Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

En torno a la fundamentación de la dignidad personal

Las trágicas experiencias de las guerras mundiales llevaron a la Declaración Universal de los Derechos Humanos promovida por la ONU en 1948. A partir de entonces gran parte de las Constituciones de nueva creación reconocen la inviolabilidad de la dignidad humana. Sin embargo, los redactores de la declaración pusieron empeño en omitir las razones teóricas en las que se fundan dichos derechos, por el temor a que diferencias teóricas aplazaran o hicieran inviable dicho reconocimiento. La fragmentación en la que se halla la antropología filosófica desde hace varios siglos está reclamando un principio unificador de los saberes en torno al ser humano. En este contexto la dignidad humana como experiencia universal se presenta como principio unificador. Seis décadas después sigue pendiente la elaboración de una sólida, y también universalmente aceptable, fundamentación de la dignidad humana y sus derechos fundamentales, cuestión complicada que parece requerir un nuevo avance en la ontología y en la antropología filosófica.

La protección de los derechos al honor, intimidad y propia imagen del menor con suficiente madurez: entre el respeto a sus decisiones y la intervención del Ministerio Fiscal

En virtud del art. 3.1 de la Ley Orgánica 1/1982, de 5 de mayo, cuando los menores tengan suficiente madurez deberán consentir por sí mismos las intromisiones en sus derechos al honor, intimidad y propia imagen. Sin embargo, atendiendo al art. 4 de la Ley Orgánica de Protección Jurídica del Menor, cuando la intromisión tenga lugar en un medio de comunicación seguirá siendo ilegítima, aun consentida por un menor maduro, si se considera contraria a su honor e intereses, debiendo intervenir en su defensa el Ministerio Fiscal. Esta regulación plantea diversas cuestiones relacionadas con la protección de los derechos al honor, intimidad y propia imagen del menor con suficiente madurez —en particular, sobre la función del fiscal como garante de estos derechos y el papel que se otorga al consentimiento del menor— que son objeto de estudio del presente trabajo.

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

The corporate regimen of labour companies in the New Act 44/2015, on 14th October, of labour and investee companies

Act 44/2015, on 14th October, of labour and investee companies, aims to accommodate the different instruments, limits and requirements with which the legal regime of the labour companies is set, to the current economic and legal context where they must develop their economic activity. The purpose of the law is to preserve their special status, while it seeks to modernize its legal structure to ensure the economic solvency of the business plan, without weakening the social profile that is required. The new law includes two organisational figures, ‘labour companies’ and the calling ‘investee companies’, of the last one, only leaving evidence of what is to be understood by them referring its regulation to a subsequent regulatory development. Until the publication of the regulation, our work has focused on the corporate aspect of the labour companies by analysing the modifications made on the typological elements and legal regime of these organisational figures to determine whether the law is the necessary and sufficient instrument to achieve the challenge proposed.

It is just not fair: the Endangered Species Act in the United States and Ontario

The United States and the Canadian province of Ontario have enacted endangered species laws that regulate private land. The rationale for this is that the vast majority of endangered species in the two countries rely on private lands for survival. However, from a landowner perspective the law is deemed unfair. This paper presents analysis from 141 interviews with landowners in three U.S. states and Ontario. In recognition of distributive justice claims, both the U.S. government and the Ontario government have enacted programs aimed at increasing financial incentives for participation and compliance with the law. However, the law is still perceived as unfair. The central argument of this paper is that future amendments and new policies for endangered species should confront two other forms of environmental justice: procedural justice and justice-as-recognition. Landowners in both countries expressed not only concerns about compensation, but also a deep desire to be included in the protection and recovery process, as well as to be recognized by government and society as good stewards of the land. The paper concludes by stating that future policy amendments need to address justice-as-recognition if endangered species conservation on private lands is to be considered fair by landowners.

Assessing variation in personal health service delivery and workplace smoking ban enforcement by local health departments

Thesis (Ph.D.)--University of Washington, 2016-08

Strategies for protecting intellectual property when using CUDA applications on graphics processing units

Recent advances in the massively parallel computational abilities of graphical processing units (GPUs) have increased their use for general purpose computation, as companies look to take advantage of big data processing techniques. This has given rise to the potential for malicious software targeting GPUs, which is of interest to forensic investigators examining the operation of software. The ability to carry out reverse-engineering of software is of great importance within the security and forensics elds, particularly when investigating malicious software or carrying out forensic analysis following a successful security breach. Due to the complexity of the Nvidia CUDA (Compute Uni ed Device Architecture) framework, it is not clear how best to approach the reverse engineering of a piece of CUDA software. We carry out a review of the di erent binary output formats which may be encountered from the CUDA compiler, and their implications on reverse engineering. We then demonstrate the process of carrying out disassembly of an example CUDA application, to establish the various techniques available to forensic investigators carrying out black-box disassembly and reverse engineering of CUDA binaries. We show that the Nvidia compiler, using default settings, leaks useful information. Finally, we demonstrate techniques to better protect intellectual property in CUDA algorithm implementations from reverse engineering.

The Brooklyn Hills Improvement Co.'s plat no. 1 : property at Woodhaven, L.I. ; Brooklyn Hills Improvement Co.'s map showing relative position of property to prominent points in cities of New York & Brooklyn /

Woodside map is black-and-white cadastral map with lot lines/dimensions, lot/block numbers, and street widths.

Les droits réels et personnels sur les titres détenus auprès d'un intermédiaire : analyse comparative en droit québécois interne et international privé

Les transactions sur les valeurs mobilières ainsi que leur mise en garantie se font bien au-delà des frontières nationales. Elles impliquent une multitude d’intervenants, tels que l’émetteur, un grand nombre d’intermédiaires disposés en structure pyramidale, un ou des investisseurs et, bien évidemment, les bénéficiaires desdites valeurs mobilières ou garanties. On peut aussi signaler l’existence de nombreux portefeuilles diversifiés contenant des titres émis par plusieurs émetteurs situés dans plusieurs états. Toute la difficulté d’une telle diversité d’acteurs, de composantes financières et juridiques, réside dans l’application de règles divergentes et souvent conflictuelles provenant de systèmes juridiques d’origines diverses (Common Law et civiliste). De nombreux juristes, de toutes nationalités confondues, ont pu constater ces dernières années que les règles de création, d’opposabilité et de réalisation des sûretés, ainsi que les règles de conflit de lois qui aident à déterminer la loi applicable à ces différentes questions, ne répondaient plus adéquatement aux exigences juridiques nationales dans un marché financier global, exponentiel et sans réelles frontières administratives. Afin de résoudre cette situation et accommoder le marché financier, de nombreux textes de loi ont été révisés et adaptés. Notre analyse du droit québécois est effectuée en fonction du droit américain et canadien, principales sources du législateur québécois, mais aussi du droit suisse qui est le plus proche de la tradition civiliste québécoise, le tout à la lueur de la 36e Convention de La Haye du 5 juillet 2006 sur la loi applicable à certains droits sur des titres détenus auprès d'un intermédiaire. Par exemple, les articles 8 et 9 du Uniform Commercial Code (UCC) américain ont proposé des solutions modernes et révolutionnaires qui s’éloignent considérablement des règles traditionnelles connues en matière de bien, de propriété, de sûreté et de conflits de lois. Plusieurs autres projets et instruments juridiques dédiés à ces sujets ont été adoptés, tels que : la Loi uniforme sur le transfert des valeurs mobilières (LUTVM) canadienne, qui a été intégrée au Québec par le biais de la Loi sur le transfert de valeurs mobilières et l’obtention de titres intermédiés, RLRQ, c.T-11.002 (LTVMQ) ; la 36e Convention de La Haye du 5 juillet 2006 sur la loi applicable à certains droits sur des titres détenus auprès d'un intermédiaire; la Loi fédérale sur le droit international privé (LDIP) suisse, ainsi que la Loi fédérale sur les titres intermédiés (LTI) suisse. L’analyse de ces textes de loi nous a permis de proposer une nouvelle version des règles de conflit de lois en matière de sûretés et de transfert des titres intermédiés en droit québécois. Cette étude devrait susciter une réflexion profonde du point de vue d’un juriste civiliste, sur l’efficacité des nouvelles règles québécoises de sûretés et de conflit de lois en matière de titres intermédiés, totalement inspirées des règles américaines de Common Law. Un choix qui semble totalement ignorer un pan du système juridique civiliste et sociétal.

Dolor osteo-muscular y factores asociados en el personal de enfermería de un centro hospitalario de alta complejidad en Colombia

Antecedentes: Los trastornos musculo-esqueléticos son una de las primeras causas de ausentismo laboral y afectan con mayor frecuencia columna y miembros. El personal de enfermería está expuesto a riesgo biomecánico superior dado por la manipulación manual de pacientes. Estimar la magnitud de asociación entre dolor osteo-muscular y carga biomecánica por movilización de pacientes en personal de enfermería y, los factores que modifican tal efecto, es de gran importancia en el ámbito laboral en busca de estrategias de prevención de enfermedades de origen laboral. Objetivo: determinar los factores predictores de dolor osteo-muscular en trabajadores de enfermería en un centro hospitalario de alta complejidad. Materiales y métodos: Estudio analítico transversal, en el que participaron 141 personas, quienes otorgaron su consentimiento informado. Los criterios de inclusión fueron: edad≥ 18 años, estudiantes, practicantes, auxiliares y jefes de enfermería asistenciales de salas de cirugía y hospitalización, antigüedad mínima de 2 meses en el cargo. Se utilizaron como criterios de exclusión: personal de enfermería en cargos administrativos y de las áreas de urgencias y cuidados intensivos, trabajadores con diagnóstico establecido artrosis, osteoartritis o artritis reumatoide, mujeres gestantes. Para lograr los objetivos aplicó el Cuestionario Nórdico, el cuestionario internacional de actividad física IPAQ y la metodología MAPO. Resultados: La frecuencia global de dolor osteo-muscular en el último año fue de 55%, implicando más frecuentemente columna lumbar, columna dorsal y miembro superior. Se evaluaron los servicios de onco-hematología, hospitalización y salas de cirugía y las clasificaciones de MAPO fueron medio a alto, no hubo áreas con riesgo irrelevante. Mediante análisis de regresión logística multivariada, se pudo determinar que los principales predictores de dolor osteo-muscular son trabajar en un área con MAPO nivel alto (OR=2,236, con respecto a MAPO medio) y en el turno de la mañana (OR=2,355, con respecto a turno en la tarde/noche).

Modelo de competencias en TIC para el personal de una organización del sector eléctrico

La presente investigación pretendió incorporar el uso intensivo de TIC en los procedimientos establecidos y necesarios en los procesos de generación, distribución y control de la energía, lo que se expresa en un manual para el sistema de gestión humana de la organización analizada. La investigación partió de un levantamiento de un estado del arte, continuó con la realización de un análisis de actitudes y aptitudes de los colaboradores, basado en propuestas teóricas y mejores prácticas existentes del medio, y, por último, concluyó con un manual de gestión humana en el que se indican las competencias en los diferentes perfiles de la organización para el uso de TIC y su aplicación, con el propósito de alinearse con las perspectivas y objetivos de la organización analizada al tener como base la perdurabilidad y la competitividad de la misma.

Decentralized systems for the protection and portability of personal data

The General Data Protection Regulation (GDPR) has been designed to help promote a view in favor of the interests of individuals instead of large corporations. However, there is the need of more dedicated technologies that can help companies comply with GDPR while enabling people to exercise their rights. We argue that such a dedicated solution must address two main issues: the need for more transparency towards individuals regarding the management of their personal information and their often hindered ability to access and make interoperable personal data in a way that the exercise of one's rights would result in straightforward. We aim to provide a system that helps to push personal data management towards the individual's control, i.e., a personal information management system (PIMS). By using distributed storage and decentralized computing networks to control online services, users' personal information could be shifted towards those directly concerned, i.e., the data subjects. The use of Distributed Ledger Technologies (DLTs) and Decentralized File Storage (DFS) as an implementation of decentralized systems is of paramount importance in this case. The structure of this dissertation follows an incremental approach to describing a set of decentralized systems and models that revolves around personal data and their subjects. Each chapter of this dissertation builds up the previous one and discusses the technical implementation of a system and its relation with the corresponding regulations. We refer to the EU regulatory framework, including GDPR, eIDAS, and Data Governance Act, to build our final system architecture's functional and non-functional drivers. In our PIMS design, personal data is kept in a Personal Data Space (PDS) consisting of encrypted personal data referring to the subject stored in a DFS. On top of that, a network of authorization servers acts as a data intermediary to provide access to potential data recipients through smart contracts.

Dyspareunia In Hiv-positive And Hiv-negative Middle-aged Women: A Cross-sectional Study.

To evaluate whether dyspareunia is associated with HIV status in menopausal women and also to assess which factors are associated with dyspareunia in a group of HIV-positive menopausal women. A cross-sectional study was conducted with 178 HIV-negative and 128 HIV-positive women aged 40-60 years. The Short Personal Experiences Questionnaire (SPEQ) was used to collect data. Sociodemographic, clinical, behavioural and reproductive factors were evaluated, as well as factors related to the HIV infection. Dyspareunia was defined as pain during intercourse. A bivariate analysis and Poisson multiple regression analysis were performed. Overall, 41.4% of the HIV-positive women reported dyspareunia compared with 34.8% of the HIV-negative women (p=0.242). In the HIV-positive women, bivariate analysis revealed an association between dyspareunia and having a steady partner (p=0.047); the woman's partner having undergone HIV testing (p=0.020); vaginal dryness (p<0.001); muscle/joint pain (p=0.021); physical/emotional violence (p=0.049); urinary incontinence (p=0.004); and the use of lamivudine/zidovudine (p=0.048). The Poisson multiple regression analysis found an association between dyspareunia and vaginal dryness (prevalence ratio (PR)=1.96, 95% CI 1.10 to 3.50, p=0.023) and urinary incontinence (PR=1.86, 95% CI 1.06 to 3.27, p=0.031). Dyspareunia was common in this group of HIV-positive women and was associated principally with vaginal dryness and urinary incontinence. The importance of treating dyspareunia within the context of sexual health in this group of women should be emphasised and appropriate management of this issue may reduce the likelihood of lesions on the vaginal wall, which may act as a portal of entry for other infections.

Gestos nos cantos da Lagoa Azul : crianças brincantes produtoras de cultura

Universidade Estadual de Campinas . Faculdade de Educação Física