Bedeutung der Spitalentschädigung nach Patientengruppen für Managed Care

Das Patientenklassifikationssystem AP-DRG wurde im Juli 2001 in einem Zürcher Spital und im Jahr 2002 in den Waadtländer Spitälern und in einem zweiten Zürcher Spital eingeführt. Die AP-DRGs (All Patients Diagnosis Related Groups) sind in erster Linie ein nützliches Messinstrument für die Finanzierung, die Planung und das Management der Spitäler, aber sie können sich auch als ernorm hilfreich erweisen für die Risikoeinschätzung sowie für Managed-Care-Programme.<Managed Care> [Article original en français] AP-DRG, quel intérêt pour le Managed Care? / L. Schenker. Introduits depuis juillet 2001 dans un hôpital zurichois et en 2002 dans les hôpitaux vaudois et dans un deuxième hôpital zurichois, les APDRG (All Patient Diagnosis Related Groups) sont avant tout un instrument de mesure utile pour le financement, la planification et la gestion des hôpitaux mais ils peuvent se révéler extrêmement utiles pour l évaluation des risques ainsi que pour les programmes de Managed Care. <ManagedCareInfo.net>

Conditional and syllogistic deductive tasks dissociate functionally during premise integration.

Deduction allows us to draw consequences from previous knowledge. Deductive reasoning can be applied to several types of problem, for example, conditional, syllogistic, and relational. It has been assumed that the same cognitive operations underlie solutions to them all; however, this hypothesis remains to be tested empirically. We used event-related fMRI, in the same group of subjects, to compare reasoning-related activity associated with conditional and syllogistic deductive problems. Furthermore, we assessed reasoning-related activity for the two main stages of deduction, namely encoding of premises and their integration. Encoding syllogistic premises for reasoning was associated with activation of BA 44/45 more than encoding them for literal recall. During integration, left fronto-lateral cortex (BA 44/45, 6) and basal ganglia activated with both conditional and syllogistic reasoning. Besides that, integration of syllogistic problems additionally was associated with activation of left parietal (BA 7) and left ventro-lateral frontal cortex (BA 47). This difference suggests a dissociation between conditional and syllogistic reasoning at the integration stage. Our finding indicates that the integration of conditional and syllogistic reasoning is carried out by means of different, but partly overlapping, sets of anatomical regions and by inference, cognitive processes. The involvement of BA 44/45 during both encoding (syllogisms) and premise integration (syllogisms and conditionals) suggests a central role in deductive reasoning for syntactic manipulations and formal/linguistic representations.

Multi-period vendor managed inventory systems

In this paper we develop two models for an inventory system in which the distributormanages the inventory at the retailers location. These type of systems correspondto the Vendor Managed Inventory (VMI) systems described ib the literature. Thesesystems are very common in many different types of industries, such as retailingand manufacturing, although assuming different characteristics.The objective of our model is to minimize total inventory cost for the distributorin a multi-period multi-retailer setting. The inventory system includes holdingand stock-out costs and we study the case whre an additional fixed setup cost ischarged per delivery.We construct a numerical experiment to analyze the model bahavior and observe theimpact of the characteristics of the model on the solutions.

Should banking supervision and monetary policy tasks be given to different agencies?

This paper adds some new arguments to the thesis that the responsibility forbanking supervision should be assigned to an agency formally separated bythe Central bank. We also provide some additional evidence on the macroand microeconomic performance of OECD countries whose banking systems areclassified according to the regulatory regime in place. We find that theinflation rate is considerably higher and more volatile in countries wherethe Central bank acts as a monopolist in banking supervision. Besides,although banks seem to be more profitable when Central banks supervise them,they incur into higher costs and rely more on deposits with respect to moresophisticated liabilities as a funding source.The data are not definitively in favor of functional separation. However, we argue that the evolution of financial intermediaries, moral hazard problems and especially cost accountability seem to suggest that separation would be a better solution for industrialized countries.We also critically discuss the current arrangement of financial regulationand supervision in the EMU: our proposal is to establish an independentEuropean System of Financial Supervisors (ESFS) structured similarly to theESCB.

Intra-individual stability of neuromotor tasks from 6 to 18 years: a longitudinal study.

This study investigates the intra-individual stability of the speed of several motor tasks and the intensity of associated movements in 256 children (131 girls, 125 boys) from the Zurich generational study using the Zurich neuromotor assessment battery (ZNA) over a 12-year period from the age of 6 to 18 years. The stability was assessed by correlograms of standard deviation scores calculated from age- and gender-adjusted normative values and compared with standing height and full scale intelligence quotient (IQ). While motor tasks of hand, finger and foot (HFT) and contralateral associated movements (CAM) exhibited a moderate stability (summary measure as correlation coefficients between two measurements made 4 years apart: .61 and .60), other tasks (dynamic balance, static balance and pegboard) were only weakly stable (.46, .47 and .49). IQ and height were more stable than neuromotor components (.72 and .86). We conclude that the moderately stable HFT and CAM may reflect "motor traits", while the stability of the pegboard and balance tasks is weaker because these skills are more experience related and state-dependent.

Differences in Frontal Activation in Adult Patients with Schizophrenia and in Psychotic Adolescents with Schizophrenic Symptoms in Two Fmri Tasks

Background: Language processing abnormalities and inhibition difficulties are hallmark features of schizophrenia. The objective of this study is to asses the blood oxygenation level-dependent (BOLD) response at two different stages of the illness and compare the frontal activity between adolescents and adults with schizophrenia. Methods: 10 adults with schizophrenia (mean age 31,5 years) and 6 psychotic adolescents with schizophrenic symptoms (mean age 16,2 years) underwent functional magnetic resonance imaging while performing two frontal tasks. Regional activation is compared in the bilateral frontal areas during a covert verbal fluency task (letter version) and a Stroop task (inhibition task). Results: Preliminary results show poorer task performance and less frontal cortex activation during both tasks in the adult group of patients with schizophrenia. In the adolescent patients group, fMRI analysis show significant and larger activity in the left frontal operculum (Broca's area) in the verbal fluency task and greater activity in the medium cingulate during the inhibition phase of the Stroop task. Conclusions: These preliminary findings suggest a decrease of frontal activity in the course of the illness. We assume that schizophrenia contributes to frontal brain activity reduction.

Europe and the Petersberg Tasks – Nation-State behavior through the prism of Strategic Culture

Les missions Petersberg són l'operatiu militar més ambiciós organitzat per la Unió Europea en el desenvolupament de la CSDP, Política Europea de Seguretat i Defensa. Amb l'objectiu d'aconseguir una organització efectiva y funcional d'aquestes missions, és desitjable que les cultures estratègiques dels diferents Estats membres siguin, en gran mesura, compatibles en benefici d'una cultura estratègica europea amb directrius clares. Aquest estudi compara les cultures estratègiques d'Alemanya, el Regne Unit i França en referència al seu nivell de compatibilitat contrastant-les amb dos casos recents, exemples paradigmàtics de cultures estratègiques integrals. D'aquesta manera, pretenem descriure les circumstàncies en què es desenvolupen les missions Petersberg.

Aplicatiu per gestionar la informació administrativa, tècnica i comptable per una empresa constructora

Les tendencies del mercat actual i futur obliguen a les empreses a ser cada vegada més competitives. Tota empresa que desitgi competir en el mercat actual ha de considerar la informació com un dels seus principals actius. Per aquesta raó, és necessari que l’empresa disposi dels sistemes d’informació adequats per ser gestionada. En les pimes ( petites i mitjanes empreses ), i en la majoria dels casos, la seva informació es troba repartida en diversos aplicatius informàtifcs. Això comporta principalment una duplicitat de dades, costos de manteniment i possibles errades en la informació. Dins del sector de les pimes, es troben empreses contructores d’un volum petit o mig, les quals enmagatzemen molta informació tècnica i de planificació per desemvolupar els seus projectes. Aquesta necessitat els hi suposa, tenir un aplicatiu eficient per la gestió i seguiment de la producció de les seves tasques i per altra banda l’aplicatiu necessari com qualsevol pime a nivell administratiu i comptable. L’objectiu principal d’aquest treball és generar un aplicatiu que integri la informació administrativa, comptable i tècnica per una empresa constructora. Amb l’assoliment d’aquest objectiu l’empresa constructora guanya temps en l’entrada i accés a les dades, evita la seva duplicitat i redueix el seu manteniment. En resum, redueix els costos de l’empresa i augmenta la seva seguretat en la informació. Un el mercat, existeixen aplicatius anomenats ERP ( Enterprise resource planning o sistemes de planificació de recursos ) els quals la seva gran virtud es la integració de les dades. Aprofitant aquests aplicatius i seleccionant-ne el més adequat, s’ha generat la part de gestió i planificació necessària per l’empresa constructora integrant-la i personalitzant-la en els processos existents de l’aplicació ( comptabilitat, ventes, compres, recursos humans, magatzems, etc… ) Entre les conclusions més rellevants obtingudes en aquest treball, voldriem destacar la millora i reducció d’entrada, accés i manteniment de la informació, l’històric que proporciona l’eina i per tan la millora de la gestío i planificació de l’empresa.

The costs of crossing paths and switching tasks between audition and vision.

Switching from one functional or cognitive operation to another is thought to rely on executive/control processes. The efficacy of these processes may depend on the extent of overlap between neural circuitry mediating the different tasks; more effective task preparation (and by extension smaller switch costs) is achieved when this overlap is small. We investigated the performance costs associated with switching tasks and/or switching sensory modalities. Participants discriminated either the identity or spatial location of objects that were presented either visually or acoustically. Switch costs between tasks were significantly smaller when the sensory modality of the task switched versus when it repeated. This was the case irrespective of whether the pre-trial cue informed participants only of the upcoming task, but not sensory modality (Experiment 1) or whether the pre-trial cue was informative about both the upcoming task and sensory modality (Experiment 2). In addition, in both experiments switch costs between the senses were positively correlated when the sensory modality of the task repeated across trials and not when it switched. The collective evidence supports the independence of control processes mediating task switching and modality switching and also the hypothesis that switch costs reflect competitive interference between neural circuits.