Spezialisierte Ambulante Palliativ-Versorgung

AbstractSince 2007, patients with severe advanced life-limiting illnesses and high, complex symptom burdens have a right to receive specialized outpatient palliative care (SAPV). Multi-professional teams with heterogeneous organizational structures provide care in cooperation with primary care givers, not limited to cancer patients. The aim of SAPV is to foster patient’s autonomy and quality of life. SAPV can be provided as counseling of patient and care givers, coordination of care, additional supportive and full care provision. While the basis of SAPV provision is regulated by a SAPV directive, different contracts between care providers and health care insurances regulate organization, cooperation, definition of care levels, service provision and compensation. Some regions have model contracts that are binding for all SAPV teams in the area; in other regions teams negotiate e. g. compensation, individually with insurances. The article gives an overview of the regulations regarding SAPV.

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The Development of MaccabiDent Quality Measures for Oral Health

Open Access Journal of Dental Sciences ◽

10.23880/oajds-16000280 ◽

2020 ◽

Vol 5 (4) ◽

Author(s):

Guy Tobias

Keyword(s):

Oral Health ◽

Continuing Education ◽

Success Rate ◽

Quality Measures ◽

X Rays ◽

Care Providers ◽

Dental Services ◽

Dental Examination ◽

Care Givers

Introduction: Success depends, at least in part, on the quality of the product, quality of service, and quality of infrastructure. Lack of quality measures in dentistry limits improvements in oral health care. This article focused on developing quality measures in dentistry. Materials and Methods: Quality measures were developed and data from a three-year period were evaluated for MaccabiDent, a provider of dental services in Israel, treating 650,000 patients a year. The following 4 measurements were examined: The percentage of orthodontic patients who underwent a bi-annual dental examination with x- rays and were treated by a hygienist; The percentage of children aged 3-12, in a B or C risk group that had a fluoride application twice yearly; Continuing Education for dental care providers; Implant success rate. Results: 43.3% of patients had at least one dental examination with x-rays. 76.5% of the children had a fluoride application at least twice a year, with an average of 58.9% in all clinics. 13.8% of care givers reported participation in Continuing Education courses. Success rate of implants was 99%. Discussion: Our findings, based on three years of data, will provide the foundation for the development of measures that will improve quality in all 53 dental clinics of the Health Dental Organization (HDO). Conclusion: The most important outcome of this article is to show the importance of determining and measuring quality variables which might serve as a lead for a national index.

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Study Protocol for the Development of a European eHealth Platform to Improve Quality of Life in Individuals With Huntington's Disease and Their Partners (HD-eHelp Study): A User-Centered Design Approach

Frontiers in Neurology ◽

10.3389/fneur.2021.719460 ◽

2021 ◽

Vol 12 ◽

Author(s):

Pearl J. C. van Lonkhuizen ◽

Niko J. H. Vegt ◽

Eline Meijer ◽

Erik van Duijn ◽

Susanne T. de Bot ◽

...

Keyword(s):

Quality Of Life ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Health Care Providers ◽

End Users ◽

Care Provision ◽

User Centered Design ◽

Care Providers ◽

User Centered

Background: Huntington's disease (HD) is an autosomal dominant neurodegenerative disease that affects the quality of life (QoL) of HD gene expansion carriers (HDGECs) and their partners. Although HD expertise centers have been emerging across Europe, there are still some important barriers to care provision for those affected by this rare disease, including transportation costs, geographic distance of centers, and availability/accessibility of these services in general. eHealth seems promising in overcoming these barriers, yet research on eHealth in HD is limited and fails to use telehealth services specifically designed to fit the perspectives and expectations of HDGECs and their families. In the European HD-eHelp study, we aim to capture the needs and wishes of HDGECs, partners of HDGECs, and health care providers (HCPs) in order to develop a multinational eHealth platform targeting QoL of both HDGECs and partners at home.Methods: We will employ a participatory user-centered design (UCD) approach, which focusses on an in-depth understanding of the end-users' needs and their contexts. Premanifest and manifest adult HDGECs (n = 76), partners of HDGECs (n = 76), and HCPs (n = 76) will be involved as end-users in all three phases of the research and design process: (1) Exploration and mapping of the end-users' needs, experiences and wishes; (2) Development of concepts in collaboration with end-users to ensure desirability; (3) Detailing of final prototype with quick review rounds by end-users to create a positive user-experience. This study will be conducted in the Netherlands, Germany, Czech Republic, Italy, and Ireland to develop and test a multilingual platform that is suitable in different healthcare systems and cultural contexts.Discussion: Following the principles of UCD, an innovative European eHealth platform will be developed that addresses the needs and wishes of HDGECs, partners and HCPs. This allows for high-quality, tailored care to be moved partially into the participants' home, thereby circumventing some barriers in current HD care provision. By actively involving end-users in all design decisions, the platform will be tailored to the end-users' unique requirements, which can be considered pivotal in eHealth services for a disease as complex and rare as HD.

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Policy, Service, and Training Provision for Women Following a Traumatic Birth: An International Mapping Study

10.21203/rs.3.rs-558420/v1 ◽

2021 ◽

Author(s):

Gill Thomson ◽

Magali Quillet Diop ◽

Suzannah Stuijfzand ◽

Antje Horsch

Keyword(s):

Mental Health ◽

Service Provision ◽

Health Concern ◽

Care Provision ◽

Care Providers ◽

Birth Experience ◽

National Policies ◽

Traumatic Birth ◽

And Training ◽

Traumatic Birth Experience

Abstract Background: High numbers of women experience a traumatic birth, which can lead to Post Traumatic Stress Disorder (PTSD) onset, and negative and pervasive impacts for women, infants and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this study was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods: A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture ‘country level data’; ‘care provision’ (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration ‘training’ for maternity professionals. Results: Eighteen countries participated. Only one country had national policies regarding the screening, treatment and prevention of a traumatic birth experience/PTSD. Service provision was provided formally in six countries (33%), or informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Thirty-nine percent of the countries offered ‘a few hours’ professional/pre-registration training but none offered nationally mandated post-registration training. Conclusions: A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.

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Use of rating assessment of financial and economic operation effectiveness of the JSC “RZD” branches

Vestnik of the Railway Research Institute ◽

10.21780/2223-9731-2019-78-6-366-371 ◽

2020 ◽

Vol 78 (6) ◽

pp. 366-371

Author(s):

P. A. Shanchenko ◽

K. O. Vinnikova ◽

E. V. Ershova ◽

I. N. Lenskaya

Keyword(s):

Objective Assessment ◽

Organizational Structures ◽

Assessment System ◽

Basic Principles ◽

Economic Operation ◽

Vector Orientation ◽

Definition Of ◽

Further Development

Rating is one of the methods of economic analysis used for comparative assessment of effectiveness of production and economic operation of the organizational structures in different branches of economy. Rating assessment of railways is used in JSC “RZD” since 2018 for objective assessment of economic and financial sustainability and effectiveness of management of structural divisions (branches). Methods of rating assessment adapted for structural divisions of JSC “RZD” with regard to the specificity of their operation are examined in the work.Main objectives of establishing the rating assessment system of financial and economic operation of the JSC “RZD” branches are examined, detailed rating classification is presented.Basic principles are developed for establishing the rating assessment system of operation effectiveness of the deputies of the JSC “RZD” branches heads in terms of financial and economic operation, as well as classification of indicators of financial and economic operation of the JSC “RZD” branches by types of operation with definition of their vector orientation.The following conclusions are made: 1. Presented rating assessment is an indicator of the quality of financial and economic operation management of the JSC “RZD” branches. 2. Use of rating assessment for results analysis is relevant for motivation of the management in charge for economic operations. 3. Further development of the rating assessment system consists in establishing the events classifier and optimization of the current expenses.

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Futility of Medical treatment

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v2i1.19 ◽

2018 ◽

Vol 2 (1) ◽

pp. 13 ◽

Cited By ~ 1

Author(s):

Albar Mohammed Ali ◽

Chamsi Pasha Hassan

Keyword(s):

Medical Futility ◽

Health Sciences ◽

Best Interests ◽

End Of Life Decisions ◽

Ethical Implications ◽

Patient’S Autonomy ◽

Wide Range ◽

Futile Treatment ◽

Definition Of ◽

To Receive

Medical and technological resources allow many patients affected by advanced diseases to receive more aggressive and expensive treatments than ever before. This wide range of available options can frequently lead to complex end-of-life decisions, such as when to start palliative care programs. Medical futility refers to interventions that are unlikely to produce any significant benefit for the patient. Medical futility is a daily problem, with significant ethical implications and concerns about the respect of the main ethics principles: beneficence, non-maleficence, patient’s autonomy, and justice. Proceeding with futile treatment is neither in the best interests of the patient nor of the healthcare system. This paper examines the definition of futility, applications of the concept of medical futility, the complexities of management when care is considered futile.International Journal of Human and Health Sciences Vol. 02 No. 01 Jan’18. Page : 13-17

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US bank failure and bailout during the financial crisis

Journal of Financial Economic Policy ◽

10.1108/jfep-02-2016-0011 ◽

2016 ◽

Vol 8 (3) ◽

pp. 316-347 ◽

Cited By ~ 4

Author(s):

Wenling Lu ◽

David A. Whidbee

Keyword(s):

Financial Crisis ◽

Design Methodology ◽

De Novo ◽

Organizational Structures ◽

Content Type ◽

Asset Portfolio ◽

The Impact ◽

To Receive ◽

Regulatory Intervention

Purpose This paper aims to examine the characteristics of banks that were the target of intervention in the form of bailout or failure during the financial crisis and, of those subjected to intervention, what characteristics distinguish those that received bailout funds from those that were deemed failures. Design/methodology/approach The study estimates a series of logit regressions in an effort to identify the causes of regulatory intervention while controlling for bank-level characteristics and the economic and regulatory environment. Findings The empirical results indicate that many of the same characteristics associated with banks receiving bailout funds are similar to the characteristics associated with failed banks. However, non-performing loans increased the likelihood of failure, but reduced the likelihood of a bank receiving Capital Purchase Program (CPP) funds, suggesting that regulatory authorities discriminated in their use of CPP funds based on the quality of a bank’s asset portfolio. Further, those banks located in states with limits on de novo branching and those banks that are part of a multi-bank holding company structure were less likely to fail but were more likely to receive CPP funds. Originality/value This paper provides a comprehensive analysis of regulatory intervention in the banking industry during the late 2000s financial crisis and the impact of different banking organizational structures, economic circumstances, and financial fragility on the likelihood of a bank failing or receiving bailout funds.

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Multidisciplinary Quality Assessment: the Case of a Child Development Team, Part 1

British Journal of Occupational Therapy ◽

10.1177/030802269405700905 ◽

1994 ◽

Vol 57 (9) ◽

pp. 345-348 ◽

Cited By ~ 5

Author(s):

Lynne M Howard

Keyword(s):

Child Development ◽

Quality Assessment ◽

Service Provision ◽

Quality Service ◽

Development Team ◽

Working Definition ◽

Process And Outcome ◽

Definition Of

This is the first of three articles reporting research that focused on the increasing attention being paid to measuring the quality of hearth service provision. It addresses the problem of how quality can be measured across a multidisciplinary service and uses a district child development team as an example of such a service, in part 1, the child development team and its origins are examined and a working definition of a quality service in this setting is formulated. The service is broken down into its component parts of structure, process and outcome, according to the model proposed by Donabedian, to examine it more systematically. The following articles will describe the methodology and the results of the research and discuss the findings.

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Immunoferritin localization of intracellular antigens in positively stained frozen sections

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010008170x ◽

1978 ◽

Vol 36 (2) ◽

pp. 168-169

Author(s):

K. T. Tokuyasu

Keyword(s):

Surface Tension ◽

Water Surface ◽

Thin Layers ◽

The Other ◽

Positive Staining ◽

Frozen Sections ◽

The Past ◽

Ultrathin Frozen Sections ◽

Definition Of

During the past investigations of immunoferritin localization of intracellular antigens in ultrathin frozen sections, we found that the degree of negative staining required to delineate u1trastructural details was often too dense for the recognition of ferritin particles. The quality of positive staining of ultrathin frozen sections, on the other hand, has generally been far inferior to that attainable in conventional plastic embedded sections, particularly in the definition of membranes. As we discussed before, a main cause of this difficulty seemed to be the vulnerability of frozen sections to the damaging effects of air-water surface tension at the time of drying of the sections.Indeed, we found that the quality of positive staining is greatly improved when positively stained frozen sections are protected against the effects of surface tension by embedding them in thin layers of mechanically stable materials at the time of drying (unpublished).

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