Perusterveydenhuollon ja erikoissairaanhoidon käytön seuranta ja ennakointi kuntanäkökulmasta

Follow-up of utilisation and prediction of primary health care and hospital care from the municipality point of view. Planning, follow-up, and evaluation of primary health care within municipality entail comprehensive information about factors that influence health. In addition to populationbased research, various statistical data and registries serve as sources of information. The present study examined utilisation of primary health care and hospital care with the existing databases, registries, and categorization of Diagnosis Related Groups (DRGs) from the municipality (purchaser) point of view. Research involving the cases of Paimio, Sauvo, and Turku as examples of municipalities pointed out that, even in the small municipalities, it is possible to assess and predict health services to be offered to the inhabitants by following databases and registries. Health-related databases and registries include a plenty of possible uses that have not adequately been employed at the level of municipality. Descriptive futures research and community analysis formed the framework of the study. Descriptive futures research may be used to establish predictions based on past developmental traditions, and quantitative time trend analyses may be employed to make estimations about future events. Community analysis will assist in making conclusions about population- based health care needs, in assessing the functionality or effectiveness of the health care system, and in appropriately targeting limited resources. The aim of the present study was to describe the health service profile so that the arrangements and planning of health services as well as the contract negotiations of hospital care become easier within municipalities. Another aim was to assess the application of Hilmo (registry for posting hospital care periods), Aitta and Sotka (statistical databases) for the purposes of resource planning in the procurement of hospital care. A third aim was to evaluate how the system of the DRGs adapts in the prediction of retaining health services within short (1-year), intermediate (5-year) and long range (10-15-year) intervals. The findings indicated that the follow-up of primary health care utilisation combined with follow-up of hospital care utilisation allows municipalities to plan and predict health services when databases are applied. Information about the past contacts with the databases has indicated that the health care culture and incidence of disease change rather slowly in the area of investigation. For the purposes of health care research, it is recommended that methods of application used in making predictions about health care utilisation need to be further developed

La cerca única, o com fer fàcil el camí a l'usuari

This paper presents a reflection on the need for libraries to think about how to facilitate access to the documentary sources they manage.As the number of resources available in electronic form increases, libraries are in the need to provide a simple and usable search tool that allows integrating the contents of the various information management systems they give access to.To define user expectations to the search interface, some of the features that they are accustomed to use in their requests for information on the Internet have been included.The technologies that allow the discovery layer implementation as a search tool that integrates the various information systems of the library are presented next. And below are some examples of implementations that work in line with the integration of various information sources into a single search engine, as models to consider for implementing a system of this kind.The purpose of it all is to present a state of the art of some cases of operational deployments as a starting point for any organization interested in improving access it offers to its resources on the basis of references study.

End point of Hawking radiation

The formation and semiclassical evaporation of two-dimensional black holes is studied in an exactly solvable model. Above a certain threshold energy flux, collapsing matter forms a singularity inside an apparent horizon. As the black hole evaporates the apparent horizon recedes and meets the singularity in a finite proper time. The singularity emerges naked, and future evolution of the geometry requires boundary conditions to be imposed there. There is a natural choice of boundary conditions which matches the evaporated black hole solution onto the linear dilaton vacuum. Below the threshold energy flux no horizon forms and boundary conditions can be imposed where infalling matter is reflected from a timelike boundary. All information is recovered at spatial infinity in this case.

Prevalence of iodine inadequacy in Switzerland assessed by the estimated average requirement cut-point method in relation to the impact of iodized salt.

OBJECTIVE: To assess the iodine status of Swiss population groups and to evaluate the influence of iodized salt as a vector for iodine fortification. DESIGN: The relationship between 24 h urinary iodine and Na excretions was assessed in the general population after correcting for confounders. Single-day intakes were estimated assuming that 92 % of dietary iodine was excreted in 24 h urine. Usual intake distributions were derived for male and female population groups after adjustment for within-subject variability. The estimated average requirement (EAR) cut-point method was applied as guidance to assess the inadequacy of the iodine supply. SETTING: Public health strategies to reduce the dietary salt intake in the general population may affect its iodine supply. SUBJECTS: The study population (1481 volunteers, aged ≥15 years) was randomly selected from three different linguistic regions of Switzerland. RESULTS: The 24 h urine samples from 1420 participants were determined to be properly collected. Mean iodine intakes obtained for men (n 705) and women (n 715) were 179 (sd 68.1) µg/d and 138 (sd 57.8) µg/d, respectively. Urinary Na and Ca, and BMI were significantly and positively associated with higher iodine intake, as were men and non-smokers. Fifty-four per cent of the total iodine intake originated from iodized salt. The prevalence of inadequate iodine intake as estimated by the EAR cut-point method was 2 % for men and 14 % for women. CONCLUSIONS: The estimated prevalence of inadequate iodine intake was within the optimal target range of 2-3 % for men, but not for women.