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- Fullman, N., et al.
(författare)
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Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
- 2018
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Ingår i: Lancet. - : Elsevier BV. - 0140-6736. ; 391:10136, s. 2236-2271
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Tidskriftsartikel (refereegranskat)abstract
- Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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- Aarstad, Åsne, et al.
(författare)
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Researching Private Security in Africa : Two Theoretical Orientations, Two Tales of Security Governance
- 2018
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Ingår i: Global Policy. - : John Wiley & Sons. - 1758-5880 .- 1758-5899. ; 9:4, s. 586-588
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Recension (övrigt vetenskapligt/konstnärligt)abstract
- The two books highlight two different views on the way that private security is governed in the African states under review. The Governance of Private Security by Marco Boggero. Basingstoke: Palgrave Macmillan, 2018. xvii + 199 pp., £99.99 hardcover 978‐3‐319‐69592‐1, £79.50 e‐book 978‐3‐319‐69593‐8 Private Security in Africa: From the Global Assemblage to the Everyday edited by Paul Higate and Mats Utas. London: Zed Books, 2017. 192 pp., £24.99 paperback 9781786990259
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- Akiba, K., et al.
(författare)
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LHC forward physics
- 2016
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Ingår i: Journal of Physics G: Nuclear and Particle Physics. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 43:11
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Tidskriftsartikel (refereegranskat)
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- de Oliveira Neto, Francisco Gomes, et al.
(författare)
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Visualisation to Support Fault Localisation in Distributed Embedded Systems within the Automotive Industry
- 2018
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Ingår i: 2018 IEEE International Symposium on Software Reliability Engineering Workshops (ISSREW). - : IEEE. - 9781538694435
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Konferensbidrag (refereegranskat)abstract
- This paper presents the design, development and evaluation of a software tool to assist the localisation of root causes of test case failures in distributed embedded systems, specifically vehicle systems controlled by a network of electronic control units (ECUs). We use data visualising to provide sensible information from a large number of test execution logs from large-scale software integration testing under a continuous integration process. Our goal is to allow more efficient root-cause identification of failures and foster a continuous feedback loop in the fault localisation process. We evaluate our solution in-situ at the Research and Development division of Volvo Car Corporation (VCC). Our prototype helps the failure debugging procedures by presenting clear and concise data and by allowing stakeholders to filter and control which information is displayed. Moreover, it encourages a systematic and continuous analysis of the current state of testing by aggregating and categorising historical data from test harnesses to identify patterns and trends in test results.
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- de Oliveira, Ricardo Ramos, et al.
(författare)
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Impact of the Vendor Lock-in Problem on Testing as a Service (TaaS)
- 2017
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Ingår i: 2017 IEEE INTERNATIONAL CONFERENCE ON CLOUD ENGINEERING (IC2E 2017). - : IEEE. - 9781509058174 ; , s. 190-196
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Konferensbidrag (refereegranskat)abstract
- Testing as a Service (TaaS) is a new business and service model that provides efficient and effective software quality assurance and enables the use of a cloud for the meeting of quality standards, requirements and consumer's needs. However, problems that limit the effective use of TaaS involve lack of standardization in writing, execution, configuration and management of tests and lack of portability and interoperability among TaaS platforms - the so-called lock-in problem. The lock-in problem is a serious threat to software testing in the cloud and may become critical when a provider decides to suddenly increase prices, or shows serious technical availability problems. This paper proposes a novel approach for solving the lock-in problem in TaaS with the use of design patterns. The aim to assist software engineers and quality control managers in building testing solutions that are both portable and interoperable and promote a more widespread adoption of the TaaS model in cloud computing.
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