A Demand and Capacity Model For Home-Based Intermediate Care: Optimizing The ‘Step Down’ Pathway

This is the author accepted manuscript. The final version is available from IEEE via the DOI in this recordIntermediate care supports timely discharge from hospital for patients with complex healthcare needs. The purpose of 'step-down' care is to enable patients to leave hospital as soon as medically fit, avoiding costly discharge delays and consequent risks to patient health and wellbeing. Determining optimal intermediate care capacity requires balancing costs to both acute hospital and community care providers. Too much community capacity results in underutilized resources and poor economic efficiency, while too little risks excessive hospital discharge delays. Application of discrete-time simulation shows that total costs across the acute-community interface can be minimized by identifying optimal community capacity in terms of the maximum number of patients for which home visits can be provided by the service. To our knowledge, this is the first simulation study to model the patient pathway from hospital discharge through to community visits. Simulation modeling has supported short-term resource planning in a major English healthcare system.Health Data Research U

La obra de Alfredo Bryce Echenique: desde la óptica de las redes intelectuales-literarias

The work of Alfredo Bryce Echenique can get to frame itself in the study of intellectual-literary networks, if is placed it within the Latin American scope, next to Julio Ramon Ribeyro and Mario Vargas Llosa, in one triada Peruvian that as transatlantic network tied Latin America with Europe and the United States. The present work tries to come near to the analysis of these “connective mechanisms” of this transatlantic network tended by this triad Peruvian in concrete examples in chronicles of Alfredo Bryce Echenique with the entailment with the rest of its work.La obra de Alfredo Bryce Echenique puede llegar a enmarcarse en el estudio de redes intelectuales-literarias, si se la sitúa dentro del ámbito latinoamericano, junto a Julio Ramón Ribeyro y Mario Vargas Llosa, en una triada peruana que como red transatlántica vinculó América Latina con Europa y los Estados Unidos. El presente trabajo intenta aproximarse al análisis de estos “mecanismos conectivos o articuladores” de esta red trasatlántica tendida por esta triada peruana en ejemplos concretos en las crónicas ensayísticas de Alfredo Bryce Echenique con la vinculación con el resto de su obra

Autoimmune neurological syndromes associated limbic encephalitis and paraneoplastic cerebellar degeneration

PMID = 2759205

The clinico-radiological spectrum of Dyke-Davidoff-Masson syndrome in adults

PMID = 2873375