DESIGN: After reporting the extent of participation in 12 types of social ties (eg, spouse, parent, friend, workmate, member of social group), subjects were given nasal drops containing 1 of 2 rhinoviruses and monitored for the development of a common cold. SETTING: Quarantine. PARTICIPANTS: A total of 276 healthy volunteers, aged 18 to 55 years, neither seropositive for human immunodeficiency virus nor pregnant. OUTCOME MEASURES: Colds (illness in the presence of a verified infection), mucus production, mucociliary clearance function, and amount of viral replication. RESULTS: In response to both viruses, those with more types of social ties were less susceptible to common colds, produced less mucus, were more effective in ciliary clearance of their nasal passages, and shed less virus. These relationships were unaltered by statistical controls for prechallenge virus-specific antibody, virus type, age, sex, season, body mass index, education, and race. Susceptibility to colds decreased in a dose-response manner with increased diversity of the social network. There was an adjusted relative risk of 4.2 comparing persons with fewest (1 to 3) to those with most (6 or more) types of social ties. Although smoking, poor sleep quality, alcohol abstinence, low dietary intake of vitamin C, elevated catecholamine levels, and being introverted were all associated with greater susceptibility to colds, they could only partially account for the relation between social network diversity and incidence of colds. CONCLUSIONS: More diverse social networks were associated with greater resistance to upper respiratory illness.

Adolescent↗

Social relations and smoking behavior: results from the first MONICA Survey Augsburg.

This study examines the relationship between various aspects of social relations and the prevalence of smoking, using data from the first MONICA Survey, Augsburg, FRG, 1984/85. Study population of the survey was a two-stage cluster sample of 5312 men and women aged 25 to 64. The response was 79.4%. The measurement of social relations included a modified form of the Syme/Berkman social network scale, as used in the Alameda County Study. Analyses were carried out separately for the total four-level social network index in relation to smoking, and for specific components of that index (marital status, contacts with friends and relatives, activities in informal groups). The results showed for both men and women, that there was a significant association between the social network index and the prevalence of smoking: the more social ties and contacts, the lower the percentage of smokers. The results from multiple logistic regression analyses indicated an effect of social relations on smoking, that is at least partly independent of age, gender and educational level. In general, the findings may contribute to a better understanding of 'risk groups', and the possible pathways leading from social relations to health and disease.

Adult↗