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The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems. Source


Blattner B.,University of Applied Health Sciences at Bochum-Hordel
Public Health Forum | Year: 2012

Since its foundation, one aim of the teaching commission of the German association of public health is to ensure that all study programmes in Public Health offered in Germany are of comparable level and meet international standards. The criteria for comparison have changed in course of the Bologna process: Instead of the course content, the competencies that graduates have acquired when they enter the labour market are now relevant. Source


Bilda K.,University of Applied Health Sciences at Bochum-Hordel
Aphasiology | Year: 2011

Background: Chronic aphasia is a lifelong handicap that often leads to social isolation, loss of autonomy, and restricted social activities. Hence it is essential to develop cost-effective therapeutic approaches that enable people with aphasia to practise language skills in reallife contexts. Over the last several years there has been a shift from impairment-oriented language therapy to functional approaches that train language skills in more realistic contexts. Studies performed in the cognitive neurosciences have produced evidence that massed practice and forced use are essential for achieving sustained learning success in patients with aphasia. Conversational script training is based on the theory that massed practice of a whole task is likely to result in automatic and effortless language output that may facilitate participation in everyday life activities. To enhance automatisation of script use cue-based massed drilling is required. Computers are an ideal and cost-effective medium for the implementation of this massed practice and drill. Several studies have documented the positive effects of computer treatment for people grappling with the effects of long-lasting aphasia. Aims: The study involved the development of a video-based script training programme. The objective was to show the positive effects and usefulness of the programme. Methods & Procedures: The study is a case series consisting of a pre-test, 10 days of computer-based therapy with 3 hours of daily training, and two follow-up evaluations at 4 weeks and 6 months respectively. The material included 50 conversational scripts that were presented in video scenes filmed at original locations. The baseline and posttreatment scripts were audio taped, transcribed, and compared with the target scripts on the point scale of the subtest "classification of sentences" of the Aachener Aphasia Test (AAT). Additionally, language skills were tested with the AAT and various questionnaires were filled out together with the participants and their partners to evaluate the effects of the training in the patients' everyday lives. Five participants with chronic aphasia took part in the study. All were German speakers aged 45 and upwards. They exhibited a variety of types and degrees of severity of aphasia. Word-finding difficulties accounted for a significant part of their aphasia. Outcomes & Results: The quality and quantity of production of script-related words improved in every patient. Three positive themes were identified from the questionnaires and interviews: increased verbal communication skills, improvement in communication skills evident in various everyday situations, and increased confidence. Conclusions: Video-based script training was found to be an effective treatment for chronic aphasia. © 2010 Psychology Press. Source


Gress S.,University of Applied Health Sciences at Bochum-Hordel
Public Health Forum | Year: 2015

From a health economics perspective, managed competition is important in improving the health of the population. However, the success of managed competition has been limited so far. Moreover, health insurers have few incentives to provide long-term effective prevention and health promotion. Instead, they prefer to provide services which are effective as a marketing tool in the short term. © 2015 by De Gruyter. Source


Posenau A.,University of Applied Health Sciences at Bochum-Hordel | Peters T.,Ruhr University Bochum
GMS Zeitschrift fur Medizinische Ausbildung | Year: 2016

Aim: Interprofessional education (IPE) istakingon increasing importance in our complex healthcare system and receiving ever greater attention in the teaching of health science. The majority of concepts and methods employed in this area are based on normative ideas about interprofessional cooperation and only seldom based on empirical research. This paper is an initial attempt to augment this deductive approach with an inductive perspective for the purpose of subsequently providing empirical support for IPE teaching methods. Method: Drawingon the qualitative approach to linguistic conversation analysis, language-based professional markers are identified on the basis of recorded classroom simulations with nursing and midwifery students; it is assumed that these markers are significant in relevant interprofessional communication processes and, as a result, influence actual collaboration between the health professions. These markers are classified and commented on, and their importance to teaching and practical implementation in interprofessional interaction is emphasized. Results: Students routinely use various professional markers in simulations. However, these occur much less frequently than initially expected, except when marking difference in relation to physicians. At the same time, all the interactions are shaped by pronounced self-presentation among the students, and this comprises a large aspect of the interactions observed here. Profession-specific communication and differentiation processes also appear to be slow in estab ishing themselves in terms of students delegatingtasks or voicing expectations. In addition, the role of “student” has a function that should not be underestimated in these interactions. Conclusion: Professional markers are an essential component of interprofessional communication and are based on numerous, observable linguistic phenomena, of which only a few are presented here. This empirical approach has not yet appeared in the discourse surrounding IPE; however, it is, in the authors’opinion, not only necessary to compare interprofessional interactions with lived reality, but also to be in a position to operationalize interprofessional practice and ultimately assign it to competency areas. For this reason, further empirical observations and analyses are needed to tighten the still unclear definition of interprofessional communication and to develop empirically founded, measurable criteria for teachingand testing. © 2016 Posenau et al. Source

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