143 research outputs found

    Approaches to Financing Care for the Uninsured

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    Towards a multidimensional self-assessment for software process improvement: a pilot tool

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    The SPI Manifesto provides a framework for guiding software development organisations in their improvement efforts. Based on the Values of People, Business and Change, which are supported and informed by one or more of the ten principles, the designer and developer can avoid pitfalls, minimise risks and make their business successful. It has been established, in theory and practice, that improving the process results in improvement of the products and services emanating from that process. Following a number of earlier multidimensional analyses of the SPI Manifesto, carried out by the authors, a series of tabular representations identifying the nature, importance and strength of relationships between the Manifesto’s Values and Principles in terms of eight dimensions encapsulated in the acronym STEEPLED (Sociocultural, Technical, Economic, Environmental, Political, Legal, Ethical and Demographic) were developed. In this paper, we present a conceptualisation of a pilot automated tool (based on the STEEPLED Analysis), which could, potentially, be implemented/realised and used for self-assessment by software developing organisations. Starting with a self-assessment, current issues and requirements could be identified and revealed. The self-assessment using the pilot automated tool would, additionally, reveal areas requiring improvement, and would serve as a guide for the participating organisation to put focus on prioritising candidate process areas that require improvement. Also, the field testing of the pilot tool could enable the design and improvement of the tool itself, which, in turn, will be used in future for expert external/independent process assessment

    Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

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    In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients’ choice, as well as the differences among the socio-demographic groups. We also estimate the marginal willingness to pay for the improvement in attribute levels by calculating marginal rates of substitution. The results show that respondents from a village or the capital, with low education and bad health status are more driven by the changes in the price attribute when choosing between health care providers. Respondents value the good skills and reputation of the physician and the attitude of the personnel most, followed by modern equipment and maintenance of the office/hospital. Access attributes (travelling and waiting time) are less important. The method of discrete choice experiment is useful to reveal patients’ preferences, and might support the development of an evidence-based and sustainable health policy on patient payments

    How will a drier climate change carbon sequestration in soils of the deciduous forests of Central Europe?

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    Global warming is accompanied by increasing water stress across much of our planet. We studied soil biological processes and changes in soil organic carbon (SOC) storage in 30 Hungarian oak forest sites in the Carpathian Basin along a climatic gradient (mean annual temperature (MAT) 9.6\u201312.1 C, mean annual precipitation (MAP) 545\u2013725 mm) but on similar gently sloped hillsides where the parent materials are loess and weathered dust inputs dating from the end of the ice age. The purpose of this research was to understand how a drying climate, predicted for this region, might regulate long-term SOC sequestration. To examine the effects of decreasing water availability, we compared soil parameters and processes in three categories of forest that represented the moisture extremes along our gradient and that were defined using a broken-stick regression model. Soil biological activity was significantly lower in the driest (\u2018\u2018dry\u2019\u2019) forests, which had more than double the SOC concentration in the upper 30 cm layer (3.28 g C/100 g soil \ub1 0.11 SE) compared to soils of the wettest (\u2018\u2018humid\u2019\u2019) forests (1.32 g C/100 g soil \ub1 0.09 SE), despite the fact that annual surface litter production in humid forests was * 37% higher than in dry forests. A two-pool SOM model constrained to fit radiocarbon data indicates that turnover times for fast and slow pools are about half as long in the humid soil compared to the dry soil, and humid soils transfer C twice as efficiently from fast to slow pools. Enzyme activity and fungal biomass data also imply shorter turnover times associated with faster degradation processes in the soils of humid forests. Thermogravimetry studies suggest that more chemically recalcitrant compounds are accumulating in the soils of dry forests. Taken together, our results suggest that the predicted climate drying in this region might increase SOC storage in Central European mesic deciduous forests even as litter production decreases

    Rapid migration from traditional or hybrid to fully virtual education in the age of the coronavirus pandemic: challenges, experiences and views of college and university students

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    The abrupt outbreak of the coronavirus pandemic throughout the world in March 2020 resulted in the sudden closure of all schools, colleges and universities, institutions, and an unprecedented pivot to remote learning. Students and teachers were confronted with the overwhelming challenge of migrating from the traditional face-to-face or hybrid mode of education to fully virtual learning and assessment environments within an extremely short amount of time. This migration was exceptionally difficult, as it took place halfway through the academic or school year in most countries. While pandemic restrictions currently vary across different regions, the 2020-2021 academic session continues to pose challenges despite the experience gained. In addition to a review of the current state-of-the-art in relation to the effects of COVID-19 on teaching and learning, this paper reports on an empirical study carried out in 26 countries (from Asia, Europe, Africa and America), by 36 academics from 29 academic institutions. Through an extensive global survey of college and university students, information was collected about the challenges (technological, economic, psychological) faced by them, as a result of the pandemic. We also asked the students’ to offer their ideas and suggestions for further improvements in teaching and learning, as we look toward a post-COVID world. In this paper, we address issues relating to the availability of, and accessibility to, necessary digital technologies (e.g., learning and communication platforms), isolation, disconnection, and loneliness among students, the overall impact of the pandemic on learning and academic performance, and the reliability of assessment methods., cybercrime dangers and fake information. A total of 1005 responses to the survey were received and analysed. The results are presented in this paper together with reflections of the authors. The paper concludes with a summary of suggestions for process improvements in distance education, and the need for preventive preparedness in the post-COVID period

    Challenges of rapid migration to fully virtual education in the age of the Corona virus pandemic: experiences from across the world

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    The social disruption caused by the sudden eruption of the Corona Virus pandemic has shaken the whole world, influencing all levels of education immensely. Notwithstanding there was a lack of preparedness for this global public health emergency which continues to affect all aspects of work and life. The problem is, naturally, multifaceted, fast evolving and complex, affecting everyone, threatening our well-being, the global economy, the environment and all societal and cultural norms and our everyday activities. In a recent UNESCO report it is noted that nearly a billion and a quarter (which is 67,7 % of the total number) of learners have been affected by the Corona Virus pandemic worldwide. The education sector at all levels has been one of the hardest hit sectors particularly as the academic/school year was in full swing. The impact of the pandemic is widespread, representing a health hazard worldwide. Being such, it profoundly affects society as a whole, and its members that are, in particular, i) individuals (the learners, their parents, educators, support staff), ii) schools, training organisations, pedagogical institutions and education systems, iii) quickly transformed policies, methods and pedagogies to serve the newly appeared needs of the latter. Lengthy developments of such scale usually take years of consultation, strategic planning and implementation. In addition to raising awareness across the population of the dangers of the virus transmission and instigating total lockdown, it has been necessary to develop mechanisms for continuing the delivery of education as well as demanding mechanisms for assuring the quality of the educational experience and educational results. There is often scepticism about securing quality standards in such a fast moving situation. Often in the recent past, the perception was that courses and degrees leading to an award are inferior if the course modules (and sometimes its assessment components) were wholly online. Over the last three decades most Higher Education institutions developed both considerable infrastructure and knowhow enabling distance mode delivery schools (Primary and Secondary) had hardly any necessary infrastructure nor adequate knowhow for enabling virtual education. In addition, community education and various training providers were mainly delivered face-to-face and that had to either stop altogether or rapidly convert materials, exercises and tests for online delivery and testing. A high degree of flexibility and commitment was demanded of all involved and particularly from the educators, who undertook to produce new educational materials in order to provide online support to pupils and students. Apart from the delivery mode of education, which is serving for certificated programmes, it is essential to ensure that learners’ needs are thoroughly and continuously addressed and are efficiently supported throughout the Coronavirus or any other future lockdown. The latter can be originated by various causes and reasons that vary in nature, such as natural or socioeconomical. Readiness, thus, in addition to preparedness, is the primary key question and solution when it comes to quality education for any lockdown. In most countries, the compulsory primary and secondary education sectors have been facing a more difficult challenge than that faced by Higher Education. The poor or in many cases non-existent technological infrastructure and low technological expertise of the teachers, instructors and parents, make the delivery of virtual education difficult or even impossible. The latter, coupled with phenomena such as social exclusion and digital divide where thousands of households do not have adequate access to broadband Internet, Wi-Fi infrastructure and personal computers hamper the promising and strenuous virtual solutions. The shockwaves of the sudden demands on all sectors of society and on individuals required rapid decisions and actions. We will not attempt to answer the question “Why was the world unprepared for the onslaught of the Coronavirus pandemic” but need to ascertain the level of preparedness and readiness particularly of the education sector, to effect the required rapid transition. We aimed to identify the challenges, and problems faced by the educators and their institutions. Through first-hand experiences we also identify best practices and solutions reached. Thus we constructed a questionnaire to gather our own responses but also experiences from colleagues and members of our environment, family, friends, and colleagues. This paper reports the first-hand experiences and knowledge of 33 co-authors from 27 institutions and from 13 different countries from Europe, Asia, and Africa. The communication technologies and development platforms used are identified; the challenges faced as well as solutions and best practices are reported. The findings are consolidated into the four areas explored i.e. Development Platforms, Communications Technologies, Challenges/Problems and Solutions/Best Practices. The conclusion summarises the findings into emerging themes and similarities. Reflections on the lasting impact of the effect of Coronavirus on education, limitations of study, and indications of future work complete the paper
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