Use of out-of-hours services : the patient's point of view on co-payment: a mixed methods approach

Introduction: In many countries out of hours (OOH);,care is offered by different :health care services. General; practitioners (GP); tend to offer services in competition with emergency departments (ED). Patients behaviour : depends on a number of factors. In this study, we highlight the knowledge and ideas of patients concerning the co-payment system. Methods: We used a mixed methods design, combining quantitative-and qualitative research. During two week-ends in January 2005 all patients using the ED or the GP OOH service, were invited for an interview with a structured questionnaire. A-stratified random sample of patients participated; in a semi-structured interview. Both methods add-complementary data to answer the research-questions. Results:, Most Mentioned reasons-for seeking help at the ED are: accessibility (15.0%), proximity (64%) and; competence of the Staff (5.6%). Reasons for choosing the GP are; GP: is easy to find; Minor medical problem or anxiety and confidence in the GP The Odds of not knowing the. co-payment system are significantly higher in patients visiting the ED (OR 1:783; 95% CI: 1.493-2.129). Mostly GP users recognize the problem of ED overuse. They suggested especially to provide clear information about the tasks of the different:services and about the payment system, to reduce ED overuse, Conclusion and discussion; When intending to. shift from;ED to GP services for Minor medical problems, aiming at just one measure is no option. Information campaigns. aiming to :address the entire population; Can clarify the role of each player in Out-of-hours care

Semantics in the wild : a digital assistant for Flemish citizens

Public service fragmentation across more than 800 digital channels of government administrations in the region of Flanders (Belgium), causes administrative burden and frustrations, as citizens expect a coherent service. Given the autonomy of the various entities, the fragmentation of information and budget constraints, it is not feasible to rewire the entire e-gov ecosystem to a single portal. Therefore, the Flemish Government is building a smart digital assistant, which supports citizens on the governmental portals, by integrating status information of various transactions. This paper outlines our ongoing research on a method for raising semantic interoperability between different information systems and actors. In this approach, semantic agreements are maintained and implemented end-to-end using the design principles of Linked Data. The lessons learned can speed-up the process in other countries that face the complexity of integrating e-government portals

The influence of inclination angle on void fraction and heat transfer during condensation inside a smooth tube

Most work in literature on condensation in tubes has been done for smooth tubes in the horizontal and vertical configurations. Recent experimental works with condensation at different inclination angles showed that the heat transfer characteristics were a function of inclination angle. These works were limited to heat transfer and pressure drop measurements with visual observations. However, no work has been done on measuring the void fractions during condensation at different inclination angles. The purpose of this study was to measure void fractions and heat transfer coefficients during condensation for tube inclinations ranging from vertical downwards (-90ᵒ) to vertical upwards (90ᵒ) at a saturation temperature of 40 ᵒC. Measurements were taken in an experimental set-up in which condensation occurred on the inside of a test section. The test section was a circular tube with an inner diameter of 8.38 mm and a heat transfer length of 1.488. The refrigerant used was R134a, and the void fractions were measured using two capacitive void fraction sensors. Mass fluxes ranging from 100 – 400 kg/m2.s and vapour qualities ranging from 10 – 90% were considered. Heat transfer coefficients were also compared with void fractions. It was found that at combinations of low mass fluxes and vapour qualities, void fraction and heat transfer were significantly affected by changes in inclination angle. Generally, void fractions and heat transfer coefficients increased with downward inclination angles with an optimum angle between -10ᵒ and - 30ᵒ (downward flow). At some intermediate mass flux and vapour quality conditions, the void fraction and heat transfer coefficients were observed to be independent of the inclination angle despite changes in the prevailing flow patterns.NRF, TESP, University of Stellenbosch/ University of Pretoria, SANERI/SANEDI, CSIR, EEDSM Hub and NAC.http://www.elsevier.com/locate/ijmulflow2017-04-30hb201

Numerical study of the thermal and hydraulic characteristics of a round tube heat exchanger with louvered fins and delta winglets

Paper presented at the 8th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Mauritius, 11-13 July, 2011.Louvered fin and round tube heat exchangers are widely used in air conditioning devices and heat pumps. In this study the effect of punching delta winglet vortex generators into the louvered fin surface in the near wake region of each tube was investigated. Numerical simulations were performed on the compound design and the thermal and hydraulic characteristics were evaluated. It was found that the delta winglets can significantly reduce the size of the wake regions. This results in an enhanced heat transfer. Further, it was shown that the vortices do not propagate far downstream. Due to the flow deflection they are destroyed in the downstream louver bank. For the configuration studied, the pressure drop penalty of adding vortex generators was also significant, indicating that an optimization is necessary to select a compound design with improved overall performance.mp201

Thermodynamics of greenhouse systems : a new approach leading to new proposals for sustainable production

Paper presented at the 8th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Mauritius, 11-13 July, 2011.Greenhouse production systems produce in the Netherlands and Flanders economical important quantities of vegetables, fruit and ornamentals. Control of the crop environment has led to a high primary energy use (1500MJ/m²/year). This high primary energy use affects the economical and environmental sustainability. Research projects in the Netherlands and Flanders are launched to achieve sustainable greenhouse systems with high crop yields and low primary energy use. Until now, these projects didn’t result in the desired primary energy savings. On the contrary, the civil building industry succeeds by the passive house technology in a magnitude’s reduction for primary energy use. The primary energy saving research in greenhouse systems was mainly based on analysis of energy balances. However, the thermodynamic theory indicates that an analysis based on the concept of exergy (free energy) and energy is preferred. Such analysis could reveal possibilities for primary energy savings. The different processes and in/outputs of the greenhouse system are outlined. The appropriate equations for exergy calculations are developed. First, analyses are performed on the processes of transpiration and ventilation. Further, a total system assessment is performed. The exergy analysis indicates that primary energy saving in greenhouse systems could be the same as in the building industry, but adapted technologies need to be developed. The Institute for Agricultural and Fisheries Research (ILVO) will use this exergy analysis as a basis for the development of an exergy efficient greenhouse prototype (EXEkas).mp201

Embedding expertise for policy responses to COVID-19: comparing decision-making structures in two federal democracies

The COVID-19 crisis focused attention on how experts from different scientific fields provided advice to governments through expert committees and task forces. We compared experiences in two federal democracies, Belgium and Australia, by applying a mixed methods approach (literature review, media review, policy documents analysis). This comparative study found that expertise was institutionalized in different ways and its processes and priorities shifted over time. The policy coordination challenges inherent in federalism were largely overcome in Australia through strongly embedded health advisory processes. In Belgium, the advisory process was less stable, with advisory councils being abandoned, replaced, expanded, or downgraded during the course of the crisis.Security and Global Affair

Applying the volume averaging theory to open-cell metal foam in natural convection/radiation

Papers presented to the 11th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, South Africa, 20-23 July 2015.Heat sinks made out of open-cell aluminium foam are investigated numerically in natural convection. Results derived from a 2D numerical model are compared to results for in-house experiments. Different foam heights are studied. The numerical model is based on the volume averaging theory. The aluminium foam that is used has 10 pores per linear inch and a porosity of 93%. The temperature of the substrate was varied between 55°C and 95°C. The geometry used in the numerical model replicates the experimental test rig as well as possible. A discussion of the determination of the closure terms is given. If only convective heat transfer is taken into account in the numerical model, the relative differences between the numerical and experimental results are smaller than 29% for all foam heights studied. However, when the influence of radiation is included in the numerical model, it is shown that the numerical results differ less than 9% with the experimental ones. This validates the choice of closure terms used in the model and this shows that it is necessary to properly model radiative heat transfer in numerical models of open-cell aluminium foam in natural convection.am201