ARCA

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Planning elderly and palliative care in Montenegro

Introduction: Montenegro, a newly independent Balkan state with a population of 650,000, has a health care reform programme supported by the World Bank. This paper describes planning for integrated elderly and palliative care. <br><br> Description: The current service is provided only through a single long-stay hospital, which has institutionalised patients and limited facilities. Broad estimates were made of current financial expenditures on elderly care. A consultation was undertaken with stakeholders to propose an integrated system linking primary and secondary health care with social care; supporting people to live, and die well, at home; developing local nursing homes for people with higher dependency; creating specialised elderly-care services within hospitals; and providing good end-of-life care for all who need it. Effectiveness may be measured by monitoring patient and carers’ perceptions of the care experience. <br><br> Discussion: Changes in provision of elderly care may be achieved through redirection of existing resources, but the health and social care services also need to enhance elderly care budgets. The challenges for implementation include management skills, engaging professionals and political commitment. <br><br> Conclusion: Middle-income countries such as Montenegro can develop elderly and palliative care services through redirection of existing finance if accompanied by new service objectives, staff skills and integrated management

Fourier Analysis of Signals on Directed Acyclic Graphs (DAG) Using Graph Zero-Padding

Directed acyclic graphs (DAGs) are used for modeling causal relationships, dependencies, and flows in various systems. However, spectral analysis becomes impractical in this setting because the eigen-decomposition of the adjacency matrix yields all eigenvalues equal to zero. This inherent property of DAGs results in an inability to differentiate between frequency components of signals on such graphs. This problem can be addressed by alternating the Fourier basis or adding edges in a DAG. However, these approaches change the physics of the considered problem. To address this limitation, we propose a graph zero-padding approach. This approach involves augmenting the original DAG with additional vertices that are connected to the existing structure. The added vertices are characterized by signal values set to zero. The proposed technique enables the spectral evaluation of system outputs on DAGs (in almost all cases), that is the computation of vertex-domain convolution without the adverse effects of aliasing due to changes in a graph structure, with the ultimate goal of preserving the output of the system on a graph as if the changes in the graph structure were not done.Comment: 10 pages, 12 figure