PubMed · 16267509
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2005-11-03. Turkey's evolution.. https://doi.org/10.1038/438001b
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During the 1990s, proposals to contain health expenditures and demands raised by changes in the epidemiological profile led to organizational reforms in primary healthcare services in European Union countries, aimed at promoting the coordination of services provided by the various levels of care. Based on a literature review, document analysis, and interviews with key informants, the current study analyzes the institutional configurations for first-level healthcare and discusses the pre-coordination organizational reforms in the European Union countries. First-level outpatient care is provided in these countries through a wide variety of institutional configurations, observing the different financing mechanisms, range of healthcare professionals, range of clinical services provided, and the position occupied by physicians in primary care within the healthcare system. Reforms in the last decade were accompanied by a diversification in the outpatient care organizational models, with an expansion in the clinical, healthcare coordination management, and financing functions of primary care professionals, indicating a process in transition, with a redefinition of the roles played by general practitioners as the leaders of patient care.
The ENEA Radiation Protection Institute has been operating the only neutron personal dosimetry service in Italy since the 1970s. Since the 1980s the service has been based on PADC (poly allyl diglycol carbonate) for fast neutron dosimetry, while thermal neutron dosimetry has been performed using thermoluminescence (TL) dosemeters. Since the service was started, a number of aspects have undergone evolution. The latest and most important changes are as follows: in 1998 a new PADC material was introduced in routine, since 2001 TL thermal dosimetry has been based on LiF(Mg,Cu,P) [GR-200] and (7)LiF(Mg,Cu,P) [GR-207] detectors and since 2003 a new image analysis reading system for the fast neutron dosemeters has been used. Herein an updated summary of how the service operates and performs today is presented. The approaches to calibration and traceability to estimate the quantity of H(p)(10) are mentioned. Results obtained at the performance test of dosimetric services in the EU member states and Switzerland sponsored by the European Commission and organised by Eurados in 1999 are reported. Last but not least, quality assurance (QA) procedures introduced in the routine operation to track the whole process of dose evaluation (i.e. plastic QA, acceptance test, test etching bath reproducibility and 'dummy customer' (blind test) for each issuing monitoring period) are presented and discussed.