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The role of EU funds in capital investment for health-care:A case study of Estonia's approach to provider network transformation, 2004-2024
No full textBackground Many health systems need substantial capital investment to advance people-centred, integrated care, but public capital budgets are often constrained. Estonia strategically leveraged EU grants to enable provider-network transformation alongside broader service-delivery reforms.Reform contentAfter EU accession, Estonia leveraged EU grants to finance coordinated programmes of investment aligned with national strategies. Across 121 projects, €652.8 million was invested, of which €463.8 million came from EU funds. Investments supported optimisation of the acute hospital network, expansion of nursing/long-term care, establishment of multidisciplinary primary health-care (PHC) centres, and upgrades to digital infrastructure and emergency preparedness. Project selection was determined by functional development plans, reform-related eligibility criteria and co-financing rules, with the Estonian Health Insurance Fund (EHIF) engaged to assess long-term budget impact. Expected resultsOverall, this multi-phase investment programme was designed to modernise infrastructure, rationalise acute capacity, expand PHC scope and strengthen continuity of care and preparedness. Observed system changes include: fewer acute beds and more nursing beds; modernised regional hospitals; and substantial PHC and digital upgrades. However, uptake of extended PHC services was limited in practice, highlighting the need to combine capital and organisational change. ConclusionsEstonia’s experience shows that EU grant funds - though modest relative to total health spending - can spur reconfiguration when embedded in clear strategies, conditional access to capital, inclusive stakeholder engagement, and purchaser alignment. Future sustainability will depend on securing predictable domestic capital and ensuring that infrastructure investments are matched by service-delivery and workforce changes to realise intended benefits
Ultrasound-driven formation of defects and radicals in contact-electro-catalysis: a DFT and AIMD investigation
No full textThis study reveals the critical chemical and physical roles of ultrasound in enhancing contact-electro-catalysis (CEC), using the methane (CH4) oxidation process as a model system. By integrating density functional theory (DFT), ab initio molecular dynamics (AIMD), and targeted experiments, we demonstrate for the first time that ultrasonic treatment significantly modifies the solid material’s (i.e. CEC catalyst) surface chemistry and morphology, leading to enhanced catalytic performance. FTIR and Raman spectroscopy analyses reveal distinct molecular-level changes in the tested solid material (i.e. fluorinated ethylene propylene (FEP)) following ultrasonication, specifically the formation of C–H bonds, aligning closely with theoretical spectra predictions. Additionally, ultrasound induces substantial physical alterations, tripling the surface roughness of FEP, and significantly elevating fluoride ion concentrations in the surrounding solution, indicating pronounced C–F bond cleavage. AIMD simulations further elucidate that ultrasound-generated radicals initiate homogenous catalytic pathways by cleaving C–H bonds in CH4, identifying this as a critical mechanistic step previously unclarified. Those induced structural defects in FEP could also simultaneously enhance heterogeneous catalytic activity. Our findings establish a comprehensive mechanistic framework that resolves prior ambiguities in ultrasound-assisted CEC processes, offering robust theoretical and experimental foundations for advancing CEC catalytic efficiency and guiding future CEC catalyst development
Enhanced Hydrogeochemical Baseline of a CO2 Injection Facility in Southern Alberta, Canada
Get PDFGeological storage of CO2 is anticipated to play a significant role in the management and reduction of greenhouse gas emissions. Monitoring of CO₂ injection facilities is essential to provide reassurance of the containment of the injected CO2. Here, we report results over six years (2018–2023) for a hydrogeological and geochemical (gas compositions, δ13CCH4, δ13CCO2, δ2HCH4 and noble gas concentration and isotopes) monitoring program at a small-scale CO2 injection facility located near Brooks, Alberta, Canada with injection ∼300 m below ground. The results provide a comprehensive record of the subsurface hydrological and geochemical conditions over the six-year period. Injected CO2 was not detected in samples from the injection zone. There was also no indication of injected CO2 in samples collected from surface casing vents of the three ∼300 m deep wells, nor was injected CO2 observed in samples from the six shallow groundwater wells (<105 m deep). Various compositional and isotopic changes have been observed over time which are interpreted to either be indirectly related to CO2 injection or completely unrelated indicating non-CO2 injection related variability in the baseline conditions of the site. Additionally, a progressive reduction in hydraulic head has been observed in some shallow aquifers consistent with drought conditions in the region. Our study implies that complex subsurface changes may occur at CO2 storage sites which may be unrelated to human activity, complicating the monitoring of CO2 injection
Registered Report Stage I: Prioritizing sociability over morality:Preferring false empathic over truthful unempathic emotion communication
Get PDFLiterature on person perception suggests the primacy of morality over sociability in interactions. While theories of emotion highlight the importance of adhering to socially acceptable display rules, a contentious debate surrounds whether individuals prioritize moral or sociable communication of emotions. We investigated how people perceive and react to others who falsely communicate empathic versus truthfully communicate unempathic emotions related to others' (mis)fortunes. Through three preregistered studies, we examined participants' perceptions (sociability and morality) and behavioral reactions (in a Dictator Game) by employing various paradigms (vignette and retrospective recall) and situations (e.g., promotion and lottery). Consistently across our studies, we found that participants perceived targets who truthfully communicated unempathic emotions as higher on morality and lower on sociability compared to those who falsely communicated empathic emotions. Moreover, Studies 2 and 3 revealed that participants formed more favorable impressions of, and were more willing to interact with, the target who falsely communicated empathic emotions, as opposed to those who truthfully communicated unempathic emotions. This preference was explained by perceived morality and sociability attributed to the targets. Building on these findings, we propose two follow-up studies aimed at replicating our results and extending them to a laboratory setting – a Gamble Game where participants will directly encounter an actual (mis)fortune, and a Dictator Game with an allegedly real interaction partner. Our expected findings indicate that falsely communicating empathic emotions is favored over truthfully communicating unempathic emotions, suggesting the primacy of sociability over morality in the context of communicating emotions related to others' (mis)fortunes
Spatial and social cognition jointly determine multimodal demonstrative reference:Experimental evidence from Turkish and Spanish
Get PDFAll languages in the world have demonstrative terms such as ‘this’ and ‘that’ in English, which have traditionally been treated as spatial words. Here we aim to provide experimental evidence that demonstrative choice is jointly determined by spatial considerations (e.g., whether the referent is near or far) and socio-cognitive factors (e.g., the listener's attention focus). We also test whether demonstrative choice varies depending on the speaker's use of pointing, to provide evidence for a multimodal account of demonstrative systems. We focus on the Turkish system and compare it with the Spanish one to better understand the cross-linguistic variability of 3-term demonstrative systems. Corpus studies have suggested that the Turkish proximal ‘bu’ and distal ‘o’ mark a spatial contrast between near and far space, whereas the medial ‘şu’ is used to direct the listener's attention to a new referent. Supporting this analysis, an online experiment using a picture-based demonstrative-choice task revealed that the medial form ‘şu’ was preferred when the listener was looking at the wrong object. The results of a second experiment using video stimuli further showed that the medial ‘şu’ was preferred when the speaker pointed to the referent to direct the listener's attention, whereas the proximal demonstrative was used in near space and the distal in far space, mostly in joint attention and without pointing. The results of a third experiment in Spanish showed radically different patterns of demonstrative-pointing use. The medial ‘ese’ was preferred in joint attention, whereas the proximal ‘este’ and distal ‘aquel’ were selected to direct the listener's attention towards the intended referent but without an effect of pointing. Our results confirm that demonstrative choice within a given system is determined by both spatial and socio-cognitive factors, interacting with pointing patterns and varying across languages. Leveraging recent experimental work in several languages, we interpret these findings as further evidence for the weighted parameters framework (e.g., referent position and listener attention), which explains demonstrative choice beyond previous categorical analyses
Navigating digital welfare:A multi‐level maze?
Get PDFGreater conceptual and empirical engagement with welfare state complexity is needed in studies of digital welfare. This article explores how existing concepts such as welfare systems, subsidiarisation, rescaling and fragmentation can advance our understanding of claimants' digital welfare experiences. Focussing on the United Kingdom—well-known for its digital welfare approach to Universal Credit—the article demonstrates the need for scholars to look beyond single digital reforms. It draws on empirical data from the Navigating Digital Welfare project to explore experiences of digital welfare from the perspective of claimants in multi-level welfare systems who engage with multiple ‘modes of digitalisation’ and competing digitally mediated citizen–state relations. The research finds that multi-level welfare creates a complex and unsettling digital welfare experience for individuals who can access multiple types of social security and engage with multiple unpredictable interfaces, possess limited understanding of the links between different agencies and data sharing and experience frequent difficulties accessing human contacts. This context has the potential to create heightened inequalities due to multiple administrative burdens which can lead to underclaiming, misinformation or an inability to access services
The experience of long-term care staff caring for people with dementia in low- and middle-income Countries (LMICs):A qualitative evidence synthesis
Get PDFBackground: The demand for long-term residential care for people with dementia is, especially for those in the moderate to severe stages, increasing. However, dementia care services within long-term care (LTC) settings remain underdeveloped in low- and middle-income countries (LMICs). Objectives: This qualitative evidence synthesis aimed to explore LTC staff’s experiences of taking care of people with dementia in LTC facilities in LMICs. Methods: A comprehensive literature search was conducted of six databases in January 2023 and updated in August 2024 for qualitative studies of LTC staff’s experience of caring for people with dementia. Thematic synthesis was utilised for data synthesis, and NVivo facilitated this process. Results: 8,565 studies were screened, and 11 articles were included in this review. The studies included were conducted in Brazil (n = 2), China (n = 5), India (n = 1), Iran (n = 1), Malaysia (n = 1) and South Africa (n = 1) between 2012 and 2024. An overarching theme was identified: We are an island: underdeveloped dementia care within the LTC settings in LMICs, and the following categories identified as (1) the development of care provided for people living with dementia within care home settings is in its infancy; (2) the positive and effective coping strategies that may help embrace a brighter future of dementia care; (3) the deficiencies in caregiving approaches that contributed to poor-quality care for people living with dementia. Conclusions: The development of dementia care services within LTC in LMICs is still in its early stages. The main concern is the lack of available support and training for care staff and their insufficient dementia knowledge and care competencies. We hope that this review will help to increase attention to this significant issue of long-term institutional care for people with dementia in LMICs and that further research could investigate and enhance potential improvements in the practical implementation of long-term residential dementia care.</p
What role for local knowledge in ocean governance?
No full textRecent years have seen a significant reappraisal of ‘local knowledge’ and its value in science policy and global science governance. This type of knowledge, often interchangeably used with the term ‘traditional knowledge’, was already discussed and embedded in the 1992 Earth Summit in Rio de Janeiro, with the Convention on Biological Diversity (CBD) and the ensuing Nagoya Protocol adopted in 2010 on Access to Genetic Resources and Equitable Sharing of Benefits arising from their utilization. The Nagoya Protocol refers to “traditional knowledge” of “Indigenous and local communities”. In 2022, the Conference of the Parties of the CBD made a Decision adopting the Global Biodiversity Framework (GBF) which importantly promotes coherence and cooperation across biodiversity and other relevant multilateral agreements4 engaging with what it terms as “best available data” and “traditional knowledge
Optimal placement of electric vehicle slow-charging stations: A continuous facility location problem under uncertainty
Get PDFElectric vehicles (EVs) are becoming a key mechanism to reduce emissions in the transportation industry, and hence contribute to the green transition. In this paper, we present a mathematical programming model which determines the optimal placement of EV charging stations such that chargers are placed in the most cost-efficient way possible for all stakeholders, assuming additionally that EV charging demand is inherently stochastic in nature. The model is formulated as a two-stage, continuous location–allocation model in the form of a generalised Weber problem in two dimensions. However, this formulation is non-convex and notoriously difficult to solve. We therefore propose a suitable discretisation procedure to find high quality solutions in suitable time. The discretisation procedure shows strong performance across a variety of computational experiments using randomly generated scenarios, maintaining robustness in terms of the objective value and overall solution quality.A part of this solution procedure was entered into the 15th AIMMS-MOPTA Optimisation Modelling Competition
Classification of donkey systems in Ethiopia
Get PDFWorking donkeys play a critical role in transportation, agriculture and household resilience in low- and middle-income countries. Other animals that are kept for production purposes, such as cattle, are often grouped into broad production system classes, such as dairy or pastoral, for comparison between and better understanding of the needs and outputs of animals within specific sectors. Despite the importance of working donkeys for sustaining livelihoods there are no systematic classifications of these populations. The aim of this study was to classify and characterise donkey systems in Ethiopia using household-level questionnaire data which included donkey ownership, husbandry, use and local environment data, through multiple factor and hierarchical cluster analysis. Household questionnaire data from 241 donkey-owning households in three districts of Ethiopia were used. Three distinct clusters of donkey ownership were identified: ‘Domestic-Pastoral’; ‘Domestic-Agricultural’ and ‘Commercial’. Differences between systems are primarily influenced by donkey purpose, environmental (agro-ecological) factors, and husbandry practices. Constraints associated with donkey ownership varied across clusters: households in the commercial system reported higher incidence of injuries and welfare concerns, in the pastoral system the main constraints were drought and feed shortage, and domestic-agricultural households reported infectious diseases as the main challenge. This new classification of donkey systems provides a framework for analysing donkey health and welfare data, enabling more context-specific needs assessments and facilitating the design of targeted interventions to improve equid health and household livelihoods
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