Are Intensive Family Preservation Services Useful?: A Study in the United Kingdom

This evaluation of the first year of an Intensive Family Preservation Service in England is based on the analysis of eighty-six families: fifty-seven families who received the service and a comparison group of twenty-nine families who did not. The study considered whether the program was fulfilling its objectives of reducing the number of children and young people in the public care system; offering a safe, supportive service for children who need protection; integrating the program into family support services as a whole, and improving family functioning. The findings were complex to interpret. Child protection was improved but there was not a reduction in the number of children needing out of home care (indeed there was an increase) meaning that short term savings in costs could not be made. Nor were there lasting improvements in the children’s behavior. There were instead a number of more subtle, arguably more sensitive outcomes: parents’ capacity to tolerate their child’s behavior was greater and overall family functioning was better for most families who received the service. Also families were, on the whole, able to make better use of follow up services.

AN ASSESSMENT OF KNOWLEDGE AND ATTITUDES OF GENETIC COUNSELING SERVICES IN U.S. HTCs

Hemophilia is a hereditary bleeding disorder which requires lifelong specialized care. A network of Hemophilia Treatment Centers (HTCs) exists to meet the medical needs of patients affected by hemophilia. Genetic counseling services are an integral part of the HTC model of care; however, many HTCs do not have genetic counselors on staff. As a result, the duty to provide these services must fall to other healthcare providers within the HTC. To assess the knowledge and attitudes of these providers we developed a 49 question survey that was distributed electronically to hematologists and nurses at U.S. HTCs. The survey consisted of a three sections: demographic information, knowledge of hemophilia genetics, and attitudes towards genetic services. A total of 111 complete responses were received and analyzed. The average knowledge score among all participants was 74.8% with a total of 81 participants receiving a passing score of 70% or above. Thirty participants scored below 70% in the knowledge section. In general, attitude scores were high indicating that the majority of hematologists and nurses in HTCs feel confident in their ability to provide genetic counseling services. Over 90% of participants reported that they have some form of access to genetic counseling services at their center. Hematologists and nurses practicing in U.S. HTCs demonstrate sufficient knowledge of the genetics of hemophilia, and they generally feel confident in their ability to provide genetic counseling services to their patients. While their knowledge is sufficient, the average knowledge score was lower than 75%. Certain questions covering new genetic technologies and testing practices were more commonly missed than questions asking about more basic aspects of hemophilia genetics, such as inheritance and carrier testing. Finally, many clinics report having access to a counselor, but it is oftentimes a hematologist or nurse who is providing genetic counseling services to patients. Given the inconsistency in knowledge among providers coupled with the high confidence in one’s ability to counsel patients, it leaves room to question whether information about the genetics of hemophilia is being communicated to patients in the most appropriate and accurate manner.

Implementing Intensive Family Preservation Services: A Case of Infidelity

The importance of treatment fidelity in evaluations of all human service programs, including intensive family preservation services (IFPS), is examined in this article. Special attention is focused on the issue of treatment fidelity in IFPS programs attempting to adhere to a specific program model (Homebuilders©), and on the problems that lack of treatment fidelity has caused for research that has been conducted on this and other program models. Attempts to address the issue of treatment fidelity in other program areas offer models for constructing treatment fidelity assessment tools for IFPS. The authors suggest a schema for assessing treatment fidelity in evaluations of IFPS programs that should help to explore relationships among different approaches to IFPS, the consistency with which they are being implemented, and the outcomes that result.

Domestic Violence Resources for Women Receiving Intensive Family Preservation Services

Intimate partner violence is a common correlate of child abuse and neglect and often is not addressed in family preservation services. In many cases, the ideologies of family preservationists and advocates for women 's safety can be at odds. This article presents a study of a collaborative model of intervention, utilizing family preservation workers and community resource practitioners working with domestic violence as group facilitators. The study utilizes a pretest, post-test design to evaluate a domestic violence resource group for women who were concurrently receiving intensive family preservation services. The study examines the effect of the program on participants' self-perceptions regarding self-esteem, independence, goals, social isolation, and assertiveness. Caseworker perceptions of client characteristics also are evaluated, and qualitative responses of the effects of the program are included.

Impact of knowledge brokering on performance heterogeneity among business models

Purpose – The strategic management literature lacks a comprehensive explanation as to why seemingly similar business models in the same industry perform differently. This paper strives to explain this phenomenon. Design/methodology/approach – The model is conceptualized and accompanied by a case study on the airline industry to explain knowledge brokerage that creates value from the effective utilization of knowledge resources acquired from intra- and inter-firm environments. Findings – The model explains a cyclical view of business model flexibility in which the knowledge-based resource accumulation of the business model is spread across the intra- and inter-firm environments. Knowledge brokerage strategies from the inter- and intra-firm environments result in improved performance of the business model. The flexibility that the business model acquires is determined by how efficiently resource accumulation is aligned with its external environment. Originality/value – The paper effectively integrates the concepts of knowledge brokerage and business models from a resource accumulation-based view and simultaneously arrives at the performance heterogeneity of seemingly similar business models within the same industry. It has performance implications for firms that start out without any distinct resources of their own, or that use an imitated business model, to attain better performance through business model evolution aligned with successful knowledge brokerage strategies. It adds to the resource accumulation literature by explaining how resources can be effectively acquired to create value.

Data-Intensive architecture for scientific knowledge discovery

This paper presents a data-intensive architecture that demonstrates the ability to support applications from a wide range of application domains, and support the different types of users involved in defining, designing and executing data-intensive processing tasks. The prototype architecture is introduced, and the pivotal role of DISPEL as a canonical language is explained. The architecture promotes the exploration and exploitation of distributed and heterogeneous data and spans the complete knowledge discovery process, from data preparation, to analysis, to evaluation and reiteration. The architecture evaluation included large-scale applications from astronomy, cosmology, hydrology, functional genetics, imaging processing and seismology.

On a meaningful integration of web services in data-intensive biomedical environments: The DICODE approach

This paper reports on an innovative approach that aims to reduce information management costs in data-intensive and cognitively-complex biomedical environments. Recognizing the importance of prominent high-performance computing paradigms and large data processing technologies as well as collaboration support systems to remedy data-intensive issues, it adopts a hybrid approach by building on the synergy of these technologies. The proposed approach provides innovative Web-based workbenches that integrate and orchestrate a set of interoperable services that reduce the data-intensiveness and complexity overload at critical decision points to a manageable level, thus permitting stakeholders to be more productive and concentrate on creative activities.

Business model for healthcare interoperability services

En la situación actual donde los sistemas TI sanitarios son diversos con modelos que van desde soluciones predominantes, adoptadas y creadas por grandes organizaciones, hasta soluciones a medida desarrolladas por cualquier empresa de la competencia para satisfacer necesidades concretas. Todos estos sistemas se encuentran bajo similares presiones financieras, no sólo de las condiciones económicas mundiales actuales y el aumento de los costes sanitarios, sino también bajo las presiones de una población que ha adoptado los avances tecnológicos actuales, y demanda una atención sanitaria más personalizable a la altura de esos avances tecnológicos que disfruta en otros ámbitos. El objeto es desarrollar un modelo de negocio orientado al soporte del intercambio de información en el ámbito clínico. El objetivo de este modelo de negocio es aumentar la competitividad dentro de este sector sin la necesidad de recurrir a expertos en estándares, proporcionando perfiles técnicos cualificados menos costosos con la ayuda de herramientas que simplifiquen el uso de los estándares de interoperabilidad. Se hará uso de especificaciones abiertas ya existentes como FHIR, que publica documentación y tutoriales bajo licencias abiertas. La principal ventaja que nos encontramos es que ésta especificación presenta un giro en la concepción actual de la disposición de información clínica, vista hasta ahora como especial por el requerimiento de estándares más complejos que solucionen cualquier caso por específico que sea. Ésta especificación permite hacer uso de la información clínica a través de tecnologías web actuales (HTTP, HTML, OAuth2, JSON, XML) que todo el mundo puede usar sin un entrenamiento particular para crear y consumir esta información. Partiendo por tanto de un mercado con una integración de la información casi inexistente, comparada con otros entornos actuales, hará que el gasto en integración clínica aumente dramáticamente, dejando atrás los desafíos técnicos cuyo gasto retrocederá a un segundo plano. El gasto se centrará en las expectativas de lo que se puede obtener en la tendencia actual de la personalización de los datos clínicos de los pacientes, con acceso a los registros de instituciones junto con datos ‘sociales/móviles/big data’.---ABSTRACT---In the current situation IT health systems are diverse, with models varying from predominant solutions adopted and created by large organizations, to ad-hoc solutions developed by any company to meet specific needs. However, all these systems are under similar financial pressures, not only from current global economic conditions and increased health care costs, but also under pressure from a population that has embraced the current technological advances, and demand a more personalized health care, up to those enjoyed by technological advances in other areas. The purpose of this thesis is to develop a business model aimed at the provision of information exchange within the clinical domain. It is intended to increase competitiveness in the health IT sector without the need for experts in standards, providing qualified technical profiles less expensively with the help of tools that simplify the use of interoperability standards. Open specifications, like FHIR, will be used in order to enable interoperability between systems. The main advantage found within FHIR is that introduces a shift in the current conception of available clinical information. So far seen, the clinical information domain IT systems, as a special requirement for more complex standards that address any specific case. This specification allows the use of clinical information through existing web technologies (HTTP, HTML, OAuth2, JSON and XML), which everyone can use with no particular training to create and consume this information. The current situation in the sector is that the integration of information is almost nonexistent, compared to current trends. Spending in IT health systems will increase dramatically within clinical integration for the next years, leaving the technical challenges whose costs will recede into the background. The investment on this area will focus on the expectations of what can be obtained in the current trend of personalization of clinical data of patients with access to records of institutions with ‘social /mobile /big data’.

Applying model-driven engineering to the development of Rich Internet Applications for Business Intelligence

Business Intelligence (BI) applications have been gradually ported to the Web in search of a global platform for the consumption and publication of data and services. On the Internet, apart from techniques for data/knowledge management, BI Web applications need interfaces with a high level of interoperability (similar to the traditional desktop interfaces) for the visualisation of data/knowledge. In some cases, this has been provided by Rich Internet Applications (RIA). The development of these BI RIAs is a process traditionally performed manually and, given the complexity of the final application, it is a process which might be prone to errors. The application of model-driven engineering techniques can reduce the cost of development and maintenance (in terms of time and resources) of these applications, as they demonstrated by other types of Web applications. In the light of these issues, the paper introduces the Sm4RIA-B methodology, i.e., a model-driven methodology for the development of RIA as BI Web applications. In order to overcome the limitations of RIA regarding knowledge management from the Web, this paper also presents a new RIA platform for BI, called RI@BI, which extends the functionalities of traditional RIAs by means of Semantic Web technologies and B2B techniques. Finally, we evaluate the whole approach on a case study—the development of a social network site for an enterprise project manager.

Latin Americaʹs emergence in global services: a new driver of structural change in the region?

Studies of international production acknowledge that the ability of firms to learn, upgrade and innovate in global value chains (GVCs) is influenced by knowledge flows within these global networks and by the national institutional systems in which the firms are embedded. Little is known, however, about how differences in national innovation and business systems shape the way firms and national economies insert themselves in global value chains and how this influences their upgrading trajectories. Based on a review of the existing academic literature, the chapter examines the impact of national innovation and business systems from middle-income and developing countries on learning and innovation processes in services GVCs.

The farmer's encyclopedia and business guide : a repository of practical knowledge /

Issued in 1889 under title "The little giant cyclopedia", and in 1893 under title "The marvel cyclopedia". Also issued under titles "The nutshell cyclopedia" and "Armstrong's treasury of ready reference.