Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Una década de planes de movilidad urbana sostenible en España 2004-2014

Los Planes de Movilidad Urbana Sostenible (PMUS) son una herramienta de reciente implantación en España que en la última década se ha desarrollado en un buen número de municipios. El objetivo es conocer cuál ha sido la dimensión territorial y el impacto que este instrumento de planificación de la movilidad ha tenido en nuestro país entre los años 2004 y 2014. Como resultado se ha logrado describir el panorama de los PMUS en España y su evolución durante esta última década en cada una de las Comunidades Autónomas.

D5.5 – First Version Scenario Arrangement Document – round 1

This deliverable outlines the implementation plan for each of the first-round studies of the RAGE pilots. The main goal of these pilots is to perform a small-scale test of the RAGE games with end-users and intermediary stakeholders in five different non-leisure domains to guide the further development of the games for the final validation studies. At the same time the pilots implement the pre-testing of the research instruments and methodology for answering the main evaluation questions in the five areas of investigation identified in D8.1: 1) usability, 2) game experience, 3) learning effectiveness, 4) transfer effect and 5) pedagogical costs and benefits. Finally, the pilots are aimed at collecting preliminary results for a first formative evaluation of the games and game technologies, with the goal of feeding back useful information to development for the final versions of games and assets. The results of the first pilot will be compared with the results of the final evaluation studies to demonstrate improvements of the game and game effects from first to final version. A revision of the deliverable will be done in the next few months to produce the final arrangement document (D5.1, due at M21).

Task sharing within a managed clinical network to improve child health in Malawi

BACKGROUND: Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village health clinics to district hospitals which refers patients to one of the four central hospitals. The clinics and district hospitals are staffed by nurses, non-physician clinicians and recently qualified doctors. There are 16 paediatric specialists working in two of the four central hospitals which serve the urban population as well as accepting referrals from district hospitals. In order to provide expert paediatric care as close to home as possible, we describe our plan to task share within a managed clinical network and our hypothesis that this will improve paediatric care and child health.

PRESENTATION OF THE HYPOTHESIS: Managed clinical networks have been found to improve equity of care in rural districts and to ensure that the correct care is provided as close to home as possible. A network for paediatric care in Malawi with mentoring of non-physician clinicians based in a district hospital by paediatricians based at the central hospitals will establish and sustain clinical referral pathways in both directions. Ultimately, the plan envisages four managed paediatric clinical networks, each radiating from one of Malawi's four central hospitals and covering the entire country. This model of task sharing within four hub-and-spoke networks may facilitate wider dissemination of scarce expertise and improve child healthcare in Malawi close to the child's home.

TESTING THE HYPOTHESIS: Funding has been secured to train sufficient personnel to staff all central and district hospitals in Malawi with teams of paediatric specialists in the central hospitals and specialist non-physician clinicians in each government district hospital. The hypothesis will be tested using a natural experiment model. Data routinely collected by the Ministry of Health will be corroborated at the district. This will include case fatality rates for common childhood illness, perinatal mortality and process indicators. Data from different districts will be compared at baseline and annually until 2020 as the specialists of both cadres take up posts.

IMPLICATIONS OF THE HYPOTHESIS: If a managed clinical network improves child healthcare in Malawi, it may be a potential model for the other countries in sub-Saharan Africa with similar cadres in their healthcare system and face similar challenges in terms of scarcity of specialists.

Extending Automated Testing To High-level Software Requirements : A study on the feasibility of automated acceptance-testing

Automated acceptance testing is the testing of software done in higher level to test whether the system abides by the requirements desired by the business clients by the use of piece of script other than the software itself. This project is a study of the feasibility of acceptance tests written in Behavior Driven Development principle. The project includes an implementation part where automated accep- tance testing is written for Touch-point web application developed by Dewire (a software consultant company) for Telia (a telecom company) from the require- ments received from the customer (Telia). The automated acceptance testing is in Cucumber-Selenium framework which enforces Behavior Driven Development principles. The purpose of the implementation is to verify the practicability of this style of acceptance testing. From the completion of implementation, it was concluded that all the requirements from customer in real world can be converted into executable specifications and the process was not at all time-consuming or difficult for a low-experienced programmer like the author itself. The project also includes survey to measure the learnability and understandability of Gherkin- the language that Cucumber understands. The survey consist of some Gherkin exam- ples followed with questions that include making changes to the Gherkin exam- ples. Survey had 3 parts: first being easy, second medium and third most difficult. Survey also had a linear scale from 1 to 5 to rate the difficulty level for each part of the survey. 1 stood for very easy and 5 for very difficult. Time when the partic- ipants began the survey was also taken in order to calculate the total time taken by the participants to learn and answer the questions. Survey was taken by 18 of the employers of Dewire who had primary working role as one of the programmer, tester and project manager. In the result, tester and project manager were grouped as non-programmer. The survey concluded that it is very easy and quick to learn Gherkin. While the participants rated Gherkin as very easy.

Analysis of the Market Potential of Syrian Organic Fruit and Vegetables for Exports to Germany

Syria has been a major producer and exporter of fresh fruit and vegetables (FFV) in the Arabic region. Prior to 2011, Syrian FFV were mainly exported to the neighbouring countries, the Gulf States and Northern Africa as well as to Eastern European countries. Although the EU is potentially one of the most profitable markets of high quality FFV (such as organic ones) in the world, Syrian exports of FFV to Western European countries like Germany have been small. It could be a lucrative opportunity for Syrian growers and exporters of FFV to export organic products to markets such as Germany, where national production is limited to a few months due to climatic conditions. Yet, the organic sector in Syria is comparatively young and only a very small area of FFV is certified according to EU organic regulations. Up to the author’s knowledge, little was known about Syrian farmers’ attitudes towards organic FFV production. There was also no study so far that explored and analysed the determining factors for organic FFV adoption among Syrian farmers as well as the exports of these products to the EU markets. The overarching aim of the present dissertation focused on exploring and identifying the market potential of Syrian exports of organic FFV to Germany. The dissertation was therefore concerned with three main objectives: (i) to explore if German importers and wholesalers of organic FFV see market opportunities for Syrian organic products and what requirements in terms of quality and quantity they have, (ii) to determine the obstacles Syrian producers and exporters face when exporting agricultural products to Germany, and (iii) to investigate whether Syrian farmers of FFV can imagine converting their farms to organic production as well as the underlying reasons why they do so or not. A twofold methodological approach with expert interviews and a farmer survey were used in this dissertation to address the abovementioned objectives. While expert interviews were conducted with German and Syrian wholesalers of (organic) FFV in 2011 (9 interviews each), the farmer survey was administrated with 266 Syrian farmers of FFV in the main region for the production of FFV (i.e. the coastal region) from November 2012 till May 2013. For modelling farmers’ decisions to adopt organic farming, the Theory of Planned Behaviour as theoretical framework and Partial Least Squares Structural Equation Modelling as the main method for data analysis were used in this study. The findings of this dissertation yield implications for the different stakeholders (governmental institutions and NGOs, farmers, exporters, wholesalers, etc.) who are interested in prompting the Syrian export of organic products. Based on the empirical results and a literature review, an action plan to promote Syrian production and export of organic products was developed which can help in the post-war period in Syria at improving the organic sector.

Retour post-isolement en milieu psychiatrique : développement, implantation et évaluation d’une intervention en soins aigus

L’isolement avec ou sans contention (IC) en milieu psychiatrique touche près d’un patient sur quatre au Québec (Dumais, Larue, Drapeau, Ménard, & Giguère-Allard, 2011). Il est pourtant largement documenté que cette pratique porte préjudice aux patients, aux infirmières et à l’organisation (Stewart, Van der Merwe, Bowers, Simpson, & Jones, 2010). Cette mesure posant un problème éthique fait l’objet de politiques visant à la restreindre, voire à l’éliminer. Les études sur l’expérience de l’isolement du patient de même que sur la perception des infirmières identifient le besoin d'un retour sur cet évènement. Plusieurs équipes de chercheurs proposent un retour post-isolement (REPI) intégrant à la fois l’équipe traitante, plus particulièrement les infirmières, et le patient comme intervention afin de diminuer l’incidence de l’IC. Le REPI vise l’échange émotionnel, l’analyse des étapes ayant mené à la prise de décision d’IC et la projection des interventions futures. Le but de cette étude était de développer, implanter et évaluer le REPI auprès des intervenants et des patients d’une unité de soins psychiatriques aigus afin d’améliorer leur expérience de soins. Les questions de recherche étaient : 1) Quel est le contexte d’implantation du REPI? 2) Quels sont les éléments facilitants et les obstacles à l’implantation du REPI selon les patients et les intervenants? 3) Quelle est la perception des patients et des intervenants des modalités et retombées du REPI?; et 4) L’implantation du REPI est-elle associée à une diminution de la prévalence et de la durée des épisodes d’IC? Cette étude de cas instrumentale (Stake, 1995, 2008) était ancrée dans une approche participative. Le cas était celui de l’unité de soins psychiatriques aigus pour premier épisode psychotique où a été implanté le REPI. En premier lieu, le développement du REPI a d’abord fait l’objet d’une documentation du contexte par une immersion dans le milieu (n=56 heures) et des entretiens individuels avec un échantillonnage de convenance (n=3 patients, n=14 intervenants). Un comité d’experts (l’étudiante-chercheuse, six infirmières du milieu et un patient partenaire) a par la suite développé le REPI qui comporte deux volets : avec le patient et en équipe. L’évaluation des retombées a été effectuée par des entretiens individuels (n= 3 patients, n= 12 intervenants) et l’examen de la prévalence et de la durée des IC six mois avant et après l’implantation du REPI. Les données qualitatives ont été examinées selon une analyse thématique (Miles, Huberman, & Saldana, 2014), tandis que les données quantitatives ont fait l’objet de tests descriptifs et non-paramétriques. Les résultats proposent que le contexte d’implantation est défini par des normes implicites et explicites où l’utilisation de l’IC peut générer un cercle vicieux de comportements agressifs nourris par un profond sentiment d’injustice de la part des patients. Ceux-ci ont l’impression qu’ils doivent se conformer aux attentes du personnel et aux règles de l’unité. Les participants ont exprimé le besoin de créer des opportunités pour une communication authentique qui pourrait avoir lieu lors du REPI, bien que sa pratique soit variable d’un intervenant à un autre. Les résultats suggèrent que le principal élément ayant facilité l’implantation du REPI est l’approche participative de l’étude, alors que les obstacles rencontrés relèvent surtout de la complexité de la mise en œuvre du REPI en équipe. Lors du REPI avec le patient, les infirmières ont pu explorer ses sentiments et son point de vue, ce qui a favorisé la reconstruction de la relation thérapeutique. Quant au REPI avec l’équipe de soins, il a été perçu comme une opportunité d’apprentissage, ce qui a permis d’ajuster le plan d’intervention des patients. Suite à l’implantation du REPI, les résultats ont d’ailleurs montré une réduction significative de l’utilisation de l’isolement et du temps passé en isolement. Les résultats de cette thèse soulignent la possibilité d’outrepasser le malaise initial perçu tant par le patient que par l’infirmière en systématisant le REPI. De plus, cette étude met l’accent sur le besoin d’une présence authentique pour atteindre un partage significatif dans la relation thérapeutique, ce qui est la pierre d’assise de la pratique infirmière en santé mentale. Cette étude contribue aux connaissances sur la prévention des comportements agressifs en milieu psychiatrique en documentant le contexte dans lequel se situe l’IC, en proposant un REPI comportant deux volets de REPI et en explorant ses retombées. Nos résultats soutiennent le potentiel du développement d’une prévention tertiaire qui intègre à la fois la perspective des patients et des intervenants.

D5.1 – Scenario Arrangement Document – round 1

This deliverable is a confirmation and update of 'D5.5 - First Version Scenario Arrangement Document – round 1' after a revisions with game developers. It outlines the implementation plan for each of the first-round studies of the RAGE pilots. The main goal of these pilots is to perform a small-scale test of the RAGE games with end-users and intermediary stakeholders in five different non-leisure domains to guide the further development of the games for the final validation studies.

Highway Location Reference Procedure Project, 1990

The purpose of the proposed Highway Location Reference Procedure is stated in the contract as follows: "Establishment of a highway network locational reference process that will primarily allow for the proper correlation of pavement management data, and secondarily provide the basis for other existing and future data base integration and for the planned Iowa DOT Geographic Information System. In addition, the locational reference process will be able to correlate network applications with a statewide spatial location method to facilitate the relationship of Iowa DOT data to that of other agencies and to allow for the graphic display of the network in map form." The Design Specifications and Implementation Plan, included in this Final Report, are intended to provide the basis for proceeding with immediate development and implementation of the pavement management system. These specifications will also support the future Iowa DOT implementation of other integrated data bases and/or the planned Geographic Information System.

The Advocate E-Newsletter, March 9, 2016

At the end of February, the Centers for Medicare & Medicaid Services approved Iowa's plan to modernize Medicaid with an implementation date of April 1, 2016, citing significant improvements the state has made to demonstrate readiness and enhance provider networks. Updates to MDS Section Q Materials. Severe Weather Awareness Week. Long-Term Care Social Workers of Iowa Spring Conference (April 14-15, Gateway Conference Center, Ames). Iowa Governor's Conference on Aging & Disabilities (May 23-26, Iowa Events Center, Des Moines). New Resource to Help LGBT Elders Avoid the Sweetheart Scam.

bepress Launches Beta of Expert Gallery to Promote Research Expertise

We at bepress are excited to announce the beta launch of the Expert Gallery, a new product for institutions eager to highlight the rich expertise of their faculty. The Expert Gallery facilitates the valuable work of connecting an institution’s researchers with opportunities that might otherwise be missed. Groups such as Marketing and Communications and the Office of Research can use the product to better land funding opportunities, speaking engagements, and professional collaborations for top faculty members. The Expert Gallery is designed to let stakeholders within and outside of the institution find researchers by interest, skill set, and research emphasis: simple searching and browsing, along with the flexibility to create and display custom galleries, helps facilitate targeted discovery for experts on campus. A built-in, rich toolset lets institutions organize, manage, and connect their researchers to the right opportunities and interested parties outside the institution. While most expert galleries contain just biographical information and a bibliography, integration of the bepress Expert Gallery with SelectedWorks profiles lets researchers prove their expertise with a full picture of their scholarly research, including published and unpublished works, datasets, teaching materials, and media appearances. Launching the Expert Gallery as a new product reflects an important expansion of bepress’s mission. For years we’ve helped libraries reclaim their central role through providing services across campus. We’ve especially focused on supporting the library in its important efforts to promote the institution through the scholarship it produces. With the Expert Gallery, the library can meet its campus’s needs to go beyond demonstrating the value of its scholarship. Now the library can offer a way to promote the institution through the rich skills of the people who make it unique. We plan to continue on this path of helping institutions maximize the impact of people as well as their people’s scholarship. In early 2017 we will launch a suite of services that includes SelectedWorks, the Expert Gallery, and a set of faculty reporting and analytics tools.

And now for something completely different: looking ahead to new encryption and secrecy protocols

Transmitting sensitive data over non-secret channels has always required encryption technologies to ensure that the data arrives without exposure to eavesdroppers. The Internet has made it possible to transmit vast volumes of data more rapidly and cheaply and to a wider audience than ever before. At the same time, strong encryption makes it possible to send data securely, to digitally sign it, to prove it was sent or received, and to guarantee its integrity. The Internet and encryption make bulk transmission of data a commercially viable proposition. However, there are implementation challenges to solve before commercial bulk transmission becomes mainstream. Powerful have a performance cost, and may affect quality of service. Without encryption, intercepted data may be illicitly duplicated and re-sold, or its commercial value diminished because its secrecy is lost. Performance degradation and potential for commercial loss discourage the bulk transmission of data over the Internet in any commercial application. This paper outlines technical solutions to these problems. We develop new technologies and combine existing ones in new and powerful ways to minimise commercial loss without compromising performance or inflating overheads.

Retail Food Establishments: Guide to HACCP Plans

A Hazard Analysis and Critical Control Point (HACCP) system is a plan to reduce the risk of safety hazards in food. The HACCP System identifies potential biological, chemical and physical hazards from the time the food enters the facility to when it is served. The Hazard Analysis identifies critical control points based on the ingredients, raw materials and processes. Control measures are then identified, implemented and monitored to ensure the ongoing safety of the finished products.

Internationalization of IT company: Case study of a Finnish MOOC platform

The interest to small and media size enterprises’ (SMEs) internationalization process is increasing with a growth of SMEs’ contribution to GDP. Internet gives an opportunity to provide variety of services online and reach market niche worldwide. The overlapping of SMEs’ internationalization and online services is the main issue of the research. The most SMEs internationalize according to intuitive decisions of CEO of the company and lose limited resources to worthless attempts. The purpose of this research is to define effective approaches to online service internationalization and selection of the first international market. The research represents single holistic case study of local massive open online courses (MOOCs) platform going global. It considers internationalization costs and internationalization theories applicable to online services. The research includes preliminary screening of the markets and in-depth analysis based on macro parameters of the market and specific characteristics of the customers and expert evaluation of the results. The specific issues as GILT (Globalization, Internationalization, Localization and Translation) approach and Internet-enabled internationalization are considered. The research results include recommendations on international market selection methodology for online services and for effective internationalization strategy development.

Plano de negócios Pharma SPA

A promoção de um espírito empreendedor e de inovação é uma necessidade primordial para o crescimento económico, sustentado na criação de empresas inovadoras. Este trabalho de projecto consiste na elaboração de um plano de negócios para a criação de um empreendimento, que propõe uma nova abordagem estratégica ao sector parafarmacêutico. A Pharma Spa pretende promover o negócio de uma forma inovadora, através da diversificação e complementaridade da actividade da parafarmácia, com a prestação de serviços da área da saúde e bem-estar, integrando uma clínica e um Spa. Este conceito de negócio segue uma estratégia de Marketing Lateral e aposta nas relações com o cliente, promovendo o Marketing Experiencial. O plano de negócios apresentado, permite aferir que a Pharma Spa apresenta viabilidade económico-financeira, sendo interessante a sua concretização, pelo que podemos inferir que estamos na presença de um projecto com elevado potencial de sucesso. ABSTRACT; The promotion of an entrepreneurial and innovative spirit is a primordial necessity for economic growth, supported by the creation of innovative companies. This project consists in the elaboration of a business plan to create an enterprise, which considers a new strategical vision to the parapharmaceutical sector. The Pharma Spa pretends to promote the business in an innovative way, through the diversification and complementing of the parapharmacy activity, with the services rendering in the health area and well-being, integrating a clinic and a Spa. This business concept follows a strategy of “Lateral Marketing” and increment the relations with the customer, promoting the “Experiential Marketing”. The business plan presented, allows concluding that the Pharma Spa presents economical and financial viability, which his implementation is interesting, and we can assess that we are in the presence of a project with high potential of success.