Core Group Members Research Articles

The role of core protest group members in sustaining protest against controversial construction and engineering projects

Community-based protests against major construction and engineering projects are becoming increasingly common as concerns over issues such as corporate social accountability, climate change and corruption become more prominent in the public's mind. Public perceptions of risk associated with these projects can have a contagious effect, which mismanaged can escalate into long-term and sometimes acrimonious protest stand-offs that have negative implications for the community, firms involved and the construction industry as a whole. This paper investigates the role of core group members in sustaining community-based protest against construction and engineering projects. Using a thematic story telling approach which draws on ethnographic method and social contagion theories, it presents an in-depth analysis of a single case study – one of Australia's longest standing community protests against a construction project. It concludes that core group members play a critical role, within anarchic structures which provide a high degree of spontaneity and improvisation, in sustaining movement continuity by building collective identity, mobilising resources and a moving interface which developers find hard to communicate with.

Reversing the roles

Groupwork in a criminal justice setting has traditionally taken the form of a group of offenders undertaking a programme of structured work facilitated by (usually two) professionals. Circles of Support and Accountability (COSA) represent a departure from this traditional model. The COSA model uses a group of volunteers to form a ‘Circle’ around an offender who is viewed as being very much part of the group. The approach is currently being used in the UK as part of the risk management process for convicted sex offenders who are experiencing social isolation, a factor that has been linked to the risk of re-offending. The goal of our research was to understand the COSA group process and this article presents a study of a relatively new and different approach to groupwork within criminal justice. We looked at the expectations and opinions of both core group members and volunteers to make some assessment of how this non- traditional form of groupwork operates. The research presented an almost entirely positive picture of COSA from the perspective of both the volunteers and the core group members. All Core members (and we acknowledge that the research focus is a small group of male offenders) felt that the group experience offered them support and a sense of belonging that had previously been missing in their lives.

Reproductive correlates of social network variation in plurally breeding degus (Octodon degus)

Studying the causes and reproductive consequences of social variation can provide insight into the evolutionary basis of sociality. Individuals are expected to behave adaptively to maximize reproductive success, but reproductive outcomes can also depend on group structure. Degus (Octodon degus) are plurally breeding rodents, in which females allonurse indiscriminately. However, communal rearing does not appear to enhance female reproductive success, and larger group sizes are correlated with decreasing per capita pup production. To further investigate mechanisms underlying these patterns, we asked how differences in sex, season and average group reproductive success are related to degu association networks. We hypothesized that if reproductive differences mirror social relationships, then females (core group members) should show stronger and more stable associations than males, and female association strength should be strongest during lactation. We also hypothesized that, at the group level, social cohesion would increase reproductive output, while social conflict would decrease it. Females did have higher association strength and more preferred partners than males, but only during lactation, when overall female associations increased. Females also had more stable preferred social partnerships between seasons. A measure of social cohesion (average association strength) was not related to per capita pup production of female group members, but potential social conflict (heterogeneity of association strengths) was negatively related to per capita pup production of female group members. Our results highlight temporal and multilevel patterns of social structure that may reflect reproductive costs and benefits to females.

The development and interaction of terrorist and fanatic groups

Through the mathematical study of two models we quantify some of the theories of co-development and co-existence of focused groups in the social sciences. This work attempts to develop the mathematical framework behind the social sciences of community formation. By using well developed theories and concepts from ecology and epidemiology we hope to extend the theoretical framework of organizing and self-organizing social groups and communities, including terrorist groups. The main goal of our work is to gain insight into the role of recruitment and retention in the formation and survival of social organizations. Understanding the underlining mechanisms of the spread of ideologies under competition is a fundamental component of this work. Here contacts between core and non-core individuals extend beyond its physical meaning to include indirect interaction and spread of ideas through phone conversations, emails, media sources and other similar mean. This work focuses on the dynamics of formation of interest groups, either ideological, economical or ecological and thus we explore the questions such as, how do interest groups initiate and co-develop by interacting within a common environment and how do they sustain themselves? Our results show that building and maintaining the core group is essential for the existence and survival of an extreme ideology. Our research also indicates that in the absence of competitive ability (i.e., ability to take from the other core group or share prospective members) the social organization or group that is more committed to its group ideology and manages to strike the right balance between investment in recruitment and retention will prevail. Thus under no cross interaction between two social groups a single trade-off (of these efforts) can support only a single organization. The more efforts that an organization implements to recruit and retain its members the more effective it will be in transmitting the ideology to other vulnerable individuals and thus converting them to believers.

Reversing the roles

Groupwork in a criminal justice setting has traditionally taken the form of a group of offenders undertaking a programme of structured work facilitated by (usually two) professionals. Circles of Support and Accountability (COSA) represent a departure from this traditional model. The COSA model uses a group of volunteers to form a 'Circle' around an offender who is viewed as being very much part of the group. The approach is currently being used in the UK as part of the risk management process for convicted sex offenders who are experiencing social isolation, a factor that has been linked to the risk of re-offending. The goal of our research was to understand the COSA group process and this article presents a study of a relatively new and different approach to groupwork within criminal justice. We looked at the expectations and opinions of both core group members and volunteers to make some assessment of how this non- traditional form of groupwork operates. The research presented an almost entirely positive picture of COSA from the perspective of both the volunteers and the core group members. All Core members (and we acknowledge that the research focus is a small group of male offenders) felt that the group experience offered them support and a sense of belonging that had previously been missing in their lives.

PCR-RFLP에 의한 Vibrio core group을 포함한 Vibrio 종의 구분

Vibrio속의 core 균주(Vibrio alginolyticus, Vibrio parahaemolyticus)를 포함하여 총 6 종의 Vibrio 균주(V. fluvialis, V. proteolyticus, V. vulnificus, V. mimicus)와 Grimontia (Vibrio) hollisae의 16S rDNA를 PCR 증폭하여 Alu I, Cfo I, Dde I, Hae III, Msp I, Rsa I의 6 종의 제한효소를 처리 후 RFLP 분석을 수행하였다. 2 종의 core 균주와 V. proteolyticus는 4 종의 제한효소(Cfo I, Dde I, Msp I, Rsa I)에서 동일한 제한효소 패턴을 나타내었다. 제한효소의 패턴의 조합에 의해 6 종의 Vibrio 종은 6 개의 RFLP type으로 구분되었다. 특히 Alu I의 경우, 실험된 6 종의 Vibrio속에 대하여 각기 다른 6 개의 종 특이적 RFLP type을 나타내었다. 제한효소 패턴에 근거하여 작성한 덴드로그램에서 Vibrio core group 균주인 V. alginolyticus 와 V. parahaemolyticus는 90% 이상의 매우 높은 유사도를 나타내었다. 반면 Grimontia hollisae는 실험된 모든 제한효소 패턴에서 Vibrio속 세균과는 분명히 구분되는 RFLP type을 나타내었다. 따라서 PCR-RFLP는 제한효소를 적절히 선택한다면 Vibrio 속 세균의 신속한 구분에 여전히 유용하다. The 16S rDNA - RFLP types for six Vibrio species (V. fluvialis, V. proteolyticus, V. vulnificus, V. mimicus) including two core group members, V. alginolyticus and V. parahaemolyticu s, and Grimontia (Vibrio) hollisae were determined using PCR-RFLP analysis. Six tetrameric restriction enzymes (Alu I, Cfo I, Dde I, Hae III, Msp I, and Rsa I) were selected for RFLP analysis. V. alginolyticus, V. parahaemolyticus, and V. proteolyticus showed the same RFLP pattern following digestion with four of the six used restriction enzymes: CfoI, DdeI, MspI, and RsaI. Various restriction enzyme combinations generated digests recognizable as distinct RFLP types for each of the assayed Vibrio species. In particular, AluI single digestion produced species specific band patterns that enabled the differentiation between these Vibrio species. Dendrogram based on restriction patterns showed that two Vibrio core group members, V. alginolyticus and V. parahaemolyticus were closely related having a similarity over 90%. Although the observed RFLP pattern for Grimontia hollisae shared several common bands with other Vibrio spp., G. hollisae results were still clearly distinct from Vibrio spp. RFLP types for all restriction enzymes tested. If restriction enzymes are aptly selected, PCR-RFLP analysis is still a rapid and effective tool for differentiating Vibrio species.

Characterizing the Structure of Operating Room Staffing Using Social Network Analysis

: Very little research has been focused on the interdisciplinary staffing characteristics of the operating room team, an essential component of providing safe patient care in a high-risk setting. : The aim of this study was to determine how the operating room staffing of two surgical specialties compares in terms of social network variables. : Staffing data from all general and neurosurgical procedures performed at a large Midwestern hospital were analyzed using Social Network Analysis methods. Network variables include centrality, team coreness, and the core/periphery network structure. Multidimensional scaling, correlation, and descriptive statistics were used for the analysis. : The core/periphery network structure was characteristic of both surgical services. Team coreness, a measure of how often the team worked together, was associated with the length of the case (p < .001). Procedure start time predicts the team coreness measure, with cases starting later in the day less likely to be staffed with a high core team (p < .001). Registered nurses constitute the majority of core interdisciplinary team members in both groups. : Analysis of the core/periphery structure of specialty team staffing networks indicates that many procedures are staffed with individuals who are associated peripherally with the specialty. Registered nurses as core group members are in a position to take a leadership role in the communication of norms and process variations to noncore members. The effect of having late starting cases staffed with a lower core team should be studied further because it pertains to patient outcomes. Future work should strive to account for the complex and dynamic nature of team development.

Abstracts of NEMASYM: The Third Nematode-Bacteria Symbioses Research Coordination Network Meeting

Intimate associations between microbes and eukaryotes are widespread in nature, occurring in every type of ecological niche. The spectrum of such interactions ranges from highly integrated obligatory symbioses to ‘loose’ associations. Microbial symbioses are integral to the function of every ecosystem on Earth. Therefore to gain insights into fundamental processes underlying symbiosis and the role of symbiosis in earth/human ecosystems, researchers in this project have focused on one of the most common eukaryote-prokaryote interactions: that between nematodes and bacteria. Associations between nematodes and bacteria range from fortuitous to obligate and from beneficial to pathogenic. The ubiquity and diversity of nematode-bacterium symbioses make them an excellent model to understand the key questions in symbiosis. However, while numerous researchers worldwide are currently studying associations between these two groups of organisms, these scientists rarely interact because their field of research is often defined by the organism studied rather than by the process (in this case, symbiosis). To reddress this critical need for crossing disciplinary lines, a Research Coordination Network on ‘Nematode-Bacteria Symbioses’ (NEMASYM) was established in 2008 to promote the intellectual discourse among scientists studying bacteria-nematode associations. This network is funded by the National Science Foundation and its specific goals of are: 1) Foster interdisciplinary collaborations between scientists; 2) Encourage scientists engaged in basic and applied research to explore how cross-talk and networking can enhance and advance science in this field; and 3) Develop and distribute educational materials to scientists and educators to promote the study of nematode-bacteria symbioses as model systems in science and education. There is no other group in the United States or elsewhere that is similar to this research work group in its broad scope of nematode-bacteria interactions. A focal point of the network is the organization of annual meetings for core group members and their post-doctoral associates and graduate students. The inaugural NEMASYM meeting was held in Madison, Wisconsin on August 9-16, 2009 in conjunction with the 6th International Symbiosis Society meeting. The theme focus of that meeting was ‘‘Contributions of bacteria to nematode development, nutrition, and behavior’’. A total of 45 participants representing nine countries from five continents attended this event. There were 42 oral and 25 poster presentations. The second NEMASYM meeting took place in Tucson, Arizona on November 11-14, 2010. The theme of this meeting was ‘‘Contributions of bacterial symbionts to nematode pathogenesis’’. There were 46 participants representing eight countries from four continents. Keynote speakers were: 1) John ( Jack) Werren from University of Rochester, New York, who talked about the evolutionary consequences of Wolbachia symbionts in insects; 2) Raffi Aroian from University of California, San Diego who discussed the use of bacteria to cure human nematode diseases; and 3) David Clarke From University Cork College, Ireland, who presented results of his research program on the regulation of pathogenicity and mutualism in Photorhabdus symbionts. In addition to these keynote presentations there were 30 oral presentations that are herein presented.

Exploring the influence of service user involvement on health and social care services for cancer

Service user involvement in health and social care is a key policy driver in the UK. In cancer care it is central to developing services which are effective, responsive and accessible to patients. Cancer network partnership groups are set up to enable joint working between service users and health care professionals and to drive service improvements. The aim of this study was to explore the influence of the cancer network partnership groups' service user involvement activities on cancer care. This was a qualitative study involving documentary analysis and in-depth case studies of a sample of partnership groups. Five partnership groups were purposively selected as case studies from Macmillan regions across the UK; documents were collated from a further five groups. Forty people, including core group members and key stakeholders in cancer services, were interviewed. The evidence from this study suggests that cancer network partnership groups are at their most influential at 'grass roots' level - contributing to patient information resources, enhancing access to services, and improving care environments. While such improvements are undoubtedly important to patients, the groups' aim is to influence strategic changes, for example in cancer care commissioning or macro-level policy decision-making. The evolution of open, participatory relationships between service users and professionals, and recognition of the value of experiential knowledge are seen as key factors in influencing cancer care. The provision of dedicated resources to strengthen service user involvement activities is also vital.

Geospatial Methods for Identification of Core Groups for HIV/AIDS

Objectives: Disease transmission dynamics among members of a sexual network's core group make the group an ideal target for prevention for positives. Identifying the geographic territory of an HIV/AIDS core group is complicated by the numerous factors that may spatially structure cases including alcohol availability. We employ spatial analytic methods in an attempt to identify the geographic distribution of the core HIV/AIDS group. Methods: Five year HIV/AIDS detection rates were analyzed for each HIV/AIDS risk category (i.e., MSM, IDU, HRH) at the census tract level (n = 164) in New Orleans using spatial analytic techniques in multivariate models. Results: MSM was the most common risk category for newly detected HIV cases. Both MSM and IDU cases appeared to decline or enter an endemic phase. Each risk category exhibited unique spatial structure. Among IDUs and HRHs nearly all the spatial structure was explained in terms of the independent variables. However, among MSMs residual spatial structure remained after controlling for independent variables. Conclusions: Residual spatial structure in the MSM HIV/AIDS detection rates after controlling for social structure could be explained by the presence of core group members. The study's limitations are noted.

HIV and African Americans in the southern United States: sexual networks and social context.

Heterosexual HIV transmission among African Americans in the rural southern United States has climbed in recent years. Concurrent partnerships and bridge populations have emerged as key elements in the spread of sexually transmitted infections (STIs). The goal of this study was to examine published empiric data and other literature concerning the extent of these network patterns and their relationship to the socioeconomic context among African Americans in the rural South. The authors conducted a review of public health, medical, and social sciences literature. In areas of the rural South with high STI rates, there is extensive concurrency with evidence of dense sexual networks and bridging among the general population, core group members, and other high-risk subpopulations. Qualitative research reveals socioeconomic factors that support these network patterns: low ratio of men to women, economic oppression, racial discrimination, and high incarceration rates of black men. Concurrency and bridging likely contribute to increased heterosexual HIV transmission among blacks in the South; contextual factors promote these network patterns in this population.

Using Gay Men’s Sexual Networks to Reduce Sexually Transmitted Disease (STD)/Human Immunodeficiency Virus (HIV) Transmission

An individual's risk of acquiring or transmitting a sexually transmitted disease or HIV is affected both by individual risk factors and by one's location within a sexual network. Therefore, prevention efforts must consider intervening with both individuals and with network conformations. Helping gay and bisexual men make more informed choices about their partners and fragmenting networks to reduce the likelihood of risky encounters between high-risk core group members and those at lower risk are two strategies for reducing transmission in this population. Network-level interventions are particularly well suited for places such as commercial sex venues and Internet sites where gay and bisexual men meet new sexual partners.

Institutional Transition and Cultural Inheritance

Business groups are a prominent enterprise system in most East Asian and emerging economies. This article addresses an important but understudied issue – ownership and control of these large conglomerates. Studying the ownership structure of the top 100 Taiwanese business groups sheds light on the debate between the culturalists and the institutionalists. Culturalists claim family domination even in institutional changes while institutionalists suggest more dispersed and open shareholding after economic liberalization. The longitudinal analysis of group ownership across three time periods reveals a mixed structure. Although the family still controls most of the old, core groupmembers, new firms and joint ventures that are owned by multiple family groups rose significantly during the institutional transition of 1987–93. The evidence shows that organizational changes neither completely comply with emerging rules, nor do they hold on to existing cultural logics. Neither the culturalists nor the institutionalists have correctly predicted the metamorphosis. Rather, the concept of compromise strategy, which allows organizations to retain their core interests while at the same time respond to institutional constraints and/or incentives, provides a proper explanation.

Call for Proposals: The Seventh International Buddhist Christian Conference, "Hear the Cries of the World"

The Society for Buddhist Christian Studies will hold the Seventh International Buddhist-Christian Conference at the Loyola Marymount University campus, Los Angeles, California, 3–8 June 2005. (This conference was earlier posted to take place in August 2004, but was postponed for various reasons.) The overall theme will remain as previously announced: “Hear the Cries of the World: Buddhism and Christianity in Dialogue Toward Global Healing.” The program committee welcomes proposals for working groups, scheduled to meet in three successive morning sessions for two hours each, addressing a specific theme or issue, with one or two coordinators and five or more core-group members; full panels, to be presented in one two-hour session, on a specific theme, with a moderator, three to four speakers, and one or two respondents; and individual papers on a specific topic related to an issue or issues in Buddhist-Christian dialogue. Proposals for working groups on themes such as religion and ecology, human rights and social justice, women and religion, toward a global ethic, practice across traditions, Catholic-Buddhist relations, religious responses to violence, religion and globalization, and other relevant themes, are welcomed. Working group proposals should include the title or theme of the working group, a short 200–300 word description of the goal(s) of the working group, and the names and contact information (including address, phone, fax, and e-mail) of the coordinator(s) and at least five other core-group members. Proposals for full panels for a two-hour time slot, addressing specific themes, including issues in doctrine and theory, ritual, religious practice, methodology, and others, are encouraged. Full panel proposals should include the title of the panel, a short 100–200 word description of the theme and intent of the panel, and the names and contact information of the moderator and three or four panel participants. Individual paper proposals for a 30-minute presentation on various themes, including doctrinal, ritual, practical, ethical, and other issues relevant to BuddhistChristian dialogue are also encouraged.

Taking “Bold Voices” Home—and to Heart

“ I will identify the most pressing challenge in my immediate work environment ... initiate dialogue with my colleagues to find solutions to this challenge ... (and) remain actively involved in the solutions until they are working.” This pledge is from the commitment card that past AACN President Connie Barden, RN, MSN, CCNS, CCRN, encouraged attendees to sign at the 2003 National Teaching Institute (NTI), sponsored by the American Association of Critical-Care Nurses. Participants who signed the card received a pin denoting their commitment to the “Bold Voice” theme that Barden initiated.Excited about accepting the challenge, members of our pediatric intensive care unit (PICU) who attended the conference agreed that our colleagues “back home” should be made aware of it. If everyone in the unit made the commitment, our voice would be even bolder and more powerful.Our first step was to present the Bold Voice commitment to our multidisciplinary unit-based Practice Council, which unanimously endorsed and embraced the idea. To lay the groundwork for the initiative, we distributed copies of Barden’s opening session address at the NTI in which she issued the challenge and prominently displayed information, as well as the commitment cards, on a poster in the unit. The entire multidisciplinary team was challenged to commit to Bold Voices.In addition to those of us who signed the cards at the NTI, more than 40 of our multidisciplinary staff members also signed them. Now, nurses, doctors, child-life therapists, pharmacists, and a myriad of other team members proudly display the “Act Boldly” commitment pin.However, the Bold Voices effort did not stop there! A core group of team members also wanted to change the unit culture to be more nurturing and supportive, a place where professional growth and development would be encouraged.Because of the nursing shortage, nursing must depend on new or less experienced nurses for staffing. Our unit wanted to provide an atmosphere that transitioned the newer staff in a safe, nurturing way. We wanted to ensure that nursing’s reputation for “eating their young” didn’t carry over into our unit and that new nurses wouldn’t be allowed to simply “sink or swim.” We wanted our new colleagues to be recognized immediately as a part of the team.At a daylong retreat, the group brainstormed ways to ensure that new staff members would be welcomed as equal team members. As a result, the slogan “Bold Voices Build Strong Teams” was adopted, and a bulletin board titled Team PICU was developed. So that new employees can recognize their colleagues, photographs of various team members are posted on this board. A caption below each photograph lists each person’s areas of expertise, which helps new staff know who to seek out for information.In addition, terms such as “newbies” and “junior” are deemed unacceptable. The group also decided to utilize the words Bold Voices as a call for help when staff members are being disrespected in any way. When Bold Voices is called out, available team members come to the rescue by standing by the person to provide support and assist in diffusing the situation. It doesn’t take long for those who are disrespectful to understand that this type of behavior will not be tolerated.The core group remains active, involved, and committed to Bold Voices. At the end of our retreat day, a statement was penned and signed by the core group members. It read: “I commit to being a team player and mentor in the PICU. I commit to being a positive role model in giving and receiving feedback. I acknowledge that this may involve changes in my own behavior. Bold Voices do make strong teams. I commit to using my bold voice to build the PICU team.”We realize that more is needed than simply signing a commitment card, wearing a pin, and saying a pledge. For our team, lip service to Bold Voices just won’t do.“In Our Unit” highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming “In Our Unit,” send it to Critical Care Nurse, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn@aacn.org.

Chlamydia trachomatis omp1 genotypic diversity and concordance with sexual network data.

Sexual and social network analysis have been proposed as novel sexually transmitted disease control and research tools. Here, the concordance between chlamydia genotype data and a large sexual network constructed from routinely collected contact tracing data was examined. A sexual network was constructed for Manitoba, Canada, from province-wide contact tracing data. Positive chlamydia specimens from the same time period were collected and genotyped by omp1 DNA sequencing. A high degree of concordance was found between transmission events, on the basis of molecular data, and proposed transmission events, on the basis of sexual network data. Discordant results appeared to occur when a portion of the network contained potential core group members or in areas where contact tracing is difficult to carry out. The agreement between the molecular and epidemiologic data suggests that the use of routine contact tracing data is a valid approach for the construction of sexual networks.

Evaluating the use of developmental action inquiry in constructing a problem-based learning curriculum for pre-registration nursing education in Hong Kong: a student perspective.

Developmental action inquiry (DAI) was chosen as the change strategy for introducing problem-based learning (PBL) in a pre-registration nursing programme. The central task was to transform the tutor and student participants to become collaborators in this curriculum reconstruction project. This paper expounds the way in which the action inquiry was constructed and in light of students' feedback analysis, the way in which PBL has made a difference in student learning was evaluated. Taking into consideration the change context and different group characteristics, the DAI was conducted in terms of two dynamically interlinked circles that formed partnerships between PBL core group members and tutors, and between tutors and students in coconstructing knowledge useful for PBL curriculum development. The findings of the student evaluation questionnaire reveal that the majority of students felt PBL made a difference to their expectations of self, the student group and the teacher role in creating a facilitative environment to enhance learning. However, there was a significant difference among individual student group responses. The students' positive and negative PBL experience in self-learning, tutor-student interaction, and group-learning were identified as crucial factors contributing to these group variations. The evaluation findings show that a paradigm shift from teacher-centred to student-centred learning, from valuing self-learning to co-operative group-learning, and from theory-based to practice-based learning occurred among the students. DAI was found to be an effective change strategy for transforming participants to become collaborators in searching for useful knowledge and coconstructing the PBL learning context.

Assessment of a geographically targeted field intervention on gonorrhea incidence in two New York State counties.

Using study findings that demonstrated the importance of core group members in gonorrhea transmission, in 1984, one New York State county changed its approach toward gonorrhea control by targeting its field intervention activities toward infected persons from a geographic core area. In late 1988, New York State experienced an epidemic increase in the number of syphilis cases. In response, the New York State sexually transmitted disease (STD) control program enacted a Syphilis Initiative, which required the diversion of field staff from gonorrhea to syphilis control activities for a 3-year period. Each of these events held the possibility of impacting gonorrhea incidence in this county. To evaluate the impact of core interventions on reducing gonorrhea incidence as compared to traditional nontargeted field intervention methods and to determine the influence on gonorrhea incidence of diverting field activities from gonorrhea to syphilis case finding. A Poisson regression method was used to estimate gonorrhea incidence for a 22-year period in two similar counties: one county that used core intervention and one that applied traditional case-finding methods. The impact of core intervention was estimated in terms of the reduction in the gonorrhea incidence rate from the preintervention incidence rates. After initiation of the core intervention, the relative risk of gonorrhea decreased by 61%. Between 30 % to 40% of the total reported cases were interviewed for contacts annually during the intervention period. In the control county, the relative risk was reduced by 50% despite a significantly higher percentage of annual case interviews (60%-70%). In addition, a small change in the definition of core (from census tracts encompassing 50% of gonorrhea cases to 30%-35%) during the Syphilis Initiative led to a significant increase (16%) in the relative risk of gonorrhea. Targeting partner notification activities toward a geographic core area population appears effective in reducing the risk of gonorrhea, and it was more efficient because the overall percentage of cases interviewed was smaller than in a county using a nontargeted approach. Diversion of staff during a syphilis epidemic, combined with a narrowing of the geographic scope of the core intervention, was associated with an increase in gonorrhea incidence.

Implementing an Informatics System in a Perioperative Environment

This article identifies and describes strategies for successful implementation of an informatics system in a perioperative environment. With the trend toward managed care, perioperative nurses must address the challenge of instituting advanced technology in organizations with limited staffing and other resources. Planning methods of the past no longer are relevant in today's health care systems; therefore, innovative planning approaches are important. Five key elements in implementation of an informatics system are: a collaborative planning process, education and involvement of staff members regarding the systems design, development of a timetable, selection of a focus group, and assessment of staff members' training requirements. Methods are described for using a focus group process, including recommendations for structuring the focus group and establishing responsibilities of core group members.

A core group model for disease transmission

Models for sexually transmitted diseases generally assume that the size of the core group is fixed. Publicly available information on disease prevalence may influence the recruitment of new susceptibles into highly sexually active populations. It is assumed that the recruitment rate into the core population is low while disease prevalence is high, core group members mix only with each other, disease levels outside the core are negligible, and some core group members reduce their risk through the use of a partially effective vaccine or prophylactics. A demographic-epidemic model is formulated in which the combined size of the core and non-core population is constant. A simpler version models the epidemic in an isolated core population of constant size under the influence of educational programs and measures that reduce susceptibility. The threshold condition for an endemic infection is determined. Backward bifurcations, multiple infective stationary states, and hysteresis phenomena can be observed even in the simplified version. Abrupt changes in disease prevalence levels may result from small changes in the disease management parameters and do not occur in the absence of such a program. The general conclusion is that partially effective vaccination or education programs may increase the total number of cases while decreasing the relative frequency of cases in the core group. The study throws some new light on the role of the reproduction number in connection with elimination attempts. It shows that although the reproduction number defines the threshold for the spread of the disease in a susceptible population, it is of limited value when elimination of an existing epidemic is planned.