Will austerity cuts dismantle the Spanish healthcare system?

In the face of austerity, a series of disconnected “reforms” could, without corrective measures, lead to the effective dismantling of large parts of the Spanish healthcare system, with potentially detrimental effects on health. Helena Legido-Quigley and colleagues explain.

Using realist evaluation to assess primary healthcare teams’ responses to intimate partner violence in Spain

Objective: Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application. Methods: We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis. Results: There were several key mechanisms —the teams’ self-efficacy, perceived preparation, women-centred care—, and contextual factors —an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care—that should be considered to develop adequate primary health-care responses to violence. Conclusion: The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings.

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules

Background: Numerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise. Methods: This article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules. Results: A contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted. Conclusion: The authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare.

Aging and the governance of the healthcare system in Japan. Bruegel Working Paper 2014/14, December 2014

Japan is the most rapidly aging country in the world. This is evidence that the social security system, which consists of the pension system, healthcare system and other programmes, has been working well. The population is shrinking because of a falling birth rate. It is expected that the population will fall from 128 million in 2010 to 87 million in 2060. During this period, the ratio of people aged 65 or over will rise from 23 percent to 39.9 percent. Japan’s age dependency ratio was 62 in 2013, the highest among advanced nations. It is expected to rise sharply to 94 in 2050 (see Figure 1 on page 4). A total reform of the Japanese social security system, therefore, is inevitable. From the point of view of fiscal reconstruction, reform of the healthcare system is the most important issue. The biggest problem in the healthcare system is that both the funding system and the care-delivery system are extremely fragmented. The government is planning its reform of the healthcare system based on the principle of integration. Other advanced economies could learn from the Japanese experience.

Rilievi cinematici continui condotti con sensori a basso costo

Nel qui presente elaborato vengono descritte le principali caratteristiche del sistema di posizionamento GPS e le tecniche di rilievo. Particolare attenzione viene posta al rilievo cinematico continuo con sensori a basso costo (Ublox EVK 7P). Inotre verra descritta nel dettaglio la strumentazione atta ad acquisire il segnale, e la relativa preparazione. In particolare i dati acquisiti dalla strumentazione verranno elaborati con appositi software, dai quali si otterranno diverse soluzioni. Di seguito sara presente anche la procedura di elaborazione dei dati registrati. In fine le soluzioni ottenute saranno oggetto di confronto.

Utilizzo di sensori a basso costo per la localizzazione indoor

I sistemi di localizzazione, negli ultimi anni, sono stati oggetto di numerose ricerche a livello internazionale.Gli sviluppi più importanti hanno avuto inizio nell’ambito stradale con sistemi di navigazione e localizzazione, possibili grazie alle forti capacità del GPS.Infatti il GPS indica l’intero apparato che permette il funzionamento della maggior parte dei navigatori disponibili in commercio, che, però, non sono utilizzabili in ambito indoor, in quanto la ricezione del segnale proveniente dai satelliti GPS diventa scarsa o pressoché nulla. In questo senso, la localizzazione risulta rilevante nel caso di indoor positioning, ossia quando utenti hanno bisogno di conoscere la propria posizione e quella degli altri membri della squadra di soccorso all’interno di un edificio come, ad esempio, i vigili del fuoco durante un’operazione di salvataggio. Sono questi fattori che portano all’idea della creazione di un sistema di localizzazione indoor basato su smartphone o una qualsiasi altra piattaforma disponibile. Tra le diverse tecnologie e architetture legate al posizionamento indoor/outdoor e inerziale, con questa tesi, si vuole esporre la foot-mounted inertial navigation, un sistema che permette di conoscere la propria posizione, sia all’interno di edifici,sia in campi aperti, tramite l’utilizzo di una rete wireless o GPS e l’aiuto di sensori a basso costo.Tuttavia per conoscere la stima ottimale della posizione, della velocità e dell’orientamento corrente di un utente dotato di sensori sarà necessaria l’integrazione di diversi algoritmi, che permettono di modellare e stimare errori o di conoscere e predire la posizione futura dello stesso. Gli scopi principali di questo lavoro sono: 1)Tracciare i movimenti di un utente usando diversi sensori per ottenere una stima ottimale della posizione dello stesso; 2)Localizzare l’utente in 3 dimensioni con precisione; 3)Ottenere una transizione senza interruzioni per un posizionamento continuo tra aree indoor e outdoor;

Království ticha a smíru; básně (1905-1907)

Author's pseudonym, Jan Rokyta, at head of title.

Na domácí půdě : básně /

Mode of access: Internet.

Performance audit [of] the Department of Healthcare and Family Services Prompt Payment Act Compliance and Medicaid Payment Process /

Contains performance audit of state moneys provided by or through Illinois state agencies to the Illinois Dept. of Healthcare and Family Services Prompt Payment Act Compliance and Medicaid Payment Process, under contracts or grant agreements in year 2007.

Fialky; básné od Ant. Jaroslawa Puchmagera.

Mode of access: Internet.

Nowé básné.

Mode of access: Internet.