Financial divergences of equalization and their impact on regional development in Morocco

2020 ◽  
pp. 002085232090535
Author(s):  
Aziza Benkada ◽  
Mohammed Belouchi
Keyword(s):  
Regional Development ◽  
Public Management ◽  
Development Strategies ◽  
Financial Resources ◽  
Actual Situation ◽  
Detailed Understanding ◽  
Public Facilities ◽  
The Impact

The purpose of this article is to analyse the impact of financial equalization on regional development in Morocco. While the redistribution of wealth through the financial equalization mechanism promotes equality and equity in favour of poor and disadvantaged regions, this mechanism still suffers from several shortcomings. The following analysis confirms that financial equalization has an amortization effect both on the donor regions that are forced to allocate part of their resources and on the recipient regions that risk falling into a development trap. Notwithstanding this analysis, equalization promotes solidarity and equality between territories; however, the actual situation on the ground confirms that this mechanism does not encourage beneficiary regions to improve their tax effort or develop their development strategies. The effectiveness of the equalization system therefore requires a detailed understanding of the reasons for inequalities in order to act on the causes rather than on the symptoms. Points for practitioners In the processes of territorial public management, the scarcity of financial resources is all the more reason to opt for more efficient investments. The quality of investments is more important than their quantity. The adoption of such an approach is a strategic move if disastrous consequences on public facilities are to be avoided in the long term. The various levels of local authorities must also take responsibility for improving their own resources and building up their development strategies.

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

scholarly journals Measuring Key Quality Indicators in Cloud Gaming: Framework and Assessment Over Wireless Networks

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1387
Author(s):  
Oswaldo Sebastian Peñaherrera-Pulla ◽  
Carlos Baena ◽  
Sergio Fortes ◽  
Eduardo Baena ◽  
Raquel Barco
Keyword(s):  
Communication Networks ◽  
Mobile Networks ◽  
Video Game ◽  
Know How ◽  
Fifth Generation ◽  
New Generation ◽  
Graphics Rendering ◽  
The Impact

Cloud Gaming is a cutting-edge paradigm in the video game provision where the graphics rendering and logic are computed in the cloud. This allows a user’s thin client systems with much more limited capabilities to offer a comparable experience with traditional local and online gaming but using reduced hardware requirements. In contrast, this approach stresses the communication networks between the client and the cloud. In this context, it is necessary to know how to configure the network in order to provide service with the best quality. To that end, the present work defines a novel framework for Cloud Gaming performance evaluation. This system is implemented in a real testbed and evaluates the Cloud Gaming approach for different transport networks (Ethernet, WiFi, and LTE (Long Term Evolution)) and scenarios, automating the acquisition of the gaming metrics. From this, the impact on the overall gaming experience is analyzed identifying the main parameters involved in its performance. Hence, the future lines for Cloud Gaming QoE-based (Quality of Experience) optimization are established, this way being of configuration, a trendy paradigm in the new-generation networks, such as 4G and 5G (Fourth and Fifth Generation of Mobile Networks).

scholarly journals Understanding contributors to quality of care in long-term care and changes under COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 960-960
Author(s):  
Sara Luck ◽  
Katie Aubrecht
Keyword(s):  
Quality Of Care ◽  
Long Term Care ◽  
The United States ◽  
Control Measures ◽  
Qualitative Description ◽  
Care Staff ◽  
Term Care ◽  
The Impact

Abstract Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.

Public Administration in Central and Eastern Europe

2021 ◽  
Author(s):  
Stanisław Mazur
Keyword(s):  
Public Administration ◽  
Public Management ◽  
Western Europe ◽  
Economic Transformation ◽  
The European Union ◽  
Quality Of Governance ◽  
Anglo American ◽  
The 2008 Financial Crisis ◽  
The Impact

In the early 1990s, the Central and Eastern European countries (CEE countries) saw the collapse of communist regimes and an unprecedented political and economic transformation that resulted in the establishment of democratic, law-governed states and market economies. Administrative reforms, which became an important milestone in this transformation, were considerably influenced both by administrative legacies predominant in the countries and by the Europeanization processes associated with their accession to the European Union. The administrative legacies, which combine elements of various traditions (e.g., German, Napoleonic, and Anglo-American) are still strongly affected by what is left of the communist era. Conversely, the impact of Europeanization processes on public administrations in CEE countries has proved to be much weaker than initially expected. The process of building a professional and apolitical civil service in CEE countries has been plagued by discontinuity and inconsistency, owing to the specific administrative culture of the region, the weakening pressure to modernize EU institutions, and the consequences of the 2008 financial crisis, as well as growing populist tendencies in the region. All these factors encouraged the belief that political control over public administration needs to be tightened in order for the effectiveness and quality of governance mechanisms to be improved. The quality of governance and public management varies widely across the CEE countries. What they have in common—at least to some extent—is the fairly high dynamics of change, including the reversal of the effects of previously implemented reforms. The latter factor may be interpreted as a search for country-specific reform paths, partly due to disappointment with the values and models prevailing in Western Europe, and somewhat as a consequence of growing populist tendencies in the region.

scholarly journals Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner
Keyword(s):  
Quality Of Life ◽  
Conceptual Framework ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

The impact of cancer and quality of life for long-term survivors

2008 ◽  
Vol 17 (9) ◽  
pp. 891-900 ◽  
Author(s):  
Brad J. Zebrack ◽  
Jaehee Yi ◽  
Laura Petersen ◽  
Patricia A. Ganz
Keyword(s):  
Quality Of Life ◽  
The Impact ◽  
Long Term Survivors
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