The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Romanian healthcare system at a glance

Directory of Open Access Journals (Sweden)

Christiana Balan

2013-04-01

Full Text Available The Romanian healthcare system is facing constant challenges to produce high quality care with low costs. Objectives The paper aims to analyze the efficiency of the Romanian healthcare system in terms of resources allocation. The evaluation and the dimension of healthcare system efficiency are important for identifying a balance between the resources required and the health outcomes. Prior Work Previous studies describe the Romanian healthcare system as a system in transition. This study focuses on the relationship between the inputs and outputs of the system. Approach In order to assess the efficiency of the Romanian healthcare system we use Data Envelopment Analysis approach. Both input and output healthcare indicators are observed for the period 1999-2010 and the years when healthcare inputs have been used efficiently are identified. Results The results show that human, financial, and technological resources have been used at maximum capacity in 1999, 2003, 2004, 2007 and 2010. Implications Though efficiency is defined differently by diverse stakeholders, healthcare policies should focus on rising the responsibility of communities and individuals for better treatments and services and better access to information on healthcare providers. Value The paper is an empirically based study of the healthcare resources allocation in Romania.

My care pathways - creating open innovation in healthcare.

Science.gov (United States)

Lundberg, Nina; Koch, Sabine; Hägglund, Maria; Bolin, Peter; Davoody, Nadia; Eltes, Johan; Jarlman, Olof; Perlich, Anja; Vimarlund, Vivian; Winsnes, Casper

2013-01-01

In this paper we describe initial results from the Swedish innovation project "My Care Pathways" which envisions enabling citizens to track their own health by providing them with online access to their historical, current and prospective future events. We describe an information infrastructure and its base services as well as the use of this solution as an open source platform for open innovation in healthcare. This will facilitate the development of end-user e-services for citizens. We have technically enabled the information infrastructure in close collaboration with decision makers in three Swedish health care regions, and system vendors as well as with National eHealth projects. Close collaboration between heterogeneous actors made implementation in real practice possible. However, a number of challenges, mainly related to legal and business issues, persist when implementing our results. Future work should therefore target the development of business models for sustainable provision of end-user e-services in a public health care system such as the Swedish one. Also, a legal analysis of the development of third party provider (nonhealthcare based) personal health data e-services should be done.

Healthcare Firms and the ERP Systems

Directory of Open Access Journals (Sweden)

A. Garefalakis

2016-04-01

Full Text Available With the continuous and drastic changes due to the economic crisis, along with the increasing market demands, major reforms are initiated in the healthcare sector in order to improve the quality of healthcare and operational efficiency, while reducing costs and optimizing back-end operations. ERP systems have been the basic technological infrastructure to many sectors as well as healthcare. The main objective of this study is to discuss how the adoption of ERP systems in healthcare organizations improves their functionality, simplifies their business processes, assure the quality of care services and helps their management accounting and controlling. This study presents also the stages required for the implementation of ERP system in healthcare organizations. This study utilizes a literature review in order to reach the research conclusions. Specifically, through related case studies and research, it examines how ERP systems are used to evaluate the better functionality of the healthcare organizations, addressing in parallel important problems, and possible malfunctions. The implementation of ERP systems in healthcare organizations promises to evolve and align strictly to the organizations’ corporate objectives and high-levels of healthcare quality. In order to accomplish this goal, the right decisions should be made by the managers of the healthcare organization regarding the choice of the appropriate ERP system following its installation and its application. Limited research exists on the significance ERP systems implementation in healthcare organizations, while possible dysfunctions and challenges during its installation and implementation are recorded. Therefore, new evidence in the significance of ERP systems in healthcare organization is provided.

Architecture of personal healthcare information system in ubiquitous healthcare

NARCIS (Netherlands)

Bhardwaj, S.; Sain, M.; Lee, H.-J.; Chung, W.Y.; Slezak, D.; et al., xx

2009-01-01

Due to recent development in Ubiquitous Healthcare now it’s time to build such application which can work independently and with less interference of Physician. In this paper we are try to build the whole architecture of personal Healthcare information system for ubiquitous healthcare which also

Influencing Swedish homeowners to adopt district heating system

Energy Technology Data Exchange (ETDEWEB)

Mahapatra, Krushna; Gustavsson, Leif [Ecotechnology, Mid Sweden University, Akademigatan 1, 831 25 Oestersund (Sweden)

2009-02-15

Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Oestersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey. (author)

Influencing Swedish homeowners to adopt district heating system

International Nuclear Information System (INIS)

Mahapatra, Krushna; Gustavsson, Leif

2009-01-01

Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Ostersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey

Influencing Swedish homeowners to adopt district heating system

Energy Technology Data Exchange (ETDEWEB)

Mahapatra, Krushna; Gustavsson, Leif [Ecotechnology, Mid Sweden University, Akademigatan 1, 831 25 Oestersund (Sweden)

2009-02-15

Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Oestersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey. (author)

Digital Components in Swedish NPP Power Systems

International Nuclear Information System (INIS)

Karlsson, Mattias; Eriksson, Tage

2015-01-01

Swedish nuclear power plants have over the last 20 years of operation modernised or exchanged several systems and components of the electrical power system. Within these works, new components based on digital technology have been employed in order to realize functionality that was previously achieved by using electro-mechanical or analogue technology. Components and systems such as relay protection, rectifiers, inverters, variable speed drives and diesel-generator sets are today equipped with digital components. Several of the systems and components fulfil functions with a safety-role in the NPP. Recently, however, a number of incidents have occurred which highlight deficiencies in the design or HMI of the equipment, which warrants questions whether there are generic problems with some applications of digital components that needs to be addressed. The use of digital components has presented cost effective solutions, or even the only available solution on the market enabling a modernisation. The vast majority of systems using digital components have been operating without problems and often contribute to improved safety but the challenge of non-detectable, or non-identifiable, failure modes remain. In this paper, the extent to which digital components are used in Swedish NPP power systems will be presented including a description of typical applications. Based on data from maintenance records and fault reports, as well as interviews with designers and maintenance personnel, the main areas where problems have been encountered and where possible risks have been identified will be described. The paper intends to investigate any 'tell-tales' that could give signals of unwanted behaviour. Furthermore, particular benefits experienced by using digital components will be highlighted. The paper will also discuss the safety relevance of these findings and suggest measures to improve safety in the application of digital components in power systems. (authors)

Benefits negotiation: three Swedish hospitals pursuit of potential electronic health record benefits.

Science.gov (United States)

Jeansson, John S

2013-01-01

At the very heart of Swedish healthcare digitalisation are large investments in electronic health records (EHRs). These integrated information systems (ISs) carry promises of great benefits and value for organisations. However, realising IS benefits and value has, in general, proven to be a challenging task, and as organisations strive to formalise their realisation efforts a misconception of rationality threatens to emerge. This misconception manifests itself when the formality of analysis threatens to underrate the impact of social processes in deciding which potential benefits to pursue. This paper suggests that these decisions are the result of a social process of negotiation. The purpose of this paper is to observe three benefits analysis projects of three Swedish hospitals to better understand the character and management of proposed benefits negotiations. Findings depict several different categories of benefits negotiations, as well as key factors to consider during the benefits negotiation process.

Margins in Swedish district heating systems; Marginaler i Fjaerrvaermesystem

Energy Technology Data Exchange (ETDEWEB)

Selinder, Patrik; Zinko, Heimo [ZW Energiteknik AB, Nykoeping (Sweden)

2003-03-01

It can be assumed on good reasons that the Swedish district heating nets are designed with relatively large margins concerning the transportable power. This is done historically to be able to transport the necessary power that can be called for on the coldest winter days but which occur rarely and also due to the former (until 2001) applied recommendations for the dimensioning of hot water flows. The aim of this project was to investigate the possibilities of reducing the connecting power to customers, both from a technical and from the customer point of view. The heating system of a building in Sweden is normally dimensioned according to a certain outdoor air temperature (DUT in Swedish). According to the Swedish Building Code, DUT20 is defined for a given location in such a way that if the heating system is designed for this temperature, the room temperature is allowed to decrease by 3 deg C in the average once in 20 years. That means that for economical reasons, a power deficiency is accounted for in the case of strong cold. The value of DUT is depending on the thermal inertia of the building. Buildings with high thermal inertia can have a higher DUT and vice versa. A reduced system size can in principle mean smaller size of pipes and consumer substations and more power available for additional customers to be connected. In principle, that means a more profitable district heating operation. Besides costs, another problem with oversized capacities are possible operational problems due to slow dynamic system responses, for instance at restarting occasions after a pump stop. A smaller valve size will result in a better system dynamic and may result in a more compliant system operation and increased delivery quality. By choosing just right DUT for every building and abandoning safety margins, it is shown in the report that the connecting power can be reduced in especially medium light to heavy buildings with larger time constants. However, this also means that the

HIV-positive migrants’ encounters with the Swedish health care system

DEFF Research Database (Denmark)

Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina

2016-01-01

of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated......Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients....... Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid...

Perceptions of complementary therapies among Swedish registered professions in surgical care.

Science.gov (United States)

Bjerså, Kristofer; Forsberg, Anna; Fagevik Olsén, Monika

2011-02-01

There is increasing interest in complementary and alternative medicine (CAM) among healthcare professions. However, no studies have been conducted in Sweden or in a surgical context. The aim of this study is to describe different perceptions of complementary therapies among registered healthcare professions in Swedish surgical care. Sixteen interviews were conducted with registered physicians, nurses, physiotherapists and clinical dieticians at a Swedish university hospital. Analysis was made with a phenomenographic research approach. The findings showed variations in perceptions of the definition of complementary therapies. A constructive approach toward use was observed, but there was a conflict in matters of indications and contraindications, and also criticism over a lack of knowledge. There was seen to be a need for education to be able to act professionally. Scepticism over high costs of treatment was highlighted. In conclusion, a need for policies on management, education and research in the field of CAM should be addressed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Environmental impact assessment of the Swedish high-level radioactive waste disposal system - examples of likely considerations

International Nuclear Information System (INIS)

1994-01-01

Sweden is investigating the feasibility of establishing a high-level radioactive waste (HLW) disposal system consisting of three components as follows: (1) Encapsulation facility, (2) system for transporting waste and (3) geologic repository. Swedish law requires that an Environmental Impact Assessment (EIA) be written for any planned action expected to have a significant impact on the environment. Before embarking on construction and operation of a HLW disposal system, the Swedish government will evaluate the expected environmental impacts to assure that the Swedish people and environmental will not be unduly affected by the disposal system. The EIA process requires that reasonable alternatives to the proposed action, including the 'zero' or 'no action' alternative, be considered so that the final approved plan for disposal will have undergone scrutiny and comparison of alternatives to arrive at a plan which is the best achievable given reasonable physical and monetary constraints. This report has been prepared by the Center for Nuclear Waste Regulatory Analyses (CNWRA) for use by the Swedish Radiation Protection Institute (SSI). The purpose of this report is to establish a document which outlines the types of information which would be in an EIA for a three part disposal system like that envisioned by the Swedish Nuclear Fuel and Waste Management Company (SKB) for the disposal of Sweden's HLW. Technical information that would normally be included in an EIA is outlined in this document. The SSI's primary interest is in radiological impacts. However, for the sake of completeness and also to evaluate all environmental impacts in a single document, non-radiological impacts are also included. Swedish authorities other than the SSI may have interest in the non-radiological parts of the document. 26 refs

Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare.

Science.gov (United States)

von Knorring, Mia; de Rijk, Angelique; Alexanderson, Kristina

2010-09-17

This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs) in Sweden were subjected to qualitative analysis. The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1) they have high status and expertise; 2) they lack knowledge of the system; 3) they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others) in relation to the physician role. Further research is needed to elucidate how managers in healthcare organisations assume the manager role in relation to the medical

Parents' experiences of parental groups in Swedish child health-care: Do they get what they want?

Science.gov (United States)

Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

2016-03-01

Almost all parents in Sweden are invited to parental groups organized by the child health service (CHS) during their child's first year, but only 40% chose to attend. The aim of this study was to describe parents' experiences of participating in these parental groups. A total of 143 parents from 71 different parental groups at 27 child health-care (CHC) centres in one Swedish county completed an online questionnaire. A majority of the parents found the parental groups to be meaningful and more than 60% met someone in the group who they socialized with outside the meetings. Parents wanted a greater focus on child-related community information, existential questions, relationships and parenting in general. Group leadership seems to be of significance to how parents in a group connect and whether the parental role is affected. Making CHC nurses more aware of the topics parents desire could help them meet parents' needs. Education and training in group dynamics and group leadership could be of value in further improving the high-quality service CHC nurses already offer parents. More knowledge is needed about what would attract those parents who do not participate. © The Author(s) 2014.

Pervasive mobile healthcare systems for chronic disease monitoring.

Science.gov (United States)

Huzooree, Geshwaree; Kumar Khedo, Kavi; Joonas, Noorjehan

2017-05-01

Pervasive mobile healthcare system has the potential to improve healthcare and the quality of life of chronic disease patients through continuous monitoring. Recently, many articles related to pervasive mobile healthcare system focusing on health monitoring using wireless technologies have been published. The main aim of this review is to evaluate the state-of-the-art pervasive mobile healthcare systems to identify major technical requirements and design challenges associated with the realization of a pervasive mobile healthcare system. A systematic literature review was conducted over IEEE Xplore Digital Library to evaluate 20 pervasive mobile healthcare systems out of 683 articles from 2011 to 2016. The classification of the pervasive mobile healthcare systems and other important factors are discussed. Potential opportunities and challenges are pointed out for the further deployment of effective pervasive mobile healthcare systems. This article helps researchers in health informatics to have a holistic view toward understanding pervasive mobile healthcare systems and points out new technological trends and design challenges that researchers have to consider when designing such systems for better adoption, usability, and seamless integration.

Development, implementation, and experiences of the Swedish spent fuel and waste sea transportation system

International Nuclear Information System (INIS)

Gustafsson, B.; Dybeck, P.; Pettersson, S.

1989-01-01

In Sweden, electrical production from the first commercial nuclear plant commenced in 1972, i.e. 17 years ago. There are now 12 nuclear reactors in operation, the last two were connected to the grid in fall 1985. These 12 reactors produced about 50% of the present electrical demand in Sweden. The remaining 50% are mainly covered by hydro power stations. The operating record for the Swedish reactors has generally been very good. Nevertheles, the Swedish parliament has taken a decision, that nuclear power shall be phased out from the Swedish system not later than the year 2010. Many of them - to use a mild expression-question the wisdom of this decision. The efforts in the waste management area will, however, be given a continued high priority. The primary responsibility for the management of nuclear waste lies with the waste producer. In order to achieve a good coordination and an effective management the four Swedish nuclear power utilities have delegated these responsibilities to the jointly owned Swedish Nuclear Fuel and Waste Management Co., SKB. This means that SKB is responsible for measures required for the implementation of the national nuclear waste management program such as planning, design, construction and operation of waste facilities including the necessary R and D work. The responsibility of the nuclear power utilities also includes the financing of the waste management program. A special funding system, controlled by the authorities, has been established for this purpose

[Healthcare value chain: a model for the Brazilian healthcare system].

Science.gov (United States)

Pedroso, Marcelo Caldeira; Malik, Ana Maria

2012-10-01

This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

Activity System Theory Approach to Healthcare Information System

OpenAIRE

Bai, Guohua

2004-01-01

Healthcare information system is a very complex system and has to be approached from systematic perspectives. This paper presents an Activity System Theory (ATS) approach by integrating system thinking and social psychology. First part of the paper, the activity system theory is presented, especially a recursive model of human activity system is introduced. A project ‘Integrated Mobile Information System for Diabetic Healthcare (IMIS)’ is then used to demonstrate a practical application of th...

Patient-centredness in integrated healthcare delivery systems - needs, expectations and priorities for organised healthcare systems.

Science.gov (United States)

Juhnke, Christin; Mühlbacher, Axel C

2013-01-01

Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems. A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales. Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser-Meyer-Olkin of 0.914 for the patients (experts: 38.427%, Kaiser-Meyer-Olkin = 0.797). Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination. The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Patient-centeredness in Integrated healthcare delivery systems - Needs, expectations and priorities for organized healthcare systems

Directory of Open Access Journals (Sweden)

Christin Juhnke

2013-11-01

Full Text Available Introduction: Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems. Methods: A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales. Results: Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser–Meyer–Olkinof 0.914 for the patients (experts: 38.427%, Kaiser–Meyer–Olkin = 0.797. Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination. Conclusion and Discussion: The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Patient-centeredness in Integrated healthcare delivery systems - Needs, expectations and priorities for organized healthcare systems

Directory of Open Access Journals (Sweden)

Christin Juhnke

2013-11-01

Full Text Available Introduction: Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems.Methods: A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales.Results: Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser–Meyer–Olkinof 0.914 for the patients (experts: 38.427%, Kaiser–Meyer–Olkin = 0.797. Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination.Conclusion and Discussion: The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Reaching Agreement in Uncertain Circumstances: The Practice of Evidence-Based Policy in the Case of the Swedish National Guidelines for Heart Diseases

Science.gov (United States)

Eckard, Nathalie; Nedlund, Ann-Charlotte; Janzon, Magnus; Levin, Lars-Åke

2017-01-01

This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that…

Concepts and trends in healthcare information systems

CERN Document Server

Koutsouris, Dionysios-Dimitrios

2014-01-01

​Concepts and Trends in Healthcare Information Systems covers the latest research topics in the field from leading researchers and practitioners. This book offers theory-driven research that explores the role of Information Systems in the delivery of healthcare in its diverse organizational and regulatory settings. In addition to the embedded role of Information Technology (IT) in clinical and diagnostics equipment, Information Systems are uniquely positioned to capture, store, process, and communicate timely information to decision makers for better coordination of healthcare at both the individual and population levels. For example, data mining and decision support capabilities can identify potential adverse events for an individual patient while also contributing to the population's health by providing insights into the causes of disease complications. Information systems have great potential to reduce healthcare costs and improve outcomes. The healthcare delivery systems share similar characteristics w...

Systems design for remote healthcare

CERN Document Server

Bonfiglio, Silvio

2014-01-01

This book provides a multidisciplinary overview of the design and implementation of systems for remote patient monitoring and healthcare. Readers are guided step-by-step through the components of such a system and shown how they could be integrated in a coherent framework for deployment in practice. The authors explain planning from subsystem design to complete integration and deployment, given particular application constraints. Readers will benefit from descriptions of the clinical requirements underpinning the entire application scenario, physiological parameter sensing techniques, information processing approaches and overall, application dependent system integration. Each chapter ends with a discussion of practical design challenges and two case studies are included to provide practical examples and design methods for two remote healthcare systems with different needs. ·         Provides a multi-disciplinary overview of next-generation mobile healthcare system design; ·         Includes...

Awareness of the healthcare system and rights to healthcare in the Colombian population.

Science.gov (United States)

Delgado Gallego, María Eugenia; Vázquez-Navarrete, María Luisa

2013-01-01

To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. The most underprivileged users were less likely to be aware of the healthcare system, hampering their ability to make informed decisions and to exercise their health rights. To correct this situation, health institutions and the government should act decisively to reduce social inequalities. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

The role of ICT in nursing practice: an integrative literature review of the Swedish context.

Science.gov (United States)

Fagerström, Cecilia; Tuvesson, Hanna; Axelsson, Lisa; Nilsson, Lina

2017-09-01

The Swedish healthcare system employs information and communication technologies (ICT) in nursing practice to meet quality-, security- and efficiency-related demands. Although ICT is integrated with nursing practices, nurses do not always feel that they are convenient to use it. We need to improve our knowledge of the role of ICT in healthcare environments and so we decided to complement existing experience of how ICT influences nursing practice. This study aimed to review and synthesise the available literature on the role of ICT in nursing practice in Swedish healthcare settings. To consolidate previous studies based on diverse methodologies, an integrative literature review was carried out. Three databases were used to search for literature, 20 articles met the inclusion criteria. The literature review indicates that ICT integration into nursing practice is a complex process that impacts nurses' communication and relationships in patient care, working conditions, and professional identities and development. Nurses are found to express ambiguous views on ICT as a usable service in their everyday practice since it impacts both positively and negatively. Although ICT cannot replace physical presence, it can be considered a complementary service that gives rise to improved patient care. However, nonverbal communication cues may be missed when ICT is used as mediating tool and ICT can be limiting because it is not always designed to meet nurse and patient needs. The meaning of an encounter appears to change when ICT is used in nursing practice, not only for patient relationships but also for interpersonal communication. © 2016 Nordic College of Caring Science.

Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare

Directory of Open Access Journals (Sweden)

de Rijk Angelique

2010-09-01

Full Text Available Abstract Background This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Methods Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs in Sweden were subjected to qualitative analysis. Results The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1 they have high status and expertise; 2 they lack knowledge of the system; 3 they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Conclusions Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others in relation to the physician role. Further research is needed to elucidate how managers in healthcare

Knowledge and attitudes of Swedish politicians concerning induced abortion.

Science.gov (United States)

Sydsjö, Adam; Josefsson, Ann; Bladh, Marie; Muhrbeck, Måns; Sydsjö, Gunilla

2012-12-01

Induced abortion is more frequent in Sweden than in many other Western countries. We wanted to investigate attitudes and knowledge about induced abortion among politicians responsible for healthcare in three Swedish counties. A study-specific questionnaire was sent to all 375 elected politicians in three counties; 192 (51%) responded. The politicians stated that they were knowledgeable about the Swedish abortion law. More than half did not consider themselves, in their capacity as politicians, sufficiently informed about abortion-related matters. Most politicians (72%) considered induced abortion to be primarily a 'women's rights issue' rather than an ethical one, and 54% considered 12 weeks' gestational age an adequate upper limit for induced abortion. Only about a third of the respondents were correctly informed about the number of induced abortions annually carried out in Sweden. Information and knowledge on induced abortion among Swedish county politicians seem not to be optimal. Changes aimed at reducing the current high abortion rates will probably not be easy to achieve as politicians seem to be reluctant to commit themselves on ethical issues and consider induced abortion mainly a women's rights issue.

Behavioral Reference Model for Pervasive Healthcare Systems.

Science.gov (United States)

Tahmasbi, Arezoo; Adabi, Sahar; Rezaee, Ali

2016-12-01

The emergence of mobile healthcare systems is an important outcome of application of pervasive computing concepts for medical care purposes. These systems provide the facilities and infrastructure required for automatic and ubiquitous sharing of medical information. Healthcare systems have a dynamic structure and configuration, therefore having an architecture is essential for future development of these systems. The need for increased response rate, problem limited storage, accelerated processing and etc. the tendency toward creating a new generation of healthcare system architecture highlight the need for further focus on cloud-based solutions for transfer data and data processing challenges. Integrity and reliability of healthcare systems are of critical importance, as even the slightest error may put the patients' lives in danger; therefore acquiring a behavioral model for these systems and developing the tools required to model their behaviors are of significant importance. The high-level designs may contain some flaws, therefor the system must be fully examined for different scenarios and conditions. This paper presents a software architecture for development of healthcare systems based on pervasive computing concepts, and then models the behavior of described system. A set of solutions are then proposed to improve the design's qualitative characteristics including, availability, interoperability and performance.

Swedish Homeowners' Attitude towards Water-Based Heating Systems

Energy Technology Data Exchange (ETDEWEB)

Gustavsson, L; Mahapatra, K [Mid Sweden Univ., Ecotechnology, SE-831 25 Oestersund (Sweden)

2008-10-15

In 2004 and 2007, we conducted questionnaire surveys of 1,500 randomly selected Swedish homeowners of detached houses to understand their attitude towards adopting an innovative heating system (IHS). The results showed that there was no substantial change in homeowners' attitude towards IHSs. More than 80% of the respondents did not intend to install a new heating system. Economic aspects and functional reliability were the most important factors in the respondents' choice of heating system while environmental factors were of less importance. Installers were the most frequently consulted source of information on heating systems. Respondents perceived the relative advantage of pellet boilers over oil or electricity-based heating systems, but bedrock heat pump system was ranked higher than pellet heating system in every aspect except for investment cost. Pellet heating system has advantages with respect to investment cost. District heating system was considered as most functionally reliable and automatic. Keywords: Heat sector, socio-economic aspects, market implementation

The Integration of Two Healthcare Systems: A Common Healthcare Problem.

Science.gov (United States)

Cassatly, Hannah; Cassatly, Michael

2015-01-01

The change in reimbursement mandated by the Affordable Care Act is causing a rapid consolidation of the marketplace as well as the delivery of clinical care in a team-based model. This case report examines the successful joining of two clinical teams concurrent with the merger of two healthcare organizations and discusses some of the difficulties encountered. A subsequent discussion focuses on the resolution: the need for physicians to embrace the team concept of healthcare delivery and for healthcare systems to facilitate this transition with team and leadership coaching.

Swedish experiences in implementing national and international safeguards

International Nuclear Information System (INIS)

Nilsson, A.; Elborn, M.; Grahn, P.

1991-01-01

This paper reports that international safeguards have been applied in Sweden since the early 70s. Experiences have been achieved from exclusive bilateral and trilateral control followed by NPT safeguards in 1975. The Swedish State System for accountancy and Control (SSAC) includes all regulations that follows from prevailing obligations regarding the peaceful uses of nuclear material. The system has been developed in cooperation between the national authority, the Swedish Nuclear Power Inspectorate (SKI) and the Swedish nuclear industry. The paper presents experiences from the practical implementation of the SSAC and the IAEA safeguards system, gained by the SKI and the nuclear industry, respectively. Joint approaches and solutions to some significant safeguards issues are presented. The cooperation between the nuclear industry and the authority in R and D activities, in particular with respect to the Swedish Support Program is highlighted, e.g. the use of nuclear facilities in development or training tasks. some of the difficulties encountered with the system are also touched upon

From denial to awareness: a conceptual model for obtaining equity in healthcare

OpenAIRE

Höglund, Anna T.; Carlsson, Marianne; Holmström, Inger K.; Lännerström, Linda; Kaminsky, Elenor

2018-01-01

Background Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in health...

An evolving systems-based methodology for healthcare planning.

Science.gov (United States)

Warwick, Jon; Bell, Gary

2007-01-01

Healthcare planning seems beset with problems at all hierarchical levels. These are caused by the 'soft' nature of many of the issues present in healthcare planning and the high levels of complexity inherent in healthcare services. There has, in recent years, been a move to utilize systems thinking ideas in an effort to gain a better understanding of the forces at work within the healthcare environment and these have had some success. This paper argues that systems-based methodologies can be further enhanced by metrication and modeling which assist in exploring the changed emergent behavior of a system resulting from management intervention. The paper describes the Holon Framework as an evolving systems-based approach that has been used to help clients understand complex systems (in the education domain) that would have application in the analysis of healthcare problems.

Some perspectives on affordable healthcare systems in China.

Science.gov (United States)

Zhang, Y T; Yan, Y S; Poon, C C Y

2007-01-01

Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural

Summary of operating experience at Swedish nuclear power plants in 1984

International Nuclear Information System (INIS)

1985-01-01

The four owners on nuclear power plants in Sweden - The Swedish State Power Board, Forsmarks Kraftgrupp AB, Sydkraft AB and OKG AKTIEBOLAG - formed in 1980 the Nuclear Safety Board of the Swedish Utilities as a joint body for collaboration in safety matters. The Board participates in coordination of the safety work of the utilities and conducts its own safety projects, whereever this is more efficient than the utilities' working independently. The work of the Board shall contribute to optimizing safety in the operation of the Swedish nuclear power plants. The most important function of the Board is to collect, process and evaluate information on operational disturbances and incidents at Swedish and foreign nuclear power plants and then use the knowledge thus gained to improve the safety of the operation of the Swedish nuclear power plants (experience feedback). The work with Experience Feedback proceeds in three stages: Event follow-up, Fault analysis and Feedback of results. The Board runs a system for experience feedback (ERF). ERF is a computer-based information and communication system. ERF provides the Board with a daily update of operating experience in both Swedish and foreign nuclear power plants. Each Swedish nuclear power station supplies the ERF system with data on, among other things, operation and operational distrubances. Important experiences are thereby fed back to plant operation. Experience from foreign nuclear power stations can be of interest to the Swedish nuclear power plants. This information comes to RKS and is reviewed daily. The information that is considered relevant to Swedish plants is fed after analysis into the ERF system. Conversely, foreign nuclear power stations can obtain information from the operation of the Swedish plants. (author)

Strategic alliances in healthcare: opportunities for the Veterans Affairs healthcare system.

Science.gov (United States)

Halverson, P K; Kaluzny, A D; Young, G J

1997-01-01

Strategic alliances are proving to be effective strategies for responding and adapting to changing environments, and as such they offer the U.S. Department of Veterans Affairs (VA) healthcare system valuable opportunities for accomplishing the goals of its major reorganization effort. This article begins with an examination of basic strategic-alliance structures that are employed across many different types of industries. Next, consideration is given to the ways in which these basic alliance structures may be adapted to the unique organizations and individuals that serve as providers, purchasers, and consumers of health services. Finally, this article explores how models of strategic alliance in healthcare can be tailored to the specific needs and constraints of the VA healthcare system through an examination of existing and potential alliance opportunities.

Examining quality and efficiency of the U.S. healthcare system.

Science.gov (United States)

Kumar, Sameer; Ghildayal, Neha S; Shah, Ronak N

2011-01-01

The fundamental concern of this research study is to learn the quality and efficiency of U.S. healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the U.S. healthcare system with those of other developed nations. The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e., GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in U.S. healthcare. At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The U.S. healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology-induced costs and consumer behavior. Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the "waste" from the

The Swedish Energy Market 2005

International Nuclear Information System (INIS)

2005-10-01

The Swedish Energy Market, 2005 is an annual publication that presents information and statistics on the network based energy markets in Sweden, i.e. the markets for electricity, natural gas and district heating. It also provides an overview of the issues that have arisen on these markets during the second half of 2004 and the first half of 2005. Considerable work is being carried out in the EU on creating a single market for electricity and natural gas. This publication therefore describes expansion of the Swedish market towards a Nordic and a European market. The publication normally includes a theme chapter, describing some event of particular interest for the Swedish energy market during the year. This year, the theme chapter is devoted to the Storm Gudrun, which struck the south of the country at the beginning of January, and its effects on electricity supply throughout the country. The chapter is based on the report submitted to the Government by the Energy Markets Inspectorate in the spring of 2005, and also includes a summary of the Inspectorate's proposals for measures to improve the security of electricity transmission. Energy in Sweden, which is another of the Swedish Energy Agency's annual publications, provides information and statistics on the development of the entire Swedish energy system

The Swedish police as a part of the security systems of nuclear material and other radioactive materials

International Nuclear Information System (INIS)

Nylen, L.

2001-01-01

Full text: In Sweden a special transport system has been developed for transport of nuclear substances and nuclear waste. This system in itself includes a high security level. Extraordinary circumstances can give cause for protective police measures and intervention. In concerned provinces an incident and emergency response planning take place of the police actions that may be needed at the following types of event: a) bomb threat; b) attack or threat of attack on transport vehicle; c) demonstrations. If a Swedish nuclear power plant is the subject of a bomb threat or other criminal assault, it is in Sweden, according to the Police Act, the task of the police to intervene, interrupt criminal acts and to restore order and security. The role of the Swedish police as regards the physical protection is, among other things, to carry out a certain control within protected area by special trained police personnel before a reactor is put into operation or restarted after revision or repair. Police authorities that have a nuclear power station within its jurisdiction should establish a plan for police actions at the nuclear power station in consultation with legal owner or management of the plant, the Swedish Nuclear Power Administration and the county administration. Special training and frequent practice of response personnel is crucial as well as co-training with key personnel at nuclear power stations. The National Criminal Investigation Department coordinates and commands police measures concerning different types of nuclear transports. Close co-operation with security and operational personnel at the nuclear power stations, operators of the transport system, the Swedish Nuclear Power Administration and the Swedish Radiation Protection Institute is very important. (author)

TRIUMF - The Swedish data base system for radioactive waste in SFR

International Nuclear Information System (INIS)

Skogsberg, Marie; Andersson, Per-Anders

2006-01-01

All short lived LLW/ILW from the operation and maintenance of all Swedish Nuclear Power Plants are disposed in SFR, the Swedish final repository for radioactive operational waste. It is important to save all the information about radioactive waste that is needed now and in the future. To be secure that, we have developed a database system in Sweden called Triumf, consisting information about all the waste packages that are disposed in SFR. The waste producers register data concerning individual waste package during production. Before transport to SFR a data file with all information about the individual waste packages is transferred to Triumf. When transferred, the data are checked against accepted limitations before the waste can be loaded on the ship for transport to SFR. After disposal at SFR the deposition location in the repository is added to the database for each waste package. (author)

Measuring healthcare productivity - from unit to system level.

Science.gov (United States)

Kämäräinen, Vesa Johannes; Peltokorpi, Antti; Torkki, Paulus; Tallbacka, Kaj

2016-04-18

Purpose - Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. The purpose of this paper is to focus on healthcare production system productivity measurement. Design/methodology/approach - Traditionally, healthcare productivity has been studied and measured independently at the unit, organization and system level. Suggesting that productivity measurement should be done in different levels, while simultaneously linking productivity measurement to incentives, this study presents the challenges of productivity measurement at the different levels. The study introduces different methods to measure productivity in healthcare. In addition, it provides background information on the methods used to measure productivity and the parameters used in these methods. A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical information for managers. Findings - The study introduces different approaches and methods to measure productivity in healthcare. Practical implications - A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical benefits for managers. Originality/value - The authors focus on the measurement of the whole healthcare production system and try to avoid sub-optimization. Additionally considering an individual patient approach, productivity measurement is examined at the unit level, the organizational level and the system level.

Swedish Technology Teachers' Views on Assessing Student Understandings of Technological Systems

Science.gov (United States)

Schooner, Patrick; Klasander, Claes; Hallström, Jonas

2018-01-01

Technology education is a new school subject in comparison with other subjects within the Swedish compulsory school system. Research in technology education shows that technology teachers lack experience of and support for assessment in comparison with the long-term experiences that other teachers use in their subjects. This becomes especially…

Swedish Government Minister at CERN

CERN Document Server

2008-01-01

The Swedish Minister for Higher Education and Research recently visited CERN. The Swedish Minister was greeted by Swedish scientists working at CERN. Signing of the Swedish Computing Memorandum of Understanding. Pär Omling, Director-General of the Swedish Research Council (left), and Jos Engelen, CERN’s Chief Scientific Officer. Lars Leijonborg, the Swedish Minister for Higher Education and Research, was welcomed to CERN by Director-General Robert Aymar on 10 March. After an introduction to the Laboratory’s activities, the Minister was given guided tours of the control room, the ATLAS surface hall and experiment cavern and the adjoining LHC tunnel. Mr Leijonborg was then greeted by Swedish scientists and given an overview of the Swedish research programme at CERN. Five Swedish university groups are taking part in LHC research. Swedish universities are notably involved in the manufacture of parts for the sub-detectors of AT...

Big problems for Swedish nuclear industry

International Nuclear Information System (INIS)

Holmstroem, Anton; Runesson, Linda

2006-01-01

A report of the problems for Swedish nuclear industry the summer of 2006. A detailed description of the 25th of July incident at Forsmark 1 is provided. The incident was classified as level two on the INIS scale. The other Swedish nuclear plants were subject to security evaluations in the aftermath, and at Forsmark 2 similar weaknesses were found in the security system (ml)

Consumer response to a report card comparing healthcare systems.

Science.gov (United States)

Braun, Barbara L; Kind, Elizabeth A; Fowles, Jinnet B; Suarez, Walter G

2002-06-01

Report cards to date have focused on quality of care in health plans rather than within healthcare delivery systems. The purpose of this study was to evaluate consumer response to the first healthcare system-level report card. Qualitative assessment of consumer response. We conducted 5 focus groups of community members to evaluate consumer response to the report card; 2 included community club members, 3 included community-dwelling retired persons. Discussions were audiotaped and transcribed; comments were categorized by topic area from the script, and common themes identified. Focus group participants, in general, were unaware of the current emphasis on medical quality improvement initiatives. However, they believed that the opinion that the descriptive clinic information and patient survey data contained in the report card would be most useful mainly for choosing a healthcare system if they were dissatisfied with current medical care, if their healthcare options changed, or if they were in poor health. Personal experience was considered a more trustworthy measure of healthcare quality than were patient survey results. Trustworthiness was perceived to be higher if the report card sponsor was not affiliated with the healthcare systems being evaluated. Participants also believed care system administrators should use the data to enact positive clinic-level and physician-level changes. Healthcare consumers appreciated the attention to patient experiences and supported healthcare quality improvement initiatives. Report cards were considered important for choosing a healthcare system in certain circumstances and for guiding quality improvement efforts at all levels.

State governance versus dentists' autonomy - the case of Swedish dental care.

Science.gov (United States)

Franzén, Cecilia

2018-03-01

A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists' autonomy and whether the government's political intentions can be fulfilled. The paper is based on documents from government authorities and professional theories. The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists' professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. This article shows that the state's governance does not directly detail dentists' work, which indicates a balance between state governance and dentists' autonomy. However, further research is required to get knowledge on Swedish dentists' view of the governance.

Creating a medical English-Swedish dictionary using interactive word alignment.

OpenAIRE

Nyström , Mikael; Merkel , Magnus; Ahrenberg , Lars; Zweigenbaum , Pierre; Petersson , Håkan; Ahlfeldt , Hans

2006-01-01

Background: This paper reports on a parallel collection of rubrics from the medical terminology systems ICD-10, ICF, MeSH, NCSP and KSH97-P and its use for semi-automatic creation of an English-Swedish dictionary of medical terminology. The methods presented are relevant for many other West European language pairs than English-Swedish. Methods: The medical terminology systems were collected in electronic format in both English and Swedish and the rubrics were extracted in parallel language pa...

The Swedish Energy Market 2005

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-10-01

The Swedish Energy Market, 2005 is an annual publication that presents information and statistics on the network based energy markets in Sweden, i.e. the markets for electricity, natural gas and district heating. It also provides an overview of the issues that have arisen on these markets during the second half of 2004 and the first half of 2005. Considerable work is being carried out in the EU on creating a single market for electricity and natural gas. This publication therefore describes expansion of the Swedish market towards a Nordic and a European market. The publication normally includes a theme chapter, describing some event of particular interest for the Swedish energy market during the year. This year, the theme chapter is devoted to the Storm Gudrun, which struck the south of the country at the beginning of January, and its effects on electricity supply throughout the country. The chapter is based on the report submitted to the Government by the Energy Markets Inspectorate in the spring of 2005, and also includes a summary of the Inspectorate's proposals for measures to improve the security of electricity transmission. Energy in Sweden, which is another of the Swedish Energy Agency's annual publications, provides information and statistics on the development of the entire Swedish energy system.

Trends in pharmacy staff’s perception of patient safety in Swedish community pharmacies after re-regulation of conditions

DEFF Research Database (Denmark)

Kälvemark Sporrong, Sofia; Nordén-Hägg, Annika

2014-01-01

pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market. Methods: Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects...... no significant differences. Conclusions: The comparison carried out in this study indicates a negative effect in Swedish community pharmacies on safety and quality issues, as experienced by pharmacy staff. It is recommended that the possible effects of healthcare reforms are assessed before implementation...

Healthcare and healthcare systems: inspiring progress and future prospects.

Science.gov (United States)

Durrani, Hammad

2016-01-01

Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population

Prescribing during pregnancy and lactation with reference to the Swedish classification system

DEFF Research Database (Denmark)

Olesen, Charlotte; Sørensen, Henrik Toft; Berg, Lolkje de Jong-van den

1999-01-01

retail pharmacies, made it possible to identify prescriptions by individual use. All 34,334 prescriptions were set against the Swedish classification of risk of drug use in pregnancy and lactation. RESULTS: During pregnancy, safe (group A), potentially harmful (group B3, C, and D), and non...... and II), drugs with possible harmful neonatal effects (group III), and non-classifiable drugs accounted for 43.5%, 4.8%, and 35.8% of the prescriptions, respectively. CONCLUSION: According to the Swedish classification system, we found that during pregnancy and lactation a high proportion of Danish women...... were exposed to one or more drugs in high risk groups; furthermore, knowledge regarding their safety for the fetus and neonate was limited for a large proportion of the prescriptions. Current evidence about long-term effects of prenatal exposure stresses the need for long-term follow-up of health...

Engineering Value-Effective Healthcare Solutions: A Systems Design Perspective

DEFF Research Database (Denmark)

Patou, François; Maier, Anja

2017-01-01

Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare...... of Design for Evolvability and by elaborating on two examples: MRI systems and Point-of-Care in-vitro diagnostics solutions. We specifically argue that Design for Evolvability can realign the agendas of various healthcare stakeholders, serving both individual and national interests. We finally acknowledge...... the limitations of current engineering design practices and call for new theoretical and empirical research initiatives taking a systems perspective on healthcare product and service design....

Redistributive effects of Swedish health care finance.

Science.gov (United States)

Gerdtham, U G; Sundberg, G

1998-01-01

This paper investigates the redistributive effects of the Swedish health care financing system in 1980 and 1990 for four different financial sources: county council taxes, payroll taxes, direct payments and state grants. The redistributive effects are decomposed into vertical, horizontal and 'reranking' segments for each of the four financial sources. The data used are based on probability samples of the Swedish population, from the Level of Living Survey (LNU) from 1981 and 1991. The paper concludes that the Swedish health care financing system is weakly progressive, although direct payments are regressive. There is some horizontal inequity and 'reranking', which mainly comes from the county council taxes, since those tax rates vary for each county council. The implication is that, to some extent, people with equal incomes are treated unequally.

Mapping healthcare systems: a policy relevant analytic tool.

Science.gov (United States)

Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

2017-07-01

In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Dynamic modelling of nitrous oxide emissions from three Swedish sludge liquor treatment systems

DEFF Research Database (Denmark)

Lindblom, E.; Arnell, M.; Flores-Alsina, X.

2016-01-01

The objective of this paper is to model the dynamics and validate the results of nitrous oxide (N2O)emissions from three Swedish nitrifying/denitrifying, nitritation and anammox systems treating real anaerobic digester sludge liquor. The Activated Sludge Model No. 1 is extended to describe N2O...

Requirements for Interoperability in Healthcare Information Systems

Directory of Open Access Journals (Sweden)

Rita Noumeir

2012-01-01

Full Text Available Interoperability is a requirement for the successful deployment of Electronic Health Records (EHR. EHR improves the quality of healthcare by enabling access to all relevant information at the diagnostic decision moment, regardless of location. It is a system that results from the cooperation of several heterogeneous distributed subsystems that need to successfully exchange information relative to a specific healthcare process. This paper analyzes interoperability impediments in healthcare by first defining them and providing concrete healthcare examples, followed by discussion of how specifications can be defined and how verification can be conducted to eliminate those impediments and ensure interoperability in healthcare. This paper also analyzes how Integrating the Healthcare Enterprise (IHE has been successful in enabling interoperability, and identifies some neglected aspects that need attention.

Efficiency vs Effectiveness: a Benchmarking Study on European Healthcare Systems

Directory of Open Access Journals (Sweden)

Corrado lo Storto

2017-10-01

Full Text Available ABSTRACT. This paper illustrates a benchmarking study concerning the healthcare systems in 32 European countries as of 2011 and 2014. Particularly, this study proposes a two-dimensional approach (efficiency/effectiveness models to evaluate the performance of national healthcare systems. Data Envelopment Analysis has been adopted to compute two performance indices, measuring efficiency and effectiveness of these healthcare systems. The results of the study emphasize that the national healthcare systems achieve different efficiency and effectiveness levels. Their performance indices are uncorrelated and behave differently over time, suggesting that there might be no real trade-off between them. The healthcare systems’ efficiencies remain generally stable, while the effectiveness values significantly improved from 2011 to 2014. However, comparing the efficiency and effectiveness scores, the authors identified a group of countries with the lowest performing healthcare systems that includes Ukraine, Bulgaria, Switzerland, Lithuania, and Romania. These countries need to implement healthcare reforms aimed at reducing resource intensity and increasing the quality of medical services. The results also showed the benefits of the proposed approach, which can help policy makers to identify shortcomings in national healthcare systems and justify the need for their reform.

Healthcare system information at language schools for newly arrived immigrants

DEFF Research Database (Denmark)

Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

2017-01-01

a language school in Copenhagen in 2012 received either a course or written information on the Danish healthcare system and subsequently evaluated this quantitatively. Results: The evaluation revealed a positive appraisal of the course/information provided. Conclusion: In times of austerity, incorporating......Objective: In most European countries, immigrants do not systematically learn about the host countries’ healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Method: Immigrants attending...... healthcare information into an already existing language programme may be pertinent for providing immigrants with knowledge on the healthcare system....

Impact of telephone nursing education program for equity in healthcare.

Science.gov (United States)

Höglund, Anna T; Carlsson, Marianne; Holmström, Inger K; Kaminsky, Elenor

2016-09-21

The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person's human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses. The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one's own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions. The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments. The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare

Swedish Disarmament Policy

OpenAIRE

2012-01-01

NPIHP Partners Host Conference on Swedish Disarmament Policy Dec 05, 2012 The Nuclear Proliferation International History Project is pleased to announce a conference on Swedish nuclear disarmament policy, organized and hosted by Stockholm University on 26 november 2012. Organized by Stockholm University Professor Thomas Jonter, Emma Rosengren, Goran Rydeberg, and Stellan Andersson under the aegis of the Swedish Disarmament Resaerch Project, the conference featured keynote addresses by Hans Bl...

The Swedish sea transportation system for safety reasons

International Nuclear Information System (INIS)

Dybeck, P.

1993-01-01

Sweden began to design and build a sea transportation system. The ship M/S SIGYN is specially designed for transports of radioactive waste. It is a combined roll-on/roll-off and lift-on/lift-off vessel. It is built for world wide operation and with the highest requirements of two independent classification societies, Lloyds Register of Shipping and Bureau Veritas. The ship is also designed to conform to the Swedish/Finish ice class 1A. The transport cask for spent fuel, TN 17/2, and core component TN 17-CC are designed as type (B) casks and manufactured to comply with the IAEA Regulations for the Safe Transport of Radioactive Materials, 1973. (J.P.N.)

Army Healthcare Enterprise Management System

National Research Council Canada - National Science Library

2001-01-01

.... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...

System integrational and migrational concepts and methods within healthcare

DEFF Research Database (Denmark)

Endsleff, F; Loubjerg, P

1997-01-01

In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE...... (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems....

The healthcare system and provision of oral healthcare in European Union member states. Part 4: Greece.

Science.gov (United States)

Damaskinos, P; Koletsi-Kounari, H; Economou, C; Eaton, K A; Widström, E

2016-03-11

This paper presents a description of the healthcare system and how oral healthcare is organised and provided in Greece, a country in a deep economic and social crisis. The national health system is underfunded, with severe gaps in staffing levels and the country has a large private healthcare sector. Oral healthcare has been largely provided in the private sector. Most people are struggling to survive and have no money to spend on general and oral healthcare. Unemployment is rising and access to healthcare services is more difficult than ever. Additionally, there has been an overproduction of dentists and no development of team dentistry. This has led to under or unemployment of dentists in Greece and their migration to other European Union member states, such as the United Kingdom, where over 600 Greek dentists are currently working.

Knowledge management systems success in healthcare: Leadership matters.

Science.gov (United States)

Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga

2017-01-01

To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cyberterrorism: is the U.S. healthcare system safe?

Science.gov (United States)

Harries, David; Yellowlees, Peter M

2013-01-01

The Internet has brought with it many benefits; key among them has been its ability to allow the expansion of communication and transfer of all kinds of information throughout the U.S. healthcare system. As a consequence, healthcare has become increasingly dependent on the activities carried out in that environment. It is this very dependence that increases the likelihood of individuals or organizations conducting activities through the Internet that will cause physical and/or psychological harm. These activities have become known by the term "cyberterrorism." In the healthcare landscape this can appear in a variety of forms, such as bringing down a hospital computer system or publicly revealing private medical records. Whatever shape it takes, the general effects are the same: patient care is compromised, and trust in the health system is diminished. Fortunately no significant cyber attack has been successfully launched against a U.S. healthcare organization to date. However, there is evidence to suggest that cyber threats are increasing and that much of the U.S. healthcare system is ill equipped to deal with them. Securing cyberspace is not an easy proposition as the threats are constantly changing, and recognizing that cyberterrorism should be part of a broader information technology risk management strategy, there are several"best practices" that can be adopted by healthcare organizations to protect themselves against cyber attacks.

Healthcare systems--an international review: an overview.

Science.gov (United States)

Lameire, N; Joffe, P; Wiedemann, M

1999-01-01

Based on the source of their funding, three main models of healthcare can be distinguished. The first is the Beveridge model, which is based on taxation and has many public providers. The second is the Bismarck 'mixed' model, funded by a premium-financed social insurance system and with a mixture of public and private providers. Finally, the 'Private Insurance model' is only in existence in the US. The present report explores the impact of these healthcare models on the access to, quality and cost of healthcare in selected European countries. Access is nearly 100% in countries with a public provider system, while in most of the 'mixed' countries, the difference from 100% is made up by supplementary private insurance. No differences are seen between public and mixed provider systems in terms of quality of care, despite the fact that the countries with the former model spend, in general, less of their Gross National Product on healthcare. The Private Insurance/private provider model of the US produces the highest costs, but is lowest in access and is close to lowest ranking in quality parameters.

Design principles for achieving integrated healthcare information systems.

Science.gov (United States)

Jensen, Tina Blegind

2013-03-01

Achieving integrated healthcare information systems has become a common goal for many countries in their pursuit of obtaining coordinated and comprehensive healthcare services. This article focuses on how a small local project termed 'Standardized pull of patient data' expanded and is now used on a large scale providing a majority of hospitals, general practitioners and citizens across Denmark with the possibility of accessing healthcare data from different electronic patient record systems and other systems. I build on design theory for information infrastructures, as presented by Hanseth and Lyytinen, to examine the design principles that facilitated this smallscale project to expand and become widespread. As a result of my findings, I outline three lessons learned that emphasize: (i) principles of flexibility, (ii) expansion from the installed base through modular strategies and (iii) identification of key healthcare actors to provide them with immediate benefits.

Engineering the system of healthcare delivery

National Research Council Canada - National Science Library

Rouse, William B; Cortese, Denis A

2010-01-01

"As the United States continues to debate reform of its healthcare system, this book argues that providing health insurance for all without improving the delivery system will not improve the current...

Technical description of the Swedish natural gas distribution system

Energy Technology Data Exchange (ETDEWEB)

Nilsson, Ronny [KM Miljoeteknik AB (Sweden)

1997-06-01

This description of the Swedish distribution network has been produced to provide information for distribution companies, trade organisations, etc., who have an interest in getting a clear understanding of the technical design and standards, technical directives, etc., which have served as guidance in the development. The technical description covers the piping system from a measuring and regulating station (MR station) up to the consumer`s substation, however, only sections with a maximum operating pressure of 4 bar. By way of introduction, the description contains introductory information on supply channels, consumption patterns and the principal design of the high pressure network in Sweden 10 refs, 10 figs, 1 tab

Understanding how orthopaedic surgery practices generate value for healthcare systems.

Science.gov (United States)

Olson, Steven A; Mather, Richard C

2013-06-01

Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

Hadoop-Based Healthcare Information System Design and Wireless Security Communication Implementation

Directory of Open Access Journals (Sweden)

Hongsong Chen

2015-01-01

Full Text Available Human health information from healthcare system can provide important diagnosis data and reference to doctors. However, continuous monitoring and security storage of human health data are challenging personal privacy and big data storage. To build secure and efficient healthcare application, Hadoop-based healthcare security communication system is proposed. In wireless biosensor network, authentication and key transfer should be lightweight. An ECC (Elliptic Curve Cryptography based lightweight digital signature and key transmission method are proposed to provide wireless secure communication in healthcare information system. Sunspot wireless sensor nodes are used to build healthcare secure communication network; wireless nodes and base station are assigned different tasks to achieve secure communication goal in healthcare information system. Mysql database is used to store Sunspot security entity table and measure entity table. Hadoop is used to backup and audit the Sunspot security entity table. Sqoop tool is used to import/export data between Mysql database and HDFS (Hadoop distributed file system. Ganglia is used to monitor and measure the performance of Hadoop cluster. Simulation results show that the Hadoop-based healthcare architecture and wireless security communication method are highly effective to build a wireless healthcare information system.

Intelligent scheduling of execution for customized physical fitness and healthcare system.

Science.gov (United States)

Huang, Chung-Chi; Liu, Hsiao-Man; Huang, Chung-Lin

2015-01-01

Physical fitness and health of white collar business person is getting worse and worse in recent years. Therefore, it is necessary to develop a system which can enhance physical fitness and health for people. Although the exercise prescription can be generated after diagnosing for customized physical fitness and healthcare. It is hard to meet individual execution needs for general scheduling of physical fitness and healthcare system. So the main purpose of this research is to develop an intelligent scheduling of execution for customized physical fitness and healthcare system. The results of diagnosis and prescription for customized physical fitness and healthcare system will be generated by fuzzy logic Inference. Then the results of diagnosis and prescription for customized physical fitness and healthcare system will be scheduled and executed by intelligent computing. The scheduling of execution is generated by using genetic algorithm method. It will improve traditional scheduling of exercise prescription for physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent scheduling of execution for customized physical fitness and healthcare system.

The Nigerian, Swedish and Chilean Pension Systems: A ...

African Journals Online (AJOL)

preferred customer

the concern for the long-term financial viability of existing government operated pension ... Thus, this study comparatively evaluates the Nigerian, Swedish and Chilean pension ... Keywords: Demographic crisis, Pension reform, Public policy .... care which employers owe their employees on retirement or in case of death.

Neoliberalism and the recommodification of health inequalities: A case study of the Swedish welfare state 1980 to 2011.

Science.gov (United States)

Farrants, Kristin; Bambra, Clare

2018-02-01

This paper examines the effects of neoliberalism on health inequalities through an empirical examination of the recommodification of the social determinants of health. It uses a detailed case study of changes to three specific welfare policy domains in Sweden: unemployment, healthcare, and pensions. Using time series data from the repeat cross-sectional Swedish Living Conditions Survey for 1980-2011, it examines: (1) the effects of reductions in the replacement rate value of unemployment benefit on inequalities in self-reported general health between the employed and the unemployed; (2) the effects of reductions in the replacement rate value of pensions on educational inequalities in self-reported general health among pensioners; and (3) the effects of the increase in user charges on inequalities in having visited a doctor in the past 3 months by educational level. The results suggest mixed effects of welfare state recommodification on health inequalities: inequalities increased between the Swedish employed and unemployed, yet they did not increase in the retired population, and inequalities in access to healthcare also remained steady during the study period. The paper concludes that the association between recommodification and health inequalities in Sweden is stronger regarding unemployment benefits than pensions or healthcare, and that this may relate to the stigmatisation of the unemployed.

The Effects of Swedish Knife Model on Students' Understanding of the Digestive System

Science.gov (United States)

Cerrah Ozsevgec, Lale; Artun, Huseyin; Unal, Melike

2012-01-01

This study was designed to examine the effect of Swedish Knife Model on students' understanding of digestive system. A simple experimental design (pretest-treatment-posttest) was used in the study and internal comparison of the results of the one group was made. The sample consisted of 40 7th grade Turkish students whose ages range from 13 to 15.…

Transformacija partijno-politicheskoj sistemy Shvecii v konce XX — nachale XXI veka [The transformation of the Swedish political party system in the late 20th/early 21st century

Directory of Open Access Journals (Sweden)

Ryabichenko Arkady

2013-01-01

Full Text Available This article studies the process of transformation of the Swedish political party system in the 1980s. The study aims to develop a typology of the Swedish political party system before and after the transformation processes commenced. The article identifies the key prerequisites for such transformation: the crisis of social democracy and an increase in the nationalist attitudes in the society caused by the negative repercussions of the system of integration of migrants into the society based on the multiculturalism principles. The interethnic tension manifested itself in the wide support for the Swedish Democrats Party in the 2010 parliamentary election. From a political party system dominated by social democrats, the Swedish political party system turned into one with two leading parties – the centre-left Swedish Social Democratic Labour Party and the centre-right Moderate Party. The Swedish Democrats position themselves as an alternative to the two party blocs headed by the dominating parties (the Alliance and the Red-Green. The study employs an interdisciplinary approach in the framework of science synthesis. Its results can be of practical significance for politicians, social activists, and academicians.

Imperatives for "Right" Educational Choices in Swedish Educational Policy

Science.gov (United States)

Puaca, Goran

2014-01-01

The present article is based on a critical semiotic investigation of the Swedish Long-Term Survey on economic development. It aims to examine how recent Swedish policy trends bring specific economic, political and social processes together to form a system of meaning for both motivation and regulation over individuals' educational choices. What is…

From denial to awareness: a conceptual model for obtaining equity in healthcare.

Science.gov (United States)

Höglund, Anna T; Carlsson, Marianne; Holmström, Inger K; Lännerström, Linda; Kaminsky, Elenor

2018-01-22

Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation. A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively. Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare. A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach

Commercial versus in-situ usability testing of healthcare information systems: towards "public" usability testing in healthcare organizations.

Science.gov (United States)

Kushniruk, Andre W; Borycki, Elizabeth M; Kannry, Joseph

2013-01-01

The need for improved usability in healthcare IT has been widely recognized. In addition, methods from usability engineering, including usability testing and usability inspection have received greater attention. Many vendors of healthcare software are now employing usability testing methods in the design and development of their products. However, despite this, the usability of healthcare IT is still considered to be problematic and many healthcare organizations that have purchased systems that have been tested at vendor testing sites are still reporting a range of usability and safety issues. In this paper we explore the distinction between commercial usability testing (conducted at centralized vendor usability laboratories and limited beta test sites) and usability testing that is carried out locally within healthcare organizations that have purchased vendor systems and products (i.e. public "in-situ" usability testing). In this paper it will be argued that both types of testing (i.e. commercial vendor-based testing) and in-situ testing are needed to ensure system usability and safety.

Development of Intelligent Auxiliary System for Customized Physical Fitness and Healthcare

Directory of Open Access Journals (Sweden)

Huang Chung-Chi

2016-01-01

Full Text Available With the advent of global high-tech industry and commerce era, the sedentary reduces opportunities of physical activity. And physical fitness and health of people is getting worse and worse. At present, the shortage of physical fitness instructors greatly affected the effectiveness of health promotion. Therefore, it is necessary to develop an auxiliary system which can reduce the workload of instructors and enhance physical fitness and health for people. But current general physical fitness and healthcare system is hard to meet individualized needs. The main purpose of this research is to develop an intelligent auxiliary system for customized physical fitness and healthcare. It records all processes of physical fitness and healthcare system by wireless sensors network. The results of intelligent auxiliary systems for customized physical fitness and healthcare will be generated by fuzzy logic Inference. It will improve individualized physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent auxiliary system for customized physical fitness and healthcare.

LIFE CYCLE ASSESSMENT IN HEALTHCARE SYSTEM OPTIMIZATION. INTRODUCTION

Directory of Open Access Journals (Sweden)

V. Sarancha

2015-03-01

Full Text Available Article describes the life cycle assessment method and introduces opportunities for method performance in healthcare system settings. LSA draws attention to careful use of resources, environmental, human and social responsibility. Modelling of environmental and technological inputs allows optimizing performance of the system. Various factors and parameters that may influence effectiveness of different sectors in healthcare system are detected. Performance optimization of detected parameters could lead to better system functioning, higher patient safety, economic sustainability and reduce resources consumption.

Swedish industrial and energy supply measures in a European system perspective

OpenAIRE

Trygg, Louise

2006-01-01

A common electricity market in Europe will in all probability lead to a levelling out of the electricity price, which implies that Swedish consumers will face higher electricity prices with a European structure. This new market situation will force industry and energy suppliers to take new essential measures as actors in a deregulated European electricity market. In this thesis it is shown how over 30 Swedish small and medium-sized industries can reduce their use of electricity by about 50%. ...

Enhancing Health-Care Services with Mixed Reality Systems

Science.gov (United States)

Stantchev, Vladimir

This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

The ability of criminal law to produce gender equality: judicial discourses in the Swedish criminal legal system.

Science.gov (United States)

Burman, Monica

2010-02-01

The main aim of the Swedish Women's Peace reform in 1998 was to enhance criminal legal protection for women exposed to violence in heterosexual relationships and to promote gender equality. However, these ambitions risk being contravened in a masculinist criminal legal system. One problem concerns how the victim is constructed in criminal legal cases. The author argues that moral balancing and discourses of responsibility and guilt in Swedish cases constrain the agency possible for women and suggest that a more comprehensive policy in Sweden must be developed to include violent men, their agency, and their responsibility for the violence.

Process-driven selection of information systems for healthcare

Science.gov (United States)

Mills, Stephen F.; Yeh, Raymond T.; Giroir, Brett P.; Tanik, Murat M.

1995-05-01

Integration of networking and data management technologies such as PACS, RIS and HIS into a healthcare enterprise in a clinically acceptable manner is a difficult problem. Data within such a facility are generally managed via a combination of manual hardcopy systems and proprietary, special-purpose data processing systems. Process modeling techniques have been successfully applied to engineering and manufacturing enterprises, but have not generally been applied to service-based enterprises such as healthcare facilities. The use of process modeling techniques can provide guidance for the placement, configuration and usage of PACS and other informatics technologies within the healthcare enterprise, and thus improve the quality of healthcare. Initial process modeling activities conducted within the Pediatric ICU at Children's Medical Center in Dallas, Texas are described. The ongoing development of a full enterprise- level model for the Pediatric ICU is also described.

Public trust in the healthcare system in a developing country.

Science.gov (United States)

Peters, Dexnell; Youssef, Farid F

2016-04-01

Broadly defined, trust in the healthcare system is concerned with how the public perceives the system and the actors therein as it pertains to their ability to both deliver services and seek the best interests of their clientele. Trust is important because it impacts upon a range of health behaviors including compliance and ultimately affects the ability of the healthcare system to meet its goals. While several studies exist on public trust within the developed world, few studies have explored this issue in developing countries. This paper therefore assesses public trust in the healthcare system of a developing small island nation, Trinidad and Tobago. A cross-sectional survey of adults was conducted using a questionnaire that has been successfully used across Europe. We report that trust levels in the healthcare system in Trinidad and Tobago are relatively low with less than 50% of persons indicating fair trust in the healthcare system. In addition, individual health professionals also did not score highly with lowest scores found for nurses and complementary therapists. Results on four out of five dimensions of trust also demonstrated scores significantly lower than those reported in more developed nations. Open-ended comments supported these findings with the majority of persons indicating a lack of confidence in the healthcare system. These results may reflect the reality in the wider developing world, and we suggest that bolstering trust is a needed area of focus in the delivery of healthcare services throughout the nation. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

A review of the Australian healthcare system: A policy perspective

Science.gov (United States)

Sambasivan, Murali

2018-01-01

This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries’ healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care. PMID:29686869

[Interpretation in the Danish health-care system].

Science.gov (United States)

Lund Hansen, Marianne Taulo; Nielsen, Signe Smith

2013-03-04

Communication between health professional and patient is central for treatment and patient safety in the health-care system. This systematic review examines the last ten years of specialist literature concerning interpretation in the Danish health-care system. Structural search in two databases, screening of references and recommended literature from two scientists led to identification of seven relevant articles. The review showed that professional interpreters were not used consistently when needed. Family members were also used as interpreters. These results were supported by international investigations.

[Connecting the Baltic area : the Swedish postal System in the seventeenth century] / Kaarel Vanamölder

Index Scriptorium Estoniae

Vanamölder, Kaarel, 1981-

2011-01-01

Arvustus: Connecting the Baltic area : the Swedish postal System in the seventeenth century. Ed. by Heiko Droste. Södertörn Studies in History, 9, Södertörn Academic Studies, 42 (Huddinge: Södertörns högskola, 2011)

UP-report. Energy systems studies. Basis of the Development platform. System to the Swedish Energy Agency's strategy work FOKUS; UP-rapport. Energisystemstudier. Underlag fraan Utvecklingsplattformen. System till Energimyndighetens strategiarbete FOKUS

Energy Technology Data Exchange (ETDEWEB)

Ingelstam, Lars; Alm, Maria

2012-11-01

The report serves as input to the Swedish Energy Agency's strategies and priorities for research and innovation in the thematic area Energy systems studies for the period 2011 - 2016. The report has been compiled by members of the the Development platform System. This report provides background and circumstances for the energy system studies theme, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and knowledge that enabled the Swedish Energy Agency to then develop a strategy that meets the needs of society and business.

Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

Science.gov (United States)

Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

2015-09-01

Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region.

Science.gov (United States)

Barbarito, Fulvio; Pinciroli, Francesco; Mason, John; Marceglia, Sara; Mazzola, Luca; Bonacina, Stefano

2012-08-01

Information technologies (ITs) have now entered the everyday workflow in a variety of healthcare providers with a certain degree of independence. This independence may be the cause of difficulty in interoperability between information systems and it can be overcome through the implementation and adoption of standards. Here we present the case of the Lombardy Region, in Italy, that has been able, in the last 10 years, to set up the Regional Social and Healthcare Information System, connecting all the healthcare providers within the region, and providing full access to clinical and health-related documents independently from the healthcare organization that generated the document itself. This goal, in a region with almost 10 millions citizens, was achieved through a twofold approach: first, the political and operative push towards the adoption of the Health Level 7 (HL7) standard within single hospitals and, second, providing a technological infrastructure for data sharing based on interoperability specifications recognized at the regional level for messages transmitted from healthcare providers to the central domain. The adoption of such regional interoperability specifications enabled the communication among heterogeneous systems placed in different hospitals in Lombardy. Integrating the Healthcare Enterprise (IHE) integration profiles which refer to HL7 standards are adopted within hospitals for message exchange and for the definition of integration scenarios. The IHE patient administration management (PAM) profile with its different workflows is adopted for patient management, whereas the Scheduled Workflow (SWF), the Laboratory Testing Workflow (LTW), and the Ambulatory Testing Workflow (ATW) are adopted for order management. At present, the system manages 4,700,000 pharmacological e-prescriptions, and 1,700,000 e-prescriptions for laboratory exams per month. It produces, monthly, 490,000 laboratory medical reports, 180,000 radiology medical reports, 180

Integrating hospital information systems in healthcare institutions: a mediation architecture.

Science.gov (United States)

El Azami, Ikram; Cherkaoui Malki, Mohammed Ouçamah; Tahon, Christian

2012-10-01

Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.

WISH: a Wireless Mobile Multimedia Information System in Healthcare using RFID.

Science.gov (United States)

Yu, Weider D; Ray, Pradeep; Motoc, Tiberiu

2008-05-01

It is important to improve the efficiency of healthcare-related operations and the associated costs. Healthcare organizations are constantly under increased pressure to streamline operations and provide enhanced services to their patients. Wireless mobile computing technology has the potential to provide the desired benefits and would be a critical part of today's healthcare information system. In this paper, a system is presented to better facilitate the functions of physicians and medical staff in healthcare by using modern wireless mobile technology, Radio Frequency Identification (RFID) tools, and multimedia streaming. The paper includes a case study of the development of such a system in the context of healthcare in the United States. The results of the study show how wireless mobile multimedia systems can be developed for the improvement of the quality and efficiency in healthcare for other nations as well. Our testing data show a time reduction of more than 50% in the daily activities of hospital staff.

Challenges in Swedish hydropower – politics, economics and rights

Directory of Open Access Journals (Sweden)

Kristina Ek

2017-10-01

Full Text Available Two systems working in parallel have contributed to implementation difficulties in Swedish water governance. While the old system is designed to be predictable and stable over time, the new system is intended to be transparent and holistic, guided by the principles of Integrated Water Resource Management. The paper disentangles the challenges in Swedish water governance and proposes a blueprint for future research. The proposed research project is unique in the sense that it explores the imbalances between the new and the old water governance systems from a multi-disciplinary perspective, elaborating upon the clashes between the traditional, nationally based regulatory system and the new holistic water governance system from legal, political and economic perspectives.

Corporate Governance in the Swedish Banking Sector

OpenAIRE

Palmberg, Johanna

2010-01-01

This paper studies the corporate governance structure among Swedish banks. Who controls the Swedish banks and what characteristics does the Swedish banking sector have? Issues related to corporate governance such as ownership structure, board of directors and control-enhancing mechanisms will be studied. The Swedish banking law, how Swedish banks handled the financial crises and government measures to deal with the financial crisis is also analyzed.

SWEDISH CRIME FICTION AS SOCIALLY INVOLVED LITERATURE

Directory of Open Access Journals (Sweden)

Monika Samsel-Chojnacka

2011-01-01

Full Text Available Swedish crime novel has been transforming for many years to become more socially involved. The ambition of many writers is not only to entertain the readers but also to participating in the social debate, criticizing the political and economical system, focusing on important issues such as violence against women, exploitation of working class by the privileged ruling class, the problems of a modern family and the situation of immigrants. Since the moment when in the mid 60’s two journalists Maj Sjöwall and Per Wahlöö decided to use popular literature to spread social matters many other Swedish writers have decided to follow their way. Some of them are journalists – like Liza Marklund, Börge Hellström and Anders Roslund or Stieg Larsson. Their novels as well as the ones written by Henning Mannkel on Kurt Wallander have become crucial evidence of changes of Swedish society in the past twenty years. Modern Swedish crime fiction illustrates the population in the model fashion that is the reason why it can become one of the interests of the sociology of literature.

Information security requirements in patient-centred healthcare support systems.

Science.gov (United States)

Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

2013-01-01

Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

The Vat Exemption for Health Care: Eu Law and its Impact on Swedish law

Directory of Open Access Journals (Sweden)

Påhlsson Robert

2015-12-01

Full Text Available The general rule in EU law is that value-added tax (VAT is to be levied on all goods and services. There are a number of exceptions, however, one of which applies to certain medical services. This paper examines the legal basis for tax exemptions in EU VAT law and in Swedish law, with particular attention to the extent to which the rapidly growing private health-care sector is covered by these tax exemptions.

The healthcare experiences of Arab Israeli women in a reformed healthcare system.

Science.gov (United States)

Elnekave, Eldad; Gross, Revital

2004-07-01

Arab Israeli women are subject to unique social stresses deriving from their status as part of an ethno-political minority and from their position as women in a patriarchal community. Collectively, their health profiles rate poorly in comparison to Jewish Israeli women or to women in the vast majority of developed countries. To examine the experiences of Arab Israeli women in the contemporary Israeli healthcare system, following implementation of the National Health Insurance Law (NHIL). The study combined quantitative and qualitative research methodologies. A telephone survey utilizing a structured questionnaire was conducted during August-September 1998 among a random national sample of 849 women, with a response rate of 83%. Between the months of January and July of 2000, qualitative data was attained via participant-observation, long and short semi-structured interviews, and focus groups in one large Muslim Arab Israeli village. Arab Israeli women in the national survey reported poorer self-assessed health, lower rates of care by a woman primary care physician, lower satisfaction ratings for primary care physicians and more frequently foregoing medical care than did native or immigrant Jewish Israeli women. Three major factors contributing to Arab Israeli women's healthcare experiences were elucidated by the qualitative study: (1) the threat of physical and social exposure (2) difficulties in communicating with male physicians and (3) the stifling effect of family politics and surveillance on healthcare. We discuss our findings in relation to structural changes associated with the recent reform of the Israeli health care system. We conclude by suggesting policy measures for better adapting primary care services to the needs of Arab Israeli women, and note the relevance to other systems that aim to provide service to cultural and ethno-political minorities, in which healthcare delivery is shaped by unique local circumstances.

Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors.

Science.gov (United States)

Xesfingi, Sofia; Vozikis, Athanassios

2016-03-15

Patient satisfaction is an important measure of healthcare quality as it offers information on the provider's success at meeting clients' expectations and is a key determinant of patients' perspective behavioral intention. The aim of this paper is first to assess the degree of patient satisfaction, and second, to study the relationship between patient satisfaction of healthcare system and a set of socio-economic and healthcare provision indicators. This empirical analysis covers 31 countries for the years 2007, 2008, 2009 and 2012. The dependent variable, the satisfaction index, is defined as the patient satisfaction of their country's health system. We first construct an index of patient satisfaction and then, at a second stage, this index is related to socio-economic and healthcare provision variables. Our findings support that there is a strong positive association between patient satisfaction level and healthcare provision indicators, such as nurses and physicians per 100,000 habitants, with the latter being the most important contributor, and a negative association between patient satisfaction level and number of hospital beds. Among the socio-economic variables, public health expenditures greatly shape and positive relate to patient satisfaction, while private spending on health relates negatively. Finally, the elder a patient is, the more satisfied with a country's healthcare system appears to be. We conclude that there is a strong positive association between patient satisfaction and public health expenditures, number of physicians and nurses, and the age of the patient, while there is a negative evidence for private health spending and number of hospital beds.

Systems healthcare: a holistic paradigm for tomorrow.

Science.gov (United States)

Fiandaca, Massimo S; Mapstone, Mark; Connors, Elenora; Jacobson, Mireille; Monuki, Edwin S; Malik, Shaista; Macciardi, Fabio; Federoff, Howard J

2017-12-19

Systems healthcare is a holistic approach to health premised on systems biology and medicine. The approach integrates data from molecules, cells, organs, the individual, families, communities, and the natural and man-made environment. Both extrinsic and intrinsic influences constantly challenge the biological networks associated with wellness. Such influences may dysregulate networks and allow pathobiology to evolve, resulting in early clinical presentation that requires astute assessment and timely intervention for successful mitigation. Herein, we describe the components of relevant biological systems and the nature of progression from at-risk to manifest disease. We illustrate the systems approach by examining two relevant clinical examples: Alzheimer's and cardiovascular diseases. The implications of systems healthcare management are examined through the lens of economics, ethics, policy and the law. Finally, we propose the need to develop new educational paradigms to enhance the training of the health professional in an era of systems medicine.

Evaluating Complex Healthcare Systems: A Critique of Four Approaches

Directory of Open Access Journals (Sweden)

Heather Boon

2007-01-01

Full Text Available The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or ‘whole’ systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK, whole systems research, whole medical systems research described by NCCAM (USA and a model from NAFKAM (Norway. Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced; the necessity of using mixed methods including randomized clinical trials (RCTs (explanatory and pragmatic and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM as well as conventional therapies. In contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first especially with respect to how the ‘definitive’ RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems.

The Swedish Dilemma: Nuclear Energy v. the Environment

International Nuclear Information System (INIS)

Nordhaus, W.D.

1995-01-01

A phaseout of nuclear power in Sweden is supposed to be accomplished by year 2010. This study is an economic analysis of the questions that are parts of the Swedish nuclear dilemma. Even though the economic questions are in focus, the important environmental, health and safety questions are also treated. The basic argument is that Sweden should choose an energy system that allows its citizens to maximize their consumption in a long-term perspective. Consumption is here given a meaning that includes elements outside the market, such as environmental, health and safety aspects valued in a reasonable way. Considerations must also be given to international aspects like global environment, a free and open system of trade and the value of a stable set of rules and proprietary rights. The study compares the economic pros and cons of different energy systems within this general frame. A detailed model of the Swedish energy and power sectors was developed for the study, called the Swedish Energy and Environment Policy (SEEP) model. The SEEP model is built on modern economic theory and includes energy and environmental factors in a uniform way. 51 refs, 36 tabs, 6 figs

Present-Day Influence of English on Swedish as Found in Swedish Job Advertisements.

Science.gov (United States)

Larson, Ben E.

1990-01-01

A brief analysis of job advertisements in Swedish newspapers notes the increasing trend toward the use of English rather than Swedish words for certain terms, attributing such use to the wish to show an international labor perspective. (five references) (CB)

The healthcare system and the provision of oral healthcare in European Union member states. Part 8: Italy.

Science.gov (United States)

Bindi, M; Paganelli, C; Eaton, K A; Widström, E

2017-05-26

In Italy healthcare is provided for all Italian citizens and residents and it is delivered mainly by public providers, with some private or private-public entities. Italy's public healthcare system - the Servizio Sanitario Nazionale (SSN) - is organised by the Ministry of Health and administered on a devolved regional basis. It is financed by general taxation that provides universal coverage, largely free of charge at the point of service. The central government establishes the basic national health benefits package, which must be uniformly provided throughout the country, through services guaranteed under the NHS provision called LEA - (Livelli Essenziali di Assistenza [Essential Level of Assistance]) and allocates national funds to the regions. The regions, through their regional health departments, are responsible for organising, administering and delivering primary, secondary and tertiary healthcare services as well as preventive and health promotion services. Regions are allowed a large degree of autonomy in how they perform this role and regarding decisions about the local structure of the system. Complementary and supplementary private health insurance is also available. However, as in most other Mediterranean European countries, in Italy oral healthcare is mainly provided under private arrangements. The public healthcare system provides only 5-8% of oral healthcare services and this percentage varies from region to region. Oral healthcare is included in the Legislation on Essential levels of care (LEAs) for specific populations such as children, vulnerable people (medically compromised and those on low income) and individuals who need oral healthcare in some urgent/emergency cases. For other people, oral healthcare is generally not covered. Apart from the national benefits package, regions may also carry out their own initiatives autonomously, but must finance these themselves. The number of dentists working in Italy has grown rapidly in the last few years

Corruption in the Nigerian healthcare system | Buowari | Nigerian ...

African Journals Online (AJOL)

Corruption is the use of public resources for private gain. This is common in most countries though reduced in some and alarming in others. It affects all sectors of the economy and the healthcare system is not spared. Medical corruption is increasing in countries with high rates of corruption and all healthcare professionals ...

Oral healthcare systems in the extended European union.

Science.gov (United States)

Widström, Eeva; Eaton, Kenneth A

2004-01-01

This article reports a survey of the systems for the provision of oral healthcare in the 28 member and accession states of the EU/EEA in 2003. Descriptions of the systems were collected from the principal dental advisers to governments in the individual states. In many states these were the Chief Dental Officers (CDOs). In states without a CDO, descriptions were gathered from CDO equivalents or senior academics. A template (model description) was used to guide all respondents. Additional statistical information on oral healthcare costs and workforce was collected from the Council of European Chief Dental Officers, WHO and World Bank websites. The study showed that in broad terms there were six patterns (Beveridgian, Bismarkian, The Eastern European (in transition), Nordic, Southern European and Hybrid) for the administration and financing of oral healthcare in the expanding EU. The extent and nature of government involvement in planning and coordinating oral healthcare services and the numbers and pay of the oral healthcare workforce varied between the different models. The biggest recent changes in European oral healthcare were found to have occurred in Eastern Europe, where there has been wide scale privatization of the previously public dental services. However, most of the EU accession (Eastern European) states seemed to be slowly developing insurance systems to cover oral health treatment costs. In the existing EU/EEA, the public dental services such as those in the Nordic countries still have strong political support and some expansion has occurred. In Southern Europe public dental services seemed to have gained some acceptance for the treatment of children and special needs groups. In UK, which has a unique public dental service system, there are plans to make big changes in the delivery, commissioning and remuneration of dental services in the near future. Some EU member states which operate the Bismarkian system with health insurances offering wide

Development of Wearable Systems for Ubiquitous Healthcare Service Provisioning

OpenAIRE

Ogunduyile, O.O.; Olugbara, O.O.; Lall, M.

2013-01-01

This paper reports on the development of a wearable system using wireless biomedical sensors for ubiquitous healthcare service provisioning. The prototype system is developed to address current healthcare challenges such as increasing cost of services, inability to access diverse services, low quality services and increasing population of elderly as experienced globally. The biomedical sensors proactively collect physiological data of remote patients to recommend diagnostic services. The prot...

Quality of the ophthalmological service to outpatients of the public and private healthcare systems.

Science.gov (United States)

Hercos, Benigno Vicente Santos; Berezovsky, Adriana

2017-01-01

To compare perceptions of the quality of ophthalmological services offered to outpatients from the public healthcare system to those from the private healthcare system, and to determine which measures are seen as necessary and a priority for improving the quality of care. This was a prospective observational study on 200 patients, 101 and 99 of whom were from the public and private healthcare systems, respectively. All patients underwent an ophthalmological examination at an ophthalmology hospital in Belo Horizonte, Minas Gerais, Brazil. Personal interviews were conducted using two structured questionnaires adapted from the modified SERVQUAL scale. Overall, patients from the private healthcare system were significantly more dissatisfied than those from the public healthcare system. In both systems, reliability was considered to be the most important determinant of quality, and it presented the highest level of dissatisfaction. Satisfaction with the public healthcare system was significantly greater than that with the private healthcare system in terms of the tangibles, reliability, responsiveness, and assurance determinants of the SERVQUAL scale. Institutions must plan, execute, evaluate, and monitor measures that seek to improve the overall patient satisfaction with the quality of services provided, particularly in the private healthcare system, and special attention must be paid to reliability in both healthcare systems. The identification and monitoring of the quality of healthcare services through the periodic use of the SERVQUAL scale may provide healthcare managers with information so that they can identify, plan, and monitor necessary and priority measures. This could be a key strategy for improving the quality of outpatient health services in the public and private systems.

Releases of radioactive substances from Swedish nuclear power plants (RAKU)

Energy Technology Data Exchange (ETDEWEB)

Ingemansson, T.; Bergstroem, C. [ALARA Engineering AB, Skultuna (Sweden)

1997-04-01

Releases of radioactivity to air and water from Swedish nuclear power plants have been studied and compared with those from foreign reactors. Averaged over the years from commissioning of the reactors to the last year data are available, the release of radioactive noble gas from the Swedish BWRs has been about the same as from comparable foreign reactors. The oldest Swedish BWRs, Oskarshamn 1 and 2 (O1 and O2) and Ringhals 1 (R1), have simple off-gas systems with only one delay volume. All BWRs in US, Germany, Japan and Switzerland are equipped with more sophisticated off-gas systems. It can be expected that O1, O2 and R1 therefore will have the highest release of noble gas activity at an international comparison if they do not modernize their off-gas system. BWRs in US, Germany and Japan are today equipped with recombiners and with one exception also charcoal columns. Japanese BWRs report zero releases to air. Releases of radioactivity to water after commissioning was about the same for most of the studied reactors. Some of the newest German plants have had low annual releases already at commissioning. Improvements of the treatment systems at old German, Swiss and US reactors have significantly lowered the releases. For most of the Swedish plants the annual releases to water have remained at the initial level. Forsmark 3 has succeeded in decreasing the release of radionuclides to water by a factor of almost one hundred compared to other Swedish reactors. Also O3 has managed to decrease the liquid effluents. Japanese plants have zero release of radioactivity excluding tritium to water. The release of tritium is about the same for all reactors of the same type in the world. 35 refs, 31 figs, 24 tabs.

A scalable healthcare information system based on a service-oriented architecture.

Science.gov (United States)

Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

2011-06-01

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

Using HFACS-Healthcare to Identify Systemic Vulnerabilities During Surgery.

Science.gov (United States)

Cohen, Tara N; Francis, Sarah E; Wiegmann, Douglas A; Shappell, Scott A; Gewertz, Bruce L

2018-03-01

The Human Factors Analysis and Classification System for Healthcare (HFACS-Healthcare) was used to classify surgical near miss events reported via a hospital's event reporting system over the course of 1 year. Two trained analysts identified causal factors within each event narrative and subsequently categorized the events using HFACS-Healthcare. Of 910 original events, 592 could be analyzed further using HFACS-Healthcare, resulting in the identification of 726 causal factors. Most issues (n = 436, 60.00%) involved preconditions for unsafe acts, followed by unsafe acts (n = 257, 35.39%), organizational influences (n = 27, 3.72%), and supervisory factors (n = 6, 0.82%). These findings go beyond the traditional methods of trending incident data that typically focus on documenting the frequency of their occurrence. Analyzing near misses based on their underlying contributing human factors affords a greater opportunity to develop process improvements to reduce reoccurrence and better provide patient safety approaches.

CMOS Enabled Microfluidic Systems for Healthcare Based Applications

KAUST Repository

Khan, Sherjeel M.; Gumus, Abdurrahman; Nassar, Joanna M.; Hussain, Muhammad Mustafa

2018-01-01

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen.

CMOS Enabled Microfluidic Systems for Healthcare Based Applications

KAUST Repository

Khan, Sherjeel M.

2018-02-27

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen.

Vancomycin resistant enterococci (VRE in Swedish sewage sludge

Directory of Open Access Journals (Sweden)

Aspan Anna

2009-05-01

Full Text Available Abstract Background Antimicrobial resistance is a serious threat in veterinary medicine and human healthcare. Resistance genes can spread from animals, through the food-chain, and back to humans. Sewage sludge may act as the link back from humans to animals. The main aims of this study were to investigate the occurrence of vancomycin resistant enterococci (VRE in treated sewage sludge, in a Swedish waste water treatment plant (WWTP, and to compare VRE isolates from sewage sludge with isolates from humans and chickens. Methods During a four month long study, sewage sludge was collected weekly and cultured for VRE. The VRE isolates from sewage sludge were analysed and compared to each other and to human and chicken VRE isolates by biochemical typing (PhenePlate, PFGE and antibiograms. Results Biochemical typing (PhenePlate-FS and pulsed field gel electrophoresis (PFGE revealed prevalence of specific VRE strains in sewage sludge for up to 16 weeks. No connection was found between the VRE strains isolated from sludge, chickens and humans, indicating that human VRE did not originate from Swedish chicken. Conclusion This study demonstrated widespread occurrence of VRE in sewage sludge in the studied WWTP. This implies a risk of antimicrobial resistance being spread to new farms and to the society via the environment if the sewage sludge is used on arable land.

School Principals' Perceptions of "Basic Values" in the Swedish Compulsory School System in Regard to Bronfenbrenner's Ecological Systems Theory

Science.gov (United States)

Drakenberg, Margareth; Malmgren, Therese Vincenti

2013-01-01

The purpose of this study is to compare how Swedish school principals understand basic values that are important in fulfilling the Swedish national curriculum, Curriculum 1994 (a new curriculum, Curriculum 2011, which came into operation in autumn 2011, has only minor differences compared to the common text in Curriculum 1994), considering…

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems

DEFF Research Database (Denmark)

Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

2016-01-01

unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia......Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely......, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than...

The implementation of mindfulness in healthcare systems: a theoretical analysis.

Science.gov (United States)

Demarzo, M M P; Cebolla, A; Garcia-Campayo, J

2015-01-01

Evidence regarding the efficacy of mindfulness-based interventions (MBIs) is increasing exponentially; however, there are still challenges to their integration in healthcare systems. Our goal is to provide a conceptual framework that addresses these challenges in order to bring about scholarly dialog and support health managers and practitioners with the implementation of MBIs in healthcare. This is an opinative narrative review based on theoretical and empirical data that address key issues in the implementation of mindfulness in healthcare systems, such as the training of professionals, funding and costs of interventions, cost effectiveness and innovative delivery models. We show that even in the United Kingdom, where mindfulness has a high level of implementation, there is a high variability in the access to MBIs. In addition, we discuss innovative approaches based on "complex interventions," "stepped-care" and "low intensity-high volume" concepts that may prove fruitful in the development and implementation of MBIs in national healthcare systems, particularly in Primary Care. In order to better understand barriers and opportunities for mindfulness implementation in healthcare systems, it is necessary to be aware that MBIs are "complex interventions," which require innovative approaches and delivery models to implement these interventions in a cost-effective and accessible way. Copyright © 2015 Elsevier Inc. All rights reserved.

ERP (enterprise resource planning) systems can streamline healthcare business functions.

Science.gov (United States)

Jenkins, E K; Christenson, E

2001-05-01

Enterprise resource planning (ERP) software applications are designed to facilitate the systemwide integration of complex processes and functions across a large enterprise consisting of many internal and external constituents. Although most currently available ERP applications generally are tailored to the needs of the manufacturing industry, many large healthcare systems are investigating these applications. Due to the significant differences between manufacturing and patient care, ERP-based systems do not easily translate to the healthcare setting. In particular, the lack of clinical standardization impedes the use of ERP systems for clinical integration. Nonetheless, an ERP-based system can help a healthcare organization integrate many functions, including patient scheduling, human resources management, workload forecasting, and management of workflow, that are not directly dependent on clinical decision making.

A review of scope and costs for the swedish system for management of nuclear waste

International Nuclear Information System (INIS)

1994-01-01

From a financial analysis of the swedish nuclear waste management program it is deduced that a 25 year long operation of the swedish reactors will not create funds large enough to finance the program at the present fee level (0.019 SEK/kWh). The real interest rate is of great importance for the return from the fees. The cost estimates for decommissioning are much lower than that for comparable reactors in other countries (e.g. Trojan, USA vs Ringhals 2), possibly totaling up to 20 GSEK for all twelve swedish reactors. 3 figs., 12 tabs

A healthcare management system for Turkey based on a service-oriented architecture.

Science.gov (United States)

Herand, Deniz; Gürder, Filiz; Taşkin, Harun; Yuksel, Emre Nuri

2013-09-01

The current Turkish healthcare management system has a structure that is extremely inordinate, cumbersome and inflexible. Furthermore, this structure has no common point of view and thus has no interoperability and responds slowly to innovations. The purpose of this study is to show that using which methods can the Turkish healthcare management system provide a structure that could be more modern, more flexible and more quick to respond to innovations and changes taking advantage of the benefits given by a service-oriented architecture (SOA). In this paper, the Turkish healthcare management system is chosen to be examined since Turkey is considered as one of the Third World countries and the information architecture of the existing healthcare management system of Turkey has not yet been configured with SOA, which is a contemporary innovative approach and should provide the base architecture of the new solution. The innovation of this study is the symbiosis of two main integration approaches, SOA and Health Level 7 (HL7), for integrating divergent healthcare information systems. A model is developed which is based on SOA and enables obtaining a healthcare management system having the SSF standards (HSSP Service Specification Framework) developed by the framework of the HSSP (Healthcare Services Specification Project) under the leadership of HL7 and the Object Management Group.

The potential of Swedish furniture companies in Vietnam : How Vietnamese consumers perceive the product values of Swedish furniture

OpenAIRE

Dinh, Thi Phuong Lan; Karlsson, Jonas

2012-01-01

Introduction: Swedish furniture companies have been quite successful in many parts of the world recently, with IKEA being a famous example of that. Meanwhile, Vietnam has one of the fastest-growing economies in South East Asia. However, there has not been any Swedish furniture company established on the Vietnamese market so far. Therefore, it would be useful to see if the Vietnamese furniture consumers would appreciate Swedish furniture, in order to analyze whether Swedish furniture companies...

ICT use for information management in healthcare system for chronic disease patient

Science.gov (United States)

Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira

2013-10-01

Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

Method for selecting e-health standards to support interoperability of healthcare information systems

CSIR Research Space (South Africa)

Adebesin, F

2014-05-01

Full Text Available There is growing concern over the fragmentation and inability of healthcare information systems (e-health systems) to exchange pertinent healthcare information that can empower healthcare professionals to make informed decisions regarding the care...

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

Directory of Open Access Journals (Sweden)

Kristina D. Wood

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology. Setting: Ambulatory care and community practice Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers. Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients. Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system. Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.   Type: Idea Paper

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

Directory of Open Access Journals (Sweden)

Cathy H. Ficzere, PharmD, BCPS

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.Setting: Ambulatory care and community practicePractice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers.Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients.Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system.Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.

Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

Science.gov (United States)

Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

2012-04-01

This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

Task-role-based Access Control Model in Smart Health-care System

OpenAIRE

Wang Peng; Jiang Lingyun

2015-01-01

As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for...

Task-role-based Access Control Model in Smart Health-care System

Directory of Open Access Journals (Sweden)

Wang Peng

2015-01-01

Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

Effects of an incinerator project on a healthcare-waste management system.

Science.gov (United States)

Khammaneechan, Patthanasak; Okanurak, Kamolnetr; Sithisarankul, Pornchai; Tantrakarnapa, Kraichat; Norramit, Poonsup

2011-10-01

This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 healthcare facilities: government hospitals, healthcare centres, and private clinics. The results showed 63% of healthcare risk waste (HCRW) handlers attended the HCRW management training. Improvements in each stage of the HCRW management system were observed in all groups of facilities. The total cost of the HCRW management system did not change, however; the costs for hospitals decreased, whereas those for clinics increased significantly. It was concluded that the central healthcare waste incinerator project positively affected HCRW management in the area, although the costs of management might increase for a particular group. However, the benefits of changing to a more appropriately managed HCRW system will outweigh the increased costs.

Swedish projects

International Nuclear Information System (INIS)

Thunell, J.

1992-01-01

A description is given of research activities, concerning heating systems, which were carried out in Sweden during 1991. The main subject areas dealt with under the gas technology group within the area of heating systems were catalytic combustion, polyethylene materials, and gas applications within the paper and pulp industries. A list is given of the titles of project reports published during 1991 and of those begun during that year. Under the Swedish Centre for Gas Technology (SGC), the main areas of research regarding gas applications were polyethylene materials, industrial applications and the reduction of pollutant emissions. A detailed list is given of research projects which were in progress or proposed by March 1992 under the heating system gas technology research group in Sweden. This list also presents the aims and descriptions of the methods, etc. (AB)

Injustice to transsexual women in a hetero-normative healthcare system.

Science.gov (United States)

Newman-Valentine, Douglas; Duma, Sinegugu

2014-11-21

Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process. The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa. An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded. Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women. A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African.

Strategies for healthcare information systems

NARCIS (Netherlands)

Stegwee, R.A.; Spil, Antonius A.M.

2001-01-01

Information technologies of the past two decades have created significant fundamental changes in the delivery of healthcare services by healthcare provider organizations. Many healthcare organizations have been in search of ways and strategies to keep up with continuously emerging information

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

An Attribute Based Access Control Framework for Healthcare System

Science.gov (United States)

Afshar, Majid; Samet, Saeed; Hu, Ting

2018-01-01

Nowadays, access control is an indispensable part of the Personal Health Record and supplies for its confidentiality by enforcing policies and rules to ensure that only authorized users gain access to requested resources in the system. In other words, the access control means protecting patient privacy in healthcare systems. Attribute-Based Access Control (ABAC) is a new access control model that can be used instead of other traditional types of access control such as Discretionary Access Control, Mandatory Access Control, and Role-Based Access Control. During last five years ABAC has shown some applications in both recent academic fields and industry purposes. ABAC by using user’s attributes and resources, makes a decision according to an access request. In this paper, we propose an ABAC framework for healthcare system. We use the engine of ABAC for rendering and enforcing healthcare policies. Moreover, we handle emergency situations in this framework.

Software engineering principles applied to large healthcare information systems--a case report.

Science.gov (United States)

Nardon, Fabiane Bizinella; de A Moura, Lincoln

2007-01-01

São Paulo is the largest city in Brazil and one of the largest cities in the world. In 2004, São Paulo City Department of Health decided to implement a Healthcare Information System to support managing healthcare services and provide an ambulatory health record. The resulting information system is one of the largest public healthcare information systems ever built, with more than 2 million lines of code. Although statistics shows that most software projects fail, and the risks for the São Paulo initiative were enormous, the information system was completed on-time and on-budget. In this paper, we discuss the software engineering principles adopted that allowed to accomplish that project's goals, hoping that sharing the experience of this project will help other healthcare information systems initiatives to succeed.

Architecture and implementation for a system enabling smartphones to access smart card based healthcare records.

Science.gov (United States)

Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

2013-01-01

The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided. In order to fulfill this role the present study proposes the architecture for a Healthcare Smartcard system, which provides authenticated healthcare professionals with remote mobile access to a Patient's Healthcare Record, through their Smartphone. Furthermore the research proceeds to develop a working prototype system.

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

Directory of Open Access Journals (Sweden)

Anne Marie Lyngsø

2016-03-01

Full Text Available Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

CMOS Enabled Microfluidic Systems for Healthcare Based Applications.

Science.gov (United States)

Khan, Sherjeel M; Gumus, Abdurrahman; Nassar, Joanna M; Hussain, Muhammad M

2018-04-01

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Creating a medical English-Swedish dictionary using interactive word alignment

Directory of Open Access Journals (Sweden)

Zweigenbaum Pierre

2006-10-01

Full Text Available Abstract Background This paper reports on a parallel collection of rubrics from the medical terminology systems ICD-10, ICF, MeSH, NCSP and KSH97-P and its use for semi-automatic creation of an English-Swedish dictionary of medical terminology. The methods presented are relevant for many other West European language pairs than English-Swedish. Methods The medical terminology systems were collected in electronic format in both English and Swedish and the rubrics were extracted in parallel language pairs. Initially, interactive word alignment was used to create training data from a sample. Then the training data were utilised in automatic word alignment in order to generate candidate term pairs. The last step was manual verification of the term pair candidates. Results A dictionary of 31,000 verified entries has been created in less than three man weeks, thus with considerably less time and effort needed compared to a manual approach, and without compromising quality. As a side effect of our work we found 40 different translation problems in the terminology systems and these results indicate the power of the method for finding inconsistencies in terminology translations. We also report on some factors that may contribute to making the process of dictionary creation with similar tools even more expedient. Finally, the contribution is discussed in relation to other ongoing efforts in constructing medical lexicons for non-English languages. Conclusion In three man weeks we were able to produce a medical English-Swedish dictionary consisting of 31,000 entries and also found hidden translation errors in the utilized medical terminology systems.

Creating a medical English-Swedish dictionary using interactive word alignment

Science.gov (United States)

Nyström, Mikael; Merkel, Magnus; Ahrenberg, Lars; Zweigenbaum, Pierre; Petersson, Håkan; Åhlfeldt, Hans

2006-01-01

Background This paper reports on a parallel collection of rubrics from the medical terminology systems ICD-10, ICF, MeSH, NCSP and KSH97-P and its use for semi-automatic creation of an English-Swedish dictionary of medical terminology. The methods presented are relevant for many other West European language pairs than English-Swedish. Methods The medical terminology systems were collected in electronic format in both English and Swedish and the rubrics were extracted in parallel language pairs. Initially, interactive word alignment was used to create training data from a sample. Then the training data were utilised in automatic word alignment in order to generate candidate term pairs. The last step was manual verification of the term pair candidates. Results A dictionary of 31,000 verified entries has been created in less than three man weeks, thus with considerably less time and effort needed compared to a manual approach, and without compromising quality. As a side effect of our work we found 40 different translation problems in the terminology systems and these results indicate the power of the method for finding inconsistencies in terminology translations. We also report on some factors that may contribute to making the process of dictionary creation with similar tools even more expedient. Finally, the contribution is discussed in relation to other ongoing efforts in constructing medical lexicons for non-English languages. Conclusion In three man weeks we were able to produce a medical English-Swedish dictionary consisting of 31,000 entries and also found hidden translation errors in the utilized medical terminology systems. PMID:17034649

Creating a medical English-Swedish dictionary using interactive word alignment.

Science.gov (United States)

Nyström, Mikael; Merkel, Magnus; Ahrenberg, Lars; Zweigenbaum, Pierre; Petersson, Håkan; Ahlfeldt, Hans

2006-10-12

This paper reports on a parallel collection of rubrics from the medical terminology systems ICD-10, ICF, MeSH, NCSP and KSH97-P and its use for semi-automatic creation of an English-Swedish dictionary of medical terminology. The methods presented are relevant for many other West European language pairs than English-Swedish. The medical terminology systems were collected in electronic format in both English and Swedish and the rubrics were extracted in parallel language pairs. Initially, interactive word alignment was used to create training data from a sample. Then the training data were utilised in automatic word alignment in order to generate candidate term pairs. The last step was manual verification of the term pair candidates. A dictionary of 31,000 verified entries has been created in less than three man weeks, thus with considerably less time and effort needed compared to a manual approach, and without compromising quality. As a side effect of our work we found 40 different translation problems in the terminology systems and these results indicate the power of the method for finding inconsistencies in terminology translations. We also report on some factors that may contribute to making the process of dictionary creation with similar tools even more expedient. Finally, the contribution is discussed in relation to other ongoing efforts in constructing medical lexicons for non-English languages. In three man weeks we were able to produce a medical English-Swedish dictionary consisting of 31,000 entries and also found hidden translation errors in the utilized medical terminology systems.

The orthopaedist's role in healthcare system governance.

Science.gov (United States)

Probe, Robert A

2013-06-01

Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

Service models for remote healthcare monitoring systems.

Science.gov (United States)

Moorman, Bridget A

2010-01-01

These scenarios reflect where the future is heading for remote health monitoring technology and service expectations. Being able to manage a "system of systems" with timely service hand-off over seams of responsibility and system interfaces will become very important for a BMET or clinical engineer. These interfaces will include patient homes, clinician homes, commercial/civilian infrastructure, public utilities, vendor infrastructure as well as internal departmental domains. Concurrently, technology is changing rapidly resulting in newer software delivery modes and hardware appliances as well as infrastructure changes. Those who are able to de-construct the complex systems and identify infrastructure assumptions and seams of servicing responsibility will be able to better understand and communicate the expectations for service of these systems. Moreover, as identified in Case 1, prodigious use of underlying system monitoring tools (managing the "meta-data") could move servicing of these remote systems from a reactive approach to a proactive approach. A prepared healthcare organization will identify their current and proposed future service combination use cases and design service philosophies and expectations for those use cases, while understanding the infrastructure assumptions and seams of responsibility. This is the future of technical service to the healthcare clinicians and patients.

Understanding healthcare innovation systems: the Stockholm region case.

Science.gov (United States)

Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

2016-11-21

Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

Ensuring healthcare system integrity with blockchain

OpenAIRE

I. L?hmus

2016-01-01

Blockchain, the underlying protocol behind Bitcoin, has received a tremendous amount of attention over the last two years. Whilst initially focused on financial services, the technology holds much promise for addressing challenges in health-care system. Electronic health records and related information systems have several advantages over historical paper-based management - smooth data transfer between medical care providers, patient empowerment etc. While being convenient and effient these s...

[Current legislation in the healthcare system 2015/2016].

Science.gov (United States)

Martenstein, I; Wienke, A

2016-05-01

The energy of the legislator in the healthcare system was barely stoppable in 2015. Many new laws have been brought into force and legal initiatives have also been implemented. The Hospital Structure Act, the Treatment Enhancement Act, amendments of the official medical fee schedules for physicians, the Prevention Act, the E-Health Act, the Anti-corruption Act, the hospital admission guidelines and amendments of the model specialty training regulations are just some of the essential alterations that lie ahead of the medical community. This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice.

Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

Directory of Open Access Journals (Sweden)

Ramona Fernanda Ceriotti Toassi

2013-06-01

Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

Prevalence of footrot in Swedish slaughter lambs

Directory of Open Access Journals (Sweden)

Nyman Ann-Kristin J

2011-04-01

Full Text Available Abstract Background Footrot is a world-wide contagious disease in sheep and goats. It is an infection of the epidermis of the interdigital skin, and the germinal layers of the horn tissue of the feet. The first case of footrot in Swedish sheep was diagnosed in 2004. Due to difficulties in distinguishing benign footrot from early cases of virulent footrot and because there is no possibility for virulence testing of strains of Dichelobacter nodosus in Sweden, the diagnosis is based of the presence or absence of clinical signs of footrot in sheep flocks. Ever since the first diagnosed case the Swedish Animal Health Service has worked intensively to stop the spread of infection and control the disease at flock level. However, to continue this work effectively it is important to have knowledge about the distribution of the disease both nationally and regionally. Therefore, the aims of this study were to estimate the prevalence of footrot in Swedish lambs at abattoirs and to assess the geographical distribution of the disease. Methods A prevalence study on footrot in Swedish lambs was performed by visual examination of 2000 feet from 500 lambs submitted from six slaughter houses. Each foot was scored according to a 0 to 5 scoring system, where feet with score ≥2 were defined as having footrot. Moreover, samples from feet with footrot were examined for Dichelobacter nodosus by culture and PCR. Results The prevalence of footrot at the individual sheep level was 5.8%, and Dichelobacter nodosus was found by culture and PCR in 83% and 97% of the samples from feet with footrot, respectively. Some minor differences in geographical distribution of footrot were found in this study. Conclusions In a national context, the findings indicate that footrot is fairly common in Swedish slaughter lambs, and should be regarded seriously.

Radiological protection of the environment from the Swedish point of view

International Nuclear Information System (INIS)

Holm, Lars-Erik; Hubbard, Lynn; Larsson, Carl-Magnus; Sundell-Bergman, Synnoeve

2002-01-01

The current system of radiological protection is aimed at protecting human health, and largely neglects both the effects of radiation on the environment and the managerial aspects of environmental protection. The Swedish Radiation Protection Act was revised in 1988 and includes environmental protection as one of its aims. In practice, little guidance had been given in the regulations based on the Act until 1998, when the Swedish Radiation Protection Authority (SSI) formulated environmental aims in its regulations concerning protection of human health and the environment in connection to the final management of spent nuclear fuel and waste. These regulations focus on protection of biodiversity and biological resources, based on ecosystem characterisation. In a broader perspective, the Swedish Parliament established 15 national environmental quality objectives in 1999, covering all aspects of protecting the environment, including the effects of radiation. This paper reviews the background for radiological protection of the environment from both an international and a Swedish perspective, describing the aims and current activities in establishing a system for assessing environmental effects and their consequences that can be used in decision-making. Such activities are largely a result of the European Union research project FASSET (Framework for Assessment of Environmental Impact), carried out under the 5th Framework Programme of the Union. This work is complemented at the Swedish national level by government support to initiate a national environmental monitoring and assessment programme for characterising the radiation environment, which will provide the foundation for decision-making. (review)

Adoption of innovative heating systems. Needs and attitudes of Swedish homeowners

Energy Technology Data Exchange (ETDEWEB)

Mahapatra, K; Gustavsson, L [Ecotechnology, Mid Sweden University, 831 25 Oestersund (Sweden)

2009-11-15

Questionnaire surveys of Swedish homeowners of detached houses were carried out in 2004 and 2007 to understand their needs and attitudes towards attributes of innovative heating systems (IHSs) comprised of a bedrock heat pump, district heating, or a wood pellet boiler. In each occasion 1,500 homeowners were randomly selected. The response rate was 42% in 2004 and 48% in 2007. Results showed that the majority of the respondents were satisfied with their existing heating system and did not intend to install new systems. Economic factors and functional reliability were the most important factors in the respondents' choices of heating system, while environmental factors were of lower importance. Among the IHSs, respondents had the most favorable attitude towards bedrock heat pumps followed by district heating and pellet boilers. But the attitude was more favorable towards electric boilers than for pellet boilers. The least favorable attitude was towards oil boilers. Between 2004 and 2007, there was a positive change in respondents' attitude towards IHSs and electric boilers, and a negative change in attitude towards resistance heaters and oil boilers.

The Changing Nature of Autonomy: Transformations of the Late Swedish Teaching Profession

Science.gov (United States)

Wermke, Wieland; Forsberg, Eva

2017-01-01

This article discusses teacher autonomy in the case of the Swedish teaching profession since the 1980s. It is argued that deregulation, decentralization, and marketization reforms of the 1990s have indeed increased teacher autonomy, but in some respects also led to a increase of complexity in the Swedish school system. In order to handle this…

E-health and healthcare enterprise information system leveraging service-oriented architecture.

Science.gov (United States)

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

2012-04-01

To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

Flexible solution for interoperable cloud healthcare systems.

Science.gov (United States)

Vida, Mihaela Marcella; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara; Bernad, Elena

2012-01-01

It is extremely important for the healthcare domain to have a standardized communication because will improve the quality of information and in the end the resulting benefits will improve the quality of patients' life. The standards proposed to be used are: HL7 CDA and CCD. For a better access to the medical data a solution based on cloud computing (CC) is investigated. CC is a technology that supports flexibility, seamless care, and reduced costs of the medical act. To ensure interoperability between healthcare information systems a solution creating a Web Custom Control is presented. The control shows the database tables and fields used to configure the two standards. This control will facilitate the work of the medical staff and hospital administrators, because they can configure the local system easily and prepare it for communication with other systems. The resulted information will have a higher quality and will provide knowledge that will support better patient management and diagnosis.

Environmental assessment of Swedish agriculture

International Nuclear Information System (INIS)

Engstroem, Rebecka; Finnveden, Goeran; Wadeskog, Anders

2007-01-01

This article describes an environmental assessment of Swedish agriculture, including upstream and downstream effects. The analysis is based on environmentally extended input-output analysis, but it is also supplemented with data from other sources. The analysis shows that direct effects by the Swedish agriculture are the most important, while indirect effects from other sources including mobile and impacts abroad are also considerable. The most important impacts from Swedish agriculture according to the analysis are eutrophication, global warming and resource use. The agricultural sector produces a large share of the Swedish emissions causing both global warming and eutrophication. In addition, current agricultural practice causes problems with loss of biodiversity. The most important actors in the sector are agriculture itself, but also all actors using fossil fuels: primarily the transport sector and the energy sector. In addition, consumers are important since they can influence the composition of agricultural production. The analysis shows the importance of including upstream and downstream effects when analysing the environmental impacts from a sector. (author)

Food, Paper, Wood, or Energy? Global Trends and Future Swedish Forest Use

Directory of Open Access Journals (Sweden)

Erik Westholm

2010-12-01

Full Text Available This paper presents a futures study of international forest trends. The study, produced as part of the Swedish Future Forest program, focuses on global changes of importance for future Swedish forest use. It is based on previous international research, policy documents, and 24 interviews with selected key experts and/or actors related to the forest sector, and its findings will provide a basis for future research priorities. The forest sector, here defined as the economic, social, and cultural contributions to life and human welfare derived from forest and forest-based activities, faces major change. Four areas stand out as particularly important: changing energy systems, emerging international climate policies, changing governance systems, and shifting global land use systems. We argue that global developments are, and will be, important for future Swedish forest use. The forest sector is in transition and forest-, energy, climate- and global land use issues are likely to become increasingly intertwined. Therefore, the “forest sector” must be disembedded and approached as an open system in interplay with other systems.

It is time to talk about people: a human-centered healthcare system

Directory of Open Access Journals (Sweden)

Borgi Lea

2010-11-01

Full Text Available Abstract Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a Reason's system approach 1 and b User-centered design 23. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system.

Establishing values-based leadership and value systems in healthcare organizations.

Science.gov (United States)

Graber, David R; Kilpatrick, Anne Osborne

2008-01-01

The importance of values in organizations is often discussed in management literature. Possessing strong or inspiring values is increasingly considered to be a key quality of successful leaders. Another common theme is that organizational values contribute to the culture and ultimate success of organizations. These conceptions or expectations are clearly applicable to healthcare organizations in the United States. However, healthcare organizations have unique structures and are subject to societal expectations that must be accommodated within an organizational values system. This article describes theoretical literature on organizational values. Cultural and religious influences on Americans and how they may influence expectations from healthcare providers are discussed. Organizational cultures and the training and socialization of the numerous professional groups in healthcare also add to the considerable heterogeneity of value systems within healthcare organizations. These contribute to another challenge confronting healthcare managers--competing or conflicting values within a unit or the entire organization. Organizations often fail to reward members who uphold or enact the organization's values, which can lead to lack of motivation and commitment to the organization. Four key elements of values-based leadership are presented for healthcare managers who seek to develop as values-based leaders. 1) Recognize your personal and professional values, 2) Determine what you expect from the larger organization and what you can implement within your sphere of influence, 3) Understand and incorporate the values of internal stakeholders, and 4) Commit to values-based leadership.

[Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

Science.gov (United States)

Roth-Deubel, André N; Molina-Marín, Gloria

2013-01-01

Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

Using grey literature to prepare pharmacy students for an evolving healthcare delivery system.

Science.gov (United States)

Happe, Laura E; Walker, Desiree'

2013-05-13

To assess the impact of using "grey literature" (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students' perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information. A reading from the grey literature was identified and assigned to the students for each topic in the course. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students' knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (pgrey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.

How can fossil fuel based public bus transport systems become a sustainable solution for Swedish medium-sized cities?

OpenAIRE

Borén, Sven; Nurhadi, Lisiana; Ny, Henrik

2013-01-01

Vehicles, infrastructure, fuel systems and other energy-driven systems that serve public transport are complex with many resource inputs and outputs, and involve many processes. Life Cycle Assessment (LCA) and Life Cycle Costing (LCC) helps analyzing those by quantifying environmental and economic effects, but will not in themselves provide a full systems perspective. Swedish authorities have set ambitious national goals, and many regions targets a 100% increase in public transport by 2020. T...

Asan medical information system for healthcare quality improvement.

Science.gov (United States)

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil.

Science.gov (United States)

Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

2016-07-01

Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives, strengthen

Nurses' Use and Perception of an Information and Communication Technology System for Improving Coordination During Hospital Discharges: A Survey in Swedish Primary Healthcare.

Science.gov (United States)

Christiansen, Line; Fagerström, Cecilia; Nilsson, Lina

2017-07-01

To facilitate communications between care levels and improve coordination during hospital discharges, there is great potential in using information and communication technology systems, because they can significantly help to deter unnecessary readmissions. However, there is still a lack of knowledge about how often nurses use information and communication technology and the indicators related to its use. The aims of this study were to describe the indicators related to nurses' use of an information and communication technology system for collaboration between care levels and to estimate whether the level of use can be related to nurses' perceptions of the information and communication technology system's contribution to improve coordination during hospital discharges. A quantitative survey of 37 nurses from 11 primary healthcare centers was performed in a county in southern Sweden. The data were analyzed using descriptive and comparative analyses. The results showed that perceptions concerning the information and communication technology system's usability and time consumption differed between nurses who used the system and those who did not. Simultaneously, the nurses were rather unaware of the ability of the information and communication technology system to improve coordination during patient discharges.

Demonstration and Dialogue: Mediation in Swedish Nuclear Waste Management

International Nuclear Information System (INIS)

Elam, Mark; Lidberg, Maria; Soneryd, Linda; Sundqvist, Goeran

2009-01-01

This report analyses mediation and mediators in Swedish nuclear waste management. Mediation is about establishing agreement and building common knowledge. It is argued that demonstrations and dialogue are the two prominent approaches to mediation in Swedish nuclear waste management. Mediation through demonstration is about showing, displaying, and pointing out a path to safe disposal for inspection. It implies a strict division between demonstrator and audience. Mediation through dialogue on the other hand, is about collective acknowledgements of uncertainty and suspensions of judgement creating room for broader discussion. In Sweden, it is the Swedish Nuclear Fuel and Waste Management Co. (SKB) that is tasked with finding a method and a site for the final disposal of the nation's nuclear waste. Two different legislative frameworks cover this process. In accordance with the Act on Nuclear Activities, SKB is required to demonstrate the safety of its planned nuclear waste management system to the government, while in respect of the Swedish Environmental Code, they are obliged to organize consultations with the public. How SKB combines these requirements is the main question under investigation in this report in relation to materials deriving from three empirical settings: 1) SKB's safety analyses, 2) SKB's public consultation activities and 3) the 'dialogue projects', initiated by other actors than SKB broadening the public arena for discussion. In conclusion, an attempt is made to characterise the long- term interplay of demonstration and dialogue in Swedish nuclear waste management

Applying analytic hierarchy process to assess healthcare-oriented cloud computing service systems.

Science.gov (United States)

Liao, Wen-Hwa; Qiu, Wan-Li

2016-01-01

Numerous differences exist between the healthcare industry and other industries. Difficulties in the business operation of the healthcare industry have continually increased because of the volatility and importance of health care, changes to and requirements of health insurance policies, and the statuses of healthcare providers, which are typically considered not-for-profit organizations. Moreover, because of the financial risks associated with constant changes in healthcare payment methods and constantly evolving information technology, healthcare organizations must continually adjust their business operation objectives; therefore, cloud computing presents both a challenge and an opportunity. As a response to aging populations and the prevalence of the Internet in fast-paced contemporary societies, cloud computing can be used to facilitate the task of balancing the quality and costs of health care. To evaluate cloud computing service systems for use in health care, providing decision makers with a comprehensive assessment method for prioritizing decision-making factors is highly beneficial. Hence, this study applied the analytic hierarchy process, compared items related to cloud computing and health care, executed a questionnaire survey, and then classified the critical factors influencing healthcare cloud computing service systems on the basis of statistical analyses of the questionnaire results. The results indicate that the primary factor affecting the design or implementation of optimal cloud computing healthcare service systems is cost effectiveness, with the secondary factors being practical considerations such as software design and system architecture.

New Swedish environmental and sustainable education research

Directory of Open Access Journals (Sweden)

Johan Öhman

2011-01-01

Full Text Available This special issue of Education & Democracy presents examples froma new generation of Swedish research on environmental and sustainability education and thereby complement the picture of the current Swedish environmental and sustainability education research outlined in the recent Danish-Swedish special issue of Environmental EducationResearch (Vol 16, No 1 and the anthology Democracy and Values inEducation for Sustainable Development – Contributions from Swedish Research (Öhman 2008. All the contributors to this issue are associatedwith the Graduate School in Education and Sustainable Development (GRESD, either as PhD students or as supervisors.

Using ESB and BPEL for Evolving Healthcare Systems Towards Pervasive, Grid-Enabled SOA

Science.gov (United States)

Koufi, V.; Malamateniou, F.; Papakonstantinou, D.; Vassilacopoulos, G.

Healthcare organizations often face the challenge of integrating diverse and geographically disparate information technology systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing information technology infrastructure, becomes a necessity. Moreover, the availability of these systems at the point of care when needed is a vital issue for the quality of healthcare provided to patients. This chapter takes a process perspective of healthcare delivery within and across organizational boundaries and presents a disciplined approach for evolving healthcare systems towards a pervasive, grid-enabled service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues, the business process execution language for supporting collaboration requirements and grid middleware technology for both addressing common SOA scalability requirements and complementing existing system functionality. In such an environment, appropriate security mechanisms must ensure authorized access to integrated healthcare services and data. To this end, a security framework addressing security aspects such as authorization and access control is also presented.

Improvement of emotional healthcare system with stress detection from ECG signal.

Science.gov (United States)

Tivatansakul, S; Ohkura, M

2015-01-01

Our emotional healthcare system is designed to cope with users' negative emotions in daily life. To make the system more intelligent, we integrated emotion recognition by facial expression to provide appropriate services based on user's current emotional state. Our emotion recognition by facial expression has confusion issue to recognize some positive, neutral and negative emotions that make the emotional healthcare system provide a relaxation service even though users don't have negative emotions. Therefore, to increase the effectiveness of the system to provide the relaxation service, we integrate stress detection from ECG signal. The stress detection might be able to address the confusion issue of emotion recognition by facial expression to provide the service. Indeed, our results show that integration of stress detection increases the effectiveness and efficiency of the emotional healthcare system to provide services.

Simulating conditions for combined heat and power in the Swedish district heating sector

International Nuclear Information System (INIS)

Knutsson, David

2005-01-01

The most important issues in the European energy sector today are how to increase competitiveness on the energy markets, reduce both CO2 emissions and dependence on imported fuels. These issues are also important aspects of Swedish energy policy. In Sweden, the district heating (DH) sector has commonly been used to achieve Swedish energy policy goals. However, the ongoing integration and deregulation of the energy markets in Europe now means that the Swedish DH sector can also play an important role in achieving international targets. This thesis investigates the extent to which the Swedish DH sector can contribute to compliance with current energy policy targets, both international and Swedish. The study consisted of simulations of the Swedish DH sector response to various policy instruments in a model that takes the local features of virtually all Swedish DH systems into account. The findings show, for example, that there is great potential for combined heat and power (CHP) generation in the Swedish DH sector. By exporting this CHP electricity to other European countries with less effective and fossil dependent power generation plants, the CO2 emissions from the European energy sector could be substantially reduced. This would also result in increased security of supply and competitiveness in the EU, since fuel use would be more effective. In Sweden, increased CHP generation would also be a way of maintaining an effective national security of supply of power

Discourse analysis: A useful methodology for health-care system researches.

Science.gov (United States)

Yazdannik, Ahmadreza; Yousefy, Alireza; Mohammadi, Sepideh

2017-01-01

Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular research strategy for researchers in various disciplines which has been little employed by health-care researchers. The methodology involves a focus on the sociocultural and political context in which text and talk occur. DA adds a linguistic approach to an understanding of the relationship between language and ideology, exploring the way in which theories of reality and relations of power are encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and productive qualitative methodology but has been underutilized within health-care system research. Without a clear understanding of discourse theory and DA it is difficult to comprehend important research findings and impossible to use DA as a research strategy. To redress this deficiency, in this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical background, DA types and analysis strategy. Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system.

Biomass and Swedish energy policy

International Nuclear Information System (INIS)

Johansson, Bengt

2001-01-01

The use of biomass in Sweden has increased by 44% between 1990 and 1999. In 1999 it was 85 TWh, equivalent to 14% of the total Swedish energy supply. The existence of large forest industry and district heating systems has been an essential condition for this expansion. The tax reform in 1991 seems, however, to have been the most important factor responsible for the rapid bioenergy expansion. Through this reform, the taxation of fossil fuels in district heating systems increased by approximately 30-160%, depending on fuel, whereas bioenergy remained untaxed. Industry is exempted from the energy tax and pays reduced carbon tax. No tax is levied on fossil fuels used for electricity production. Investment grants have existed for biomass-based electricity production but these grants have not been large enough to make biomass-based electricity production economically competitive in a period of falling electricity prices. Despite this, the biomass-based electricity production has increased slightly between 1990 and 1999. A new taxation system aiming at a removal of the tax difference between the industry, district heating and electricity sectors has recently been analysed by the Swedish government. One risk with such a system is that it reduces the competitiveness for biomass in district heating systems as it seems unlikely that the taxes on fossil fuels in the industry and electricity sectors will increase to a level much higher than in other countries. A new system, based on green certificates, for supporting electricity from renewable energy sources has also been proposed by the government.

Emergy Evaluation of a Swedish Nuclear Power Plant

International Nuclear Information System (INIS)

Kindberg, Anna

2007-03-01

Today it is common to evaluate and compare energy systems in terms of emission of greenhouse gases. However, energy systems should not only reduce their pollution but also give a large energy return. One method used to measure energy efficiency is emergy (embodied energy, energy memory) evaluation, which was developed by the system ecologist Howard T. Odum. Odum defines emergy as the available energy of one kind previously used up directly and indirectly to make a service or product. Both work of nature and work of human economy in generating products and services are calculated in terms of emergy. Work of nature takes the form of natural resources and work of human economy includes labour, services and products used to transform natural resources into something of value to the economy. The quotient between work of nature and work of human economy gives the emergy return on investment of the investigated product. With this in mind the present work is an attempt to make an emergy evaluation of a Swedish nuclear power plant to estimate its emergy return on investment. The emergy return on investment ratio of a Swedish nuclear power plant is calculated to approximately 11 in this diploma thesis. This means that for all emergy the Swedish economy has invested in the nuclear power plant it gets 11 times more emergy in return in the form of electricity generated by nuclear power. The method used in this work may facilitate future emergy evaluations of other energy systems

Emergy Evaluation of a Swedish Nuclear Power Plant

Energy Technology Data Exchange (ETDEWEB)

Kindberg, Anna

2007-03-15

Today it is common to evaluate and compare energy systems in terms of emission of greenhouse gases. However, energy systems should not only reduce their pollution but also give a large energy return. One method used to measure energy efficiency is emergy (embodied energy, energy memory) evaluation, which was developed by the system ecologist Howard T. Odum. Odum defines emergy as the available energy of one kind previously used up directly and indirectly to make a service or product. Both work of nature and work of human economy in generating products and services are calculated in terms of emergy. Work of nature takes the form of natural resources and work of human economy includes labour, services and products used to transform natural resources into something of value to the economy. The quotient between work of nature and work of human economy gives the emergy return on investment of the investigated product. With this in mind the present work is an attempt to make an emergy evaluation of a Swedish nuclear power plant to estimate its emergy return on investment. The emergy return on investment ratio of a Swedish nuclear power plant is calculated to approximately 11 in this diploma thesis. This means that for all emergy the Swedish economy has invested in the nuclear power plant it gets 11 times more emergy in return in the form of electricity generated by nuclear power. The method used in this work may facilitate future emergy evaluations of other energy systems.

Forging a Frailty-Ready Healthcare System to Meet Population Ageing.

Science.gov (United States)

Lim, Wee Shiong; Wong, Sweet Fun; Leong, Ian; Choo, Philip; Pang, Weng Sun

2017-11-24

The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs) aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG) and the Alexandra Health System (AHS) to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy ("living well"), the well unhealthy ("living with illness"), the unwell unhealthy ("living with frailty"), and the end-of-life (EoL) ("dying well"). For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as "wellness kampungs" and "share-a-pot". A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members of the public. At the National

Dynamic modelling of nitrous oxide emissions from three Swedish sludge liquor treatment systems

DEFF Research Database (Denmark)

Lindblom, E.; Arnell, M.; Flores-Alsina, X.

2014-01-01

The objective of this paper is to model the dynamics and validate the results of nitrous oxide (N2O)emissions from three Swedish nitrifying/denitrifying, nitritation and anammox systems treating real anaerobic digester sludge liquor. The Activated Sludge Model No. 1 is extended to describe N2O...... production by both heterotrophic and autotrophic denitrification. In addition, mass transfer equations are implemented to characterize the dynamics of N2O in the water and the gas phases.The biochemical model is simulated and validated for two hydraulic patterns: (1) a sequencing batch reactor; and, (2...

Corruption in health-care systems and its effect on cancer care in Africa.

Science.gov (United States)

Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

2015-08-01

At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Forest-derived methane in the Swedish transport sector: A closing window?

International Nuclear Information System (INIS)

Lönnqvist, Tomas; Grönkvist, Stefan; Sandberg, Thomas

2017-01-01

Forest-derived methane could complement biogas from anaerobic digestion as a transport fuel. The conditions for a systemic transition have been analyzed in this article. The analysis contains three blocks: the vehicle gas development, the policy framework, and commercial projects to produce methane from forest biomass. The results reveal that several conditions for a systemic transition are in place. There is established infrastructure for feedstock supply and biofuels distribution. Infrastructure development is an important albeit not determining factor. Private and public actors have advanced plans for commercial scale plants, technological know-how, and experience from a demonstration plant. However, a major barrier for a systemic transition is the low predictability of Swedish policy instruments. The Swedish government is not free to design policy instruments but must consider compatibility with the EU framework and has changed the energy tax on biofuels several times to avoid overcompensation according to the EU regulation. This has contributed to the low predictability. The interviewees have suggested several concrete policy instruments. However, they have also emphasized that the exact design of the policy instruments is less important than the predictability of the support. - Highlights: • Forest-derived methane may complement biogas from anaerobic digestion in transport. • There are infrastructure and industrial actors ready for a commercial introduction. • The predictability of Swedish policy instruments is perceived as very low. • Compatibility with EU framework constrains Swedish policy instruments design.

Leading processes of patient care and treatment in hierarchical healthcare organizations in Sweden--process managers' experiences.

Science.gov (United States)

Nilsson, Kerstin; Sandoff, Mette

2015-01-01

The purpose of this study is to gain better understanding of the roles and functions of process managers by describing Swedish process managers' experiences of leading processes involving patient care and treatment when working in a hierarchical health-care organization. This study is based on an explorative design. The data were gathered from interviews with 12 process managers at three Swedish hospitals. These data underwent qualitative and interpretative analysis with a modified editing style. The process managers' experiences of leading processes in a hierarchical health-care organization are described under three themes: having or not having a mandate, exposure to conflict situations and leading process development. The results indicate a need for clarity regarding process manager's responsibility and work content, which need to be communicated to all managers and staff involved in the patient care and treatment process, irrespective of department. There also needs to be an emphasis on realistic expectations and orientation of the goals that are an intrinsic part of the task of being a process manager. Generalizations from the results of the qualitative interview studies are limited, but a deeper understanding of the phenomenon was reached, which, in turn, can be transferred to similar settings. This study contributes qualitative descriptions of leading care and treatment processes in a functional, hierarchical health-care organization from process managers' experiences, a subject that has not been investigated earlier.

Swedish-Estonian energy forest research cooperation

International Nuclear Information System (INIS)

Ross, J.; Kirt, E.; Koppel, A.; Kull, K.; Noormets, A.; Roostalu, H.; Ross, V.; Ross, M.

1996-01-01

The Organization of Estonian energetic economy is aimed at cutting the usage of oil, gas and coal and increasing the local resources firewood, oil-shale and peat for fuel. The resources of low-valued firewood-brushwood, fallen deadwood etc. are available during the following 10-15 years, but in the future the cultivation of energy forest (willow) plantations will be actual. During the last 20 years the Swedish scientists have been extensively studying the willow forest selection, cultivation and use in energetics and waste water purification systems. A Swedish-Estonian energy forest research project was started in 1993 between the Swedish Agricultural University on one hand and Toravere Observatory, Institute of Zoology and Botany, Estonian Academy of Sciences and Estonian Potato Processing Association on the other hand. In spring 5 willow plantations were established with the help of Swedish colleagues and obtained from Sweden 36000 willow cuttings. The aim of the project: a) To study experimentally and by means of mathematical modelling the biogeophysical aspects of growth and productivity of willow plantations in Sweden and Estonian climatological conditions. b) To study the possibility of using the willow plantations in waste waters purification. c) To study the economical efficiency of energy forest as an energy resource under the economic and environmental conditions of Estonia. d) To study the economic efficiency of willow plantations as a raw material for the basket industry in Estonia. e) To select the most productive and least vulnerable willow clones for practical application in energy plantations. During 1993 in all five plantations detailed analysis of soil properties has been carried out. In the plantation at Toravere Observatory phytometrical measurements were carried out - the growth of plant biomass leaf and stem area, vertical distribution of dry matter content, biomass and phyto area separately for leaves and stems has been performed. Some

Report on the status of instrumentation and control in Swedish nuclear power plants

International Nuclear Information System (INIS)

Stroebeck, E.

1992-01-01

Nuclear power plants accounted for 46% of the total electric power production in Sweden in 1990. The availability of the Swedish reactors remains at a very high level. The oldest Swedish nuclear power plant has been in operation for nearly 20 years, and in the next 5 to 10 years a large portion of the NPP electrical equipment has to be replaced. The paper presents an overview of activities on control and instrumentation in the following: Future developments; implementation of computer-based systems; training simulators; nuclear safety research. The operating experience in Swedish nuclear power plants in 1991 is also presented. (author)

Seven Guiding Commitments: Making the U.S. Healthcare System More Compassionate

Directory of Open Access Journals (Sweden)

Beth A. Lown MD

2014-11-01

Full Text Available Despite the current focus on patient centeredness, healthcare professionals face numerous challenges that impede their ability to provide compassionate care that ameliorates concerns, distress, or suffering. These include fragmentation and discontinuity of care, technologies that both help and hinder communication and relationship-building, burgeoning operational and administrative requirements, inadequate communication skills training, alarming rates of burnout, and increased cost and market pressures. A compassionate healthcare system begins with compassionate people, but the organizations in which they train and work must reliably enable them to express and act on their compassion rather than impede it. We present a set of guiding commitments and recommendations to foster a more compassionate healthcare system. We urge healthcare organizations to adopt these commitments and take action to embed compassionate care in all aspects of training, research, patient care and organizational life.

The Indiana University Center for Healthcare Innovation and Implementation Science: Bridging healthcare research and delivery to build a learning healthcare system.

Science.gov (United States)

Azar, Jose; Adams, Nadia; Boustani, Malaz

2015-01-01

In the United States, it is estimated that 75,000 deaths every year could be averted if the healthcare system implemented high quality care more effectively and efficiently. Patient harm in the hospital occurs as a consequence of inadequate procedures, medications and other therapies, nosocomial infections, diagnostic evaluations and patient falls. Implementation science, a new emerging field in healthcare, is the development and study of methods and tools aimed at enhancing the implementation of new discoveries and evidence into daily healthcare delivery. The Indiana University Center for Healthcare Innovation and Implementation Science (IU-CHIIS) was launched in September 2013 with the mission to use implementation science and innovation to produce great-quality, patient-centered and cost-efficient healthcare delivery solutions for the United States of America. Within the first 24 months of its initiation, the IU-CHIIS successfully scaled up an evidence-based collaborative care model for people with dementia and/or depression, successfully expanded the Accountable Care Unit model positively impacting the efficiency and quality of care, created the first Certificate in Innovation and Implementation Science in the US and secured funding from National Institutes of Health to investigate innovations in dementia care. This article summarizes the establishment of the IU-CHIIS, its impact and outcomes and the lessons learned during the journey. Copyright © 2015. Published by Elsevier GmbH.

Comparing gender awareness in Dutch and Swedish first-year medical students - results from a questionaire

Directory of Open Access Journals (Sweden)

Andersson Jenny

2012-01-01

Full Text Available Abstract Background To ascertain good and appropriate healthcare for both women and men implementation of gender perspectives in medical education is needed. For a successful implementation, knowledge about students' attitudes and beliefs about men, women, and gender is crucial. The aim of this study was to compare attitudes to gender and gender stereotyping among Dutch and Swedish male and female medical students. Methods In this cross-sectional study, we measured the attitudes and assumptions about gender among 1096 first year medical students (616 Dutch and 480 Swedish with the validated Nijmegen Gender Awareness in Medicine Scale (N-GAMS. The response rate was 94% in the Netherlands and 93% in Sweden. Univariate analysis of variance (ANOVA was used to compare the scores between Dutch and Swedish male and female students. Linear regressions were used to analyze the importance of the background variables. Results There were significant differences in attitudes to gender between Dutch and Swedish students. The Swedish students expressed less stereotypical thinking about patients and doctors and the Dutch were more sensitive to gender differences. The students' sex mattered for gender stereotyping, with male students in both countries agreeing more with stereotypical statements. Students' age, father's birth country and mother's education level had some impact on the outcome. Conclusions There are differences between cultures as well as between men and women in gender awareness that need to be considered when implementing gender in medical education. This study suggests that to arouse the students' interest in gender issues and make them aware of the significance of gender in medical work, the examples used in discussions need to be relevant and challenging in the context of the specific country. Due to different levels of knowledge and different attitudes within the student population it is important to create a climate for dialogue where

The Effects of the Investment Support Scheme on the Dynamics of the Swedish Photovoltaic Sector

International Nuclear Information System (INIS)

Palmblad, Linus

2006-01-01

The support from the Swedish government to the PV sector has so far been focused on research and development. But in May 2005 the Swedish government showed that they want to follow the global trend and introduced a market deployment initiative directed to grid connected PV systems on buildings for public activities. Compared to subsidy schemes in other countries it is small. But the Swedish PV market is still under development and the market support will lead to a significant leap for the installed capacity of PV systems in Sweden. The aim of this study is to create a picture of the dynamics in the Swedish PV sector and make an early evaluation of the effects of the market deployment initiative. Information has been gathered from five new PV projects in Sweden through interviews with involved actors. The analysis is carried out with an innovation systems perspective. The goal of the market support is to create prerequisites for further diffusion of PV systems and development of a competent PV sector in Sweden. When evaluating the market support it is therefore more interesting to look at how the support has affected the dynamics of the Swedish PV innovation system instead of just looking at how many systems that have been built. Despite that this report was carried out in an early phase of the market deployment initiative, it shows that the market support has certainly had some effect on the Swedish PV innovation system. These effects are described and backed up by examples from the studied projects. The report also describes the most notable blocking mechanisms that became clear during the work. The occurrences of selfreinforcing mechanisms are crucial for the growth of the PV market. These mechanisms are also illustrated and together with the blocking mechanisms this gives a picture of the most important areas for policy measures. The results of this report shows that the market deployment initiative has lead to the start of a number of new PV projects and that

The Effects of the Investment Support Scheme on the Dynamics of the Swedish Photovoltaic Sector

Energy Technology Data Exchange (ETDEWEB)

Palmblad, Linus

2006-01-15

The support from the Swedish government to the PV sector has so far been focused on research and development. But in May 2005 the Swedish government showed that they want to follow the global trend and introduced a market deployment initiative directed to grid connected PV systems on buildings for public activities. Compared to subsidy schemes in other countries it is small. But the Swedish PV market is still under development and the market support will lead to a significant leap for the installed capacity of PV systems in Sweden. The aim of this study is to create a picture of the dynamics in the Swedish PV sector and make an early evaluation of the effects of the market deployment initiative. Information has been gathered from five new PV projects in Sweden through interviews with involved actors. The analysis is carried out with an innovation systems perspective. The goal of the market support is to create prerequisites for further diffusion of PV systems and development of a competent PV sector in Sweden. When evaluating the market support it is therefore more interesting to look at how the support has affected the dynamics of the Swedish PV innovation system instead of just looking at how many systems that have been built. Despite that this report was carried out in an early phase of the market deployment initiative, it shows that the market support has certainly had some effect on the Swedish PV innovation system. These effects are described and backed up by examples from the studied projects. The report also describes the most notable blocking mechanisms that became clear during the work. The occurrences of selfreinforcing mechanisms are crucial for the growth of the PV market. These mechanisms are also illustrated and together with the blocking mechanisms this gives a picture of the most important areas for policy measures. The results of this report shows that the market deployment initiative has lead to the start of a number of new PV projects and that

Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

Science.gov (United States)

Munro, Neil; Duckett, Jane

2016-06-01

To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Components of Maternal Healthcare Delivery System Contributing to ...

African Journals Online (AJOL)

Components of Maternal Healthcare Delivery System Contributing to Maternal Deaths ... transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal ...

Renovating the Commons: Swedish health care reforms in perspective.

Science.gov (United States)

Saltman, Richard B; Bergman, Sven-Eric

2005-01-01

Recent reform experience in Sweden supports the premise that key dimensions of a country's health care system reflect the core social norms and values held by its citizenry. The fundamental structure of the Swedish health system has remained notably consistent over the past half century, that is, tax-based financing and publicly operated hospitals. Yet on other, nearly as important, parameters, there has been substantial change, for example, the persistent pursuit for thirty years of a stronger primary care framework and the effort to allow patient choice of doctor, health center, and hospital within the publicly operated system. This particular combination of continuity and change has occurred as traditional Swedish values of jamlikhet (equality) and trygghet (security) have been challenged in an environment shaped by an aging population, changing medical technology, and Sweden's integration into the European Single Market. This article explores the ongoing process of health system development in Sweden in the context of the country's broader social and cultural characteristics.

Real-time locating systems (RTLS) in healthcare: a condensed primer.

Science.gov (United States)

Kamel Boulos, Maged N; Berry, Geoff

2012-06-28

Real-time locating systems (RTLS, also known as real-time location systems) have become an important component of many existing ubiquitous location aware systems. While GPS (global positioning system) has been quite successful as an outdoor real-time locating solution, it fails to repeat this success indoors. A number of RTLS technologies have been used to solve indoor tracking problems. The ability to accurately track the location of assets and individuals indoors has many applications in healthcare. This paper provides a condensed primer of RTLS in healthcare, briefly covering the many options and technologies that are involved, as well as the various possible applications of RTLS in healthcare facilities and their potential benefits, including capital expenditure reduction and workflow and patient throughput improvements. The key to a successful RTLS deployment lies in picking the right RTLS option(s) and solution(s) for the application(s) or problem(s) at hand. Where this application-technology match has not been carefully thought of, any technology will be doomed to failure or to achieving less than optimal results.

Applying e-procurement system in the healthcare: the EPOS paradigm

Science.gov (United States)

Ketikidis, Panayiotis H.; Kontogeorgis, Apostolos; Stalidis, George; Kaggelides, Kostis

2010-03-01

One of the goals of procurement is to establish a competitive price, while e-procurement utilises electronic commerce to identify potential sources of supply, to purchase goods and services, to exchange contractual information and to interact with suppliers. Extensive academic work has been extensively devoted to e-procurement in diverse industries. However, applying e-procurement in the healthcare sector remains unexplored. It lacks an efficient e-procurement mechanism that will enable hospitals and healthcare suppliers to electronically exchange contractual information, aided by the technologies of optimisation and business rules. The development and deployment of e-procurement requires a major effort in the coordination of complex interorganisational business process. This article presents an e-procurement optimised system (EPOS) for the healthcare marketplace, a complete methodological approach for deploying and operating such system, as piloted in public and private hospitals in three European countries (Greece, Spain and Belgium) and suppliers of healthcare items in the fourth country (Italy). The efficient e-procurement mechanism that EPOS suggests enables hospitals and pharmaceutical and medical equipment suppliers to electronically exchange contractual information.

Healthcare system simulation using Witness

International Nuclear Information System (INIS)

Khakdaman, Masoud; Zeinahvazi, Milad; Zohoori, Bahareh; Nasiri, Fardokht; Wong, Kuan Yew

2013-01-01

Simulation techniques have a proven track record in manufacturing industry as well as other areas such as healthcare system improvement. In this study, simulation model of a health center in Malaysia is developed through the application of WITNESS simulation software which has shown its flexibility and capability in manufacturing industry. Modelling procedure is started through process mapping and data collection and continued with model development, verification, validation and experimentation. At the end, final results and possible future improvements are demonstrated.

Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

Directory of Open Access Journals (Sweden)

Fridh Gerd

2006-06-01

Full Text Available Abstract Background Individualbased measures for comorbidity are of increasing importance for planning and funding health care services. No measurement for individualbased healthcare costs exist in Sweden. The aim of this study was to validate the Johns Hopkins ACG Case-Mix System's predictive value of polypharmacy (regular use of 4 or more prescription medicines used as a proxy for health care costs in an elderly population and to study if the prediction could be improved by adding variables from a population based study i.e. level of education, functional status indicators and health perception. Methods The Johns Hopkins ACG Case-Mix System was applied to primary health care diagnoses of 1402 participants (60–96 years in a cross-sectional community based study in Karlskrona, Sweden (the Swedish National study on Ageing and Care during a period of two years before they took part in the study. The predictive value of the Johns Hopkins ACG Case-Mix System was modeled against the regular use of 4 or more prescription medicines, also using age, sex, level of education, instrumental activity of daily living- and measures of health perception as covariates. Results In an exploratory biplot analysis the Johns Hopkins ACG Case-Mix System, was shown to explain a large part of the variance for regular use of 4 or more prescription medicines. The sensitivity of the prediction was 31.9%, whereas the specificity was 88.5%, when the Johns Hopkins ACG Case-Mix System was adjusted for age. By adding covariates to the model the sensitivity was increased to 46.3%, with a specificity of 90.1%. This increased the number of correctly classified by 5.6% and the area under the curve by 11.1%. Conclusion The Johns Hopkins ACG Case-Mix System is an important factor in measuring comorbidity, however it does not reflect an individual's capability to function despite a disease burden, which has importance for prediction of comorbidity. In this study we have shown that

The Erasure of Sex and Gender Minorities in the Healthcare System

Directory of Open Access Journals (Sweden)

Marianne LeBreton

2013-09-01

Full Text Available Socio-cultural notions of gender and sex influence the structuring of healthcare systems. This case study exemplifies how the Western gender binary, and cisnormativity in particular, can create barriers to accessing healthcare services for transgender populations and lead to erasure.

Security And Privacy Issues in Healthcare Monitoring Systems: A Case Study

DEFF Research Database (Denmark)

Handler, Daniel Tolboe; Hauge, Lotte; Spognardi, Angelo

2017-01-01

Security and privacy issues are rarely taken into account in automated systems for monitoring elderly people in their home, exposing inhabitants to a number of threats they are usually not aware of. As a case study to expose the major vulnerabilities these systems are exposed to, this paper reviews...... a generic example of automated healthcare monitoring system. The security and privacy issues identified in this case study can be easily generalised and regarded as alarm bells for all the pervasive healthcare professionals....

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

OpenAIRE

Cathy H. Ficzere, PharmD, BCPS; Traci M. Poole, PharmD, BCACP; Rachel B. Franks, PharmD, BCACP; Elisa M. Greene, PharmD, BCACP; Kristina D. Wood, PharmD, BCACP; Philip E. Johnston, PharmD

2013-01-01

Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology. Setting: Ambulatory care and community practice Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party p...

Web-based integrated public healthcare information system of Korea: development and performance.

Science.gov (United States)

Ryu, Seewon; Park, Minsu; Lee, Jaegook; Kim, Sung-Soo; Han, Bum Soo; Mo, Kyoung Chun; Lee, Hyung Seok

2013-12-01

The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.

Population aging and its impacts: strategies of the health-care system in Taipei.

Science.gov (United States)

Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

2010-11-01

Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities. Copyright © 2010 Elsevier B.V. All rights reserved.

Swedish Cleantech Opportunities 2010

Energy Technology Data Exchange (ETDEWEB)

2011-07-01

A market overview from the Swedish Energy Agency. 'Cleantech (short for clean technologies) refers to energy and environmentally friendly related technologies. Global demand for this kind of products continues to grow and cleantech can thus generate new jobs, growth and tax revenues. The Swedish Energy Agency is active in the energy segment of cleantech and support companies in their early stages of development. This market overview outlines the current status of the sector, in Sweden and globally. It also presents business leaders and innovators in this field.'

The Learning Healthcare System: Where are we now? A systematic review.

Science.gov (United States)

Budrionis, Andrius; Bellika, Johan Gustav

2016-12-01

The Learning Healthcare System paradigm has attracted the attention of researchers worldwide. The great potential originating from high-scale health data reuse and the inclusion of patient perspectives into care models promises personalized care, lower costs of health services and minimized consumption of resources. The aim of this review is to summarize the attempts to adopt the novel paradigm, putting emphasis on implementations and evaluating the impact on current medical practices. PRISMA methodology was followed for structuring the review process. Three major research databases (PubMed, IEEE Xplore and ACM DL) were queried with the predefined search terms "learning healthcare" and "learning health". Publications containing specific theoretical or empirical results were considered. Three hundred and fifty-eight publications were identified; however, only 32 met the inclusion criteria. Nineteen papers were characterized as theoretical contributions, while the rest presented empirical achievements. Only one paper described the initial estimates of impact and economy. Individualistic communication of studies ignoring popular frameworks for assessing and reporting research achievements prevents the systematic generation of knowledge. Evaluating the impact of the Learning Healthcare System instances where it is implemented could work as a catalyst in reaching higher acceptance and adoption of the proposed ideas by healthcare worldwide; however, it mostly remains described in theory. The review demonstrated the interest of researchers in exploring the Learning Healthcare System ideas. However, it also revealed minimal focus on evaluating the impact of the novel paradigm on both healthcare service delivery and patient outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Screening migrants for tuberculosis - a missed opportunity for improving knowledge and attitudes in high-risk groups: A cross-sectional study of Swedish-language students in Umeå, Sweden.

Science.gov (United States)

Nkulu, Faustine K K; Hurtig, Anna-Karin; Ahlm, Clas; Krantz, Ingela

2010-06-17

. Information may currently be inaccessible to most of these immigrants due to the language barrier and unfamiliarity with the Swedish healthcare system. If TB education was included as a component of screening programmes, ensuring that it was tailored to educational background, addressed misconceptions and access problems, it could well help improve TB control in these communities.

Screening migrants for tuberculosis - a missed opportunity for improving knowledge and attitudes in high-risk groups: A cross-sectional study of Swedish-language students in Umeå, Sweden

Directory of Open Access Journals (Sweden)

Ahlm Clas

2010-06-01

low with several misconceptions and negative attitudes. Information may currently be inaccessible to most of these immigrants due to the language barrier and unfamiliarity with the Swedish healthcare system. If TB education was included as a component of screening programmes, ensuring that it was tailored to educational background, addressed misconceptions and access problems, it could well help improve TB control in these communities.

Fundamental design bases for independent core cooling in Swedish nuclear power reactors

International Nuclear Information System (INIS)

Jelinek, Tomas

2015-01-01

New regulations on design and construction of nuclear power plants came into force in 2005. The need of an independent core cooling system and if the regulations should include such a requirement was discussed. The Swedish Radiation Safety authority (SSM) decided to not include such a requirement because of open questions about the water balance and started to investigate the consequences of an independent core cooling system. The investigation is now finished and SSM is also looking at the lessons learned from the accident in Fukushima 2011. One of the most important measures in the Swedish national action plan is the implementation of an independent core cooling function for all Swedish power plants. SSM has investigated the basic design criteria for such a function where some important questions are the level of defence in depth and the acceptance criteria. There is also a question about independence between the levels of defence in depth that SSM have included in the criteria. Another issue that has to be taken into account is the complexity of the system and the need of automation where independence and simplicity are very strong criteria. In the beginning of 2014 a memorandum was finalized regarding fundamental design bases for independent core cooling in Swedish nuclear power reactors. A decision based on this memorandum with an implementation plan will be made in the first half of 2014. Sweden is also investigating the possibility to have armed personnel on site, which is not allowed currently. The result from the investigation will have impact on the possibility to use mobile equipment and the level of protection of permanent equipment. In this paper, SSM will present the memorandum for design bases for independent core cooling in Swedish nuclear power reactors that was finalized in March 20147 that also describe SSM's position regarding independence and automation of the independent core cooling function. This memorandum describes the Swedish

Data Privacy in Cloud-assisted Healthcare Systems: State of the Art and Future Challenges.

Science.gov (United States)

Sajid, Anam; Abbas, Haider

2016-06-01

The widespread deployment and utility of Wireless Body Area Networks (WBAN's) in healthcare systems required new technologies like Internet of Things (IoT) and cloud computing, that are able to deal with the storage and processing limitations of WBAN's. This amalgamation of WBAN-based healthcare systems to cloud-based healthcare systems gave rise to serious privacy concerns to the sensitive healthcare data. Hence, there is a need for the proactive identification and effective mitigation mechanisms for these patient's data privacy concerns that pose continuous threats to the integrity and stability of the healthcare environment. For this purpose, a systematic literature review has been conducted that presents a clear picture of the privacy concerns of patient's data in cloud-assisted healthcare systems and analyzed the mechanisms that are recently proposed by the research community. The methodology used for conducting the review was based on Kitchenham guidelines. Results from the review show that most of the patient's data privacy techniques do not fully address the privacy concerns and therefore require more efforts. The summary presented in this paper would help in setting research directions for the techniques and mechanisms that are needed to address the patient's data privacy concerns in a balanced and light-weight manner by considering all the aspects and limitations of the cloud-assisted healthcare systems.

The Transformation of Swedish Shipping, 1970-2010

OpenAIRE

Sjögren, Hans; Taro Lennerfors, Thomas; Taudal Poulsen, Rene

2012-01-01

Since the early 1970s, as shipping has undergone a period of structural change, Swedish shipping has rapidly declined from a position of global importance. The Swedish-controlled fleet has dwindled, and the structure of the industry itself has changed. This article explores the influence of shipping markets, shipping regulations, company strategies, maritime know-how, and financial resources on the development of Swedish shipping from 1970 to 2010. A comparison is made between, on the one han...

Patient Relationship Management: What the U.S. Healthcare System Can Learn from Other Industries.

Science.gov (United States)

Poku, Michael K; Behkami, Nima A; Bates, David W

2017-01-01

As the U.S. healthcare system moves to value-based care, the importance of engaging patients and families continues to intensify. However, simply engaging patients and families to improve their subjective satisfaction will not be enough for providers who want to maximize value. True optimization entails developing deep and long-term relationships with patients. We suggest that healthcare organizations must build such a discipline of "patient relationship management" (PRM) just as companies in non-healthcare industries have done with the concept of customer relationship management (CRM). Some providers have already made strides in this area, but overall it has been underemphasized or ignored by most healthcare systems to date. As healthcare providers work to develop their dedicated PRM systems, tools, and processes, we suggest they may benefit from emulating companies in other industries who have been able to engage their customers in innovative ways while acknowledging the differences between healthcare and other industries.

Education for the nuclear power industry: Swedish perspective

International Nuclear Information System (INIS)

Blomgren, J.

2005-01-01

In the Swedish nuclear power industry staff, very few newly employed have a deep education in reactor technology. To remedy this, a joint education company, Nuclear Training and Safety Center (KSU), has been formed. To ensure that nuclear competence will be available also in a long-term perspective, the Swedish nuclear power industry and the Swedish Nuclear Power Inspectorate (SKI) have formed a joint center for support of universities, the Swedish Nuclear Technology Center (SKC). The activities of these organisations, their links to universities, and their impact on the competence development for the nuclear power industry will be outlined. (author)

Cadmium exposure in the Swedish environment

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

This report gives a thorough description of cadmium in the Swedish environment. It comprises three parts: Cadmium in Sweden - environmental risks;, Cadmium in goods - contribution to environmental exposure;, and Cadmium in fertilizers, soil, crops and foods - the Swedish situation. Separate abstracts have been prepared for all three parts

Quality Registries in Sweden, Healthcare Improvements and Elderly Persons with Cognitive Impairments.

Science.gov (United States)

Mattsson, Titti

2016-12-01

Policy-makers, the medical industry and researchers are demonstrating a keen interest in the potential of large registries of patient data, both nationally and internationally. The registries offer promising ways to measure and develop operational quality within health and medical care services. As a result of certain favourable patient data regulations and government funding, the development of quality registries is advanced in Sweden. The combination of increasing demand for more cost-efficient healthcare that can accommodate the demographic development of a rapidly ageing population, and the emergence of eHealth with an increasing digitalisation of patient data, calls attention to quality registries as a possible way for healthcare improvements. However, even if the use of registries has many advantages, there are some drawbacks from a patient privacy point of view. This article aims to analyse this growing interdependence of quality registries for the healthcare sector. It discusses some lessons from the Swedish case, with particular focus on the collection of data from elderly persons with cognitive impairments.

Swedish Cleantech Opportunities 2010

Energy Technology Data Exchange (ETDEWEB)

2011-07-01

A market overview from the Swedish Energy Agency. 'Cleantech (short for clean technologies) refers to energy and environmentally friendly related technologies. Global demand for this kind of products continues to grow and cleantech can thus generate new jobs, growth and tax revenues. The Swedish Energy Agency is active in the energy segment of cleantech and support companies in their early stages of development. This market overview outlines the current status of the sector, in Sweden and globally. It also presents business leaders and innovators in this field.'

An Intelligent Virtual Human System For Providing Healthcare Information And Support

Science.gov (United States)

2011-01-01

healthcare system, and also to other SMs and Veterans by way of a variety of social networking tools (e.g., 2nd Life, Facebook, etc.). The user can progress... CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8

Swedish REGULATORY APPROACH TO SAFETY Assessment AND SEVERE ACCIDENT MANAGEMENT

International Nuclear Information System (INIS)

Frid, W.; Sandervaag, O.

1997-01-01

The Swedish regulatory approach to safety assessment and severe accident management is briefly described. The safety assessment program, which focuses on prevention of incidents and accidents, has three main components: periodic safety reviews, probabilistic safety analysis, and analysis of postulated disturbances and accident progression sequences. Management and man-technology-organisation issues, as well as inspections, play a key role in safety assessment. Basis for severe accident management were established by the Government decisions in 1981 and 1986. By the end of 1988, the severe accident mitigation systems and emergency operating procedures were implemented at all Swedish reactors. The severe accident research has continued after 1988 for further verification of the protection provided by the systems and reduction of remaining uncertainties in risk dominant phenomena

Healthcare Systems and Other Applications

NARCIS (Netherlands)

van Kasteren, T.L.M.; Kröse, B.J.A.

2007-01-01

This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models

Safety Assessment - Swedish Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Kjellstroem, B. [Luleaa Univ. of Technology (Sweden)

1996-12-31

After the reactor accident at Three Mile Island, the Swedish nuclear power plants were equipped with filtered venting of the containment. Several types of accidents can be identified where the filtered venting has no effect on the radioactive release. The probability for such accidents is hopefully very small. It is not possible however to estimate the probability accurately. Experiences gained in the last years, which have been documented in official reports from the Nuclear Power Inspectorate indicate that the probability for core melt accidents in Swedish reactors can be significantly larger than estimated earlier. A probability up to one in a thousand operating years can not be excluded. There are so far no indications that aging of the plants has contributed to an increased accident risk. Maintaining the safety level with aging nuclear power plants can however be expected to be increasingly difficult. It is concluded that the 12 Swedish plants remain a major threat for severe radioactive pollution of the Swedish environment despite measures taken since 1980 to improve their safety. Closing of the nuclear power plants is the only possibility to eliminate this threat. It is recommended that until this is done, quantitative safety goals, same for all Swedish plants, shall be defined and strictly enforced. It is also recommended that utilities distributing misleading information about nuclear power risks shall have their operating license withdrawn. 37 refs.

Safety Assessment - Swedish Nuclear Power Plants

International Nuclear Information System (INIS)

Kjellstroem, B.

1996-01-01

After the reactor accident at Three Mile Island, the Swedish nuclear power plants were equipped with filtered venting of the containment. Several types of accidents can be identified where the filtered venting has no effect on the radioactive release. The probability for such accidents is hopefully very small. It is not possible however to estimate the probability accurately. Experiences gained in the last years, which have been documented in official reports from the Nuclear Power Inspectorate indicate that the probability for core melt accidents in Swedish reactors can be significantly larger than estimated earlier. A probability up to one in a thousand operating years can not be excluded. There are so far no indications that aging of the plants has contributed to an increased accident risk. Maintaining the safety level with aging nuclear power plants can however be expected to be increasingly difficult. It is concluded that the 12 Swedish plants remain a major threat for severe radioactive pollution of the Swedish environment despite measures taken since 1980 to improve their safety. Closing of the nuclear power plants is the only possibility to eliminate this threat. It is recommended that until this is done, quantitative safety goals, same for all Swedish plants, shall be defined and strictly enforced. It is also recommended that utilities distributing misleading information about nuclear power risks shall have their operating license withdrawn. 37 refs

Photovoltaic Systems for Swedish Prosumers : A technical and economic analysis focused on cooperative multi-family housing

OpenAIRE

Sommerfeldt, Nelson; Muyingo, Henry; af Klintberg, Tord

2016-01-01

This report is designed to be a comprehensive information resource for Swedish prosumers considering an investment in solar PV systems. The target audience are multi-family cooperative houses, however much of the information is applicable to other building owners and solar energy more broadly. The primary question to be answered; is a rooftop PV investment profitable in Sweden? Naturally there are many variables that can affect the answer; therefore a Monte Carlo methodology is used to conver...

Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare.

Science.gov (United States)

Eriksson, Nomie; Ujvari, Sandor

2015-01-01

Clinical governance and leadership concepts can lead to more or less successful implementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, as institutional entrepreneurs can, working in a team, implement sustained change in hospital clinical practice. This paper describes two case studies, conducted at two Swedish hospitals over a period of two years, in which changes in clinical practice were implemented. In both cases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use a qualitative approach and take an intra-organizational perspective with semi-structured in-depth interviews and document analysis. The new clinical practices were successfully implemented with a considerable influence of the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively, based on their structural and normative legitimacy and the adoption of learning processes, advocated, and supported change. Fiery Spirits, given flexibility and opportunity, can be powerful forces for change outside the trajectory of management-inspired and management-directed change. Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and more willing to test new clinical practices. The paper complements literature on how the Fiery Spirit concept aligns with concepts of clinical governance and leadership and how change can be achieved. Additionally, the findings show the effects of legitimacy and learning processes on change in clinical practice.

Sulfur problems in Swedish agriculture

Energy Technology Data Exchange (ETDEWEB)

Johansson, O

1959-01-01

The present paper deals with some aspects of the sulfur situation in Swedish agriculture with special emphasis on the importance of and relationships among various sources of sulfur supply. An inventory of the sulfur content of Swedish soils and hay crops includes 649 soil samples and a corresponding number of hay samples from 59 locations. In a special investigation the samples were found to be representative of normal Swedish farm land. It is concluded that the amount of sulfur compounds in the air is the primary factor which determines the amount of sulfur added to the soil from the atmosphere. Compared with values obtained in other countries, the amount of sulfur added by the precipitation in Sweden is very low. The distribution in air and precipitation of sulfur from an industrial source was studied in a special investigation. An initial reason for the present study was the damage to vegetation caused by smoke from an industrial source. It was concluded that the average conditions in the vicinity of the industrial source with respect to smoke constituents in the air and precipitation were unfavorable only to the plants directly within a very narrow region. Relationships among the sulfur contents of air, of precipitation, of soils and of plants have been subject to special investigations. In the final general discussion and conclusions it is pointed out that the results from these investigations indicate evident differences in the sulfur status of Swedish soils. The present trend toward the use of more highly concentrated fertilizers poor in sulfur may be expected to cause a considerable change in the sulfur situation in Swedish agriculture. 167 references, 40 figures, 44 tables.

In Praise of the Present: The Pupil at Centre in Swedish Educational Politics in the Post-War Period

Science.gov (United States)

Wedin, Tomas

2017-01-01

According to an influential narrative in Swedish educational historiography, the Swedish educational system underwent a drastic change during the 1990s, moving towards a more individualistic and marketised system. Without denying the relevance of this perspective, this article argues that we can trace antecedents to the reforms undertaken in the…

Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems.

Science.gov (United States)

Khan, Sobia; Vandermorris, Ashley; Shepherd, John; Begun, James W; Lanham, Holly Jordan; Uhl-Bien, Mary; Berta, Whitney

2018-03-21

Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By

Tensions in Stakeholder Relations for a Swedish Football Club

DEFF Research Database (Denmark)

Junghagen, Sven

2018-01-01

Swedish football is an industry not yet being as commercial as the big leagues and is regulated in terms of ownership of clubs. This implies a need for management of stakeholder relations for a Swedish football club. This paper identifies important stakeholders in Swedish football and discusses...

Swedish High-End Apparel Online

OpenAIRE

Hansson, Christoffer; Grabe, Thomas; Thomander, Karolina

2010-01-01

The study aims to through a qualitative case study describe how six Swedish high-end apparel companies attributed as part of “the Swedish fashion wonder” with online distribution have been affected by six chosen factors. The six factors presented are extracted from previous studies and consist of customer relationships, intermediary relationships, pricing, costs and revenue, competitors and impact on the brand. The results show that customer relationships is an important factor that most comp...

Operating experience from Swedish nuclear power plants 2004

International Nuclear Information System (INIS)

2005-01-01

2004 was somewhat of a record year for the Swedish nuclear power stations. No serious faults occurred, and production exceeded previous record outputs. Total output from the eleven nuclear power units during the year amounted to 75 TWh, which is the largest amount of power ever produced by nuclear power in Sweden. Corresponding figures for earlier years are 59 TWh (2003), 65 TWh (2002) and 69 TWh (2001). An important reason for this excellent result was the very high energy availability. Forsmark 1, for example, exceeded 97 % availability, while Forsmark 2 just reached 97 %. For all the Swedish nuclear power stations as a whole, availability in 2004 amounted to 91 %. In addition to the connection between production and energy availability, there is also a connection with safety. During the year, safety in the Swedish power stations has been high, not only in absolute terms but also in an international perspective. One measure of safety is to be found in the number of accidents, incidents, anomalies or deviations reported to the IAEA on a scale known as the International Nuclear Event Scale (INES). Sweden has undertaken to report all events in accordance with this international system. Three reports were submitted by the Swedish Nuclear Power Inspectorate, which is responsible for national reporting, during the year. None of them had any significance for reactor safety: all were categorised as incidents or minor deviations from the regulations. Summarising, 2004 has been an excellent year for nuclear power safety, which is also reflected by the record electricity production during the year

Operating experience from Swedish nuclear power plants 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

2004 was somewhat of a record year for the Swedish nuclear power stations. No serious faults occurred, and production exceeded previous record outputs. Total output from the eleven nuclear power units during the year amounted to 75 TWh, which is the largest amount of power ever produced by nuclear power in Sweden. Corresponding figures for earlier years are 59 TWh (2003), 65 TWh (2002) and 69 TWh (2001). An important reason for this excellent result was the very high energy availability. Forsmark 1, for example, exceeded 97 % availability, while Forsmark 2 just reached 97 %. For all the Swedish nuclear power stations as a whole, availability in 2004 amounted to 91 %. In addition to the connection between production and energy availability, there is also a connection with safety. During the year, safety in the Swedish power stations has been high, not only in absolute terms but also in an international perspective. One measure of safety is to be found in the number of accidents, incidents, anomalies or deviations reported to the IAEA on a scale known as the International Nuclear Event Scale (INES). Sweden has undertaken to report all events in accordance with this international system. Three reports were submitted by the Swedish Nuclear Power Inspectorate, which is responsible for national reporting, during the year. None of them had any significance for reactor safety: all were categorised as incidents or minor deviations from the regulations. Summarising, 2004 has been an excellent year for nuclear power safety, which is also reflected by the record electricity production during the year.

Consequences of the quota requirement for energy efficiency. Can a Swedish quota obligation systems give less energy usage?; Konsekvenser av kvotplikt foer energieffektivisering. Kan ett svenskt kvotpliktssystem ge mindre energianvaendning?

Energy Technology Data Exchange (ETDEWEB)

Bjoerkroth, Sara; Bladh, Mats; Holmberg, Rurik; Lock, Anna; Naderi, Ronak; Widerstroem, Glenn

2012-11-01

The Agency has on behalf of the government investigated what the consequences would be of the introduction of a compulsory quota system in Sweden. Under the proposed new EU directive on energy efficiency, all Member States should introduce a compulsory quota system, where energy companies actively initiate measures for energy efficiency among end users. In Sweden, a quota obligation system of this kind would mean energy efficiency of about 3 TWh per year, which can be difficult to achieve. The Swedish Energy Agency suggests that if a compulsory quota system is introduced, the quota obligation should be placed on the network companies. If not, there is a risk of complications in the Swedish and Nordic electricity market. The Energy Markets Inspectorate consider that the quota obligation can not be on the network companies because of their function as regulated monopoly. The Swedish Energy Agency suggests that efficiency measures can be implemented in all sectors, including transport.

The prosody of Swedish underived nouns: No lexical tones required

Directory of Open Access Journals (Sweden)

Bruce Morén-Duolljá

2013-02-01

Full Text Available This paper provides a detailed representational analysis of the morpho-prosodic system of underived nouns in a dialect of Swedish.  It shows that the morphology, stress and tonal patterns are not as complex as they first appear once the data are looked at in sufficient detail.  Further, it shows that the renowned Swedish "lexical pitch accent" is not the result of lexical tones/tonemes.  Rather, Swedish is like all other languages and uses tones to mark the edges of prosodic constituents on the surface. "Accent 2" occurs when tones mark the edge of a structural uneven trochee (i.e. recursive foot and "accent 1" occurs elsewhere. This analysis is counter all other treatments of North Germanic tones and denies the almost unquestioned assumption that there is an underlying tone specification on roots and/or affixes in many North Germanic varieties. At the same time, it unifies the intuitions behind the three previous approaches found in the literature.

IoT-based Asset Management System for Healthcare-related Industries

Directory of Open Access Journals (Sweden)

Lee Carman Ka Man

2015-11-01

Full Text Available The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS is proposed and developed based on Artificial Neural Network (ANN and Fuzzy Logic (FL, incorporating IoT technologies for asset management to optimize the supply of resources.

Quality function deployment in healthcare: a literature review and case study.

Science.gov (United States)

Gremyr, Ida; Raharjo, Hendry

2013-01-01

This article aims to provide a literature review on the use of quality function deployment (QFD) in healthcare and a case study in order to provide contextual knowledge as a means of improving applications of QFD in healthcare. The literature search was done via Google Scholar, PubMed/MEDLINE, and Web of Science using the keywords "quality function deployment" and "healthcare"; focusing on journal publications and their related citations. The case study was done within a design for Six Sigma project (DFSS) in a Swedish hospital. Empirical data were collected through face-to-face interviews and project documentation. Four potentials (better understanding of customers' needs and wants, identification of opportunities for process improvement, effective system thinking approach, and better communication and more transparent process) and three antecedents (understanding the customer, understanding the customer's needs, and finding ways to prioritize and translate those needs) of QFD application in healthcare were identified from the literature review. From the case study, the application of QFD leads to an increased awareness of a complex multiple-customer concept, traceability of the improvement strategies in a more structured way, and the formation of a new process organization. A time study at one clinic (cardiology) before and after the project within which the QFD was used showed that the time spent on prescription of medication has decreased by more than 20 percent. This has increased the time that doctors can spend with their patients. This paper highlights the potentials and antecedents of applying QFD in healthcare from previous research. Furthermore, the practical findings obtained from applying QFD in the project can also provide some useful insights for practitioners. The novel contribution is two-fold. First, it is the identification of the potentials and antecedents of using QFD in healthcare context. Second, it is the findings and learning from a

The Swedish Model

DEFF Research Database (Denmark)

Kokko, Ari

2012-01-01

The main characteristics of ‘the Swedish model’ are arguably related to the country's knowledge-intensive industry and its advanced welfare state. The purpose of this chapter is to discuss the historical development of these two features of the Swedish economy. The first part looks at industrial...... development, highlighting both the reasons for the rapid industrialization in the late 19th century and the subsequent shift from raw materials to human capital and knowledge as the main competitive advantages. The second part turns to the development of welfare state, stressing the gradual increase...... in benefits and coverage as well as the emphasis on universal rather than means-tested benefits. The final part suggests some policy conclusions for today's developing countries and emerging economies....

Gender Integration and the Swedish Armed Forces

DEFF Research Database (Denmark)

Gustafsson, Daniel Marcus Sunil

This paper discusses different gender aspects of the Swedish Armed Forces with specific references to sexual harassment and prostitution. By using the concept of Hegemonic Masculinity, sexual harassment of the women in the Swedish Armed Forces is explained in terms of a need of the men within...... the organisation to reinforce the notion of women as inferior and subordinate to men, whereby the external hegemony is believed to be restored. Likewise, male Swedish peacekeepers’ demand for prostitution during international peacekeeping missions is explained in terms of a need to confirm manhood and as homo...

A home healthcare system in the cloud - Addressing security and privacy challenges

OpenAIRE

Deng M.; Petkovic M.; Nalin M.; Baroni I.

2011-01-01

Cloud computing is an emerging technology that is expected to support Internet scale critical applications which could be essential to the healthcare sector. Its scalability, resilience, adaptability, connectivity, cost reduction, and high performance features have high potential to lift the efficiency and quality of healthcare. However,it is also important to understand specific risks related to security and privacy that this technology brings. This paper focuses on a home healthcare system ...

Healthcare regions and their care networks: an organizational-systemic model for SUS.

Science.gov (United States)

Santos, Lenir

2017-04-01

This paper describes a comprehensive effort to develop studies regarding Brazil's Unified Healthcare System (SUS), as a result of the combination of public services in a network that follows a region-based rationale (tripartite organization). The SUS emerges from such an integration and should be organized as such. The intention is to demonstrate that this type of organization is essential, given that Brazil is organized as a Federation, and all three governmental levels are, in a broad sense, equally responsible for healthcare. Healthcare services and actions are a complex set of activities that are interconnected on behalf of citizen health, which is a global concept that cannot be split up. Services must follow this rationale and be organized as such. Thus, healthcare services must be systematically organized to serve everyone equally, regardless of where a citizen lives. This systemic organization requires permanent interaction between federative units to discuss and operationalize reference services, funding and other technical and administrative aspects. These are the essential elements that make the SUS so complex and demand it be organized regionally, as a network of healthcare services.

Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial

Science.gov (United States)

Abbott, Allan; Schröder, Karin; Enthoven, Paul; Nilsen, Per; Öberg, Birgitta

2018-01-01

Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP. Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context. Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated. Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and

Barriers to Business Model Innovation in Swedish Agriculture

OpenAIRE

Sivertsson, Olof; Tell, Joakim

2015-01-01

Swedish agricultural companies, especially small farms, are struggling to be profitable in difficult economic times. It is a challenge for Swedish farmers to compete with imported products on prices. The agricultural industry, however, supports the view that through business model innovation, farms can increase their competitive advantage. This paper identifies and describes some of the barriers Swedish small farms encounter when they consider business model innovation. A qualitative approach...

Comparison of U.S. and Swedish calculation economic transition points

International Nuclear Information System (INIS)

Owen, P.S.; Parker, M.B.; Omberg, R.P.

1979-03-01

This paper was prepared in response to the view of the Swedish delegation that the U.S. calculation of the economic transitions was in error. The report analyzed the principle differences between the U.S. approach and Swedish approach and concluded that the Swedish results can be reproduced using the U.S. method and Swedish data. Conversely, the U.S. results should be reproducible by Sweden

Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities.

Science.gov (United States)

Timpka, Toomas; Schyllander, Jan; Stark Ekman, Diana; Ekman, Robert; Dahlström, Örjan; Hägglund, Martin; Kristenson, Karolina; Jacobsson, Jenny

2018-02-01

Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties. An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location. Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries. One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Medical data transmission system for remote healthcare centres

International Nuclear Information System (INIS)

Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A

2007-01-01

The main motivation of this project is to improve the healthcare centres equipment and human resources efficiency, enabling those centres for transmission of parameters of medical interest. This system facilitates remote consultation, in particular between specialists and remote healthcare centres. Likewise it contributes to the qualification of professionals. The electrocardiographic (ECG) and electroencephalographic (EEG) signals are acquired, processed and then sent, fulfilling the effective norms, for application in the hospital network of Cordoba Province, which has nodes interconnected by phone line. As innovative aspects we emphasized the low cost of development and maintenance, great versatility and handling simplicity with a modular design for interconnection with diverse data transmission media (Wi-Fi, GPRS, etc.). Successfully experiences were obtained during the acquisition of the signals and transmissions on wired LAN networks. As improvements, we can mention: energy consumption optimization and mobile communication systems usage, in order to offer more autonomy

Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

Directory of Open Access Journals (Sweden)

Menke J Michael

2008-12-01

Full Text Available Abstract Background This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures. Methods The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83% completed the survey. Results The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers. Conclusion Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco

Innovation in Swedish Restaurant Franchises

OpenAIRE

Loikkanen, Jenny; Mazura, Jekaterina; Schrader, Jelena

2015-01-01

Background – The franchising industry in Sweden has experienced a vast growth in the recent years, and it makes up a significant part of the Swedish economy. The restaurant industry accounts for a large amount of the Swedish franchises. Due to the dynamic business environment today, companies need to increasingly strive for improvement in order to sustain their competitive advantage and to enhance their performance. Innovation may be required, and franchises are no exceptions. However, due to...

Swedish projects

International Nuclear Information System (INIS)

Thunell, J.

1993-01-01

The main sources of the financing of Swedish research on gas technology are listed in addition to names of organizations which carry out this research. The titles and descriptions of the projects carried out are presented in addition to lists of reports published with information on prices. (AB)

Implications of climate change (global warming) for the healthcare system.

Science.gov (United States)

Raffa, R B; Eltoukhy, N S; Raffa, K F

2012-10-01

Temperature-sensitive pathogenic species and their vectors and hosts are emerging in previously colder regions as a consequence of several factors, including global warming. As a result, an increasing number of people will be exposed to pathogens against which they have not previously needed defences. We illustrate this with a specific example of recent emergence of Cryptococcus gattii infections in more temperate climates. The outbreaks in more temperate climates of the highly virulent--but usually tropically restricted--C. gattii is illustrative of an anticipated growing challenge for the healthcare system. There is a need for preparedness by healthcare professionals in anticipation and for management of such outbreaks, including other infections whose recent increased prevalence in temperate climates can be at least partly associated with global warming. (Re)emergence of temperature-sensitive pathogenic species in more temperate climates will present new challenges for healthcare systems. Preparation for outbreaks should precede their occurrence. © 2012 Blackwell Publishing Ltd.

Obstetric Thromboprophylaxis: The Swedish Guidelines

Directory of Open Access Journals (Sweden)

Pelle G. Lindqvist

2011-01-01

Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

Science.gov (United States)

ROBBINS, JACOB A.

2015-01-01

The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

Science.gov (United States)

Potančok, Martin; Voříšek, Jiří

2016-09-01

Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. © The Author(s) 2015.

[The quality of the German health-care system in an international comparison - a systematic review].

Science.gov (United States)

Lauerer, M; Emmert, M; Schöffski, O

2013-08-01

Studies assessing the quality of the German health-care system in an international comparison come to different results. Therefore, this review aims to investigate how the German health-care system is evaluated in comparison to other health-care systems by reviewing international publications. Results show starting points for ways to improve the German health-care system, to maintain and expand its strengths as well as to derive strategies for solving identified problems. A systematic review searching different databases [library catalogues, WorldCat (including MEDLINE and OAIster-search), German National Library, Google Scholar and others]. Search requests were addressed to English or German language publications for the time period 2000-2010 (an informal search was conducted in October 2011 for an update). Results of the identified studies were aggregated and main statements derived. In total, 13 publications assessing the German health-care system in an international comparison were identified. These comparisons are based on 377 measures. After aggregation, 244 substantially different indicators remained, which were dedicated to 14 categories. It became apparent that the German health-care system can be characterised by a high level of expenses, a well-developed health-care infrastructure as well as a high availability of personal and material resources. Outcome measures demonstrate heterogeneous results. It can be stated that, particularly in this field, there is potential for further improvement. The utilisation of health-care services is high, the access is mostly not regulated and out of pocket payments can pose a barrier for patients. Waiting times are not regarded as a major weakness. Although civic satisfaction seems to be acceptable, a large portion of the citizens calls for elementary modifications. Especially, more patient-centred health-care delivery should be addressed as well as management of information and the adoption of meaningful electronic

Incentives for vertical integration in healthcare: the effect of reimbursement systems.

Science.gov (United States)

Byrne, M M; Ashton, C M

1999-01-01

In the United States, many healthcare organizations are being transformed into large integrated delivery systems, even though currently available empirical evidence does not provide strong or unequivocal support for or against vertical integration. Unfortunately, the manager cannot delay organizational changes until further research has been completed, especially when further research is not likely to reveal a single, correct solution for the diverse healthcare systems in existence. Managers must therefore carefully evaluate the expected effects of integration on their individual organizations. Vertical integration may be appropriate if conditions facing the healthcare organization provide opportunities for efficiency gains through reorganization strategies. Managers must consider (1) how changes in the healthcare market have affected the dynamics of production efficiency and transaction costs; (2) the likelihood that integration strategies will achieve increases in efficiency or reductions in transaction costs; and (3) how vertical integration will affect other costs, and whether the benefits gained will outweigh additional costs and efficiency losses. This article presents reimbursement systems as an example of how recent changes in the industry may have changed the dynamics and efficiency of production. Evaluation of the effects of vertical integration should allow for reasonable adjustment time, but obviously unsuccessful strategies should not be followed or maintained.

Designing a Safer Interactive Healthcare System - The Impact of Authentic User Participation

Science.gov (United States)

Went, Kathryn L.; Gregor, Peter; Ricketts, Ian W.

Information technology has been widely promoted in the healthcare sector to improve current practice and patient safety. However, end users are seldom involved extensively in the design and development of healthcare systems, with lip service often paid to the idea of true user involvement. In this case study the impact of sustained authentic user participation was explored using an interdisciplinary team, consisting of experts both in interaction and healthcare design and consultant anaesthetists, nurses, and pharmacists, to create an electronic prescribing and administration system. This paper details the interface that was created and provides examples of the way in which the design evolved in response to the sustained authentic user participation methods. The working prototype both reduced the opportunity for user error and was preferred by its users to the existing manual system.

Metaphorical expressions used in Swedish news media narratives to portray the shortage of nurses and their working conditions.

Science.gov (United States)

Blomberg, Helena; Stier, Jonas

2016-02-01

The aim of the study is to uncover and reveal how nurses as a profession and their working conditions are dramatized and portrayed in Swedish media narratives about the shortage of nurses. The media is an arena where stakeholders can air their views of the healthcare sector in general and the situation for nurses in particular. The focus in this study is the debate in Sweden on the shortage of nurses. Qualitative discursive study. A discourse analysis of media narratives about nurses and their working conditions published in several Swedish newspapers from 2009-2014. 1779 articles were included in the study. A selection (113 articles) of these articles was further analysed using a qualitative discursive psychological approach. Nurses are portrayed as being good, concerned about and critical of healthcare managers and politicians for not taking action. The accused actors justify their actions by partially accepting or displacing responsibility. The shortage of nurses is framed as a social problem - a threat to patients' safety. Seven different types of metaphorical expression frame the problem as inevitable, beyond control, abstract, an individual and collegial problem and nurses as replaceable. In addition, nurses and patients are dehumanized and no-one is held responsible. This study analyses the role of the media in emphasizing the seriousness or obscurity of the problem and possible solutions to it. Alternative narratives are needed to re-frame the nursing shortage and to find sustainable solutions. © 2015 John Wiley & Sons Ltd.

Seeking perfection in healthcare. A case study in adopting Toyota Production System methods.

Science.gov (United States)

Kaplan, Gary S; Patterson, Sarah H

2008-01-01

Virginia Mason Health System's vision to be the quality leader in healthcare means continually adopting new ways of thinking. One change has been shifting from believing defects are to be expected to believing zero defects in healthcare is not only possible, but also necessary. Generally, healthcare has advanced in technology and understanding of disease, but its business and management systems have changed little since the 1950s. Virginia Mason realized it needed a management method to help make real and measurable improvements in safety, quality, service and staff satisfaction.

Is spoken Danish less intelligible than Swedish?

NARCIS (Netherlands)

Gooskens, Charlotte; van Heuven, Vincent J.; van Bezooijen, Renee; Pacilly, Jos J. A.

2010-01-01

The most straightforward way to explain why Danes understand spoken Swedish relatively better than Swedes understand spoken Danish would be that spoken Danish is intrinsically a more difficult language to understand than spoken Swedish. We discuss circumstantial evidence suggesting that Danish is

Private investment in hospitals: a comparison of three healthcare systems and possible implications for real estate strategies.

Science.gov (United States)

van der Zwart, Johan; van der Voordt, Theo; Jonge, Hans de

2010-01-01

This article explores lessons to be learned from three different healthcare systems and the possible implications for the management of healthcare real estate, in particular in connection to the Dutch system. It discusses similarities and differences among the different systems, in search of possible consequences on cost, financing, and design innovation. To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation to move from a centrally directed system to a so-called regulated market system. The deregulation of real estate investment that accompanies the new healthcare delivery system offers healthcare organizations new opportunities, but also more responsibility and greater risk in return on investment. Consequently, healthcare organizations must find new methods of financing. Private investment is one of the options. Three healthcare systems were analyzed on the basis of a literature review and document analysis, then schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on private-sector financing and its implications for healthcare real estate decision making in the Netherlands, the United Kingdom, and Germany. The strengths and weaknesses of three healthcare systems with differing proportions of private and public investment in hospitals were explored. Research revealed a gap between intended effects and actual effects with regard to quality and cost. Costly private finance does not necessarily lead to "value for money." Transferring real estate decisions to private investors decreases the influence of the healthcare organization on future costs and quality. The three healthcare systems show substantial differences between public and private responsibilities. Less governmental involvement affords both opportunities and risks for hospitals. Private investment may lead to innovation

Lean healthcare.

Science.gov (United States)

Weinstock, Donna

2008-01-01

As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

Swedish industry and Kyoto - An assessment of the effects of the European CO2 emission trading system

International Nuclear Information System (INIS)

Braennlund, Runar; Lundgren, Tommy

2007-01-01

We assess the effects on Swedish industry input demands and output of different climate policy scenarios connected to energy policy induced by the Kyoto protocol. We use a unique dataset containing firm-level data on outputs and inputs between 1991 and 2001 to estimate a factor demand model, which we use to simulate different policy scenarios. Sector-specific estimation suggests that the proposed quadratic profit function specification exhibits properties and robustness that are consistent with economic theory; that is, all own-price elasticities are negative and all output elasticities are positive. Furthermore, the elasticities show that the input demands are, in most cases, relatively inelastic. Simulation of the model for six different policy scenarios reveal that effects on the Swedish base industry of a EU-level permit-trading system depends on (i) the removal or maintenance of the current CO 2 tax, (ii) the price of permits, and (iii) the future price of electricity. Our analysis shows that changes in electricity price may be more important than the price of permits for some sectors. (author)

Views of the United States healthcare system: Findings from documentary analysis of an interprofessional education course.

Science.gov (United States)

Bultas, Margaret W; Ruebling, Irma; Breitbach, Anthony; Carlson, Judy

2016-11-01

As the healthcare system of the United States becomes more complex, collaboration among health professionals is becoming an essential aspect in improving the health of individuals and populations. An interprofessional education course entitled "Health Care System and Health Promotion" was developed to allow health profession students to work and learn together about issues related to healthcare delivery, health promotion, and the effect of policy issues on key stakeholders in the system. A qualitative document analysis research design was used to evaluate the effect of this interprofessional course on students' views of the current healthcare system of the United States. Fifty-nine student articles were analysed using document analysis. Health professions represented in the sample included occupational therapy, physical therapy, athletic training, nursing, and radiation therapy, nuclear medicine technology, and magnetic resonance imaging. Eight themes were identified including: increased personal awareness, the need for a system change, concern for access, affordability of healthcare, vision for future practice role, need for quality care, the value of interprofessional collaboration (IPC), and the importance of disease prevention. The results of the study suggest that healthcare education can benefit from the integration of Interprofessional Education (IPE) courses into their curriculum especially when teaching content common to all healthcare professions such as healthcare systems and health promotion.

Sustainability of midwifery practice within the South African healthcare system

OpenAIRE

2012-01-01

M.Cur. The study on ‘Sustainability of midwifery practice within the South African healthcare system’ is stimulated by the lack of research that influences policy to support midwifery practice in South Africa. The poor database and health information systems for midwives result in the poor performance of maternal healthcare in the public sector (Parkhurst, Penn- Kekana, Blaauw, Balabanova, Danishevski, Rahman, Onama, & Ssengooba 2005) in spite of meeting the Safe Motherhood Initiative of t...

Critical success factors in implementing an e-rostering system in a healthcare organisation.

Science.gov (United States)

Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

2017-01-01

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

An integrated healthcare enterprise information portal and healthcare information system framework.

Science.gov (United States)

Hsieh, S L; Lai, Feipei; Cheng, P H; Chen, J L; Lee, H H; Tsai, W N; Weng, Y C; Hsieh, S H; Hsu, K P; Ko, L F; Yang, T H; Chen, C H

2006-01-01

The paper presents an integrated, distributed Healthcare Enterprise Information Portal (HEIP) and Hospital Information Systems (HIS) framework over wireless/wired infrastructure at National Taiwan University Hospital (NTUH). A single sign-on solution for the hospital customer relationship management (CRM) in HEIP has been established. The outcomes of the newly developed Outpatient Information Systems (OIS) in HIS are discussed. The future HEIP blueprints with CRM oriented features: e-Learning, Remote Consultation and Diagnosis (RCD), as well as on-Line Vaccination Services are addressed. Finally, the integrated HEIP and HIS architectures based on the middleware technologies are proposed along with the feasible approaches. The preliminary performance of multi-media, time-based data exchanges over the wireless HEIP side is collected to evaluate the efficiency of the architecture.

Accounting System in Croatian Public Healthcare Organizations: an Empirical Analysis

Directory of Open Access Journals (Sweden)

Davor VAŠIČEK

2010-06-01

Full Text Available In considering the adequacy of adopting accruals and IPSASs, this paper tests the appropriateness of existing modified accrual accounting and financial reporting system in Croatian public healthcare sector. The paper indicates that accounting information system contains discrepancies and constraints in assuring true and fair view of organization’s financial position and performance. Our statistics confirms low level of cost and managerial accounting methods development, and external and internal financial reporting convergence.Having in mind its specificities, we argue that Croatian public healthcare sector represents a segmental accounting subsystem within the integral public sector accounting framework, where accruals implementation might prove justifiable.

Healthcare systems, the State, and innovation in the pharmaceutical industry

Directory of Open Access Journals (Sweden)

Ignacio José Godinho Delgado

Full Text Available Abstract: This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist, in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry.

PALLIATIVE CARE – ITS ROLE IN HEALTHCARE SYSTEMS

Directory of Open Access Journals (Sweden)

Urška Lunder

2003-11-01

Full Text Available Background. In the last decades a palliative care has been well established in the majority of West European countries. However, majority of these countries are not able to follow needs for palliative care because of demographic changes (older population, changes of morbidity pattern (increase of chronic progressive diseases and social changes (disability of families to care for their relatives at their homes. Research is showing evidence on palliative care effectiveness at end of life and in bereavement. There is still a great need for healthcare professionals’ change in their attitudes, knowledge and skills. In many National strategic plans (United Kingdom, Ireland, Sweden, Australia, New Zealand and Canada palliative care becomes a priority in the national public health. New organizational planning supports establishement of palliative care departments in hospitals and other healthcare settings and consultant teams at all levels of healthcare system. Hospices, caritative and independent organizations, will remain as a source of good clinical practice and philosophy of care at the end of life also in the future.

Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

Science.gov (United States)

Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

2016-10-01

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

BSNCare+: A Robust IoT-Oriented Healthcare System with Non-Repudiation Transactions

Directory of Open Access Journals (Sweden)

Kuo-Hui Yeh

2016-12-01

Full Text Available Recently, the rapid advancement in technologies of modern intelligent objects has led to a new network paradigm, called the Internet of Things (IoT, in which every networked and automated object has been connected in a pervasive manner. New types of IoT-based application services are thus presented. In a healthcare oriented environment, the usage of IoT has brought opportunities for assisting physicians (or nurses to provide on-demand and real-time body-care services to patients with higher accuracy and better efficiency. However, while IoT-oriented techniques deliver such advantages, they may encounter system security vulnerabilities and patient privacy threats not seen in the past. In this paper, we propose a robust IoT-based healthcare system, called BSNCare+, in which body sensor networks (BSNs are adopted as the underlying communication architecture. In the proposed healthcare system, we exploit lightweight crypto-primitives to construct a secure communication mechanism that does achieve data confidentiality and entity authentication among intelligent body sensors, the mobile gateway and the backend BSN-Care server. In addition, we evaluate the performance of the proposed healthcare system using the Raspberry PI series platform. The results show the practicability and feasibility of BSNCare+.

The Swedish dilemma - Nuclear energy v. the environment

International Nuclear Information System (INIS)

Nordhaus, W.D.

1995-11-01

A phaseout of nuclear power in Sweden is supposed to be accomplished by year 2010. This study is an economic analysis of the questions that are parts of the nuclear dilemma. Even though the economic questions are in focus, the important environmental, health and safety questions are also treated. The basic argument is that Sweden should choose an energy system that allows its citizens to maximize their consumption in a long-term perspective. Consumption is here given a meaning that includes elements outside the market, such as environmental, health and safety aspects valued in a reasonable way. Considerations must also be given to international aspects like global environment, a free and open system of trade and the value of a stable set of rules and proprietary rights. The study compares the economic pros and cons of different energy systems within this general frame. A detailed model of the Swedish energy and power sectors was developed for the study, called the Swedish Energy and Environment Policy (SEEP) model. the SEEP model is built on modern economic theory and includes energy and environmental factors in a uniform way. 8 figs 16 tabs

The Swedish dilemma - Nuclear energy v. the environment

Energy Technology Data Exchange (ETDEWEB)

Nordhaus, W D [Yale Univ. (United States)

1995-11-01

A phaseout of nuclear power in Sweden is supposed to be accomplished by year 2010. This study is an economic analysis of the questions that are parts of the nuclear dilemma. Even though the economic questions are in focus, the important environmental, health and safety questions are also treated. The basic argument is that Sweden should choose an energy system that allows its citizens to maximize their consumption in a long-term perspective. Consumption is here given a meaning that includes elements outside the market, such as environmental, health and safety aspects valued in a reasonable way. Considerations must also be given to international aspects like global environment, a free and open system of trade and the value of a stable set of rules and proprietary rights. The study compares the economic pros and cons of different energy systems within this general frame. A detailed model of the Swedish energy and power sectors was developed for the study, called the Swedish Energy and Environment Policy (SEEP) model. the SEEP model is built on modern economic theory and includes energy and environmental factors in a uniform way. 8 figs 16 tabs.

A Systems Approach to Healthcare Innovation Using the MIT Hacking Medicine Model.

Science.gov (United States)

Gubin, Tatyana A; Iyer, Hari P; Liew, Shirlene N; Sarma, Aartik; Revelos, Alex; Ribas, João; Movassaghi, Babak; Chu, Zen M; Khalid, Ayesha N; Majmudar, Maulik D; Lee, Christopher Xiang

2017-07-26

MIT Hacking Medicine is a student, academic, and community-led organization that uses systems-oriented "healthcare hacking" to address challenges around innovation in healthcare. The group has organized more than 80 events around the world that attract participants with diverse backgrounds. These participants are trained to address clinical needs from the perspective of multiple stakeholders and emphasize utility and implementation viability of proposed solutions. We describe the MIT Hacking Medicine model as a potential method to integrate collaboration and training in rapid innovation techniques into academic medical centers. Built upon a systems approach to healthcare innovation, the time-compressed but expertly guided nature of the events could enable more widely accessible preliminary training in systems-level innovation methodology, as well as creating a structured opportunity for interdisciplinary congregation and collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.

Executable Design Models for a Pervasive Healthcare Middleware System

DEFF Research Database (Denmark)

Jørgensen, Jens Bæk; Christensen, Søren

2002-01-01

 UML is applied in the design of a pervasive healthcare middleware system for the hospitals in Aarhus County, Denmark. It works well for the modelling of static aspects of the system, but with respect to describing the behaviour, UML is not sufficient. This paper explains why and, as a remedy, su...

Yoga Therapy in the German Healthcare System.

Science.gov (United States)

Cramer, Holger

2018-05-09

An estimated 15.7 million Germans are currently practicing yoga or are at least interested in starting to practice, and they often perceive yoga as a therapeutic approach. From a healthcare system perspective, the situation is less clear. Here, yoga is only recognized as a recreational or preventive activity. When yoga teachers fulfill specific qualifications, their preventive yoga classes are covered by the statutory health insurances. Only those with additional qualifications in medicine or psychotherapy, however, can independently use and promote "yoga therapy." The general perception of yoga in Germany as a preventive practice is reflected in the professional organization of yoga providers. Most providers are considered to be yoga teachers rather than yoga therapists and are organized mainly in yoga teacher associations. Despite the uncertain legal framework, yoga is now considered in a number of medical guidelines; in a number of hospitals, yoga is part of multimodal inpatient treatment programs and is delivered by physical therapists or members of other health professions. An increasing number of yoga therapy clinical trials are conducted in Germany, and efforts are underway to establish yoga therapy as an accepted adjunct treatment approach for selected medical conditions within the German healthcare system.

Classification of Swedish Learner Essays by CEFR Levels

Science.gov (United States)

Volodina, Elena; Pilán, Ildikó; Alfter, David

2016-01-01

The paper describes initial efforts on creating a system for the automatic assessment of Swedish second language (L2) learner essays from two points of view: holistic evaluation of the reached level according to the Common European Framework of Reference (CEFR), and the lexical analysis of texts for receptive and productive vocabulary per CEFR…

A Swedish Mutual Support Society of Problem Gamblers

Science.gov (United States)

Binde, Per

2012-01-01

Mutual support societies for problem gamblers have existed in Sweden for 20 years. They have helped more people with gambling problems than any other institution inside or outside the Swedish health care system. This paper outlines the background of these societies and describes the meetings of one of them. Data come from interviews with members…

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C. S.; Friedman, C. P.; Douglas, G.; Miller, D. J.

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations. PMID:10566414

The chief nurse executive role in large healthcare systems.

Science.gov (United States)

Englebright, Jane; Perlin, Jonathan

2008-01-01

Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C S; Friedman, C P; Douglas, G; Miller, D J

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations.

Bringing Big Data to the Forefront of Healthcare Delivery: The Experience of Carolinas HealthCare System.

Science.gov (United States)

Dulin, Michael F; Lovin, Carol A; Wright, Jean A

2017-01-01

The use of big data to transform care delivery is rapidly becoming a reality. To deliver on the promise of value-based care, providers must know the key drivers of wellness at the patient and community levels, as well as understand resource constraints and opportunities to improve efficiency in the health-care system itself. Data are the linchpin. By gathering the right data and finding innovative ways to glean knowledge, we can improve clinical care, advance the health of our communities, improve the lives of our patients, and operate more efficiently. At Carolinas HealthCare System-one of the nation's largest health-care systems, with nearly 12 million patient encounters annually at more than 900 care locations-we have made substantial investments to establish a centralized data and analytics infrastructure that is transforming the way we deliver care across the continuum. Although the impetus and vision for our program have evolved over the past decade, our efforts coalesced into a strategic, centralized initiative with the launch of the Dickson Advanced Analytics (DA) group in 2012. DA has yielded significant gains in our ability to use data, not only for reporting purposes and understanding our business but also for predicting outcomes and informing action.While these efforts have been successful, the path has not been easy. Effectively harnessing big data requires navigating myriad technological, cultural, operational, and other hurdles. Building a program that is feasible, effective, and sustainable takes concerted effort and a rigorous process of continuous self-evaluation and strategic adaptation.

Bringing Big Data to the Forefront of Healthcare Delivery: The Experience of Carolinas HealthCare System.

Science.gov (United States)

Dulin, Michael F; Lovin, Carol A; Wright, Jean A

2016-01-01

The use of big data to transform care delivery is rapidly becoming a reality. To deliver on the promise of value-based care, providers must know the key drivers of wellness at the patient and community levels, as well as understand resource constraints and opportunities to improve efficiency in the healthcare system itself. Data are the linchpin. By gathering the right data and finding innovative ways to glean knowledge, we can improve clinical care, advance the health of our communities, improve the lives of our patients, and operate more efficiently. At Carolinas HealthCare System-one of the nation's largest healthcare systems, with nearly 12 million patient encounters annually at more than 900 care locations-we have made substantial investments to establish a centralized data and analytics infrastructure that is transforming the way we deliver care across the continuum. Although the impetus and vision for our program have evolved over the past decade, our efforts coalesced into a strategic, centralized initiative with the launch of the Dickson Advanced Analytics (DA2) group in 2012. DA2 has yielded significant gains in our ability to use data, not only for reporting purposes and understanding our business but also for predicting outcomes and informing action.While these efforts have been successful, the path has not been easy. Effectively harnessing big data requires navigating myriad technological, cultural, operational, and other hurdles. Building a program that is feasible, effective, and sustainable takes concerted effort and a rigorous process of continuous self-evaluation and strategic adaptation.

The Swedish National Defence Research Establishment and the plans for Swedish nuclear weapons

International Nuclear Information System (INIS)

Jonter, Thomas

2001-03-01

This study analyses the Swedish nuclear weapons research since 1945 carried out by the Swedish National Defence Research Establishment (FOA). The most important aspect of this research was dealing with protection in broad terms against nuclear weapons attacks. However, another aspect was also important from early on - to conduct research aiming at a possible production of nuclear weapons. FOA performed an extended research up to 1968, when the Swedish Government signed the Non-Proliferation Treaty (NPT), which meant the end of these production plans. Up to this date, five main investigations about the technical conditions were made, 1948, 1953, 1955, 1957 and 1965, which all together expanded the Swedish know-how to produce a bomb. The Swedish plans to procure nuclear weapons were not an issue in the debate until the mid 50's. The reason for this was simple, prior to 1954 the plans were secretly held within a small group of involved politicians, military and researchers. The change of this procedure did take place when the Swedish Supreme Commander in a public defence report in 1954 favoured a Swedish Nuclear weapons option. In 1958 FOA had reached a technical level that allowed the Parliament to make a decision. Two programs were proposed - the L-programme (the Loading Programme), to be used if the parliament would say yes to a production of nuclear weapons, and the S-programme (the Protection Programme), if the Parliament would say no. The debate on the issue had now created problems for the Social Democratic Government. The Prime Minister, Tage Erlander, who had earlier defended a procurement of nuclear weapons, was now forced to reach a compromise. The compromise was presented to the parliament in a creative manner that meant that only the S-programme would be allowed. The Government argued that the technical level did allow a 'freedom of action' up to at least the beginning of the 60's when Sweden was mature to make a decision on the issue. During this period

Local fisheries management at the Swedish coast: biological and social preconditions.

Science.gov (United States)

Bruckmeier, Karl; Neuman, Erik

2005-03-01

Most of the Swedish coastal fisheries are not sustainable from either a social, economic or ecological point of view. We propose the introduction of local fisheries management (LFM) as a tool for restructuring the present large-scale management system in order to achieve sustainability. To implement LFM two questions need to be answered: How to distribute the resource fish among different resource user groups? How to restructure present fisheries management to meet the criteria of sustainability? Starting from these questions we describe possible forms of LFM for Swedish coastal fishery supported by recent research. The biological and social preconditions for restructuring fisheries management are derived from an analysis of the ecological and managerial situation in Swedish fishery. Three types of LFM--owner based, user based, and community based management--are analyzed with regard to the tasks to be carried outin LFM, the roles of management groups, and the definition and optimal size of management areas.

Pathways towards chronic care-focused healthcare systems: evidence from Spain.

Science.gov (United States)

García-Goñi, Manuel; Hernández-Quevedo, Cristina; Nuño-Solinís, Roberto; Paolucci, Francesco

2012-12-01

Increasing healthcare expenditure is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation that include ageing, medical innovation, and changes in the burden of disease, such as the growing prevalence of chronic diseases. Most healthcare systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and therefore they are not suitably or efficiently organized to respond to the changing needs and preferences of users. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in several different countries showing their advantages but also the difficulties associated with their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies focused on testing the feasibility of moving towards chronic care models. In particular, we discuss a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based healthcare systems and apply it to the current Spanish National Health System (NHS). We find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts. We outline the policies that are being implemented and the pathway that the Spanish NHS is taking to address the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy being followed by the Spanish NHS will significantly transform its current healthcare delivery model in the next few years. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Swedish Opinion on Nuclear Power 1986 - 2011

Energy Technology Data Exchange (ETDEWEB)

Holmberg, Soeren

2012-11-01

This report contains the Swedish opinion on Nuclear Power and European Attitudes on Nuclear Power. It also includes European Attitudes Towards the Future of Three Energy Sources; Nuclear Energy, Wind Power and Solar Power - with a focus on the Swedish opinion. Results from measurements done by the SOM Inst. are presented.

Zero tolerance against patriarchal norms? A cross-sectional study of Swedish physicians' attitudes towards young females requesting virginity certificates or hymen restoration.

Science.gov (United States)

Juth, Niklas; Lynöe, Niels

2015-03-01

Many countries, Sweden among them, lack professional guidelines and established procedures for responding to young females requesting virginity certificates or hymen restoration due to honour-related threats. The purpose of the present survey study was to further examine the attitudes of the Swedish healthcare professionals concerned towards young females requesting virginity certificates or hymen restorations. The study indicates that a small majority of Swedish general practitioners and gynaecologists would accommodate these patients, at least given certain circumstances. But a large minority of physicians would under no circumstances help the young females, regardless of speciality, years of practice within medicine, gender, or experience of the phenomenon. Their responses are similar to other areas where it has been claimed that society should adopt a zero tolerance policy against certain phenomena, for instance drug policy, where it has also been argued that society should never act in ways that express support for the practice in question. However, this argument is questionable. A more pragmatic approach would also allow for follow-ups and evaluation of virginity certificates and hymen restorations, as is demonstrated by the Dutch policy. Hence, there are some obvious advantages to this pragmatic approach compared to the restrictive one espoused by a large minority of Swedish physicians and Swedish policy-makers in this area. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Operational Experience from Swedish nuclear power plants 1996

International Nuclear Information System (INIS)

1997-01-01

A summary of two pages is given for each Swedish reactor with data on availability, scrams, radiation doses and important events during 1996. Special reports are presented on the following issues: Reactor core spray system inoperable at OKG-2, Containment pressure relief system incorrectly closed at Forsmark-1, Isolation condenser blocked for residual heat and continued operation with defective isolation valve at OKG-1; and Degraded pressure suppression function of the containment at Barsebaeck-2

The Value That Infectious Diseases Physicians Bring to the Healthcare System.

Science.gov (United States)

McQuillen, Daniel P; MacIntyre, Ann T

2017-09-15

While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare. We discuss data showing that ID physicians improve clinical outcomes, positively impact transitions of care, and direct system-level improvements through infection prevention and antimicrobial stewardship. We identify areas where value-based care provides additional future opportunities for ID physicians. A Clinical Affairs Committee-sponsored study of ID physicians' positive impact on patient outcomes shows that few medical specialties are better positioned to positively impact the Triple Aim approach-better health, better care, and lower per capita cost-that is the principle tenet of healthcare system reform. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A post-Bertalanffy Systemics Healthcare Competitive Framework Proposal.

Science.gov (United States)

Fiorini, Rodolfo A; Santacroce, Giulia F

2014-01-01

Health Information community can take advantage of a new evolutive categorization cybernetic framework. A systemic concept of principles organizing nature is proposed. It can be used as a multiscaling reference framework to develop successful and competitive antifragile system and new HRO information management strategies in advanced healthcare organization (HO) and high reliability organization (HRO) conveniently. Expected impacts are multifarious and quite articulated at different system scale level: major one is that, for the first time, Biomedical Engineering ideal system categorization levels can be matched exactly to practical system modeling interaction styles, with no paradigmatic operational ambiguity and information loss.

The Design and Analysis of a Secure Personal Healthcare System Based on Certificates

Directory of Open Access Journals (Sweden)

Jungho Kang

2016-11-01

Full Text Available Due to the development of information technology (IT, it has been applied to various fields such as the smart home, medicine, healthcare, and the smart car. For these fields, IT has been providing continuous prevention and management, including health conditions beyond the mere prevention of disease, improving the quality of life. e-Healthcare is a health management and medical service to provide prevention, diagnosis, treatment, and the follow-up management of diseases at any time and place in connection with information communication technology, without requiring patients to visit hospitals. However, e-Healthcare has been exposed to eavesdropping, manipulation, and the forgery of information that is personal, biological, medical, etc., and is a security threat from malicious attackers. This study suggests a security service model to exchange personal health records (PHRs for e-Healthcare environments. To be specific, this study suggests a scheme in which communicators are able to securely authorize and establish security channels by constituting the infrastructure each organization relies on. In addition, the possibility of establishing a security service model is indicated by suggesting an e-Healthcare system for a secure e-Healthcare environment as a secure personal health record system. This is anticipated to provide securer communication in e-Healthcare environments in the future through the scheme suggested in this study.

Transitioning from learning healthcare systems to learning health care communities.

Science.gov (United States)

Mullins, C Daniel; Wingate, La'Marcus T; Edwards, Hillary A; Tofade, Toyin; Wutoh, Anthony

2018-02-26

The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care. Addressing the LHS framework implementation challenges and utilizing community levers are requisite components of a learning health care community model, version two of the LHS archetype.

Healthcare system and the wealth-health gradient: a comparative study of older populations in six countries.

Science.gov (United States)

Maskileyson, Dina

2014-10-01

The present study provides a comparative analysis of the association between wealth and health in six healthcare systems (Sweden, the United Kingdom, Germany, the Czech Republic, Israel, the United States). National samples of individuals fifty years and over reveal considerable cross-country variations in health outcomes. In all six countries wealth and health are positively associated. The findings also show that state-based healthcare systems produce better population health outcomes than private-based healthcare systems. The results indicate that in five out of the six countries studied, the wealth-health gradients were remarkably similar, despite significant variations in healthcare system type. Only in the United States was the association between wealth and health substantially different from, and much greater than that in the other five countries. The findings suggest that private-based healthcare system in the U.S. is likely to promote stronger positive associations between wealth and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

X-PAT: a multiplatform patient referral data management system for small healthcare institution requirements.

Science.gov (United States)

Masseroli, Marco; Marchente, Mario

2008-07-01

We present X-PAT, a platform-independent software prototype that is able to manage patient referral multimedia data in an intranet network scenario according to the specific control procedures of a healthcare institution. It is a self-developed storage framework based on a file system, implemented in eXtensible Markup Language (XML) and PHP Hypertext Preprocessor Language, and addressed to the requirements of limited-dimension healthcare entities (small hospitals, private medical centers, outpatient clinics, and laboratories). In X-PAT, healthcare data descriptions, stored in a novel Referral Base Management System (RBMS) according to Health Level 7 Clinical Document Architecture Release 2 (CDA R2) standard, can be easily applied to the specific data and organizational procedures of a particular healthcare working environment thanks also to the use of standard clinical terminology. Managed data, centralized on a server, are structured in the RBMS schema using a flexible patient record and CDA healthcare referral document structures based on XML technology. A novel search engine allows defining and performing queries on stored data, whose rapid execution is ensured by expandable RBMS indexing structures. Healthcare personnel can interface the X-PAT system, according to applied state-of-the-art privacy and security measures, through friendly and intuitive Web pages that facilitate user acceptance.

Global health education in Swedish medical schools.

Science.gov (United States)

Ehn, S; Agardh, A; Holmer, H; Krantz, G; Hagander, L

2015-11-01

Global health education is increasingly acknowledged as an opportunity for medical schools to prepare future practitioners for the broad health challenges of our time. The purpose of this study was to describe the evolution of global health education in Swedish medical schools and to assess students' perceived needs for such education. Data on global health education were collected from all medical faculties in Sweden for the years 2000-2013. In addition, 76% (439/577) of all Swedish medical students in their final semester answered a structured questionnaire. Global health education is offered at four of Sweden's seven medical schools, and most medical students have had no global health education. Medical students in their final semester consider themselves to lack knowledge and skills in areas such as the global burden of disease (51%), social determinants of health (52%), culture and health (60%), climate and health (62%), health promotion and disease prevention (66%), strategies for equal access to health care (69%) and global health care systems (72%). A significant association was found between self-assessed competence and the amount of global health education received (pcurriculum. Most Swedish medical students have had no global health education as part of their medical school curriculum. Expanded education in global health is sought after by medical students and could strengthen the professional development of future medical doctors in a wide range of topics important for practitioners in the global world of the twenty-first century. © 2015 the Nordic Societies of Public Health.

[The five commandments for preparing the Israeli healthcare system for emergencies].

Science.gov (United States)

Adini, Bruria; Laor, Danny; Cohen, Robert; Lev, Boaz; Israeli, Avi

2010-07-01

In the last decade, the Israeli healthcare system dealt with many casualties that resulted from terrorist actions and at the same time maintained preparedness for other potential hazards such as natural disasters, toxicological, chemical, radiological and biological events. There are various models for emergency preparedness that are utilized in different countries. The aim of the article is to present the structure and the methodology of the Israeli healthcare system for emergencies. Assuring emergency preparedness for the different scenarios is based on 5 major components that include: comprehensive contingency planning; control and command of operations; central control of readiness; capacity building; coordination and collaboration among the numerous emergency agencies. CLose working relationships between the military and civilian systems characterize the operations of the emergency system. There is a mutual sharing of information, coordinated operations to achieve risk assessment and determine priorities, and consensual allocation of resources. The ability of the medical system to operate in optimal coordination with interface bodies, including the Israel Defense Forces, is derived from three main elements: the shortage of resources necessitate that all agencies work together to develop an effective response to emergencies; the Israeli society is characterized by transition of personnel from the military to the civilian system which promotes joint operations, whereas in most other countries these systems are completely separated; and also developing mechanisms for continuous and coordinated operation in routine and emergency times, such as the Supreme Health Authority. The Israeli healthcare system was put to the test several times in the Last decade, during the terror wave that occurred between 2001-2006, the 2nd Lebanon War and in operation "Cast Lead". An extensive process of learning lessons, conducted during and following each of these periods, and the

Toward a Nationwide Mobile-Based Public Healthcare Service System with Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Chien-wen Shen

2016-01-01

Full Text Available This paper describes the development of a nationwide public healthcare service system with the integration of cloud technology, wireless sensor networks, and mobile technology to provide citizens with convenient and professional healthcare services. The basic framework of the system includes the architectures for the user end of wireless physiological examinations, for the regional healthcare cloud, and for national public healthcare service system. Citizens with chronic conditions or elderly people who are living alone can use the wireless physiological sensing devices to keep track of their health conditions and get warning if the system detects abnormal signals. Through mobile devices, citizens are able to get real-time health advice, prompt warning, health information, feedback, personalized support, and intervention ubiquitously. With the long-term tracking data for physiological sensing, reliable prediction models for epidemic diseases and chronic diseases can be developed for the government to respond to and control diseases immediately. Besides, such a nationwide approach enables government to have a holistic understanding of the public health information in real time, which is helpful to establish effective policies or strategies to prevent epidemic diseases or chronic diseases.

Demonstration and Dialogue: Mediation in Swedish Nuclear Waste Management. Deliverable D10

International Nuclear Information System (INIS)

Elam, Mark; Sundqvist, Goeran; Lidberg, Maria; Soneryd, Linda

2008-10-01

This report analyses mediation and mediators in Swedish nuclear waste management. Mediation is about establishing agreement and building common knowledge. It is argued that demonstrations and dialogue are the two prominent approaches to mediation in Swedish nuclear waste management. Mediation through demonstration is about showing, displaying, and pointing out a path to safe disposal for inspection. It implies a strict division between demonstrator and audience. Mediation through dialogue on the other hand, is about collective acknowledgements of uncertainty and suspensions of judgement creating room for broader discussion. In Sweden, it is the Swedish Nuclear Fuel and Waste Management Co. (SKB) that is tasked with finding a method and a site for the final disposal of the nation's nuclear waste. Two different legislative frameworks cover this process. In accordance with the Act on Nuclear Activities, SKB is required to demonstrate the safety of its planned nuclear waste management system to the government, while in respect of the Swedish Environmental Code, they are obliged to organize consultations with the public. How SKB combines these requirements is the main question under investigation in this report in relation to materials deriving from three empirical settings: 1) SKB's safety analyses, 2) SKB's public consultation activities and 3) the 'dialogue projects', initiated by other actors than SKB broadening the public arena for discussion. In conclusion, an attempt is made to characterise the long-term interplay of demonstration and dialogue in Swedish nuclear waste management

Processing Relative Clause Extractions in Swedish

Directory of Open Access Journals (Sweden)

Damon Tutunjian

2017-12-01

Full Text Available Relative clauses are considered strong islands for extraction across languages. Swedish comprises a well-known exception, allegedly allowing extraction from relative clauses (RCE, raising the possibility that island constraints may be subject to “deep variation” between languages. One alternative is that such exceptions are only illusory and represent “surface variation” attributable to independently motivated syntactic properties. Yet, to date, no surface account has proven tenable for Swedish RCEs. The present study uses eyetracking while reading to test whether the apparent acceptability of Swedish RCEs has any processing correlates at the point of filler integration compared to uncontroversial strong island violations. Experiment 1 tests RCE against licit that-clause extraction (TCE, illicit extraction from a non-restrictive relative clause (NRCE, and an intransitive control. For this, RCE was found to pattern similarly to TCE at the point of integration in early measures, but between TCE and NRCE in total durations. Experiment 2 uses RCE and extraction from a subject NP island (SRCE to test the hypothesis that only non-islands will show effects of implausible filler-verb dependencies. RCE showed sensitivity to the plausibility manipulation across measures at the first potential point of filler integration, whereas such effects were limited to late measures for SRCE. In addition, structural facilitation was seen across measures for RCE relative to SRCE. We propose that our results are compatible with RCEs being licit weak island extractions in Swedish, and that the overall picture speaks in favor of a surface rather than a deep variation approach to the lack of island effects in Swedish RCEs.

The application of the unified modeling language in object-oriented analysis of healthcare information systems.

Science.gov (United States)

Aggarwal, Vinod

2002-10-01

This paper concerns itself with the beneficial effects of the Unified Modeling Language (UML), a nonproprietary object modeling standard, in specifying, visualizing, constructing, documenting, and communicating the model of a healthcare information system from the user's perspective. The author outlines the process of object-oriented analysis (OOA) using the UML and illustrates this with healthcare examples to demonstrate the practicality of application of the UML by healthcare personnel to real-world information system problems. The UML will accelerate advanced uses of object-orientation such as reuse technology, resulting in significantly higher software productivity. The UML is also applicable in the context of a component paradigm that promises to enhance the capabilities of healthcare information systems and simplify their management and maintenance.

Productivity changes in OECD healthcare systems: bias-corrected Malmquist productivity approach.

Science.gov (United States)

Kim, Younhee; Oh, Dong-Hyun; Kang, Minah

2016-10-01

This study evaluates productivity changes in the healthcare systems of 30 Organization for Economic Co-operation and Development (OECD) countries over the 2002-2012 periods. The bootstrapped Malmquist approach is used to estimate bias-corrected indices of healthcare performance in productivity, efficiency and technology by modifying the original distance functions. Two inputs (health expenditure and school life expectancy) and two outputs (life expectancy at birth and infant mortality rate) are used to calculate productivity growth. There are no perceptible trends in productivity changes over the 2002-2012 periods, but positive productivity improvement has been noticed for most OECD countries. The result also informs considerable variations in annual productivity scores across the countries. Average annual productivity growth is evenly yielded by efficiency and technical changes, but both changes run somewhat differently across the years. The results of this study assert that policy reforms in OECD countries have improved productivity growth in healthcare systems over the past decade. Countries that lag behind in productivity growth should benchmark peer countries' practices to increase performance by prioritizing an achievable trajectory based on socioeconomic conditions. For example, relatively inefficient countries in this study indicate higher income inequality, corresponding to inequality and health outcomes studies. Although income inequality and globalization are not direct measures to estimate healthcare productivity in this study, these issues could be latent factors to explain cross-country healthcare productivity for future research. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The actual status of the development of a Danish/Swedish system concept for a solar combisystem

DEFF Research Database (Denmark)

Fiedler, Frank; Bales, Chris; Thür, Alexander

2005-01-01

partners a system concept has been developed that is characterized by its high compactness and flexibility. It allows the use of different types of boilers, heating distribution systems and a variable store and collector size. Two prototypes have been built, one for the Danish market with a gas boiler......, and one for the Swedish market with a pellet boiler as auxiliary heater. After intensive testing and eventual further improvements at least two systems will be installed and monitored in demonstration houses. The systems have been modeled in TRNSYS and the simulation results will be used to further...... and Sweden it has been decided to develop a common system concept for both countries, which increases the market potential for the manufacturer. The focus of the development is on systems for the large number of rather well insulated existing single family houses. In close collaboration with the industrial...

Healthcare waste generation and its management system: the case ...

African Journals Online (AJOL)

Healthcare waste generation and its management system: the case of health ... of an environmental risk to health care workers, the public and the environment at large. ... Only four out of ten health centers used local type of incinerators, while ...

[Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

Science.gov (United States)

Roig, Francesc; Saigí, Francesc

2011-01-01

Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Swedish Industry and Kyoto. An Assessment of the Effects of the European CO2 Emission Permit Trading System

International Nuclear Information System (INIS)

Braennlund, Runar; Lundgren, Tommy

2005-01-01

We assess the effects on Swedish industry input and output demands of different climate policy scenarios connected to energy policy induced by the Kyoto protocol. A unique data set containing firm level data on outputs and inputs during the years 1991-2001 is used to estimate a factor demand model, which is then simulated for different policy scenarios. Sector specific estimation suggests that the proposed quadratic profit function specification exhibit properties and robustness that are consistent with economic theory; that is, all own-price elasticities are negative and all output elasticities are positive. Furthermore, the elasticities show that the input demands are, in most cases, relatively inelastic. Simulation of the model for 6 different policy scenarios reveal that the effects on Swedish base industry of a EU level permit trade system is dependent on (i) removal or no removal of current CO 2 tax, (ii) the established price of permits, and (iii) what will happen to the electricity price. Our analysis show that changes in electricity price may be more important than the price of permits for some sectors

Does EU ETS lead to emission reductions through trade? The case of the Swedish emissions trading sector participants

International Nuclear Information System (INIS)

Sandoff, Anders; Schaad, Gabriela

2009-01-01

The first trading period of the European Emissions Trading Scheme (EU ETS) has recently come to an end. The experiences of the actors in the trading sector will be of great importance in evaluating the aim and direction of this 'Grand Policy Experiment'. This paper gives an account of the attitudes and actions of the companies included in the Swedish emissions trading sector after about 15 months of experience with the system. The data are based on a study commissioned by the Swedish Environmental Protection Agency, and is a comprehensive survey that encompasses all companies operating installations included in the Swedish Emission Trading Registry. However, the results point in a somewhat disquieting direction. Although the Swedish companies have shown significant interest in reducing emissions, this survey indicates that this is done without close attention to the pricing mechanism of the market-based instruments. If this praxis is widespread within the European trading sector, it can have a serious negative effect on the efficiency of the system.

Infrastructuring Multicultural Healthcare Information Systems

DEFF Research Database (Denmark)

Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik

2017-01-01

This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study...... of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare....

Does advanced practice in radiography benefit the healthcare system? A literature review.

Science.gov (United States)

Thom, S E

2018-02-01

With ever-increasing demands on the National Health Service (NHS), members of staff are blurring their professional boundaries in the attempt to benefit the healthcare system. This review aims to establish whether advancing practice within radiography does benefit the healthcare system by examining published literature. Key words were input into databases such as: CINAHL, Science Direct and PubMed. Various filters were applied to narrow down the articles. Key themes were identified within the literature: cost, job satisfaction, patient benefits, restrictions and workload. Having advanced practitioners undertake some of the radiologists' workload was potentially cost effective whilst continuing/increasing the standard of quality. Patients benefitted from the quality of their examinations, the high accuracy of their reports and the speed those reports were attained. Evidence within the literature emphasises that advanced practice does benefit the healthcare system by means of: cost reduction, job satisfaction, patient benefits and workload. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Accounting Information Systems in Healthcare: A Review of the Literature.

Science.gov (United States)

Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

2017-01-01

As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

A system dynamics approach for healthcare waste management: a case study in Istanbul Metropolitan City, Turkey.

Science.gov (United States)

Ciplak, Nesli; Barton, John R

2012-06-01

Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75-90% of this waste is classified as 'domestic' in nature, 20-25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year(-1) of healthcare waste by 2025 and almost 10 000 t year(-1) by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

Science.gov (United States)

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Swedish women's perceptions of and conformity to feminine norms.

Science.gov (United States)

Kling, Johanna; Holmqvist Gattario, Kristina; Frisén, Ann

2017-06-01

The relatively high gender equality in the Swedish society is likely to exert an influence on gender role construction. Hence, the present research aimed to investigate Swedish women's perceptions of and conformity to feminine norms. A mixed methods approach with two studies was used. In Study 1, young Swedish women's gender role conformity, as measured by the Conformity to Feminine Norms Inventory 45 (CFNI-45), was compared to the results from previously published studies in Canada, the United States, and Slovakia. Overall, Swedish women displayed less conformity than their foreign counterparts, with the largest difference on the subscale Sexual fidelity. In Study 2, focus group interviews with young Swedish women added a more complex picture of feminine norms in the Swedish society. For instance the results indicated that Swedish women, while living in a society with a strong gender equality discourse, are torn between the perceived need to invest in their appearances and the risk of being viewed as non-equal when doing so. In sum, despite the fact that traditional gender roles are less pronounced in Sweden, gender role conformity is still a pressing issue. Since attending to the potential roles of feminine norms in women's lives previously has been proposed to be useful in counseling and therapeutic work, the present research also offers valuable information for both researchers and practitioners. [Correction added on 5 May 2017, after first online publication in April 2017: An incorrect Abstract was inadvertently captured in the published article and has been corrected in this current version.]. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

The nuclear waste issue in Swedish mass media

International Nuclear Information System (INIS)

Hedberg, P.

1991-04-01

This is an investigation of the representation given in the Swedish mass media of questions concerning the nuclear waste. The investigation covers the period from 1979 to 1989 of 8 newspapers of different political colours and the Swedish radio and television. (KAE)

Swedish Taxation Since 1862: An Overview

OpenAIRE

Henrekson, Magnus; Stenkula, Mikael

2015-01-01

This paper examines the development of taxation in Sweden from 1862 to 2013. The examination covers six key aspects of the Swedish tax system: the taxation of labor income, capital income, consumption, inheritance and gift, wealth and real estate. The importance of these taxes varied greatly over time and Sweden increasingly relied on broad-based taxes (such as income taxes and general consumption taxes) and taxes that were less visible to the public (such as payroll taxes and social security...

Views of Swedish commissioning parents relating to the exploitation discourse in using transnational surrogacy

OpenAIRE

Arvidsson, Anna; Johnsdotter, Sara; Essén, Birgitta

2015-01-01

Transnational surrogacy, when people travel abroad for reproduction with the help of a surrogate mother, is a heavily debated phenomenon. One of the most salient discourses on surrogacy is the one affirming that Westerners, in their quest for having a child, exploit poor women in countries such as India. As surrogacy within the Swedish health care system is not permitted, Swedish commissioning parents have used transnational surrogacy, and the majority has turned to India. This interview stud...

The Swedish programme for radioactive waste management

International Nuclear Information System (INIS)

Bjurstroem, S.; Forsstroem, H.

1986-10-01

The following systems and facilities are currently in operation and under implementation: a sea transportation system for all kinds of nuclear waste, a central facility for interim storage of spent fuel (CLAB) and a central underground repository for final disposal of low and medium level reactor waste (SFR). For the remaining steps - final disposal of highly active and longlived radioactive residues - a concept, based on encapsulation of the fuel elements in copper canisters and final storage of the canisters in a repository situated 500 m down in crystalline rock (KBS-3), has been developed and approved by the government in accordance with the Swedish nuclear legislation. Although a feasible method for final disposal of the highly active residues has been shown, the Swedish legislation requires that research be carried out to reach the best possible base for the final decision around the year 2000. In parallel with this a geological investigation programme is carried out to find a suitable site for a final repository. The final site selection is foreseen at the end of the 1990's. All costs for the management of radioactive waste from the nuclear power plants are carried by a fee determined annually. The fee is 0.019 SEK/kWh for 1986

Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

Science.gov (United States)

Hörberg, Ulrica; Erlingsson, Christen; Syrén, Susanne

2015-01-01

Being healthcare professionals in the complex field of forensic psychiatry care (FPC) seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer's philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient's care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one's own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family's resources. PMID:26448874

UP-report. The power system. Basis of the Development platform. Power to Swedish Energy Agency's strategy work FOKUS; UP-rapport. Kraftsystemet. Underlag fraan Utvecklingsplattformen. Kraft till Energimyndighetens strategiarbete FOKUS

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-11-01

The report serves as input to to Swedish Energy Agency's strategies and priorities for research and innovation in the power system for the period 2011 - 2016. The report has been compiled by members of the development platform Kraft. This report provides background and circumstances for the power system theme, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and skills that enabled the Swedish Energy Agency to then develop a strategy that meets the needs of society and business.

Addiction and recovery : perceptions among professionals in the Swedish treatment system

OpenAIRE

Samuelsson, Eva; Blomqvist, Jan; Christophs, Irja

2013-01-01

AIMS - The objective of the study was to explore perceptions of different addictions among Swedish addiction care personnel. DATA - A survey was conducted with 655 addiction care professionals in the social services, health care and criminal care in Stockholm County. Respondents were asked to rate the severity of nine addictions as societal problems, the individual risk to getting addicted, the possibilities for self-change and the perceived significance of professional treatment in finding a...

Physician leadership: a health-care system's investment in the future of quality care.

Science.gov (United States)

Orlando, Rocco; Haytaian, Marcia

2012-08-01

The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system.

Ensuring the security and privacy of information in mobile health-care communication systems

Directory of Open Access Journals (Sweden)

Ademola P. Abidoye

2011-09-01

Full Text Available The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hospital. With the implementation of electronic patient records and the Internet and Intranets, medical information sharing amongst relevant health-care providers was made possible. But the vital issue in this method of information sharing is security: the patient’s privacy, as well as the confidentiality and integrity of the health-care information system, should not be compromised. We examine various ways of ensuring the security and privacy of a patient’s electronic medical information in order to ensure the integrity and confidentiality of the information.

Hand hygiene and healthcare system change within multi-modal promotion: a narrative review.

Science.gov (United States)

Allegranzi, B; Sax, H; Pittet, D

2013-02-01

Many factors may influence the level of compliance with hand hygiene recommendations by healthcare workers. Lack of products and facilities as well as their inappropriate and non-ergonomic location represent important barriers. Targeted actions aimed at making hand hygiene practices feasible during healthcare delivery by ensuring that the necessary infrastructure is in place, defined as 'system change', are essential to improve hand hygiene in healthcare. In particular, access to alcohol-based hand rubs (AHRs) enables appropriate and timely hand hygiene performance at the point of care. The feasibility and impact of system change within multi-modal strategies have been demonstrated both at institutional level and on a large scale. The introduction of AHRs overcomes some important barriers to best hand hygiene practices and is associated with higher compliance, especially when integrated within multi-modal strategies. Several studies demonstrated the association between AHR consumption and reduction in healthcare-associated infection, in particular, meticillin-resistant Staphylococcus aureus bacteraemia. Recent reports demonstrate the feasibility and success of system change implementation on a large scale. The World Health Organization and other investigators have reported the challenges and encouraging results of implementing hand hygiene improvement strategies, including AHR introduction, in settings with limited resources. This review summarizes the available evidence demonstrating the need for system change and its importance within multi-modal hand hygiene improvement strategies. This topic is also discussed in a global perspective and highlights some controversial issues. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Intercultural and Interlinguistical Mediation in the Healthcare System: The Challenge of Conflict Management

Directory of Open Access Journals (Sweden)

Federico Farini

2008-09-01

Full Text Available Nowadays, young women and their children are the most important migrant users of health-care services. In particular, these people may encounter different cultural constructions of health, disease, therapy, and motherhood. The observed difficulties in intercultural communication encourage healthcare systems to promote mediation. Mediation consists of the intervention of a third person, who promotes reciprocal understanding and acceptance between participants. The research presented in this article focuses on the intercultural communication that is produced in these services between health-care personnel and migrant patients. To achieve this goal, the research aims at integrating different theoretical and methodological approaches: conversation analysis, in order to observe the interaction between healthcare personnel and patients, pointing out the cues of the participants’ turn-taking sequences; analysis of the cultural presuppositions of the healthcare system as a communication system with a specific function in society, by highlighting contextualization cues, that is, cultural presuppositions that steer the interaction system, which result from the wider social context and are cues of the cultural identities that characterize it. It was observed that the patients in most cases have very few opportunities to answer the physicians’ questions or to pose questions or doubts. Substituting the patients as the main participants in interactions, the mediator never refuses the physicians’ indications, never expresses doubts, and never asks the patients if they have some reason to doubt or refuse. In these cases, interlinguistic and intercultural mediation de-emphasizes the importance of the larger social context, of the durability of relationships between the parties, and of their social and political recognition.

Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

Directory of Open Access Journals (Sweden)

Hong J. Kan

2013-01-01

Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

Public health, healthcare, health and inequality in health in the Nordic countries

DEFF Research Database (Denmark)

Christiansen, Terkel; Lauridsen, Jørgen Trankjær; Kifmann, Mathias

2018-01-01

-economic equality in health. Each of the five countries has established extensive public health programmes, although with somewhat different measures to increase health of the populations. We compare these countries to the UK and Germany by using data from the European Social Survey for 2002 and 2012 in addition......All five Nordic countries emphasize equal and easy access to healthcare, assuming that increased access to healthcare leads to increased health. It is the purpose of the present study to explore to which extent the populations of these countries have reached good health and a high degree of socio...... to OECD statistics for the same years. Health is measured by self-assessed health in five categories, which is transformed to a cardinal scale using Swedish time trade-off (TTO) weights. As socio-economic measures we use household income and length of education. Socio-economic inequality in health...

Mitigation of severe accidents in Swedish nuclear power plants

International Nuclear Information System (INIS)

Soederman, E.

1987-01-01

Sweden is the first country to build filtered venting systems, the first one became operable at Barsebaeck nuclear power plant in 1985. In new concepts, now being installed in Sweden, an enhanced containment spray system is the basic element and the filtered venting is only the secondary mitigating system. The filter is a new design, a submerged multi venturi scrubber. The Swedish strategy has been built on three basics: improved knowledge through research; containment integrity through mitigating systems; and accident management to prevent severe accidents. 2 figs

[Awareness survey of Healthcare Number System pros and cons according to medical doctors in Japan].

Science.gov (United States)

Takahashi, Yoshimitsu; Uryuhara, Yoko; Inoue, Machiko; Okamoto, Shigeru; Kashihara, Hidenori; Kito, Kumiko; Shinohara, Keiko; Mandai, Marie; Morioka, Miho; Tanaka, Shiro; Kawakami, Koji; Nakayama, Takeo

2015-01-01

After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the doctors' characteristics, and analyze the benefits and harms of the System that they identified. A cross-sectional survey was conducted of doctors via the Internet. The participants were selected from a convenience sample of a panel of doctors based on stratified sampling including four groups: working at a hospital and content analysis. There were 562 respondents (68%). By group, 16/143 (11%), 25/138 (18%), 31/132 (23%), and 43/149 (29%) doctors, respectively, thought that the System was unnecessary. The variables that correlated with the main outcome were age (per 5 years; odds ratio [95% confidence interval], 1.14 [1.01-1.29]) and type of medical facility (working at a clinic; 1.99 [1.30-3.08]). The doctors identified that unifying information could decrease administrative duties, facilitate inter-facility collaboration, and prevent inappropriate medical consultations. This could result in decreased healthcare costs and personalized healthcare. However, the doctors also identified that integrating information and dealing with big data could increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. This could result in deteriorating healthcare. Since some information should not be integrated, the System raises ethical considerations about privacy. Among the doctors surveyed here, 10-30% thought the System was unnecessary. These respondents tended to be older and work at a clinic. The System could decrease the cost of healthcare and enable personalized healthcare but could also increase information leakage and information management, cause

Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

International Nuclear Information System (INIS)

Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

2004-02-01

This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation

Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

Energy Technology Data Exchange (ETDEWEB)

Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

2004-02-01

This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation.

Healthcare financing in Croatia

Directory of Open Access Journals (Sweden)

Nevenka Kovač

2013-12-01

Full Text Available Healthcare financing system is of crucial importance for the functioning of any healthcare system, especially because there is no country in the world that is able to provide all its residents with access to all the benefits afforded by modern medicine. Lack of resources in general and rising healthcare expenditures are considered a difficult issue to solve in Croatia as well. Since Croatia gained its independence, its healthcare system has undergone a number of reforms, the primary objective of which was to optimize healthcare services to the actual monetary capacity of the Croatian economy. The objectives of the mentioned re - forms were partially achieved. The solutions that have been offered until now, i.e. consolidation measures undertaken in the last 10 years were necessary; however, they have not improved the operating conditions. There is still the issue of the deficit from the previous years, i.e. outstanding payments, the largest in the last decade. Analysis of the performance of healthcare institutions in 2011 shows that the decision makers will have to take up a major challenge of finding a solution to the difficulties the Croatian healthcare system has been struggling with for decades, causing a debt of 7 billion kuna. At the same time, they will need to uphold the basic principles of the Healthcare Act, i.e. to provide access to healthcare and ensure its continuity, comprehensiveness and solidarity, keeping in mind that the National Budget Act and Fiscal Responsibility Act have been adopted.

Sensitivity of district heating system operation to heat demand reductions and electricity price variations: A Swedish example

International Nuclear Information System (INIS)

Åberg, M.; Widén, J.; Henning, D.

2012-01-01

In the future, district heating companies in Sweden must adapt to energy efficiency measures in buildings and variable fuel and electricity prices. Swedish district heating demands are expected to decrease by 1–2% per year and electricity price variations seem to be more unpredictable in the future. A cost-optimisation model of a Swedish local district heating system is constructed using the optimisation modelling tool MODEST. A scenario for heat demand changes due to increased energy efficiency in buildings, combined with the addition of new buildings, is studied along with a sensitivity analysis for electricity price variations. Despite fears that heat demand reductions will decrease co-generation of clean electricity and cause increased global emissions, the results show that anticipated heat demand changes do not increase the studied system's primary energy use or global CO 2 emissions. The results further indicate that the heat production plants and the fuels used within the system have crucial importance for the environmental impact of district heat use. Results also show that low seasonal variations in electricity price levels with relatively low winter prices promote the use of electric heat pumps. High winter prices on the other hand promote co-generation of heat and electricity in CHP plants. -- Highlights: ► A MODEST optimisation model of the Uppsala district heating system is built. ► The impact of heat demand change on heat and electricity production is examined. ► An electricity price level sensitivity analysis for district heating is performed. ► Heat demand changes do not increase the primary energy use or global CO 2 emissions. ► Low winter prices promote use of electric heat pumps for district heating production.

Trends in pharmacy staff's perception of patient safety in Swedish community pharmacies after re-regulation of conditions.

Science.gov (United States)

Kälvemark Sporrong, Sofia; Nordén-Hägg, Annika

2014-10-01

All changes in the regulation of pharmacies have an impact on the work carried out in pharmacies and also on patient safety, regardless of whether this is the intention or not. To compare staff apprehension regarding some aspects of patient safety and quality in community pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market. Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects possible. All four items demonstrated a significant decrease in the first survey after the changes as compared to before. In the second survey significant differences were found on the two items representing safety climate whereas the items representing team climate and management showed no significant differences. The comparison carried out in this study indicates a negative effect in Swedish community pharmacies on safety and quality issues, as experienced by pharmacy staff. It is recommended that the possible effects of healthcare reforms are assessed before implementation, in order to counteract conceivable decline in factors including patient safety and working conditions.

Demand for private healthcare in a universal public healthcare system: empirical evidence from Sri Lanka.

Science.gov (United States)

Pallegedara, Asankha; Grimm, Michael

2017-11-01

This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal public healthcare policy, richer people tend to use private sector healthcare services rather than public services. We also find significant regional and ethnic discrepancies in healthcare access bearing the risk of social tensions if these are further amplified. Latent class analysis shows in addition that the choice between private and public sector healthcare significantly differs between people with and without chronic diseases. We find in particular that chronically ill people rely for their day-to-day care on the public sector, but for their inpatient care they turn more often than non-chronically ill people to the private sector, implying an additional financial burden for the chronically ill. If the observed trend continues it may not only increase further the health-income gradient in Sri Lanka but also undermine the willingness of the middle class to pay taxes to finance public healthcare. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Design and Evaluation of Public Hearings for Swedish Site Selection. A Report from the RISCOM II Project

International Nuclear Information System (INIS)

Andersson, Kjell; Wene, Clas-Otto; Drottz Sjoeberg, Britt-Marie

2003-08-01

Public hearings were held in the Swedish municipalities of Oesthammar, Tierp, Aelvkarleby, Hultsfred, Oskarshamn and in Nykoeping in February of 2001. The municipalities had taken part in feasibility studies, conducted by the Swedish Nuclear Fuel and Waste Management Co (SKB), in the previous years. The hearings were organised by the Swedish regulatory authorities, i.e. the Swedish Nuclear Power Inspectorate (SKI) and the Swedish Radiation Protection Authority (SSI), and aimed at complementing the authorities' reviews of SKB's work and plans, called FUD-K [1]. Central themes of the hearings were SKB's choice of municipalities for the next phase of the programme to build a spent nuclear fuel repository, and their choice of method for this work. Representatives of the municipalities participated in the planning of the hearings, which were guided by the RISCOM Model. In this report we give a background to the hearings, we introduce the RISCOM Model and how it was used to design the hearings, we then analyse the hearing context with a systems analysis approach. Finally, we describe the hearing agenda and evaluate the results with respect to transparency

Electronic healthcare information security

CERN Document Server

Dube, Kudakwashe; Shoniregun, Charles A

2010-01-01

The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

Patient Populations, Clinical Associations, and System Efficiency in Healthcare Delivery System

Science.gov (United States)

Liu, Yazhuo

The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes' perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease' correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

Develop security architecture for both in-house healthcare information systems and electronic patient record

Science.gov (United States)

Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

2003-05-01

In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

Patient exposures in Swedish diagnostic radiology

International Nuclear Information System (INIS)

Bengtsson, G.; Blomgren, P.-G.; Bergman, K.; Aaberg, L.

1977-05-01

Doses to about 1000 Swedish patients in 13 hospitals and several photofluorographic and dental installations were measured. The measurements comprised radiation quality, exposure-area product and doses to a few parts of the body where dosimeters could be placed. Calculations yielded energy imparted as well as doses to the thyroid, mammae, lungs, bone marrow, ovaries and testes. The possibility of reducing patientdoses is discussed. The radiation risk to the Swedish population isestimated,based on mean annual collective dose per individual for different body organs.(K.K.)

Risk management in Swedish hedge funds

OpenAIRE

Fri, Samuel; Nilsson, Joakim

2011-01-01

Background: Risk management has always been a complex topic, especially when it comes to hedge funds. Since hedge funds are able to utilize many kinds of financial instruments it is difficult to find a risk management strategy that goes well with them. Not much research regarding the Swedish hedge fund industry and its risk management has been done; hence we find it an interesting topic to focus this thesis on. Purpose: The purpose of this thesis is to increase the knowledge of how Swedish he...

Modelling vital success factors in adopting personalized medicine system in healthcare technology and management

Directory of Open Access Journals (Sweden)

Subhas C. Misra

2018-06-01

Full Text Available Biomedical engineering has grown as a vast field of research that includes many areas of engineering and technology also. Personalized Medicine is an emerging approach in today’s medicare system. It bears a very strong potential to consolidate modern e-health systems fundamentally. Scientists have already discovered some of the personalized drugs that can shift the whole medicare system into a new dimension. However, bringing the change in the whole medicare system is not an easy task. There are several factors that can affect the successful adoption of Personalized Medicine systems in the healthcare management sector. This paper aims at identifying the critical factors with the help of an empirical study. A questionnaire was distributed amongst some clinicians, clinical researchers, practitioners in pharmaceutical industries, regulatory board members, and a larger section of patients. The response data collected thereby were analyzed by using appropriate statistical methods. Based on the statistical analysis, an attempt is made to prepare a list of critical success factors in the adoption of personalized medicine in healthcare management. The study indicates that eight of the thirteen hypothesized factors have statistical relationship with “Success”. The important success factors detected are: data management, team work and composition, privacy and confidentiality, mind-set, return on investment, sufficient time, R&D and alignment. To the best of our knowledge, this is the first academic paper in which an attempt has been made to model the vital critical factors for the successful implementation of Personalized Medicine in healthcare management. The study bears the promise of important applications in healthcare engineering and technology. Keywords: Healthcare management, Personalized medicine, E-health, Success factors, Medicare systems, Regression analysis

Deregulation and internationalisation - impact on the Swedish nuclear industry

International Nuclear Information System (INIS)

Haukeland, Sverre R.

2010-01-01

The deregulation of the Swedish electricity market in 1996 was well known in advance, and the nuclear power plants in Sweden, as well as their main suppliers, made early preparations for a this new situation. In a study - performed by the author at Malardalen University in Sweden - it is concluded that the electricity industry, including the nuclear power plants, was fundamentally transformed in conjunction with market liberalisation. Two large foreign companies, E-on and Fortum, entered the Swedish market and became part-owners of the nuclear plants. After deregulation, the electricity market in Sweden is dominated by these two companies and the large national company Vattenfall. Similarly, Vattenfall has recently grown into an international energy company, acquiring generation capacity in Northern Europe outside of Sweden, including nuclear power plants in Germany. Restructuring of the nuclear industry on the supplier side started in the 1980's, when the Swedish company ASEA and BBC of Switzerland merged to become ABB. Several years later the Swedish nuclear plant supplier ABB-Atom became part of Westinghouse Electric Company, today owned by Toshiba. The Swedish experience thus confirms an international trend of mergers and consolidation in the nuclear industry. (authors)

3D printing of wearable fractal-based sensor systems for neurocardiology and healthcare

Science.gov (United States)

Ramasamy, Mouli; Varadan, Vijay K.

2017-04-01

Neurocardiology is the pathophysiological interplay of nervous and cardiovascular systems. The communication between the heart and brain has revealed various methodologies in healthcare that could be investigated to study the heart-brain interactions and other cardiovascular and neurological diseases. A textile based wearable nanosensor system in the form of e-bra, e-shirt, e-headband, e-brief, underwear etc, was presented in this SPIE conferences earlier for noninvasive recording of EEG and EKG, and showing the correlation between the brain and heart signals. In this paper, the technology is expanded further using fractal based geometries using 3D printing system for low cost and flexible wearable sensor system for healthcare.

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

Directory of Open Access Journals (Sweden)

Line Neerup Handlos

2016-09-01

Full Text Available Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

Science.gov (United States)

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-01-01

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption. PMID:27657096

Return Migrants' Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example.

Science.gov (United States)

Neerup Handlos, Line; Fog Olwig, Karen; Bygbjerg, Ib Christian; Norredam, Marie

2016-09-19

Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants' access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

Failure data collection from a Swedish nuclear power plant

International Nuclear Information System (INIS)

Andersson, B.; Bhattacharyya, A.; Hilding, S.

1975-01-01

The Swedish nuclear utilities have formed a joint working group in the field of reliability data of thermal power plants, nuclear and fossil fuelled. The primary task of the working group is to create a standard procedure of collecting failure data from the Swedish nuclear power plants in operation. The failure data will be stored in a joint data bank. A first test collection of such data has been implemented on Oskarshamn I, and the experience with this work is discussed in this report. Reliability analysis of an engineering system is based on the availability of pertinent information on the system components. Right from the beginning within the Swedish nuclear industry the consensus has been that such data can be suitably obtained by monitoring the operating power stations. This has led to a co-operative arrangement between the vendor, ASEA-ATOM and a utility, Oskarshamnsverkets Kraftgrupp AB (OKG) to utilize information from component malfunctions in the reliability analysis. The utility prepares component failure reports which are sent to the vendor for further treatment. Experience gathered to date indicates that this arrangement is effective although many persons are involved in this process of information transmittal. The present set-up is flexible enough to accommodate necessary changes in view of problems which arise now and then in monitoring a complex system like a nuclear power station. This report briefly describes the structure of the failure data collection system. The way in which the raw data collection is done in the station by the owner and the subsequent data processing by the vendor is discussed. A brief status report of the information collected since 1971 is given. It can be concluded that valuable reliability data can be obtained by monitoring component failure reports from an operating power plant. Two requirements are, however, that all the parties involved in the arrangement follow given instructions carefully and that the assumed

How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust.

Science.gov (United States)

Irestig, Robert; Burström, Kristina; Wessel, Maja; Lynöe, Niels

2010-05-01

To elucidate the perceived treatment that the homeless have received from the healthcare and other societal organisations and to present homeless persons' trust in the healthcare system and suggestions of necessary changes for improving it. Homeless individuals in special houses and institutions in the County of Stockholm were asked to answer a short version of a public health survey, including added questions about how they experienced the healthcare providers' attitudes towards them and how much trust they had in the healthcare system. A total of 155 homeless persons (123 male and 32 female) were interviewed. Three-quarters of the participants stated that they had fairly or very high trust in healthcare services and also felt that they had been fairly or very well treated. Fewer females than males reported being treated well and they declared a lower degree of trust in the healthcare system. The homeless suggest that extra resources be set aside to organise their healthcare, including a higher level of knowledge of the medical problems prevailing in the group. Those who felt badly treated also asked for less neglect and disrespect from the healthcare staff. Even though a majority experience that they are being well treated within the healthcare system, the study also indicated disadvantages in the treatment of homeless persons in Sweden. The study also reveals an imbalance between the official ethical framework in Sweden and of the specific moral of some individual healthcare providers. One way to facilitate their entry into the healthcare system might be to create special surgeries for the homeless.

Irradiated fuel storage and transport: A Swedish perspective

International Nuclear Information System (INIS)

Mennerdahl, D.

2001-01-01

This paper gives the views of the author and may not correspond to the views of the Swedish industry or the licensing authority. The views are based on experience from consultation to the Swedish licensing authority and from participation in international cooperation, in particular in the OECD/NEA NSC Working Group on Burnup Credit. (author)

Social capital among healthcare professionals: A prospective study of its importance for job satisfaction, work engagement and engagement in clinical improvements.

Science.gov (United States)

Strömgren, Marcus; Eriksson, Andrea; Bergman, David; Dellve, Lotta

2016-01-01

Social capital can be an important resource to facilitate the needed improvements in quality of care and efficiency in hospitals. To assess the importance of social capital (recognition, vertical trust, horizontal trust and reciprocity) for job satisfaction, work engagement and engagement in clinical improvements. A prospective cohort design was used. Intensive care units and emergency, surgical and medical units at five Swedish hospitals with ongoing development of their processes of care. Healthcare professionals (physicians, registered nurses, assistant nurses) at five Swedish midsize hospitals. The participants answered a questionnaire at two occasions, NN=1602 at baseline and NN=1548 at one-year follow-up. Mean hospital response rate was 53% at baseline and 59% at follow-up. Univariate, multivariate and logistic regression analyses were performed, and the prospective analysis was based on 477 respondents. Social capital was associated with healthcare professionals' general work engagement and job satisfaction. Analysis showed positive associations between all measured aspects of social capital and engagement in clinical improvements of patient safety and quality of care. The prospective analysis showed that increased social capital predicted increased job satisfaction, work engagement and engagement in clinical improvements of patient safety. Social capital is strongly related to job satisfaction and active engagement with clinical improvements. The findings contribute to a deeper knowledge of social capital as a predictive factor that influences patient safety and health among healthcare staff. Copyright © 2015 Elsevier Ltd. All rights reserved.

Barriers to Business Model Innovation in Swedish Agriculture

Directory of Open Access Journals (Sweden)

Olof Sivertsson

2015-02-01

Full Text Available Swedish agricultural companies, especially small farms, are struggling to be profitable in difficult economic times. It is a challenge for Swedish farmers to compete with imported products on prices. The agricultural industry, however, supports the view that through business model innovation, farms can increase their competitive advantage. This paper identifies and describes some of the barriers Swedish small farms encounter when they consider business model innovation. A qualitative approach is used in the study. Agriculture business consultants were interviewed. In a focus group led by the researchers, farmers discussed business model innovation, including the exogenous and endogenous barriers to such innovation. The paper concludes many barriers exist when farmers consider innovation of agricultural business models. Some barriers are caused by human factors, such as individuals’ attitudes, histories, and traditions. Other barriers are more contextual in nature and relate to a particular industry or company setting. Still other barriers, such as government regulations, value chain position, and weather, are more abstract. All barriers, however, merit attention when Swedish agricultural companies develop new business models.

Private investments in hospitals : a comparison of three healthcare systems and possible implications for real estate strategies

NARCIS (Netherlands)

van der Zwart, J.; van der Voordt, Theo; de Jonge, H.

2010-01-01

Objectives: This article explores lessons to be learned from three different healthcare systems and the possible implications for the management of healthcare real estate, in particular in connection to the Dutch system. It discusses similarities and differences among the different systems, in

The Relationship Between Burnout Syndrome Among the Medical Staff and Work Conditions in the Polish Healthcare System.

Science.gov (United States)

Głębocka, Alicja

2017-01-01

Psychologists emphasize that people employed in social service organizations are vulnerable to chronic stress and burnout syndrome caused by a close and unsatisfied interpersonal relationship. However, emotional exhaustion, depersonalization, and a feeling of diminished personal accomplishment can be attributed to other external factors. One of them is poor living and occupational conditions. According to a report by OECD, the healthcare system in Poland is the worst among the member countries. The aim of the present study was to define the relationship between occupational burnout and the rating of the Polish healthcare system among the medical staff. The study included 224 participants. The Maslach Burnout Inventory and the Dehumanized Behavior and the Głębocka and Rużyczka scale of Behavioral Indicators of Patient's Dehumanization were applied. The evaluations of the healthcare system were also collected. The results demonstrate that physicians were the group of most emotionally exhausted and, simultaneously, most life-satisfied persons, while nurses presented the highest level of dehumanization and the lowest level of satisfaction from life achievements. Only did physicians evaluate the healthcare system as a relatively good one. They were also more tolerant of latent dehumanization. A relationship between the dimensions of burnout and the evaluation of healthcare system were observed. The emotionally exhausted or prone to dehumanization persons were more likely to evaluate the Polish healthcare system negatively.

Coherence in the Danish Healthcare System

DEFF Research Database (Denmark)

Frederiksen, Jesper; Olivares Bøgeskov, Benjamin Miguel

2017-01-01

In this article, we investigate ‘coherence in healthcare’ as a strategy of welfare policy. We conduct our investigation within the theoretical and methodological framework of Scandinavian praxeology, and we construct our empirical data from Danish administrative documents. The tools and terms...... of this tradition are used to generate data from discourse as representations of institutional logics. The aim is to uncover how coherence in healthcare emerges as different strategies in healthcare governance in relation to different institutions seen as positions. Hence, our findings suggest that, although...... the stated aim in policy is to improve coherence in healthcare for the benefit of the patients, various ambiguities within the institutions producing policy tend to maintain a certain order rather than introducing changes. Furthermore, we discuss how this section of the welfare state, examined in relation...

Prevalence and Causes of Sick Leave among Healthcare System Employees of Joibar Province in 2015

Directory of Open Access Journals (Sweden)

Siavosh Etemadi neZhad

2017-09-01

Full Text Available Introduction and purpose: Absenteeism is defined as being absent from work without a good reason. Sick leave among healthcare providers can have serious negative impacts on organizational performance. This study was conducted to determine the prevalence and causes of sick leave in the healthcare system of Joibar, Iran. Methods: This analytical cross-sectional study was performed on all employees of the healthcare system of Joibar, Iran (n=239. Data was collected using a checklist including demographic data and reasons for absenteeism (the number of absent days, work experience, and  employment status by presenting to the Human Resources Department of the healthcare system. Data was analyzed by using Chi-square test and Spearman’s rank correlation coefficient in SPSS, version 20. Results: The mean age of the employees was 35.72±3.3 years. Sick leave was mostly observed in the age group of 30-39, official staff, married women, and employees with work experience of 6 to 10 years (83 cases. Among the studied diseases, cold and musculoskeletal disorders were the most frequent causes of absenteeism among employees in the healthcare system. Conclusion: Based on our findings, musculoskeletal disorders were the most important causes of absenteeism, which are preventable. To improve the physical and ergonomic conditions of the staff, we suggest healthcare authorities to install ergonomy software (Office Exercise Program and provide standard and adjustable seats and office desks.

The Appliance Pervasive of Internet of Things in Healthcare Systems

OpenAIRE

Talpur, Mir Sajjad Hussain

2013-01-01

In fact, information systems are the foundation of new productivity sources, medical organizational forms, and erection of a global economy. IoT based healthcare systems play a significant role in ICT and have contribution in growth of medical information systems, which are underpinning of recent medical and economic development strategies. However, to take advantages of IoT, it is essential that medical enterprises and community should trust the IoT systems in terms of performance, security,...

An effectiveness analysis of healthcare systems using a systems theoretic approach

Directory of Open Access Journals (Sweden)

Inder Kerry

2009-10-01

Full Text Available Abstract Background The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning. Methods/design To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research. Results Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation

An effectiveness analysis of healthcare systems using a systems theoretic approach.

Science.gov (United States)

Chuang, Sheuwen; Inder, Kerry

2009-10-24

The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning. To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research. Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation surveyors is developed that provides a systematic search for

A review of the scope and the cost of the Swedish nuclear waste management system

International Nuclear Information System (INIS)

1994-03-01

A Swedish translation of this report appears as an appendix in SOU 1004:108 (ISBN 91-38-13755-0). The report is prepared for the Nuclear Fond Commission and Ministry of Environment and Natural Resources

Swedish earthquakes and acceleration probabilities

International Nuclear Information System (INIS)

Slunga, R.

1979-03-01

A method to assign probabilities to ground accelerations for Swedish sites is described. As hardly any nearfield instrumental data is available we are left with the problem of interpreting macroseismic data in terms of acceleration. By theoretical wave propagation computations the relation between seismic strength of the earthquake, focal depth, distance and ground accelerations are calculated. We found that most Swedish earthquake of the area, the 1904 earthquake 100 km south of Oslo, is an exception and probably had a focal depth exceeding 25 km. For the nuclear power plant sites an annual probability of 10 -5 has been proposed as interesting. This probability gives ground accelerations in the range 5-20 % for the sites. This acceleration is for a free bedrock site. For consistency all acceleration results in this study are given for bedrock sites. When applicating our model to the 1904 earthquake and assuming the focal zone to be in the lower crust we get the epicentral acceleration of this earthquake to be 5-15 % g. The results above are based on an analyses of macrosismic data as relevant instrumental data is lacking. However, the macroseismic acceleration model deduced in this study gives epicentral ground acceleration of small Swedish earthquakes in agreement with existent distant instrumental data. (author)

EXPLORING PATENT ACTIVITY AND ITS POTENTIAL ASSOCIATION WITH HEALTHCARE OUTCOMES: A CASE STUDY OF OSTOMY PRODUCTS IN SWEDEN.

Science.gov (United States)

Calara, Paul Samuel; Althin, Rikard; Inglese, Gary; Nichols, Thomas

2017-01-01

The aim of this study was to evaluate whether ostomy industry patent activity (PA) is associated with patient outcomes and healthcare costs. Two groups of ostomy pouch users based on manufacturer PA (low or high) were compared in terms of ostomy-related wear patterns, adverse events, and healthcare expenditure. Using Swedish registry data, all patients with newly formed stomas were divided between each group and were followed during a 2-year period (2011-12). Propensity score matching and parametric duration analysis were used to compare outcomes between patients of similar characteristics such as sex, age, and ostomy surgery type. In both one- and two-piece systems, the high PA group had significantly lower monthly ostomy-related expenditure than the low PA group (one-piece: 197.47 EUR versus 233.34 EUR; two-piece: 164.00 EUR versus 278.98 EUR). Fewer pouch and skin wafer purchases per month were an important driver of cost differences. Both groups had similar likelihood of purchasing dermatological products for skin complications over time. PA in the ostomy care industry was associated with reduced healthcare costs, but not necessarily with fewer skin complications. It suggests that there is a health economic benefit from products made by patent intensive companies which may differentiate them from generic comparators, but more research is needed to understand the impact of activities conducive to medical innovation on health outcomes.

Swedish skiers knowledge, experience and attitudes towards off-piste skiing and avalanches

OpenAIRE

Mårtensson, Stefan; Wikberg, Per-Olov; Palmgren, Petter

2013-01-01

The winter of 2012/2013 was the most accident-prone season in the Swedish avalanche history with a total of seven dead Swedes. In April 2013 the Swedish Mountain Safety Council initiated a web-based survey aimed towards Swedish skiers. The aim was to identify the target group's knowledge, experience and attitudes towards off-piste skiing and avalanches. Respondents were asked to answer a total of 28 questions. 1047 Swedish off-piste skiers answered, and we analysed them in more detail. The Sw...

Exploring the Barriers: A Qualitative Study about the Experiences of Mid-SES Roma Navigating the Spanish Healthcare System.

Science.gov (United States)

Aiello, Emilia; Flecha, Ainhoa; Serradell, Olga

2018-02-22

Whereas the topic of the 'cultural sensitivity' of healthcare systems has been addressed extensively in the US and the UK, literature on the subject in most European countries, specifically looking at the situation of Roma, is still scarce. Drawing on qualitative research conducted mainly in the city of Barcelona under the communicative approach with Roma subjects who have stable socioeconomic positions and higher cultural capitals (end-users, professionals of the healthcare system, and key informants of a regional policy oriented to the improvement of Roma living conditions), the present study aims to fill this gap. We explore the barriers that the Roma face in accessing the healthcare system, reflecting on how these barriers are accentuated by the existing anti-Roma prejudices and institutional arrangements that do not account for minority cultures. Our results point out a series of obstacles at two levels, in the interaction with healthcare professionals, and in relation to existing institutional arrangements, which prevent Roma families from having equal access to the healthcare system. Education stands up as a mechanism to contest anti-Roma sentiments among healthcare professionals.

[Development method of healthcare information system integration based on business collaboration model].

Science.gov (United States)

Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

2015-02-01

Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

Directory of Open Access Journals (Sweden)

Ulrica Hörberg

2015-01-01

Full Text Available Being healthcare professionals in the complex field of forensic psychiatry care (FPC seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer’s philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient’s care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one’s own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family’s resources.

Reliable in their failure: an analysis of healthcare reform policies in public systems.

Science.gov (United States)

Contandriopoulos, Damien; Brousselle, Astrid

2010-05-01

In this paper, we analyze recommendations of past governmental commissions and their implementation in Quebec as a case to discuss the obstacles that litter the road to healthcare system reform. Our analysis shows that the obstacles to tackling the healthcare system's main problems may have less to do with programmatic (what to do) than with political and governance (how to do it) questions. We then draw on neo-institutional theory to discuss the causes and effects of this situation. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

System theory and safety models in Swedish, UK, Dutch and Australian road safety strategies.

Science.gov (United States)

Hughes, B P; Anund, A; Falkmer, T

2015-01-01

Road safety strategies represent interventions on a complex social technical system level. An understanding of a theoretical basis and description is required for strategies to be structured and developed. Road safety strategies are described as systems, but have not been related to the theory, principles and basis by which systems have been developed and analysed. Recently, road safety strategies, which have been employed for many years in different countries, have moved to a 'vision zero', or 'safe system' style. The aim of this study was to analyse the successful Swedish, United Kingdom and Dutch road safety strategies against the older, and newer, Australian road safety strategies, with respect to their foundations in system theory and safety models. Analysis of the strategies against these foundations could indicate potential improvements. The content of four modern cases of road safety strategy was compared against each other, reviewed against scientific systems theory and reviewed against types of safety model. The strategies contained substantial similarities, but were different in terms of fundamental constructs and principles, with limited theoretical basis. The results indicate that the modern strategies do not include essential aspects of systems theory that describe relationships and interdependencies between key components. The description of these strategies as systems is therefore not well founded and deserves further development. Copyright © 2014 Elsevier Ltd. All rights reserved.

The role of privacy protection in healthcare information systems adoption.

Science.gov (United States)

Hsu, Chien-Lung; Lee, Ming-Ren; Su, Chien-Hui

2013-10-01

Privacy protection is an important issue and challenge in healthcare information systems (HISs). Recently, some privacy-enhanced HISs are proposed. Users' privacy perception, intention, and attitude might affect the adoption of such systems. This paper aims to propose a privacy-enhanced HIS framework and investigate the role of privacy protection in HISs adoption. In the proposed framework, privacy protection, access control, and secure transmission modules are designed to enhance the privacy protection of a HIS. An experimental privacy-enhanced HIS is also implemented. Furthermore, we proposed a research model extending the unified theory of acceptance and use of technology by considering perceived security and information security literacy and then investigate user adoption of a privacy-enhanced HIS. The experimental results and analyses showed that user adoption of a privacy-enhanced HIS is directly affected by social influence, performance expectancy, facilitating conditions, and perceived security. Perceived security has a mediating effect between information security literacy and user adoption. This study proposes several implications for research and practice to improve designing, development, and promotion of a good healthcare information system with privacy protection.

Development of online diary and self-management system on e-Healthcare for asthmatic children in Taiwan.

Science.gov (United States)

Lin, Hsueh-Chun; Chiang, Li-Chi; Wen, Tzu-Ning; Yeh, Kuo-Wei; Huang, Jing-Long

2014-10-01

Many regional programs of the countries educate asthmatic children and their families to manage healthcare data. This study aims to establish a Web-based self-management system, eAsthmaCare, to promote the electronic healthcare (e-Healthcare) services for the asthmatic children in Taiwan. The platform can perform real time online functionality based upon a five-tier infrastructure with mutually supportive components to acquire asthma diaries, quality of life assessments and health educations. We have designed five multi-disciplinary portions on the interactive interface functioned with the analytical diagrams: (1) online asthma diary, (2) remote asthma assessment, (3) instantaneous asthma alert, (4) diagrammatical clinic support, and (5) asthma health education. The Internet-based asthma diary and assessment program was developed for patients to process self-management healthcare at home. In addition, the online analytical charts can help healthcare professionals to evaluate multi-domain health information of patients immediately. eAsthmaCare was developed by Java™ Servlet/JSP technology upon Apache Tomcat™ web server and Oracle™ database. Forty-one voluntary asthmatic children (and their parents) were intervened to examine the proposed system. Seven domains of satisfiability assessment by using the system were applied for approving the development. The average scores were scaled in the acceptable range for each domain to ensure feasibility of the proposed system. The study revealed the details of system infrastructure and developed functions that can help asthmatic children in self-management for healthcare to enhance communications between patients and hospital professionals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Fit for the Future? A New Approach in the Debate about What Makes Healthcare Systems Really Sustainable

Directory of Open Access Journals (Sweden)

Matthias Fischer

2014-12-01

Full Text Available As healthcare systems face enormous challenges, sustainability is seen as a crucial requirement for making them fit for the future. However, there is no consensus with regard to either the definition of the term or the factors that characterize a “sustainable healthcare system”. Therefore, the aim of this article is twofold. First, it gives examples of the existing literature about sustainable healthcare systems and analyzes this literature with regard to its understanding of sustainability and the strengths and weaknesses of the different approaches. The article then identifies crucial factors for sustainable healthcare systems, and the result, a conceptual framework consisting of five distinct and interacting factors, can be seen as a starting point for further research.

Design and implementation of a smart card based healthcare information system.

Science.gov (United States)

Kardas, Geylani; Tunali, E Turhan

2006-01-01

Smart cards are used in information technologies as portable integrated devices with data storage and data processing capabilities. As in other fields, smart card use in health systems became popular due to their increased capacity and performance. Their efficient use with easy and fast data access facilities leads to implementation particularly widespread in security systems. In this paper, a smart card based healthcare information system is developed. The system uses smart card for personal identification and transfer of health data and provides data communication via a distributed protocol which is particularly developed for this study. Two smart card software modules are implemented that run on patient and healthcare professional smart cards, respectively. In addition to personal information, general health information about the patient is also loaded to patient smart card. Health care providers use their own smart cards to be authenticated on the system and to access data on patient cards. Encryption keys and digital signature keys stored on smart cards of the system are used for secure and authenticated data communication between clients and database servers over distributed object protocol. System is developed on Java platform by using object oriented architecture and design patterns.

10 March 2008 - Swedish Minister for Higher Education and Research L. Leijonborg signing the guest book with CERN Chef Scientific Officer J. Engelen, followed by the signature of the Swedish Computing Memorandum of Understanding by the Director General of the Swedish Research Council P. Ömling.

CERN Multimedia

Maximilien Brice

2008-01-01

10 March 2008 - Swedish Minister for Higher Education and Research L. Leijonborg signing the guest book with CERN Chef Scientific Officer J. Engelen, followed by the signature of the Swedish Computing Memorandum of Understanding by the Director General of the Swedish Research Council P. Ömling.

Water scrubbers as new mitigating devices in Swedish reactors

International Nuclear Information System (INIS)

Espefaelt, R.

1988-01-01

Controlling the containment pressure is an important part of the Swedish severe accident mitigation strategy. As a final measure, venting of the containment atmosphere to the environment is feasible via a filtered venting system using a water scrubber as the filtering device. The comprehensive theoretical and experimental verification of the Multi Venturi Scrubber System has resulted in the following predicted scrubber performance: Both during the scrubber heat-up phase and in long periods of operation, where the water of the scrubber is heated to saturation, a decontamination factor of the order of several thousand is predicted. During no conditions foreseen in the safety analysis are decontamination factors below DF = 500 in the BWR scrubber and DF = 1500 in the PWR scrubber envisaged. These values are equivalent to a retention of 99.8 % and 99.9 % respectively and correspond to a case with only about 10-20 cm of water above the venturi tube outlets and unfavorable gas dynamic conditions. They can be compared to the design values (DF = 100 and 500, respectively) required to limit ground contamination to the very low level specified by Swedish authorities. 1 fig

Injustice to transsexual women in a hetero-normatie healthcare system

Directory of Open Access Journals (Sweden)

Douglas Newman-Valentine

2014-11-01

Conclusion: A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homoand trans-phobia that will in turn strengthen the belief that transsexual women are un-African.

Teachers' Pedagogical Mathematical Awareness in Swedish Early Childhood Education

Science.gov (United States)

Björklund, Camilla; Barendregt, Wolmet

2016-01-01

Revised guidelines for Swedish early childhood education that emphasize mathematics content and competencies in more detail than before raise the question of the status of pedagogical mathematical awareness among Swedish early childhood teachers. The purpose of this study is to give an overview of teachers' current pedagogical mathematical…

Pengaruh Swedish Massage Therapy terhadap Tingkat Kualitas Hidup Penderita Leukemia Usia Sekolah

Directory of Open Access Journals (Sweden)

Dewi Umu Kulsum

2017-08-01

Hasil penelitian menggambarkan terdapat perbedaan kualitas hidup pada kelompok intervensi sebelum dan sesudah dilakukan swedish massage therapy (p = 0,000 pada α = 5. Hasil penelitian merekomendasikan bahwa swedish massage therapy bisa dipakai sebagai metode alternatif dalam meningkatkan kualitas hidup penderita leukemia usia sekolah. Kata kunci: Kualitas hidup, leukemia, swedish massage therapy.

Ethical aspects of medical age assessment in the asylum process: a Swedish perspective.

Science.gov (United States)

Malmqvist, Erik; Furberg, Elisabeth; Sandman, Lars

2018-05-01

According to European regulations and the legislations of individual member states, children who seek asylum have a different set of rights than adults in a similar position. To protect these rights and ensure rule of law, migration authorities are commonly required to assess the age of asylum seekers who lack reliable documentation, including through various medical methods. However, many healthcare professionals and other commentators consider medical age assessment to be ethically problematic. This paper presents a simplified and amended account of the main findings of a recent ethical analysis of medical age assessment in the asylum process commissioned by the Swedish National Board of Health and Welfare. A number of ethical challenges related to conflicting goals, equality and fairness, autonomy and informed consent, privacy and integrity, and professional values and roles are identified and analysed. It is concluded that most of these challenges can be met, but that this requires a system where the assessment is sufficiently accurate and where adequate safeguards are in place. Two important ethical questions are found to warrant further analysis. The first is whether asylum seekers' consent to the procedure can be considered genuinely voluntary. The second is whether and how medical age assessments could affect negative public attitudes towards asylum seekers or discriminatory societal views more generally.

INVESTMENTS AS A FACTOR OF STABILITY OF THE RUSSIAN HEALTHCARE SYSTEM

Directory of Open Access Journals (Sweden)

Lyudmila Valentinovna Tokun

2016-01-01

Full Text Available In this article the author examines the structure of public expenditure on health in Russia and analyzes the adequacy of the investments in the health system. Goal / Objectives. The aim of this article is to analyze the expenses of the project “Development strategy of the Russian healthcare system for the long-term period 2015–2030”. The main objectives of this article are the definition of the technical condition of the buildings and improvement of health facilities, evaluation of the value of fixed assets in the healthcare and medical equipment depreciation, evaluation of tariff s in the compulsory health insurance system. Methodology. the method of comparative analysis of 10 past years indicators is used in this article Results. From 2005 to 2014 healthcare expenditures have increased 3 times, which is comparable to GDP growth. In the same period, investments in health have increased by 2 times. The main increase in expenditures occurred in the wages. These trends may indicate a lack of attention in relation to fixed assets. In relation to the renovation and the depreciation factor, rate of growth and the level of investment cast doubt on the adequacy and sustainability of the healthcare’s material basis for the provision of necessary medical assistance. It is required to calculate the standard, which includes continuous updating of fixed assets based on the each region of RF, depending on the regional characteristics and the structure of fixed assets. Conclusions / Significance. The study concluded that at the moment the size of the annual investment in health by the federal and regional budgets do not meet the needs of even simple reproduction, not to mention the modernization and development. Planning budget investment requirements can be carried out based on a special standard ratio, which takes into account the volume, composition and structure of fixed assets. Financial stability of the Russian healthcare depends not only on

A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

Science.gov (United States)

Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

2004-01-01

The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

Designing an architectural style for Pervasive Healthcare systems.

Science.gov (United States)

Rafe, Vahid; Hajvali, Masoumeh

2013-04-01

Nowadays, the Pervasive Healthcare (PH) systems are considered as an important research area. These systems have a dynamic structure and configuration. Therefore, an appropriate method for designing such systems is necessary. The Publish/Subscribe Architecture (pub/sub) is one of the convenient architectures to support such systems. PH systems are safety critical; hence, errors can bring disastrous results. To prevent such problems, a powerful analytical tool is required. So using a proper formal language like graph transformation systems for developing of these systems seems necessary. But even if software engineers use such high level methodologies, errors may occur in the system under design. Hence, it should be investigated automatically and formally that whether this model of system satisfies all their requirements or not. In this paper, a dynamic architectural style for developing PH systems is presented. Then, the behavior of these systems is modeled and evaluated using GROOVE toolset. The results of the analysis show its high reliability.

Perceptions of support among Swedish parents of children after end of successful cancer treatment: a prospective, longitudinal study.

Science.gov (United States)

Kukkola, Laura; Hovén, Emma; Cernvall, Martin; von Essen, Louise; Grönqvist, Helena

2017-12-01

Most children survive childhood cancer, however parenting a child diagnosed with cancer is a major challenge. The main aim of the current study was to describe Swedish parents' need, opportunity and benefit of support from healthcare professionals and significant others after end of a child's successful cancer treatment. Data was collected from approximately one week after end of successful treatment/six months after transplantation (T4, n = 212) up to five years thereafter (T7, n = 137). Parents answered questions via telephone about need, opportunity and benefit of talking to psychologists, social workers, partners and friends. The proportion reporting need of support from healthcare professionals varied between 73% (mothers' need of support from social workers, T4) and 7% (fathers' need of support from psychologists/social workers, T7). Need of support from significant others varied between 99% (mothers' and fathers' need of support from partners, T4) and 27% (fathers' need of support from friends, T7). The proportion reporting need of support decreased over time (p friends at T5 (p parent perceive support from healthcare professionals as beneficial. More parents should get access to psychosocial support services after end of a child's cancer treatment/transplantation.

UP-report. Fuel-based energy systems. Basis of the Development platform. Fuel to the Swedish Energy Agency's strategy work FOKUS; UP-rapport. Braenslebaserade energisystem. Underlag fraan Utvecklingsplattformen. Braensle till Energimyndighetens strategiarbete FOKUS

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-11-01

The report serves as input to the Swedish Energy Agency's strategies and priorities for research and innovation in the fuel-based energy system for the period 2011 - 2016. The report has been compiled by members of the development platform Fuel. This report provides background and conditions for the fuel based energy system, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and knowledge which enabled the Swedish Energy Agency to then develop a strategy that meets the needs of the society and business.

Do It Yourself solution of Internet of Things Healthcare System: Measuring body parameters and environmental parameters affecting health.

Directory of Open Access Journals (Sweden)

Mirjana Maksimović

2016-03-01

Full Text Available The rapid advancements in information and communications technologies (ICT and the increasing number of smart things shift an old-fashioned healthcare system to a model better suited for a population of the 21st century. New healthcare approaches based on Internet of Things (IoT/Internet of Medical Things (IoMT powered systems make health monitoring, diagnostics and treatment more personalized, timely and convenient, enabling a global approach to the healthcare system infrastructure development. Commercial systems in this area exist in various forms but usually do not fit the general patient needs, and those that do are usually economically unacceptable due to the high operational and development costs. Do It Yourself (DIY healthcare, including mobile applications and consumer medical devices, nowadays is the top healthcare trend. Therefore, this paper, based on well-known low-cost technologies, presents a DIY IoMT solution for observing human vital parameter as well as environmental factors affecting health.

GENIUS & the Swedish Fast Reactor programme

International Nuclear Information System (INIS)

Wallenius, Janne

2012-01-01

Concluding remarks: Sweden’s growing fast reactor programme focuses on LFR technology, but we also participate in ASTRID. • An innovative facility for UN fabrication, an LBE thermal hydraulics loop and a lead corrosion facility are operational. • A plutonium fuel fabrication lab is is under installation (this week!) • The government is assessing the construction of ELECTRA-FCC, a centre for Gen IV-system R&D, at a tentative cost of ~ 140±20 M€. • Location: Oskarshamn (adjacent to intermediate repository) • Date of criticality: 2023 (best case) • Swedish participation in IAEA TWG-FR should intensify

Psychosocial working conditions and depressive symptoms among Swedish employees

DEFF Research Database (Denmark)

Magnusson Hanson, Linda L; Theorell, Töres; Bech, Per

2009-01-01

Survey 2003. Work demands, decision authority, support and conflicts at work were measured in 2003. Depressive symptoms were recorded in 2006 by a short version of the depression subscale of the Symptom Checklist 90 (SCL-90). Linear regression analyses were performed. RESULTS: After adjusting......PURPOSE: To investigate prospective associations between working conditions and depressive symptoms in Swedish men and women. METHODS: The study was based on SLOSH (N = 5,985), a follow-up of a representative sample of gainfully employed Swedes 16-64 years of age from the Swedish Work Environment...... authority, support and conflicts at work are predictive of depressive symptoms in the general Swedish working population....

Swedish Art Song: A Singer's Handbook to Diction and Repertoire

Science.gov (United States)

Hersey, Anna Christine

2012-01-01

This essay is a guide to Swedish lyric diction for American singers. An overview of the linguistic traits and basic grammar of the Swedish language prepares the reader for a detailed description of Swedish phonemes and their occurrence in the language. Differences in pronunciation conventions as they pertain to classical singing, particularly the…

HL7 and DICOM based integration of radiology departments with healthcare enterprise information systems.

Science.gov (United States)

Blazona, Bojan; Koncar, Miroslav

2007-12-01

Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. However, this requirement represents one of the major challenges for the Information and Communication Technology (ICT) solutions, as systems today use diverse technologies, proprietary protocols and communication standards which are often not interoperable. One of the main producers of clinical information in healthcare settings represent Radiology Information Systems (RIS) that communicate using widely adopted DICOM (Digital Imaging and COmmunications in Medicine) standard, but in very few cases can efficiently integrate information of interest with other systems. In this context we identified HL7 standard as the world's leading medical ICT standard that is envisioned to provide the umbrella for medical data semantic interoperability, which amongst other things represents the cornerstone for the Croatia's National Integrated Healthcare Information System (IHCIS). The aim was to explore the ability to integrate and exchange RIS originated data with Hospital Information Systems based on HL7's CDA (Clinical Document Architecture) standard. We explored the ability of HL7 CDA specifications and methodology to address the need of RIS integration HL7 based healthcare information systems. We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers. The outcome of our pilot work proves our original assumption of HL7 standard being able to adopt radiology data into the integrated healthcare systems. Uniform DICOM to CDA translation scripts and business processes within IHCIS is desired and cost effective regarding to use of supporting IHCIS services aligned to SOA.

System-Level Shared Governance Structures and Processes in Healthcare Systems With Magnet®-Designated Hospitals: A Descriptive Study.

Science.gov (United States)

Underwood, Carlisa M; Hayne, Arlene N

The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.

[Data coding in the Israeli healthcare system - do choices provide the answers to our system's needs?].

Science.gov (United States)

Zelingher, Julian; Ash, Nachman

2013-05-01

The IsraeLi healthcare system has undergone major processes for the adoption of health information technologies (HIT), and enjoys high Levels of utilization in hospital and ambulatory care. Coding is an essential infrastructure component of HIT, and ts purpose is to represent data in a simplified and common format, enhancing its manipulation by digital systems. Proper coding of data enables efficient identification, storage, retrieval and communication of data. UtiLization of uniform coding systems by different organizations enables data interoperability between them, facilitating communication and integrating data elements originating in different information systems from various organizations. Current needs in Israel for heaLth data coding include recording and reporting of diagnoses for hospitalized patients, outpatients and visitors of the Emergency Department, coding of procedures and operations, coding of pathology findings, reporting of discharge diagnoses and causes of death, billing codes, organizational data warehouses and national registries. New national projects for cLinicaL data integration, obligatory reporting of quality indicators and new Ministry of Health (MOH) requirements for HIT necessitate a high Level of interoperability that can be achieved only through the adoption of uniform coding. Additional pressures were introduced by the USA decision to stop the maintenance of the ICD-9-CM codes that are also used by Israeli healthcare, and the adoption of ICD-10-C and ICD-10-PCS as the main coding system for billing purpose. The USA has also mandated utilization of SNOMED-CT as the coding terminology for the ELectronic Health Record problem list, and for reporting quality indicators to the CMS. Hence, the Israeli MOH has recently decided that discharge diagnoses will be reported using ICD-10-CM codes, and SNOMED-CT will be used to code the cLinical information in the EHR. We reviewed the characteristics, strengths and weaknesses of these two coding

Building a Healthcare System's Innovation Program.

Science.gov (United States)

Conger, Michelle D

2016-01-01

OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

Science.gov (United States)

Juhnke, Christin; Bethge, Susanne

2016-01-01

Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

[Perceived quality in hospitals of the Andalusia Healthcare System. The case of neurosurgery departments].

Science.gov (United States)

Cordero Tous, N; Horcajadas Almansa, Á; Bermúdez González, G J; Tous Zamora, D

2014-01-01

To analyse the characteristics of the perceived quality in hospitals of the Andalusia healthcare system and compare this with that in Andalusian Neurosurgery departments. Randomised surveys, adjusted for working age, were performed in Andalusia using a telephone questionnaire based on the SERVQUAL model with the appropriate modification, with the subsequent selection of a subgroup associated with neurosurgery. Perceived quality was classified as; technical, functional and infrastructure quality. The overall satisfaction was 76.3%. Frequency analysis found that variables related to the technical quality (good doctors, successful operations, trained staff, etc.) obtained more favourable outcomes. Those related to time (wait, consulting, organizing schedules) obtained worse outcomes. The care of families variables obtained poor results. There was no difference between the overall Andalusian healthcare system and neurosurgery departments. In the mean analysis, women and older people gave more favourable responses, especially for variables related to infrastructure quality. In the "cluster" analysis, there were more favourable responses by elderly people, with no differences in gender (P<.009). There is no difference in perceived quality between the Andalusian healthcare system overall and neurosurgery departments. The perceived quality of the Andalusian healthcare system is higher in the elderly people. The analysis of perceived quality is useful for promoting projects to improve clinical management. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Operating experience from Swedish nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-06-01

The total production of electricity from Swedish nuclear power plants was 70.5 TWh during 1998, which is the second highest yearly production ever. Production losses due to low demand totaled 5.1 TWh combined for all twelve units and production losses due to coastdown operation totaled an additional 0.5 TWh. The reason for this low power demand was a very good supply of water to the hydropower system. Hydroelectric power production was 73.6 TWh, an increase by roughly 5 TWh since 1997. Hence, the hydroelectric power production substantially exceeded the 64 TWh expected during a normal year, i.e. a year with average rainfall. Remaining production sources, mainly fossil fuel electricity production combined with district heating, contributed with 10 TWh. The total electricity production was 154.2 TWh, the highest yearly production ever. The total electricity consumption including transmission losses was 143.5 TWh. This is also the highest consumption ever and an increase by one percent compared to 1997. The preliminary net result of the electric power trade shows a net export by 10.7 TWh. The figures above are calculated from the preliminary production results. A comprehensive report on electric power supply and consumption in Sweden is given in the 1998 Annual Report from the Swedish Power Association. Besides Oskarshamn 1, all plants have periodically been operated in load-following mode, mostly because of the abundant supply of hydropower. The energy availability for the three boiling water reactors at Forsmark averaged 93.3 % and for the three pressure water reactors at Ringhals 91.0 %, both figures are the highest ever noted. In the section `Special Reports` three events of importance to safety that occurred during 1998 are reported. The events were all rated as level 1 according to the International Nuclear Event Scale (INES) Figs, tabs.; Also available in Swedish

Subcontractors and Component Suppliers in the Swedish Wind Power Industry

International Nuclear Information System (INIS)

Takeuchi, Linn

2003-05-01

This paper studies the Swedish component suppliers in the wind power industry. This group has not received much attention so far, and today very little is known. This study addresses the fact that the Swedish component suppliers have not been able to penetrate the wind power market despite the Swedish industry's strength in mechanical and electrical engineering. The aims of this paper were to gather information regarding the existing production and to identify factors that affect the Swedish component suppliers' scope to penetrate the wind turbine market. To date, although Sweden has spent considerable amounts of money on projects involving wind turbines, there is no series production of large wind turbines in Sweden. The historical development of the wind turbine industry suggests this alone would have inhibited the development of component production in Sweden. Yet, the country's proximity and good access to large wind turbine producing countries should be an advantage. Various factors and issues are identified and discussed in this paper that are relevant for the Swedish component suppliers' scope to penetrate the wind turbine market. These include market and product development, buyer-supplier relationships, export and sourcing behaviors, and time of market entry. This is a first step towards increasing the knowledge of Swedish component production and it is recognized that more studies are required. Various areas where relevant knowledge is largely missing or scarce are identified and discussed as well, and should serve as relevant starting points for continued research

External review and validation of the Swedish national inpatient register