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Esta investigación busca profundizar en la segregación escolar del alumnado con necesidades educativas especiales del segundo ciclo de Educación Infantil estimando su magnitud, determinando la incidencia de la titularidad del centro y de su adscripción al Programa Bilingüe y describiendo su evolución. Para ello, se realiza un estudio ex post facto con datos de los 10.182 estudiantes del segundo ciclo de Educación Infantil matriculados en alguno de los 77 centros ordinarios públicos y privados-concertados situados en dos ciudades de tamaño medio-grande de la Comunidad de Madrid. Los resultados indican que la magnitud de la segregación escolar está en torno al 0.20 (ISG); que la incidencia de la titularidad es baja (4.6 %), pero es alta la del Programa Bilingüe (17.2 % de promedio); y que la segregación ha descendido ligeramente en los últimos años, pero las diferencias entre centros atendiendo a su titularidad y adscripción al Programa Bilingüe han crecido. Con ello, se concluye que hay que prestar atención a la segregación en Educación Infantil y tomar medidas para combatirla. También se destaca la necesidad de replantear el Programa Bilingüe por su incidencia en la segregación escolar. (AU)

This research aims to explore the school segregation of students with special educational needs in the second cycle of Early Childhood Education by estimating its magnitude, determining the incidence of school ownership and affiliation to the Bilingual Program, and describing its evolution. To achieve this, we conduct an ex post facto study with data from the 10,182 students enrolled in one of the 77 public and private-subsidised schools in the Community of Madrid. The results indicate that the magnitude of school segregation is around 0.20 (ISG); that the incidence of school ownership is low (4.6 %), while the incidence of the Bilingual Program is high (17.2 % on average); and that segregation has slightly decreased in recent years, however the differences between schools based on ownership and affiliation to the Bilingual Program have increased. Therefore, we conclude that it is necessary to address segregation in Early Childhood Education and that measures need to be taken to combat it. We also highlight the importance of reconsidering the Bilingual Program due to its impact on school segregation. (AU)

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Esta investigación busca profundizar en la segregación escolar del alumnado con necesidades educativas especiales del segundo ciclo de Educación Infantil estimando su magnitud, determinando la incidencia de la titularidad del centro y de su adscripción al Programa Bilingüe y describiendo su evolución. Para ello, se realiza un estudio ex post facto con datos de los 10.182 estudiantes del segundo ciclo de Educación Infantil matriculados en alguno de los 77 centros ordinarios públicos y privados-concertados situados en dos ciudades de tamaño medio-grande de la Comunidad de Madrid. Los resultados indican que la magnitud de la segregación escolar está en torno al 0.20 (ISG); que la incidencia de la titularidad es baja (4.6 %), pero es alta la del Programa Bilingüe (17.2 % de promedio); y que la segregación ha descendido ligeramente en los últimos años, pero las diferencias entre centros atendiendo a su titularidad y adscripción al Programa Bilingüe han crecido. Con ello, se concluye que hay que prestar atención a la segregación en Educación Infantil y tomar medidas para combatirla. También se destaca la necesidad de replantear el Programa Bilingüe por su incidencia en la segregación escolar. (AU)

This research aims to explore the school segregation of students with special educational needs in the second cycle of Early Childhood Education by estimating its magnitude, determining the incidence of school ownership and affiliation to the Bilingual Program, and describing its evolution. To achieve this, we conduct an ex post facto study with data from the 10,182 students enrolled in one of the 77 public and private-subsidised schools in the Community of Madrid. The results indicate that the magnitude of school segregation is around 0.20 (ISG); that the incidence of school ownership is low (4.6 %), while the incidence of the Bilingual Program is high (17.2 % on average); and that segregation has slightly decreased in recent years, however the differences between schools based on ownership and affiliation to the Bilingual Program have increased. Therefore, we conclude that it is necessary to address segregation in Early Childhood Education and that measures need to be taken to combat it. We also highlight the importance of reconsidering the Bilingual Program due to its impact on school segregation. (AU)

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INTRODUCTION: While indoor smoking restrictions are common, outdoor restrictions are still rare. We explored opinions and support for regulating smoking in different indoor and outdoor environments among adults who smoke and those who recently quit smoking, in Spain. METHODS: The 2021 ITC EUREST-PLUS Spain Survey is a cross-sectional study conducted among a nationally representative sample of 1006 adults aged ≥18 years who smoked cigarettes (n=867) or had recently quit smoking (n=139). Using Poisson regression with robust variance, we estimated adjusted prevalence and prevalence ratios of favorable opinions on regulating smoking in different indoor and outdoor environments and support for regulation in unregulated outdoor environments, by sociodemographic and smoking-related characteristics. RESULTS: There were highly favorable opinions for regulating smoking in places with minors (>95% in primary and secondary playgrounds, and cars with pre-school children and minors) and outdoor transportation (60-80%). There were less favorable opinions for regulating smoking in outdoor terraces of bars/pubs and restaurants (15-20%). Support for further total outdoor regulations on smoking was moderate for markets/shopping centers, public building entrances and swimming pools (40-60%), and low for restaurants/bars/pubs (29.2%). Having quit smoking, having no significant others who smoke and/or believing that cigarette smoke is harmful to others, were factors positively associated with favorable opinions and support for regulating smoking. CONCLUSIONS: The settings in Spain with the most favorable opinions for regulation among adults who smoke and have recently quit smoking are places with minors, private cars with others and outdoor areas of public transportation, while the settings with the least favorable opinions were outdoor terraces of bars, pubs, and restaurants. Support for further total outdoor smoking bans is generally moderate, but low for restaurants, bars, and pubs. Overall, these findings suggest the feasibility of extending smoke-free policies to other public and private settings to protect others from tobacco smoke exposure.

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Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician's response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

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Public-private partnerships in drug R&D have great potential for driving innovation. They can bridge between excellent fundamental research and development and commercialization of innovative medicines to address unmet needs for the therapy of severe diseases in the interest of public health and human welfare. Therefore, public-private partnerships in drug R&D are promoted and publicly funded by governments and the European Commission. Nonetheless, they need to comply with legal requirements, particularly stemming from State aid law and competition law. Those requirements do not only protect a fair competition, but rather also further open information exchange as well as fair sharing of risks and fair participation in gains and results with the goal of having a successful collaboration and increasing the chance of successful commercialization of pharmaceutical innovations.

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IMPACT: This article presents novel analyses of the income sources of National Health Service (NHS) acute trusts in England. The results suggest that there are variations according to deprivation in the extent of private financial resources available to NHS institutions. They suggest a need to open up discussions about how best to mitigate spatial differences in the charitable and private patient income of NHS trusts, particularly if these sources of income grow in importance going forward. ABSTRACT: The article provides-for the first time-an analysis of spatial variation in the income sources of National Health Service (NHS) acute trusts in England. It shows that, compared to trusts serving less deprived communities, trusts serving more deprived communities receive a lower proportion of income from charitable sources; and that trusts serving deprived communities also receive a lower proportion of income from private patients. The study serves to provide evidence of spatial inequality in the private resources that support local public institutions.

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PURPOSE: The objective of this research is to explore the applicability of machine learning and fully homomorphic encryption (FHE) in the private pathological assessment, with a focus on the inference phase of support vector machines (SVM) for the classification of confidential medical data. METHODS: A framework is introduced that utilizes the Cheon-Kim-Kim-Song (CKKS) FHE scheme, facilitating the execution of SVM inference on encrypted datasets. This framework ensures the privacy of patient data and negates the necessity of decryption during the analytical process. Additionally, an efficient feature extraction technique is presented for the transformation of medical imagery into vectorial representations. RESULTS: The system's evaluation across various datasets substantiates its practicality and efficacy. The proposed method delivers classification accuracy and performance on par with traditional, non-encrypted SVM inference, while upholding a 128-bit security level against established cryptographic attacks targeting the CKKS scheme. The secure inference process is executed within a temporal span of mere seconds. CONCLUSION: The findings of this study underscore the viability of FHE in enhancing the security and efficiency of bioinformatics analyses, potentially benefiting fields such as cardiology, oncology, and medical imagery. The implications of this research are significant for the future of privacy-preserving machine learning, promoting progress in diagnostic procedures, tailored medical treatments, and clinical investigations.

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Private enterprise development encounters numerous challenges. China encourages state-owned enterprises to acquire equity stakes in private enterprises, thereby facilitating development of private enterprises through reverse mixed-ownership reform. To test the effectiveness of this approach, we focus on the impact of state-owned equity on the organizational resilience of private enterprises. Using empirical research methods and data from A-share listed Chinese companies from 2009 to 2022, we find that reverse mixed-ownership reform is significantly and positively correlated with the organizational resilience of private enterprises. Further analysis reveals that involvement of shareholders from state-owned enterprises can bolster the organizational resilience of private enterprises by mitigating their financing constraints. This paper extends the research on the mechanism by which a heterogeneous ownership structure can impact the organizational resilience of private enterprises and offers insights for private enterprises on how to bolster their organizational resilience through mixed-ownership reform.

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In this study we focused on the need to fill a knowledge gap among Italian botanical studies namely that of ornamental species census. In particular, we addressed one of the regions in southern Italy with less knowledge in the field of such studies and with an obvious presence of non-native species. A widespread census of the Apulian territory was carried out between 2021 and 2024 in both urban and suburban areas including street trees, parks, and private and historic gardens. The inventory of ornamental trees, shrubs, and succulents of Apulia (southern Italy) was carried out in six provinces, i.e., Bari, Barletta-Andria-Trani, Brindisi, Foggia, Lecce, and Taranto. The checklist comprises 287 taxa (including 265 species, 6 varieties, 5 subspecies, and 11 forms) included in 179 genera belonging to 78 families. We evaluated the number of taxa per families and genera, the presence of each taxa in the provinces of Apulia, the number of taxa per occurrence status, growth forms, geographical origin, and the number of native and alien taxa and also the artificial hybrids. Remarks of the most significant taxa and evaluation of geographical distribution in Italy were also taken into consideration. A large number of surveyed taxa (51.74%) are comprised in the list reported in the recent study on allochthonous vascular flora in Italy with a marked prevalence of Neophyte Casual Alien and Neophyte Naturalized Alien species.

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BACKGROUND: Miscarriage is a common medical occurrence which can be associated with significant psychological distress. Patients and partners are frequently disappointed by aspects of their care, especially with regard to emotional support. Although most published studies investigated the experiences of patients and partners in emergency departments (EDs) of public hospitals, miscarriage is also frequently diagnosed in non-emergency settings, such as during sonography or antenatal appointments, and approximately 25% of Australian women receive maternity care in private hospitals. AIM: Because the experience of miscarriage is known to be setting-dependent, it is important to understand how patients and partners experience care outside the ED. Here, we addressed this gap by investigating the experiences of patients and partners who attended a private maternity hospital for miscarriage using a mixed-methods approach. MATERIALS AND METHODS: Eighteen patients and six partners who had recently experienced a miscarriage were recruited at a private maternity hospital to take part in both semi-structured interviews and online surveys. RESULTS: Overall, patients and partners were highly satisfied with the emotional care they received. Thematic analysis of semi-structured interviews allowed us to identify a total of ten themes that contributed to satisfaction with emotional care. CONCLUSIONS: We provide the first specific insights into the experiences of women and partners who received care for miscarriage in an Australian private hospital setting, and the first example of a healthcare setting that achieves high satisfaction with emotional care around miscarriage. The ten themes we identify provide a framework for improving satisfaction with care also in other settings.

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Whether private healthcare providers should be encouraged over public providers remains unclear. On the one hand, because private providers are profit-driven, they are more motivated to compete for demand by enhancing quality if demand is elastic. However, because they are more motivated to maximize revenue, they may sacrifice quality to maximize profit. A crucial factor in determining whether private providers should be encouraged is the extent to which their quality exceeds or falls short of that of the public provider. This study, therefore, investigates whether the public and private differ in providing quality healthcare services using the 2014 Ghana Demographic and Health Survey. Our measure of healthcare quality is based on patient satisfaction level with nine healthcare services (cleanliness, waiting time, comfort and safety, consultation time, privacy, listening, explanation, treatment advice and confidentiality) provided by public and private healthcare facilities. We applied an instrumental variable approach to account for endogeneity issues related to the patient's choice of healthcare provider. We find that private facility users have a higher probability of being very satisfied with "waiting time", "consultation time", "listening", "cleanliness", "comfort and safety", "confidentiality", and "privacy" than public users, thus suggesting that private facilities provide better service than public. We thus recommend encouraging the private sector to enter the healthcare market. We also find that failing to account for endogeneity in provider choice when estimating the effect of healthcare facility ownership on healthcare service quality underestimates the effects.

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OBJECTIVE: To identify barriers and facilitators contributing to the successful implementation of the allied health assistant role in private disability practice to better meet population needs. DESIGN: A qualitative case study. SETTING: This study was completed with staff working in private disability practices in a regional context in the Northern Territory. PARTICIPANTS: Eight participants were interviewed, including three allied health assistants, three allied health professionals, and two managers with allied health backgrounds. RESULTS: More barriers were reported than facilitators, with four key themes identified. Financial risk was a barrier when employing allied health assistants. This risk was mediated by providing part-time employment or having allied health assistants in dual roles. Reduced confidence from allied health professionals and assistants to complete delegation work was the second barrier. A facilitator was increasing allied health assistants' task variation, which participants reported increased retention. Finally, a positive working relationship between allied health professionals and assistants facilitates delegation. CONCLUSION: This research offers private disability providers insight into the realities of employing an allied health assistant. It also suggests that formal training programs for both allied health assistants and professionals require increased focus on delegation in the private disability sector. On a government level, a review of the NDIS price guide for allied health assistant rates is needed if private providers are to better meet the requirements for NDIS participants in regional areas.

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BACKGROUND: Cancer is a leading cause of death in Europe and prevention measures, like screening, are therefore becoming increasingly important. Although European countries provide universal health coverage, including cancer screenings, many people also have private health insurance. AIM: The aim of this study is to analyse the relationship between Voluntary private health insurance (VPHI) and cancer screening, specifically breast and colorectal cancer screening. METHOD: Using data from SHARE, the Survey of Health, Ageing and Retirement in Europe, different logistic and multilevel regressions were estimated. RESULTS: The major finding shows a positive correlation between people being screened for cancer and having VPHI. CONCLUSIONS: Three conclusions can be drawn: advantageous selection may exist in private health insurance; spillover effects may exist from the public sector into the private sector, which in turn may result in a lower insurance premium; and there may be a perpetuation of inequalities in health service utilisation. Several policy implications can be drawn from this result, but the most relevant concerns narrowing the inequities that could potentially arise between those who have private health insurance and those who do not.

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BACKGROUND: In KwaZulu-Natal (KZN), South Africa, COVID-19 vaccinations commenced in May 2021. This study investigated the extent and reasons for COVID-19 vaccine (C19V) wastage in KZN and strategies undertaken to mitigate loss. METHODS: This two-phase multicenter study was conducted at private and public healthcare facilities from May 2021 to July 2022. RESULTS: KZN reported 2% Pfizer and 1% Janssen C19V wasted, mainly due to expiry. C19V waste-minimization strategies reported by 100% public and private sector vaccination leads included cold chain monitoring, designated trained staff and the use of stock-management systems. CONCLUSIONS: The WHO's risk-mitigation factors should be implemented continuously to minimize vaccine wastage.

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In low-and-middle-income countries (LMICs), private pharmacies play a crucial role in the supply of medicines and the provision of healthcare. However, they also engage in poor practices including the improper sale of medicines and caregiving beyond their legal scope. Addressing the deficiencies of private pharmacies can increase their potential contribution towards enhancing universal health coverage. Therefore, it is important to identify the determinants of their performance. The existing literature has mostly focused on pharmacy-level factors and their regulatory environment, ignoring the market in which they operate, particularly their relationship to existing public sector provision. In this study, we fill the gap in the literature by examining the relationship between the practices of private pharmacies and resource shortages in nearby public health facilities in Odisha, India. This is possible due to three novel primary datasets with detailed information on private pharmacies and different levels of public healthcare facilities, including their geospatial coordinates. We find that when public healthcare facilities experience shortages of healthcare workers and essential medicines, private pharmacies step in to fill the gaps created by adjusting the type and amount of care provision and medicine dispensing services they provide. Moreover, the relationship depends on their location, with public facilities and private pharmacies in rural areas performing substitutive caregiving roles, while they are complementary in urban areas. This study highlights how policies aimed at addressing resource shortages in public health facilities can generate dynamic responses from private pharmacies, highlighting the need for thorough scrutiny of the interaction between public healthcare facilities and private pharmacies in LMICs.

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Background: The healthcare system in Ireland was profoundly affected by COVID-19. This study aimed to explore the impact of the pandemic on cancer surgery in Ireland, from 2019 to 2022 using three national health data sources. Methods: A repeated cross-sectional study design was used and included: (i) cancer resections from the National Histopathology Quality Improvement (NHQI) Programmes; (ii) cancer surgery from the National Cancer Registry Ireland (NCRI), and (iii) cancer surgery from Hospital Inpatient Enquiry (HIPE) System. Cancer surgery was presented by invasive/in situ and invasive only cancers (NCRI & HIPE), and by four main cancer types (breast, lung, colorectal & melanoma for NCRI & HIPE data only). Results: The annual number of cancer resections (NHQI) declined by 4.4% in 2020 but increased by 4% in 2021 compared with 2019. NCRI data indicated invasive/in-situ cancer surgery for the four main cancer types declined by 14% in 2020 and 5.1% in 2021, and by 12.3% and 7.3% for invasive cancer only, compared to 2019. Within HIPE for the same tumour types, invasive/in situ cancer surgery declined by 21.9% in 2020 and 9.9% in 2021 and by 20.8% and 9.6% for invasive cancer only. NHQI and HIPE data indicated an increase in the number of cancer surgeries performed in 2022. Conclusions: Cancer surgery declined in the initial pandemic waves suggests mitigation measures for cancer surgery, including utilising private hospitals for public patients, reduced the adverse impact on cancer surgery.

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Private equity ownership across the US health care system is rapidly increasing, yet ownership structures are complex and opaque. We used an economic data set tracking mergers and acquisitions linked to Medicare data to identify private equity hospice acquisitions. Given the influence of for-profit ownership on hospice quality, transparent data on private equity investment are fundamental to ensuring high-quality end-of-life care.

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Animals exhibiting mirror self-recognition (MSR) are considered self-aware; however, studies on their level of self-awareness remain inconclusive. Recent research has indicated the potential for cleaner fish (Labroides dimidiatus) to possess a sophisticated level of private self-awareness. However, as this study revealed only an aspect of private self-awareness, further investigation into other elements is essential to substantiate this hypothesis. Here, we show that cleaner fish, having attained MSR, construct a mental image of their bodies by investigating their ability to recall body size. A size-based hierarchy governs the outcomes of their confrontations. The mirror-naïve fish behaved aggressively when presented with photographs of two unfamiliar conspecifics that were 10% larger and 10% smaller than their body sizes. After passing the MSR test, they refrained from aggression toward the larger photographs but still behaved aggressively toward the smaller ones without re-examining their mirror images. These findings suggest that cleaner fish accurately recognize their body size based on mental images of their bodies formed through MSR. Additionally, mirror-experienced fish frequently revisited the mirror when presented with an intimidating larger photograph, implying the potential use of mirrors for assessing body size. Our study established cleaner fish as the first non-human animal to be demonstrated to possess private self-awareness.

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Small private online course-based flipped teaching is an innovative hybrid instructional approach that merges online and offline activities, fostering autonomous learning among students prior to class and facilitating the assimilation of knowledge within the confines of the classroom. To determine the effectiveness of the small private online course-based flipped teaching model on undergraduate nursing students' self-directed learning abilities, we performed a practice version of the small private online course-based flipped teaching program as a quasi-experiment, specifically designed for the Surgical Nursing course and assessed its effectiveness in students' self-directed learning abilities. To this end, a total of 264 students from the 2019 nursing major cohort were selected. Three classes comprising 131 students were randomly selected as the experimental group, and three other classes, comprising 133 students, were set as the control group. The results revealed no significant differences in the scores of self-directed learning abilities between the experimental and control groups before the experiment. After the experiment, the average scores on each dimension of the self-directed learning abilities improved significantly, and the final score of the experimental group was higher than that of the control group. The small private online course-based flipped teaching model can promote undergraduate nursing students' self-directed learning abilities, owing to its practicality and feasibility for the selected course.

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BACKGROUND: Eliminating financial barriers and improving healthcare accessibility pertain to be key elements of the United Nation's sustainable development goals. These have directed health policymakers to advocate private health insurance as a health promotion strategy to enable patients to obtain absolute and affordable medical care when needed. Against this backdrop, the current study investigates the coverage trend and financial risk-protective nature of private health insurance plans. MATERIALS AND METHOD: We examined 12 months' hospital billing data of private health insurance holders with cancer, cardiac, neurological, and renal diseases. The billing and insurance claim data of 5002 patients were extracted from the billing section of a tertiary care teaching hospital located in southern India from April 2022 through March 2023. Five per cent of patients from each disease condition were selected through proportionate random sampling for analysis (n = 250). The cost incurred and reimbursement trend under various cost heads were investigated by examining the cost incurred by the patient during the hospitalization and comparing it with the amount reimbursed by the insurance company. RESULTS: The scrutiny exhibits that private health insurance fails to provide comprehensive coverage, resulting in under-insurance among subscribers. Reimbursement received for each cost category is also discussed. To the best of our knowledge, this is the first study that has used institutional data instead of large survey data or patient data. CONCLUSION: The research concludes by soliciting policymakers, healthcare providers, and insurers to develop strategies to enhance the affordability and accessibility of healthcare to promote health and wellness.