Transforming towards sustainable health and wellbeing systems:Eight guiding principles based on the experiences of nine Dutch Population Health Management initiatives

Introduction Population Health Management initiatives are increasingly introduced, aiming to develop towards sustainable health and wellbeing systems. Yet, little is known about which strategies to implement during this development. This study provides insights into which strategies are used, why, and when, based on the experiences of nine Dutch Population Health Management initiatives. Methods The realist evaluation approach was used to gain an understanding of the relationships between context, mechanisms and outcomes when Population Health Management strategies were implemented. Data were retrieved from three interview rounds (n = 207) in 2014, 2016 and 2017. Data was clustered into guiding principles, underpinned with strategy-context-mechanism-outcome configurations. Results The Dutch initiatives experienced different developments, varying between immediate large-scale collaborations with eventual relapse, and incremental growth towards cross-sector collaboration. Eight guiding principles for development towards health and wellbeing systems were identified, focusing on: 1. Shared commitment for a Population Health Management-vision; 2. Mutual understanding and trust; 3. Accountability; 4. Aligning politics and policy; 5. Financial incentives; 6. A learning cycle based on a data-infrastructure; 7. Community input and involvement; and 8. Stakeholder representation and leadership. Conclusion Development towards a sustainable health and wellbeing system is complex and time-consuming. Its success not only depends on the implementation of all eight guiding principles, but is also influenced by applying the right strategies at the right moment in the development

Reproductive cycle and migration of the blue shark (prionace glauca) in south atlantic ocean.

A study conducted in Southern Atlantic Ocean, between 27°S and 35°S, and researches developed by several authors propose the existence of an annual reproductive cycle for the blue shark, Prionace glauca, in the South Atlantic Ocean

Caracterização da morfologia uterina e das fases de desenvolvimento embrionário do tubarão-azul, Prionace glauca (Linnaeus, 1758).

Uma amostra de 60 fêmeas do tubarão-azul, Prionace glauca (Linnaeus, 1758), capturadas no Sul do Brasil, foi submetida a análises biométricas, sendo coletados para análises detalhadas os aparelhos reprodutores de 30 fêmeas, dentre os quais, oito gravídicos. Os úteros foram descritos e classificados em seis categorias de acordo com a fase de maturidade sexual. A fecundidade uterina variou entre 10 e 39, sem apresentar relação com o comprimento total (CT). O conteúdo dos úteros foi classificado em cinco fases de desenvolvimento desde ovos uterinos até embriões com cerca de 18 cm CT. Foi possível determinar com exatidão o sexo dos embriões a partir de 10,0 cm CT, não sendo observada a predominância de nenhum dos sexos dentro dos úteros

Additional language teaching and learning in International Baccalaureate primary years program schools

This research is based on the belief that language is the vehicle of instruction, rather than a merely a subject . It focuses on additional language (AL) teaching and learning in a diverse range of Primary Y ears Programme (PYP) settings and languages. The research explores and documents practices in relation to school language policies, cultural influences, teacher beliefs and practices, teacher training, materials, assessments, and student learning outcomes and their alignment with PYP principles and practices..

Some exact and numerical results for plane steady sheared flow of an incompressible inviscid fluid

Analytical and numerical solutions are presented for the steady flow of an inviscid fluid about symmetric lifting profiles at an angle of attack in a plane sheared onset flow for which conformal mapping plays a critical role. For uniform shear (i.e. the onset flow speed varies linearly with position) in two dimensions, the disturbance field is potential and hence a solution based on the conformal transformation technique may be constructed. The Moriya transformation, which employs a leading-term transformation coefficient that stretches and rotates the field at great distances from the foil (as distinct from other classical transformations which leave the far field unchanged) is used and, with a limited number of terms selected for the transformation, a simple elegant solution is obtained that may be easily evaluated at arbitrary points on the foil contour. An additional investigation is reported for the field solution -- involving a locally similar but globally non-uniform sheared onset flow -- about one of the foils for which a simple O-type grid is analytically generated from the mapping function. These data indicate that the uniform-shear solution overpredicts the lift and surface speed on the suction side of the foil relative to the more realistic onset flow: the numerical solution predicts surface speeds that generally lie between those for the uniform flow and the uniformly sheared flow solutions.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29989/1/0000356.pd