Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal

Public-private partnerships (PPPs) are widely spread long-term arrangements between governments and strategic private partner(s). One of their objectives is to reduce the financial pressure on the public treasury with regard to new investments. PPPs have been employed within the health care sector which, in turn, carries a huge social burden. In Portugal, for instance, PPPs in health care concern bundling hospital infrastructure and clinical services management. Notwithstanding the need to ensure sustainability and efficient use of hospital resources, it is clearly compulsory to guarantee that patients receive appropriate and timely care, with maximum security, and equitable manner. Still, little or even no attention has been paid in the literature to the clinical response capacity of PPP hospitals and to the populism arguing that these entities have a lower social performance than typical public hospitals. This study uses robust benchmarking methodologies alongside recent data about Portuguese hospitals (FY2012-FY2017) to demystify this idea and to demonstrate that, actually, PPP hospitals can deliver health care services with social performance levels at least as good as public hospitals.info:eu-repo/semantics/publishedVersio

Public-private partnerships in health care services: Do they outperform public hospitals regarding quality and access? Evidence from Portugal

Public-private partnerships (PPPs) are widely spread long-term arrangements between governments and strategic private partner(s). One of their objectives is to reduce the financial pressure on the public treasury with regard to new investments. PPPs have been employed within the health care sector which, in turn, carries a huge social burden. In Portugal, for instance, PPPs in health care concern bundling hospital infrastructure and clinical services management. Notwithstanding the need to ensure sustainability and efficient use of hospital resources, it is clearly compulsory to guarantee that patients receive appropriate and timely care, with maximum security, and equitable manner. Still, little or even no attention has been paid in the literature to the clinical response capacity of PPP hospitals and to the populism arguing that these entities have a lower social performance than typical public hospitals. This study uses robust benchmarking methodologies alongside recent data about Portuguese hospitals (FY2012-FY2017) to demystify this idea and to demonstrate that, actually, PPP hospitals can deliver health care services with social performance levels at least as good as public hospitals.info:eu-repo/semantics/publishedVersio

Assessing sustainable development goals attainment through energy-environmental efficiency: The case of Latin American and Caribbean countries

This study evaluates the attainment of sustainable development goals (SDGs) using energy-environmental efficiency as a principal driver. Hicks-Moorsteen Index, based on optimal targets, is utilized to estimate the performance of Latin America and the Caribbean (LAC) countries towards SDGs. Performance is decomposed into catch-up efficiency and technological progress. Results show that, compared to 2012, only 15% of the countries evaluated exhibit improved catch-up efficiency in 2020, while 74% of the countries evaluated showed technological progress in 2020 compared to 2012. Improvement in SDGs attainment in LAC results from technological advancement and not catch-up efficiency. Gross catch-up inefficiency appears to obstruct SDGs attainment. The regression elaborates the indirect extrinsic socio-economic dimension of the SDGs accomplishment. Specifically, the results of the fully modified ordinary least squares and generalized method of moments for the examined years support the desired prospects for green productivity among the cross-section of LAC. Moreover, in each of the upper years, the result suggests that environmental performance and renewable energy-induced economic progress are vital for the examined countries' sustainable green productivity. Notably, the result predicts a slow but progressive path toward achieving the SDGs, suggesting more intentional and inclusive effort by the respective economies.info:eu-repo/semantics/publishedVersio

Solvability for a nonlinear coupled system of Kirchhoff type for the beam equations with nonlocal boundary conditions

In this paper, we investigate a mathematical model for a nonlinear coupled system of Kirchhoff type of beam equations with nonlocal boundary conditions. We establish existence, regularity and uniqueness of strong solutions. Furthermore, we prove the uniform rate of exponential decay. The uniform rate of polynomial decay is considered

Modeling and simulation of tankless gas water heaters to reduce temperature overshoots and undershoots

The hot water user’s comfort perception is severely affected by sudden water temperature changes above a certain magnitude. Sudden temperature changes, with overshoots or undershoots, could occur in hot water systems based on domestic tankless gas water heaters (TGWH). These are mainly due to sudden changes on the overall hot water flow rate demand and to the response delays inherent to the heating system, which cannot be anticipated by the equipment controller. This work presents the modeling and simulation of a proposed solution to reduce the temperature undershoots or overshoots to small acceptable values, not perceptible by the users. The proposed solution includes a tank acting as a thermal capacitance, a mixing valve to mix the tank and heat cell water flows and a bypass valve, connected to the output, the latter to eliminate the outlet temperature overshoots. Typical situations originating temperature undershoots and/or overshoots are simulated for validation of the proposed solution, showing that it is able to: a) Substantially reduce the waiting time for hot water in the cold start of the water heater; b) Respond to sudden increases of the hot water flow with only a small acceptable decrease in the outlet water temperature (for hot water flow rates varying from 2 to 14 L/min the temperature undershoots are lower than 0.5 °C); and c) Complete elimination of temperature overshoots for sudden decreases of the hot water flow rate.Papers presented to the 12th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Costa de Sol, Spain on 11-13 July 2016

Spin filtering and magnetoresistance in ballistic tunnel junctions

We theoretically investigate magnetoresistance (MR) effects in connection with spin filtering in quantum-coherent transport through tunnel junctions based on non-magnetic/semimagnetic heterostructures. We find that spin filtering in conjunction with the suppression/enhancement of the spin-dependent Fermi seas in semimagnetic contacts gives rise to (i) spin-split kinks in the MR of single barriers and (ii) a robust beating pattern in the MR of double barriers with a semimagnetic well. We believe these are unique signatures for quantum filtering.Comment: Added references + corrected typo

Orelha de Elefante Mexicana (Opuntia stricta [Haw.] Haw.) spineless cactus as an option in crossbred dairy cattle diet

new genotype of spineless cactus is being used in the diets of dairy cattle that are raised in semi-arid regions. However, little is known about its nutritional value. This study aimed to evaluate the effects of replacing Miúda (Nopalea cochenillifera Salm Dyck) with Orelha de Elefante Mexicana (Opuntia stricta [Haw.] Haw.) spineless cactus, on nutrient intake and digestibility, milk yield and composition, feeding behaviour, microbial protein synthesis, nitrogen balance, and ruminal and blood parameters of dairy cows. Ten Girolando cows, 500 ± 51.6 kg bodyweight, were distributed in a double Latin square design 5 x 5. The treatments consisted of replacement levels of Miúda (MIU) by Orelha de Elefante Mexicana (OEM) at 0, 25, 50, 75, and 100%. The intake and digestibility of dry matter (DM) (14.38–12.95 kg d-1, 716.3–658.9 g d-1), organic matter (OM) (13.01–11.43 kg d-1, 747.8–704.8 g d-1), crude protein (CP) (2.02–1.61 kg d-1, 863.8–845.2 g d-1) and total digestible nutrients (TDN) (9.38–7.92 kg d-1) decreased linearly with the increase in replacement. Despite the decrease in intake and digestibility, the supply of nutrients was sufficient to maintain a milk yield of 12.5 kg d-1. The average daily weight gain decreased linearly with the increase in replacement, while protein microbial efficiency (g microbial CP kg-1 TDN intake; 91.24 to 127.44 g kg-1) increased linearly. Thus, OEM could replace 100% MIU in diets with 48% of spineless cactus, for crossbred lactating cows with 12.5 kg d-1 milk yield. Therefore, OEM is a viable new option for producing milk in smallholder livestock systems in semi-arid regions.Keywords: Alternative forage, milk yield, ruminal parameter, semi-arid, smallholder livestock syste

Associação da prática de atividade física e do estado de saúde sobre a qualidade de vida de mulheres com fibromialgia

This study analyzed the association between physical activity, health status and life quality among women with fibromyalgia. Cross-sectional study based on the clinical information of 177 women (42.1 ± 8.6 years old) diagnosed with fibromyalgia and assisted in rheumatology clinics of the private sector of the Unified Health System (UHS) in the city of Maringá-PR, Brazil. The instruments were the International Physical Activity Questionnaire (IPAQ), the Fibromyalgia Impact Questionnaire (FIQ) and the WHOQOL-Bref. Data analysis was conducted through Mann-Whitney test, Spearman correlation and Structural Equation Analysis (p<0.05). Results showed positive correlations between physical activity and life quality domain. Health status showed negative correlation life quality domains. Structural Equation Analysis revealed days of walking per week showed positive association with life quality domains. Model 3 showed that the impact of fibromyalgia on the health status showed a moderate negative association with life quality domains. Based on the results obtained, the conclusion is that light physical activity, characterized as walking, represents a positive factor in the domains of quality of life in women with fibromyalgia and also, the impact of this disease on the health status of the patients is associated negatively areas of quality of life.301Este estudo analisou a associação entre atividade física, estado de saúde e qualidade de vida de mulheres com fibromialgia. Estudo transversal baseado na informação clínica de 177 mulheres (42,1 ± 8,6 anos) diagnosticadas com fibromialgia e auxiliadas em clínicas de reumatologia do setor privado do Sistema Único de Saúde (SUS) na cidade de Maringá-PR, Brasil. Os instrumentos utilizados foram o Questionário Internacional de Atividade Física (IPAQ), o Questionário de Impacto da Fibromialgia (FIQ) e o WHOQOL-Bref. A análise dos dados foi realizada através do teste de Mann-Whitney, correlação de Spearman e Análise de Equações Estruturais (p <0,05). Os resultados mostraram correlações positivas entre a atividade física e o domínio da qualidade de vida. O estado de saúde apresentou correlações negativas com a qualidade de vida. A Análise de Equação Estrutural revelou que os dias de caminhada por semana se associou positivamente com domínios de qualidade de vida. O modelo 3 mostrou que o impacto da fibromialgia no estado de saúde apresentou associação negativa e moderada com os domínios de qualidade de vida. Com base nos resultados obtidos, conclui-se que a atividade física leve, caracterizada pela caminhada, representa um fator positivo nos domínios da qualidade de vida em mulheres com fibromialgia e também, o impacto desta doença sobre o estado de saúde dos pacientes está associado negativamente domínios da qualidade de vida

Limiting Carleman weights and anisotropic inverse problems

In this article we consider the anisotropic Calderon problem and related inverse problems. The approach is based on limiting Carleman weights, introduced in Kenig-Sjoestrand-Uhlmann (Ann. of Math. 2007) in the Euclidean case. We characterize those Riemannian manifolds which admit limiting Carleman weights, and give a complex geometrical optics construction for a class of such manifolds. This is used to prove uniqueness results for anisotropic inverse problems, via the attenuated geodesic X-ray transform. Earlier results in dimension $n \geq 3$ were restricted to real-analytic metrics.Comment: 58 page

Optical diagnostics for high electron density plasmas

Nowadays high electron density plasmas are, beside their fundamental interest, widely used for many applications, e.g., light sources and plasma processing. The well known examples of high electron density plasmas can be found among the class of thermal plasmas as, e.g., the Inductively Coupled Plasma (ICP) and the Wall Stabilized Cascaded Arc (WSCA). Usually the pressure of the plasma is high, i.e., sub atmospheric to atmospheric. Other examples are the plasmas generated in tokamaks for fusion purposes and the recently exploited plasmas for etching and deposition devices such as the Electron Cyclotron Resonance plasmas. For the plasmas mentioned, the electron density is typical in the range of 1018 to 1023 m3, and the electron velocity distribution is close to a Maxwellian velocity distribution