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The World Health Organization (WHO) recommends focusing on primary health care (PHC) as the first strategy of countries to achieve the improvement of the health level of communities and has emphasized it again in 2021. Therefore, we intend to take a different look at the PHC system with reform, innovation, and initiative by using the experiences of leading countries and identify practical and evidence-based solutions to achieve greater health.
Methods:
This is a scoping review study that has identified innovations and reforms related to PHC since the beginning of 2000 to the end of 2022. In this study, Scopus, Web Of Science, and PubMed databases have been searched using appropriate keywords. This study is done in six steps using Arkesy and O’Malley framework. In this study, the framework of six building blocks of WHO was used to summarize and report the findings.
Results:
By searching in different databases, we identified 39426 studies related to reforms in primary care, and after the screening process, 106 studies were analyzed. Our findings were classified and reported into 9 categories (aims, stewardship/leadership, financing & payment, service delivery, health workforce, information, outcomes, policies/considerations, and limitations).
Conclusion:
The necessity and importance of strengthening PHC is obvious to everyone due to its great consequences, which requires a lot of will, effort, and coordination at the macro-level of the country, various organizations, and health teams, as well as the participation of people and society.
This chapter develops a simplified discrete-time version of Kremer's model (Kremer QJE 1993) aimed at explaining the existence of a transition from a stagnation regime (where GDP per capita remains constant despite continuous technological progress) to the modern growth regime (where GDP per capita grows continuously despite population growth). As such, this chapter provides a first illustration of what a Unified Growth Model can bring to the study of the long period. We also use that model to cast some light on the Industrial Revolution, and its particular timing and location in space.
In the volume’s afterword, the founder of the Discourse–Pragmatic Variation and Change Research network assesses how the field has expanded over recent decades, and offers suggestions for its future development. The afterword discusses the strengths of this volume, including the breadth and diversity of topics covered. It calls for further studies of discourse–pragmatic variation in contact settings, for cross–linguistic comparisons, and for studying languages other than English, arguing that such analyses will facilitate exploration of how discourse–pragmatic variation and change manifests across languages. It also recommends an expansion of data sources, methodological approaches and theoretical frameworks, arguing that such expansion will diversify the kind of research questions discourse variationists can be pursue.
Anthropomorphic stone stelae of monumental dimensions dated to the 4th and 3rd millennia BC have been found in southern Europe between the Atlantic Ocean and the Caucasus. They are understood as symbolic human representations the size of which arises out of a new self-awareness of humankind in the world. Anthropomorphic stelae are one of many innovations appearing during this epoch. Other innovations are copper metallurgy and tools, in particular weapons and jewellery, as well as the wheel, the wagon, and the plough drawn by animals. These innovations are depicted on stelae; what is more, the stele itself is an innovation in which the other changes are bundled. Comparable stylistic features of stelae in different areas demonstrate far-reaching contacts. Often the origin of anthropomorphic stelae is seen in the Russian steppes, with the archaeogenetically proven migration from east to west being the cause for the building of stelae in central and western Europe. However, the oldest known stelae apparently originate in western Europe. The impulses behind the dissemination of innovations must have emanated from continuous exchange relations, but the migration in the 3rd millennium bce did not bring with it the idea itself of anthropomorphic stelae. Nowadays the question about the function of stelae is usually answered with the representation of ancestors. When anthropomorphic stones keep the memory of common roots alive, they serve the building of identity.
La prise en charge classique de la dépression unipolaire repose généralement sur l’association d’antidépresseurs et/ou psychothérapie . Dans un premier temps, nous présenterons le programme ENVIE, premier programme français de psychoéducation indiqué dans le traitement de la phase aiguë de la dépression unipolaire. Son objectif est d’enseigner aux patients les connaissances actuelles dont nous disposons sur la dépression unipolaire et les traitements efficaces, grâce à des séances didactiques et interactives . Dans un second temps, nous évaluerons l’intérêt des psychothérapies dans le traitement des symptômes dépressifs résiduels et la prévention de la rechute. En effet, malgré le développement de nouvelles molécules au cours des dernières décennies, de nombreux patients souffrant de dépression unipolaire montrent une amélioration importante encore que partielle avec la persistance de symptômes infracliniques connus pour favoriser la rechute . L’approche psychothérapique de la dépression s’est parallèlement construite à travers notamment la thérapie cognitive. Devant l’intérêt grandissant représenté par la psychothérapie de la dépression, de nouveaux courants sont plus récemment apparus à travers la thérapie d’acceptation et d’engagement et la thérapie cognitive basée sur la pleine conscience . Enfin, malgré une efficacité établie, l’accès à une psychothérapie peut être long et coûteux. La prise en charge par Internet pourrait pallier aux inconvénients des soins classiques et permettre un traitement de la dépression unipolaire de très bonne qualité à un prix abordable. Dans ce contexte, nous nous proposons d’aborder « E-COMPARED » en tant que un projet de recherche européen visant à évaluer deux modes de prise en charge de la dépression chez l’adulte : la prise en charge classique (face-à-face) et combinée (face-à-face et Internet). Cet essai clinique sera réalisé, pour la France, au sein des 11 centres experts du réseau dépression résistante (Fondation FondaMental). En conclusion, ce symposium devrait apporter un éclairage nouveau sur l’importance de l’approche psychothérapique sous ces différentes formes dans la prise en charge thérapeutique de la dépression unipolaire.
Innovations are dramatically changing the traditionally conservative global ocean shipping industry as it works to become more efficient and more sustainable. Academic and former shipping company owner Peter Lorange is best placed to make sense of how to approach and keep ahead of these changes. This book explains what the key innovations are, how to ensure a return on investment, the barriers to innovation and how to overcome them. Drawing on a number of specialist case studies, Lorange outlines the specific analytical and decision-making steps to consider and the actions to take to arrive at a new strategic blueprint for modern shipping companies. This book is invaluable for practising shipping company executives, advanced students of shipping, logistics, port management and maritime economics, and investors deciding whether to invest in a particular shipping firm.
Although adoption of agricultural innovations has been extensively examined in the literature, its impact on indicators of farm production and household welfare measures remains ambiguous in the context of sub-Saharan Africa (SSA). This study contributes to the literature by conducting a meta-regression analysis on 92 studies published between 2001 and 2015 in the SSA region. Overall, empirical results from the meta-analysis suggest that adoption of agricultural innovations has a positive and significant effect on indicators of farm production and household welfare measures. However, the magnitude of the impact is relatively small, which also suggests a weak relationship.
I introduce a minimum innovation size required for patents into a Schumpeterian growth model. We show that to satisfy the patentability requirement for minimum innovation size, each research and development (R&D) firm targets only industries in which the incumbent's technology is of sufficient obsolescence. This is because the technological gap between innovator and incumbent is greater in industries using older technologies. Although the increase in minimum innovation size reduces the number of industries targeted for R&D, it also increases the amount of R&D investment directed at those targeted industries. Consequently, introducing a minimum innovation size has a nonmonotonic (or negative) effect on the aggregate flow of innovations. Further, by deriving the endogenous long-run distribution of innovation size, we show that an increase in minimum innovation size reduces the mean innovation size. This implies that even if the patent office only grants patents for superior innovations, it causes innovators to produce generally inferior-quality innovations.
The article analyses the recent reform of contract law in France. The section of the Civil Code on the law of contract was amended and restructured in its entirety last year. The revised section came into force on 1 October 2016. The article considers its main innovations and compares them with the corresponding principles of English law and some contract law international instruments, mainly the UNIDROIT Principles and the Principles of European Contract Law. The article also assesses whether the new provisions achieve their stated aim of rendering French contract law more accessible, predictable, influential abroad and commercially attractive.
Sustained interaction between a bilingual's two languages can be a first step toward diachronic language change. We describe two investigations that explore this by examining how bilinguals process innovative syntactic structures in their first language. In the first investigation, a sentence recall/sentence matching task, bilinguals and monolinguals exhibited differences in their tolerance of expressions of induced motion, which vary in acceptability between the two languages (Portuguese and English). In the second investigation, a priming methodology was employed to induce bilinguals to produce in their first language (Spanish) innovative constructions modeled on the second language (English), using materials where the alternation is shared between the two languages (voice, reciprocal) or not (dative). The two investigations provide a window into how languages interact in bilinguals, inducing tolerance of ungrammaticality which, we will argue, could lead to long-term novel representations in the linguistic competence repositories.
This paper concerns discrete-time Markov decision chains with denumerable state and compact action sets. Besides standard continuity requirements, the main assumption on the model is that it admits a Lyapunov function ℓ. In this context the average reward criterion is analyzed from the sample-path point of view. The main conclusion is that if the expected average reward associated to ℓ2 is finite under any policy then a stationary policy obtained from the optimality equation in the standard way is sample-path average optimal in a strong sense.
The aim of this paper is to present and test a model that examines the relationship between organizational learning culture and innovativeness. Organizational learning culture consists of the organizational learning process and of different culture types that can be placed within the competing values framework. It is defined as a set of norms and values within an organization that support systematic, in-depth approaches aimed at achieving higher-level organizational learning. Innovativeness consists of both innovative culture and innovations. Innovations, the process or outcome of innovating, are more likely to occur and be more successful if there is a strong innovative culture, meaning that the behavioral patterns of the employees are directed towards innovating. We used data from 112 Turkish firms employing more than 50 people. The relationship between organizational learning culture and innovativeness is empirically tested via structural equation modeling (SEM). We found support for a very strong positive relationship between organizational learning culture and innovative culture, as well as for the indirect relation between organizational learning culture and innovations via innovative culture.
After the enthusiasm for creating “intelligent robots” in the early 1980's, progress of robotics research in the past decade has not fulfilled our expectations but revealed various difficulties in understanding motor control by man and implementing intelligent functions in robotic machines. To regain the initiative in the development of intelligent machines, this paper first presents a critical review of the state of the art of robot control and points out the necessity for improving robot servo-loops in order to facilitate skilled and dexterious motions in robotic manipulators and mechanical hands. It is then shown that the introduction of a quasi-natural potential in Lagrange's formulation of robot dynamics gives rise to the design of hyperstable PID servo-loops, which establish global asymptotic stability of set-point control. The hyperstability theoretical framework is then applied to the design of control commands in various control problems, such as hybrid (position/force) control, impedance control, model-based adaptive control, and learning control. In all cases, the passivity concept of residual robot dynamics plays a vital role in conjunction with the concept of feedback connections of two hyperstable nonlinear or linear blocks.
The paper shows that the use of both types of random noise, white noise and Poisson noise, can be justified when using an innovations approach. The historical background for this is sketched, and then several methods of whitening dependent time series are outlined, including a mixture of Gaussian white noise and a compound Poisson process: this appears as a natural extension of the Gaussian white noise model for the prediction errors of a non-Gaussian time series. A statistical method for the identification of non-linear time series models with noise made up of a mixture of Gaussian white noise and a compound Poisson noise is presented. The method is applied to financial time series data (dollar-yen exchange rate data), and illustrated via six models.
Lamperti's transformation, an isometry between self-similar and stationary processes, is used to solve some problems of linear estimation of continuous-time, self-similar processes. These problems include causal whitening and innovations representations on the positive real line, as well as prediction from certain finite and semi-infinite intervals. The method is applied to the specific case of fractional Brownian motion (FBM), yielding alternate derivations of known prediction results, along with some novel whitening and interpolation formulae. Some associated insights into the problem of discrete prediction are also explored. Closed-form expressions for the spectra and spectral factorization of the stationary processes associated with the FBM are obtained as part of this development.
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