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The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with multi-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set incentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems' characteristics. 相似文献
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Diagnostic Value of PSA and AP Tests for the Detection of Spermatozoa in Postmortem Swabs from the Genital and Anal Region in Males 下载免费PDF全文
Laurence Weitzig M.D. Ann Sophie Schroeder M.D. Ph.D. Christa Augustin Ph.D. Tobias Raupach M.D. M.M.E. Susanne Sehner M.Sc. Sven Anders M.D. M.M.E. 《Journal of forensic sciences》2015,60(1):41-44
The aim of this study was to clarify whether positive results for prostate‐specific antigen (PSA) and acid phosphatase (AP) occur in postmortem swabs from the genito‐anal region in males (n = 80; 4 regions) and females (n = 20; 3 regions) and to calculate the positive predictive value (PPV) concerning the presence of spermatozoa. In male subjects, the highest incidence of positive test results was found in urethral swabs (PSA 76%, AP 71%) and the lowest frequencies appeared in perianal and rectal swabs (15–20%). Microscopic evaluation for spermatozoa was positive between 39% in urethral swabs and 1% in rectal swabs. PPV regarding positive identification of spermatozoa was 33.3% for PSA and 31.5% for AP. The combination of both tests yielded a PPV of 38.2%. In female cases, no spermatozoa were identified, and one case was PSA‐ and AP‐positive in perianal swabs. Our findings indicate that PSA and AP tests are of limited value for the postmortem detection of spermatozoa in male subjects. 相似文献
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Susanne Lütz 《Politische Vierteljahresschrift》2003,44(2):231-243
Ohne Zusammenfassung 相似文献
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While both India and Brazil are seriously affected by the HIV/AIDS epidemic, each country has chosen a different approach to providing affordable pharmaceutical treatment. Whereas the Indian government has paved the way for market-driven solutions, Brazilian public authorities are strongly involved in the research and production of HIV/AIDS medication. Brazilian regulations permit comprehensive and free provision of HIV/AIDS drugs, whereas the majority of the affected population in India does not receive adequate pharmaceutical treatment. To explain the different policy outputs, we draw on the developmental state literature. Efficient decisionmaking structures, a devoted bureaucracy, and effective policy instruments enable public authorities to provide public goods even in the context of relative scarcity. We show that the assumptions of developmental state theory have to be complemented by the assessment of civil society actors' potential to trigger governmental interventions in the market. 相似文献
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The articles that make up this special issue were all derived from presentations at a conference that took place at the Pennsylvania State University in the Fall of 1993. This paper presents an overview of the themes and issues discussed at that conference. While the conference was broadly international, co-sponsored by Penn State University and the Max-Planck-Institut and supported financially by the DAAD, the articles included in this special issue focus principally on the nature and amount of hate crimes and xenophobia in Germany. This article describes the international and comparative nature of the conference and explains the decision to focus on the German situation. 相似文献
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Dumbleton SM 《Journal of prevention & intervention in the community》2005,30(1-2):57-73
Sociologists, economists, social workers, and psychologists provide data and analyses of the human calamity of homelessness. The general public can seem indifferent to such reports, perhaps overwhelmed by the intractability and scope of the problem. This essay describes how writers can give voice to the homeless by telling the story of individual people. Novelists, who use imagination to envision the interior life of the single homeless person, are particularly powerful. They create a negative image that contains all the essential elements of home, enabling readers to create in their own imagination the reality of what it means to live on the outside. 相似文献