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 1,495 records · Page 83Linked to original sources
PubMed2001

The cost effectiveness of specialised facilities for service users with persistent challenging behaviours.

Little systematic research relates specifically to the last people to leave a psychiatric hospital at the end of a closure programme. The long-running evaluation of the reprovision of services from Friern Hospital in North London allowed a special study to be made of such a group (67 people in all), whose range of problem behaviours made placement in community settings most difficult. The patients were relatively young, with a shorter length of stay than the remainder of the former long-stay hospital population. They were assessed three times: before leaving Friern, and one and 5 years after relocation. The social and clinical characteristics of each person were measured, and the full costs of their care calculated. The "difficult-to-place" patients moved to four highly staffed rehabilitation facilities, where the total cost of their care was, on average, 1230 UK pounds per week. There was no overall change in their psychiatric state over the 5 years after they left Friern Hospital although, in the longer-term, they gained skills in several areas of daily functioning. Most importantly, there was a fall of almost 50% in the number of challenging behaviours exhibited by the study group. At the five-year follow-up point, the cost of care had fallen, on average, by 170 UK pounds per week, and 24 people had been able to move to more independent accommodation arrangements. Study participants had gained a new network of community service contacts, and used services provided by a greater variety of agencies. The indicators suggest that high expenditure on alternative care was justified retrospectively by overall long-term outcomes. An important policy lesson from the Friern Hospital reprovision study is that adequate funds should be reserved until the end of the closure programme to allow the investment of resources in provision for patients with the most severe problem behaviours.

Adult↗
PubMed2005

[An investigation of social support networks for working mothers].

The purpose of our study was to investigate the social support network for working mothers, including physical, emotional and informational sources, and to discuss strategies to reduce stress caused by their multiple role strain. We asked 18 participants to fill in a questionnaire and conducted semi-constructed interviews. The results of this study showed that more than half of the working mothers want to continue their career because of self growth and the rewards from their job. Many mothers responded that a sympathetic understanding by their husbands, families and people at workplaces is essential to create a balance between their career and housework. As a result, their husbands mainly provide physical support in housekeeping and child caring, whereas their mothers provide physical and emotional support from knowledge based upon their own experience. Almost all working mothers complained of a shortage of nurseries and child caring facilities as well as limited availability of flexible services. In conclusion, the results of our study suggested that the identity of the traditional gender role needs to be changed to a contemporary one, like a husband fully participating in his child's rearing activities by reconsidering his working hours. Moreover, community services to support working mothers should be increased.

Adult↗
PubMed1998

[Coordination or competence: an emerging problem in the development of network treatment for alcoholics].

The author recognizes the significance and relevance of the network treatment for alcoholics is such a way as an effort to respond not only to the medical needs but also to social service needs, in order to support the recovery of alcoholics. Consequently we are faced to an indispensable task to look back historically the developmental process of the treatment service for alcoholics in Japan. A recent policy development in the alcohol treatment is stimulating the shift from the overweight medical approach to a more comprehensive approach including social services. This innovation is bringing about not only a wider treatment options but also a newly emerging problem of "coordination or competence" as well. It was implied in this paper that a concept of "shared function" is promising to consider this new problem.

Alcoholism↗
PubMed1998

Service needs and networks of rural women with HIV/AIDS.

Despite the fact that one of every 16 women with AIDS in the United States lives in a rural area, little is known about their demographic and epidemiologic characteristics, service needs, social support networks, or service utilization patterns. This article reports key findings from case studies of services to rural women with HIV/AIDS in southwest Georgia, northwest Mississippi, southeastern South Carolina, south Texas, and south-central Washington. Despite the growing numbers of HIV-positive women in these areas, many primary care physicians lack training in the diagnosis and treatment of HIV infection in women, and multidisciplinary protocols for the "shared care" of HIV-positive pregnant women are still being developed. Concerns about confidentiality and the lack of health insurance and transportation pose major access barriers. The findings suggest a need for new kinds of rural initiatives that embed HIV prevention and care into broader programs of educational and economic development.

Adolescent↗
PubMed2002

[Regional networking of medical and vocational rehabilitation-- the bad Krozingen model].

Regional networking facilitates flexible and individual integration of vocational programmes in medical rehabilitation. We present a pilot project of Theresienklinik II in cooperation with the Education centre for occupation and health (Bildungszentrum Beruf und Gesundheit) in Bad Krozingen. Orthopaedic and cardiac patients who are in danger to lose their capacity to work, participate in an integrated vocational reorientation programme during extended medical rehabilitation. The aim of the pilot project is an early assessment of motivation, work hardening, aptitude and interest, in order to accelerate vocational retraining and reintegration. Within one year 30 patients participated in the programme. Presented are the contents and course of the pilot project. First results show a high patient satisfaction with the programme.

Adult↗
PubMed1998

The need for a coherent curriculum and supported infrastructure in health informatics education--the HEALNet experience. Health Evidence Application and Linkage Network.

The Canadian National Centres of Excellence Network, Health Evidence Application and Linkage Network (HEALNet) is a network linking universities, the private sector and other public sector organisations in supporting research and fostering commercial opportunities. Its aim is to develop high quality health care decision support methodologies and tools that support the transfer of research evidence into practice. The HEALNet education program aims to support the training of highly qualified personnel as well as the development of educational approaches so that health personnel can better exploit such methodologies and decision support tools given the new opportunities of information technology. There is a need to draw from the different types of expertise within HEALNet to provide an integrated curriculum. At the same time, there is a concern regarding the lack of a coherent infrastructure in health informatics in many Canadian medical schools.

Canada↗
PubMed2002

Sexual assault history and social support: six general population studies.

We evaluated the association of sexual assault history with later social support, operationalized as network size, marital status, presence of a partner, frequency of network contacts, and emotional support from friends and family, from spouse, and from partner. Data came from six independent general population surveys (pooled N = 9,865) whose results were summarized using meta-analysis. People who had been sexually assaulted were less likely than others to be married (OR = 0.75, 95% CI = 0.65, 0.87) or to report at least weekly contact with friends and relatives (OR = 0.48, 95% CI = 0.31, 0.75), and reported less emotional support from friends and family (OR = 0.72,95% CI = 0.58,0.89) and spouse (OR = 0.67, 95% CI = 0.54, 0.82). Results were consistent across studies, genders, and ethnic groups. Circumstances of sexual assault were sometimes related to social support.

Adaptation, Psychological↗
PubMed2003

[A regional public health research network INSERM "PRISMAL" (perception, representation and risk management in rural health settings)].

The PRISMAL (Perception, representation and health risk management in rural settings) network comprises three academic research teams, two health insurance agencies, and two health care networks in the Franche-Comté region that share their expertise to study the relationship between health and the rural environment. Three main objectives guide the network's activities and are linked to the following questions: 1) What are the epidemiological changes linked to the rural setting; what are their causes and effects? 2) What are the relationships between the rural environment, health risks, behaviours in seeking health care, access to health care services and quality of life? 3) What are the perceptions and representations of the affected populations on health risks specific to the rural setting? Research activities utilise specific diseases as examples of the result from interaction with the rural environment, such as "farmer's lung", alveolar echinococcosis, occupational risks for farmers, lung cancer, suicide attempts, premature birth, and vascular stroke. The partnership's framework extends well beyond the medical world and includes ecologists, geographers, sociologists, administrators and environmental technicians.

Agriculture↗
PubMed2003

[A development of the network for functional trainings in daycare services in a large district].

After the Long-Term Care Insurance (LTCI) regulation has been enacted, all the daycare agencies/institutions must provide functional trainings to their clients as one of the standard services. However, the regulation is limited only to their personnel arrangement rather than the service content, which is left to each agency/institution. We feel that functional trainings as a daycare service need more attention so that we can bridge the content gaps between agencies/institutions. To solve this problem, we planned to send training professionals to these daycare providers in the surrounding areas. At the same time, we have been holding training courses for daycare stuff and each trainer, which contributed to fill the knowledge and skill gaps between these trainers'. The purpose of this paper is to report our study with some suggestions about the ideal functional trainings in the future daycare services.

Aged↗
PubMed1996

Physician-sponsored networks. Will physicians take back medicine?

Until about the late 1980s, American physicians and their allies, hospitals and the health care manufacturing industries, dominated all facets of the health system--the clinical, the economic, and the political. The bulk of these providers' revenue flowed to them from a highly fragmented insurance system whose governing principle was to provide each insured patient free choice of doctor and hospital. Two distinct, concurrent shifts threaten to erode the medical profession's traditional dominance. The first is a rapid, general shift of control from the supply side of the health sector to its demand side. The second is a shift away from government control, over which organized medicine held much sway in the past, toward private regulators--the executives of the managed care industry. Is the trend towards greater dependence of practicing physicians on non-physician executives inevitable, or can physicians retain--and, in part, regain--their hitherto autonomous position in the health system?

Community Networks↗
PubMed2000

[A resources-activities analysis in cardiology: a report on Piemonte experience. The Cardiology Network of the Piemonte Section of the Associazione Nazionale Medici Cardiologi Ospedalieri].

We are living in an era characterized by cost-containment. Thus, expenditure for the health system represents one of the most important items of the national balance. Nowadays, the optimal management of health organization is essential. In addition, patients expect hospitals to provide more and more effective and efficient cures. With respect to this need, in order to achieve high standard of health cure, the identification of work and the time that the medical departments dedicate to a specific therapeutic and/or diagnostic procedure represent a fundamental tool for the optimal management of patients. However, to provide reliable results, these data should be collected in the largest number of structures possible. For this purpose, 17 departments of cardiology have organized a network with the goal of creating the most important data base on this matter available in Italy. The evaluation of the data obtained (more than 8000 medical procedures) allows us to identify the resources normally used for curing patients admitted to cardiological departments. These provide an extensive view of the work load in the Public Health Services fundamental to implementing a health service in accordance with the criteria of Total Quality Management. The present paper illustrates the scope of this study and the methods used to create the data base. In addition, it discusses some cultural aspects related to the introduction of managerial criteria in the medical arena. The detailed results, regarding the items analyzed, will be presented in a special paper.

Cardiology↗
PubMed2003

Exploring and encouraging through social interaction: a qualitative study of nurses' participation in self-help groups for cancer patients.

Self-help groups are a growing phenomenon across national borders. Current sociologic empirical evidence shows that nurses and other healthcare professionals have become an integral part of self-help groups. The aim of the study is to describe and highlight the experiences of patients with cancer (n = 21) and oncology nurses (n = 12) with self-help groups. These experiences are drawn on to illustrate the characteristics of professional involvement in self-help groups for patients with cancer. Data were obtained by individual qualitative interviews. The results show that the nurse functions as a social networker and uses her contextual competence by consciously encouraging relationships between fellow patients. Furthermore, the study illustrates that the nurse's involvement with self-help groups for patients with cancer serves as a complementary dimension to the traditional nursing discourse. It is concluded that when individualized care is supported through social practice and when personal issues are exchanged and negotiated, the nurse facilitates a milieu of togetherness in self-help groups for patients with cancer. The concept of self-help groups is a valuable contribution to new theories and service development in psychosocial care and complies with the understanding of the postmodern individual, who viewed as primarily responsible for negotiating, socializing, and making his or her own decisions.

Adult↗
PubMedDate not supplied

The Family Empowerment Network: a service model to address the needs of children and families affected by Fetal Alcohol Spectrum Disorders.

Fetal Alcohol Spectrum Disorders (FASD) represent a leading cause of mental retardation and learning disabilities in children seen in pediatric offices today. This article provides an overview of FASD and describes a model program, the Family Empowerment Network (FEN). FEN is an information, referral, and support network for children and families affected by Fetal Alcohol Spectrum Disorders (FASD) and the professionals who serve them. FEN's mission includes: (a) increasing awareness about FASD by providing education, training and resources to families, providers, and the general public; (b) providing support and referrals to families affected; and (c) increasing opportunities for diagnosis and intervention. We hope to increase awareness of the resources available to nurses and their patients and provide a template that can be replicated in other service delivery systems. Pediatric nurses are in a unique position not only to assist in the recognition of children at risk of FASD, to link families to appropriate diagnostic and intervention services, but also to work to develop additional local and regional resources with other providers.

Adolescent↗
PubMed1996

Physician directed networks: the new generation of managed care.

The external pressure to reduce cost while maintaining quality and services is moving the whole industry into a rapid mode of integration. Hospitals, vendors, MCOs, and now, physicians, are faced with the difficult decisions concerning how their operations will be integrated into the larger health care delivery system. These pressures have forced physicians to consolidate, build leverage, and create efficiencies to become more productive; thereby better positioning themselves to respond to the challenges and the opportunities that lie before them. This initial phase of consolidation has given many physicians the momentum to begin to wrestle back the control of health care and the courage to design the next generation of managed care: Physician Directed Managed Care. What will be the next phase? Perhaps, the next step will be fully-integrated specialty and multi-specialty groups leading to alternate delivery sites. "Everyone thinks of changing the world, but no one thinks of changing himself." - Leo Tolstoy

Community Networks↗
PubMedDate not supplied

[Limitations and alternatives to the implementation of a program for drug users at risk of HIV infection using the Social Network Approach].

The authors describe the development of a preventive program focused on intravenous drug users at risk of HIV infection, using the Social Network Approach as the intervention model. The authors describe the project's steps in a large university hospital in southern Brazil, emphasizing the unique methods and techniques developed by the treatment staff. Problems encountered during the project development are discussed, aimed at identifying the reasons why the program only achieved partial success. The authors identify critical issues, such as the use of a new technique not previously tried in Brazil, difficulties in maintaining IV drug users in treatment, lack of infrastructure for walk-in treatment, and the challenge of motivating staff and patients to continue treatment. The authors conclude by listing suggestions aimed at facilitating the development of new projects based on the same conceptual model.

Community Networks↗
PubMed1999

A catalyst for change in communication skills: the Canadian Breast Cancer Initiative.

A major focus of the Canadian Breast Cancer Initiative (CBCI) has been the development of the programming, partnerships and networks necessary to enhance communication skills within the physician-patient relationship. In this paper, the rationale for taking this approach and the scope of the activities that have been undertaken will be described, as well as the rationale for producing this series of papers. February has been chosen as the month of publication, as previous major activities of the CBCI in the area of physician-patient communication skills have been held in the month of February. It is hoped that February may become known as Communication Skills Month just as October is Breast Cancer Month: the gauntlet is thrown down to others to continue making February the month to reinforce the significance of physician-patient communication skills in the provision of quality health care.

Breast Neoplasms↗
PubMed1998

Marshfield Clinic, physician networks, and the exercise of monopoly power.

OBJECTIVE: Antitrust enforcement can improve the performance of large, vertically integrated physician-hospital organizations (PHOs). Objective: To examine the recent court decisions in the Blue Cross and Blue Shield United of Wisconsin v. Marshfield Clinic antitrust case to understand better the benefits and costs of vertical integration in healthcare. SUMMARY AND CONCLUSIONS: Vertical integration in the Marshfield Clinic may have had the benefits of reducing transactions and uncertainty costs while improving the coordination between ambulatory and inpatient visits, but at the cost of Marshfield Clinic's monopolizing of physician services and foreclosing of HMO entry in northwest Wisconsin. The denial of hospital staff privileges to non-Marshfield Clinic physicians combined with certificate-of-need regulations impeded physician entry and solidified Marshfield Clinic's monopoly position. Enforcement efforts of recent antitrust guidelines by the U.S. Department of Justice and the Federal Trade Commission will need to address carefully the benefits and costs of vertically integrated systems.

Antitrust Laws↗
PubMed2003

[Home care in Sapporo].

We established a clinic specialized in home care in Sapporo in July 2001. In these 2 years we have provided medical home care service to 160 patients, and 97 are still receiving regular service. At first we accepted any patients living within 16 km from the clinic. However, bad traffic conditions in winter made it difficult to visit patients living in districts far away from the clinic. Therefore, we planned a network of home care physicians in Sapporo. Now 12 home care physicians hold monthly meetings. In Sapporo, meetings of home care related workers are organized in each ward, as suggested by the Sapporo Medical Association. There is a relatively good supply of home care related services and resources, including availability of an important number of visiting nurses. Patients being taken care of at home who present an acute exacerbation of symptoms are relatively easily accepted by acute hospitals. But those who have difficulties in continuing home care due to a sudden change in family conditions are not easily accepted by nursing hospitals. Recently, the number of group homes and lodging houses for elderly persons has markedly increased in Sapporo. It might have some problems in medical support in the near future.

Aged↗