Comparative financing analysis and political economy of noncommunicable diseases

The pandemic of chronic non-communicable diseases (NCDs) poses substantial challenges to the health financing sustainability in high-income and low/middle income countries (LMICs). The aim of this review is to identify the bottle neck inefficiencies in NCDs attributable spending and propose sustainable health financing solutions. The World Health Organization (WHO) introduced the “best buy” concept to scale up the core intervention package against NCDs targeted for LMICs. Population- and individual-based NCD best buy interventions are projected at US$170 billion over 2011–2025. Appropriately designed health financing arrangements can be powerful enablers to scale up the NCD best buys. Rapidly developing emerging nations dominate the landscape of LMICs. Their capability and willingness to invest resources for eradicating NCDs could strengthen WHO outreach efforts in Asia, Africa, and Latin America, much beyond current capacities. There has been a declining trend in international donor aid intended to cope with NCDs over the past decade. There is also a serious misalignment of these resources with the actual needs of recipient countries. Globally, the momentum towards the financing of intersectoral actions is growing, and this presents a cost-effective solution. A budget discrepancy of 10:1 in WHO and multilateral agencies remains in donor aid in favour of communicable diseases compared to NCDs. LMICs are likely to remain a bottleneck of NCDs imposed financing sustainability challenge in the long-run. Catastrophic household health expenditure from out of pocket spending on NCDs could plunge almost 150 million people into poverty worldwide. This epidemiological burden coupled with population ageing presents an exceptionally serious sustainability challenge, even among the richest countries which are members of the Organization for Economic Co-operation and Development (OECD). Strategic and political leadership of WHO and multilateral agencies would likely play essential roles in the struggle that has just begun.     

Fraudster’s and victims’ profiles and loss predictors’ hierarchy in the mental healthcare industry in the US

Abstract

Background

Fraud- or theft-related crimes account for the highest number of crimes in the mental health industry in the US.     

Within the triangle of healthcare legacies: comparing the performance of South-Eastern European health systems

Objective: Inter-regional comparison of health-reform outcomes in south-eastern Europe (SEE).

Methods: Macro-indicators were obtained from the WHO Health for All Database. Inter-regional comparison among post-Semashko, former Yugoslavia, and prior-1989-free-market SEE economies was conducted.

Results: United Nations Development Program Human Development Index growth was strongest among prior-free-market SEE, followed by former Yugoslavia and post-Semashko. Policy cuts to hospital beds and nursing-staff capacities were highest in post-Semashko. Physician density increased the most in prior-free-market SEE. Length of hospital stay was reduced in most countries; frequency of outpatient visits and inpatient discharges doubled in prior-free-market SEE. Fertility rates fell for one third in Post-Semashko and prior-free-market SEE. Crude death rates slightly decreased in prior-free-market-SEE and post-Semashko, while growing in the former Yugoslavia region. Life expectancy increased by 4 years on average in all regions; prior-free-market SEE achieving the highest longevity. Childhood and maternal mortality rates decreased throughout SEE, while post-Semashko countries recorded the most progress.

Conclusions: Significant differences in healthcare resources and outcomes were observed among three historical health-policy legacies in south-eastern Europe. These different routes towards common goals created a golden opportunity for these economies to learn from each other.     

Project-based pedagogy for the facilitation of webpage design

Real issues of web design and development include many problem-solving tasks. There are, however, some inadequacies associated with the implementation of appropriate pedagogy for organised and structured instruction that supports the rational problem-solving paradigm. The purpose of this article is to report on a study for the design and implementation of an Instructional Web Design Programme (IWDP) with methodology-specific guidelines in an information systems design context. A second purpose is to discuss the pedagogy developed within the IWDP and its effects on promoting technological problem solving of learners in the project-based classroom. A qualitative, action-research approach was the basis for this study. The sample consisted of 17 learners at an institution of higher education. The researchers used a focus group interview, journals and essays to observe learners’ behaviour, to analyse their project designs and to assess their opinions and experiences with regard to the IWDP. An organised and structured instructional environment within the IWDP helped the teacher to promote technological problem solving. The teacher and learners acknowledged the components of the programme (for example, assessment criteria, range statements, performance indicators, pre-defined learner tasks and activities) in the project-based classroom. Practical and cognitive apprenticeship and experiential and situated learning were used to accommodate the problem-solving needs of learners. Learners indicated a need for a variety of tools and expert guidance in a peer-based collaborative learning environment.     

Population,wealth, and resources up to the year 2000

The authors use the second-generation Mesarovic-Pestel model to produce global scenarios. In the first (open-loop) case there is little interaction between different areas (eg agriculture, energy, or resources). The results are similar to forecasts made by other research groups. The authors show that in the long run this open-loop approach is implausible. The closed-loop approach significantly alters the scenarios. This is highlighted by the combined-problem scenario, which adopts some of the more pessimistic assumptions from the other organisations' projections while retaining the interactions between areas. The authors stress the importance of the closed-loop approach when considering global futures. They also examine the regional trends which may be masked by the global figures.     

A Synergy Between the Technological Process and a Methodology for Web Design: Implications for Technological Problem Solving and Design

Traditional instructional methodology in the Information System Design (ISD) environment lacks explicit strategies for promoting the cognitive skills of prospective system designers. This contributes to the fragmented knowledge and low motivational and creative involvement of learners in system design tasks. In addition, present ISD methodologies, including web design methodologies, do not focus sufficiently on technological problem solving and design. Engagement in system design tasks demands critical thinking [Shelly, Cashman & Rosenblatt, 2001, Systems Analysis and Design, 4th edn. Course Technology, Boston] and abstraction skills [Harris, 1999, Systems Analysis and Design for the Small Enterprise, The Dryden Press, Harcourt Brace College Publishers, Fort Worth]. The aim of this paper is to explain a synergy between the technological process and web design methodology and its influence on the development of the cognitive skills of learners in the ISD context. In this research, the Team Structure Software Process (TSSP) methodology was integrated with the stages of the technological process. An interface approach between Information Systems and Technology Education was adopted during the implementation of an Instructional Web Design Program (IWDP), which served as a framework for building a software product. This research was based on a qualitative, action-research approach where individual interviews, focus group interviews, observation and document sources were used to gather data. Seventeen students at an institution of higher education were observed and their experiences were investigated through a focus group interview, journals and an essay. In addition, an interview with the teacher was conducted to investigate her thoughts and feelings during the implementation of the IWDP. During the implementation of the IWDP, multi-method learning was promoted, enlarging learners' insight into the design process and a climate for enhancing intellectual processes and skills created [Jakovljevic, 2002, An Instructional Model for Teaching Complex Thinking through Web Page Design, DEd thesis, Rand Afrikaan University, Johannesburg] This revised version was published online in July 2006 with corrections to the Cover Date.