Engaging citizens and local communities in the solar revolution: Rooftop Solar PV Country Comparison Report

The report produced by CAN Europe and its member organisations focusing on rooftop solar PV on residential buildings (including both individual and collective self-consumption) shows that there are still significant barriers at national level which impede a higher uptake of rooftop solar PV, and many Member States still lack the right regulatory framework and enabling environment

La sostenibilidad del sistema hospitalario en Cataluña. El balance de una década

ResumenLa preocupación por la sostenibilidad del sistema hospitalario ha ido creciendo a medida que se ha constatado que el incremento de la demanda es sostenido, mientras que la expectativa de crecimiento de recursos públicos para darle respuesta queda por debajo de las necesidades. La Central de Balances de CatSalut ha permitido conocer la relación que han mantenido la actividad y los recursos del conjunto de los hospitales de la Red de Hospitales de Utilización Pública (XHUP) de Cataluña desde 1993 hasta 2000. Con su análisis ha sido posible conocer cómo ha funcionado el sector hospitalario público en Cataluña durante los años noventa, prestando especial atención a la evolución de la productividad general del sistema hospitalario en el tiempo.La actividad ha crecido un 4,1% anual acumulativo; los gastos, un 1,8%, y los ingresos, un 1,9%. El coste por unidad estandarizada de valoración ha evolucionado de manera que en el año 2000 representaba un 85,3% del coste unitario de 1993.AbstractConcern about the viability of the hospital system has increased as demand has continued to grow and as the expected increase in public resources to meet this demand remains below requirements. The Central de Balances of CatSalut, which groups all the economic results of the Catalan Public Hospital Network (CPHN), has enabled determination of the relationship between activity and resources in the hospitals within the public sector from 1993 to 2000. We analyzed data from the Central de Balances to determine hospital functioning throughout the 1990s, paying special attention to the development of the hospital system's general productivity over this period.The annual accumulative growth in activity was 4.1%, that of expenses was 1.8% and that of revenues was 1.9%. Unitary cost in 2000 was 85.3% of the unitary cost in 1993

Análisis del coste hospitalario : información e instrumentos para el ajuste de la función de costes hospitalarios /

Consultable des del TDXTítol obtingut de la portada digitalitzadaEl sector hospitalari públic és el majoritari tant a Catalunya com a Espanya. En aquest entorn no s'ha primat l'anàlisi dels costos de la provisió de serveis de salut. La variabilitat dels costos i la definició de producte hospitalari s'ha basat en els Sistemes de Classificació de Pacients (SCP) i més concretament, en els Grups Relacionats amb el Diagnòstic (GRD). La hipòtesi de treball ha estat que la variabilitat deguda a la complexitat del procés de producció hospitalari no queda ben reflectida amb l'ús dels SCP ja que només aporten informació sobre la dimensió de la complexitat del concepte de producte hospitalari. Queden per explicar la seriositat de la malaltia, els outliers, els factors socioeconòmics, les característiques del procés, i els factors estructurals. Tots ells, junt amb l'ajust dels costos relatius (pesos) associats als GRD, poden explicar molt millor la variabilitat del cost hospitalari basat en al definició correcta del producte. S'ha analitzat una base de dades corresponent als hospitals de l'Institut Municipal d'Assistència Sanitària, amb 35.262 casos i 12.792 milions de pessetes assignats a pacient mitjançant una metodologia d'assignació basada en activitats (cost sobre base clínica). S'ha determinat que: - La capacitat explicativa de la variabilitat del cost dels pacients analitzats ha augmentat des del 19% mitjançant GRDs i pesos associats estàndard, fins al 50% si introduïm el concepte integral de la definició de producte, incorporem la mesura de casos extrems i ajustem correctament el pesos a l'entorn europeu. - S'ha modelitzat una funció de costos que permet analitzar el comportament de les diferents dimensions explicatives del producte i la seva influència sobre el cost per pacient. Dels resultats s'han extret implicacions: - La capacitat explicativa del cost no augmenta amb l'increment de categories dels sistemes de classificació de pacients, sinó que millora gràcies a l'explicació multidimensional del producte hospitalari. Així quants menys grups haguem de fer servir, més racional serà l'ús dels sistemes de classificació de pacients per a la gestió clínica, hospitalària i sanitària. - L'absència d'informació individual sobre el component socioeconòmic del pacient resta capacitat explicativa de la variabilitat del cost hospitalari. Aquesta manca d'informació s'hauria de replantejar tot i els problemes ètics que presenta la seva utilització, ja que és causa de variabilitat justificable no recollida pels actuals sistemes d'informació. És, per tant, causa de risc financer per determinats hospitals.Public hospital sector is the majority in Catalonia as well as in Spain. In this environment, cost analysis of health services supply was not considered an important issue. Cost variability and hospital product definition were based on Patient Classification Systems (PCS) and more specifically on Diagnosis Related Groups (DRG). The initial hypothesis was that the variability due to complexity of hospital production process was not well reflected by using PCS because they only add information about the complexity dimension of hospital product concept. It remains to explain the seriousness of illness, outliers, socio-economic status, process characteristics and structural factors. All together, with cost-based DRG-Weight, can improve the explanation of hospital cost variability based on the appropriate product definition. Database belonging to the Institut Muncipal d'Assistència Sanitària was analysed. The database includes 35,262 patients and 12.762 million pesetas assigned to them. The assignation was performed through a methodology based on activities (clinical-cost). It was determined that: - Explanatory power of cost variability for the analysed patients increased from 19% using DRG and Medicare weights, to 50% after introducing the integral concept of product definition, adding outlier cases measures and adjusting weights to the European environment. - Cost function could be determined. This enabled to analyse the different product dimensions behaviour and their influence on per-patient cost. The implications of the results were: - Cost explanatory power does not increase by adding PCS categories, but do improve through the multidimensional explanation of hospital product. Thus, the less groups we use, more rational will be the PCS to the clinic, hospital and health system management. - The absence of individual information of patient socioeconomic status undermines explanatory power of hospital cost variability. This information lack has to be reconsidered, although the ethic problems that its collection represents, since socio-economic status is a reason of some justified cost variability that is not included by current information systems. Thus, patient socio-economic status variability is a reason of financial risk for determined hospitals

Una Estrategia de desarrollo sostenible para la Eurorregión Pirineos-Mediterráneo : orientaciones básicas

El estudio tiene por objeto formular los requisitos necesarios para poner en marcha una estrategia para el desarrollo sostenible de la Eurorregión Pirineo-Mediterráneo. Este es un proyecto de cooperación transfronteriza regional promovido por el ex presidente de la Generalitat, Honorable Sr. Pasqual Maragall, que, además de Cataluña, incluye Aragón, Islas Baleares, Languedoc-Roussillon y Midi-Pyrénées. En la Unión Europea hay más de 70 eurorregiones, que ha sido creadas por regiones o entidades locales, o ambosL'estudi té per objecte formular els requisits necessaris per posar en marxa una estratègia per al desenvolupament sostenible de l'Euroregió Pirineus-Mediterrània. Aquest és un projecte de cooperació transfronterera regional promogut per l'expresident de la Generalitat, Honorable Sr Pasqual Maragall, que, a més de Catalunya, inclou Aragó, Illes Balears, Llenguadoc-Rosselló i Migdia-Pirineus. A la Unió Europea hi ha més de 70 euroregions, que ha estat creades per regions o entitats locals, o ambdó

A systematic review on multi-criteria group decision-making methods based on weights: analysis and classification scheme

Interest in group decision-making (GDM) has been increasing prominently over the last decade. Access to global databases, sophisticated sensors which can obtain multiple inputs or complex problems requiring opinions from several experts have driven interest in data aggregation. Consequently, the field has been widely studied from several viewpoints and multiple approaches have been proposed. Nevertheless, there is a lack of general framework. Moreover, this problem is exacerbated in the case of experts’ weighting methods, one of the most widely-used techniques to deal with multiple source aggregation. This lack of general classification scheme, or a guide to assist expert knowledge, leads to ambiguity or misreading for readers, who may be overwhelmed by the large amount of unclassified information currently available. To invert this situation, a general GDM framework is presented which divides and classifies all data aggregation techniques, focusing on and expanding the classification of experts’ weighting methods in terms of analysis type by carrying out an in-depth literature review. Results are not only classified but analysed and discussed regarding multiple characteristics, such as MCDMs in which they are applied, type of data used, ideal solutions considered or when they are applied. Furthermore, general requirements supplement this analysis such as initial influence, or component division considerations. As a result, this paper provides not only a general classification scheme and a detailed analysis of experts’ weighting methods but also a road map for researchers working on GDM topics or a guide for experts who use these methods. Furthermore, six significant contributions for future research pathways are provided in the conclusions.The first author acknowledges support from the Spanish Ministry of Universities [grant number FPU18/01471]. The second and third author wish to recognize their support from the Serra Hunter program. Finally, this work was supported by the Catalan agency AGAUR through its research group support program (2017SGR00227). This research is part of the R&D project IAQ4EDU, reference no. PID2020-117366RB-I00, funded by MCIN/AEI/10.13039/ 501100011033.Peer ReviewedPostprint (published version

A hierarchical integration method under social constraints to maximize satisfaction in multiple criteria group decision making systems

Aggregating multiple opinions or assessments in a decision has always been a challenging field topic for researchers. Over the last decade, different approaches, mainly based on weighting data sources or decision-makers (DMs), have been proposed to resolve this issue, although social choice theory, focused on frameworks to combine individual opinions, is generally overlooked. To resolve this situation, a novel methodology is developed in this paper based on social choice theory and statistical mathematics. This method innovates by dividing the assessment into components which provides a multiple assessment analysis, assigning weights to each source regarding their position compared to the group for each considered criteria. This multiple-weighting process maximises individual and group satisfaction. Furthermore, the method makes it possible to manage previously assigned influence. An example is given to illustrate the proposed methodology. Additionally, sensitivity analysis is performed and comparisons with other methods are made. Finally, conclusions are presented.The first author acknowledges support from the Spanish Ministry of Education, Culture and Sports [grant number FPU18/01471]. The second and third author wish to recognise their support from the Serra Hunter programme. Finally, this work was supported by the Catalan agency AGAUR through its research group support program (2017SGR00227). This research is part of the R&D project IAQ4EDU, reference no. PID2020-117366RB-I00, funded by MCIN/AEI/10.13039/501100011033.Peer ReviewedPostprint (published version

A Sustainable Development Strategy for the Pyrenees-Mediterranean Euroregion : Basic Guidelines

L'estudi presenta té per objecte formular els requisits necessaris per posar en marxa una estratègia per al desenvolupament sostenible de l'Euroregió Pirineus-Mediterrània. Aquest és un projecte de cooperació transfronterera regional promogut per l'expresident de la Generalitat, Honorable Sr Pasqual Maragall, que, a més de Catalunya, inclou Aragó, Illes Balears, Llenguadoc-Rosselló i Migdia-Pirineus. A la Unió Europea hi ha més de 70 euroregions, que han estat en funcionant per diferents periodes de temps, després d'haver estat creat per regions o entitats locals, o ambdósThe study presents sets out to formulate the necessary requirements for putting in place a strategy aimed at the sustainable development of the Pyreness-Mediterranean Euroregion. This is a cross-border regional cooperation project promoted by the former President of the Generalitat, Honorable Mr. Pasqual Maragall, which, in addition to Catalonia, includes Aragon, the Balearic Islands, Languedoc-Roussillon and Midi-Pyrénées. In the EU there are more than 70 Euroregions, bearing this or other names, which have been in existence for varying lenghts of time, having been set up by regions or local entities, or bot

A systematic review on MIVES: a sustainability-oriented multi-criteria decision-making method

Sustainability has practically become a mandatory concept to be considered in every decision, and multiple decision-making methods have been adapted to take it into account. Among them, sustainability centred methods are also known as sustainability assessments, which provides sustainability indexes to select and prioritize alternatives. One of these most recent presented techniques is MIVES, a multi attribute utility theory multi-criteria decision-making value function-based method initially developed to introduce environmental and social indicators in civil engineering design decisions and later adapted for general evaluation and prioritization of homogenous and heterogeneous alternatives. Over the last decade, it has been widely studied and applied to specific situations, but a MIVES summary is currently lacking. Therefore, in this paper MIVES literature is reviewed with a deep bibliometric analysis carried out to provide on multiple data about MIVES state-of-the-art. Furthermore, a thematic clusters categorisation is done to reveal the usefulness of MIVES as design and decision-making tool, cataloguing the wide applications of MIVES as sustainability index. Finally, a MIVES characteristics discussion is carried out to help researchers deepen their knowledge towards the method and highlight potential future research pathways.The first author acknowledges the Goverment of Spain: Ministry of Education, Culture and Sports [grant number FPU18/01471]. The second and last author wishes to recognize the support from Serra Hunter programme. Finally, this work was supported by Catalan agency AGAUR trough their research groups support program (2017SGR00227). This research is part of the R&D project IAQ4EDU, reference no. PID2020-117366RB-I00, funded by MCIN/AEI/10.13039/501100011033.Peer ReviewedPostprint (published version

Influence of the Dietary Polyunsaturation Level on Chicken Meat Quality: Lipid Oxidation

The present study was carried out to evaluate the influence of increasing amounts of dietary polyunsaturated fatty acids (PUFA) and α-tocopheryl acetate (α-TA) supplementation on lipid oxidation of raw and cooked thigh meat stored under refrigeration. One hundred ninety-two female, 1-d-old, broiler chickens were randomly distributed into 16 experimental treatments resulting from the combination of 4 levels of dietary PUFA (15, 34, 45, and 61 g/kg) and 4 levels of supplementation with α-TA (0, 100, 200, and 400 mg/kg). Thiobarbituric acid reactive substance (TBARS) values in cooked meat and cooked refrigerated meat were 12- and 24-fold higher, respectively, than in raw meat. Dietary polyunsaturation and α-TA supplementation affected lipid oxidation more markedly in cooked meat and cooked refrigerated meat than in raw meat and raw refrigerated meat. Lipid oxidationa in cooked meat showed a significant linear increase as the concentration of PUFA in raw meat increased. The oxidative stability of meat was not affected by an increase in the dietary α-TA level from 200 to 400 mg/kg. Nonlinear relationship between TBARS values in cooked meat and α-tocopherol content of raw meat showed saturation in the antioxidant effect of α-Toc. The equation y = x (11.88+ 63.38e−0.007z) was calculated to predict the minimum inclusion of α-tocopherol to diets (z) of chickens with certain dietary PUFA content (x) to assure a certain TBARS value (y)

Budget impact analysis of switching to digital mammography in a population-based breast cancer screening program: a discrete event simulation model

Objective: To assess the budgetary impact of switching from screen-film mammography to full-field digital mammography in a population-based breast cancer screening program. Methods: A discrete-event simulation model was built to reproduce the breast cancer screening process (biennial mammographic screening of women aged 50 to 69 years) combined with the natural history of breast cancer. The simulation started with 100,000 women and, during a 20-year simulation horizon, new women were dynamically entered according to the aging of the Spanish population. Data on screening were obtained from Spanish breast cancer screening programs. Data on the natural history of breast cancer were based on US data adapted to our population. A budget impact analysis comparing digital with screen-film screening mammography was performed in a sample of 2,000 simulation runs. A sensitivity analysis was performed for crucial screening-related parameters. Distinct scenarios for recall and detection rates were compared. Results: Statistically significant savings were found for overall costs, treatment costs and the costs of additional tests in the long term. The overall cost saving was 1,115,857J (95%CI from 932,147 to 1,299,567) in the 10th year and 2,866,124J (95%CI from 2,492,610 to 3,239,638) in the 20th year, representing 4.5% and 8.1% of the overall cost associated with screenfilm mammography. The sensitivity analysis showed net savings in the long term. Conclusions: Switching to digital mammography in a population-based breast cancer screening program saves long-term budget expense, in addition to providing technical advantages. Our results were consistent across distinct scenarios representing the different results obtained in European breast cancer screening programs.This was supported by grants from the Health Ministry of Spain (Fondo de Investigación Sanitaria PI07/90357)