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Caribbean: birth of a regional network responding to HIV/AIDS and vulnerability.

In December 2004, representatives from 30 Caribbean NGOs met in Kingston, Jamaica to form a regional network of organizations working with populations most vulnerable to HIV/AIDS--the Caribbean Vulnerable Communities (CVC) Network. In this article, two Caribbean researchers and activists situate this vulnerability and the civil society response in their specific socio-historical context.

HIV Infections↗

[A network of epidemiological information in community medicine practice: methodological principles of the VENUS Program].

Implementation of epidemiological studies involving the participation of large networks of ambulatory care physicians requires prior resolution of the methodological dilemma between a "volunteer sentinel doctors" approach and one based on sampling techniques. A study of the VENUS program (concerning Sexually Transmitted Diseases) illustrates this latter approach for which formulae are proposed for estimating the rate of incidence in the population. Methodological implications of this technique are commented upon, and the complementary indications for the two techniques for gathering information on ambulatory morbidity are discussed.

Ambulatory Care↗

[Study of non-insulin-dependent diabetes mellitus in primary care in the community of Madrid using the network of sentinel physicians].

OBJECTIVES: To describe the frequency, clinical features and therapeutic management of diagnosed diabetics not dependent on insulin, who were controlled in Primary Care in the Community of Madrid. DESIGN: The study was performed through a network of sentinel doctors, which covered about 2% of Madrid's total population. The sentinel doctors had to notify on each known diabetic patient once (new cases), on their first consultation during the study period. SETTING: Community of Madrid. Information on 1,449 diabetic patients not dependent on insulin and diagnosed in Primary Care was obtained. Their personal and clinical data and prior history of chronic complications were gathered. RESULTS: Average number of notified diabetics was 28.4 per doctor (18.7 per 1,000 registered patients > 14 years old). About 4.1 new cases (1.46 per 1,000) were diagnosed each year. CONCLUSIONS: Diabetic patients not dependent on insulin represent an enormous burden on Primary Health Care in the Community of Madrid.

Adolescent↗

Health information networks. Where are we headed?

Proponents of community health information networks have high hopes for improving care and cutting costs by sharing information among providers, payers and others. But significant issues must be resolved before networks can deliver on those high expectations.

Community Health Planning↗

The Appalachia Cancer Network: cancer control research among a rural, medically underserved population.

Residents of Appalachia, especially those in rural Appalachia, are generally considered to be medically underserved. In fact, cancer mortality in Appalachia, especially in rural Appalachia, is higher than it is in the remainder of the United States. Developing from the Appalachia Leadership Initiative on Cancer, the Appalachia Cancer Network (ACN) is a network of academic and community organizations that seek to conduct surveillance, intervention, and dissemination research to reduce this excess cancer burden in Appalachia. The purpose of this report is to (1) describe the approach to cancer control research in ACN, a Special Population Network, among the medically underserved of Appalachia, and (2) to put forward observations from this experience to enhance the research of other academic and community networks among underserved populations. ACN has instituted a conceptual model, organizational structure, and other methods to foster this research and to develop junior and community-based investigators. Important issues and questions related to the effectiveness of such research networks have also been articulated.

Appalachian Region↗

CHIME-Net, the Connecticut Health Information Network: a pilot study.

CHIME-Net is a state-wide community health information network project which uses a frame-relay approach to interfacility and internet connectivity. This is a collaborative effort among competitive institutions, which embraces technologies new to the health care industry. The experiences of implementation of the CHIME-Net pilot project are presented as a first milestone for the state-wide effort.

Community Networks↗

The challenges of governing public-private community health partnerships.

This article identifies key challenges that arise in governing public-private partnerships designed to improve community health status. Using telephone interview and focus group data, we describe how the 25 public-private community health partnerships participating in the Community Care Network (CCN) Demonstration Program grapple with three interrelated clusters of governance issues: turf, community accountability, and growth and development.

Community Health Planning↗