Using HIT to deliver integrated care for the frail elderly in the UK: current barriers and future challenges

In this paper we briefly describe the results of a 3 year project examining the use of Health Information Technologies (e.g., electronic patient record systems) to deliver integrated care. In particular, we focus on one group of patient (the frail elderly) and efforts to design an e-health supported healthcare pathway (the frail elderly pathway--FEP). The aim of FEP is to bring together clinicians and staff from health and social care and allow them to share patient information. Our findings show that progress in delivering a fully-supported and working FEP has been slow, not least because of the difficulties experienced by healthcare staff in using current IT systems. In addition, there are many strategic and technical issues which remain unresolved (e.g., systems interoperability).     

Bridging child welfare and juvenile justice: preventing unnecessary detention of foster children

Gaps in service coordination between child welfare and other child-serving agencies are well documented. This article examines the gap between the child welfare and juvenile justice systems and discusses a program, Project Confirm, designed to reduce the problems associated with this gap. Project Confirm aims to improve cooperation between juvenile justice and child welfare agencies to prevent the unnecessary detention of arrested foster children in secure facilities. The program's design is outlined, and implementation statistics and government partner perceptions of the program in its first year of operations are provided. The article also identifies future challenges to implementation and discusses the broader implications of the program. In making this appeal for coordination and collaboration among public agencies, I'm not talking about pro forma integration efforts-I'm not talking about memoranda of understanding or top-level reorganizations that have autonomous agencies vaguely reporting to a single box labeled "human services." Rather, I'm talking about the much more challenging objective of achieving real working partnerships at the front line. (Nelson, 1998, p. 6)     

Aggressive Behaviors in Social Interaction and Developmental Adaptation: A Narrative Analysis of Interpersonal Conflicts During Early Adolescence

Using conflict narratives reported by adolescents in grade 7 (mean age = 13.4 years), this study investigated the interactional properties and developmental functions of four types of aggressive behaviors: social aggression, direct relational aggression, physical aggression, and verbal aggression. A total of 475 participants from the Carolina Longitudinal Study ( Cairns & Cairns, 1994 ) were included. Results showed that the majority of conflict interactions involved more than a dyad. The use of social aggression (e.g., concealed social attack) was associated with more individuals involved in the conflict. Social aggression was primarily reported as an initiating behavior for interpersonal conflicts, while direct relational aggression was a responding behavior. Medium to high levels of reciprocity were found for physical, verbal, and direct relational aggression, whereas a low level of reciprocity was reported for social aggression. School authorities were most likely to intervene in physical aggression. The use of social aggression was associated with higher network centrality among adolescents. Developmental maladjustment in late adolescence and early adulthood was primarily predicted by physical aggression.     

Attributional Retraining Increases Career Decision-Making Self-Efficacy

This study examined whether 60 college students (41 women and 19 men), grouped according to their career locus of control, were differentially affected by a videotaped career intervention. The intervention was an attributional retraining procedure designed to persuade students to attribute low levels of confidence in making career decisions and career-related failures to a lack of effort. Results indicated that the career decision-making self-efficacy (CDMSE) of students who initially exhibited an external career locus of control significantly increased after the attributional retraining procedure (p < .05), whereas the students who initially exhibited an internal career locus of control demonstrated no significant increase in CDMSE after attributional retraining.     

Getting real: heuristics in sociological knowledge

Theory and Society - This article examines the connections among heuristics, the epistemological and ontological presuppositions that underlie theorizing, and substantive explanations in sociology....     

Monotone B-Spline Smoothing for a Generalized Linear Model Response

Various methods have been proposed for smoothing under the monotonicity constraint. We review the literature and implement an approach of monotone smoothing with B-splines for a generalized linear model response. The approach is expressed as a quadratic programming problem and is easily solved using the statistical software R. In a simulation study, we find that the approach performs better than other approaches with much faster computation time. The approach can also be used for smoothing under other shape constraints or mixed constraints. Supplementary materials of the appendices and R code to implement the developed approach is available online.     

State Terror and the Reproduction of Imprisoned Dissent

Cuban visual art underwent an extraordinary renaissance during the 1980s, fuelled in part by a relaxation of cultural policy enacted at high political levels, by a relatively prosperous interlude, and by the emergence of an exceptionally talented and energetic generation of artists. Their increasingly critical work, together with the economic and political crisis that the country entered toward the end of the decade as the Soviet Union unravelled, sparked harsh measures against the artists and their works, and precipitated the emigration of most of the artists in the first years of the 1990s. This paper explores some of the reactions in the wake of these traumatic events, noting the many ways in which withdrawal became a characteristic artistic position for the period.     

ERROR-FREE MILESTONES IN ERROR PRONE MEASUREMENTS

A predictor variable or dose that is measured with substantial error may possess an error-free milestone, such that it is known with negligible error whether the value of the variable is to the left or right of the milestone. Such a milestone provides a basis for estimating a linear relationship between the true but unknown value of the error-free predictor and an outcome, because the milestone creates a strong and valid instrumental variable. The inferences are nonparametric and robust, and in the simplest cases, they are exact and distribution free. We also consider multiple milestones for a single predictor and milestones for several predictors whose partial slopes are estimated simultaneously. Examples are drawn from the Wisconsin Longitudinal Study, in which a BA degree acts as a milestone for sixteen years of education, and the binary indicator of military service acts as a milestone for years of service.     

A note on maximum entropy spectrum estimation

This article studies the maximum entropy spectrum estimation. After a bnei discussion on iiow co select ciic appropriate constraints and tiie objec¬tive functions, we decide to choose the constraints containing only the first four sample moments and, consequently, to employ the second order spectral entropy as the objective function. The resulting (maximum entropy) spectral estimate is the power spectral density of an ARMA sequence. Examples for comparing our proposal with the traditional maximum entropy spectral estimate follow at the end.