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Background: The implementation science literature acknowledges a need for engagement of key stakeholders when designing, delivering and evaluating implementation work. To date, the literature reports minimal or focused stakeholder engagement, where stakeholders are engaged in either barrier identification and/or barrier prioritisation. This paper begins to answer calls from the literature for the development of tools and guidance to support comprehensive stakeholder engagement in implementation research and practice. The paper describes the systematic development of the Implementation‐STakeholder Engagement Model (I‐STEM) in the context of an international, large‐scale empirical implementation study (ImpleMentAll) aimed at evaluating the effectiveness of a tailored implementation toolkit. The I‐STEM is a sensitising tool that defines key considerations and activities for undertaking stakeholder engagement activities across an implementation process. Methods: In‐depth, semistructured interviews and observations were conducted with implementers who were tailoring implementation strategies to integrate and embed internet‐based cognitive behavioural therapy (iCBT) services in 12 routine mental health care organisations in nine countries in Europe and Australia. The analytical process was informed by principles of first‐ and third‐generation Grounded Theory, including constant comparative method. Results: We conducted 55 interviews and observed 19 implementation‐related activities (e.g., team meetings and technical support calls). The final outcome of our analysis is expressed in an initial version of the I‐STEM, consisting of five interrelated concepts: engagement objectives, stakeholder mapping, engagement approaches, engagement qualities and engagement outcomes. Engagement objectives are goals that implementers plan to achieve by working with stakeholders in the implementation process. Stakeholder mapping involves identifying a range of organisations, groups or people who may be instrumental in achieving the engagement objectives. Engagement approaches define the type of work that is undertaken with stakeholders to achieve the engagement objectives. Engagement qualities define the logistics of the engagement approach. Lastly, every engagement activity may result in a range of engagement outcomes. Conclusion: The I‐STEM represents potential avenues for substantial stakeholder engagement activity across key phases of an implementation process. It provides a conceptual model for the planning, delivery, evaluation and reporting of stakeholder engagement activities. The I‐STEM is nonprescriptive and highlights the importance of a flexible, iterative approach to stakeholder engagement. It is developmental and will require application and validation across a range of implementation activities. Patient or Public Contribution: Patient contribution to ImpleMentAll trial was facilitated by GAMIAN‐Europe at all stages—from grant development to dissemination. GAMIAN‐Europe brings together a wide variety of patient representation organisations (local, regional and national) from almost all European countries. GAMIAN‐Europe was involved in pilot testing the ItFits‐toolkit and provided their views on the various aspects, including stakeholder engagement. Patients were also represented in the external advisory board providing support and advice on the design, conduct and interpretation of the wider project, including the development of the ItFits‐toolkit. Trial registration: ClinicalTrials.gov NCT03652883. Retrospectively registered on 29 August 2018. [ABSTRACT FROM AUTHOR]

The opening up of the railway to competition in Europe has been accompanied by many technical challenges never before seen in the railway field. One of these challenges concerns precise energy metering. As European railways have been a monopoly until now, the current systems can only measure the energy consumption of a single operator. In accordance with European law, the installation of an energy meter has been mandatory in new or refurbished rolling stocks since 2014. Nevertheless, these energy meters are still not fully reliable, with misreadings and missing readings being common occurrences. To address the problem of energy metering data reliability, this paper presents a method for validating the reading measurement based on a physical model and validates it in two different case studies. For the issue of energy metering data availability, different estimators are developed, and their performance are shown with the aim of calculating the missing consumptions for both case studies. Finally, the paper suggests how these methods may be implemented in other types of trains. [ABSTRACT FROM AUTHOR]

The paper addresses a real-time optimization-based reference calculation integrated with a control structure for Modular Multilevel Converters (MMC) operating under normal and constrained situations (where it has reached current and/or voltage limitations, as it may occur during system faults). Firstly, a nonlinear optimization problem has been developed in which it prioritizes to satisfy the AC grid current set-points imposed by the transmission System Operator (TSO). The constrained nonlinear optimization problem is formulated based on the steady-state model of the MMC, whereby the prioritization is achieved through distinct weights defined in the Objective Function’s (OF) terms. The resultant optimization problem, however, is highly nonlinear requiring high computation burden to be solved in real-time. To cope with this issue, this paper applies a Linear Time-Varying (LTV) approximation, which permits to represent the nonlinear dynamics of the system as constant parameters, while a Linear Time-Invariant (LTI) system is used to formulate the optimization constraints. The converter’s current references are determined in real-time by solving a constrained linearized optimization problem at each control time step, which considers the TSO’s demands, the current MMC operating point and its physical limitations. Theoretical analyses comparing the responses of the linear and nonlinear optimization problems are performed to validate the accuracy of the LTV approximation. Finally, the linearized-optimization problem is integrated with the MMC controllers, evaluated under different AC and DC network conditions and compared with conventional control strategies, where it is shown that the presented method can be potentially employed to obtain the MMC current references for distinct network scenarios. [ABSTRACT FROM AUTHOR]

The production of mixed municipal waste changes due to the increase of separation rate, urbanization and other factors. The future changes in the legislation and technology development influences the way the waste is being treated. Thus the method, location and capacity of processing sites are unknown. The realization of future projects can be supported by the developing of transportation infrastructure. Such a feature may be represented by a robust transfer station grid, which can be designed to handle all possible future realizations and technological solutions (establishment of waste treatment facilities). The paper presents an approach utilising a mathematical model for the design of transfer stations. It is formulated as a multi-objective two-stage mixed-integer stochastic programming problem, where the trade-off between the environmental aspect and the economic viability is considered. The model is tested through a case study for the Czech Republic, where the waste treatment of over 6,000 municipalities is analysed. The solutions for different preferences are assessed throughout the principle called out-of-sample stability with 10,000 scenarios. The optimal decision consists of the robust transfer station grid with selected locations and their respective capacity. The particular solution with respect to the potential trade-off suggests to save 1.148 mil of travelled kilometres with only 0.77 mil EUR. The output in the form of decision support can serve possible stakeholders from the field of waste management to plan more sustainable projects. • A transfer station grid designed to handle future realizations and developments. • The efficiency of waste transport was analysed for more than 6000 municipalities. • A trade-off between environmental aspects and the economic viability was considered. • A solution suggests to save travelled 1.148 mil km with only extra 0.77 mil EUR. • Introduction. [ABSTRACT FROM AUTHOR]

The role of evidence and expertise in policy-making has been of interest to public health professionals and political scientists alike. The public health community often sees its efforts as part of a linear knowledge transfer process and tends to blame itself for inadequate communication or translation of its arguments to policy-makers' language when its efforts fail. Political science, especially theories of the policy process, offer alternative perspectives to explain the success or failure of experts' preferred policy goals. This paper focuses on the concept of epistemic communities (groups of experts with a common policy goal derived from their shared knowledge) in policy-making, drawing on examples from the field of health technology assessment in Europe. By combining the parsimony and the central focus on experts of the linear knowledge transfer model with the recognition of complexity of political science, the epistemic communities concept provides a useful structure for the public health community to analyze its efforts to influence policy. [ABSTRACT FROM AUTHOR]

Previous investigations have revealed the unsafety of the current calculation methods in Eurocode 4 for evaluating the fire resistance of concrete-filled steel tubular (CFST) columns, which has given place to a movement in Europe for correcting the existing methods and developing new design rules. In order to support the development of new guidance, further experimental research is needed, especially concerning slender columns and large eccentricities. In this paper, the results of a series of fire tests on slender CFST columns of different section shape (circular and square) subjected to large eccentricities are presented. The influence of the cross-section shape, load eccentricity and percentage of reinforcement on the response of these columns at elevated temperatures is studied in this paper, focusing on the effect of large eccentricities combined with high slenderness. On the basis of the experimental results, the current design rules in Eurocode 4 are assessed, and a previous calculation method developed by the authors is also evaluated. [ABSTRACT FROM AUTHOR]

Background: In a context of population ageing, it is a priority for planning and prevention to understand the socioeconomic (SE) patterning of functional limitations and its consequences on healthcare needs. This paper aims at measuring the gender and SE inequalities in functional limitations and their age of onset among the Southern European elderly; then, we evaluate how functional status is linked to formal and informal care use. Methods: We used Portuguese, Italian and Spanish data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 2011 (n = 9233). We constructed a summary functional limitation score as the sum of two variables: i) Activities of Daily Living (ADL) and ii) Instrumental Activities of Daily Living (IADL). We modelled the functional limitation as a function of age, gender, education, subjective poverty, employment and marital status using multinomial logit models. We then estimated how functional limitation affected informal and formal care demand using negative binomial and logistic models. Results: Women were 2.3 percentage points (pp) more likely to experience severe functional limitation than men, and overcame a 10% probability threshold of suffering from severe limitation around 5 years earlier. Subjective poverty was associated with a 3.1 pp. higher probability of severe functional limitation. Having a university degree reduced the probability of severe functional limitation by 3.5 pp. as compared to none educational level. Discrepancies were wider for the oldest old: women aged 65-79 years old were 3.3 pp. more likely to suffer severe limitations, the excess risk increasing to 15.5 pp. among those older than 80. Similarly, educational inequalities in functional limitation were wider at older ages. Being severely limited was related with a 32.1 pp. higher probability of receiving any informal care, as compared to those moderately limited. Finally, those severely limited had on average 3.2 hospitalization days and 4.6 doctor consultations more, per year, than those without limitations. Conclusion: Functional limitations are unequally distributed, hitting women and the worse-off earlier and more severely, with consequences on care needs. Considering the burden on healthcare systems and families, public health policies should seek to reduce current inequalities in functional limitations. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes a 44-year (from 1958 to 2001) wave hindcast conducted for the North Atlantic, using a fine grid in the North East Atlantic coastal areas of Europe. The wind fields were obtained by a local area model that was applied in the areas adjacent to the European coasts, which was forced by the results of the NCEP reanalysis. While the NCEP results have a spatial distribution of 2° and a time step of 6 h the wind fields produced by the local area model have a spatial resolution of 0.5° and a time step of 1 h, which is important for accurate descriptions of the conditions in coastal areas and in rapidly changing storms. A version of the WAM model that allowed two-way nesting was adopted and calculations were made with nested grids allowing a fine resolution in the coastal areas of Europe. This paper includes the description of the set-up of the wave model and the validation performed vs. in-situ measurements so as to allow assessments of the quality of the data produced in this study. [Copyright &y& Elsevier]

Background High levels of sedentary behavior are often measured in preschoolers, but only a few interventions have been developed to counteract this. Furthermore, detailed descriptions of interventions in preschoolers targeting different forms of sedentary behavior could not be located in the literature. The aim of the present paper was to describe the different steps of the Intervention Mapping Protocol used towards the development of an intervention component of the ToyBox-study focusing on decreasing preschoolers' sedentary behavior. The ToyBoxstudy focuses on the prevention of overweight in 4- to 6-year-old children by implementing a multi-component kindergarten-based intervention with family involvement in six different European countries. Methods Applying the Intervention Mapping Protocol, six different steps were systematically completed for the structured planning and development of the intervention. A literature search and results from focus groups with parents/caregivers and kindergarten teachers were used as a guide during the development of the intervention and the intervention materials. Results The application of the different steps in the Intervention Mapping Protocol resulted in the creation of matrices of change objectives, followed by the selection of practical applications for five different intervention tools that could be used at the individual level of the preschool child, at the interpersonal level (i.e., parents/caregivers) and at the organizational level (i.e., kindergarten teachers). No cultural differences regarding preschoolers' sedentary behavior were identified between the participating countries during the focus groups, so cultural and local adaptations of the intervention materials were not necessary to improve the adoption and implementation of the intervention. Conclusions A systematic and evidence-based approach was used for the development of this kindergarten-based family-involved intervention targeting preschoolers, with the inclusion of parental involvement. The application of the Intervention Mapping Protocol may lead to the development of more effective interventions. The detailed intervention matrices that were developed as part of the ToyBox-study can be used by other researchers as an aid in order to avoid repetitive work for the design of similar interventions. [ABSTRACT FROM AUTHOR]

The paper deals with the management problem how to decide on tree species suitability under changing environmental conditions. It presents an algorithm that classifies the output of a range shift model for major tree species in Europe into multiple classes that can be linked to qualities characterizing the ecological niche of the species. The classes: i) Core distribution area, ii) Extended distribution area, iii) Occasional occurrence area, and iv) No occurrence area are first theoretically developed and then statistically described. The classes are interpreted from an ecological point of view using criteria like population structure, competitive strength, site spectrum and vulnerability to biotic hazards. The functioning of the algorithm is demonstrated using the example of a generalized linear model that was fitted to a pan-European dataset of presence/absence of major tree species with downscaled climate data from a General Circulation Model (GCM). Applications of the algorithm to tree species suitability classification on a European and regional level are shown. The thresholds that are used by the algorithm are precision-based and include Cohen's Kappa. A validation of the algorithm using an independent dataset of the German National Forest Inventory shows good accordance of the statistically derived classes with ecological traits for Norway spruce, while the differentiation especially between core and extended distribution for European beech that is in the centre of its natural range in this area is less accurate. We hypothesize that for species in the core of their range regional factors like forest history superimpose climatic factors. Problems of uncertainty issued from potentially applying a multitude of modelling approaches and/or climate realizations within the range shift model are discussed and a way to deal with the uncertainty by revealing the underlying attitude towards risk of the decision maker is proposed. [Copyright &y& Elsevier]

An analysis of Bošković's early paper concerned with the polar light (aurora borealis) gives an insight into the validity of the mathematical method which the young Bošković applied to significant geophysical phenomena in order to comprehend their nature. Based on the given data, we have examined numerical results about the height of atmosphere and the heights of the auroras which were observed over Europe in 1726 and in 1737. In his text there is not a single mathematical formula. Following his instructions we have derived a formula which may be used to determine the distance of an aurora by observing it from one station. For the assumed aurora model, his method is applicable. We find that described ideas on the physical cause of aurora, conceived in a fluid coming from the sun, have elements of modern knowledge. [ABSTRACT FROM AUTHOR]

Abstract: Energy efficiency in buildings is essential for economic, social, and environmental reasons. Under current European legislation, buildings have to be certified with an energy efficiency index. To provide a fair comparison of the energy performance in buildings we need a global and unified representation. In this paper we propose the Energy Efficiency Ontology (EEOnt) to provide a foundation upon which this requirement can be built. EEOnt extends the applicability of other ontological models of buildings incorporating energy efficiency data and knowledge that can be calculated with high spatial and temporal resolution in what we call an Energy Efficiency Landscape (EELB). These EELB''s provide significant information which allows a detailed diagnosis of the energy efficiency within the building. Consequently, EEOnt is capable of representing buildings and energy efficiency in a unified way. Furthermore, it supplies a tool for managing the energy efficiency in buildings and constructing national inventories. These two features link the global and particular needs of governments and users, thus becoming key to both improve the energy efficiency in buildings and to implement viable certification schemes. [Copyright &y& Elsevier]

Voltage-source-converter (VSC) technologies present a bright opportunity in a variety of fields within the power system industry. New modular multilevel converters (MMCs) are expected to supersede two- and three-level VSC-based technologies for HVDC applications due to their recognized advantages in terms of scalability, performance, and efficiency. The computational burden introduced by detailed modeling of MMC-HVDC systems in electromagnetic-transients (EMT)-type programs complicates the study of transients especially when these systems are integrated into a large network. This paper presents a novel average-value model (AVM) for efficient and accurate representation of a detailed MMC–HVDC system. It also develops a detailed 401-level MMC-HVDC model for validating the AVM and studies the performance of both models when integrated into a large 400-kV transmission system in Europe. The results show that the AVM is significantly more efficient while maintaining its accuracy for the dynamic response of the overall system. [ABSTRACT FROM AUTHOR]

A precise 3D model of the crust is necessary to start any tectonic or geodynamic interpretation. It is also essential for seismic interpretations of structures lying below as well as for correct analysis of shallow structures using reflection seismics. During the last decades, a number of wide-angle refraction experiments were performed on the territory of central and eastern Europe (POLONAISE'97, CELEBRATION 2000, SUDETES 2003), resulting in many high quality 2D models. It is an interesting and complicated transition zone between Precambrian and Palaeozoic Platforms. This paper presents 3D model of the velocity distribution in the crust and upper mantle interpolated from 2D models of the structure along 33 profiles. The obtained model extends to a depth of 50 km and accurately describes the main features of the crustal structures of Poland and surrounding areas. Different interpolation techniques (Kriging, linear) are compared to assure maximum precision. The final model with estimated uncertainty is an interesting reference of the area for other studies. [ABSTRACT FROM AUTHOR]

There are numerous useful methods that can be conducted in data analysis in order to check data correctness and authenticity. One of contemporary and efficient methods is application of so-called Benford's Law. In this paper we examine ways of application of this law in investigation of specific net income number set. Our aim is to make a conclusion if this number set conforms to Benford's Law. An examination target focus is set on values of top 500 central and east European companies according to their income. Data set contains 1,500 records and spans through 3 years (2007, 2008 and 2009) including 500 net incomes per year. Research is based on net income profit and loss subsets as well as absolute values of net income. Analysis covers first digit Benford's Law test and proves conformance to Benford's Law of all observed subsets. [ABSTRACT FROM AUTHOR]

The integration of the spot electricity markets in Europe shall lead to multi-area power exchanges that will substitute the local markets. In such scheme, market prices are affected by physical (e.g., network) constraints, yet they should sometimes follow regulatory policy rules, which do not necessarily reflect or depend on physical characteristics. In some cases, complex pricing rules should be implemented, which impose price discrimination for supply and demand entities within the same area. The methodology presented in this paper enables the balancing of supply and demand in a multi-area market considering energy and reserve bids, under complex pricing rules, which mix energy and reserve prices. A demand bid corresponds to the whole cost a demand entity is willing to pay for its participation in the energy market, including the cost for the procurement of the necessary reserves. The approach attains price integration of energy and reserves markets, simultaneous settlement of energy and reserves, and significant decrease of the payments through the uplift accounts. The main principle is the formulation of a mixed complementarity problem for the system equilibrium conditions, in which supply and demand are associated to explicitly or implicitly defined prices, which may be different even in the same zone. [ABSTRACT FROM PUBLISHER]

This paper aims at investigating empirically the relationship between self-declared satisfaction with life and an individual's well-being as measured by the indices of deprivation and social exclusion proposed in the income distribution literature. Results on European countries show that life satisfaction decreases with an increase in deprivation and exclusion after controlling for individual's income, relative income and other influential factors in a multivariate setting. [ABSTRACT FROM AUTHOR]

The objective of this paper is to analyze the role of technology learning in European wind power generation in the presence of public R&D. A Cobb–Douglas cost function is employed to derive a learning curve model for wind power, thus illustrating how the investment costs for this technology are influenced by global learning-by-doing, scale effects, and a European R&D-based knowledge stock. We assume that public R&D expenses targeting wind power add to the above stock, and these R&D outlays are in turn hypothesized to be influenced by technology cost levels, the opportunity cost of public R&D as well as by government budget constraints. We estimate the learning and the R&D model, respectively, using a panel data set covering five European countries over the time period 1986–2002. The empirical results confirm the importance of both learning-by-doing and public R&D support in the cost reduction process, and governments' R&D expenses have declined in response to lowered investment costs. This is efficient in the sense that public funds are best targeted at technologies which are far from being commercial. The results also illustrate that governments in Europe have been sensitive to the opportunity cost of public R&D in the energy R&D budget process. [Copyright &y& Elsevier]

Abstract: As a fuzzy counterpart of Brownian motion, Liu process has attracted more and more attention in the recent literature. In this paper, the concept of fractional Liu process is proposed as an extension of Liu process. Furthermore, we obtain the expressions of the membership functions, expected values and variances of arithmetic and geometric fractional Liu processes for each fixed time. As an application, geometric fractional Liu process is assumed to characterize the stock price, which formulates a new fuzzy stock model. Based on this proposed model, European option pricing formulas are gained and two numerical examples are given with different parameters. [Copyright &y& Elsevier]

The paper presents a geographic information system (GIS) model-based approach for analysis of potential contamination of soil and water by pyrethroids for the European continent. Pyrethroids are widely used pesticides and their chemical and toxicological characteristics suggest there may be concerns about human health and ecosystems, although so far there is no strong evidence indicating actual risk. However, little monitoring has been conducted and limited experimental information is available. We perform an assessment exercise that demonstrates how accessible information and GIS-based modeling allow to estimate the spatial distribution of chemical concentrations and fluxes at a screening level. The assessment highlights potential hot spots and the main environmental transport pathways, in a quick and simple way. By combining information on pesticide use, crop distribution and landscape and climate parameters we identify potential problem areas to help focusing monitoring campaigns. The approach presented here is simple and fast, and can be applied to virtually all pesticide classes used over a large domain, and is therefore suitable for the screening of large quantities of chemicals, of which the majority has not undergone any systematic environmental monitoring program. The method has been tested through benchmarking with other well-established models. However, further research is needed to evaluate it against experimental observations. [Copyright &y& Elsevier]

Abstract: The Bulgarian Emergency Response System (BERS) is being developed in the Bulgarian National Institute of Meteorology and Hydrology since 1994. BERS is based on numerical weather forecast meteorological information and a numerical long-range dispersion model accounting for the transport, dispersion, chemical and radioactive transformations of pollutants. In the present paper, the further development of this system for a mixture of radioactive gaseous and aerosol pollutants is described. The basic module for the BERS, the numerical dispersion model EMAP, is upgraded with a “dose calculation block”. Two scenarios for hypothetical accidental atmospheric releases from two NPPs, one in Western, and the other in Eastern Europe, are numerically simulated. The effective doses from external irradiation, from air submersion and ground shinning, effective dose from inhalation and absorbed dose by thyroid gland formed by 37 different radionuclides, significant for the early stage of a nuclear accident, are calculated as dose fields for both case studies and discussed. [Copyright &y& Elsevier]

Understanding the climate change processes requires application of special methodologies for revealing a ground surface temperature history (GSTH). It was proved by different authors that the GSTH may be determined on the basis of analysis of the temperature field observed in short boreholes. In this paper, the authors analyze four mathematical models describing the GSTH: (1) sudden change, (2) linear increase, (3) square root of time increase and (4) exponential increase. Fifteen borehole temperature profiles from Europe, Asia and North America were selected in three groups based on their geographical proximity. After careful analysis of temperature-depth profiles in these boreholes it was found out that two models (linear increase and square root of time increase) provide the best fit with field data. The calculated warming rates in the 20th century were compared with those obtained by a few parameters estimation (FPE) technique. [ABSTRACT FROM AUTHOR]

Integral attention in practice: In this paper three models of successful integration of mental health and experiences in the form of case studies, three relevant institutions will be presented in the field of mental health and integrated within the Soma & Psy network: the Hospital Consortium of Vic, the Fondation de Nant (Suïssa) and the Parc Sanitari Sant Joan de Deu. Today, mental health is an emerging social need. Mental disorders are a wide range of situations of varying importance and gravity affecting every year almost 20% of the population. In this regard, WHO brand as an objective in its Action Plan on Mental that 80% of countries have developed or updated their mental health policies in accordance with international and regional human rights instruments Health 2020. A model of care for mental health problems, implies the existence of a number of community, hospital, health and social services that are managed holistically based on a specific territory or betting the three institutions. However, the application of a particular model is not always easy and you have to deal with resistance and many obstacles. Each of the institutions will present greater challenges and difficulties which have been found to implement a model of integration in mental health. Description of the paper: The Consortium of Vic Hositalari detail the geographical context of the region Osona, the story of Vic Health Consortium, as well as inclusion in the Comprehensive System Salut d'Osona. Also, the problem of a fragmented mental health care will be addressed and how it has been overcome with an assistance model quality health standards, health and mental health partner who attends a reference population of 160,000 people. From the Fondation de Nant, founded in 1943, the service young, adults and the elderly, as well as its commitment to proximity, accessibility and stigmatizing offered will be addressed. The focus is marked by a humanistic spirit to their beneficiaries and their collaborators. In the Parc Sanitari Sant Joan de Deu is remarkable the evolution of the organization, founded in 1854, and addressing the synergies that have been created in recent years between physical health and mental health to provide the health center of a health model comprehensive and open to the community. The health park serves a reference population of over five million people. Results: The greatest impacts and outcomes of the three institutions will be presented in the form of case studies. The Vic Hospital Consortium will present the impact of the Integrat System Salut Osona focused on the needs of the patient as well as the changes that have occurred in Osona from the implementation of the Strategic Plan de Salut Mental in Osona. From the Fondation de Nant the result of networking and the impact of a conceptual model of integration based on proximity, accessibility and stigmatizing will be displayed. From the experience of six years of the inclusion of four-bed child and adolescent psychiatry in a pediatric service and rich experience of liaison with the same service they will be evoked the teachings of this form of integration and whys accent since the notion of link with broader than those traditionally invoked meanings. From the Parc Sanitari Sant Joan de Deu major transformations in recent decades entity will be addressed in line with changes in mental health policies in Europe, specifically in Spain and Catalunya. Also, if the start of the guards at the general hospital psychiatry with other medical specialties will be detailed. Previously these guards were realized in the acute inpatient unit. Featured: The field of mental health should be an example of care model: integrated, territorially-based, community-oriented, managed by various by establishing partnerships between various actors in a territory. Conclusion: A comprehensive health model is complex, but only through mainstreaming, shared practices, territorially and focused on the patient can move toward better mental health. [ABSTRACT FROM AUTHOR]