Health‐care systems around the world face limited financial resources, and England is no exception. The ability of the health‐care system in England to operate within its financial resources depends ...in part on continually increasing its productivity. One means of achieving this is to identify and disseminate throughout the system the most efficient processes. We examine the annual productivity growth achieved by 151 hospitals over five financial years, using the same methods developed to measure productivity of the National Health Service as a whole. We consider whether there are hospitals that consistently achieve higher than average productivity growth. These could act as examples of good practice for others to follow and provide a means of increasing system performance. We find that the productivity growth of some hospitals over the whole period exhibits better than average performance, but there is little or no evidence of consistency in the performance of these hospitals over adjacent years. Even the best performers exhibit periods of very poor performance and vice versa. We therefore conclude that accepted methods of measuring productivity growth for the health system as a whole do not appear suitable for identifying good performance at the hospital level.
Diagnosis Related Group (DRG) payment systems are a common means of paying for hospital services. They reward greater activity and therefore potentially encourage more rapid treatment. This paper ...uses 15 years of administrative data to examine the impact of a DRG system introduced in England on hospital lengths of stay. We utilize different econometric models, exploiting within and cross jurisdiction variation, to identify policy effects, finding that the reduction of lengths of stay was greater than previously estimated and grew over time. This constitutes new and important evidence of the ability of financing reform to generate substantial and persistent change in healthcare delivery.
Na3V2(PO4)3/C nanocomposites are synthesized by an oleic acid-based surfactant-assisted method. XRD patterns reveal high-purity samples, whereas Raman spectroscopy evidence the highly disordered ...character of the carbon phase. Electron micrographs show submicron agglomerates with a sea-urchin like morphology consisting of primary nanorods coated by a carbon phase. The electrode material was tested in half and full sodium cells. The electrochemical performance is clearly improved by this optimized morphology, particularly at high C rates. Thus, 76.6 mA h g–1 was reached at 40C for Na3V2(PO4)3/C nanorods. In addition, 105.3 and 96.7 mA h g–1 are kept after 100 cycles at rates as high as 5 and 10C. This exceptional Coulombic efficiency can be ascribed to the good mechanical stability and the low internal impedance at the electrode–electrolyte interphase.
Abstract
Background
Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized ...COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates.
Methods
This was a population-based cohort study.
Data were obtained from Information System for Research in Primary Care (SIDIAP)—a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were ≥15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results.
Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality.
Results
We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e.g. 21.1% were 45–54 years old). Of the 44 575 who were tested with PCR, 32 723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6–15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75–84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes 24.5% (23.4% to 25.6%).
Conclusion
COVID-19 infections were widespread in the community, including all age–sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks.
A slight deviation of the stoichiometry has been introduced in Na3–3x V2+x (PO4)3 (0 ≤ x ≤ 0.1) samples to determine the effect on the structural and electrochemical behavior as a positive electrode ...in sodium-ion batteries. X-ray diffraction and XPS results provide evidence for the flexibility of the NASICON framework to allow a limited vanadium superstoichiometry. In particular, the Na2.94V2.02(PO4)3 formula reveals the best electrochemical performance at the highest rate (40C) and capacity retention upon long cycling. It is attributed to the excellent kinetic response and interphase chemical stability upon cycling. The electrochemical performance of this vanadium superstoichiometric sample in a full sodium-ion cell is also described.
Na3V2(PO4)3/C samples are synthesized by a wet‐ball‐milling and in situ carbon‐compositing process. The structural and morphological characterization of the milled samples shows that they are highly ...pure and crystalline composites, in which the specific surface undergoes an effective increase. The sample prepared by milling for 24 h shows an excellent electrochemical behavior and reaches a capacity value as high as 108.5 mA h g–1 at 40 C and full capacity recovery when returned to a C/2 rate at the end of the cycling. Furthermore, this sample is able to maintain 111 mA h g–1 at 10 C after 100 cycles. This exceptional performance is correlated to the good kinetic response, as evidenced by impedance spectroscopy and the analysis of the cell polarization at the charge and discharge branches.
The synthesis of Na3V2(PO4)3/C by a wet‐ball‐milling and an in situ carbon‐compositing process yields pure and crystalline composites with enlarged specific surface areas. This material reveals good performance as a cathode for sodium‐ion batteries owing to its excellent kinetic response.
Radical innovation is crucial for a firm’s success, and organisations should promote it. Prior research has argued that human capital is essential for a company’s innovation. However, the direct and ...indirect effects of Human Resource Management (HRM) on radical innovation have not yet been determined. Therefore, the present paper aims to explore the direct impact of HRM on radical innovation with a content approach and a process approach. It will also examine the mediating effect that learning through an exploration process has on HRM and radical innovation. Using data from 200 medium-sized Spanish industrial firms, our results demonstrate that Strategic Human Resource Management (SHRM) has a positive and direct effect on radical innovation. We also find that an HRM system directed toward change and creativity and SHRM positively support the process of exploration learning, and that competence exploration has a favourable impact on radical innovation. These results indicate that competence exploration mediates the effect HRM systems and SHRM have on radical innovation.
P2-Na2/3Fe1/3Mn2/3O2 was synthesized by an emulsion-based method. This preparative route provides a crystalline and high-purity sample with homogeneous distribution of the elements. The ...polycrystalline material contains nanometric particles and the morphology is controlled by the surfactant content. The effect of the nanometric texture on the performance in sodium test batteries was clearly evidenced by better coulombic efficiencies and lower cell polarization of nanometric P2-Na2/3Fe1/3Mn2/3O2 as compared to a sample of the same composition with micron-size particles. The kinetic improvement was related to low internal cell impedances and higher sodium diffusion coefficient. The superior performance found for the nanorod-like layered oxide assembled in a full Na-ion test cell allows envisaging this material as a potential candidate for the positive electrode of future Na-ion batteries.
•P2-Na2/3Fe1/3Mn2/3O2 nanorod or nanoplates are yielded with oleic acid as surfactant.•Nanometric samples feature superior coulombic efficiencies and low cell polarization.•The kinetic upturn is related to low cell impedances and high diffusion coefficient.•A full cell delivered an energy density of 280 W h kg−1 after discharging at C/20.
This paper addresses the new problems arisen after the recent judgement from the Spanish Constitutional Court ratifying revisable permanent prison. We need to bear in mind that Constitutional Law ...1/2015 introduces permanent revisable prison for the very first time in the Spanish sentencing system. This sentence faced serious problems of constitutionality that were highlighted by a report made by a group of experts that would serve as a basis for the action of unconstitutionality presented in June the 30th 2015. It has taken six years for the Constitutional Court to solve this action in the sadly predictable sense to consider this penalty as constitutional; nevertheless, three dissenting votes pointed in the opposite direction. This decision has left an open door that certain political parties have decided to take and advantage of, in a punitive turn to extend this revisable permanent prison to new criminal situations. So, this work seeks to analyze the ramifications of this judgement, contributing to the reflection on permanent revisable prison and its escalation, so as the problems that it raises.
El presente artículo aborda la nueva problemática surgida tras la reciente sentencia del Tribunal Constitucional en la que se avala la constitucionalidad de la prisión permanente revisable. Recordemos que fue la Ley Orgánica 1/2015 del 30 de marzo de 2015 la que introdujo por primera vez la prisión permanente revisable en el sistema penológico español. Una pena que enfrentaba serios problemas de inconstitucionalidad, que fueron puestos de manifiesto en un dictamen al respecto elaborado por un grupo de personas expertas en derecho penal y que serviría de base para el recurso de inconstitucionalidad que se presentó el 30 de junio de 2015. No fue hasta el pasado año 2021 que el Tribunal Constitucional español resolvió dicho recurso para en parte, como era tristemente previsible, avalar esta pena, si bien se emitieron tres votos particulares que apuntaron en el sentido opuesto. Este pronunciamiento ha dejado una puerta abierta que determinados partidos políticos han decidido aprovechar para, haciendo uso del populismo punitivo, proponer la ampliación de los supuestos de aplicación de esta cadena perpetua encubierta. Este trabajo pretende analizar el pronunciamiento judicial al contrastar sus principales argumentos con las opiniones doctrinales más relevantes, contribuyendo así a la reflexión sobre la escalada de la prisión permanente revisable y los problemas que ello plantea.
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