Communities for health: Learning from the pilots

Learning case examples and best practice from the pilot areas of Communities for Health. These pilots detail how communities have addressed a wide range of health issues and tackled health inequalities. Rural and urban deprived areas have worked to address obesity, healthy eating, mental health and sexual health.

Intermediary and structural determinants of early childhood health in Colombia: exploring the role of communities

This study examines how structural determinants influence intermediary factors of child health inequities and how they operate through the communities where children live. In particular, we explore individual, family and community level characteristics associated with a composite indicator that quantitatively measures intermediary determinants of early childhood health in Colombia. We use data from the 2010 Colombian Demographic and Health Survey (DHS). Adopting the conceptual framework of the Commission on Social Determinants of Health (CSDH), three dimensions related to child health are represented in the index: behavioural factors, psychosocial factors and health system. In order to generate the weight of the variables and take into account the discrete nature of the data, principal component analysis (PCA) using polychoric correlations are employed in the index construction. Weighted multilevel models are used to examine community effects. The results show that the effect of household’s SES is attenuated when community characteristics are included, indicating the importance that the level of community development may have in mediating individual and family characteristics. The findings indicate that there is a significant variance in intermediary determinants of child health between-community, especially for those determinants linked to the health system, even after controlling for individual, family and community characteristics. These results likely reflect that whilst the community context can exert a greater influence on intermediary factors linked directly to health, in the case of psychosocial factors and the parent’s behaviours, the family context can be more important. This underlines the importance of distinguishing between community and family intervention programmes.

The Andalusian Public Health System Virtual Library. Four years on

The Andalusian Public Health System Virtual Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA) set up in June 2006 was determined by the II Quality Plan 2005-2008. It consists of a regional government action with the aim of democratizing the health professional access to quality scientific information, regardless of the professional workplace. Andalusia is a region with more than 8 million inhabitants, with 92,000 health professionals for 41 hospitals, 1,500 primary healthcare centres, and 10 centres for non-medical attention purposes. • To obtain documentary resources for health professionals. • To help citizens to find health information. • To coordinate the Andalusian Health Documentary centres. • To establish strategic agreements with organizations. • To contribute to the Knowledge Management Development • The BV-SSPA acquires in a centralised way, all of the information resources for the whole system. • It offers services for all professionals: o Document Supply Service o Online Learning o User service • Remote access to these resources and services. • Communication and marketing plan to promote the knowledge and use of the BV-SSPA. Presently the BV-SSPA has reached: • The subscription of 2,431 electronic reviews, 8 data bases and other scientific information resources. • The establishment of the Document Supply Service, which focuses all the article orders from and for the Andalusian Public Health System. • The starting up for the online learning platform. • The introduction of the user service and virtual reference service in beta mode. • The use of appropriate tools, as the meta-researcher and the link resolver, which allow the presentation of resources and services in a tidy, easily findable way, through a Web 2.0 page where the user can take part with his contributions and where his offers and suggestion are gathered. • Access to the resources, for the Andalusian Health Professionals worldwide requiring only an internet connection. Andalusian Health Professionals have access to the greatest Health Science Electronic Resources Collection in Spain. The BV-SSPA has become the undisputed medium for the Health Research and Clinical Healthcare in our region, being consolidated as the Knowledge Manager into the Andalusian Public Health System. In 2010, it faces new projects such as the institutional repository creation, HypatiaSalud; the analysis of our research activity; and the drafting of a normalised licence model for the contracting of electronic resources.

Digital inmigrants and digital natives expectation collection in the Andalusian Public Health System Virtual Library: communication with our users

The Andalusian Public Health System Virtual Library (Biblioteca Virtual del Sistema Sanitario Público de Andalucía, BV-SSPA) provides access to health information resources and services to healthcare professionals through its Website. This virtual environment demands higher users’ knowledge in order to satisfy of the need of information of our users, as digital natives as digital immigrants, improving at the same time the communication with all of them. 1. To collect clients' views and expectations according to their nature of digital natives and immigrants. 2. To know our online reputation. A Collecting User Expectation Questionnaire will be built, taking into account the segmentation of the BV-SSPA users’ professional groups of the Andalusian Public Health System. A pilot test will be run to check the survey dimensions and items about practices, attitudes and knowledge of our users. Two Quality Function Deployment (QFD) matrices will enable the BV-SSPA services to be targeted to our digital natives or digital immigrants, according to their nature, finding the best way to satisfy their information needs. We provide feedback on BV-SSPA: users can have the opportunity to post feedback about the site via the 'Contact us' section and comment about their experience. And Web 2.0 is a shop window, providing the opportunity to show the comments; and through time, our online reputation will be built, but the BV-SSPA must manage its own personal branding. Web 2.0 tools are a driver of improvement, because they provide a key source of insight into people's attitudes. Besides, the BV-SSPA digital identity will be analyzed through indicators like major search engine referrals breakdown, top referring sites (non search engines), or top search engine referral phrases, among others. Definition of digital native and digital immigrant profiles of the BV-SSPA, and their difference, will be explained by their expectations. The design of the two QFD matrices will illustrate in just one graph the requirements of both groups for tackling digital abilities and inequalities. The BV-SSPA could deliver information and services through alternative channels. On the other hand, we are developing a strategy to identify, to measure and to manage a digital identity through communication with the user and to find out our online reputation. With the use of different tools from quantitative and qualitative methodology, and the opportunities offered by Web 2.0 tools, the BV-SSPA will know the expectations of their users as a first step to satisfy their necessities. Personalization is pivotal to the success of the Site, delivering tailored content to individuals based on their recorded preferences. The valuable user research can be used during new product development and redesign. Besides positive interaction let us build trust, show authenticity, and foster loyalty: we improve with effort, communication and show.

National Health System Virtual Library Viability Project (Spain)

Introduction: The ICT progress and development are making the set up of virtual libraries easier, with great advantages for users in terms of immediate access to vast amounts of library information, online resources, and services. Most of the Autonomous Spanish Regions are presently working on the establishment of virtual libraries with the aim of optimising economic resources destined to subscribe bibliographic information sources and offering qualified documentary services to Public Health System Professionals. The Ministry of Health and Social Policy, an institution unifying health matters, issued this Project to study the National Health System Virtual Library creation viability, in order to guarantee relevant scientific information access equity. Objectives: - To study the National Health System (NHS) Virtual Library set up viability. - To elaborate the Spanish territory health information resource map. - To identify the appropriate technological model. - To identify the documentary services to be offered. - To identify the more optimum functional, structural model. - To identify the economic model. Method: - To create a chart organization for the project´s management. - To organize Work groups. - To elaborate a standardised survey model for the libraries of the autonomous regions. Results: - Identification of the different Autonomous Region libraries of health models. - Recommendations for the NHS Virtual Library: - Functional, structural model - Technological model - Financial-economic model Conclusions: The fact that the Virtual Library would be an invaluable space for access to quality scientific information, as well as that the minimum services could be offered to every NHS user regardless of geographical situation, is confirmed. Accordingly, we thought about three different models to develop the Virtual Library, depending on this initial analysis, which will allow us to establish the most suitable model for the Spanish National Health System, considering its economic, functional and technological recommendations. It would be necessary to do a study for the NHS Virtual Library Set Up following the recommendations arising from this Project.

Social Support, Social and Temporal Comparisons Protect Well-Being and Health between 45 and 70 Years Old in Four Urban Communities

This study examined the impact of social support and of temporal and social comparisons on well-being and selfreported health in four capital cities: Paris, Berlin, Moscow and Beijing. Based on the lifespan control theory, an integrative model investigating the influence of these coping strategies, especially on the psychological regulation of health losses, was tested on 1141 respondents aged 45 to 70 years by using structural equation modelling with multigroup comparisons. Results indicated a good fit of the model to participants' responses. In all contexts, physical weaknesses favoured the use of social and temporal comparison strategies rather than social support. Moreover, across the cities, coping strategies were oriented more toward protecting self-evaluation of health than toward enhancement of well-being. Social comparison decreased the impact of physical weaknesses on health evaluation and on well-being in the four cities, but to a lesser extent in China. Results are discussed regarding the normative cross-cultural aspects that intervene during ageing in the four urban contexts.

Quality assessment of primary care for common mental disorders in isolated communities: Taking advantage of health records.

INTRODUCTION: This article is part of a research study on the organization of primary health care (PHC) for mental health in two of Quebec's remote regions. It introduces a methodological approach based on information found in health records, for assessing the quality of PHC offered to people suffering from depression or anxiety disorders. METHODS: Quality indicators were identified from evidence and case studies were reconstructed using data collected in health records over a 2-year observation period. Data collection was developed using a three-step iterative process: (1) feasibility analysis, (2) development of a data collection tool, and (3) application of the data collection method. The adaptation of quality-of-care indicators to remote regions was appraised according to their relevance, measurability and construct validity in this context. RESULTS: As a result of this process, 18 quality indicators were shown to be relevant, measurable and valid for establishing a critical quality appraisal of four recommended dimensions of PHC clinical processes: recognition, assessment, treatment and follow-up. CONCLUSIONS: There is not only an interest in the use of health records to assess the quality of PHC for mental health in remote regions but also a scientific value for the rigorous and meticulous methodological approach developed in this study. From the perspective of stakeholders in the PHC system of care in remote areas, quality indicators are credible and provide potential for transferability to other contexts. This study brings information that has the potential to identify gaps in and implement solutions adapted to the context.

Knowledge sharing in virtual communities

The Internet has transformed the scope, boundaries and dynamics of social and economic interactions. It is argued to have broadened the notion of the community from physical, colocated groups towards collectives that are able to transcend time and space, i.e. virtual communities. Even if virtual communities have been on the academic agenda for a couple of decades, there is still surprisingly little research on knowledge sharing within them. In addition, prior research has largely neglected the complex dynamics between Internet-based communication channels and the surrounding communities in which they are embedded. This thesis aims at building a better understanding of knowledge sharing supported by conversational technologies in intra-organisational virtual communities and external virtual communities supporting relationships with customers. The focus is thus on knowledge sharing in types of virtual communities that seem to be of relevance to business organisations. The study consists of two parts. The first part introduces the research topic and discusses the overall results. The second part comprises seven research publications. Qualitative research methods are used throughout the study. The results of the study indicate that investigation of the processes of knowledge sharing in virtual communities requires a socio-technical perspective, combining the individual, social and technological levels, and understanding the interplay between them. It is claimed that collective knowledge in virtual communities creates the enabling structure for knowledge sharing, and forms the invisible structure of the community on the basis of which it operates. It consists of a shared context, social capital and a unique community culture. The Internet does not inevitably erode social interaction: it seems that supporting social relationships by means of communication technology is a matter of quantity rather than quality. In order to provide access to external knowledge and expertise, firms need to open themselves up to an array of Internet-based conversations, and to consider the relevance of virtual communities to their businesses.

Ba in Virtual Communities

Virtual communities – interactive networks in cyberspace seasoned with feelings – are a highly topical research theme. Besides academics, more and more companies ponder upon the nature and implications of the sense of virtual communities. This thesis takes a novel viewpoint on this research and examines virtual communities from virtual ba perspective. Ba is the space – in this case a virtual and a mental one, where knowledge based interaction occurs. The aim of this thesis is to clarify the concept of virtual ba, and the development and appearance of ba in virtual communities. The scientific contribution of this qualitative case study is conceptual clarification and validation of the concept of virtual ba. The empirical part of the thesis examines blogs: Internet-based communication media, using data triangulation (observation, narratives and a thematic interview). The thesis provides insights into the development of virtual ba that has also managerial relevance.

Virtual communities : a virtual treasure trove for end-user developers

End-user development is a very common but often largely overlooked phenomenon in information systems research and practice. End-user development means that regular people, the end-users of software, and not professional developers are doing software development. A large number of people are directly or indirectly impacted by the results of these non-professional development activities. The numbers of users performing end-user development activities are difficult to ascertain precisely. But it is very large, and still growing. Computer adoption is growing towards 100% and many new types of computational devices are continually introduced. In addition, other devices not previously programmable are becoming so. This means that, at this very moment, hundreds of millions of people are likely struggling with development problems. Furthermore, software itself is continually being adapted for more flexibility, enabling users to change the behaviour of their software themselves. New software and services are helping to transform users from consumers to producers. Much of this is now found on-line. The problem for the end-user developer is that little of this development is supported by anyone. Often organisations do not notice end-user development and consequently neither provide support for it, nor are equipped to be able to do so. Many end-user developers do not belong to any organisation at all. Also, the end-user development process may be aggravating the problem. End-users are usually not really committed to the development process, which tends to be more iterative and ad hoc. This means support becomes a distant third behind getting the job done and figuring out the development issues to get the job done. Sometimes the software itself may exacerbate the issue by simplifying the development process, deemphasising the difficulty of the task being undertaken. On-line support could be the lifeline the end-user developer needs. Going online one can find all the knowledge one could ever need. However, that does still not help the end-user apply this information or knowledge in practice. A virtual community, through its ability to adopt the end-user’s specific context, could surmount this final obstacle. This thesis explores the concept of end-user development and how it could be supported through on-line sources, in particular virtual communities, which it is argued here, seem to fit the end-user developer’s needs very well. The experiences of real end-user developers and prior literature were used in this process. Emphasis has been on those end-user developers, e.g. small business owners, who may have literally nowhere to turn to for support. Adopting the viewpoint of the end-user developer, the thesis examines the question of how an end-user could use a virtual community effectively, improving the results of the support process. Assuming the common situation where the demand for support outstrips the supply.

Socio-Economic Dimensions of Health Care Development Among Tribals in Kerala: A Study of Tribal Communities in Wynad

The contemporary explanations and discussions of the relationship between medicine and health, and society centre around assumptions that can be broadly classified into three setsl. The first set considers health and illness as predominantly ‘biological’ and therefore, having nothing to do with the social and economic environment in which it occurs. The struggle to combat illness therefore, lies entirely within the purview of modern medicine which is neutral to economic or social change. The second considers practice of medicine as a natural science. It allows the doctor to separate himself from his subject matter, the patient, in the samelway as the natural scientist is assumed to separate himself from his subject matter, the natural world. As a 'science' and with the scientific method, it can produce unchallengable and autonomous body of knowledge which is free from the wider social and economic context. The third, different from the above, recognises the relationship between health, medicine and society. Social and environmental aspects as determinants of illness or of health comes to sharp focus here and it assigns to medicine the status of a mediator, the only viable mediator, between people and diseases. In this scheme of things the usefulness of medicine is unquestionable but the problem lies in not having enough of it to go arounds.

Virtual communities and strategic learning of calculus in enginery. 'Comunidades virtuales y el aprendizaje estratégico de cálculo en ingeniería'.

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