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BackgroundDue to the complexity of health system reform in the post-conflict, post-disaster, and development settings, attempts to restructure health services are fraught with pitfalls that are often unanticipated because of inadequate preliminary assessments. Our proposed Integrated Multimodal Assessment – combining quantitative and qualitative methodologies – may provide a more robust mechanism for identifying programmatic priorities and critical barriers for appropriate and sustainable health system interventions. The purpose of this study is to describe this novel multimodal assessment using emergency medicine in post-conflict Serbia as a model.MethodsIntegrated quantitative and qualitative methodologies – system characterization and observation, focus group discussions, free-response questionnaires, and by-person factor analysis – were used to identify needs, problems, and potential barriers to the development of emergency medicine in Serbia. Participants included emergency and pre-hospital personnel from all emergency medical institutions in Belgrade.ResultsDemographic data indicate a loosely ordered network of part-time emergency departments supported by 24-hour pre-hospital services and an academic emergency center. Focus groups and questionnaires reveal significant impediments to delivery of care and suggest development priorities. By-person factor analysis subsequently divides respondents into distinctive attitudinal types, compares participant opinions, and identifies programmatic priorities.ConclusionsBy combining quantitative and qualitative methodologies, our Integrated Multimodal Assessment identified critical needs and barriers to emergency medicine development in Serbia and may serve as a model for future health system assessments in post-conflict, post-disaster, and development settings.

Digital filter design can be performed very efficiently using modern computer tools. The drawback of the numeric-based tools is that they usually generate a tremendous amount of numeric data, and the user might easily lose insight into the phenomenon being investigated. The computer algebra systems successfully overcome some problems encountered in the traditional numeric-only approach. In this paper, we introduce an original approach to algorithm development and digital filter design using a computer algebra system. The main result of the paper is the development of an algorithm for an infinite impulse response (IIR) filter design that, theoretically, is impossible to be implemented using the traditional approach. We present a step-by-step procedure which includes derivations of closed-form expressions for (1) the transfer functions of the implemented digital filter which contains the algebraic loop; (2) the closed-form expression for computing the number of requested iteration steps; and (3) the error function representing the difference of the output sample values of the new filter and that of the conventional filter. We demonstrate how one can use some already-known multiplierless digital filter as a start-up filter to design a new digital filter whose passband edge frequency can be simply moved by using a single parameter. As a result, we obtain a multiplierless IIR filter, which belongs to the family of low-power digital filters where multipliers are replaced with a small number of adders and shifters.