Clients’ outcomes from providers’ networks: the role of relational exclusivity and complementary capabilities

Organizations have leeway in how much they employ their network relations to the benefit of their clients. When do they do so more rather than less? Relying on research on trust and knowledge absorption, the authors suggest that providers’ network relations generate better outcomes for their clients when these relations are concentrated in a limited, exclusive set of partners. The authors argue that providers’ relational exclusivity benefits clients because it facilitates the awareness and use of partners’ complementary client service capabilities. An analysis of a regional network of patient referrals among 110 hospitals supported this argument. The study highlights the role of interorganizational partnership networks in activating client service capabilities and stimulates further inquiry into providers’ network features that benefit the users of their services

Determinants of knowledge-sharing networks in primary care

Background. Around the world, health reforms are increasingly fostering collaboration and integration among primary care physicians with the aim of facilitating knowledge sharing and evidence-informed decision making. Although extant research on this topic is abundant, the evidence and results regarding social and organizational factors affecting the formation of knowledge-sharing networks in this setting are inconclusive. Purposes. The aim of this article is to explore multiple theoretical mechanisms explaining the formation of knowledge-sharing networks among primary care physicians across relevant clinical areas. Methodology/Approach. The data are collected from two local health authorities (LHAs) in the Italian National Health Service that are responsible for delivering primary care in two Italian regions. Exponential random graph models are used to test the hypotheses. Findings. Our findings indicate that knowledge-sharing networks are highly correlated across clinical areas. In addition, knowledge-sharing networks are highly reciprocal and clustered. We also observe that formal models adopted to foster collaboration have remarkably different effects on the formation of knowledge networks, depending upon the diverse knowledge management approaches adopted in the surveyed LHAs. Practice Implications. Primary care organizations need to develop and implement knowledge management practices in order to help physicians in identifying knowledge domain experts as well as to support connections through formal groupings and incentives

From network ties to network structures: Exponential Random Graph Models of interorganizational relations

Theoretical accounts of network ties between organizations emphasize the interdependence of individual intentions, opportunities, and actions embedded in local configurations of network ties. These accounts are at odds with empirical models based on assumptions of independence between network ties. As a result, the relation between models for network ties and the observed network structure of interorganizational fields is problematic. Using original fieldwork and data that we have collected on collaborative network ties within a regional community of hospital organizations we estimate newly developed specifications of Exponential Random Graph Models (ERGM) that help to narrow the gap between theories and empirical models of interorganizational networks. After controlling for the main factors known to affect partner selection decisions, full models in which local dependencies between network ties are appropriately specified outperform restricted models in which such dependencies are left unspecified and only controlled for statistically. We use computational methods to show that networks based on empirical estimates produced by models accounting for local network dependencies reproduce with accuracy salient features of the global network structure that was actually observed. We show that models based on assumptions of independence between network ties do not. The results of the study suggest that mechanisms behind the formation of network ties between organizations are local, but their specification and identification depends on an accurate characterization of network structure. We discuss the implications of this view for current research on interorganizational networks, communities, and field

Network approaches and interventions in healthcare settings: a systematic scoping review

The growing interest in networks of interactions is sustained by the conviction that they can be leveraged to improve the quality and efficiency of healthcare delivery systems. Evidence in support of this conviction, however, is mostly based on descriptive studies. Systematic evaluation of the outcomes of network interventions in healthcare settings is still wanting. Despite the proliferation of studies based on Social Network Analysis (SNA) tools and techniques, we still know little about how intervention programs aimed at altering existing patterns of social interaction among healthcare providers affect the quality of service delivery. We update and extend prior reviews by providing a comprehensive assessment of available evidence. Methods and findings We searched eight databases to identify papers using SNA in healthcare settings published between 1st January 2010 and 1st May 2022. We followed Chambers et al.’s [1] approach, using a Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We distinguished between studies relying on SNA as part of an intervention program, and studies using SNA for descriptive purposes only. We further distinguished studies recommending a possible SNA-based intervention. We restricted our focus on SNA performed on networks among healthcare professionals (e.g., doctors, nurses, etc.) in any healthcare setting (e.g., hospitals, primary care, etc.). Our final review included 102 papers. The majority of the papers used SNA for descriptive purposes only. Only four studies adopted SNA as an intervention tool, and measured outcome variables. Conclusions We found little evidence for SNA-based intervention programs in healthcare settings. We discuss the reasons and challenges, and identify the main component elements of a network intervention plan. Future research should seek to evaluate the long-term role of SNA in changing practices, policies and behaviors, and provide evidence of how these changes affect patients and the quality of service delivery

Assimilation and differentiation: A multilevel perspective on organizational and network change

This paper builds on recently derived stochastic actor-oriented models (SAOMs) for the coevolution of one-mode and two-mode networks, and extends them to the analysis of how concurrent multilevel processes of (internal) organizational and (external) network change affect one another over time. New effects are presented that afford specification and identification of two apparently conflicting micro-relational mechanisms that jointly affect decisions to modify the portfolio of internal organizational activities. The first mechanism, assimilation, makes network partners more similar by facilitating the replication and diffusion of experience. The second mechanism, functional differentiation, operates to maintain and amplify differences between network partners by preventing or limiting internal organizational change. We illustrate the empirical value of the model in the context of data that we have collected on a regional community of hospital organizations connected by collaborative patient transfer relations observed over a period of seven years. We find that processes of social influence conveyed by network ties may lead both to similarity and differences among connected organizations. We discuss the implications of the results in the context of current research on interorganizational networks

Androgenetic alopecia: a review

Purpose Androgenetic alopecia, commonly known as male pattern baldness, is the most common type of progressive hair loss disorder in men. The aim of this paper is to review recent advances in understanding the pathophysiology and molecular mechanism of androgenetic alopecia. Methods Using the PubMed database, we conducted a systematic review of the literature, selecting studies pub- lished from 1916 to 2016. Results The occurrence and development of androgenetic alopecia depends on the interaction of endocrine factors and genetic predisposition. Androgenetic alopecia is character- ized by progressive hair follicular miniaturization, caused by the actions of androgens on the epithelial cells of genetically susceptible hair follicles in androgen-dependent areas. Although the exact pathogenesis of androgenetic alopecia remains to be clari fi ed, research has shown that it is a polygenetic condition. Numerous studies have unequi- vocally identi fi ed two major genetic risk loci for androge- netic alopecia, on the X-chromosome AR ⁄ EDA2R locus and the chromosome 20p11 locus. Conclusions Candidate gene and genome-wide association studies have reported that single-nucleotide polymorphisms at different genomic loci are associated with androgenetic alopecia development. A number of genes determine the predisposition for androgenetic alopecia in a polygenic fashion. However, further studies are needed before the specific genetic factors of this polygenic condition can be fully explaine

“You see yourself like in a mirror”: the effects of internet-mediated personal networks on body image and eating disorders

Body image issues associated with eating disorders consist of attitudinal and perceptual components: individuals’ dissatisfaction with body shape or weight, and inability to correctly assess body size. While prior research has mainly explored social pressure from media, fashion, and advertising, we aim to uncover how personal networks, also encompassing internet-mediated interactions, bear upon body image. We estimate these effects with data from a survey of users of websites on eating disorders, including indicators of their body size and body image, and maps of their networks of connections. A bivariate ordered probit accounts for the joint distribution of attitudinal and perceptual body image dimensions depending on network characteristics. Results, confirmed by in-depth interviews, provide evidence that personal networks affect body image concerns, and show that this influence varies significantly by body size. Personal networks, as may be formed also (but not only) online, can be conducive to positive body image development

Investigating the temporal dynamics of inter-organizational exchange: patient transfers among Italian hospitals

Previous research on interaction behavior among organizations (resource exchange, collaboration, communication) has typically aggregated records of those behaviors over time to constitute a ‘network’ of organizational relationships. We instead directly study structural-temporal patterns in organizational exchange, focusing on the dynamics of reciprocation. Applying this lens to a community of Italian hospitals during the period 2003-2007, we observe two mechanisms of interorganizational reciprocation: organizational embedding and resource dependence. We flesh out these two mechanisms by showing how they operate in distinct time frames: Dependence operates on contemporaneous exchange structures, whereas embedding develops through longer-term historical patterns. We also show how these processes operate differently in competitive and noncompetitive contexts, operationalized in terms of market differentiation and geographic space. In noncompetitive contexts, we observe both logics of reciprocation, dependence in the short term and embedding over the long term, developing into patterns of generalized exchange in this population. In competitive contexts, we observe neither form of reciprocation and instead observe the microfoundations of status hierarchies in exchange

Lost in translation: collecting and coding data on social relations from audio-visual recordings

Some of the constitutive features of social relations are lost when information naturally produced by sequential social interaction is translated into network ties. Building on core concepts and ideas developed within conversation analysis, in this paper we argue that this happens because the sequential, multimodal and embodied character of social relations can be fully understood only with reference to the sequential constrains that are generated by – and at the same time shape the micro-dynamics of social interaction. We suggest that the translation of social interaction into social networks precludes analysis of the multiple interfaces that sustain social relations (multimodality), and the material resources around which social relations are organized (embodiment). We highlight audio-visual recording as a data collection technology that facilitates storage, retrieval, and analysis of complex information on social relations that is typically absent from social network data. An illustrative video supported case study based on the observation of social and task-related interaction among members of surgical teams provides the empirical context that supports and motivates our general reflection on network data collection strategies and technologies to study social interaction. The analysis highlights the need for social networks research to return to the study of social relations

Presenting a System of Human-Machine Interaction for Performing Map Tasks

A system for human machine interaction is presented, that offers second language learners of Italian the possibility of assessing their competence by performing a map task, namely by guiding the a virtual follower through a map with written instructions in natural language. The underlying natural language processing algorithm is described, and the map authoring infrastructure is presented