The influential role of personal advice networks on general practitioners' performance: a social capital perspective.
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ABSTRACT:
SUBMITTER: Calciolari S
PROVIDER: S-EPMC5549353 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:Within the last 10 years, there has been a growing interest in the importance of social capital and older people. The aims of the study are to advance measurements of aspects of social capital based on bonding, bridging and linking that can be used to study the impact of the local community on community-dwelling older populations and to study the distribution of these three measurements of social capital in 34 municipalities. Data are from a Danish prospective cohort study on preventive home visits among 4,034 old people 75+ in 34 municipalities in Denmark. The measurements of aspects of social capital at community level are based on theory of bonding, bridging and linking social capital. It has been possible to analyse variations in the three measurements of social capital in the 34 municipalities and to characterize different municipalities according to high versus low social capital. There are interesting patterns in distribution of the three measurements. The two extreme groups of municipalities (high and low social capital) differ with regard to demography, social and structural conditions in the municipalities. We believe that the proposed measures of social capital will be relevant in future studies of social capital and health in older populations, since they are theoretically based and cover different aspects of social capital related to older people and their local community.
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Project description:Social Capital refers to the resources associated with durable and trustworthy social connections. Social Capital can be developed through offline and online relationships. It can be distinguished between cognitive Social Capital (perception of trustworthiness, reciprocity, and support) and structural Social Capital (density of social networks and membership, and participation in groups and associations). It can also be distinguished between bonding Social Capital (resources associated with informal networks; i.e., neighbors, friends, colleagues) and bridging Social Capital (resources associated with formal networks; i.e., community service, cultural, religious or political groups/associations). The different forms and dimensions of Social Capital may have distinct effects on health outcomes and self-rated health. Therefore, public health researchers need valid and reliable instruments to investigate Social Capital. However, valid instruments including the measurement of online Social Capital are not available. The Personal Social Capital Scale aims to assess bonding and bridging Social Capital by means of cognitive and structural items. In the present investigation, three studies were carried out (N = 1149) to adapt the Personal Social Capital Scale to develop the Personal On-Offline Social Capital Brief Scale, a brief scale for measuring online and offline bonding and bridging Social Capital in Italy. Factorial structure and convergent/divergent validity in relation to scales measuring constructs with different patterns of relationships with bonding and bridging Social Capital (i.e., social support and stress; sense of community and health) were also investigated. Overall, these studies provide evidence of reliability and validity related to the internal structure of the Personal On-Offline Social Capital Brief Scale in measuring online and offline bonding and bridging Social Capital and discriminating them from similar constructs. This scale is a useful instrument for planning public health interventions.
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Project description:Background and Aims: Social interaction in the online games has been found to predict gaming disorder, but little research has examined the mechanism of this association. Drawing on the social capital theory, the present study investigated the mediating role of online social capital on the relationship between in-game social interaction and gaming disorder and the moderating role of alienation on the relationship between online social capital and gaming disorder. Methods: A sample of 457 Chinese massively multiplayer online role-playing game gamers was recruited to complete the In-game Social Interaction Questionnaire, Online Social Capital Scale, Alienation Scale, and Pathological Gaming Scale. Results: The results showed that online social capital was a mediator in the relationship between in-game social interaction and gaming disorder. Moreover, for individuals with low alienation, the effect of online social capital on gaming disorder was weaker than for those with high alienation. Conclusions: The present study provides new insight into the complex processes involved in the effect of in-game social interaction on gaming disorder, and the results have important theoretical and practical implications.
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Project description:Although tobacco smoking is the world's most important preventable cause of many chronic diseases (including COPD and asthma) and premature death, many physicians do not routinely apply smoking cessation in the daily health care of their patients. Two widely felt important concerns of physicians are that smoking cessation as part of a treatment is time-consuming and may jeopardize their relationship with patients. Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study, we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. The interviews were recorded and transcribed and subsequently analysed with NVivo12. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.
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Project description:BACKGROUND:Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further. OBJECTIVE:This study aimed to explore GPs' perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves. METHODS:A total of 10 (5 female and 5 male) GPs were recruited by purposive sampling, aged 38 to 69 years (mean 51 years), of which 4 had an urban uptake of patients and 6 a rural uptake. All of them worked in the region of Southern Denmark where GPs typically work alone or in partnership with 1 to 4 colleagues and all use electronic patient health records for prescription, referral, and asynchronous electronic consultations. We performed qualitative, semistructured, individual in-depth interviews with the GPs in their own office about how they used eHealth and mHealth devices to help patients challenged with lifestyle issues and themselves. We also interviewed how they treated lifestyle-challenged patients in general and how they imagined eHealth could be used in the future. RESULTS:All GPs had smartphones or tablets, and everyone communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. We identified 3 themes concerning the use of eHealth: (1) how eHealth is used for patients; (2) general practitioners' own experience with improving lifestyle and eHealth support; and (3) relevant coaching techniques for transformation into eHealth. CONCLUSIONS:GPs used eHealth frequently for themselves but only infrequently for their patients. GPs are familiar with behavioral change techniques and are ready to use them in eHealth if they are used to optimize processes and not hinder other treatments. Looking ahead, education of GPs and recognizing patients' ability and preference to use eHealth with regard to a healthy living are needed.
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Project description:Billions of users interact intensively every day via Online Social Networks (OSNs) such as Facebook, Twitter, or Google+. This makes OSNs an invaluable source of information, and channel of actuation, for sectors like advertising, marketing, or politics. To get the most of OSNs, analysts need to identify influential users that can be leveraged for promoting products, distributing messages, or improving the image of companies. In this report we propose a new unsupervised method, Massive Unsupervised Outlier Detection (MUOD), based on outliers detection, for providing support in the identification of influential users. MUOD is scalable, and can hence be used in large OSNs. Moreover, it labels the outliers as of shape, magnitude, or amplitude, depending of their features. This allows classifying the outlier users in multiple different classes, which are likely to include different types of influential users. Applying MUOD to a subset of roughly 400 million Google+ users, it has allowed identifying and discriminating automatically sets of outlier users, which present features associated to different definitions of influential users, like capacity to attract engagement, capacity to attract a large number of followers, or high infection capacity.
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Project description:Humans often evaluate their abilities by comparing their personal performance with that of others. For this process, it is critical whether the comparison turns out in one's favor or against it. Here, we investigate how social comparisons of performance are encoded and integrated on the neural level. We collected functional magnetic resonance images while subjects answered questions in a knowledge quiz that was related to their profession. After each question, subjects received a feedback about their personal performance, followed by a feedback about the performance of a reference group who had been quizzed beforehand. Based on the subjects' personal performance, we divided trials in downward and upward comparisons. We found that upward comparisons correlated with activity in the dorsolateral prefrontal cortex and the anterior insula. Downward comparisons were associated with increased activation in the ventral striatum (VS), the medial orbitofrontal cortex and the ventral anterior cingulate cortex (ACC). The extent to which subjects outperformed the reference group modulated the activity in the VS and in the dorsal ACC. We suggest that the co-activation of the VS and the dorsal ACC contributes to the integration of downward comparisons into the evaluation of personal performance.
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Project description:ObjectiveTo identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.DesignCross-sectional multicentric survey.SettingFourty-seven primary care private offices in Western Switzerland.ParticipantsRandom sample of 2030 patients ? 16, who encountered a general practitioner (GP) between September 2010 and February 2011.Main measuresPrimary outcomepatient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care.ResultsTo evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001).ConclusionsGPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status.
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Project description:ObjectiveTo examine the relationship between public health system network density and organizational centrality in public health systems and public health governance, community size, and health status in three public health domains.Data sources/study settingDuring the fall and the winter of 2007-2008, primary data were collected on the organization and composition of eight rural public health systems.Study designMultivariate analysis and network graphical tools are used in a case comparative design to examine public health system network density and organizational centrality in the domains of adolescent health, senior health, and preparedness. Differences associated with public health governance (centralized, decentralized), urbanization (micropolitan, noncore), health status, public health domain, and collaboration area are described.Data collection/extraction methodsSite visit interviews with key informants from local organizations and a web-based survey administered to local stakeholders.Principal findingsGovernance, urbanization, public health domain, and health status are associated with public health system network structures. The centrality of local health departments (LHDs) varies across public health domains and urbanization. Collaboration is greater in assessment, assurance, and advocacy than in seeking funding.ConclusionsIf public health system organization is causally related to improved health status, studying individual system components such as LHDs will prove insufficient for studying the impact of public health systems.
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Project description:An adequate understanding of the acculturation processes affecting immigrants and their descendants involves ascertaining the dynamic interplay between the way these individuals manage their multiple (and sometimes conflictual) cultural value systems and identifications and possible changes in their social networks. To fill this gap, the present research examines how key acculturation variables (e.g., strength of ethnic/host cultural identifications, bicultural identity integration or BII) relate to the composition and structure of bicultural individuals' personal social networks. In Study 1, we relied on a generationally and culturally diverse community sample of 123 Latinos residing in the US. Participants nominated eight individuals (i.e., alters) from their habitual social networks and across two relational domains: friendships and colleagues. Results indicated that the interconnection of same ethnicity alters across different relationship domains is linked to cultural identifications, while the amount of coethnic and host individuals in the network is not. In particular, higher interconnection between Latino friends and colleagues was linked to lower levels of U.S.Conversely, the interconnection of non-Latino friends and colleagues was associated with lower levels of Latino identification. This pattern of results suggests that the relational context for each type of cultural identification works in a subtractive and inverse manner. Further, time spent in the US was linked to both Latino and U.S. cultural identifications, but this relationship was moderated by the level of BII. Specifically, the association between time in the US and strength of both cultural identities was stronger for individuals reporting low levels of BII. Taking the findings from Study 1 as departure point, Study 2 used an agent-based model data simulation approach to explore the dynamic ways in which the content and the structure of an immigrant's social network might matter over time in predicting three possible identity patterns: coexisting cultural identifications, conflicting cultural identifications, and a mixture of the two. These simulations allowed us to detect network constellations, which lead to identification or disidentification with both cultures. We showed that distinct patterns of social relations do not lead to identity outcomes in a deterministic fashion, but that often many different outcomes are probable.
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