Search results

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

This article presents a General Theory of Social Systems. This general theory proposes a model and method for the design, behaviour, and development of social systems. The model advanced is an exposition of the universal composition of social systems in three‐dimensions. The accompanying prescribed method offers dissection and analysis of past, present, and planned systems from Micro to Meta scales in isolation and relation to external systems.

The purpose of this paper is to support the application of a combined BPM (business process management)/SOA (service‐oriented architecture) approach and contribute to the body of knowledge on the business value of SOA.

This case study highlights the promising results of a process reengineering project at Belgacom Mobile, Belgium's largest mobile telecommunications operator. The reengineering effort centered around a key automation pillar involving in particular the optimization of the SIM card ordering process. SOA principles were applied to ensure both the flexibility of the redesigned process and its capability of dealing with newly emerging SIM card types. This case demonstrates the potential benefits of combining BPM and SOA concepts to establish IT‐enabled process innovation.

In terms of performance improvement, the studied project resulted in: increased process flexibility and consistency, considerably shorter lead times, and enhanced process control.

The findings from this case study present useful insights for other companies trying to reap the benefits of combined BPM and SOA. However, the single case study approach presents some limitations to the generalizability of the proposed learning points and concepts. Some case specific features such as the sector or company size might influence the generalizability. Nevertheless, the paper rather intends to trigger conceptual thinking about IT‐enabled process innovation and an architectural approach.

The added value of this project, which contributes to the general understanding of SOA potential for BPM, lies in its innovative approach, whereby product and process are separated by means of production process ID creation. The redesign approach thus provides a sustainable answer to the ever shortening life cycle of products and technologies. In particular process practitioners will find value in reading the learning points from this paper.

Alcohol misuse leads to a massive drain upon an already stretched NHS budget. High numbers of individuals with alcohol related physical and health needs are being admitted into the secondary health care setting at great financial cost. This paper examines a profile of this population presenting to the secondary care setting over a 12‐month period. It is suggested that the misuse of alcohol does not take place in isolation. It is often accompanied by other problematic behaviours such as domestic violence, inappropriate, neglectful parenting, or child abuse, offending behaviour, and psychological problems. Evidence for the nature and extent of these associated behaviours is reported and discussed. Comparisons are made particularly with data related to tobacco smoking, and the positive aspects of smoking cessation programmes are outlined. Almost all of the population reported on over the 12‐month period were tobacco smokers. The re‐emergence of the incidence of smoking with the reduction of smoking cessation programmes is noted. The challenge for substance misuse services is how best to respond to the needs of this growing population who often present withalcohol misuse together with smoking behaviours. A collaborative model of response is outlined and suggested as the best way forward. This involves substance misuse services working together with professional colleagues within the acute hospital environment and community to ensure sustainable positive clinical outcomes following hospital discharge.

The provision and effectiveness of community‐based treatment packages for people with alcohol misuse problems, has been recognised and highlighted in government policy, most recently by The National Assembly for Wales (2000). Responding to ‘problem drinkers’ within the primary health care setting, is a cost‐effective treatment option. The Specialist Community Alcohol CPN Service, within The North West Wales NHS Trust, is part of the Mental Health & Learning Disabilities Directorate. It is also at the forefront of clinical governance measures and the service strives towards clinical excellence through evidence‐based practice. In a recent survey, it was found that 72% of referrals came from general practitioners (Sims et al., 2002). This integrated care pathway, for the ‘problem drinker in the community’ is designed in an attempt to smooth the referral process. Moreover, it is intended as a way of giving information to referrers, regarding the range of clinical interventions available and raising awareness regarding ‘options for change’ with the service user.

Treating people with alcohol problems can be very expensive. Hospital‐based community focused treatment has been a traditional response. However, treatment for this client group has developed into a very cost effective treatment option. Alcohol is exacting a heavy financial burden upon the limited resources within health care provision (Royal College of Physicians, 2001). The heavy burden placed upon primary care is reflected in the data. General practitioners make the highest number of referrals to the Specialist Alcohol Service (72%). The link to policy is clear with the Welsh Assembly placing greater focus on a condition specific specialist response (Welsh Assembly, 2001). Comparison with patients presenting to a 24‐hour emergency psychiatric assessment service at the district general hospital help define the alcohol service user group. Data confirms that a community‐focused response by specialist community psychiatric nurses is a cost effective and appropriate alternative to hospital admission.

The purpose of this paper is to examine the use of simulators as pedagogical complements to traditional case studies. The research performs experiments with a case and its accompanying simulator to assess the additional learning attained by the use of a case with its simulator as compared to using the case alone. The paper also describes the development and proposed use of cases and simulators combined.

The paper describes the development of one companion simulators, it outlines its proposed use, and it shows the results of an experiment to assess marginal learning with the simulator.

The research finds that simulators increase the understanding of subjects when used to support a case study. Students and teachers perceive the use of companion simulators as valuable.

The research provides ground for developing a new generation of case studies in which the traditional case is enhanced and augmented by simulators developed for one particular case and intended to be used only with that case.

This research has practical implications in how management is taught and learned.

The paper has implications in terms of possible changes that can be introduced to the teaching of management in business schools.

This research provides one of the few extant assessments of the learning that can be attained with the use of simulators in management education. The research proposes the creation of a new entity, the “Case+Sim” that draws on the traditional strengths of managerial case studies to be used in educating managers, but complements the case studies with simulators, which provide an added value in permitting students to test their thinking using a realistic interactive learning environment.

The librarian and researcher have to be able to uncover specific articles in their areas of interest. This Bibliography is designed to help. Volume IV, like Volume III, contains features to help the reader to retrieve relevant literature from MCB University Press' considerable output. Each entry within has been indexed according to author(s) and the Fifth Edition of the SCIMP/SCAMP Thesaurus. The latter thus provides a full subject index to facilitate rapid retrieval. Each article or book is assigned its own unique number and this is used in both the subject and author index. This Volume indexes 29 journals indicating the depth, coverage and expansion of MCB's portfolio.

Raises some questions on moral and legal rights to health care, referring to various claims contained within the report of the UK’s Commission on Social Justice – “Social Justice: Strategies for National Renewal” (1994). Explores the relationship between needs and rights – rights of action and rights of recipience, moral rights and legal rights. Proceeds to delve into the role the state plays in providing services such as health care and whether or not people have a moral right to good health and good health care. Questions if the state should provide health care and, if so, should it be provided as a legal right to citizens? Concludes that the Commission on Social Justice fails to defend the National Health Service on the grounds of justice and moral rights.

This article explores the link between adult substance misuse and the effects such behaviour can have on children in their care. The implications for child development are considered. Child protection implications can be far reaching and children's longterm exposure to adult displays of behavioural loss of control can have detrimental effects upon their development. It is argued that parental substance misuse is not however, sufficient warrant to justify the child protection registration of children. This can act as an obstacle to enabling the parents to seek appropriate clinical intervention for their substance misuse problems (Standing Conference on Drug Abuse, 1989, now Drugscope). This article highlights the combined effect of these interactions on the development of children. Rather than an end in itself child protection assessment, with possible registration, should be viewed as a window of opportunity by agencies to respond to the needs of children with a range of possible responses dependent upon how serious the problems are.