Evaluation of an integrated system for classification, assessment and comparison of services for long-term care in Europe: the eDESDE-LTC study

Background: The harmonization of European health systems brings with it a need for tools to allow the standardized collection of information about medical care. A common coding system and standards for the description of services are needed to allow local data to be incorporated into evidence-informed policy, and to permit equity and mobility to be assessed. The aim of this project has been to design such a classification and a related tool for the coding of services for Long Term Care (DESDE-LTC), based on the European Service Mapping Schedule (ESMS). Methods: The development of DESDE-LTC followed an iterative process using nominal groups in 6 European countries. 54 researchers and stakeholders in health and social services contributed to this process. In order to classify services, we use the minimal organization unit or “Basic Stable Input of Care” (BSIC), coded by its principal function or “Main Type of Care” (MTC). The evaluation of the tool included an analysis of feasibility, consistency, ontology, inter-rater reliability, Boolean Factor Analysis, and a preliminary impact analysis (screening, scoping and appraisal). Results: DESDE-LTC includes an alpha-numerical coding system, a glossary and an assessment instrument for mapping and counting LTC. It shows high feasibility, consistency, inter-rater reliability and face, content and construct validity. DESDE-LTC is ontologically consistent. It is regarded by experts as useful and relevant for evidence-informed decision making. Conclusion: DESDE-LTC contributes to establishing a common terminology, taxonomy and coding of LTC services in a European context, and a standard procedure for data collection and international comparison.

A Construction Management Framework for Mass Customisation in Traditional Construction

A Mass Customisation model is discussed as a competitive positioning strategy in the marketplace adding value to the customer’s end-use. It includes the user as part of the construction process responding to the customer’s demands and wishes. To the present day, almost all proposals for Mass Customisation have been focused on the design phase and single family houses. The reality is that the processes carried out in the work execution are so inefficient that the costs of the Mass Customisation models are assumed by the customer and they do not offer solutions that support the change management. Furthermore, this inefficiency often makes Mass Customisation unfeasible in terms of deadlines and site management. Therefore, the present proposal focuses on achieving the paradigm of Mass Customisation in the traditional residential construction complementary to the existing proposals in the design phase. All this through the proposal of a framework for the integral management in the work execution, which will address change management introduced by the users offering an efficient and productive model that reduces costs in the process. This model will focus on the synergy between different strategies, techniques and technologies currently used in the construction management (such as Lean Construction or Six Sigma), together with, other strategies and technologies that have proven to be valid solutions in other fields (such as Business Process Management, Service Oriented Architecture, etc.).

Using causal maps to support ex-post assessment of social impacts of dams

This paper presents the results of an ex-post assessment of two important dams in Brazil. The study follows the principles of Social Impact Management, which offer a suitable framework for analyzing the complex social transformations triggered by hydroelectric dams. In the implementation of this approach, participative causal maps were used to identify the ex-post social impacts of the Porto Primavera and Rosana dams on the community of Porto Rico, located along the High Paraná River. We found that in the operation of dams there are intermediate causes of a political nature, stemming from decisions based on values and interests not determined by neutral, exclusively technical reasons; and this insight opens up an area of action for managing the negative impacts of dams.

Geological risk assessment of Amtoudi Agadir in southern Morocco: a key case for sustainable cultural heritage

Medieval fortified granaries known as “agadirs” are very common in southern Morocco, being catalogued as world cultural heritage by United Nations. These Berber buildings (made of stones and tree trunks) usually located on rocky promontories, constitute historical testimonials related to the origin of Morocco, and, as tourist attractions, have a positive impact on the local economy. The sustainability of these ancient monuments requires geological-risk evaluations of the massif stability under the agadir with the proposal of stabilization measures, and an architectonic analysis with appropriate maintenance of the structural elements. An interdisciplinary study including climate, seismicity, hydrology, geology, geomorphology, geotechnical surveys of the massif, and diagnosis of the degradation of structural elements have been performed on the Amtoudi Agadir, selected as a case study. The main findings from this study are that the prevalent rocks used for construction (coming from the underlying substratum) are good-quality arkosic sandstones; the SW cliffs under the agadir are unstable under water saturation; some masonry walls are too thin and lack interlocking stones and mortar; and failures in the beams (due to flexure, fracture, and exhaustion in the resistance due to insect attacks or plant roots) are common. The basic risk assessment of ancient buildings of cultural heritage and their geologic substratum are needed especially in undeveloped areas with limited capacity to implement durable conservation policies. Therefore, recommendations have been provided to ensure the stability and maintenance of this important archaeological site.