Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Community Networks”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,171 records · Page 65Linked to original sources
PubMed2006

Xenophobia, ethnic community, and immigrant youths' friendship network formation.

Immigrant youth often rebuild their friendships and other social networks after arriving in a new country. The difficulties involved can threaten their psychosocial development. Formation of social networks needs to be understood within the macro sociocultural context that shapes the experience. Nonetheless, the current literature on social network formation rarely captures that context. Knowledge about immigrant youths' social network, for example, is often embedded in assimilation, ethnic identity, and adaptation literature. This paper examines how the sociocultural context enables immigrant youth to rebuild their friendship networks. A critical ethnography was conducted in the northwest region of the United States. Sixteen Taiwanese immigrant youth and their parents (N = 13) participated in the study. Data collection consisted of semi-structured in-depth interviews, a demographic questionnaire, and participant observations. The findings showed that because of limited English proficiency, the youth kept at a distance from American peers to avoid nervousness and embarassment. Further analysis, derived from xenophobia, found that limited English proficiency increases segregation between American peers ("we") and immigrant youth ("the other"). The English as a Second Language program inadvertently perpetuates the immigrants' sense of "otherness" and increases the odds of their becoming targets of discrimination. A protective factor for these youths is living near an ethnic community because the inclusion of coethnics increases new friendship networks. Knowledge about the teen culture in coethnics' countries of origin (China, Hong Kong, or the United States), also influences their selection of friends.

Acculturation↗
PubMed2005

Indicators predicting use of mental health services in Piedmont, Italy.

BACKGROUND: Since the 1978 Italian reform, an integrated network of community mental health services has been introduced. With few exceptions, research on determinants of mental health service use at the district level has focused on inpatient activities and social deprivation indicators. The European Psychiatric Care Assessment Team (EPCAT) standardized methodology allows for an evidence-based comparison of mental health systems between geographical areas. AIMS: To compare service provision and utilization between local catchment areas; to explore quantitative relationships between residential and community service use and socio-demographic indicators at the ecological level. METHODS: The European Socio-demographic Schedule (ESDS) was used to describe area characteristics, and the European Service Mapping Schedule (ESMS) to measure service provision and utilization in 18 catchment areas in Piedmont. RESULTS: Substantial variation in service use emerged. Acute hospital bed occupancy rates were lower in areas with more intensive community continuing care service users and with a smaller percentage of the population living alone. The non-acute hospital bed occupancy rate was directly related to the percentage of the population living alone or in overcrowded conditions, and to the level of mobile continuing care service users. Community continuing care service use was highest in areas with a larger percentage of the population living alone. DISCUSSION: Multiple regression models explained between 48 and 55% of the variation in inpatient and community service use between areas. Relationships based on ecological characteristics do not necessarily apply to the individual. This level of assessment, however, is necessary in evaluating mental health policy and service systems, and in allocating resources. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The distribution of mental health care resources should be weighted in terms of indicators of social deprivation shown to be important predictors of both inpatient and community service use, as these are likely to be related. IMPLICATIONS FOR HEALTH POLICIES: To ensure horizontal equity in access to mental health care, particularly for people with severe mental illness, evaluation of mental health policy should be based on a concurrent evidence-based assessment of the organization and use of both residential and community services, in relation to area level indicators of social deprivation. IMPLICATIONS FOR FURTHER RESEARCH: Cross-national research using an internationally standardized methodology should consider the influence of the social network independently of other socio-economic indicators, to verify the relative importance of this in predicting service use in southern and in northern European countries.

Catchment Area, Health↗
PubMed1997

Single-specialty networks, carve-outs, and consolidations.

Throughout the country health care provider groups seem to be merging at a record pace. This consolidation sharply brings into question the traditional role specialty providers have played within the health care system--causing many specialty practitioners to evaluate the myriad of specialty organizations being formed (IPA, PPM, MSO). A single-specialty organization that is able to deliver focused, consistent services to the payer that demonstrates value beyond the clutter of today's multi-specialty groups and PPMs is a very attractive entity to the managed care market. Some of the most attractive specialties for development of networks, carve-out products, and consolidations include oncology, cardiology, orthopedics, ophthalmology, and occupational medicine practices.

Community Networks↗
PubMed1998

Physician network audits can improve financial performance.

A physician network audit is one way to evaluate the strengths and weaknesses of a network's performance in five key areas: practice operations, financial management, strategy and vision, managed care readiness, and organizational governance. An objective, comprehensive audit can help identify real versus perceived problems that are troubling a network. Then steps can be taken to align incentives and improve operating results.

Community Networks↗
PubMed2003

[Impact of new information and communication technologies (NTIC) on hospital administration and patient management. Care Network for Diagnosing and Treating Neurologic Emergencies].

The combination of specialised in-patient management, the development of diagnostic and therapeutic tools, the standardisation of procedures and organisation of the dies will allow for improving the prognosis of neurological patients seen in emergency situations. In order to achieve this objective, the Networks for Diagnosing and Treating Neurological Emergencies (RAIDS-UN) in Franche-Comté (FC) aim to better the quality of in-patient management for emergency on-set neurological pathologies such as traumatic brain injuries and strokes, the preparation and structuring of the dies for diagnosis and treatment, and assistance in neurology decision making. Based upon the needs of networks which approach the problem from two different directions--the RAIDS-UN/FC network (for neurological emergencies) and the RAIDS-UN/AVC network (for prevention and treatment of strokes)--they should both be able to benefit from new information and communication technologies (ICTs) in order to promote and support innovations in practice and contribute to the improvement in quality and health promotion effectiveness. In light of these developments, one may better understand the significance of the School of Medicine's role in training experts, advisors and supervisors as well as in providing a high level of quality and effective continuing education. Since 2001, the expansion of the RAIDS-UN networks has emphasised the need for the development of new professional specialties arising on the border between technology and medicine. The operation of these networks requires a strong partnership with health professionals and strategically relies upon a regional dynamic interaction which includes the hospitals, the city, the institutions and the university. It is in this manner that the RAIDS-UN networks will support other initiatives such as the Towards Unity for Health project.

Community Networks↗
PubMed1997

Health care networks: opportunities and threats for subacute care.

To retool and prepare for the trends that facilitate growth, subacute care providers must understand the complexity of relationships among key players--provider sponsored networks, physician practice management and managed care organizations. Providers need to reengineer contracting, relationships and marketing.

Community Networks↗
PubMedDate not supplied

Induction paclitaxel, carboplatin, and infusional 5-FU followed by concurrent radiation therapy and weekly paclitaxel/carboplatin in the treatment of locally advanced head and neck cancer: a phase II trial of the Minnie Pearl Cancer Research Network.

PURPOSE: The purpose of this study was to evaluate the feasibility, toxicity, and efficacy of a novel combined-modality treatment for patients with locally advanced squamous carcinoma of the head and neck. PATIENTS AND METHODS: In this multicenter, community-based phase 11 study, 123 previously untreated patients with locally advanced squamous carcinoma of the head and neck received 6 weeks of induction chemotherapy followed by concurrent high-dose radiation therapy and weekly chemotherapy. Induction chemotherapy included paclitaxel (200 mg/m2, 1-hour i.v. infusion) on days 1 and 22, carboplatin (AUC 6.0 i.v.) on days 1 and 22, and 5-fluorouracil (225 mg/m2 per day, 24-hour continuous i.v. infusion) on days 1-43. After 1 week without therapy, radiation therapy, 1.8 Gy/day, 5 days weekly, to a total dose of 68.4 Gy, was administered to the primary site and the bilateral cervical lymph nodes. During radiation therapy, patients also received six weekly doses of paclitaxel (50 mg/m2, 1-hour i.v. infusion) and carboplatin (AUC 1.0 i.v). After completion of therapy, patients were restaged with computed tomographic and endoscopic examination; patients in complete remission were followed up without further treatment. RESULTS: One hundred twenty-three patients (74% with stage IV disease) entered this trial, and 111 patients (90%) completed the entire treatment course. Seventy of 116 evaluable patients (60%; 95% Cl, 51%-69%)had a clinical complete response to treatment. After a median follow-up of 24 months, the 2-and 3-year actuarial survivals were 66% and 51%, respectively. Local toxicity was moderately severe during combined-modality therapy; however, xerostomia has been the only frequent chronic toxicity of this program. CONCLUSIONS: This novel combined-modality treatment program, containing paclitaxel and avoiding the use of cisplatin, is feasible, is highly active, and can be administered with acceptable toxicity in a community-based setting. Aggressive nutritional support should be considered in patients receiving this regimen, to improve acute palliation and to maximize the delivery of combined-modality therapy. Further evaluation of this treatment program is warranted. Incorporation of various novel biologic agents, particularly the epidermal growth factor receptor antagonists, may further improve efficacy.

Adult↗
PubMed2006

The impact of a social network intervention on retention in Belgian therapeutic communities: a quasi-experimental study.

BACKGROUND: Although numerous studies recognize the importance of social network support in engaging substance abusers into treatment, there is only limited knowledge of the impact of network involvement and support during treatment. The primary objective of this research was to enhance retention in Therapeutic Community treatment utilizing a social network intervention. AIMS: The specific goals of this study were (1) to determine whether different pre-treatment factors predicted treatment retention in a Therapeutic Community; and (2) to determine whether participation of significant others in a social network intervention predicted treatment retention. DESIGN, SETTING AND PARTICIPANTS: Consecutive admissions to four long-term residential Therapeutic Communities were assessed at intake (n = 207); the study comprised a mainly male (84.9%) sample of polydrug (41.1%) and opiate (20.8%) abusers, of whom 64.4% had ever injected drugs. Assessment involved the European version of the Addiction Severity Index (EuropASI), the Circumstances, Motivation, Readiness scales (CMR), the Dutch version of the family environment scale (GKS/FES) and an in-depth interview on social network structure and perceived social support. Network members of different cohorts were assigned to a social network intervention, which consisted of three elements (a video, participation at an induction day and participation in a discussion session). FINDINGS: Hierarchical regression analyses showed that client-perceived social support (F1,198 = 10.9, P = 0.001) and treatment motivation and readiness (F1,198 = 8.8; P = 0.003) explained a significant proportion of the variance in treatment retention (model fit: F7,197 = 4.4; P = 0.000). By including the variable 'significant others' participation in network intervention' (network involvement) in the model, the fit clearly improved (F1,197 = 6.2; P = 0.013). At the same time, the impact of perceived social support decreased (F1,197 = 2.9; P = 0.091). CONCLUSIONS: Participation in the social network intervention was associated with improved treatment retention controlling for other client characteristics. This suggests that the intervention may be of benefit in the treatment of addicted individuals.

Adult↗
PubMedDate not supplied

[Benzodiazepine consumption: survey of community pharmacies in Aquitaine].

For many years, the use of benzodiazepines has been particularly high in France. This use can be described through pharmacy delivery. A cross-sectional one-day survey was conducted in June 1999, within a randomly selected network of community pharmacies in Aquitaine. Pharmacists were asked to interview each patient presenting with a prescription form including at least one benzodiazepine. A total of 58 pharmacies participated in this study; 328 patients were included representing 356 benzodiazepines prescribed. Among the 20 different benzodiazepines concerned, bromazepam, lorazepam and alprazolam represented more than half (54 per cent) of the prescriptions. The mean age of the patients was 62 years (median: 64) and 70 per cent of them were women. Most patients (93 per cent) were known to the pharmacist and 86 per cent had benzodiazepines prescribed by a single physician. In most cases (77 per cent), the prescribed benzodiazepine had been used for more than one year and in one quarter for more than five years. For 81 per cent of chronic users, no dose increase was observed. This study confirmed that long-term use of benzodiazepines is frequent, particularly in the elderly. This use is commonly accepted by health professionals as well as by patients, although it clearly reflects the dependence potential of benzodiazepines.

Adult↗
PubMed1997

Building a neighborhood network: interorganizational collaboration to prevent child abuse and neglect.

Policymakers have identified the community-based human services network as a promising model for restructuring services in neighborhoods affected by poverty, but researchers have found this approach complex and difficult to implement. An increase in networks and partnerships among service providers suggests that organizations are learning to work together, yet little is known about the processes of their collaboration. This article reports findings from an organizational analysis of one interorganizational collaboration in which executive directors and frontline practitioners from seven agencies worked for five years to create, implement, and institutionalize a community-based service network of informal and formal family support programs to help prevent child abuse and neglect. This article presents a theoretical framework for understanding community-based networks and interorganizational collaboration and describes and analyzes how collaboration was used as a method to build a new service network, the characteristics of the network, and factors that facilitated the collaborative processes.

Child Abuse↗
PubMed1991

Emergency psychiatric intervention on the street.

The development of outreach approaches to engage and provide services to the homeless mentally ill must account for the heterogeneity of the population. The homeless mentally ill as a group are symbols of the failure of a comprehensive and integrated system of community-based care to develop in conjunction with the widespread proliferation of deinstitutionalization policies over the past several decades. Life in a community is far more complex and less easily controlled than life in an institution. People are free to reject the label of patient and refuse all mental health services. An engagement strategy must therefore be devised from the knowledge of specific aspects of a person's life in that community, so that outreach and networking efforts can be sensitive to the total context of the problems experienced by that patient. A multidisciplinary team approach is essential to the effort to engage and monitor those chronically mentally ill individuals who are at risk for psychiatric and/or medical decompensation. A variety of skills are needed, and team members must be flexible about their roles on the team. The clinician, while maintaining expert psychiatric, diagnostic, and treatment skills, must at the same time be able to adapt to people in their own environments, provide them with necessary social and medical services, and interface with other agencies working with these persons. The work is very labor intensive. It may involve two or more clinicians spending entire days with one patient. During a crisis state, these patients will require even more intensive attention from multiple team members to prevent decompensation and rehospitalization. In conclusion, there is no one intervention style in the work of psychiatric outreach. While the type of intervention offered follows from the mission of the outreach program, all outreach teams must be able to address the totality of needs of people who are fragile and at risk for psychiatric and medical decompensation. Case management services cannot be segregated easily from the task of crisis intervention in the work with the seriously mentally ill. The failure to establish an accessible network of community-based services for those chronically disaffiliated populations of mentally ill gives the outreach team the critical role of brokering any available services needed to support the individual in the community. The flexibility required of the outreach team derives both from the scarcity of community-based resources and the heterogeneity of the population of chronically ill adults who will most need these services.(ABSTRACT TRUNCATED AT 400 WORDS)

Community Mental Health Services↗
PubMed1996

The 'market' for medical and health information in transition: the case of the Hong Kong Hospital Authority libraries.

The last few years have been a period of transition not only for hospitals and their governance but also for post-graduate medical education in Hong Kong. Both trends have a direct impact on the information market place. This article starts by studying the provision of medical and health-related information in Hong Kong. The two university medical and dental libraries, together with the hospital and health sciences libraries in government hospitals and the Department of Health, house the major collections on medicine and health care. The demand for medical and health care information is increasingly felt with the takeover of 39 hospitals by the statutory Hong Kong Hospital Authority in 1991. The major problems and issues in planning for library information services are the historically uneven development of libraries, discrepancies in funding, the changes in organizational and management structure, and the competition with higher development priorities within the organization. In view of current technology and the availability of rich external resources, the adopted strategies tend towards the formation of 10 library service networks, development of integrated library information systems on the Health Authority-wide area network, and the devolution of management responsibilities. The future challenges in store for the information professional are examined.

Community Networks↗