Public Procurement Law and Health care: From Theory to Practice. Research Paper in Law, 2/2010

From the Introduction. This contribution will focus on the core question if, how and to what extent the EU procurement rules and principles (may) affect the national health care systems. We start our analysis by summarizing the applicable EU public procurement legislation, principles and soft law and its exact scope in relation to health care. (section 2). Subsequently, we turn to the parties in a contract, subject to procurement rules in the field of health care, addressing both the definition of contracting authorities and relevant case law (section 3). This will then lead to an analysis of possible justifications for not holding a tender procedure in the field of health care (section 4). Finally, we illustrate the impact of EU public procurement rules on health care by analysing a Dutch case study, in which the question whether public hospitals in the Netherlands qualify as contracting authorities in terms of the Public Sector Directive stood central (section 5). Our conclusions will follow in section 6.

Analysis of analogue models by helical X-ray computed tomography

The aim of analogue model experiments in geology is to simulate structures in nature under specific imposed boundary conditions using materials whose rheological properties are similar to those of rocks in nature. In the late 1980s, X-ray computed tomography (CT) was first applied to the analysis of such models. In early studies only a limited number of cross-sectional slices could be recorded because of the time involved in CT data acquisition, the long cooling periods for the X-ray source and computational capacity. Technological improvements presently allow an almost unlimited number of closely spaced serial cross-sections to be acquired and calculated. Computer visualization software allows a full 3D analysis of every recorded stage. Such analyses are especially valuable when trying to understand complex geological structures, commonly with lateral changes in 3D geometry. Periodic acquisition of volumetric data sets in the course of the experiment makes it possible to carry out a 4D analysis of the model, i.e. 3D analysis through time. Examples are shown of 4D analysis of analogue models that tested the influence of lateral rheological changes on the structures obtained in contractional and extensional settings.

System Analysis of Innovative Projects in Mechanical Engineering

Modern production and innovation processes in industrial corporations differ by complex nature of modern technologies and organizational solutions. Adequate methodological approaches to their analysis and evaluation of efficiency are required. The present study contains the conceptand the model of operational and innovation program for which formulated theoretical and methodological principles and systematic statement of the general problem of planning, designed to optimize the process of resource usage under different criteria, including: investment, financial, technological, industrial and information capabilities of the corporation.

Phytoplankton abundance measured on water samples from rivers of the Lena Delta in 2010

The Lena Delta in Northern Siberia is one of the largest river deltas in the world. During peak discharge, after the ice melt in spring, it delivers between 60-8000 m**3/s of water and sediment into the Arctic Ocean. The Lena Delta and the Laptev Sea coast also constitute a continuous permafrost region. Ongoing climate change, which is particularly pronounced in the Arctic, is leading to increased rates of permafrost thaw. This has already profoundly altered the discharge rates of the Lena River. But the chemistry of the river waters which are discharged into the coastal Laptev Sea have also been hypothesized to undergo considerable compositional changes, e.g. by increasing concentrations of inorganic nutrients such as dissolved organic carbon (DOC) and methane. These physical and chemical changes will also affect the composition of the phytoplankton communities. However, before potential consequences of climate change for coastal arctic phytoplankton communities can be judged, the inherent status of the diversity and food web interactions within the delta have to be established. In 2010, as part of the AWI Lena Delta programme, the phyto- and microzooplankton community in three river channels of the delta (Trofimov, Bykov and Olenek) as well as four coastal transects were investigated to capture the typical river phytoplankton communities and the transitional zone of brackish/marine conditions. Most CTD profiles from 23 coastal stations showed very strong stratification. The only exception to this was a small, shallow and mixed area running from the outflow of Bykov channel in a northerly direction parallel to the shore. Of the five stations in this area, three had a salinity of close to zero. Two further stations had salinities of around 2 and 5 throughout the water column. In the remaining transects, on the other hand, salinities varied between 5 and 30 with depth. Phytoplankton counts from the outflow from the Lena were dominated by diatoms (Aulacoseira species) cyanobacteria (Aphanizomenon, Pseudanabaena) and chlorophytes. In contrast, in the stratified stations the plankton was mostly dominated by dinoflagellates, ciliates and nanoflagellates, with only an insignificant diatom component from the genera Chaetoceros and Thalassiosira (brackish as opposed to freshwater species). Ciliate abundance was significantly coupled with the abundance of total flagellates. A pronounced partitioning in the phytoplankton community was also discernible with depth, with a different community composition and abundance above and below the thermocline in the stratified sites. This work is a first analysis of the phytoplankton community structure in the region where Lena River discharge enters the Laptev Sea.

An analysis of the 1953 Tennessee home rule amendments [number 6 and number 7]

Mode of access: Internet.

Spatial and temporal characteristics of summer precipitation over Central Europe in a suite of high-resolution climate models

High-impact, localized intense rainfall episodes represent a major socio-economic problem for societies worldwide, and at the same time these events are notoriously difficult to simulate properly in climate models. Here, the authors investigate how horizontal resolution and model formulation influence this issue by applying the HARMONIE regional climate model (HCLIM) with three different setups; two using convection parameterization at 15 and 6.25 km horizontal resolution (the latter within the “grey-zone” scale), with lateral boundary conditions provided by ERA-Interim reanalysis and integrated over a pan-European domain, and one with explicit convection at 2 km resolution (HCLIM2) over the Alpine region driven by the 15 km model. Seven summer seasons were sampled and validated against two high-resolution observational data sets. All HCLIM versions underestimate the number of dry days and hours by 20-40%, and overestimate precipitation over the Alpine ridge. Also, only modest added value were found of “grey-zone” resolution. However, the single most important outcome is the substantial added value in HCLIM2 compared to the coarser model versions at sub-daily time scales. It better captures the local-to-regional spatial patterns of precipitation reflecting a more realistic representation of the local and meso-scale dynamics. Further, the duration and spatial frequency of precipitation events, as well as extremes, are closer to observations. These characteristics are key ingredients in heavy rainfall events and associated flash floods, and the outstanding results using HCLIM in convection-permitting setting are convincing and encourage further use of the model to study changes in such events in changing climates.

A combined analysis of two randomized controlled trials evaluating the effect of Mindfulness-Based Stress Reduction on self-reported emotional experience and physiological symptoms among Veterans with Posttraumatic Stress Disorder

Thesis (Master's)--University of Washington, 2016-06

Essays on the Analysis of Dynamic Games

Thesis (Ph.D.)--University of Washington, 2016-06

Limitations to global disease control

In October 2000, Australia was declared poliomyelitis-free” by the World Health Organisation. This declaration followed some extensive six years of surveillance of all cases of acute flaccid paralysis, by the Poliomyelitis Expert Surveillance Committee (Centre for Disease Control, Commonwealth Department of Health and Aged Care, Canberra), chaired by the author. There have been seven attempts in the history of the world to eliminate a disease from the earth’s surface. The dramatic failure of five of these, the success of global smallpox eradication, and current successes and difficulties in the case of attempts to eliminate poliomyelitis worldwide, lead one to an analysis of the factors which led both to success and to failure. The global eradication of a specific disease is one of the most important endeavours which the international community can undertake. This audit reviews the details of such approaches; that such might be used as tools for the future.

Association between clinician factors and a patient's wish to hasten death: Terminally ill cancer patients and their doctors

This study investigated the clinical factors associated with a wish to hasten death among patients with advanced cancer receiving palliative care, with a focus on the role of clinician-related factors. Patients were grouped into high- and low-scoring groups on the basis of their wish to hasten death; doctor-patient pairs were formed. Questionnaire data collected from patients and their treating doctors were subjected to multivariate analysis. Significant predictors of a high wish to hasten death in terminally ill patients from among treating clinicians included the clinician's perception of the patient's lower optimism and greater emotional suffering, the patient indicating a wish to hasten death, the doctor willing to assist the patient in hastening death (if requested and legal), and the doctor reporting less training in psychotherapy. When these variables were combined with patient factors identified in a previous study, the model significantly predicted a wish to hasten death with the following variables patient factors: a higher perceived burden on others, higher depressive symptom scores, and lower family cohesion; physician factors: the doctor willing to assist the patient in hastening death (if requested and legal), the doctor's perception of lower levels of optimism and greater emotional distress in the patient, and the doctor having less training in psychotherapy; and the setting of care: recent admission to a hospice. The findings support the multifactorial influences on the wish to hasten death and suggest that the role of the clinician is a vital context within which the wish to hasten death should be considered.

Vaccine trial as “probe” to define the burden of pneumococcal pneumonia disease [Comment]

In today's Lancet, Felicity Cutts and colleagues present their findings on the randomised double-blind placebo controlled trial on the efficacy of a nine-valent pneumococcal conjugate-vaccine (9PCV) against radiologically confirmed pneumonia and invasive pneumococcal disease in children immunised before 12 months of age in The Gambia. The study site is a rural African setting with high child-mortality, a low prevalence of HIV-1 infection in pregnant mothers, and with endemic malaria. The authors report a vaccine efficacy of 37% (95% CI 27–45%) against first-episodes of radiological pneumonia in a per-protocol analysis. Intention-to-treat analysis showed similar results. The investigators also found that the vaccine could significantly reduce the incidence of vaccine-type invasive pneumococcal disease by 77%, by 50% for all-serotype invasive pneumococcal disease, by 15% for all-cause health-facility admissions, and by 16% for overall child mortality.

Unfreezing the frame: Functional fram analysis for journalists and journalism students

This paper presents two case studies that suggest, in different but complementary ways, that the critical tool of frame analysis (Entman, 2002) has a place not only in the analytical environments of critical media research and media studies classes, where it is commonly found, but also in the media-production oriented environments of skills-based journalism training and even the newsroom. The expectations and constraints of both the latter environments, however, necessitate forms of frame analysis that are quick and simple. While commercial pressures mean newsrooms and skills-based journalism-training environments are likely to allow only an oversimplified approach to frame analysis, we argue that even a simple understanding and analysis at the production end could help to shift framing in ways that not only improve the quality and depth of Australasian newspapers' news coverage, but increase reader satisfaction with media output.

Infrared microspectroscopic mapping of the homogeneity of extruded blends: Application to starch/polyester blends

Blends of starch and a biodegradable polyester, produced by an extrusion process, which included a cross-linker/compatibilizer (maleic anhydride) and an initiator (dicumyl peroxide), were studied by infrared (IR) microspectroscopy using an attenuated total reflectance (ATR) objective. Extruded material, which had a diameter of about 3 mm, was sectioned and embedded in epoxy resin prior to IR analysis. Spectra were collected in a grid pattern across the sectioned face of the sample. Measurement of various band parameters from the spectra allowed IR maps to be constructed containing semi-quantitative information about the distribution of blend components. These maps showed the quality of the blend on a microscopic scale and showed how it varied with different concentrations of compatibilizer and initiator. (c) 2005 Elsevier Ltd. All rights reserved.

Issues of robustness and high dimensionality in cluster analysis

Finite mixture models are being increasingly used to model the distributions of a wide variety of random phenomena. While normal mixture models are often used to cluster data sets of continuous multivariate data, a more robust clustering can be obtained by considering the t mixture model-based approach. Mixtures of factor analyzers enable model-based density estimation to be undertaken for high-dimensional data where the number of observations n is very large relative to their dimension p. As the approach using the multivariate normal family of distributions is sensitive to outliers, it is more robust to adopt the multivariate t family for the component error and factor distributions. The computational aspects associated with robustness and high dimensionality in these approaches to cluster analysis are discussed and illustrated.

Probabilistic principal component analysis

Principal component analysis (PCA) is a ubiquitous technique for data analysis and processing, but one which is not based upon a probability model. In this paper we demonstrate how the principal axes of a set of observed data vectors may be determined through maximum-likelihood estimation of parameters in a latent variable model closely related to factor analysis. We consider the properties of the associated likelihood function, giving an EM algorithm for estimating the principal subspace iteratively, and discuss the advantages conveyed by the definition of a probability density function for PCA.