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Community violence and its direct, indirect, and mediating effects on intimate partner violence.

The links among social disorder, violence in the social support network (NIPV), community violence, and women's substance use were examined in a sample of 50 low-income, nonshelter women to predict intimate partner violence (IPV). The authors found that living in a neighborhood with higher levels of social disorder and using substances increased women's exposure to community violence that, in turn, was associated with increased rates of IPV. In addition, although not associated with community violence, NIPV was associated with increased IPV. The results suggest that examining neighborhood-level factors is important in domestic violence policy, practice, and research.

Adult↗

Network structure and the biology of populations.

A scientific growth area in recent years has been the study of networks of interacting entities within a population, including species in food webs, human or other animals transmitting infection, proteins in cells, cells in organisms (e.g. neuronal networks), the internet and the World Wide Web. Here, I review some of the differing network patterns that arise in theory and in practice, with an emphasis on their dynamical implications, particularly for resistance to deliberate or accidental disturbance. I offer caveats and opinionated comment about some excesses of enthusiasm and suggest some areas where these network ideas might find further application.

Animals↗

Social network type and health status in a national sample of elderly Israelis.

A typology of social support networks was examined in relation to five health measures in a national probability sample of Israelis aged 60 and over, using multiple classification analysis (N = 4214). The procedure revealed that the more resourceful diversified and friend and neighbor network types were consistently associated with better scores on measures of basic and instrumental activities of daily living, incontinence, vision and self-rated health, even when controlling for respondents' age, sex and education. The religious family network type, also endowed with considerable support potential, tended to correlate with lower health scores. The narrow family focused network had average health ratings or less, and a moderate support capability. The least resourceful network type, the attenuated network, was most frequently associated with poor health.

Aged↗

The RANZCP Australian Private Practitioners' Network.

OBJECTIVE: To provide an overview of the challenges and opportunities afforded by the practice of psychiatry in the private sector, and in so doing build a rationale for the formation of a formally established network of Australian psychiatrists who meet to advance constructive proposals concerning the private practice of psychiatry, encourage mutual support, and promote this area of psychiatric endeavour. CONCLUSIONS: Private psychiatry has dangers, challenges and many responsibilities, but it also has the potential for relative independence and creative fulfilment. It is desirable that its practitioners support each other and work constructively together in addressing the sorts of issues delineated in the Private Practitioners' Network's mission statement and objectives.

Australia↗

Health services delivery networks: what do we know and where should we be headed?

Networks of collaborating organizations have become critical mechanisms for the effective delivery of healthcare and related human services. Despite their importance, there is much about health networks that is not understood. The article by Huerta, Casebeer and VanderPlaat is an effort to discuss the importance of health services delivery networks and to point out ways in which such networks might best be studied. Their article offers a number of useful and interesting ideas for both practice and research. Many of these ideas are not, however, well organized, integrated or fully developed. This commentary provides a critique of their work, while offering some of our own suggestions about how the study of health delivery networks might be advanced.

Canada↗

When should primary care groups become multispecialty networks?

A difficulty confronting many primary care groups is determining whether--and when--to evolve into multispecialty networks. Internal triggers that signal the need to transition to a multispecialty group include having a sufficient number of primary care physicians in the group and the solidification of an effective primary care management system. External triggers include a decline in average per-member-per-month (PMPM) rates, carve-outs of portions of the PMPM payment for an increasing number of healthcare services, and increases in Medicare managed care enrollment. Primary care groups that make the transition to multispecialty networks may find it is the best model for managing the health of the population in their community.

Capitation Fee↗

The Women and Infants Demonstration Project: an integrated approach to AIDS prevention and research.

The Women and Infants Demonstration Project is a multisite, behavioral intervention research effort funded by the Centers for Disease Control. The project is evaluating a theory-based, integrated intervention model to increase the use of condoms for prevention of both sexually transmitted diseases (STDs) and unintended pregnancy among women and their partners at risk of infection with HIV. The importance of utilizing carefully targeted, credible and persistent risk reduction interventions to effect lasting behavior change has become evident over the last ten years of the AIDS epidemic. The theory-based intervention components being evaluated in this intervention study involve one-on-one stage-tailored outreach; the development and distribution of community-tailored HIV prevention materials, called role-model stories; and the development of organizational and peer networking, all within a community mobilization framework. This article describes each of the intervention components being evaluated during this 5-year study. Such an intervention effort represents an important contribution in the design of community-level AIDS prevention intervention efforts which support individual-level behavioral changes by women at risk for HIV and other sexually transmitted infections.

Adolescent↗

Phasing out state hospitals -- a psychiatric dilemma.

Whether state hospitals have a role in caring for mentally ill persons has been intensely debated for the past decade. During this time the inpatient census of public mental hospitals has fallen dramatically from 490,000 to 215,000 owing to increasingly effective treatment programs for acutely and chronically psychotic patients. The vast majority of patients currently cared for in state hospitals could be adequately treated in the community if a comprehensive spectrum of psychiatric services and residential alternatives were established. The failure to establish this network of community services before the discharge of thousands of patients has discredited the deinstitutionalization programs in many states, including California and New York, and forced California to abandon its plan to phase out all its state hospitals. Thus, although phase out of state hospitals is clinically feasible, it is unlikely at present since the fiscal and ideologic commitment to shift to community-based treatment is lacking.

Acute Disease↗