1.1 Health and social care services are facing an unprecedented challenge. Shrinking budgets, especially for adult social care, coupled with ever growing demand, mean that without additional resources, major changes will be needed if the system is to avoid collapse. This is both a national and a local issue. The state of adult social care funding locally needs to be seen in the national context...

While there is broad agreement that the way that health care providers are paid affects their performance, the empirical literature on the impacts of provider payment reforms is surprisingly thin. During the 1990s and early 2000s, many European and Central Asian (ECA) countries shifted from paying hospitals through historical budgets to fee-for-service (FFS) or patient-based payment (PBP) metho...

This paper is concerned with nitrogen inputs to European catchments, how they are likely to change in future, and the implications for the INCA model. National N budgets show that the fifteen countries currently in the European Union (the EU-15 countries) probably have positive N balances – that is, N inputs exceed outputs. The major sources are atmospheric deposition, fertilisers and animal fe...

BACKGROUND AND PURPOSE The National Institutes of Health policy calls for the inclusion of under-represented groups, such as women and minorities, in clinical research. Poor minority recruitment and retention in stroke clinical trials remain a significant challenge limiting safety and efficacy in a general population. Previous research examines participant barriers to clinical trial involvement...

Poverty, ill health and ignorance are closely interlinked and each is a determinant of the other. HIV/AIDS, malaria and tuberculosis are by far the commonest causes of ill-health and death in the poorest countries of the world which happen to be in the tropics and temperate countries in Africa, Asia and South America. Morbidity and mortality from these three diseases have a major socio-economic...

Microbial water quality monitoring is crucial for managing water resources and protecting public health. However, institutional testing activities in sub-Saharan Africa are currently limited. Because the economics of water quality testing are poorly understood, the extent to which cost may be a barrier to monitoring in different settings is unclear. This study used cost data from 18 African mon...

The Virtual Observatory (VO) is realizing global electronic integration of astronomy data. One of the long-term goals of the U.S. VO project, the Virtual Astronomical Observatory (VAO), is development of services and protocols that respond to the growing size and complexity of astronomy data sets. This paper describes how VAO staff are active in such development efforts, especially in innovativ...

75 SPECIALSECTION The second blow is a 5% cut this year in the overall budgets of most agencies. That reduction, known as sequestration, kicked in this spring after the breakdown of a 2011 agreement between the White House and Congress to reduce the federal defi cit. Society offi cials say they have felt the effect of sequestration and tighter travel budgets. For example, some 14% fewer federal...

Evidence from the US pointed out, over the years, to the existence of upcoding in management practices. Upcoding is defined as classifying patients in DRG codes associated with larger payments. The incentive for upcoding is not particular to private providers of care. Conceptually, any patient classification system that is used for payment purposes may be vulnerable to this sort of strategic be...