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INTRODUCTION: Adverse social determinants of health have been shown to be associated with a greater chance of developing chronic conditions. Although there has been increased focus on screening for health-related social needs (HRSNs) in health care delivery systems, it is seldom examined if the provision of needed services to address HRSNs is sufficiently available in communities where patients reside. METHODS: The authors used geospatial analysis to determine how well a newly formed health system and community-based organizations (CBOs) social care coordination network covered the areas in which a high number of patients experiencing HRSNs live. Geospatial clusters (hotspots) were constructed for Kaiser Permanente Northwest members experiencing any of the following 4 HRSNs: transportation needs, housing instability, food insecurity, or financial strain. Next, a geospatial polygon was calculated indicating whether a member could reach a social care provider within 30 minutes of travel time. RESULTS: A total of 185,535 Kaiser Permanente Northwest members completed a HRSN screener between April 2022 and April 2023. Overall, the authors found that among Kaiser Permanente Northwest members experiencing any of the 4 HRSNs, 97% to 98% of them were within 30 minutes of a social care provider. A small percentage of members who lived greater than 30 minutes to a social care provider were primarily located in rural areas. DISCUSSION AND CONCLUSION: This study demonstrates the importance of health system and community-based organization partnerships and investment in community resources to develop social care coordination networks, as well as how patient-level HRSN can be used to assess the coverage and representativeness of the network.

Introduction/Objectives: Community palliative care support teams specialize in providing at-home care under referral criteria distinct from hospital teams, focusing on functional status, limited benefit from continued hospital specialty care, and increased clinical complexity. This study aimed to assess the quality of referrals and the transition of care to a specialized community palliative care team, emphasizing adherence to established referral criteria. Methods: An observational, longitudinal, retrospective cohort study evaluated clinical health records of patients who received palliative care from a community team in 2023. We evaluated prior multidisciplinary follow-up, basic social support, medication changes made during the team's first consultation, and recurrences to hospital emergency care. The data was collected from the patients' clinical files. Results: The patient cohort had a mean age of 80.7 years (±11.92), ranging from 31 to 103 years. Males comprised 56.3% of the participants, with a median follow-up time of 32 days. Primary diagnoses included cancer (50%), end-stage organ failure (26%), and neurodegenerative disease (24%). Among the deceased, 85.6% died at home. Patients showed marked changes in psychological support and social rights, as we observed an improvement from 6.8% to 100% (P =.0011) and from 47.1% to 100% (P =.01) in these supports, respectively. We also observed significant changes in pharmacotherapeutic plans, regardless of the referring team. The study observed significant difficulty in recognizing referral criteria for specialized palliative care and defining clinical complexity. Referrals were often delayed, particularly for those previously under hospital care (P =.001). Increased prescription of pro re nata medications significantly correlated with home deaths (P =.021). Conclusions: Most complex patients can be effectively monitored and die at home, reserving hospital deaths for exceptional cases requiring interventions not possible at home or due to significant caregiver burden. There was no difference in the biopsychosocial approach of patients previously followed by other teams, including hospital palliative care teams, which suggests very different approaches. [ABSTRACT FROM AUTHOR]

Background: The Law of 2 February 2016 creating new rights for the sick and people at the end of life, Law called Claeys-Leonetti consecrates the deep sedation and continues maintained until death. The wish of the majority of French people is to favour death at home but this requires prerequisites and organizational requirements to ensure a quality palliative approach. Objective: Determine if the recommendations have been applied during the implementation of deep and continuous sedation maintained until death at home and identify the barriers to the application of these recommendations. Methods: Observational, descriptive study, carried out by directed questionnaire, among general practitioners and liberal nurses who contributed to the implementation at home of a deep and continuous sedation maintained until death between 2016 and 2019, supported by the ARPEGE Palliative Care Network. The questionnaire was submitted to General Practitioners and Liberal Nurses from June to October 2022 via hetero-telephone exchange. The evaluation was carried out on ten criteria defining the quality of the performance of sedation. Results: We collected 26 testimonies of sedation. On average, 7.6 criteria were followed out of the ten studied. The provisions of the law are relatively well applied, particularly as regards the designation of a trusted person, the information received by the patient, and the initiation of sedation by a nurse in the presence of a doctor. However, the lack of availability and foresight on the part of healthcare professionals has sometimes led to difficulties. Conclusion: To ensure a quality palliative approach, health professionals must be trained in palliative culture, family members must be informed and accompanied, and the expertise of palliative care team is fundamental. It is essential to anticipate end-of-life situations. This helps to ensure quality palliative care at home. [ABSTRACT FROM AUTHOR]

This article examines the growth of Indigenous grassroots community groups across Hawai'i, whose efforts are pivotal to place-based climate change resilience and community well-being. Instead of focusing on specific ecosystem resilience actions, it highlights the people and places that make this movement of community organizations resilient, leveraging both social and cultural strengths to adapt to climate impacts. For many Indigenous peoples, climate change is not new; adaptation has already been integral to relationships between environment and culture. These changes require culturally responsive approaches, not short-term engineering solutions such as coastal hardening or stream channelization. A collaboration between a grassroots artist mapping initiative ('ÃINAVIS) and a university's community-based research project ('ÃINA KUPU), this study utilizes a novel data index compiled using publicly available information to inform a series of in-depth student interviews with community groups across Hawai'i whose mission, vision, and work are dedicated to caring for 'ãina. We find that these "'Ãina Organizations" articulate climate resilience in multi-faceted and culturally grounded ways, maintaining reciprocal and mutual relationships with 'ãina, the Hawaiian term for land meaning "that which feeds." Facing various challenges and needing different systems of support, our work maps the dynamic adaptability of 'ãina expressed through community networks of collaborative care with emphasis on the importance of intergenerational knowledge and genealogical connection to place shared and passed onto future generations. The article concludes by emphasizing the importance of working on 'ãina as an exercise of Indigenous sovereignty, expanding climate resilience with cultural practice and social justice as both outcome and process of climate change adaptation. [ABSTRACT FROM AUTHOR]

Aims: The study aims to identify and compare health indicators collected by national research in Spain and in Brazil that can generate action strategies for health promoting universities. Methods: This is an epidemiological, descriptive, cross-sectional study that uses the database of the Secretariat of Health Surveillance of the Brazilian Ministry of Health and the database of the National Statistics Institute of Spain. Based on the National Health Promotion Policy, the analyzer axis prioritizes defined themes; percentage of physical exercise, daily smokers, sedentary lifestyle, obesity and self-perception of health status were evaluated. The data were collected from 2014 to 2020. Results: In Brazil, physical exercise is the highest percentage indicator, whereas in Spain, sedentary lifestyle is the highest. Regarding the age group, Brazil presented the lowest prevalence of daily smokers in the age group from 18 to 24, with little increase in older age groups; in Spain, older age groups presented the highest rates of sedentary lifestyle and obesity. In 2020, 4.5% of Brazilians reported a negative self-perception of health and in Spain 6.6%. Conclusion: The indicators 'physical exercise', 'daily smokers' and 'sedentary lifestyle' presented better results in Brazil than in Spain. Brazil presents a better perspective on health when compared with Spain, as the results showed that older ages present higher rates of sedentary lifestyle and obesity. Our study results also show that Brazilians report better self-perception in health, which can be interpreted by health promotion strategies. [ABSTRACT FROM AUTHOR]

Allosteric regulation of proteins continues to be an engaging research topic for the scientific community. Models describing allosteric communication have evolved from focusing on conformation-based descriptors of protein structural changes to appreciating the role of internal protein dynamics as a mediator of allostery. Here, we explain a violin model for allostery as a contemporary method for approaching the Cooper-Dryden model based on redistribution of protein thermal fluctuations. Based on graph theory, the violin model makes use of community network analysis to functionally cluster correlated protein motions obtained from molecular dynamics simulations. This Review provides the theory and workflow of the methodology and explains the application of violin model to unravel the workings of protein kinase A.

This article examines the role of insurgency in scaling up the co‐production of housing. Co‐production has gained in popularity in the past 15 years as both a set of practices and an intellectual framing for analyzing urbanization in the global South. Discussions of co‐production have largely emphasized the cooperative nature of the approach, asserting that a mostly non‐confrontational politics has proven effective at reshaping urban governance in ways that better meet the needs of the urban poor. However, recent analyses have identified conflict versus confrontation as a key tension in co‐production, especially as co‐productive programs seek to go to scale. I contribute to these discussions by analyzing a well‐known case of large‐scale co‐production, Thailand's Baan Mankong program, to understand the roles of insurgent versus cooperative community networks in the program's trajectory. I conclude that a more insurgent network opens up new land, resources and avenues for political participation. A more cooperative network then renders many of these interventions broadly politically acceptable to those in power. The two networks thus exist in a dialectic that has enabled the program's scaling up. I argue that research into co‐production should pay more attention to the importance of confrontational tactics by community networks. [ABSTRACT FROM AUTHOR]

From a relational perspective of the community, we explore the relationships that allowed sustaining life in spaces of proximity during the Covid-19 pandemic in Chile. From a qualitative methodology and the study of cases, one in Concepción and the other in Talca, it is observed that in the face of the rupture of daily life, community relationships are reconfigured to adapt to the new scenario. This plasticity allows them to adapt their production of relational goods to meet needs arising in the crisis and, thus, their action replaces and/or complements state and mercantile actions that diminish their protagonism. Finally, these multiple relationships and the goods they produce can be understood as a social sphere with its own meaning: the community. This plays a central role in the satisfaction of individual and collective needs and the reproduction of life, particularly in contexts of crisis. [ABSTRACT FROM AUTHOR]

The Leipzig Charter highlights the need for integrated, place-based participatory governance approaches to achieve more sustainable and just urban futures. In this article, we provide a synthesis of our transdisciplinary analysis of ten EU projects which were selected from over 100 EU-funded urban sustainability and justice projects. Through analysing these cases according to the question of 'How can city makers design governance processes for just and sustainable outcomes?', we identify six Enabling Governance Arrangements which are considered of high relevance to the integration of urban sustainability and justice through both municipality and community-led initiatives. Each Enabling Governance Arrangement was not only observed at play in multiple initiatives but was also further consolidated and confirmed in dedicated workshops with over 60 city makers of different backgrounds. This highlights their potential to stir place-specific debates around the governance of sustainable and just cities. Overall, we provide empirically grounded, actionable insights for policymakers, practitioners, and researchers on how to achieve integrated urban sustainability and justice through Enabling Governance Arrangements. Highlights: Formulates six arrangements for sustainable and just governance that can help municipalities and communities Arrangements are based on an analysis of governance processes that contributed to more sustainable and just cities Consolidated and confirmed the potential of these arrangements in workshops with over 60 city makers This demonstrates their potential to stir place-specific debates for the governance of sustainable and just cities [ABSTRACT FROM AUTHOR]

In this article we reflect on pluriversal connections for Community Informatics (CI), drawing from our collective experiences working with Indigenous Peoples in Borneo and Canada. Building on Michael Gurstein's foundational work and situating it in relation to contemporary debates around digital equity and inclusion, we present summaries of collaborative, iterative, locally-grounded participatory action research projects that illustrate the enduring methodological, ethical and conceptual questions raised in CI. Through our interactions and shared experiences, these examples also demonstrate Gurstein's (2012) focus on connecting across geographic and cultural boundaries in ways that respect the self-determined nature of place-based communities. [ABSTRACT FROM AUTHOR]

This personal and non-exhaustive account of an exciting (and Quixotic?) time in the history of computing, before the Internet was ubiquitous and controlled by corporations, describes The Community Networking Movement. It was a brief but exciting moment for community and civic action. Community networks, along with public libraries other civic innovations, were motivated by civic purpose. They were locally controlled sites on the Internet that typically free services including training and hardware donations, as well as e-mail (years before Google and others got involved) web space, and community forums. This was all done without exhaustive surveillance and the gathering and sales of private information. The paper discusses the movement in general, as well as what went wrong, what if the movement had succeeded, and whether it may be possible to regain some of the much-needed civic purpose in the future. In addition to the obvious case of being massively outspent and ignored, the organizers had shortcomings of their own, including underestimating the threat, inadequate institutional ties, and inattention to the potential of scale. If we had succeeded the current online environment may have been lesscommodified and more diverse and empowered than the one we have now. But we will never know. Today we see a world beset with problems that are colossal, quickly worsening, and are threatening our planet and our species. Building robust and resilient civic intelligence planet should be a top priority. Sadly, it is not. It may be the case in fact that our collective ability to address our problems may be eroding. Community networks with civic purpose, seem like better candidates for dealing with global--as well as local--issues, than today's corporately controlled environment. [ABSTRACT FROM AUTHOR]

Copyright of Revista Iberoamericana de Enfermería Comunitaria (RIdEC) is the property of Revista Iberoamericana de Enfermeria Comunitaria de la Asociacion de Enfermeria Comunitaria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Adolescence is a stage of transition with multiple changes and transformations. It is a critical phase to potentiate or disrupt the life course of human beings. In Latin America, adolescents and young adults from countries like Colombia have unequal access to socioeconomic resources, education, and the job market. This may generate social disadvantages and vulnerability. Aim: We aimed to identify conditions of social vulnerability and psychosocial resilience in the life course of adolescents and young adults from a community art network in Bogota, Colombia. Methods: We conducted a qualitative study with a multivocal design supported by the ethnic-social life history construction. The data were collected using narrative interviews. The interviews were transcribed, coded, categorized, and triangulated according to the principles of grounded theory as an analytical method. We adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Results: Eight adolescents and young adults between the ages of 12 and 24 years participated in the study. Five categories emerged: social vulnerability, social environment, artistic processes, psychosocial resilience, and life course. Conclusions: Social vulnerability and psychosocial resilience coexist during the life course of adolescents and young adults. Social support networks and community art processes have the potential to promote psychosocial resilience in adolescents and young adults. [ABSTRACT FROM AUTHOR]

This article examines the growth of Indigenous grassroots community groups across Hawaiʻi, whose efforts are pivotal to place-based climate change resilience and community well-being. Instead of focusing on specific ecosystem resilience actions, it highlights the people and places that make this movement of community organizations resilient, leveraging both social and cultural strengths to adapt to climate impacts. For many Indigenous peoples, climate change is not new; adaptation has already been integral to relationships between environment and culture. These changes require culturally responsive approaches, not short-term engineering solutions such as coastal hardening or stream channelization. A collaboration between a grassroots artist mapping initiative (‘ĀINAVIS) and a university’s community-based research project (‘ĀINA KUPU), this study utilizes a novel data index compiled using publicly available information to inform a series of in-depth student interviews with community groups across Hawai‘i whose mission, vision, and work are dedicated to caring for ‘āina. We find that these “ʻĀina Organizations” articulate climate resilience in multi-faceted and culturally grounded ways, maintaining reciprocal and mutual relationships with ʻāina, the Hawaiian term for land meaning “that which feeds.” Facing various challenges and needing different systems of support, our work maps the dynamic adaptability of ‘āina expressed through community networks of collaborative care with emphasis on the importance of intergenerational knowledge and genealogical connection to place shared and passed onto future generations. The article concludes by emphasizing the importance of working on ‘āina as an exercise of Indigenous sovereignty, expanding climate resilience with cultural practice and social justice as both outcome and process of climate change adaptation.

Background: Health inequalities in African American communities have been further exacerbated by COVID-19. Public health departments and other safety-net providers across the United States have partnered with community-based organizations to address barriers to COVID-19 testing in disproportionately impacted communities. This narrative review summarizes lessons learned from published examples of these community-based COVID-19 testing efforts. Methods: We searched online databases for peer-reviewed articles on community-based COVID-19 testing interventions in the United States aimed at increasing COVID-19 testing among African American populations. We abstracted information about each example and synthesized the primary lessons learned and key aspects that contributed to their success. Results: Seven examples of community-based COVID-19 testing aimed at increasing testing among African Americans and other underserved populations were identified and described, across various U.S. locations and involving multiple types of partners (1) St. Paul, MN (faith, health centers, Mayo Clinic); (2) Chicago, IL (university hospital and health centers); (3) NC (health centers, Community Advisory Board); (4) Baltimore, MD (hospitals, community clinic, mobile clinic); (5) Marion County, FL (health department and community partners); (6) New Orleans, LA (health department and health system); and (7) New York City, NY health and hospital system, mobile clinic). Discussion: Several key aspects of the COVID-19 testing models included the following: (1) close proximity of the testing site to affected communities and availability of walk-up and drive-through testing options; (2) partnerships between safety-net providers and broad community networks, which facilitated outreach and trust; (3) increased resources for safety-net providers; and (4) the use of data to identify areas of need and track impact. The merging of resources and relationships among well-equipped, safety-net providers and other health care institutions and culture-rich, community-centered organizations, to jointly address structural and systemic inequities, is key to cultivating health equity in the distribution of COVID-19 testing and other essential public health services.

In Chile, the dominant way of organizing local community relations shows little transformative capacity. This has its origin in a sociopolitical process that has fostered a heteronomous, contained, depoliticized and bureaucratized organizational culture, sustained by a neoliberal idea of neighborhood-community and framed in legislation that does not recognize its public function. But in the last fifteen years this hegemonic form has given way to more articulated and flexible community experiences, which discuss the scales of action, the type of relationship with the State and the established modes of organization. Integrating results from research carried out between 2014 and 2023, the article identifies potential for the transformation of community culture expressed in forms of networks that occur in different areas and scales: primary ties and daily neighborhood life, territorial-based organizations and heterogeneous territorial networks. The above allows us to propose the idea-horizon of the Community Sphere, which would allow us to discuss the fragmentation with which the community is observed and experienced in current Chile. [ABSTRACT FROM AUTHOR]

The availability of medications to induce abortion, especially in contexts of restricted access, has transformed practices and allowed women and/or their community organizations to assist other women in obtaining abortions, whether or not they interact with the healthcare system. This study recovers the experience of a feminist community organization that, from the province of Neuquén, extends throughout the country, creating a network of community care. An exploratory descriptive study with a qualitative approach was conducted to analyze the experiences of women who facilitate access to permitted abortion in Argentina. Through in-depth interviews with three leaders of the feminist collective La Revuelta and semi-structured interviews with 33 members of the socorrista groups, conducted between November 2019 and December 2020, we describe their history and processes of work and growth; we explore their motivations and feelings and characterize the interactions of these organizations with public and private health systems. The results of this work align with the international conversation and bibliographic production about these organizations and their particularities, and with the need to incorporate these forms of care into institutional health systems.

Abstract Background Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people’s health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. Methods In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. Discussion Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.

Shaping digital inclusion policy and practice to meet community-defined goals requires more than access to digital devices and connectivity; it must also enable their effective design and use in situated local settings. For the Nation of Hawai’i, a Kānaka Maoli (Hawai’ian) sovereignty organization with a land base in Pu‘uhonua o Waimānalo on the island of Oahu, these activities are closely associated with broader goals of Nation-building and sovereignty. Recognizing there are many different approaches to sovereignty among diverse Kānaka Maoli, in this paper we document how the Nation of Hawai’i is conceptualizing the ongoing evolution of their community networking project. We suggest that the Pu‘uhonua o Waimānalo initiative reflects one Indigenous organization’s efforts to frame community networks as a means to generate a “sovereignty mindset” among members of the Nation, as well as share resources and experience among local community members and with other communities in Hawai’i and beyond.

Abstract Latin American and the Caribbean regions (LAC) harbor one of the most biodiverse areas of the world, the Neotropics. True bugs (Hemiptera: Heteroptera) are a diverse lineage of insects, with more than 45,000 species, particularly speciose in the Neotropical region. True bugs are fundamental in the dynamics of natural and modified ecosystems, with several species critical to agriculture and public health. We compiled Heteroptera research in LAC from 1998–2022 using bibliographic databases. Productivity, collaborative networks, and the main topics studied were analyzed. A total of 1,651 Heteroptera studies from LAC were found, with continuous growth being 2021 the most prolific. Four categories (Taxonomy of extant species, Faunistic inventories and new records, Pest species biology, and Community ecology) represent most of the published research. About 60 percent of the records evaluated correspond to five families (Pentatomidae, Reduviidae, Coreidae, Miridae, and Rhyparochromidae). We emphasize the need to keep working on Heteroptera taxonomy because it will allow further advances in other areas such as phylogenetic analyses, biogeography, ecology, and natural history, among others. The results of our analyses characterize the current state of heteropterology in the region, establishing a baseline for future studies and efforts to broaden the knowledge of the group.

The volumes of waste in urban areas around the globe continue to increase due to the upsurge in disposals from exponentially growing urban populations. Ideally, the waste must be regularly collected by responsible councils, but in some countries, the collection has been erratic due to operational challenges. Unfortunately, this is the current and perpetually unresolved problem in Zimbabwe. A lack of garbage collection vehicles, as well as a lack of fuel for the available refuse collection trucks, has resulted in sporadic refuse collection in urban areas. The accumulation of uncollected waste in Zimbabwe's urban areas pollutes the environment and exposes the inhabitants to health risks, leaving waste management responsibilities to the community. This research, adopts the mixed-methods approach to evaluate the efficacy of using community social capital in waste management in urban Zimbabwe. Data was collected through a survey, observations and key informant interviews. The study revealed that due to poor refuse collection by the Harare City Council, residents have taken the initiative to use their social capital to manage waste in their communities through mechanisms like clean-up exercises, environmental cleanliness training workshops as well as forming collaborations with community-based organisations. However, these social capital initiatives are backtracked by some errant residents who continue to dump waste in undesignated areas. Measures such as the introduction of waste recycling income generation projects, giving incentives to community clean-up participants and enforcement of penalties for dumping waste in illegal places are recommended to support social capital initiatives in municipal waste management in Harare.

Strengthening interorganizational collaboration is critical to mitigate the impact of adverse childhood experiences (ACEs) and improve community health. We examined change in interorganizational collaboration around ACEs within Peace4Tarpon's network and investigated factors influencing collaboration. We conducted a community‐wide social network analysis among 32 trauma‐informed organizations in 2016 and 2018, using network analysis methods to examine interorganizational cohesion (density, transitivity, triad census) over time, and multiple regression quadratic assignment procedure to investigate factors influencing collaboration. Network cohesion measures indicated small increases in collaboration level and greater network cohesion over time. Conducting ACEs screenings was a significant factor (b = 0.237; p < 0.01) predicting likelihood of interorganizational collaboration in 2016. No assessed ACEs practices predicted collaboration in 2018, suggesting variables assessed predicted a small proportion of variance in collaboration change. Results provide a foundation for understanding how ACEs/trauma‐informed practices influence collaboration and highlight implications of interorganizational collaboration. Peace4Tarpon's 2‐year progress provides insights for other trauma‐informed communities. [ABSTRACT FROM AUTHOR]

Copyright of Salud Colectiva is the property of Instituto de Salud Colectiva Universidad Nacional de Lanus and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Community networks risk failure when they attempt to emulate models from elsewhere without engaging the community in the process and making appropriate adaptations. These 'build it and they will come' models rarely work over the long term. This research project explored claims from residents of a low-income neighbourhood in the "North End" of Winnipeg in Manitoba, Canada, that inadequate and unaffordable Internet connectivity limits their access to critical communication tools, resources, and information. Through the research, we identified the need for a sustainable model of affordable, accessible Internet connectivity that centers on building a cooperative-owned and operated community network with Indigenous and newcomer families at its heart. Findings revealed that high connectivity costs, limited digital literacy, and inadequate infrastructure are the primary barriers to meaningful connectivity in the community. The intent of the "North End Connect" research project was to work directly with the residents, to learn about their connectivity needs and wants, inform the project's technical team as to how and where to build a solution that works for the community, removing explicit and implicit barriers to access. Through our research, we validated that digital connectivity is a problem in the community. Utilizing a CBPAR approach provided a more nuanced understanding of the barriers to access from the resident's perspective and lived experience. This allowed for the development of a strengths-based roadmap that utilized existing assets to provide affordable, accessible, trustworthy, and secure Internet access to anyone who wants it. The research acted as the catalyst to motivate the community and led to ongoing interventions aimed at addressing each of the identified barriers. As we investigate these barriers, it becomes evident that addressing these issues is not just a matter of technological access but a crucial step toward fostering a more inclusive and equitable society. The project serves as a model for community-driven digital inclusion efforts and contributes to global conversations about equitable access to the internet. [ABSTRACT FROM AUTHOR]

Digital literacy research and practice typically presume certain conditions, such as an urban orientation and adequate, affordable access to connectivity and devices. But these conditions are not universal; for example, people in small, rural/remote Indigenous communities may seek to balance connectivity challenges and digital innovations with land-based living specific to place and community. Drawing on efforts to broaden critical digital literacies to support Indigenous sovereignty, we consider how overlapping contexts of places, communities, and infrastructures intersect in the cocreation of appropriate digital literacy. Specifically, we discuss a series of virtually facilitated, participatory workshops that utilize "hacker literacies" and "infrastructure literacy" to reimagine connectivity infrastructure and demonstrate the potential of community networking in, with, and by rural/remote Indigenous communities. We also reflect on limitations of this work and identify lessons for future projects. [ABSTRACT FROM AUTHOR]

This qualitative research is an work with health professionals, who work in the intra and outpatient sector in the city of Talca, Chile. The objective is to understand how the mental health of nurses was affected, due to the work stress caused by the COVID-19 emergency. The results point to fear of contagion and death as the most stressful factors in terms of work; on the other hand, there is evidence of absence of self-care, as well as psycho-emotional assistance from State institutions. He also notices how work stress is aggravated when workers do not feel support from supervisors or co-workers, as well as having limited control over their work and work pressures; Comparing experiences of intra- and extra-hospital teams, he realizes that team dynamics are essential to cope with the high workload; in this context, nurses in the outpatient area were more affected than those working in the in-hospital sector. The discussion points to the need to incorporate care strategies for those who care, highlighting the importance of analyzing social aspects that lead to work stress in extreme situations, placing the role of the community and the agency as keys in mental health management. [ABSTRACT FROM AUTHOR]

Today, the internet is often understood as a monolithic entity. This depiction is increasingly inaccurate and needs to be radically re-examined. The pluriverse concept of the internet examines local and international models of community building in interdependent but separated digital contexts. Drawing on Indigenous knowledge systems some articulations of the pluriverse describe a universe of separate, but connected and interdependent worlds, understood with reference to the concept of communities. Unlike today's internet-based communities, organized in specific siloed venues and forums where users with specific interests rarely face opposition or differences of opinion and where these interests are constantly reinforced by recirculated data and opinions, the pluriverse offers an imaginative frame where we can imagine a series of 'internets', made up of localized networks, community-driven social spaces, open source data sharing, and truly collaborative production at a replicable scale. This paper presents an exploration of the potential for pluriversal "internets." [ABSTRACT FROM AUTHOR]

Background: Networks are an essential component of community-based health research. Community-based networks require a high degree of collaboration, and the quality of this collaboration is a key factor for intervention success. As such, it is important to measure collaboration quality through network evaluation. Established tools, such as social network analysis, primarily measure connections between network members as opposed to network quality. Additionally, only few tools developed for this purpose are used in practice. Methods: This paper describes the process of developing a network assessment tool to measure the quality of network collaboration in practice. To this end, we collaborated with practice partners from a community-based health promotion network and the community health service. We adopted a mixed-methods approach consisting of a literature review and a needs assessment involving practical experts in Germany. On this basis, we developed a new network evaluation tool, the Self-Evaluation Tool for Network Quality Assessment by Practitioners in Community Health Promotion (SNAP-HP), in cyclic-iterative collaboration with our practice partners. Conclusions: The next steps include piloting, evaluating, and adapting the SNAP-HP for final open access. [ABSTRACT FROM AUTHOR]

Background: The core to successful advance care planning (ACP) facilitation is helping people determine their values, beliefs and wishes, and understand substitute decision-making. Recognizing the potential for community members to support public awareness and education we developed a model of ACP education, whereby peer facilitators associated with community organizations host workshops that educate and assist members of the public with ACP. Objectives: Describe the development and evaluation of the model for community-led peer-facilitated ACP workshops for the public. Design: Descriptive mixed methods. Methods: A training curriculum and program model were co-developed with two community organizations that had been successful in delivering ACP workshops independently in their communities. Herein we describe a mixed-methods evaluation of three cycles of implementation and improvement of the model. Results: The model centers on three key concepts; the right content (based around three steps Think, Talk, Plan), the right facilitator, and the right approach. A suite of tools was designed to support the three groups involved in the delivery of the ACP workshops: the public participants, the peer facilitators, and the community-based organizations. The peer-facilitator training addresses the facilitator's learning needs of ACP content knowledge, facilitation skills, and understanding change behavior. Training evaluation data from 106 facilitators confirmed that the curriculum prepared them to facilitate the workshops. Qualitative data revealed that support from organizations with established reputations in their community is critical, with mentoring from more experienced facilitators beneficial. Conclusion: Our model demonstrates the potential of community-led, peer-facilitated ACP initiatives to enhance the capacity of community to upstream ACP conversations. Reaching a broader audience and creating a supportive, inclusive environment for individuals to comfortably learn about ACP can drive the much-needed culture shift to normalize ACP. Meaningful community engagement, empowerment, and partnerships are essential for the successful development and widespread impact of these initiatives. Plain language summary: A model for community-led peer-facilitated advance care planning workshops for the public Why was this study done? Advance care planning (ACP) allows people to reflect on and share their personal values, goals and preferences as they relate to their future healthcare. Despite the benefits of doing ACP, the number of people who have engaged in ACP remains low. Traditionally, most ways of supporting people to engage in ACP have involved healthcare providers. In British Columbia, two community-based organizations had developed successful peer-facilitated workshops to engage and educate the public. In these workshops, non-expert members of the community (peer-facilitators) conduct interactive workshops that help members of the public understand and begin ACP. What did the researchers do? We partnered with these two organizations to develop a training curriculum and other materials required to spread this approach to other community organizations throughout the province. The model is based on three key concepts: the right content, the right facilitator, and the right approach. The materials include a suite of tools for three groups: the public participants, the peer-facilitators and the organizations. What did the researchers find? The training and suite of tools we developed successfully prepared community members ("peers") associated with community organizations to facilitate ACP workshops for the public. Support from community organizations is essential, and mentoring from more experienced facilitators is beneficial. What do the findings mean? As a provincial organization we were able to successfully partner with community organizations to develop a model and spread the workshops provincially and confirm they were acceptable and effective, improving public access to information about advance care planning. [ABSTRACT FROM AUTHOR]

Abstract Background It is becoming more common for parents of children with chronic conditions to join research teams as partners. Parent partnerships can help align research with what is relevant and important to families. It is also common for parent partners to be asked to share information about a study through their personal networks, which supports study recruitment. In this parent-led study, we explored parents' experiences when working together with researchers in patient-oriented research studies, in relation to study recruitment. Methods Demographic data were collected through a brief online survey (SurveyMonkey®) and analysed descriptively (n, %, median (interquartile range; IQR)). Qualitative data were collected through focus groups and interviews (July to October 2021), transcribed verbatim, and analysed thematically. Parent co-leads were involved in every stage of the study, including study design, recruitment, data collection, analysis, interpretation, and knowledge mobilization. Results Fifteen parents (n = 14 women) who had research partnership experience participated in this study. Most (n = 13) participants self-identified as White or of European descent. The majority (n = 10) had partnered in 1–3 research projects, while five participants had partnered in 4 + projects. Parents had a median of 3 years (IQR: 5) of partnership experience. We identified the following three themes: motivations, authentic partnerships, and learned decision making. Each theme included reflections about recruitment, and about research partnership in general. Motivations included a personal connection to the research topic, a connection to the community impacted by the research topic, and a desire to create change. Authentic partnerships were important for a meaningful experience, and enhanced participant’s willingness and ability to share study materials. Learned decision making reflected parents’ evolving decisions and practices related to sharing study information or personal information to support research. We provide a summary of participants’ recommendations for researchers who work with parent partners, and recommendations for parents as they approach research partnerships. Conclusions Experiences shared by parents who have partnered in research provide valuable information to inform recruitment methods and improve team functioning. Parent partners expressed a willingness to support recruitment and valued a strong research team working together for a common outcome. This study yields a set of recommendations guiding future research that engages parents as team members.

This paper explores the effects of a group-randomized controlled trial, Community Partners in Care (CPIC), on the development of interagency networks for collaborative depression care improvement between a community engagement and planning (CEP) intervention and a resources for services (RS) intervention that provided the same content solely via technical assistance to individual programs. Both interventions consisted of a diverse set of service agencies, including health, mental health, substance abuse treatment, social services, and community-trusted organizations such as churches and parks and recreation centers. Participants in the community councils for the CEP intervention reflected a range of agency leaders, staff, and other stakeholders. Network analysis of partnerships among agencies in the CEP versus RS condition, and qualitative analysis of perspectives on interagency network changes from multiple sources, suggested that agencies in the CEP intervention exhibited greater growth in partnership capacity among themselves than did RS agencies. CEP participants also viewed the coalition development intervention both as promoting collaboration in depression services and as a meaningful community capacity building activity. These descriptive results help to identify plausible mechanisms of action for the CPIC interventions and can be used to guide development of future community engagement interventions and evaluations in under-resourced communities.

Objective: Despite recognized benefits, engagement in Advance Care Planning (ACP) remains low. Research into peer-facilitated, group ACP interventions is limited. This study investigated the acceptability of community-led peer-facilitated ACP workshops for the public and whether these workshops are associated with increased knowledge, motivation and engagement in ACP behaviors. Methods: Peer-facilitators from 9 community organizations were recruited and trained to deliver free ACP workshops to members of the public with an emphasis on conversation. Using a cohort design, workshop acceptability and engagement in ACP behaviors was assessed by surveying public participants at the end of the workshop and 4–6 weeks later. Results: 217 participants returned post-workshop questionnaires, and 69 returned follow-up questionnaires. Over 90% of participants felt they gained knowledge across all 6 learning goals. Every ACP behavior saw a statistically significant increase in participant completion after 4–6 weeks. Almost all participants were glad they attended (94%) and would recommend the workshop to others (95%). Conclusion: This study revealed an association of peer-facilitated ACP workshops and completion of ACP behaviors in public participants. Innovation: This innovative approach supports investment in the spread of community-based, peer-facilitated ACP workshops for the public as important ACP promotion strategies.

Background/objectivesCognitive and mobility impairments are common and underdiagnosed chronic conditions that afflict community-dwelling older adults. This study describes the organization, implementation, and evaluation of an intervention for underserved and ethnically diverse older patients with dementia and/or falls risk.DesignObservation, baseline and 1 year after intervention.SettingCommunity-based primary care county clinics in inland southern California.ParticipantsA total of 272 persons, aged 70 years and older, who screened positive for falls and/or dementia and enrolled in the Cognition and Mobility Care Management program during the study period.InterventionA nurse care manager performed a patient and caregiver evaluation and created and implemented a care plan with medical, behavioral, and psychosocial interventions in partnership with patients and their primary care providers.MeasurementsProcess outcomes included rates of positive screening for dementia and fall risk, referral, enrollment, and visit completion. Patient outcomes included fall history, mobility and cognitive assessments, and depression scales. Patients and/or caregivers completed questionnaires rating perceived benefits of enrollment after 1 year in the program.ResultsMedical assistants screened 573 patients aged 70 years and older during the study period; 78% screened positive for dementia and/or fall risk. Of the patients who screened positive, 94% were referred; 91% of contacted patients elected to enroll, and 272 patients completed an intake visit (meanage = 77 years; 65% female; 75% Latino; 10% African American). The patients and caregivers who completed satisfaction questionnaires 1 year after enrollment rated the program highly, and 92% would recommend the program to others.ConclusionA primary care-based screening and comanagement program to identify and manage dementia and falls risk in primarily Latino and African American older adult patients living in an underserved area was well received, with high satisfaction and perceived benefit from patients and caregivers.

Background: Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. Methods: In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. Discussion: Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety. [ABSTRACT FROM AUTHOR]

The increasing frequency and cost of zoonotic disease emergence due to global change have led to calls for the primary surveillance of wildlife. This should be facilitated by the ready availability of remotely sensed environmental data, given the importance of the environment in determining infectious disease dynamics. However, there has been little evaluation of the temporal predictiveness of remotely sensed environmental data for infection reservoirs in vertebrate hosts due to a deficit of corresponding high‐quality long‐term infection datasets. Here we employ two unique decade‐spanning datasets for assemblages of infectious agents, including zoonotic agents, in rodents in stable habitats. Such stable habitats are important, as they provide the baseline sets of pathogens for the interactions within degrading habitats that have been identified as hotspots for zoonotic emergence. We focus on the enhanced vegetation index (EVI), a measure of vegetation greening that equates to primary productivity, reasoning that this would modulate infectious agent populations via trophic cascades determining host population density or immunocompetence. We found that EVI, in analyses with data standardised by site, inversely predicted more than one‐third of the variation in an index of infectious agent total abundance. Moreover, in bipartite host occupancy networks, weighted network statistics (connectance and modularity) were linked to total abundance and were also predicted by EVI. Infectious agent abundance and, perhaps, community structure are likely to influence infection risk and, in turn, the probability of transboundary emergence. Thus, the present results, which were consistent in disparate forest and desert systems, provide proof‐of‐principle that within‐site fluctuations in satellite‐derived greenness indices can furnish useful forecasting that could focus primary surveillance. In relation to the well‐documented global greening trend of recent decades, the present results predict declining infection burden in wild vertebrates in stable habitats; but if greening trends were to be reversed, this might magnify the already upwards trend in zoonotic emergence. [ABSTRACT FROM AUTHOR]

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This article examines, with ethnographic lenses, the emergence of shared networks in the Tseltal and Zapoteco communities in Chiapas and Oaxaca (Mexico). 'Shared networks' are first-mile signal-sharing practices that articulate interconnection infrastructure and values of coexistence to, in the cases studied, extend the internet to areas where the services of existing larger internet service providers are unsatisfactory or unavailable. It argues that by infrastructuring their own local networks and interconnecting to the global internet, Tseltal and Zapoteco people are effectively internet codesigners, building Latin-Centric Indigenous networks and shaping internet governance from below. When comunalidad values, supported by unlicensed frequencies of the electromagnetic spectrum, towers, radio antennas, houses' rooftops, routers, and cables, intersect with the values of the internet service providers and their policies, hybrids emerge. Shared networks are a result of what these hybrids enact and constrain, as well as evidence of the vivid struggles for a more inclusive and pluriversal internet. [ABSTRACT FROM AUTHOR]

The mounting evidence that current efforts to meet international goals for increasing Internet connectivity are likely to fall short has heightened interest in alternative connectivity models such as community networks. Already, there are many such initiatives globally taking differentiated approaches towards their setup and operation. This results in fragmented knowledge on the initiatives and systematic analysis of these models is limited. This study applies the People, Technology, Organization and Environment (TOE) framework to examine 21 community networks across countries in different continents to produce insights into their structure and components. The aim is to identify ways in which initiatives become sustainable. Data for the study were collected in two steps. First, qualitative data were gathered using in-depth interviews to produce a database of case studies. Second, the qualitative data were quantized, which enables the researchers to produce descriptive data. Overall, the study findings demonstrate the existence of several technology options, but the main technology used for community level connectivity is Wi-Fi. Initiatives also adopt different organizational approaches, but strategic partnerships are critical for the success of the initiatives. While strategic partners provide support for the initial set up lack of business models affect the sustainability of initiatives. Also, while environment-related issues (regulation, infrastructure) play a significant role, they are malleable as shown by changes in regulatory regimes. This study findings are useful to practitioners implementing community networks, researchers looking to gain more insights on these models and policy makers responsible for the telecommunication, and digital policies. [ABSTRACT FROM AUTHOR]

This study considers whether the use of the neighborhood-focused social networking web application, Nextdoor, might in certain instances rise to the level of community development envisioned over 25 years ago by "community networking" (ComNet) scholars. In the 1980s and 1990s, academics and journalists recognized the potential of "electronic community networks," or ComNets, to help people connect with their geographic communities and help struggling communities with civic and economic development. Those early ComNets were described as helping residents to "get together" to tackle neighborhood issues from the grassroots. Through a case study drawing from interview data and participant observation, this study looks at how residents in a metropolitan US city and a nearby suburban area might, or might not, be using Nextdoor in these developmental ways envisioned by the ComNet literature. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Early diagnosis of cerebral palsy (CP) is critical in obtaining evidence-based interventions when plasticity is greatest. In 2017, international guidelines for early detection of CP were published on the basis of a systematic review of evidence. Our study aim was to reduce the age at CP diagnosis throughout a network of 5 diverse US high-risk infant follow-up programs through consistent implementation of these guidelines. METHODS: The study leveraged plan-do-study-act and Lean methodologies. The primary outcome was age at CP diagnosis. Data were acquired during the corresponding 9-month baseline and quarterly throughout study. Balancing measures were clinic no-show rates and parent perception of the diagnosis visit. Clinic teams conducted strengths, weaknesses, opportunities, and threats analyses, process flow evaluations, standardized assessments training, and parent questionnaires. Performance of a 3- to 4-month clinic visit was a critical process step because it included a Hammersmith Infant Neurologic Examination, a General Movements Assessment, and standardized assessments of motor function. RESULTS: The age at CP diagnosis decreased from a weighted average of 19.5 (95% confidence interval 16.2 to 22.8) to 9.5 months (95% confidence interval 4.5 to 14.6), with P = .008; 3- to 4-month visits per site increased from the median (interquartile range) 14 (5.2-73.7) to 54 (34.5-152.0), with P < .001; and no-show rates were not different. Parent questionnaires revealed positive provider perception with improvement opportunities for information content and understandability. CONCLUSIONS: Large-scale implementation of international guidelines for early detection of CP is feasible in diverse high-risk infant follow-up clinics. The initiative was received positively by families and without adversely affecting clinic operational flow. Additional parent support and education are necessary.

The House Ball Community consists of sexual, gender and ethnic minority youth who form family-like houses and compete in balls. Many rely on community-based organisations as venues for socialising and accessing health-related resources. In recent years, urban gentrification has challenged the economic survival of the organisations that serve this community and its members. Between 2016 and 2017, we conducted 45 in-depth interviews with houses and gay families in the San Francisco Bay Area and regular participant observation at community events, including balls. In addition to forcing community organisations to close or move, rising rents have increased housing instability among Ballroom Community members, with some moving to distal locations. Participants felt nostalgia for organisations that provided HIV-related services and hosted balls in previous years, feeling the loss of space keenly. To maintain community and generate employment, the San Francisco Ballroom Community now offers Vogue classes at private dance studios. This allows participants to recruit new house members, welcoming a broader array of individuals into the community than those who have historically participated. However, accessing culturally appropriate sexual health services remains difficult. Health advocates should recognise that community organisations are necessary for diverse youth to build community and access sexual health services.

Abstract Background Chronic wounds are frequently colonized or infected with multiple bacterial or fungal species, which can both promote or inhibit each other. Network analyses are helpful to understand the interplay of these species in polymicrobial infections. Our aim was to analyse the network of bacterial and fungal species in chronic wounds. Methods Swabs (n = 163) from chronic wound infections (Masanga, Sierra Leone, 2019–2020) were screened for bacterial and fungal species using non-selective agars. Some of these wounds were suspected but not confirmed Buruli ulcer. Species identification was done with MALDI-TOF mass spectrometry. Network analysis was performed to investigate co-occurrence of different species within one patient. All species with n ≥ 10 isolates were taken into account. Results Of the 163 patients, 156 had a positive wound culture (median of three different species per patient; range 1–7). Pseudomonas aeruginosa (n = 75) was the dominating species with frequent co-detections of Klebsiella pneumoniae (21 cases; OR = 1.36, 95%CI: 0.63–2.96, p = 0.47), Staphylococcus aureus (14 cases; OR = 1.06, 95%CI: 0.44–2.55, p = 1) and Proteus mirabilis (13 cases; OR = 0.84, 95%CI: 0.35–1.99, p = 0.69). Conclusion The culturome of chronic wounds in Sierra Leonean patients is highly diverse and characterized by the co-occurrence of P. aeruginosa, K. pneumoniae and S. aureus.