A Thesis Submitted to the Faculty of Indiana University by Nikeshbhai Patel in Partial Fulfillment of the Requirements for the Degree of Master of Science, August 2005 / Medical health partners use heterogeneous data formats, legacy software and strictly licensed vocabularies which make it hard to integrate their data and work. Integration of services and data are the two main necessities. The current architecture used provides partial solution by providing one-to-one mapping wrappers. This thesis provides discussion on difficulties encountered by the coexistence of so many medical vocabularies and efforts to provide interoperation. Also other problems are listed which hinders the interoperation between health partners. Solution is proposed for some of these problems by forming semantic network based on multi-agent technology. Service composition and integration stages are shown to develop future advance health services. Middle layer is implemented which performs integration and provides common platform for sharing information, using global ontology and local domain ontology. Inferencebased matchmaking algorithm proposed in this thesis helps in mapping and achieving our goal. Six different filtering techniques are selected and used in matchmaking algorithm. Analysis of these filtering techniques is provided to understand the integration process. In the ending section an abstract idea is proposed on basis of network architecture and matchmaking algorithm to develop Open Terminological System.

This study examined predictors of program participation and the potential effects of participation on child development in five school sites offering integrated preschool services as part of the Toronto First Duty (TFD) demonstration project. The TFD model offered a seamless, school-based ‘service community’ integrating childcare, kindergarten, family literacy, and other early childhood services. Despite sound conceptual arguments for the utility of integrating early childhood services, no empirical studies have examined the relation between uptake of integrated preschool services and children’s developmental outcomes, within the ecological context of integrated services. This study examined program participation levels or ‘dosage’, while considering the social ecology of the child, including family and school level characteristics that may moderate or mediate the effectiveness of community-level service integration efforts to improve child outcomes during the transition to school. The ecology of participation effects was examined through generalized linear modeling techniques analyzing a linked dataset (N=272) including: (1) systematic intake form and tracking data on hours of program use, (2) children’s school readiness or child development teacher-report ratings (Early Development Instrument) measured across five domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, communication and general knowledge), and (3) a measure of service integration levels across sites. The results provided evidence that TFD achieved its outreach aims in ensuring equitable access for all families; demographic risk factors did not predict less participation in TFD integrated services. In a parallel analysis of predictors of kindergarten absences, there was one difference; males were absent more in kindergarten, whereas there were no gender differences in integrated service participation. The results provided additional evidence that the TFD model has potential in reducing disparities in children’s developmental outcomes since participation dose predicted children’s physical health and well-being, language and cognitive development, and communication and general knowledge, after taking into account demographic, parenting and site factors. Further, parents' being less child-centred and less interested in parent participation, were significant risk factors associated with children's developmental outcomes. This study has implications for understanding the ecological complexities of school readiness, and the potential processes by which program participation affects children’s outcomes.

This study examined predictors of program participation and the potential effects of participation on child development in five school sites offering integrated preschool services as part of the Toronto First Duty (TFD) demonstration project. The TFD model offered a seamless, school-based ‘service community’ integrating childcare, kindergarten, family literacy, and other early childhood services. Despite sound conceptual arguments for the utility of integrating early childhood services, no empirical studies have examined the relation between uptake of integrated preschool services and children’s developmental outcomes, within the ecological context of integrated services. This study examined program participation levels or ‘dosage’, while considering the social ecology of the child, including family and school level characteristics that may moderate or mediate the effectiveness of community-level service integration efforts to improve child outcomes during the transition to school. The ecology of participation effects was examined through generalized linear modeling techniques analyzing a linked dataset (N=272) including: (1) systematic intake form and tracking data on hours of program use, (2) children’s school readiness or child development teacher-report ratings (Early Development Instrument) measured across five domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, communication and general knowledge), and (3) a measure of service integration levels across sites. The results provided evidence that TFD achieved its outreach aims in ensuring equitable access for all families; demographic risk factors did not predict less participation in TFD integrated services. In a parallel analysis of predictors of kindergarten absences, there was one difference; males were absent more in kindergarten, whereas there were no gender differences in integrated service participation. The results provided additional evidence that the TFD model has potential in reducing disparities in children’s developmental outcomes since participation dose predicted children’s physical health and well-being, language and cognitive development, and communication and general knowledge, after taking into account demographic, parenting and site factors. Further, parents' being less child-centred and less interested in parent participation, were significant risk factors associated with children's developmental outcomes. This study has implications for understanding the ecological complexities of school readiness, and the potential processes by which program participation affects children’s outcomes.

The enactment of the Gramm-Leach-Bliley Act of 1999 promised the most fundamental reform to be made in U.S. financial services regulation in more than half a century. The Gramm-Leach-Bliley Act (GLB) removed barriers that forced separation between commercial banks, investment banks, and insurance companies; and it allowed subsidiaries of banks or insurance companies to engage in a broad range of financial activities that were not permitted for banks or insurers themselves. Few doubted the potential for GLB to have a profound impact on financial service providers and on the financial market. However, there is a striking lack of empirical research on the effects of diversification by financial firms. The first goal of this dissertation is to identify domestic “assurbanks” (insurers owning banks) and “bancassurers” (banks owning insurers) and to identify the unique subsidiaries of financial services companies licensed as commercial banks, thrifts, or insurance companies in the U.S. We construct a unique dataset that links the banking and insurance regulatory datasets. A second objective is to investigate the effects of integrating the banking and insurance sectors of the U.S. economy. We evaluate the market structure and operating performance of financial institutions in the integrated banking and insurance industry. Gains from exploiting scope economies and product mix efficiencies are often cited as motives for financial institution integration. A third objective is to estimate efficiency effects from the economies of scope across the two formally separate sectors by estimating multi-product costs, revenue, and profit functions. The final objective is to test whether scope economies exist for firms that jointly produce financial products across multiple sectors and to explain the variation of scope economy estimations. The empirical evidence suggests that both domestic assurbanks and bancassurers are large in size and count for a significant portion of the banking and insurance market share. These firms are also more diversified in terms of their traditional products with a focus on personal line products. Large bancassurers appear more interested in investing in small-size life and property-liability subsidiaries. Large assurbanks are more interested in acquiring small-size thrifts. Banks prefer to affiliate with life insurance more than property-liability insurance, and insurers are more likely to affiliate with thrift saving banks than to affiliate with commercial banks. Diversified firms have higher profitability in their traditional lines of business. Bancassurers perform well in the insurance business, but most assurbanks lose money in their banking division. The scope economy results; investigating consumption complementarities suggests that a significant number of cost scope diseconomies, revenue scope economies, and weak profit scope economies exist in the post-GLB U.S. integrated banking and insurance sectors. The scope economies are variant among firms, and certain firm characteristics (size, business portfolio, geographic diversification, product mix and diversification, insurance distribution system, and X-efficiency) are the determinants of scope economies.

Background: Tuberculosis (TB) and human-immunodeficiency virus (HIV) infections are intertwined through complex biological and social pathways that affect over one million people worldwide. Mitigation of the co-epidemic is undermined by a failure to integrate TB and HIV healthcare services as a result of critical clinical, operational and social challenges. The social challenges of TB/HIV coinfection and integrated care are least understood. Objectives: This research examines the social contexts of TB/HIV illness and related healthcare from the perspective of patients coinfected with TB and HIV. Methods: The study was set within a constructivist-interpretivist theoretical framework. Non-participant field observations and semi-structured in-depth interviews were held with 40 coinfected adults (24 women, 16 men) and 8 healthcare workers at 3 ambulatory clinics in KwaZulu-Natal, South Africa, providing varying models of TB and HIV care. Subjective meanings of illness and healthcare were analyzed in relation to patients’ social contexts. Findings and Interpretations: Coinfection exposes patients to a double and unequal form of social stigma around TB and HIV. Affected individuals construct dual identities and negotiate selective disclosure of TB over HIV in order to manage this double stigma. Their experiences with stigma are bound by social, structural and gendered inequalities, and mediate their decisions to disclose, access and adhere to medical care. Coinfection also exposes patients to pluralistic, disparate and fragmented forms of healthcare delivery. Experiences with stigma and with distinct cultures of TB and HIV care affect their decisions for integrated healthcare. While integration may allow for some technical and clinical efficiency, it may also heighten some patients’ social burden of illness as a result of HIV disclosure and stigmatization. Conclusion: Integration efforts should consider the social contexts of TB/HIV coinfection, social consequences of patients’ health decisions, and paradigms within which such efforts are set in the design and execution of successful interventions.

Background: Tuberculosis (TB) and human-immunodeficiency virus (HIV) infections are intertwined through complex biological and social pathways that affect over one million people worldwide. Mitigation of the co-epidemic is undermined by a failure to integrate TB and HIV healthcare services as a result of critical clinical, operational and social challenges. The social challenges of TB/HIV coinfection and integrated care are least understood. Objectives: This research examines the social contexts of TB/HIV illness and related healthcare from the perspective of patients coinfected with TB and HIV. Methods: The study was set within a constructivist-interpretivist theoretical framework. Non-participant field observations and semi-structured in-depth interviews were held with 40 coinfected adults (24 women, 16 men) and 8 healthcare workers at 3 ambulatory clinics in KwaZulu-Natal, South Africa, providing varying models of TB and HIV care. Subjective meanings of illness and healthcare were analyzed in relation to patients’ social contexts. Findings and Interpretations: Coinfection exposes patients to a double and unequal form of social stigma around TB and HIV. Affected individuals construct dual identities and negotiate selective disclosure of TB over HIV in order to manage this double stigma. Their experiences with stigma are bound by social, structural and gendered inequalities, and mediate their decisions to disclose, access and adhere to medical care. Coinfection also exposes patients to pluralistic, disparate and fragmented forms of healthcare delivery. Experiences with stigma and with distinct cultures of TB and HIV care affect their decisions for integrated healthcare. While integration may allow for some technical and clinical efficiency, it may also heighten some patients’ social burden of illness as a result of HIV disclosure and stigmatization. Conclusion: Integration efforts should consider the social contexts of TB/HIV coinfection, social consequences of patients’ health decisions, and paradigms within which such efforts are set in the design and execution of successful interventions.

An integration solution must sustain multiple PeopleSoft upgrades, which is necessary to preserve investment in system integrations. Since the underlying structures and connection technologies of PeopleSoft have been and can be migrated from version to version in order to enhance features and performance, it is critical for any external component of integration to be built based on publicly visible interfaces of the PeopleSoft component. We have developed a standard-based solution to integrate “PeopleSoft Campus Solution” into “Microsoft SharePoint” using Web services generated by PeopleSoft’s Pure Internet Architecture. We have illustrated such kind of integration in two examples that emulate some of the imminent problems in the University’s current information systems between the PeopleSoft Campus and SharePoint Workflow. The methodology used in this is applicable to integrations of general COTS software systems into modern enterprise information systems.

The thesis summarizes the history of enterprise application integration and shows the estimated benefits and risks that arise from attempts to harmonize corporate IT infrastructure. It also describes the main approaches to the integration and evaluates their resistance in terms of time. The thesis relates a modern interpretation of the integration of SOA (Service Oriented Architecture), including related standards. Particular attention is paid to the life cycle of services in SOA. It explains possible approaches and key principles of communication layer integrated business application system in terms of architectural design. The last part of the thesis examines for opportunities, risks and benefits of system application integration within the SOA implementation and assesses the economics of integration and the question of the investment protection.

O objetivo do estudo foianalisar os processos de ensino-aprendizagem e o desenvolvimento de competências para o trabalho em serviços especializados odontológicos do Estágio Curricular Supervisionado II da Faculdade de Odontologia da UFRGS. Trata-se de um estudo de caso do tipo único e holístico que integrou análises quantitativas e qualitativas. Participaram da pesquisa 246 estagiários de um total de 329que realizaram o estágio entre os anos de 2013 a 2016. Os dados do estudo foram produzidos através de um questionário respondido de forma online e anônima. Foram disponibilizadas 26 perguntas fechadas (respostas numa escala do tipo likert em 6 escores) articuladas a possibilidades de respostas abertas. Compõem o questionário cinco blocos temáticos e organizados em duas grandes categorias de análise: Avaliação estrutural e pedagógica da experiência do estágio(identificação sóciodemográfica, campos de estágio, atividade de educação a distância e dinâmicas pedagógicas) e do Desenvolvimento de competências profissionais (desenvolvimento de ingredientes do agir em competência - protocolos, inserção na realidade, motivação para o trabalho, valores técnicos e trabalho em equipe). As respostas quantitativas foram exportadas para o Programa Statistical Package for the Social Sciences – SPSS para Windows, versão 16.0 e submetidos à análise descritiva. Para a análise das variáveis quantitativas na comparação entre as categorias nos diferentes semestres foi utilizado o teste qui-quadrado e quando necessário o test Z para comparação de proporções com ajuste de Bonferroni. Para a análise de comparação entre as médias foi utilizado o teste de análise de variância (ANOVA).Os dados qualitativos foram analisados buscando encontrar não apenas o conteúdo textual, mas seu sentido histórico e social. Os resultados demonstram que a experiência de estágio analisada está proporcionando aprendizagens significativas sobre o funcionamento da rede de atenção especializada em saúde bucal e o agir em competência de futuros cirurgiões-dentistas. Oportuniza o debate de valores e normas e o exercício de readaptações dos protocolos. Nas dinâmicas do estágio ocorrem oportunidades de estabelecimento de relações entre teoria e prática no cotidiano profissional dos serviços. A motivação para o trabalho foi um dos itens bem avaliado do agir em competência, enquanto que o trabalho em equipe apresentou respostas nos escores mais baixos da escala likert. Os estágios no campo de gestão e as atividades de educação à distância tiveram maior número de opiniões insatisfatórias devido ao seu caráter pedagógico inovador. / The objective of this study was to analyze the teaching-learning processes and the development of competencies for specialized dental services work of the Supervised Curricular Stage II of the School of Dentistry of UFRGS. It is an unique and holistic case study that integrated quantitative and qualitative analyzes. Two-hundred and forty six interns participated in the survey from a total of 329 who completed the internship between 2013 and 2016. The data used in the analyzes was captured through an anonymous online questionnaire. Twenty-six closed-ended questions (responses on a 6-point likert-type scale) were made available with the possibility of also being filled as open-ended answers. The questionnaire consists of five thematic blocks and organized into two broad categories of analysis: Structural and pedagogical evaluation of the internship experience (sociodemographic identification, area of study, distance learning activity and pedagogical dynamics) and the development of professional skills of acting in competence(protocols, hands-on experience, work-related motivation, technical values and teamwork). The quantitative responses were exported to the Statistical Package for the Social Sciences - SPSS for Windows, version 16.0 and subjected to descriptive analysis. For the analysis of the quantitative variables in the comparison between the categories in the different semesters the chi-square test was used and, when needed, the Z test to compare proportions with Bonferroni adjustment was used. The analysis of variance (ANOVA) was used to compare means. The qualitative data were analyzed to evaluate not only the textual content, but its historical and social sense. The results demonstrate that internship experience is providing significant learning about the functioning of the network of specialized attention in oral health and of acting in competence of future surgeons-dentists. It encourages the debate of values, norms and readaptations of the protocols. In the amplitude of the questions about the dynamics of the stage can be affirmed that it occurs mainly by the opportunities of establishing relationships between theory and practice in the work routine. Work-related motivation was one of the most well rated items of acting in competence, while teamworkpresented responses at the lowest scores on the likert scale. Internships in the field of management and distance education activities had the highest number of unsatisfactory opinionsdue to their innovative pedagogical character.

The concept of value visualization is concerned with the way that firms communicate and demonstrate the value of their product-service systems (PSS), both internally and externally. In this chapter, a visualization strategy framework for PSS development is proposed. It is particularly tailored for industrial companies that are strategically shifting from selling products to becoming providers offering PSS. Value visualization strategies have traditionally focused on external sales activities. However, companies need to have a broader approach to visualization in all PSS development phases, as well as including different visualization techniques. Furthermore, different visualization strategies are needed for each particular development stage of the PSS. Companies need be able to make use of several different visualization strategies, depending on the actual content of the product-service system and its position in the development process. Whereas the product development process is rather heavy at the back, successful PSS development projects with high levels of service need to be heavy at the front (that is, they need to not only develop the system but also ensure its rollout). Examples are provided from eight market-leading companies in different industries, each of which are undertaking a strategic shift from identifying as product sellers toward becoming providers offering PSS. To conclude, value visualization has become vital for winning new contracts and retaining existing ones. It is therefore a strategic resource that managers need to pay attention to, and continuously develop, in order to compete with PSS offerings. / <p>Original Publication: Christian Kowalkowski and Daniel Kindström, Value visualization strategies for PSS development, 2009, Chapter in: Introduction to Product/Service-System Design, 159-182, Eds T. Sakao and M. Lindahl. http://dx.doi.org/10.1007/978-1-84882-909-1_8 Copyright: Springer http://www.springerlink.com/</p>