A framework for evaluating the effectiveness of flood emergency management systems in Europe

Calls for enhancing societal resilience to flooding are echoed across Europe alongside mounting evidence that flood risk will increase in response to climate change amongst other risk-enhancing factors. At a time where it is now widely accepted that flooding cannot be fully prevented, resilience discourse in public policy stresses the importance of improving societal capacities to absorb and recover from flood events. Flood emergency management has thus emerged as a crucial strategy in flood risk management. However, the extent to which emergency management supports societal resilience is dependent on the effectiveness of governance and performance in practice. Drawing from the extensive body of literature documenting the success conditions of so-called effective emergency management more broadly, this study formulates an evaluation framework specifically tailored to the study of Flood Emergency Management Systems (FEMS) in Europe. Applying this framework, this research performs a cross-country comparison of FEMS in the Netherlands, England, Poland, France, and Sweden. Important differences are observed in how FEMS have evolved in relation to differing contextual backgrounds (political, cultural, administrative and socio-economic) and exposures to flood hazard. Whereas the organization and coordination of actors are functioning effectively, other aspects of effective FEMS are relatively under-developed in several countries, such as provisions for institutional learning, recovery-based activities and community preparedness. Drawing from examples of good practice, this paper provides a critical reflection on the opportunities and constraints to enhancing the effectiveness of FEMS in Europe

Evaluating health information system projects using analytical and modeling methods

In recent years the value of the use of evaluation methods in all aspects of economic sectors, including the field of health care, has been increasingly recognized. The thrust of this paper is to explore the potential use of a) Cost-Benefit Analysis and b) Simulation and Modeling methods in estimating the value of Health Information System (HIS) projects. These methods were chosen for consideration as the most appropriate, primarily because CBA can measure delivered value of HIS interventions by weighting cost and benefits and identifying what is more socially desirable, while Simulation and Modeling tools can be used to estimate the future value of health care changes concerning HIS. The paper discusses these two families of methods, their evaluation potential is analyzed, and arguments for and against the use of each method are presented. Finally, methodological considerations and limitations are discussed and areas for future research are suggested

Through the Eye of the Beholder: Multiple Perspectives on Quality in Women\u27s Health Care

Quality is an illusive concept with different meanings to different people. Providers often define quality in terms of patient outcomes, professional standards of practice, predetermined criteria used to measure quality, and even subjective opinion. Patients describe quality in terms of the interpersonal aspects of care, how well they were treated, and the responsiveness of the provider to their needs. This qualitative study using a semi-structured interview defined quality from the perspectives of patients, physicians, nurses, and payers associated with a hospital-based women\u27s service line, and how the attributes of quality varied among the multiple groups. The study also described how stakeholders become aware of quality and how they determined a hospital\u27s quality. From the findings of the study, a conceptual framework of quality in women\u27s health was developed

Development and formative evaluation of the e-Health implementation toolkit

<b>Background</b> The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.<p></p> <b>Results</b> The content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback. There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xls<p></p> <b>Conclusions</b> The e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations

An Approach for Actions to Prevent Suicides on Commuter and Metro Rail Systems in the United States, MTI Report 12-33

The primary goals of this report are to discuss measures to prevent suicides on commuter and metro rail systems, and to outline an approach for suicide prevention on rail systems. Based on existing literature and analysis of data obtained from the Metrolink system in Southern California, it was found that most suicides occur near station platforms and near access points to the track. Suicides occurred most frequently when relatively more trains were in operation and in areas of high population density. There do not appear to be suicide “hot spots” (e.g., linked to mental hospitals in the proximity, etc.), based on data analyzed for U.S. systems. The suicide prevention measures range from relatively inexpensive signs posting call-for-help suicide hotline information to costly platform barriers that physically prevent people from jumping onto tracks in front of trains. Other prevention measures fall within this range, such as hotlines available at high frequency suicide locations, or surveillance systems that can report possible suicide attempts and provide the opportunity for intervention tactics. Because of the relatively low number of suicides on rail systems, as compared to the overall number of suicides in general, a cost-effective strategy for preventing suicides on rail systems should be approached in a very focused manner. The prevention measures executed by the rail authorities should be focused on the suicides occurring on the rail systems themselves, while the broader problem of suicides should be left to community-based prevention efforts. Moreover, prevention measures, such as surveillance and response, could “piggyback” on surveillance and response systems used for other purposes on the rail systems to make such projects economically feasible

Home and community based parenting support programmes and interventions: report of Workpackage 2 of the DataPrev project

The last decade has witnessed an increasing interest in the promotion of mental health and wellbeing because of its importance for health and social functioning at the individual level and for the social and economic wellbeing of societies. Recent research from a range of disciplines has highlighted the importance of the quality of the parent-child relationships and parenting on children‟s emotional and social development, and on adult mental health and wellbeing. Intervention studies involving children of all age groups have shown that if parenting can be influenced for the better outcomes can be changed. The DataPrev project was funded by the 6th Framework of the European Community Research Programme under Policy-Orientated Research with the aim of establishing a database of evidence-based programmes in Europe that promote mental health and wellbeing and prevent mental illness throughout the life course. This is the report of the Workpackage 2 describing the international evidence base on programmes to support parenting, including home and community based programmes

Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

Non utile per esam

Efficiency as a determinant of loyalty among users of a community of clinical practice: a comparative study between the implementation and consolidation phases

A community of clinical practice called the Online Communication Tool between Primary and Hospital Care (ECOPIH) was created to enable primary care and specialist care professionals to communicate with each other in order to resolve real clinical cases, thereby improving communication and coordination between care levels. The present work seeks to analyse whether ECOPIH makes it possible to reduce the number of referrals. To that end, the objectives are: (1) To find out the degree of loyalty among ECOPIH users, by comparing the medical professionals' profiles in the tool's implementation phase to those in its consolidation phase. (2) To evaluate the degree of fulfilment of users' expectations, by establishing the determining factors that had an influence on the physicians' intention to use ECOPIH in the implementation phase and observing whether its use had an effective, direct impact on the number of patient referrals that primary care physicians made to specialist care professionals. Two studies were conducted. Based on a survey of all the physicians in a Primary Care area, Study 1 was a descriptive study in ECOPIH's implementation phase. Study 2 was a randomised intervention study of ECOPIH users in the tool's consolidation phase. The results from both studies were compared. Various bivariate and multivariate statistical techniques (exploratory factor analysis, cluster analysis, logistic regression analysis and ANOVA) were used in both studies, which were conducted on a sample of 111 and 178 physicians, respectively. We confirmed the existence of an ECOPIH user profile stable across both phases: under-50-year-old women. Regarding the second objective, there were two particular findings. First, the discriminant factors that had an influence on greater ECOPIH use were habitual Social media website and app use and Perceived usefulness for reducing costs. Second, PC professionals who were ECOPIH members made fewer referrals to SC professionals in Cardiology, Endocrinology and Gastroenterology than older PC professionals who were not ECOPIH members. The use of a community of clinical practice by primary care and specialist care professionals helps to reduce the number of referrals among medical professionals