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At least 109 records · Page 6Linked to original sources
PubMed2004

[Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals].

In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

Attitude of Health Personnel↗
PubMed1999

Impact of a preceptor education board and computer network to engage community faculty at Dartmouth Medical School.

In 1994, as part of the Generalist Physician Initiative of The Robert Wood Johnson Foundation, Dartmouth Medical School established two programs to support and engage community-based teaching. The Preceptor Education Board and Community Computer Network were established to support a network of community-based preceptors and to facilitate communication between course directors at the school and community-based teachers. The board's mission is to organize, develop, and support a network of community-based primary care faculty, and to create and review community-based curricula. Through the board, community faculty members have made substantial contributions to curriculum, evaluation, faculty development, governance, and financing in community-based teaching. The Community Computer Network provides hardware, software, network systems, and support. Course directors and students have reported improved community-based educational experiences as a direct result of the Network. These two initiatives are dynamic and effective ways to improve the quality of community-based education and preceptors' morale. These efforts have strengthened the community faculty and their connection to the academic medical center.

Computer Communication Networks↗
PubMed1979

Changing orientations among cocaine users: consequences of involvement in community distribution networks.

A study of 44 participants in a rural community cocaine network was conducted to determine the factors associated with increased expenditures for cocaine and the consequences of such involvement. Through correlational analysis techniques, four major categories of variables were shown to be strongly related to extent of involvement: demographic, purchasing ability, supply opportunities, and cost-reduction efforts. The major effects of increased involvement were an increase in egocentrism in relations with drug-using friends, a decline in self-control over administration, heightened concerns about possession, and strengthened justifications regarding drug use.

Adult↗
PubMed2003

Overview of the community care network demonstration program and its evaluation.

This article provides an overview of the evaluation of the National Community Care Network Demonstration Program,which began with 25 public-private partnerships selected from a diverse range of communities across the United States to address problems of lack of insurance, limited access to health care, and the health status of their most disadvantaged residents. The 25 public-private partnerships included an array of individual organizations representing health care providers, public health and human service agencies, local governments,community-based organizations, and religious and educational institutions. The specific findings of the evaluation are the focus of the articles in this issue. This overview article supplies the underpinnings of the evaluation, including the conceptual framework, methodological challenges, and a brief discussion of each of the papers and how they are linked.

Community Networks↗
PubMedDate not supplied

Health system tests CRM data base. Community Health Network uses direct mail to boost physicians.

A six-month pilot patient retention project for Community Health Network (CHN), Indianapolis, ran from July 2002 to January 2003. It was a direct mail campaign on behalf of some members of the group practices owned by CHN, designed to test the use of the system's CRM database. Patients of the physicians received personal, dynamically-generated cards reminding them to schedule appointments and tests. Each mailing cost $1.76, including production and mailing.

Ambulatory Care Information Systems↗
PubMed2005

Safe community in different settings.

This paper describes the Safe Community concept and how communities aspired to safety through a structured, collaborative approach rather than a community that is already perfectly safe. The Safe Community movement started in Sweden at the end of the 1980s and was based on community-based injury prevention activities. Safe Communities are the communities that meet a set of 12 criteria (later changed to six indicators) set out by the WHO Collaborating Centre (WHO CC) on Community Safety Promotion at Karolinska Institutet in Stockholm. The communities may apply to the WHO CC to be designated as an official member of the WHO International Safe Community Network. To date, 83 communities around the world have been designated as members of the Safe Community Network, ranging in population from 1000 to nearly 2 million. Lidkjöping in Sweden was the first designated safe community in 1989 and Rapla in Estonia was the last, designated in October 2004. The movement recognizes that it is the people who not only live, learn, work and play in a community but also best understand their community's specific problems, needs, assets and capacities. Their involvement and commitment are critical factors in identifying and mobilizing resources so as to create an effective, comprehensive and coordinated community-based action on unintentional and intentional injuries.

Community Health Planning↗
PubMed2002

The South African Community Epidemiology Network on Drug Use (SACENDU): description, findings (1997-99) and policy implications.

AIMS: To (1) describe the South African Community Epidemiology Network on Drug Use (SACENDU), (2) describe trends and associated consequences of alcohol and other drug (AOD) use in South Africa for January 1997 to December 1999 and (3) outline selected policy implications identified by SACENDU participants. METHODS: A descriptive epidemiological study of AOD indicators based on data gathered from multiple sources, including specialist treatment centres, trauma units and quantitative studies of target groups such as school students and arrestees. Networks were established in five sentinel sites to facilitate the collection, interpretation and dissemination of data. RESULTS: Over time alcohol has been the most frequently reported primary substance of abuse across sites. Trauma and psychiatric data highlight the burden associated with alcohol abuse. Cannabis and Mandrax (methaqualone), alone or in combination, are the most frequently reported illicit drugs of abuse, generally comprising the largest proportions of drug-related arrests, drug-related psychiatric diagnoses and drug-positive trauma patients. From 1997 to 1999, a significant increase in indicators for cocaine/crack and heroin occurred in two sites. Ecstasy (MDMA) use, alone or in combination with other substances, is reported among young people. CONCLUSIONS: A broad range of globally abused substances is present in South Africa and the use and burden of illicit substances appears to be increasing. This points to the importance of ongoing monitoring of AOD trends. Through regular, systematic data collection the SACENDU project has made available more evidence-based information to direct AOD abuse policy and practice and has had an impact on research agendas.

Acute Disease↗
PubMed1995

A distributed, scalable, community care network architecture for wide-area electronic patient records: modeling and simulation.

Principal systems issues relative to computerizing patient medical records that are yet to be addressed in the scientific literature include (1) the characteristics of networks, i.e. bandwidth and capacity, and their impact on the performance of the system, (2) the architecture and the underlying algorithm of the system, (3) the location and migration of medical records, (4) scalability of the system, and (5) the nature of the performance variation under heavy and light use of the network. Key parameters that affect performance include the number of patients, doctors, frequency of patient visits, and the number of electronic queries and record entries initiated during a patient-doctor interaction episode. This paper presents AMPReD, a Distributed, Scalable, Community Care Network Architecture that aims to provide Real-Time Access to Geographically-Dispersed Patient Medical Records. The AMPReD model includes stationary hospitals and medical clinics, mobile clinics, migrating doctors as well as patients, the communications network, and the patient medical record database. AMPReD's goals include (1) the accurate modeling of the propagation of medical records and (2) providing real-time access to patient medical records from anywhere in the system. To achieve these goals, an asynchronous, distributed algorithm must be developed that achieves concurrent access of multiple, autonomous databases. AMPReD is modeled and simulated for a representative community care network on a network of workstations configured as a loosely-coupled parallel processor, for different parametric combinations of number of doctors, patients, and number of queries or record entries generated corresponding to every patient-doctor interaction episode. AMPReD defines and obtains key performance measures including the idle times of the doctors, patient waiting times, the access times of queries as functions of their sizes, and the growth of the databases. In addition, AMPReD also measures the deviation of the actual time required for a patient-doctor interaction episode from the scheduled interaction interval, as a function of the network load. For the representative system selected, performance measures indicate that the network, utilizing 1/2T1 links, and the database system poses no bottleneck to the system even where the number of doctors and patients within a 30 minute interval are chosen at 192 and 200 respectively. A T1 is a standard, digital, transmission link that is rated at 1.44Mbits/sec.

Algorithms↗
PubMed2006

Medical and non-medical determinants of access to renal transplant waiting list in a French community-based network of care.

BACKGROUND: Evaluation of adult candidates for kidney transplantation diverges from one centre to another. Concurrently, ethnic background, female gender, late referral to a nephrologist, distance from transplantation department and private ownership of a dialysis facility have been associated with poor access to kidney transplantation. We assessed determinants of access to a waiting list in a French community-based network of care. METHODS: From July 1997 to June 2003, 1725 adults living in Lorraine, who started renal replacement therapy in one of the 13 facilities of the network, were included. We compared, first, the patients registered on the waiting list with those not registered and, second, the patients registered before starting dialysis with those registered after. RESULTS: Using logistic regression, registration on the waiting list was exclusively associated with age and medical factors, except for one variable: medical follow-up in the department performing transplantation [odds ratio (OR): 1.67 (95%CI: 1.05-2.67)]. Registration before starting dialysis was not associated with medical factors but with age [OR of patients younger than 45 years vs those older than 65 years: 3.85 (95%CI: 1.05-24.92)] and medical follow-up in the department performing transplantation [OR: 3.56 (95%CI: 1.98-6.67)]. CONCLUSIONS: In a French community-based network, patients followed by the nephrology department performing transplantation are more likely to be registered on the transplant waiting list early in the course of chronic kidney disease. Age over 55 per se is a considerable barrier to access to kidney transplantation. Medical guidelines should allow a standardization of criteria for registration.

Adolescent↗
PubMed2002

Sociospatial knowledge networks: appraising community as place.

This article introduces a new theory of geographical analysis, sociospatial knowledge networks, for examining and understanding the spatial aspects of health knowledge (i.e., exactly where health beliefs and knowledge coincide with other support in the community). We present an overview of the theory of sociospatial knowledge networks and an example of how it is being used to guide an ongoing ethnographic study of health beliefs, knowledge, and knowledge networks in a rural community of African Americans, Latinos, and European Americans at high risk for, but not diagnosed with, type 2 diabetes mellitus. We believe that the geographical approach to understanding health beliefs and knowledge and how people acquire health information presented here is one that could serve other communities and community health practitioners working to improve chronic disease outcomes in diverse local environments.

Adolescent↗
PubMed2006

Dynamics of patient targeting for care management in Medicaid: a case study of the Durham Community Health Network.

Targeting appropriate patients for care management is crucial to maximizing quality of care and cost-effectiveness in Medicaid care management programs. This study examined patient characteristics predicting selection for care management pre- and postmanagement changes at the Durham Community Health Network (DHCN), one of North Carolina's Medicaid primary care management networks. From the beginning, care managers were directed to target asthmatics, diabetics, and high-volume utilizers of health care, using an array of markers to identify patients who needed management. In 2003, the state reinforced its focus on chronic disease and high utilizers, and new management at DCHN began emphasizing the use of protocols for patient targeting. This study examined the relative effects of patient demographics, diagnoses, PCP group, and health care utilization as predictors of patient selection before and after these changes.

Adolescent↗
PubMed1998

The influence of governmental policy on community health partnerships and community care networks: an analysis of three cases.

This is a comparative analysis of hospitals' efforts in three communities to pursue collaborative ventures to advance community health. The events occurred over a two-year period characterized by increasing market competition and national debate about comprehensive health care financing reform. The study objectives are to better understand factors that contributed to the initiation of the collaborative efforts, and factors that sustained, hindered, or thwarted these efforts. The study explores how the collaborative ventures in these three communities fared in the face of multiple and conflicting policies and the simultaneous creation of larger, competing health systems. A number of concluding generalizations address the impact of interorganizational dynamics and public policy initiatives on community health partnerships.

Community Health Planning↗
PubMed2002

MDON: a network of community partnerships.

This model for strengthening diabetes care in communities teams the public health system with the professional and lay community to address prevention, early detection, and treatment of diabetes. This article describes how the Michigan Diabetes Outreach Network (MDON) develops local, regional, and statewide partnerships to increase professional and public knowledge and to improve care delivery for this chronic and complex disease.

Community Health Services↗
PubMed1989

Changing the public image of nursing: development of a community nurses network.

Gross, Frost, and Vance give new meaning to community health nursing. They describe a nursing network that engages in the processes of politics, power, and innovation to bring about community change while enhancing the status of the profession. The community project described here demonstrates to others the expertise and autonomy of professional nurses.

Community Health Nursing↗
PubMed1995

Evaluation of Community Care Network (CCN) system in a rural health care setting.

Concurrent Engineering Research Center (CERC), under the sponsorship of NLM (National Library of Medicine) is in the process of developing a computerized patient record system for a clinical environment distributed in rural West Virginia. This realization of the CCN (Community Care Network), besides providing computer-based patient records accessible from a chain of clinics and one hospital, supports collaborative health care processes like referral and consulting. To evaluate the effectiveness of the system, a study was designed and is in the process of being executed. Three surveys were designed to provide subjective measures, and four experiments for collecting objective data. Data collection is taking place in several phases: baseline data are collected before the system is deployed; the process is repeated with minimal changes three, then six months later or as often as new versions of the system are installed. Results are then to be compared, using whenever possible matching techniques (i.e. the preliminary data collected on a provider will be matched with the data collected later on the same provider). Surveys are conducted through questionnaires distributed to providers and nurses and person-to-person interviews of the patients. The time spent on patient-chart related activities is measured by work-sampling, aided by a computer application running on a laptop PC. Information about missing patient record parts is collected by the providers, the frequency by which new features of the computerized system are used will be logged by the system itself and clinical outcome measures will be studied from the results of the clinics' own patient chart audits. Preliminary results of the surveys and plans for the immediate and distant future are discussed at the end of the paper.

Attitude to Computers↗
PubMed2002

[The network of community and national reference laboratories for residues].

The European Union established in the early 1990's a network of Community reference laboratories (CRL) for residues in living animals and their products. This field is regulated at present by the Council Directive 96/23/CE of 26 April 1996, adopted at the national level through the Decree DL.vo no. 336 of 4 August 1999. The four CRL are based in France, Germany, Italy and The Netherlands, respectively, each of them being responsible for different categories of residues. The CRL provides technical support to the European Commission in this matter as well as to the National reference laboratories (NRL) for residues in the member states. The four CRL bear responsibility also as regards the adoption of quality systems by NRL. In this respect, the revised principles of good laboratory practice recently issued by OECD demand that procedures be developed to inform and assist the NRL to implement them.

Animals↗