A national referral of an integrated network of continuing care a study case

This study aims to characterize the National Long-Term Care Network (NL-TCN) users. The Portuguese National Health Service, was restructured in 2006 with the creation of the National Long-Term Care Network to respond to new health and social needs concerning the continuity of care. Objectives- Analyse the sociodemographic profile of the network users and the review of hospital, local and regional management procedures. Methods-we used various methods of observational or experimental nature (data processing and presentation of results with the program Statistical Package for Social Sciences, version 20, descriptive statistics (frequencies, crosstabs and test chi-square)). The Pearson correlation test showed a positive correlation between time procedures at the local and regional management and hospital’s length of stay. Results- from a sample of 805 cases, 595 (74%) were admitted in the NL-TCN, a rate lower than the national average (86%). Almost half of the sample was admitted in Rehabilitation Units (46%), while nationally the highest number of admissions was in Home Care Teams (30%). The average time from hospital referral to network admission was 9.73 days with a positive correlation between referred network management procedures and hospital length of stay. Conclusions- For specialized units, the maximum waiting times were for the Long-Term and Support Units (mean 30.27 days) and the minimum waiting times were for Home Care Teams (mean 5.57 days). The average time between the local and regional management was 3.59 days. Almost 90% of referrals were orthopaedics, internal medicine and neurology and Network users were mostly elderly (average 75 years old), female and married. Most users were admitted to inpatient units (78%) and only 15% remained in their home town.

Parental Adjustment to Disability, Stress Indicators and the Influence of Social Support

Research into families of children and young people with disability maintain that parents or caregivers seem to experience higher levels of global stress than parents of children without disabilities, thereby presenting a high risk of developing disorders in their health and quality of life. The aim of this study is to understand the differences in parental stress and social support among groups of parents whose children have different disabilities in the context of parental adjustment to disability. Considering that adjustment is related to the effectiveness with which the family uses its resources and the support of their social network, we intend to analyse the differences of stress and social support among groups of parents of children with different problems and to clarify the relationships between the variables under study in order to adapt family intervention strategies. For this purpose a comparative, descriptive-correlational study was undertaken. The convenience sample included 152 parents of children with different disabilities (82 with intellectual disability, 37 with motor problems and 33 with autism) supported by schools and institutions in Viseu. The instruments used were: a Portuguese version of the Parenting Stress Index (Abidin, 1995), the Social Support Questionnaire – short version (Pinheiro & Ferreira, 2001) and a Parental Questionnaire (demographic and family data). Data were collected in schools and institutions that support people with disabilities, located in the Municipality of Viseu (Portugal). The results revealed significant differences between groups of parents in the partial results of parental stress, specifically in the Hyperactivity/Distract (DI), Acceptability (AC) and Adaptability (AD), dimensions of the Child Domain subscale (CD stress) and the Role Restriction (RO), dimension of Parent Domain subscale (PD stress). With regard to social support dimensions, we found significant differences between parents in the extent and availability of the social support network (SSQN).

The Impact of Regulation on a Firm's Incentives to Invest in Emergent Smart Grid Technologies

This paper analyzes the implementation of new technologies in network industries through the development of a suitable regulatory scheme. The analysis focuses on Smart Grid (SG) technologies which, among others benefits, could save operational costs and reduce the need for further conventional investments in the grid. In spite of the benefits that may result from their implementation, the adoption of SGs by network operators can be hampered by the uncertainties surrounding actual performances. A decision model has been developed to assess the firms' incentives to invest in "smart" technologies under different regulatory schemes. The model also enables testing the impact of uncertainties on the reduction of operational costs, and of conventional investments. Under certain circumstances, it may be justified to support the development and early deployment of emerging innovations that have a high potential to ameliorate the efficiency of the electricity system, but whose adoption faces many uncertainties.

Assessing the contribution of microgrids to the reliability of distribution networks

The emergence of microgeneration has recently lead to the concept of microgrid, a network of LV consumers and producers able to export electric energy in some circumstances and also to work in an isolated way in emergency situations. Research on the organization of microgrids, control devices, functionalities and other technical aspects is presently being carried out, in order to establish a consistent technical framework to support the concept. The successful development of the microgrid concept implies the definition of a suitable regulation for its integration on distribution systems. In order to define such a regulation, the identification of costs and benefits that microgrids may bring is a crucial task. Actually, this is the basis for a discussion about the way global costs could be divided among the different agents that benefit from the development of microgrids. Among other aspects, the effect of microgrids on the reliability of the distribution network has been pointed out as an important advantage, due to the ability of isolated operation in emergency situations. This paper identifies the situations where the existence of a microgrid may reduce the interruption rate and duration and thus improve the reliability indices of the distribution network. The relevant expressions necessary to quantify the reliability are presented. An illustrative example is included, where the global influence of the microgrid in the reliability is commented.

The Smart Paradox : Stimulate the deployment of Smart grids with effective regulatory instruments

The concept of SG (Smart Grids) encompasses a set of technologies that raise the intelligence of the electrical networks, such as smart meters or instruments of communication, sensing and auto-correction of networks. Nevertheless, the cost is still an important obstacle for the transformation of the current electricity system into a smarter one. Regulation can have an important role in setting up a favorable framework that fosters investments. However, the novelty with SG is the disembodied character of the technology, which may change the incentives of the regulated network companies to invest, affecting the effectiveness of the regulatory instruments (“cost plus” or “price cap”). This paper demonstrates that the solution to this “Smart” paradox requires strong incentive regulation mechanisms able to stimulate the adoption of SG technologies. Moreover, the regulation should not jeopardize conventional investments that are unable to be substituted by SG. Thus, a combination of performance regulation and efficiency obligations may be necessary.