Barriers and enablers of coordination across healthcare system levels

Coordination across healthcare system levels is a global imperative to ensure efficient resource utilization and provide high-quality care. The substantial body of research on coordination in healthcare mainly concerns coordination across professional and organizational domains. Consequently, there is a dearth of empirical research aimed at delineating the determinants of coordination across healthcare system levels. This paper describes and analyses the barriers and enablers of healthcare coordination across national, regional, and local system levels in a populous Swedish region. Individual interviews and focus group discussions, encompassing a total of 63 individuals, were conducted with managers, administrators, and politicians. The findings of the paper underscore that the barriers identified were most often of a structural or institutional character, whereas the enablers of the studied cross-level coordination were mostly relational. Therefore, we propose that future research should aim to further delineate the prerequisites for personal relationships to emerge, as well as how they may act as enablers of coordination across healthcare system levels.     

Asymmetric decentralization of the administration of public safety in the Canadian federal political system

Canada's federal political system has to reconcile differences over the balance between shared rule and self‐rule concerning two bedrock principles of the constitutional government: the rule of law and democratic oversight of the exercise of the power of the state to ensure that it is not usurped. The hallmark of the administration of multilevel security governance in Canada is horizontal and vertical differentiation of diverse territorial and non‐territorial community values, preferences, interests and values has given rise to the asymmetric decentralization. This article maps the historical and constitutional roots, and then draws on examples in a survey of its institutional structure across three levels of government. It concludes by discussing the governance challenges that shared sovereignty and mismatched jurisdictional authorities pose for the effective and efficient provision of public safety in Canada.     

Validation of an ion mobility spectrometry (IMS) method for the detection of heroin and cocaine on incriminated material

The validation of a qualitative ion mobility spectrometry (IMS) procedure for the detection of trace amounts of heroin and cocaine on incriminated material using a vacuum cleaner for sampling is presented. The limit of detection, the limit of decision, selectivity and robustness were determined. As an approach, robustness was determined using ionizational interferences and matrix effects. By using this simple sampling procedure, a positive result for incriminated clothes needs a contamination of 250ng cocaine and 1000ng heroin, respectively.     

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