Measuring horizontal integration among health care providers in the community: An examination of a collaborative process within a palliative care network

In many countries formal or informal palliative care networks (PCNs) have evolved to better integrate community-based services for individuals with a life-limiting illness. We conducted a cross-sectional survey using a customized tool to determine the perceptions of the processes of palliative care delivery reflective of horizontal integration from the perspective of nurses, physicians and allied health professionals working in a PCN, as well as to assess the utility of this tool. The process elements examined were part of a conceptual framework for evaluating integration of a system of care and centred on interprofessional collaboration. We used the Index of Interdisciplinary Collaboration (IIC) as a basis of measurement. The 86 respondents (85% response rate) placed high value on working collaboratively and most reported being part of an interprofessional team. The survey tool showed utility in identifying strengths and gaps in integration across the network and in detecting variability in some factors according to respondent agency affiliation and profession. Specifically, support for interprofessional communication and evaluative activities were viewed as insufficient. Impediments to these aspects of horizontal integration may be reflective of workload constraints, differences in agency operations or an absence of key structural features.

An examination of regional policy implications pertaining to SME E-Business adoption in South-East Wales

Regional policy frameworks need to focus on strengthening the ICT infrastructure, clarifying market rules to build user confidence, developing networks, facilitating ICT-enabled clustering and infrastructure sharing.

Analytical examination of animal remains from Borneo:the painting of bone and shell

Examination of a selection of shell and bone from archaeological assemblages excavated at Niah Cave and Gua Sireh, both of which are located in Sarawak, Borneo, has revealed the deliberate application of coloured material to one or more surfaces. Small fragments of the surface colourant were analysed using a variety of techniques, including microscopy, energy dispersive microwave analysis and infra-red spectrophotometry. These procedures established that, although red in colour, the applied coating in each instance was not red iron oxide. It is suggested that, based on the chemical components present, this coating was a tree resin or a similar organic substance. The paper further reports the presence of enhanced chloride values in the colourant recovered from the ancient human cranial fragment tested. It is suggested that elevated concentrations of this trace element may indicate that the site, the human remains or ingredients within the colourant were once in close proximity to the sea. (C) 2010 Elsevier Ltd. All rights reserved.

Does Basel Compliance Matter for Bank Performance ?

The global financial crisis underscored the importance of regulation and supervision to a well functioning banking system that efficiently channels financial resources into investment. In this paper, we contribute to the ongoing policy debate by assessing whether compliance with international regulatory standards and protocols enhances bank operating efficiency. We focus specifically on the adoption of international capital standards and the Basel Core Principles for Effective Bank Supervision (BCP). The relationship between bank efficiency and regulatory compliance is investigated using the (Simar and Wilson 2007) double bootstrapping approach on an international sample of publicly listed banks. Our results indicate that overall BCP compliance, or indeed compliance with any of its individual chapters, has no association with bank efficiency.

Bank Failures of the 1990s::An Exploratory Analysis

Past research has frequently attributed the incidence of bank failures to macroeconomic cycles and/or downturns in the regional economy. More recent analyses have suggested that the incidence and severity of bank failures can be linked to governance failures, which may be preventable through more stringent disclosure and auditing requirements. Using data on bank failures during the years 1991 to 1997, for the US, Canada, the UK and Germany, this study examines the relationship between institutional characteristics of national legal and auditing systems and the incidence of bank failures. In the second part of our analysis we then examined the relationship between the same institutional variables and the severity of bank failures.
The first part of our study notes a significant correlation between the law and order tradition (‘rule of law’) of a national legal system and the incidence of bank failures. Nations which were assigned high 'rule of law’ scores by country risk guides appear to have been less likely to experience bank failures. Another variable which appears to impact on bank failure rates is the ‘risk of contract repudiation’. Countries with a greater ‘risk of contract repudiation’ appear to be more likely to experience bank failures. We suggest that this may be due to a greater ex ante protection of stakeholders in countries where contract enforcement is more stringent.
The results of the second part of our study are less clear cut. However, there appears to be a significant correlation between the amount paid out by national deposit insurers (our proxy for the severity of bank failures) and the macroeconomic variable 'GDP change'. Here our findings follow the conventional wisdom; with greater amounts of deposit insurance funds being paid during economic downturns (i.e. low or negative GDP 'growth' correlates with high amounts of deposit insurance being paid out). A less pronounced relationship with the severity of bank failures can also be established for the institutional variables ' accounting standards' as well as 'risk of contract repudiation'. Countries with more stringent ‘accounting standards’ and a low ‘risk of contract repudiation’ appear to have been less prone to severe bank failures.

Earthquake aftershock anxiety: An examination of psychosocial contributing factors and symptomatic outcomes.

This study examined the direct and indirect effects of cognitions and anxiety associated with aftershocks on psychological symptoms (anxiety, depression, acute stress) and daily functioning (general and relationship). Participants were 600 adults from Christchurch. Data collection was approximately four months after the fatal 2011 earthquake. Path analysis was used. Socioeconomic status was directly associated with appraisals of uncontrollability of response to aftershocks. These cognitions were directly related to aftershock anxiety, which heightened general anxiety, depression and acute stress symptoms. These symptoms were directly associated with relationship and general life dysfunction. Aftershock anxiety plays a significant role in ongoing psychological distress associated with earthquakes.

A constructive approach for examination timetabling based on adaptive decomposition and ordering

In this study, we investigate an adaptive decomposition and ordering strategy that automatically divides examinations into difficult and easy sets for constructing an examination timetable. The examinations in the difficult set are considered to be hard to place and hence are listed before the ones in the easy set in the construction process. Moreover, the examinations within each set are ordered using different strategies based on graph colouring heuristics. Initially, the examinations are placed into the easy set. During the construction process, examinations that cannot be scheduled are identified as the ones causing infeasibility and are moved forward in the difficult set to ensure earlier assignment in subsequent attempts. On the other hand, the examinations that can be scheduled remain in the easy set.

Within the easy set, a new subset called the boundary set is introduced to accommodate shuffling strategies to change the given ordering of examinations. The proposed approach, which incorporates different ordering and shuffling strategies, is explored on the Carter benchmark problems. The empirical results show that the performance of our algorithm is broadly comparable to existing constructive approaches.

An examination of student and provider perceptions of voluntary sector social work placements in Northern Ireland

Practice based learning in Northern Ireland is a core element of social work education and comprising 50% of the degree programme for undergraduate and postgraduate students. This article presents evidence about the perceptions of practice learning from voluntary sector/non-government organisation (NGO) placement providers and final year social work students on social work degree programmes in Northern Ireland in 2011. It draws on data from 121 respondents from189 final year students and focus group interviews with voluntary sector providers offering 16% (85) of the total placements available to students. The agencies who participated in the research study provide a total of 55 PLOs to social work students, and are therefore fairly representative in terms of voluntary sector (NGO) provision. The article locates these data in the context of practice learning pedagogy and the changes introduced by the Regional Strategy for Practice Learning Provision in Northern Ireland 2010–2015. Several themes emerged including; induction, support and guidance, practice educator/student relationship, professional identity and confidence in risk assessment and decision-making. Social work educators, placement providers and employers must be cognisant of newly qualified social workers’ needs in terms of consolidating knowledge within the formative stages of their professional development.

The dynamics of murid gammaherpesvirus 4 within wild, sympatric populations of bank voles and wood mice

Murid gammaherpesvirus 4 (MuHV-4) is widely used as a small animal model for understanding gammaherpesvirus infections in man. However, there have been no epidemiological studies of the virus in wild populations of small mammals. As MuHV-4 both infects cells associated with the respiratory and immune systems and attempts to evade immune control via various molecular mechanisms, infection may reduce immunocompetence with potentially serious fitness consequences for individuals. Here we report a longitudinal study of antibody to MuHV-4 in a mixed assemblage of bank voles (Clethrionomys glareolus) and wood mice (Apodemus sylvaticus) in the UK. The study was conducted between April 2001 and March 2004. Seroprevalence was higher in wood mice than bank voles, supporting earlier work that suggested wood mice were the major host even though the virus was originally isolated from a bank vole. Analyses of both the probability of having antibodies and the probability of initial seroconversion indicated no clear seasonal pattern or relationship with host density. Instead, infection risk was most closely associated with individual characteristics, with heavier males having the highest risk. This may reflect individual variation in susceptibility, potentially related to variability in the ability to mount an effective immune response.

Highly polymorphic microsatellite loci in the bank vole (Clethrionomys glareolus)

We describe seven polymorphic, dinucleotide microsatellite loci isolated from bank voles (Clethrionomys glareolus, Rodentia: Muridae) collected from the Wirral Peninsula, United Kingdom. Microsatellites were isolated as part of a long-term study on the wider effects of host-pathogen interactions of an endemic viral disease. These microsatellites showed between five and 13 alleles per locus in these populations. Observed and expected heterozygosities varied between 0.275 to 0.777 and 0.487 to 0.794, respectively. These markers will allow us to investigate the structure of this bank vole population. © 2005 Blackwell Publishing Ltd.