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Sample records for current beneficiary survey

  1. Medicare Current Beneficiary Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Characteristics and Perceptions of the Medicare Population Data from the 2010 Medicare Current Beneficiary Survey is a series of source books based on the...

  2. Medicare Current Beneficiary Survey - Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a representative national sample of the Medicare population. There are two...

  3. Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

    Science.gov (United States)

    McInerney, Melissa; Mellor, Jennifer M

    2012-09-01

    A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. National Beneficiary Survey (NBS) Round 3

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  5. National Beneficiary Survey (NBS) Round 2

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 4,864 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  6. National Beneficiary Survey (NBS) Round 4

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  7. National Beneficiary Survey (NBS) Round 1

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 6,520 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  8. Examining differences in characteristics between patients receiving primary care from nurse practitioners or physicians using Medicare Current Beneficiary Survey data and Medicare claims data.

    Science.gov (United States)

    Loresto, Figaro L; Jupiter, Daniel; Kuo, Yong-Fang

    2017-06-01

    Few studies have examined differences in functional, cognitive, and psychological factors between patients utilizing only nurse practitioners (NPs) and those utilizing only primary care medical doctors (PCMDs) for primary care. Patients utilizing NP-only or PCMD-only models for primary care will be characterized and compared in terms of functional, cognitive, and psychological factors. Cohorts were obtained from the Medicare Current Beneficiary Survey linked to Medicare claims data. Weighted analysis was conducted to compare the patients within the two care models in terms of functional, cognitive, and psychological factors. From 2007 to 2013, there was a 170% increase in patients utilizing only NPs for primary care. In terms of health status, patients utilizing only NPs in their primary care were not statistically different from patients utilizing only PCMDs. There is a perception that NPs, as compared with PCMDs, tend to provide care to healthier patients. Our results are contrary to this perception. In terms of health status, NP-only patients are similar to PCMD-only patients. Results of this study may inform research comparing NP-only care and PCMD-only care using Medicare and the utilization of NPs in primary care. ©2017 American Association of Nurse Practitioners.

  9. Sample Loss and Survey Bias in Estimates of Social Security Beneficiaries: A Tale of Two Surveys.

    OpenAIRE

    John L. Czajka; James Mabli; Scott Cody

    2008-01-01

    Data from the Census Bureau’s Survey of Income and Program Participation (SIPP) and the Current Population Survey (CPS) provide information on current and potential beneficiaries served by Social Security Administration (SSA) programs. SSA also links administrative records to the records of survey respondents who provide Social Security numbers. These matched data expand the content of the SIPP and CPS files to fields available only through SSA and Internal Revenue Service records—such as l...

  10. Survey on the Assessment of the Current Actual Expenses Incurred by Students on the Meals and Accommodation within and around the Campuses: The Case of Tanzania Higher Education Students' Loans Beneficiaries

    Science.gov (United States)

    Nyahende, Veronica R.; Bangu, Asangye N.; Chakaza, Benedicto C.

    2015-01-01

    This Survey analyses the current actual expenses incurred by students on the meals and accommodation within and around the campuses. The study was geared towards achieving the following objectives: (i) to examine the current cost incurred by a students for meals In Campus, (ii) to examine the current cost incurred by a students for accommodation…

  11. Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

    Science.gov (United States)

    Jacobs, Paul D; Buntin, Melinda B

    2015-07-01

    To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

  12. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

    Science.gov (United States)

    Lochner, Kimberly A; Wynne, Marc

    2011-12-21

    Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring

  13. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  14. How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries.

    Science.gov (United States)

    Willink, Amber; Shoen, Cathy; Davis, Karen

    2018-01-01

    The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values. Among Medicare beneficiaries, 75 percent of people who needed a hearing aid did not have one; 70 percent of people who had trouble eating because of their teeth did not go to the dentist in the past year; and 43 percent of people who had trouble seeing did not have an eye exam in the past year. Lack of access was particularly acute for poor beneficiaries. Because few people have supplemental insurance covering these additional services, among people who received care, three-fourths of their costs of dental and hearing services and 60 percent of their costs of vision services were paid out of pocket. We propose a basic benefit package for dental, vision, and hearing services offered as a premium-financed voluntary insurance option under Medicare. Assuming the benefit package could be offered for $25 per month, we estimate the total coverage costs would be $1.924 billion per year, paid for by premiums. Subsidies to reach low-income beneficiaries would follow the same design as the Part D subsidy.

  15. Variación del estado nutricional durante el tratamiento antituberculoso en beneficiarios del programa PANTBC Change in nutritional status over the course of antituberculosis treatment in current and past beneficiaries of the program PANTBC

    Directory of Open Access Journals (Sweden)

    Juan Pablo Aparco

    2012-09-01

    Full Text Available Objetivos. Analizar la variación nutricional de los beneficiarios actuales y pasados del Programa de Alimentación y Nutrición al Paciente Ambulatorio con Tuberculosis y Familia (PANTBC. Materiales y métodos. Se realizó un análi-sis secundario a partir de la valoración antropométrica por medio del índice de masa corporal (IMC en beneficiarios actuales y pasados del programa PANTBC. Las mediciones se realizaron al inicio, segundo y quinto o sexto mes y se comparó la distribución del estado nutricional al inicio respecto al final (prueba de McNemar-Bowker. Resultados. Se incluyó información de 409 beneficiarios actuales y 110 beneficiarios pasados. Tanto en beneficiarios actuales como pasados se observó disminución progresiva de la condición de bajo peso (IMCObjectives. Analyze the nutritional changes among current and old beneficiaries of the Food and Nutrition Program for Outpatients with Tuberculosis and their Family (PANTBC, Spanish acronym. Materials and methods. A secondary analysis was conducted based on the anthropometric measurements with the body mass index (BMI in current and old beneficiaries of the PANTBC program. The measurements were taken at the baseline, second and fifth or sixth month, and the distribution of the nutritional status was analyzed at baseline as compared to the endpoint (McNemar-Bowker test. Results. Information about 409 current beneficiaries and 110 old beneficiaries were included. A progressive decline in low weight as well as an increase in overweight were observed in both current and old beneficiaries (IMC<18.5. The results of the third measurement showed that 57.7% of current beneficiaries who started with low weight ended up with normal weight, while 20.7% of those who started with normal weight ended up with overweight. The analysis of the nutritional status at baseline compared to the endpoint showed changes in distribution (p<0.05. Conclusions. Across the PANTBC program, there is a variation

  16. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

    Science.gov (United States)

    Gross, D J; Alecxih, L; Gibson, M J; Corea, J; Caplan, C; Brangan, N

    1999-04-01

    To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration. We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997. Out-of-pocket health care spending is defined to include Medicare deductibles and coinsurance; premiums for private insurance, Medicare Part B, and Medicare HMOs; payments for non-covered goods and services; and balance billing by physicians. It excludes the costs of home care and nursing facility services, as well as indirect tax payments toward health care financing. Almost 60 percent of beneficiaries with incomes below the poverty level did not receive Medicaid assistance in 1997. We estimate that these beneficiaries spent, on average, about half their income out-of-pocket for health care, whether they were enrolled in a Medicare HMO or in the traditional fee-for-service program. The 75 percent of beneficiaries with incomes between 100 and 125 percent of the poverty level who were not enrolled in Medicaid spent an estimated 30 percent of their income out-of-pocket on health care if they were in the traditional program and about 23 percent of their income if they were enrolled in a Medicare HMO. Average out-of-pocket spending among fee-for-service beneficiaries varied depending on whether beneficiaries had Medigap policies, employer-provided supplemental insurance, or no supplemental coverage. Those without supplemental coverage spent more on health care goods and

  17. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    Science.gov (United States)

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  18. Who are the beneficiaries?

    Science.gov (United States)

    Tännsjö, Torbjörn

    1992-10-01

    Is it defensible that society spends money on medical or research projects intended to help people solve their fertility problems? Suppose that we want to answer this question from the point of view of a utilitarian cost-benefit analysis. The answer to the question then depends, of course, on how expensive these projects turn out to be, relative to the costs of other possible projects. But it depends also on how we assess the benefits of these projects. To whom do they accrue? Who are the beneficiaries of these projects?

  19. Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

    Science.gov (United States)

    Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

    2017-05-01

    Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

  20. Survey of Current Best Practices for Diving in Contaminated Water

    National Research Council Canada - National Science Library

    Steigleman, W

    2002-01-01

    .... Navy divers operating in contaminated water. This survey attempted to identify the current best practices and equipment for diving in contaminated water, including personal protective equipment as well as hazard identification, diver training...

  1. Current management of anorectal malformation in Egypt: a survey of ...

    African Journals Online (AJOL)

    Background/aim: Anorectal malformation (ARM) represents a wide spectrum of anomalies. Its management includes various strategies. This survey aims at detecting the current preferences of Egyptian pediatric surgeons regarding the management of ARM. Materials and methods: A survey was circulated individually to the ...

  2. Australian survey on current practices for breast radiotherapy.

    Science.gov (United States)

    Dundas, Kylie L; Pogson, Elise M; Batumalai, Vikneswary; Boxer, Miriam M; Yap, Mei Ling; Delaney, Geoff P; Metcalfe, Peter; Holloway, Lois

    2015-12-01

    Detailed, published surveys specific to Australian breast radiotherapy practice were last conducted in 2002. More recent international surveys specific to breast radiotherapy practice include a European survey conducted in 2008/2009 and a Spanish survey conducted in 2009. Radiotherapy techniques continue to evolve, and the utilisation of new techniques, such as intensity-modulated radiation therapy (IMRT), is increasing. This survey aimed to determine current breast radiotherapy practices across Australia. An online survey was completed by 50 of the 69 Australian radiation therapy treatment centres. Supine tangential beam whole breast irradiation remains the standard of care for breast radiotherapy in Australia. A growing number of institutions are exploring prone positioning and IMRT utilisation. This survey demonstrated a wide variation in the benchmarks used to limit and report organ at risk doses, prescribed dose regimen, and post-mastectomy bolus practices. This survey also indicated, when compared with international literature, that there may be less interest in or uptake of external beam partial breast irradiation, prone positioning, simultaneous integrated boost and breath hold techniques. These are areas where further review and research may be warranted to ensure Australian patients are receiving the best care possible based on the best evidence available. This survey provides insight into the current radiotherapy practice for breast cancer in Australia. © 2015 The Royal Australian and New Zealand College of Radiologists.

  3. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  4. Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

    Science.gov (United States)

    Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

    2016-04-01

    The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

  5. A Survey of Current Computer Information Science (CIS) Students.

    Science.gov (United States)

    Los Rios Community Coll. District, Sacramento, CA. Office of Institutional Research.

    This document is a survey designed to be completed by current students of Computer Information Science (CIS) in the Los Rios Community College District (LRCCD), which consists of three community colleges: American River College, Cosumnes River College, and Sacramento City College. The students are asked about their educational goals and how…

  6. Current management of Hirschsprung's disease in Egypt: A survey ...

    African Journals Online (AJOL)

    Background/purpose Significant progress has been made in the management of Hirschsprung's disease (HD). The choice of the management plan, surgical approach, and operative details is still variable among pediatric surgeons. This survey aims to determine the current preferences of Egyptian pediatric surgeons in the ...

  7. Patient Satisfaction and Prognosis for Functional Improvement and Deterioration, Institutionalization, and Death Among Medicare Beneficiaries Over 2 Years.

    Science.gov (United States)

    Bogner, Hillary R; de Vries McClintock, Heather F; Kurichi, Jibby E; Kwong, Pui L; Xie, Dawei; Hennessy, Sean; Streim, Joel E; Stineman, Margaret G

    2017-01-01

    To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults. National representative sample with 2-year follow-up. Medicare Current Beneficiary Survey from calendar years 2001 to 2008. Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years. Not applicable. A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics. Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54-.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79-.97), be institutionalized (adjusted RRR, .72; 95% CI, .56-.92), or die (adjusted RRR, .86; 95% CI, .75-.98). Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. A Survey of Current Valued Academic Leadership Qualities in Nursing.

    Science.gov (United States)

    Delgado, Cheryl; Mitchell, Maureen M

    2016-01-01

    An informal survey was used to identify nurse faculty leadership qualities currently valued and relevant. The accelerating retirement rate for seasoned leaders has created a need for nurse educators and academic leaders. Our school was concerned that we were not meeting students' needs for today's leadership challenges. We were also interested in the experiences of leadership preparation. This was a cross-sectional, online survey of faculty at top nursing schools as determined by US News & World Report. The top leadership qualities identified were integrity, communication clarity, and problem-solving ability. Current challenges for leaders were finding qualified faculty, obtaining resources, and team building. The results may guide curricular adjustments and the transition to a new generation of nurse academic leaders.

  9. A Survey of Current e-Business (E-Government

    Directory of Open Access Journals (Sweden)

    Don Vance Kerr

    2008-05-01

    Full Text Available The Internet is a dynamic part of the business scene and there have been many examples of success and failures of e-commerce and e-business ventures. A survey was administered asking questions about industries understanding of current e-business (e-government practices in Australia. The object of the survey was to provide a benchmark of current practice. The results of this survey could have a major impact on academic curricula. The survey was sent to 671 Australian Businesses and was addressed to the Chief Information Officer. Only twenty four usable questionnaires were returned and while it is accepted that this is a limited sample, disturbing trends have appeared with respect to the lack of strategic planning for information technology use particularly in medium sized businesses in Australia. In addition, relationships between key factors associated with the business objectives for their IT infrastructure and the benefits of the organisation’s Extranet, Intranet and Internet initiatives were identified.

  10. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  11. Recent Trends in Veteran Unemployment as Measured in the Current Population Survey and the American Community Survey

    National Research Council Canada - National Science Library

    Savych, Bogdan; Klerman, Jacob A; Loughran, David S

    2008-01-01

    This technical report explores recent trends in the unemployment of recent veterans as estimated from two nationally representative surveys, the Current Population Survey "CPS" and the American Community Survey "ACS...

  12. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    Science.gov (United States)

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  13. Wake Survey of a Marine Current Turbine Under Steady Conditions

    Science.gov (United States)

    Lust, Ethan; Luznik, Luksa; Flack, Karen

    2016-11-01

    A submersible particle image velocimetry (PIV) system was used to study the wake of a horizontal axis marine current turbine. The turbine was tested in a large tow tank facility at the United States Naval Academy. The turbine is a 1/25th scale model of the U.S. National Renewable Energy Laboratory's Reference Model 1 (RM1) tidal turbine. It is a two-bladed turbine measuring 0.8 m in diameter and featuring a NACA 63-618 airfoil cross section. Separate wind tunnel testing has shown the foil section used on the turbine to be Reynolds number independent with respect to lift at the experimental parameters of tow carriage speed (Utow = 1 . 68 m/s) and tip speed ratio (TSR = 7). The wake survey was conducted over an area extending 0.25D forward of the turbine tip path to 2.0D aft, and to a depth of 1.0D beneath the turbine output shaft in the streamwise plane. Each field of view was approximately 30 cm by 30 cm, and each overlapped the adjacent fields of view by 5 cm. The entire flow field was then reconstructed into a single field of investigation. Results include streamwise and vertical ensemble average velocity fields averaged over approximately 1,000 realizations, as well as higher-order statistics. Turbine tip vortex centers were identified and plotted showing increasing aperiodicity with wake age. keywords: horizontal axis marine current turbine, particle image velocimetry, towing tank, wake survey

  14. Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

    Science.gov (United States)

    Woelfel, Joseph A; Carr-Lopez, Sian M; Delos Santos, Melanie; Bui, Ann; Patel, Rajul A; Walberg, Mark P; Galal, Suzanne M

    2014-02-01

    To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount. A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM. Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period. A total of 277 Medicare beneficiaries participated in the study. Comprehensive MTM was offered to each beneficiary. Pharmacy students conducted the MTM session under the supervision of licensed pharmacists. At the end of each MTM session, beneficiaries were asked to indicate their WTP for the service. Medication, self-reported chronic conditions, and beneficiary demographic data were collected and recorded via a survey during the session. The mean WTP for MTM was $33.15 for the 277 beneficiaries receiving the service and answering the WTP question. WTP by low-income subsidy recipients (mean ± standard deviation; $12.80 ± $24.10) was significantly lower than for nonsubsidy recipients ($41.13 ± $88.79). WTP was significantly (positively) correlated with number of medications regularly taken and annual out-of-pocket drug costs. The mean WTP for MTM was $33.15. WTP for MTM significantly varied by race, subsidy status, and number of prescription medications taken. WTP was significantly higher for nonsubsidy recipients than subsidy recipients, and significantly positively correlated with the number of medications regularly taken and the beneficiary rating of the delivered services.

  15. Towards an Airframe Noise Prediction Methodology: Survey of Current Approaches

    Science.gov (United States)

    Farassat, Fereidoun; Casper, Jay H.

    2006-01-01

    In this paper, we present a critical survey of the current airframe noise (AFN) prediction methodologies. Four methodologies are recognized. These are the fully analytic method, CFD combined with the acoustic analogy, the semi-empirical method and fully numerical method. It is argued that for the immediate need of the aircraft industry, the semi-empirical method based on recent high quality acoustic database is the best available method. The method based on CFD and the Ffowcs William- Hawkings (FW-H) equation with penetrable data surface (FW-Hpds ) has advanced considerably and much experience has been gained in its use. However, more research is needed in the near future particularly in the area of turbulence simulation. The fully numerical method will take longer to reach maturity. Based on the current trends, it is predicted that this method will eventually develop into the method of choice. Both the turbulence simulation and propagation methods need to develop more for this method to become useful. Nonetheless, the authors propose that the method based on a combination of numerical and analytical techniques, e.g., CFD combined with FW-H equation, should also be worked on. In this effort, the current symbolic algebra software will allow more analytical approaches to be incorporated into AFN prediction methods.

  16. OASDI Beneficiaries by State and County, 2011

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  17. OASDI Beneficiaries by State and County, 2010

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  18. OASDI Beneficiaries by State and County, 2014

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  19. OASDI Beneficiaries by State and County, 2003

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  20. OASDI Beneficiaries by State and County, 2002

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  1. OASDI Beneficiaries by State and County, 2009

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  2. OASDI Beneficiaries by State and County, 1999

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population - people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  3. OASDI Beneficiaries by State and County, 2013

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  4. OASDI Beneficiaries by State and County, 2000

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  5. OASDI Beneficiaries by State and County, 2008

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  6. OASDI Beneficiaries by State and County, 2015

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  7. OASDI Beneficiaries by State and County, 2007

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  8. OASDI Beneficiaries by State and County, 2016

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  9. OASDI Beneficiaries by State and County, 2006

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  10. OASDI Beneficiaries by State and County, 2005

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  11. OASDI Beneficiaries by State and County, 2001

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  12. OASDI Beneficiaries by State and County, 2004

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  13. Survey on current practices for neurological prognostication after cardiac arrest.

    Science.gov (United States)

    Friberg, Hans; Cronberg, Tobias; Dünser, Martin W; Duranteau, Jacques; Horn, Janneke; Oddo, Mauro

    2015-05-01

    To investigate current practices and timing of neurological prognostication in comatose cardiac arrest patients. An anonymous questionnaire was distributed to the 8000 members of the European Society of Intensive Care Medicine during September and October 2012. The survey had 27 questions divided into three categories: background data, clinical data, decision-making and consequences. A total of 1025 respondents (13%) answered the survey with complete forms in more than 90%. Twenty per cent of respondents practiced outside of Europe. Overall, 22% answered that they had national recommendations, with the highest percentage in the Netherlands (>80%). Eighty-nine per cent used induced hypothermia (32-34 °C) for comatose cardiac arrest patients, while 11% did not. Twenty per cent had separate prognostication protocols for hypothermia patients. Seventy-nine per cent recognized that neurological examination alone is not enough to predict outcome and a similar number (76%) used additional methods. Intermittent electroencephalography (EEG), brain computed tomography (CT) scan and evoked potentials (EP) were considered most useful. Poor prognosis was defined as cerebral performance category (CPC) 3-5 (58%) or CPC 4-5 (39%) or other (3%). When prognosis was considered poor, 73% would actively withdraw intensive care while 20% would not and 7% were uncertain. National recommendations for neurological prognostication after cardiac arrest are uncommon and only one physician out of five uses a separate protocol for hypothermia treated patients. A neurological examination alone was considered insufficient to predict outcome in comatose patients and most respondents advocated a multimodal approach: EEG, brain CT and EP were considered most useful. Uncertainty regarding neurological prognostication and decisions on level of care was substantial. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. International online survey to assess current practice in equine anaesthesia.

    Science.gov (United States)

    Wohlfender, F D; Doherr, M G; Driessen, B; Hartnack, S; Johnston, G M; Bettschart-Wolfensberger, R

    2015-01-01

    Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago. To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4. Online questionnaire survey. An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed. A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the

  15. Grading of direct laryngoscopy. A survey of current practice.

    Science.gov (United States)

    Cohen, A M; Fleming, B G; Wace, J R

    1994-06-01

    One hundred and twenty anaesthetists (30 of each grade), from three separate regions, were interviewed as to how they recorded the appearance of laryngeal structures at direct laryngoscopy and about their knowledge of the commonly used numerical grading system. About two-thirds of anaesthetists surveyed (69.2%) used the numerical grading system, but of these, over half could not identify a 'grade 2' laryngoscopic appearance correctly. Of anaesthetists who did not use the numerical method, over half could not correctly state the difference between a 'grade 2' and a 'grade 3' laryngoscopic appearance. Over 40% of anaesthetists stated incorrectly that the grading should be made on the initial view, even when laryngeal pressure had been needed. Junior anaesthetists were more likely to use the numerical method of recording. The results show that there is unacceptable uncertainty and inaccuracy in the use of the numerical grading system by users as well as non-users, which makes the current routine clinical use of the numerical grading system unsatisfactory.

  16. Current State of Agile User-Centered Design: A Survey

    Science.gov (United States)

    Hussain, Zahid; Slany, Wolfgang; Holzinger, Andreas

    Agile software development methods are quite popular nowadays and are being adopted at an increasing rate in the industry every year. However, these methods are still lacking usability awareness in their development lifecycle, and the integration of usability/User-Centered Design (UCD) into agile methods is not adequately addressed. This paper presents the preliminary results of a recently conducted online survey regarding the current state of the integration of agile methods and usability/UCD. A world wide response of 92 practitioners was received. The results show that the majority of practitioners perceive that the integration of agile methods with usability/UCD has added value to their adopted processes and to their teams; has resulted in the improvement of usability and quality of the product developed; and has increased the satisfaction of the end-users of the product developed. The top most used HCI techniques are low-fidelity prototyping, conceptual designs, observational studies of users, usability expert evaluations, field studies, personas, rapid iterative testing, and laboratory usability testing.

  17. Cataract surgery among Medicare beneficiaries.

    Science.gov (United States)

    Schein, Oliver D; Cassard, Sandra D; Tielsch, James M; Gower, Emily W

    2012-10-01

    To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States. Cataract surgery performed on Medicare beneficiaries in 2003 and 2004. Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003-2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery. The national cataract surgery rate for 2003-2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75-84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient. The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

  18. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: Ethiopia is amongst the African countries that have received significant food aid. Nonetheless, the common micronutrient deficiencies among food aid beneficiaries are not well documented. Objective: To find out the common micronutrient deficiencies among food aid beneficiaries in the country based ...

  19. Outcomes associated with comorbid atrial fibrillation and heart failure in Medicare beneficiaries with acute coronary syndrome.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeff

    2014-02-20

    Atrial fibrillation (AF) and heart failure (HF) are both common comorbid conditions of elderly patients with acute coronary syndrome (ACS), but published data on their associated clinical and economic outcomes are limited. Our study included patients from the Medicare Current Beneficiary Survey with an incident hospitalization for ACS between 03/01/2002 and 12/31/2006. Applying population weights, we identified 795 incident ACS patients, representing more than 2.5 million Medicare beneficiaries. Of this population, 13.1% had comorbid AF, and 22.9% had HF, which were identified from Medicare claims during the 6 months prior to the first ACS event (index date) Subsequent cardiovascular (CV) hospitalizations and mortality were compared using Kaplan-Meier curves. Cox proportional hazards regressions were used to estimate the relative risk of AF and HF on CV events and mortality. Healthcare costs were summarized for the calendar year in which the incident ACS event occurred. HF was associated with a 41% higher risk of mortality (HR = 1.41; 95% confidence interval [CI] 1.05-1.89). Both AF (HR = 1.46; 95% CI 1.14-1.87) and HF (HR = 1.61; 95% CI 1.26-2.06) were associated with higher risks of subsequent CV events. During the year of the incident ACS event, ACS patients with comorbid AF or HF had approximately $18,000 higher total healthcare costs than those without these comorbidities. Using a nationally representative sample of Medicare beneficiaries, we observed a significantly higher clinical and economic burden of patients hospitalized for ACS with comorbid AF and HF compared with those without these conditions.

  20. 26 CFR 1.1312-5 - Correlative deductions and inclusions for trusts or estates and legatees, beneficiaries, or heirs.

    Science.gov (United States)

    2010-04-01

    ..., heirs, or legatees; or (4) The exclusion of such amounts from the income of the beneficiaries, heirs, or... invalid the clause directing accumulation and determines that the income is required to be currently... beneficiary's tax for the year 1954, based on the exclusion from 1954 gross income of the capital gains...

  1. Current management of anorectal malformation in Egypt: a survey of ...

    African Journals Online (AJOL)

    duplicate responses, yielding 82 survey charts for analysis. The 82 responses represent 74.5% of the 110 ... aDepartment of Pediatric Surgery, Qena University Hospital, Faculty of Medicine,. South Valley University, Qena and .... complex and improvement in rectal resting pressure and anorectal inhibitory reflex, which result ...

  2. Mathematicians' Views on Current Publishing Issues: A Survey of Researchers

    Science.gov (United States)

    Fowler, Kristine K.

    2011-01-01

    This article reports research mathematicians' attitudes about and activity in specific scholarly communication areas, as captured in a 2010 survey of more than 600 randomly-selected mathematicians worldwide. Key findings include: (1) Most mathematicians have papers in the arXiv, but posting to their own web pages remains more common; (2) A third…

  3. OASDI Beneficiaries and Benefits by State, 2014

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  4. Beneficiary Activation in the Medicare Population

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Beneficiary Activation in the Medicare Population, published in Volume 4, Issue 4 of the Medicare and Medicaid Research Review,...

  5. Costs and Clinical Quality Among Medicare Beneficiaries..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Costs and Clinical Quality Among Medicare Beneficiaries - Associations with Health Center Penetration of Low-Income Residents, published in Volume 4,...

  6. Assessment of Factors Influencing Beneficiary Participation in ...

    African Journals Online (AJOL)

    ISSN 0794-5698. Assessment of Factors Influencing Beneficiary Participation in Fadama II Project ... project implementation (80%) in the stages of project development. Women .... the project as they appeared to have more family burden to ...

  7. OASDI Beneficiaries and Benefits by State- 2015

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  8. Survey of current trends in DNA synthesis core facilities.

    Science.gov (United States)

    Hager, K M; Fox, J W; Gunthorpe, M; Lilley, K S; Yeung, A

    1999-12-01

    The Nucleic Acids Research Group of the Association of Biomolecular Resource Facilities (ABRF) last surveyed DNA synthesis core facilities in April 1995. Because of the introduction of new technologies and dramatic changes in the market, we sought to update survey information and to determine how academic facilities responded to the challenge presented by commercial counterparts. The online survey was opened in January 1999 by notifying members and subscribers to the ABRF electronic discussion group. The survey consisted of five parts: general facility information, oligonucleotide production profile, oligonucleotide charges, synthesis protocols, and trends in DNA synthesis (including individual comments). All submitted data were anonymously coded. Respondents from DNA synthesis facilities were primarily from the academic category and were established between 1984 and 1991. Typically, a facility provides additional services such as DNA sequencing and has upgraded to electronic ordering. There is stability in staffing profiles for these facilities in that the total number of employees is relatively unchanged, the tenure for staff averages 5.9 years, and experience is extensive. On average, academic facilities annually produce approximately 1/16 the number of oligonucleotides produced by the average commercial facilities, but all facilities report an increase in demand. Charges for standard oligonucleotides from academic facilities are relatively higher than from commercial companies; however, the opposite is true for modified phosphoramidites. Subsidized facilities charge less than nonsubsidized facilities. Synthesis protocols and reagents are standard across the categories. Most facilities offer typical modifications such as biotinylation. Despite the competition by large commercial facilities that have reduced costs dramatically, academic facilities remain a stable entity. Academic facilities enhance the quality of service by focusing on nonstandard

  9. Roof Moisture Surveys: Current State Of The Technology

    Science.gov (United States)

    Tobiasson, Wayne

    1983-03-01

    Moisture is the big enemy of compact roofing systems. Non-destructive nuclear, capacitance and infrared methods can all find wet insulation in such roofs but a few core samples are needed for verification. Nuclear and capacitance surveys generate quantitative results at grid points but examine only a small portion of the roof. Quantitative results are not usually provided by infrared scanners but they can rapidly examine every square inch of the roof. Being able to find wet areas when they are small is an important advantage. Prices vary with the scope of the investigation. For a particular scope, the three techniques are often cost-competitive. The limitations of each technique are related to the people involved as well as the equipment. When the right people are involved, non-destructive surveys are a very effective method for improving the long-term performance and reducing the life-cycle costs of roofing systems. Plans for the maintenance, repair or replacement of a roof should include a roof moisture survey.

  10. Knowledge of Precision Farming Beneficiaries

    Directory of Open Access Journals (Sweden)

    A.V. Greena

    2016-05-01

    Full Text Available Precision Farming is one of the many advanced farming practices that make production more efficient by better resource management and reducing wastage. TN-IAMWARM is a world bank funded project aims to improve the farm productivity and income through better water management. The present study was carried out in Kambainallur sub basin of Dharmapuri district with 120 TN-IAMWARM beneficiaries as respondents. The result indicated that more than three fourth (76.67 % of the respondents had high level of knowledge on precision farming technologies which was made possible by the implementation of TN-IAMWARM project. The study further revealed that educational status, occupational status and exposure to agricultural messages had a positive and significant contribution to the knowledge level of the respondents at 0.01 level of probability whereas experience in precision farming and social participation had a positive and significant contribution at 0.05 level of probability.

  11. Defining a caring hospital by using currently implemented survey tools.

    Science.gov (United States)

    Jennings, Nancy

    2010-09-01

    Health care organizations are constantly striving to provide a more cost-effective and higher quality treatment within a caring environment. However, balancing the demands of regulatory agencies with the holistic needs of the patient is challenging. Further challenging is how to define those hospitals that provide an exceptional caring environment for their patients. By using survey tools that are already being administered in hospital settings, the opportunity exists to analyze the results obtained from these tools to define a hospital as a caring organization without the added burden of separate data collection.

  12. Current-drive theory I: survey of methods

    International Nuclear Information System (INIS)

    Fisch, N.J.

    1986-01-01

    A variety of methods may be employed to drive toroidal electric current in a plasma torus. The most promising scheme is the injection of radiofrequency waves into the torus to push electrons or ions. The pushing mechanism can be either the direct conversion of wave to particle momentum, or a more subtle effect involving the alteration by waves of interparticle collisions. Alternatively, current can be produced through the injection of neutral beams, the reflection of plasma radiation, or the injection of frozen pellets. The efficacy of these schemes, in a variety of regimes, will be assessed. 9 refs

  13. Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

    Science.gov (United States)

    Coleman, Anne L; Yu, Fei; Evans, Stacy J

    2006-12-01

    The American Academy of Ophthalmology Preferred Practice Patterns for angle closure and open-angle glaucoma (OAG) patients recommends performing bilateral gonioscopy upon initial presentation to evaluate the possibility of narrow angle or angle-closure glaucoma (ACG) and then repeating the examination at least every 5 years. This study aims to assess how commonly eye care providers perform gonioscopy before planned glaucoma surgery in OAG, anatomic narrow angle, and ACG in the Medicare population. Data obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States in 1999 were retrospectively reviewed. The proportion of patients with evidence of at least one gonioscopic examination before glaucoma surgery was determined for the period of 1995 to 1999. Demographic and clinical factors potentially influencing the decision to perform gonioscopy were also examined. Overall, gonioscopy is apparently performed in 49% of Medicare beneficiaries during the 4 to 5 years preceding glaucoma surgery. This rate was significantly lower (P gonioscopy rates (P Gonioscopy examination before glaucoma surgery in Medicare beneficiaries is underused, undercoded, and/or miscoded, given current recommendations. Underuse is of particular concern in patients undergoing laser iridotomy as it is the diagnostic test of choice in ACG.

  14. Survey of Digital Feedback Systems in High Current Storage Rings

    International Nuclear Information System (INIS)

    Teytelman, Dmitry

    2003-01-01

    In the last decade demand for brightness in synchrotron light sources and luminosity in circular colliders led to construction of multiple high current storage rings. Many of these new machines require feedback systems to achieve design stored beam currents. In the same time frame the rapid advances in the technology of digital signal processing allowed the implementation of these complex feedback systems. In this paper I concentrate on three applications of feedback to storage rings: orbit control in light sources, coupled-bunch instability control, and low-level RF control. Each of these applications is challenging in areas of processing bandwidth, algorithm complexity, and control of time-varying beam and system dynamics. I will review existing implementations as well as comment on promising future directions

  15. A survey of synthetic cannabinoid consumption by current cannabis users.

    Science.gov (United States)

    Gunderson, Erik W; Haughey, Heather M; Ait-Daoud, Nassima; Joshi, Amruta S; Hart, Carl L

    2014-01-01

    Despite growing concern about the increased rates of synthetic cannabinoid (SC) use and their effects, only limited data are available that addresses these issues. This study assessed the extent of SC product use and reported effects among a cohort of adult marijuana and tobacco users. A brief telephone interview was conducted with individuals who had given permission to be contacted for future research while screening for a cannabis/nicotine dependence medication development study (NCT01204723). Respondents (N = 42; 88% participation rate) were primarily young adults, male, racially diverse, and high school graduates. Nearly all currently smoked tobacco and cannabis, with 86% smoking cannabis on 5 or more days per week. Nearly all (91%) were familiar with SC products, half (50%) reported smoking SC products previously, and a substantial minority (24%) reported current use (i.e., past month). Despite a federal ban on 5 common SCs, which went into effect on March 1, 2011, a number of respondents reported continued SC product use. Common reasons reported for use included, but were not limited to, seeking a new "high" similar to that produced by marijuana and avoiding drug use detection via a positive urine screen. The primary side effects were trouble thinking clearly, headache, dry mouth, and anxiety. No significant differences were found between synthetic cannabinoid product users (ever or current) and nonusers by demographics or other characteristics. Among current marijuana and tobacco users, SC product consumption was common and persisted despite a federal ban. The primary reasons for the use of SC-containing products seem to be to evade drug detection and to experience a marijuana-like high.

  16. [Brief survey of some foreign currents of classical acupuncture].

    Science.gov (United States)

    Andrews, Z; Zhang, S J

    2017-05-28

    This paper reviews the history of acupuncture's dissemination to Japan, France, and England in the modern period. In particular, it examines how Chinese acupuncture methods were modified in each of these countries and how these modifications were theoretically justified based on new readings of classical texts. In each country, these currents of acupuncture practice all claimed to be transmitting true traditional acupuncture, even as they developed along different trajectories and created new and different theories and practices of acupuncture. Some of these foreign methods were re-exported back to China, where they, in turn, have influenced the development of Chinese acupuncture.

  17. Survey on current hydrotherapy use among North American burn centers.

    Science.gov (United States)

    Davison, Peter G; Loiselle, Frederick B; Nickerson, Duncan

    2010-01-01

    The authors have reviewed hydrotherapy practices in North American burn centers and described the epidemiology of hydrotherapy-associated nosocomial infections. A web-based survey was distributed to the directors of all burn care facilities listed by the American Burn Association. Questions addressed aspects of practice, including the method, additives, disposable liners, decontamination practices, nosocomial pathogens, and perceptions regarding the "ideal" method of hydrotherapy. The response rate was 44%, 59 of 142 centers, or 827 of 1900 beds. Hydrotherapy is regularly used by 83% of centers. Among these centers, 10% use exclusively immersion hydrotherapy (IH), 54% use exclusively shower cart hydrotherapy (SCH), and 35% use a combination of IH and SCH. Disposable liners are used at 80% of centers. Tap water alone is used by 51% of centers, 27% add detergent, 16% chlorhexidine, and 7% povidone-iodine. The majority of centers (57%) do not routinely culture their hydrotherapy equipment, 20% culture weekly, 7% monthly, and 17% less than once per month. Directors believe that Pseudomonas aeruginosa, methicillin-sensitive Staphylococcus aureus, and methicillin-resistant S. aureus are the most common nosocomial pathogens, followed by Acinetobacter species and Candida albicans. The relative frequency of occurrence of the first three pathogens did not vary with regard to the hydrotherapy method used. Given the opportunity to redesign, 45% of burn unit directors would implement SCH only, 42% a combination of SCH and IH, 2% exclusively IH, and 11% no hydrotherapy or bedside irrigation only. The prevalence of hydrotherapy use at North American burn centers has decreased since 1990 (83% vs 95%), yet continues to be used at the majority of centers. The use of IH has also declined (55% vs 81%). The trend away from the exclusive use of IH will likely continue, because more centers incorporate showering methods.

  18. Typography and layout of technical reports - Survey of current practices

    Science.gov (United States)

    Pinelli, T. E.; Cordle, V. M.; Mccullough, R.

    1985-01-01

    As part of a review of the NASA Langley Research Center scientific and technical information program, 50 technical reports from industry, research institutions, and government agencies were systematically examined and analyzed to determine current usage and practice in regard to (1) typography, including composition method, type style, type size, and margin treatment; (2) graphic design, including layout and imposition of material on the page; and (3) physical media, including paper, ink, and binding methods. The results indicate that approximately 50 percent of the reports were typeset, 70 percent used Roman (serif) type, 80 percent used 10- or 11-point type for text, 60 percent used a ragged right-hand margin, slightly more than half used paragraph indentation, 75 percent used a single-column layout, 65 percent had one or more figures or tables placed perpendicular to (not aligned with) the text, and perfect binding was the most frequently used binding method.

  19. Depression Following Thrombotic Cardiovascular Events in Elderly Medicare Beneficiaries: Risk of Morbidity and Mortality

    Directory of Open Access Journals (Sweden)

    Christopher M. Blanchette

    2009-01-01

    Full Text Available Purpose. Depression and antidepressant use may independently increase the risk of acute myocardial infarction and mortality in adults. However, no studies have looked at the effect of depression on a broader thrombotic event outcome, assessed antidepressant use, or evaluated elderly adults. Methods. A cohort of 7,051 community-dwelling elderly beneficiaries who experienced a thrombotic cardiovascular event (TCE were pooled from the 1997 to 2002 Medicare Current Beneficiary Survey and followed for 12 months. Baseline characteristics, antidepressant utilization, and death were ascertained from the survey, while indexed TCE, recurrent TCE, and depression (within 6 months of indexed TCE were taken from ICD-9 codes on Medicare claims. Time to death and first recurrent TCE were assessed using descriptive and multivariate statistics. Results. Of the elders with a depression claim, 71.6% had a recurrent TCE and 4.7% died within 12 months of their indexed TCE, compared to 67.6% and 3.9% of those elders without a depression claim. Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI users. Depression was associated with a shorter time to death (P=.008 in the unadjusted analysis. However, all adjusted comparisons revealed no effect by depression, antidepressant use, or SSRI use. Conclusions. Depression was not associated with time to death or recurrent TCEs in this study. Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

  20. Smoking Patterns and Smoking Cessation Willingness—A Study among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Katarzyna Milcarz

    2017-01-01

    Full Text Available This study examines the prevalence and tobacco use patterns among adult social assistance beneficiaries and their interest in quitting. The results are based on data collected in a cross-sectional survey conducted among adults in the Piotrkowski district. A sample of 3636 social assistance beneficiaries produced a total of 1817 respondents who completed face-to-face questionnaires. Overall, 37.1% of the respondents, including 52.8% men and 29.6% women, were current smokers. Over one third of the smokers reported their willingness to quit. In the study population, several characteristics were significantly associated with the current daily smoking: male gender, low educational attainment, unemployment or temporary employment, lack of awareness of smoking-associated health risks, use of e-cigarettes, and exposure to environmental tobacco smoke (ETS. The intention to quit smoking among the daily smokers was positively correlated with their awareness of smoking-associated health risks, lack of previous quit attempts, and low exposure to ETS. Smoking prevalence among social assistance recipients tends to be higher than in the general population, but more than half of the smokers are willing to quit. There is an urgency to develop policies tailored to the needs of these disadvantaged population groups.

  1. GLOBEC NEP Northern California Current Cetacean Survey Data, NH0005, 2000-2000, 0007

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — GLOBEC (GLOBal Ocean ECosystems Dynamics) NEP (Northeast Pacific) Northern California Current Cetacean Survey Data from R/V New Horizon cruises NH0005 and 0007....

  2. Students and Instant Messaging: Survey on Current Use and Demands for Higher Education

    NARCIS (Netherlands)

    De Bakker, Gijs; Sloep, Peter; Jochems, Wim

    2008-01-01

    De Bakker, G., Sloep, P. B., & Jochems, W. M. G. (2007). Students and instant messaging: survey on current use and demands for higher education. Research in Learning Technology (ALT-J), 15(2), 143-153.

  3. Current Trends in Communication Graduate Degrees: Survey of Communications, Advertising, PR, and IMC Graduate Programs

    Science.gov (United States)

    Quesenberry, Keith A.; Coolsen, Michael K.; Wilkerson, Kristen

    2015-01-01

    A survey of 61 master's degree advertising programs reveals significant trends in program titles, curriculum design, course delivery, and students served. The results provide insight for current and planned master's degree programs as research predicts a continued increase in demand for master's education over the next decade. Survey results are…

  4. A Survey of Current and Projected Ethical Dilemmas of Rehabilitation Counselors

    Science.gov (United States)

    Hartley, Michael T.; Cartwright, Brenda Y.

    2016-01-01

    Purpose: This study surveyed current and projected ethical dilemmas of rehabilitation counselors. Method: As a mixed-methods approach, the study used both quantitative and qualitative analyses. Results: Of the 211 participants who completed the survey, 116 (55.0%) reported an ethical dilemma. Based on the descriptions, common themes involved roles…

  5. How Do Pharmacists Assist Medicare Beneficiaries with Limited Income? A Cross-Sectional Study of Community Pharmacies in Alabama.

    Science.gov (United States)

    Westrick, Salisa C; Hastings, Tessa J; McFarland, Stuart J; Hohmann, Lindsey A; Hohmann, Natalie S

    2016-09-01

    Many Medicare beneficiaries have limited income and report problems paying for their medications. Programs are available to assist these low-income individuals. However, these programs are underused because of lack of general awareness and perceived complexity of program applications. To (a) determine the frequency of encounters by pharmacists with Medicare beneficiaries who cannot afford prescription drugs; (b) identify strategies that pharmacists use to assist Medicare beneficiaries who cannot afford prescription drugs; and (c) explore what pharmacists know about programs for Medicare beneficiaries with limited income. This study used a mixed-mode survey of 350 randomly sampled community pharmacies located in 32 counties in Alabama with a high proportion of Medicare beneficiaries who were potentially eligible for low-income subsidy programs. Measures included frequency of encounters by pharmacists with Medicare beneficiaries who could not afford their medications, strategies used to assist Medicare beneficiaries, and pharmacists' knowledge of programs for Medicare beneficiaries with limited income. Of 350 surveys sent, 12 were nondeliverable, and 151 were completed (response rate=44.6%). About 50% of respondents reported encountering Medicare beneficiaries who could not afford their medications at least weekly. Various strategies were reported, including refiling claims that were previously denied every day (40.7%), contacting insurance companies at least once per week (43.2%), and loaning medications at least 2-3 times per month (29.1%). Only 12.6% reported referring beneficiaries to the Aging and Disability Resource Centers (ADRCs) to assess eligibility for limited-income programs. When asked about programs for beneficiaries with limited income, the answers were predominantly "don't know for sure." Several strategies were used by pharmacists in an attempt to help limited-income Medicare beneficiaries obtain their medications. Lack of knowledge about financial

  6. Medicare Beneficiary Knowledge of the Part D Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge...

  7. Preclinical QSP Modeling in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    Science.gov (United States)

    Wu, Fan; Bansal, Loveleena; Bradshaw‐Pierce, Erica; Chan, Jason R.; Liederer, Bianca M.; Mettetal, Jerome T.; Schroeder, Patricia; Schuck, Edgar; Tsai, Alice; Xu, Christine; Chimalakonda, Anjaneya; Le, Kha; Penney, Mark; Topp, Brian; Yamada, Akihiro

    2018-01-01

    A cross‐industry survey was conducted to assess the landscape of preclinical quantitative systems pharmacology (QSP) modeling within pharmaceutical companies. This article presents the survey results, which provide insights on the current state of preclinical QSP modeling in addition to future opportunities. Our results call attention to the need for an aligned definition and consistent terminology around QSP, yet highlight the broad applicability and benefits preclinical QSP modeling is currently delivering. PMID:29349875

  8. A survey of current practices in management of Hirschsprung′s disease in Nigeria

    OpenAIRE

    Abdulrasheed A. Nasir; Emmanuel A. Ameh

    2014-01-01

    Background: Although there are several modalities of treatment for Hirschsprung′s disease (HD), there are presently no clear guidelines on treatment of the condition by paediatric surgeons in Nigeria. This survey determines the current approach to treatment among Nigerian paediatric surgeons and should help in establishing a consensus and guidelines for care in this and similar setting. Materials and Methods: An online questionnaire was designed using survey Monkey ® to determine current clin...

  9. A profile of social security child beneficiaries and their families: sociodemographic and economic characteristics.

    Science.gov (United States)

    Tamborini, Christopher R; Cupito, Emily; Shoffner, Dave

    2011-01-01

    Using a rich dataset that links the Census Bureau's Survey of Income and Program Participation calendar-year 2004 file with Social Security benefit records, this article provides a portrait of the sociodemographic and economic characteristics of Social Security child beneficiaries. We find that the incidence ofbenefit receipt in the child population differs substantially across individual and family-level characteristics. Average benefit amounts also vary across subgroups and benefit types. The findings provide a better understanding of the importance of Social Security to families with beneficiary children. Social Security is a major source of family income for many child beneficiaries, particularly among those with low income or family heads with lower education and labor earnings.

  10. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    Results: Vitamin A and iron deficiencies were the most prevalent micronutrient deficiencies among food aid beneficiaries. Other probable deficiencies prevailing were zinc, vitamins thiamine, riboflavin, niacin folate, cyano-cobalamine, ascorbic acid vitamin D and calcium because of the low intake of dairy products and meat.

  11. Tax system competition – instruments and beneficiaries

    OpenAIRE

    Krzysztof Biernacki

    2014-01-01

    Tax competition among states and jurisdictions has already been examined many times in the economic literature. However, the main scope of the research was focused on a tax rates competition in income taxes and its consequences in bringing direct investments. This scripture/commentary tries to analyze various instruments and beneficiaries of the tax system competition and provide a general overview on this subject.

  12. Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Higgins Angela Y

    2012-03-01

    Full Text Available Abstract Background The benefit of screening for decreasing the risk of death from colorectal cancer (CRC has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs vs. internal medicine (internists physicians. Methods Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey. The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening. Results Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%, or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81 or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94. Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%, while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%. Conclusion Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.

  13. 38 CFR 9.4 - Beneficiaries and options.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Beneficiaries and options... SERVICEMEMBERS' GROUP LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.4 Beneficiaries and options. Any designation of beneficiary or election of settlement options is subject to the provisions of 38 U.S.C. 1970...

  14. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic Control Specialists (ATCS) of the FAA when appropriate authorization has been furnished by the FAA...

  15. [SWOT Analysis of the National Survey on Current Status of Major Human Parasitic Diseases in China].

    Science.gov (United States)

    ZHU, Hui-hui; ZHOU, Chang-hai; CHEN, Ying-dan; ZANG, Wei; XIAO, Ning; ZHOU, Xiao-nong

    2015-10-01

    The National Survey on Current Status of Major Human Parasitic Diseases in China has been carried out since 2014 under the organization of the National Health and Family Planning Commission of the People's Republic of China. The National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (NIPD, China CDC) provided technical support and was responsible for quality control in this survey. This study used SWOT method to analyze the strengths, weaknesses, opportunities and threats that were encountered by he NIPD, China CDC during the completion of the survey. Accordingly, working strategies were proposed to facilitate the future field work.

  16. Statistical survey of day-side magnetospheric current flow using Cluster observations: magnetopause

    Directory of Open Access Journals (Sweden)

    E. Liebert

    2017-05-01

    Full Text Available We present a statistical survey of current structures observed by the Cluster spacecraft at high-latitude day-side magnetopause encounters in the close vicinity of the polar cusps. Making use of the curlometer technique and the fluxgate magnetometer data, we calculate the 3-D current densities and investigate the magnetopause current direction, location, and magnitude during varying solar wind conditions. We find that the orientation of the day-side current structures is in accordance with existing magnetopause current models. Based on the ambient plasma properties, we distinguish five different transition regions at the magnetopause surface and observe distinctive current properties for each region. Additionally, we find that the location of currents varies with respect to the onset of the changes in the plasma environment during magnetopause crossings.

  17. Potential Beneficiaries of the Obama Administration’s Executive Action Programs Deeply Embedded in US Society

    Directory of Open Access Journals (Sweden)

    Donald Kerwin

    2016-03-01

    Full Text Available The Obama administration has developed two broad programs to defer immigration enforcement actions against undocumented persons living in the United States: (1 Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA; and (2 Deferred Action for Childhood Arrivals (DACA. The DACA program, which began in August 2012, was expanded on November 20, 2014. DAPA and the DACA expansion (hereinafter referred to as “DACA-plus” are currently under review by the US Supreme Court and subject to an active injunction.This paper offers a statistical portrait of the intended direct beneficiaries of DAPA, DACA, and DACA-plus. It finds that potential DAPA, DACA, and DACA-plus recipients are deeply embedded in US society, with high employment rates, extensive US family ties, long tenure, and substantial rates of English-language proficiency. The paper also notes various groups that would benefit indirectly from the full implementation of DAPA and DACA or, conversely, would suffer from the removal of potential beneficiaries of these programs. For example, all those who would rely on the retirement programs of the US government will benefit from the high employment rates and relative youth of the DACA population, while many US citizens who rely on the income of a DAPA-eligible parent would fall into poverty or extreme poverty should that parent be removed from the United States.This paper offers an analysis of potential DAPA and DACA beneficiaries. In an earlier study, the authors made the case for immigration reform based on long-term trends related to the US undocumented population, including potential DAPA and DACA beneficiaries (Warren and Kerwin 2015. By contrast, this paper details the degree to which these populations have become embedded in US society. It also compares persons eligible for the original DACA program with those eligible for DACA-plus.As stated, the great majority of potential DAPA and DACA recipients enjoy strong family

  18. 77 FR 58510 - Proposed Information Collection; Comment Request; Current Population Survey (CPS), Annual Social...

    Science.gov (United States)

    2012-09-21

    ... various population groups. A prime statistic of interest is the classification of people in poverty and... Information Collection; Comment Request; Current Population Survey (CPS), Annual Social and Economic... conducted this supplement annually for over 50 years. The Census Bureau and the Bureau of Labor Statistics...

  19. Income Inequality and Health Status in the United States: Evidence from the Current Population Survey.

    Science.gov (United States)

    Mellor, Jennifer M.; Milyo, Jeffrey

    2002-01-01

    Current Population Survey data on self-reported health status and income for the general population and those in poverty were analyzed. No consistent association was found between income inequality and individual health status. Previous findings of such an association were attributed to ecological fallacy or failure to control for individual…

  20. Students and recorded lectures: survey on current use and demands for higher education

    NARCIS (Netherlands)

    Gorissen, Pierre; Van Bruggen, Jan; Jochems, Wim

    2012-01-01

    Gorissen, P., Van Bruggen, J., & Jochems, W. M. G. (2012). Students and recorded lectures: survey on current use and demands for higher education. Research In Learning Technology, 20(3). doi:10.3402/rlt.v20i0.17299

  1. 78 FR 54622 - Proposed Information Collection; Comment Request; Current Population Survey, Annual Social and...

    Science.gov (United States)

    2013-09-05

    ... DEPARTMENT OF COMMERCE Census Bureau Proposed Information Collection; Comment Request; Current Population Survey, Annual Social and Economic Supplement AGENCY: U.S. Census Bureau, Commerce. ACTION: Notice... designed to create a marketplace of private health insurance options for individuals and small businesses...

  2. Cardioversion for atrial fibrillation in current European practice : results of the European Heart Rhythm Association survey

    NARCIS (Netherlands)

    Hernandez-Madrid, Antonio; Svendsen, Jesper Hastrup; Lip, Gregory Y. H.; Van Gelder, Isabelle C.; Dobreanu, Dan; Blomstrom-Lundqvist, Carina

    This survey was conducted to provide an insight into the current clinical practice regarding the use of cardioversion for atrial fibrillation (AF) in Europe. Responses were received from 57 centres across Europe, 71.9 of which were university hospitals. For electrical cardioversion, general

  3. Survey Exploring Views of Scientists on Current Trends in Chemistry Education

    Science.gov (United States)

    Vamvakeros, Xenofon; Pavlatou, Evangelia A.; Spyrellis, Nicolas

    2010-01-01

    A survey exploring the views of scientists, chemists and chemical engineers, on current trends in Chemistry Education was conducted in Greece. Their opinions were investigated using a questionnaire focusing on curricula (the content and process of chemistry teaching and learning), as well as on the respondents' general educational beliefs and…

  4. Lot quality assurance sampling techniques in health surveys in developing countries: advantages and current constraints.

    Science.gov (United States)

    Lanata, C F; Black, R E

    1991-01-01

    Traditional survey methods, which are generally costly and time-consuming, usually provide information at the regional or national level only. The utilization of lot quality assurance sampling (LQAS) methodology, developed in industry for quality control, makes it possible to use small sample sizes when conducting surveys in small geographical or population-based areas (lots). This article describes the practical use of LQAS for conducting health surveys to monitor health programmes in developing countries. Following a brief description of the method, the article explains how to build a sample frame and conduct the sampling to apply LQAS under field conditions. A detailed description of the procedure for selecting a sampling unit to monitor the health programme and a sample size is given. The sampling schemes utilizing LQAS applicable to health surveys, such as simple- and double-sampling schemes, are discussed. The interpretation of the survey results and the planning of subsequent rounds of LQAS surveys are also discussed. When describing the applicability of LQAS in health surveys in developing countries, the article considers current limitations for its use by health planners in charge of health programmes, and suggests ways to overcome these limitations through future research. It is hoped that with increasing attention being given to industrial sampling plans in general, and LQAS in particular, their utilization to monitor health programmes will provide health planners in developing countries with powerful techniques to help them achieve their health programme targets.

  5. Survey of current lead use, handling, hygiene, and contaminant controls among New Jersey industries.

    Science.gov (United States)

    Blando, James D; Lefkowitz, Daniel K; Valiante, David; Gerwel, Barbara; Bresnitz, Eddy

    2007-08-01

    In 2003, a chemical handling and use survey was mailed to New Jersey employers identified as currently using lead in their industrial processes. This survey was used to ascertain characteristics about lead use, handling, and protection of employees during manufacturing operations. The survey included a diverse group of current lead users with a total lead use range from less than 1 pound to more than 63 million pounds of lead per year. The survey allowed for a comprehensive characterization of hazards and protective measures associated with this metal, still commonly used in many products and industrial processes. Forty-five surveys were returned by companies that are listed in the New Jersey Adult Blood Lead Registry, which is part of the New Jersey Adult Blood Lead Epidemiology and Surveillance (ABLES) program. This program records and investigates cases of adults with greater than 25 mu g/dL of lead in their blood; most cases are related to occupational exposures. This survey found that greater than 25% of these surveyed companies with significant potential for lead exposure did not employ commonly used and basic industrial hygiene practices. In addition, the survey found that 24% of these companies had not conducted air sampling within the last 3 years. Air sampling is the primary trigger for compliance with the Occupational Safety and Health Administration (OSHA) general industry lead standard. Only 17% of the companies have ever been cited for a violation of the OSHA lead standard, and only 46% of these companies have ever had an OSHA inspection. State-based surveillance can be a useful tool for OSHA enforcement activities. Elevated blood lead values in adults should be considered as a trigger for required compliance with an OSHA general industry lead standard.

  6. A Survey of the Current Situation of Clinical Biobanks in China.

    Science.gov (United States)

    Li, Haiyan; Ni, Mingyu; Wang, Peng; Wang, Xiaomin

    2017-06-01

    The development of biomedical research urgently needs the support of a large number of high-quality clinical biospecimens. Therefore, human biobanks at different levels have been established successively in China and other countries at a significantly increasing pace in recent years. To better understand the general current state of clinical biobanks in China, we surveyed 42 clinical biobanks based in hospitals and collected information involving their management systems, sharing mechanisms, quality control systems, and informational management systems using closed questionnaire methods. Based on our current information, there has not been such a large-scale survey in China. An understanding of the status and challenges current clinical biobanks face will provide valuable insights for the construction and sustainable development of higher quality clinical biobanks.

  7. Geriatric oncology in Spain: survey results and analysis of the current situation.

    Science.gov (United States)

    Gironés, R; Morilla, I; Guillen-Ponce, C; Torregrosa, M D; Paredero, I; Bustamante, E; Del Barco, S; Soler, G; Losada, B; Visa, L; Llabrés, E; Fox, B; Firvida, J L; Blanco, R; Antonio, M; Aparisi, F; Pi-Figueras, M; Gonzalez-Flores, E; Molina-Garrido, M J; Saldaña, J

    2017-12-11

    Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. A descriptive survey was sent to several hospitals by means of the SEOM website. A personal e-mail was also sent to SEOM members. Between March 2016 and April 2017, 154 answers were collected. Only 74 centers (48%) had a geriatrics department and a mere 21 (14%) medical oncology departments had a person dedicated to GO. The vast majority (n = 135; 88%) had the perception that the number of elderly patients with cancer seen in clinical practice had increased. Eighteen (12%) oncologists had specific protocols and geriatric scales were used at 55 (31%) centers. Almost all (92%) claimed to apply special management practices using specific tools. There was agreement that GO afforded certain potential advantages. Finally, 99% of the oncologists surveyed believed it and that training in GO had to be improved. From the nationwide survey promoted by the Spanish Geriatric Oncology Working Group on behalf of SEOM, we conclude that there is currently no defined care structure for elderly cancer patients. There is an increasing perception of the need for training in GO. This survey reflects a reality in which specific needs are perceived.

  8. A survey of current practices in management of Hirschsprung′s disease in Nigeria

    Directory of Open Access Journals (Sweden)

    Abdulrasheed A. Nasir

    2014-01-01

    Full Text Available Background: Although there are several modalities of treatment for Hirschsprung′s disease (HD, there are presently no clear guidelines on treatment of the condition by paediatric surgeons in Nigeria. This survey determines the current approach to treatment among Nigerian paediatric surgeons and should help in establishing a consensus and guidelines for care in this and similar setting. Materials and Methods: An online questionnaire was designed using survey Monkey ® to determine current clinical and operative management of patients with HD by consultant paediatric surgeons practicing in the Nigeria. The paediatric surgeons were notified by E-mail, which included a link to the survey on survey Monkey ® . The survey was also administered at the 12 th annual meeting of Association of Paediatric Surgeons of Nigeria in September, 2013, to capture those who did not complete the online survey. Thirty-one paediatric surgeons from 21 different tertiary paediatric surgery centres completed the survey. Results: Sixteen (52% respondents see up to 20% of their patients with HD in the neonatal period. Twenty-six (84% respondents do routine barium enema. Twenty six (84% respondents do full thickness rectal biopsy under general anaesthesia (GA. There was no consistency in operative techniques, with transabominal Swenson′s operation being practiced by 17 (57% respondents and 11 (37% transanal endorectal pull through. 14 (45% do pull through at any age. 12 (39% respondents do more than half of their patient as primary pull through. Conclusion: Full thickness rectal biopsy under GA is still the vogue with variations in the surgical technique for management of Hirshsprung′s disease in Nigeria. Primary pull through procedures is becoming increasingly popular. There′s a need for Paediatric Surgeons in Nigeria to come up with a guideline on management of HD, to guide trainees and other surgeons in the care of these patients.

  9. Pediatric endocrine society survey of diabetes practices in the United States: What is the current state?

    Science.gov (United States)

    Guttmann-Bauman, I; Thornton, P; Adhikari, S; Reifschneider, K; Wood, M A; Hamby, T; Rubin, K

    2018-03-26

    The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March, 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. Ninety-three unique entries from the US were entered into analysis. Care is predominantly delivered by multidisciplinary teams, based at academic institutions (65.6%), with >85% of the provider types being physicians. Each 1.0 full time equivalent certified diabetes educators serves on average 367 diabetic youth. Fee-for-service remains the standard method of reimbursement with 57% of practices reporting financial loss. Survey respondents identified under-reimbursement as a major barrier to improving patient outcomes and lack of behavioral health (BH) providers as a key gap in services provided. Our survey reveals wide variation in all aspects of pediatric diabetes care delivery in the United States. Pediatric Endocrinologists responding to the survey identified a lack of resources and the current fee for service payment model as a major impediment to practice and the lack of integrated BH staff as a key gap in service. The respondents strongly support its organizations' involvement in the dissemination of standards for care delivery and advocacy for a national payment model aligned with chronic diabetes care in the context of our emerging value-based healthcare system. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. 5 CFR 1651.10 - Deceased and non-existent beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... beneficiary form dies before the participant, the beneficiary's share will be paid equally to other living beneficiaries bearing the same relationship to the participant as the deceased beneficiary. However, if the... descendants, if any. If there are no other beneficiaries bearing the same relationship or, in the case of...

  11. A survey of current clinical practice in permanent and temporary prostate brachytherapy: 2010 update.

    Science.gov (United States)

    Buyyounouski, Mark K; Davis, Brian J; Prestidge, Bradley R; Shanahan, Thomas G; Stock, Richard G; Grimm, Peter D; Demanes, D Jeffrey; Zaider, Marco; Horwitz, Eric M

    2012-01-01

    To help establish patterns of care and standards of care of interstitial permanent low-dose-rate (LDR) and temporary high-dose-rate brachytherapy for prostate cancer and to compare the results with a similar 1998 American Brachytherapy Society (ABS) survey. A comprehensive questionnaire intended to survey specific details of current clinical brachytherapy practice was provided to the participants of the seventh ABS Prostate Brachytherapy School. Responses were tabulated and descriptive statistics are reported. Sixty-five brachytherapy practitioners responded to the survey. Eighty-nine percent (89%) of respondents performed LDR and 49% perform high-dose-rate brachytherapy. The median number of years of experience for LDR brachytherapists increased from 5 to 10 years over the course of the 12 years since the preceding survey. Compared with the first ABS, a smaller proportion of respondents received formal brachytherapy residency training (43% vs. 56%) or formal "hands-on" brachytherapy training (15% vs. 63%). There has been a marked decline in the utilization of the Mick applicator (Mick Radio-Nuclear Instruments, Inc., Mount Vernon, NY, USA) (60% vs. 28%) and an increase in the use of stranded seeds (40% vs. 11%). Compliance with postimplant dosimetry was higher in the 2010 survey. This survey does suggest an evolution in the practice of LDR brachytherapy since 1998 and aids in identifying aspects that require further progress or investigation. ABS guidelines and other practice recommendations appear to impact the practice of brachytherapy. Copyright © 2012 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  12. GROUP FINDING IN THE STELLAR HALO USING PHOTOMETRIC SURVEYS: CURRENT SENSITIVITY AND FUTURE PROSPECTS

    International Nuclear Information System (INIS)

    Sharma, Sanjib; Johnston, Kathryn V.; Majewski, Steven R.; Bullock, James; Munoz, Ricardo R.

    2011-01-01

    The Sloan Digital Sky Survey (SDSS) and the Two Micron All Sky Survey (2MASS) provided the first deep and global photometric catalogs of stars in our halo and not only clearly mapped its structure but also demonstrated the ubiquity of substructure within it. Future surveys promise to push such catalogs to ever increasing depths and larger numbers of stars. This paper examines what can be learned from current and future photometric databases using group-finding techniques. We compare groups recovered from a sample of M-giants from 2MASS with those found in synthetic surveys of simulated ΛCDM stellar halos that were built entirely from satellite accretion events and demonstrate broad consistency between the properties of the two sets. We also find that these recovered groups are likely to represent the majority of high-luminosity (L > 5 x 10 6 L sun ) satellites accreted within the last 10 Gyr and on orbits with apocenters within 100 kpc. However, the sensitivity of the M-giant survey to accretion events that were either ancient from low-luminosity objects or those on radial orbits is limited because of the low number of stars, bias toward high-metallicity stars, and the shallow depth (distance explored only out to 100 kpc from the Sun). We examine the extent to which these limitations are addressed by current and future surveys, in particular catalogs of main-sequence turnoff (MSTO) stars from SDSS and the Large Synoptic Survey Telescope (LSST), and of RR Lyrae stars from LSST or PanSTARRS. The MSTO and RR Lyrae surveys are more sensitive to low-luminosity events (L ∼ 10 5 L sun or less) than the 2MASS M-giant sample. Additionally, RR Lyrae surveys, with superior depth, are also good at detecting events on highly eccentric orbits whose debris tends to lie beyond 100 kpc. When combined we expect these photometric surveys to provide a comprehensive picture of the last 10 Gyr of Galactic accretion. Events older than this are too phase mixed to be discovered. Pushing

  13. Survey on utility technology of a tidal and ocean current energy

    Science.gov (United States)

    Hirose, Manabu; Kadoyu, Masataka; Tanaka, Hiroyoshi

    1987-06-01

    A study is made to show the current technological levels in Japan and other nations regarding the conversion of tidal current or ocean current energy to electric power and to determine the latent energy quantities and energy-related characteristics of tidal and ocean currents. In Japan, relatively large-scale experiments made so far mostly used one of the following three types of devices: Savonius-wheel type, Darrieus-wheel type, and cross-flow-wheel type. Field experiments of tidal energy conversion have been performed at the Naruto and Kurushima Straits. The energy in the Kuroshio current is estimated at about 170 billion kWh per year. Ocean current energy does not undergo large seasonal variations. The total energy in major straits and channels in the Inland Sea and other sea areas to the west is estimated at about 124 billion kWh per year. Tidal current energy shows large seasonal variations, but it is possible to predict the changes. A survey is made to determine energy-related characteristics of a tidal current at Chichino-seto, Kagoshima Prefecture. At Chichino-seto, the flow velocity ranges from 0 to 2.2m/s, with a latent tidal current energy of about 70 kW, of which about 20 kW can actually be utilized.

  14. A comprehensive survey of current and former college students with autism spectrum disorders.

    Science.gov (United States)

    Gelbar, Nicholas W; Shefyck, Allison; Reichow, Brian

    2015-03-01

    There is a paucity of research concerning individuals with autism spectrum disorders (ASD) pursuing higher education. This study sought to augment this gap in the literature by surveying individuals with ASD who are currently college students or who have previously attended college. Thirty-five individuals completed an online survey. These individuals reported receiving extensive academic supports that enabled their academic success. Their reported difficulties in the social and emotional domains received less support. In addition, not all areas of campus life were supportive, as study abroad and career service offices were reported to not understand individuals with ASD. Overall, the results of this survey indicate the importance of self-advocacy and the need for institutions of higher education to provide comprehensive supports for individuals with ASD in the academic, social, and emotional domains in order to effectively integrate this group into the campus environment.

  15. Emission of biocides from hospitals: comparing current survey results with European Union default values.

    Science.gov (United States)

    Tluczkiewicz, Inga; Bitsch, Annette; Hahn, Stefan; Hahn, Torsten

    2010-04-01

    Under the European Union (EU) Biocidal Products Directive 98/8/EC, comprehensive evaluations on substances of the Third Priority List were conducted until 31 July 2007. This list includes, among other categories, disinfectants for human hygiene (e.g., skin and surface disinfection). For environmental exposure assessment of biocides, the EU emission scenarios apply. Currently available default values for disinfectants are based on consumption data from not more than 8 hospitals and were originally assembled for other purposes. To revalidate these default values, a survey on annual consumption data was performed in 27 German hospitals. These data were analyzed to provide consumption data per bed and day and per nurse and day for particular categories of active ingredients and were compared with default values from the EU emission scenario documents. Although several deviations were detected, an overall acceptable correspondence between Emission Scenario Documents default values and the current survey data was found. (c) 2009 SETAC

  16. Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

    Science.gov (United States)

    Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

    2018-06-01

    The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

  17. A Survey on Renewable Energy Development in Malaysia: Current Status, Problems and Prospects

    OpenAIRE

    Alam Syed Shah; Nor Nor Fariza Mohd; Ahmad Maisarah; Hashim Nik Hazrul Nik

    2016-01-01

    Energy demand in Malaysia is increasing over seven per cent a year, while forty per cent of the energy is supplied from conventional fossil fuel. However, a number of social barriers have mired the social acceptance of renewable energy among the users. This study investigates the current status of renewable energy, problems and future outlook of renewable energy in Malaysia. A total of 200 respondents were surveyed from Klang Valley in Malaysia. Majority of the respondents use energy to gener...

  18. Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads.

    Science.gov (United States)

    Philpot, Lindsey M; Stockbridge, Erica L; Padrón, Norma A; Pagán, José A

    2016-06-01

    Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211).

  19. Comparing the Health Care Experiences of Medicare Beneficiaries with and without Depressive Symptoms in Medicare Managed Care versus Fee-for-Service.

    Science.gov (United States)

    Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E

    2016-06-01

    To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.

  20. Changes in agri-business outcomes among the dairy beneficiaries ...

    African Journals Online (AJOL)

    This study compared changes in uptake of agri-business practices, productivity and wealth creation between dairy beneficiaries and non-beneficiaries of Contracted Extension Service Delivery Model (CESDM) implemented by Kenya Agricultural Productivity and Agribusiness Project (KAPAP) in selected counties of Kenya ...

  1. Recent Health Care Use and Medicaid Entry of Medicare Beneficiaries.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2017-10-01

    To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. During the 18-month study period, Medicaid entry occurred for 1.1% and 3.7% of beneficiaries who aged into Medicare or originally qualified for Medicare due to disability, respectively. Among beneficiaries who aged into Medicare, 49% of new Medicaid participants had no use of inpatient, skilled nursing facility, or nursing home services during the study period. Individuals who recently used inpatient, skilled nursing facility or nursing home services had monthly rates of 1.9, 14.0, and 38.1 new Medicaid participants per 1,000 beneficiaries, respectively, compared with 0.4 new Medicaid participants per 1,000 beneficiaries with no recent use of these services. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period. These patterns should be considered when designing and evaluating interventions to reform health care delivery for dual-eligible beneficiaries. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Fadama III Beneficiaries' Adherence to Project Guidelines in Ogun ...

    African Journals Online (AJOL)

    It was recommended that the implementers should keep up their efforts at sensitising beneficiaries on the implementation guidelines of the project, re-work their strategies at addressing procurement and FUEF inadequacies among the beneficiaries and fast-track the delivery of project benefits in the communities. Key words: ...

  3. Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop.

    Science.gov (United States)

    Hamandi, Khalid; Beniczky, Sandor; Diehl, Beate; Kandler, Rosalind H; Pressler, Ronit M; Sen, Arjune; Solomon, Juliet; Walker, Matthew C; Bagary, Manny

    2017-08-01

    Inpatient video-EEG monitoring (VEM) is an important investigation in patients with seizures or blackouts, and in the pre-surgical workup of patients with epilepsy. There has been an expansion in the number of Epilepsy Monitoring Units (EMU) in the UK offering VEM with a necessary increase in attention on quality and safety. Previous surveys have shown variation across centres on issues including consent and patient monitoring. In an effort to bring together healthcare professionals in the UK managing patients on EMU, we conducted an online survey of current VEM practice and held a one-day workshop convened under the auspices of the British Chapter of the ILAE. The survey and workshop aimed to cover all aspects of VEM, including pre-admission, consent procedures, patient safety, drug reduction and reinstatement, seizure management, staffing levels, ictal testing and good data recording practice. This paper reports on the findings of the survey, the workshop presentations and workshop discussions. 32 centres took part in the survey and there were representatives from 22 centres at the workshop. There was variation in protocols, procedures and consent processes between units, and levels of observation of monitored patients. Nevertheless, the workshop discussion found broad areas of agreement on points. A survey and workshop of UK epilepsy monitoring units found that some variability in practice is inevitable due to different local arrangements and patient groups under investigation. However, there were areas of clear consensus particularly in relation to consent and patient safety that can be applied to most units and form a basis for setting minimum standards. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  4. Rip current evidence by hydrodynamic simulations, bathymetric surveys and UAV observation

    Directory of Open Access Journals (Sweden)

    G. Benassai

    2017-09-01

    Full Text Available The prediction of the formation, spacing and location of rip currents is a scientific challenge that can be achieved by means of different complementary methods. In this paper the analysis of numerical and experimental data, including RPAS (remotely piloted aircraft systems observations, allowed us to detect the presence of rip currents and rip channels at the mouth of Sele River, in the Gulf of Salerno, southern Italy. The dataset used to analyze these phenomena consisted of two different bathymetric surveys, a detailed sediment analysis and a set of high-resolution wave numerical simulations, completed with Google EarthTM images and RPAS observations. The grain size trend analysis and the numerical simulations allowed us to identify the rip current occurrence, forced by topographically constrained channels incised on the seabed, which were compared with observations.

  5. Surveys of Current Teaching and Practice for Impressions for Complete Dentures.

    Science.gov (United States)

    Hussain, N; Jabbar, H; Hayati, M; Wu, J; Hyde, T P

    2018-03-08

    The 3 objectives are to assess current preferences for impressions for complete dentures, audit practice and compare practice to current UK teaching. Three surveys where undertaken; a survey of GDPs preferences, an audit of practice and a survey of teaching in UK dental schools. UK Universities advocate border moulded custom trays. In stated preferences, 99% of practitioners used custom trays for private practice; 67% for NHS work. In actual use, the audit found 91% practitioners in private practice used custom trays; in NHS practice 78% did so. The most widely taught materials were silicone (43%), alginate (29%), & zinc oxide eugenol paste (19%). In practitioners stated preferences, 97% of NHS and 53% of private dentists listed alginate as an option; however the audit showed only 74% (NHS) and 52% (private) actually used alginate, with 20% (NHS) and 48% (private) using silicone. Definitive impressions in custom trays are used by GDPs for both private and NHS work; they are universally taught at UK dental schools. Alginate is popular in NHS practice; however, silicone is more widely taught in UK Universities. The use of silicone materials for definitive impressions has increased since 1999. In UK private practice silicone usage is aligned in popularity with alginate. Copyright© 2018 Dennis Barber Ltd.

  6. Survey of Current Status of Quality Control of Gamma Cameras in Republic of Korea

    International Nuclear Information System (INIS)

    Choe, Jae Gol; Joh, Cheol Woo

    2008-01-01

    It is widely recognized that good quality control (QC) program is essential for adequate imaging diagnosis using gamma camera. The purpose of this study is to survey the current status of QC of gamma cameras in Republic of Korea for implementing appropriate nationwide quality control guidelines and programs. A collection of data is done for personnel, equipment and appropriateness of each nuclear medicine imaging laboratory's' quality control practice. This survey is done by collection of formatted questionnaire by mails, e mails or interviews. We also reviewed the current recommendations concerning quality assurance by international societies. This survey revealed that practice of quality control is irregular and not satisfactory. The irregularity of the QC practice seems due partly to the lack of trained personnel, equipment, budget, time and hand-on guidelines. The implementation of QC program may cause additional burden to the hospitals, patients and nuclear medicine laboratories. However, the benefit of a good QC program is obvious that the hospitals can provide good quality nuclear medicine imaging studies to the patients. It is important to use least cumbersome QC protocol, to educate the nuclear medicine and hospital administrative personnel concerning QC, and to establish national QC guidelines to help each individual nuclear medicine laboratory

  7. The analysis of the survey results for the current 'business agent'

    International Nuclear Information System (INIS)

    Kim, I. H.; Shim, H. S.; Jeon, I. Y.; Kang, W. S.; Yun, K. H.; Na, S. H.; Park, T. J.; Kim, I. S.

    2004-01-01

    Our survey is conducted about the current systems in the 'Business Agents' regulations which prescribes running business such as the safe control of radiation on behalf of any permitted users. The radiation safety staffs who are engaged in the handling of radioisotope respond our quaternaries. They are as follows: 1. the radiation safety staffs' attitude to the need of 'Business Agent' regulations, 2. the satisfaction level of 'Business Agent' service, 3. the propriety of the manpower. The survey results are that the 68.4% of the respondents are in favor of the need of 'Business Agent' regulations and the 63.6% of the respondents expressed satisfactions for the service of 'Business Agent'. For the one manpower managing 'Business Agent', 32.3% of the respondents expressed as 'overburdened' and 37.5% as 'appropriate.' Our results give the feedback to develop the system of 'Business Agent' regulations as making feedback effect

  8. The Open Cluster Chemical Abundances and Mapping (OCCAM) Survey: Current Status

    Science.gov (United States)

    Frinchaboy, Peter; O'Connell, Julia; Donor, John; Cunha, Katia; Thompson, Benjamin; Melendez, Matthew; Shetrone, Matthew; Zasowski, Gail; Majewski, Steven R.; APOGEE TEAM

    2018-01-01

    The Open Cluster Chemical Analysis and Mapping (OCCAM) survey aims to produce a comprehensive, uniform, infrared-based data set forhundreds of open clusters, and constrain key Galactic dynamical and chemical parameters using the SDSS/APOGEE survey and follow-up from the McDonald Observatory Otto Struve 2.1-m telescope and Sandiford Cass Echelle Spectrograph (R ~ 60,000). We report on multi-element radial abundance gradients obtained from a sample of over 30 disk open clusters. The APOGEE chemical abundances were derived automatically by the ASPCAP pipeline and these are part of the SDSS IV Data Release 14, optical follow-up were analyzed using equivalent width analysis and spectral synthesis. We present the current open cluster sample that spans a significant range in age allowing exploration of the evolution of the Galactic abundance gradients. This work is supported by an NSF AAG grants AST-1311835 & AST-1715662.

  9. Racial disparities in smoking knowledge among current smokers: data from the health information national trends surveys.

    Science.gov (United States)

    Reimer, Rachel Ann; Gerrard, Meg; Gibbons, Frederick X

    2010-10-01

    Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

  10. Current status of brachytherapy in Korea: a national survey of radiation oncologists.

    Science.gov (United States)

    Kim, Haeyoung; Kim, Joo Young; Kim, Juree; Park, Won; Kim, Young Seok; Kim, Hak Jae; Kim, Yong Bae

    2016-07-01

    The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.

  11. Helping Hand: The Salin Kaalaman Tungo sa Kaunlaran Extension Program of Polytechnic University of the Philippines Among the Beneficiaries of the Pilot Centers in Sta. Mesa, Manila, Philippines

    Directory of Open Access Journals (Sweden)

    Junnette B. Hasco

    2016-11-01

    Full Text Available One of the four-fold functions of State Universities and Colleges in accordance by their mandates was to provide assistance to communities; this was achieved thru conducting different skills and development trainings in partnership with Local Government Units (LGU’s. This study was conducted to assess the current Extension program of the Polytechnic University of the Philippines (PUP. Some 74 beneficiaries from the 23 centers of Sta. Mesa, Manila were identified through the use of purposive sampling. The data gathering made use of aided surveys. Weighted Mean and Pearson Product Moment of Correlation was used to treat and process statistical data. Findings revealed that the Extension Services conducted by the PUP Salin Kaalaman Tungo sa Kaunlaran Extension Program (SALIN were highly effective regarding Information Dissemination, Staff and Officials, Trainings and Programs, Trainers and Speakers, Programs, Accommodation and Venue and the personal impact of the Extension Program to the Beneficiaries. Satisfaction rating on the extension program was also high. Further, this study found out that as respondents are satisfied with the implementation of SALIN, the greater the chance of positive assessment on the effectiveness of the project. The study also disclosed problems and recommendations identified by the respondents. In addressing the research gaps, this study further identified recommendations to enhance capabilities of program implementers such as better execution in the delivery of extension services, fund sourcing and forging linkages or networking.

  12. Beneficiary contact moderates relationship between authentic leadership and engagement

    Directory of Open Access Journals (Sweden)

    Caren B. Scheepers

    2016-07-01

    Full Text Available Orientation: Beneficiary contact moderates the relationship between authentic leadership and work engagement. Research purpose: The objective of this study was to examine the moderating effect of the breadth, depth and frequency of employee interaction with the beneficiaries of their work on the positive impact of authentic leadership on work engagement. Motivation for the study: Investigating the boundary conditions of the relationship between leaders and followers is vital to enhance the positive effect of leadership. Authentic leadership has not previously been examined with respect to beneficiary contact as a specific situational factor. The researchers therefore set out to ascertain whether beneficiary contact has a strengthening or weakening effect on the impact of authentic leadership on work engagement. Research design, approach and method: The researchers administered the Authentic Leadership Questionnaire (ALQ, the Utrecht Work Engagement Scale (UWES-9 and Grant’s scale on Beneficiary Contact. Main findings: The findings showed that beneficiary contact had a weakening effect on the positive relationship between authentic leadership and work engagement. Practical/managerial implications: Ideally, organisations create environments conducive to work engagement in which leadership plays an important role. This study found that one factor in the work environment, namely beneficiary contact, might have an adverse effect on the positive relationship that authentic leadership has on work engagement. Leaders should therefore take organisational contextual realities into account, such as regular, intense interaction of employees with the beneficiaries of their work. This situation could create strain for individual employees, requiring additional organisational support. Contribution/value-add: Organisations need to recognise the impact of beneficiary contact on the relationship between authentic leadership and work engagement. The researchers

  13. Current practices in vestibular schwannoma management: a survey of American and Canadian neurosurgeons.

    Science.gov (United States)

    Fusco, Matthew R; Fisher, Winfield S; McGrew, Benjamin M; Walters, Beverly C

    2014-12-01

    Comprehensive therapy for vestibular schwannomas has changed dramatically over the past fifty years. Previously, neurosurgeons were most likely to treat these tumors via an independent surgical approach. Currently, many neurosurgeons treat vestibular schwannomas employing an interdisciplinary team approach with neuro-otologists and radiation oncologists. This survey aims to determine the current treatment paradigm for vestibular schwannomas among American and Canadian neurosurgeons, with particular attention to the utilization of a team approach to the surgical resection of these lesions. A seventeen part survey questionnaire was sent by electronic mail to residency trained members of the American Association of Neurological Surgeons currently practicing in Canada or the United States. Questions were divided into groups regarding physician background, overall practice history, recent practice history, opinions on treatment paradigms, and experience with an interdisciplinary team approach. Seven hundred and six responses were received. The vast majority of neurosurgeons surgically resect vestibular schwannomas as part of an interdisciplinary team (85.7%). Regional variations were observed in the use of an interdisciplinary team: 52.3% of responding neurosurgeons who surgically treat vestibular schwannomas without neuro-otologists currently practice in the South (no other region represented more than 15.4% of this group, p=0.02). Surgeons who have treated >50 vestibular schwannomas show a trend towards more frequent utilization of an interdisciplinary approach than less experienced surgeons, but this did not reach statistical significance. The majority of neurosurgeons in the United States and Canada surgically resect vestibular schwannomas via an interdisciplinary approach with the participation of a neuro-otologist. Neurosurgeons in the South appear more likely to surgically treat these tumors alone than neurosurgeons in other regions of the U.S. and Canada

  14. Collection development and outsourcing in academic health sciences libraries: a survey of current practices.

    Science.gov (United States)

    Blecic, D D; Hollander, S; Lanier, D

    1999-04-01

    Academic health sciences libraries in the United States and Canada were surveyed regarding collection development trends, including their effect on approval plan and blanket order use, and use of outsourcing over the past four years. Results of the survey indicate that serials market forces, budgetary constraints, and growth in electronic resources purchasing have resulted in a decline in the acquisition of print items. As a result, approval plan use is being curtailed in many academic health sciences libraries. Although use of blanket orders is more stable, fewer than one-third of academic health sciences libraries report using them currently. The decline of print collections suggests that libraries should explore cooperative collection development of print materials to ensure access and preservation. The decline of approval plan use and the need for cooperative collection development may require additional effort for sound collection development. Libraries were also surveyed about their use of outsourcing. Some libraries reported outsourcing cataloging and shelf preparation of books, but none reported using outsourcing for resource selection. The reason given most often for outsourcing was that it resulted in cost savings. As expected, economic factors are driving both collection development and outsourcing practices.

  15. Current Tobacco Use Among Adults in the United States: Findings From the National Adult Tobacco Survey

    Science.gov (United States)

    Dube, Shanta R.; Tynan, Michael A.

    2012-01-01

    Objectives. We assessed the prevalence and sociodemographic correlates of tobacco use among US adults. Methods. We used data from the 2009–2010 National Adult Tobacco Survey, a national landline and cell phone survey of adults aged 18 years and older, to estimate current use of any tobacco; cigarettes; cigars, cigarillos, or small cigars; chewing tobacco, snuff, or dip; water pipes; snus; and pipes. We stratified estimates by gender, age, race/ethnicity, education, income, sexual orientation, and US state. Results. National prevalence of current use was 25.2% for any tobacco; 19.5% for cigarettes; 6.6% for cigars, cigarillos, or small cigars; 3.4% for chewing tobacco, snuff, or dip; 1.5% for water pipes; 1.4% for snus; and 1.1% for pipes. Tobacco use was greatest among respondents who were male, younger, of non-Hispanic “other” race/ethnicity, less educated, less wealthy, and lesbian, gay, bisexual, or transgender. Prevalence ranged from 14.1% (Utah) to 37.4% (Kentucky). Conclusions. Tobacco use varies by geography and sociodemographic factors, but remains prevalent among US adults. Evidence-based prevention strategies are needed to decrease tobacco use and the health and economic burden of tobacco-related diseases. PMID:22994278

  16. Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

    Science.gov (United States)

    Blaiss, Michael S; Fromer, Leonard M; Jacob-Nara, Juby A; Long, Randall M; Mannion, Karen M; Lauersen, Lori A

    2014-01-01

    Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management.

  17. Volunteering and overseas placements in the NHS: a survey of current activity.

    Science.gov (United States)

    Chatwin, John; Ackers, Louise

    2016-10-19

    The study aimed to establish current levels of overseas volunteering and placement activity across all staff grades within the National Health Service (NHS) in the North West of England. Cross-sectional survey. Descriptive statistics. 4 main regional hospitals in the North West of England, and additional NHS staff training events. Convenience sample of NHS staff (n=911). 911 NHS staff took part in the survey. The medical and dental staff group returned the highest number of responses (32.1%). 42% of staff reported some form of overseas volunteering or placement experience. Most staff took an international placement as students (33.6% men; 40.6% women). Medium-term placements were undertaken by 46.7% of men, and 52.5% of women. Settlement stays (ie, over 1 year) were reported by 7.6% men, and 8.3% women). The majority of respondents engaged in international placement were from the age groups incorporating 'below 25' to '41-50' (74%). Multiple placement experiences were uncommon: 2.5% of respondents reported three periods of overseas activity, and 1.5% reported four. All those with multiple placement experience came from the staff groups incorporating midwife/nurse/health visitor, and medical and dental. This survey captured a snapshot of current levels of volunteering and overseas placement activity across NHS staff grades in the North West. Owing to relatively homogenous organisational structures, findings are likely to broadly represent the position across the organisation as a whole. Although some degree of overseas placement activity is undertaken by a relatively high proportion of NHS staff, such activity is currently heavily skewed towards higher clinical staff grades. Significant numbers of allied health professionals and equivalent non-clinical cadres also report overseas experience, and we anticipate that the numbers will continue to rise if current policy initiatives gain momentum. Published by the BMJ Publishing Group Limited. For permission to use

  18. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  19. Current status of paediatric post-mortem imaging: an ESPR questionnaire-based survey

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Rijn, Rick R. van [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Sebire, Neil J. [Great Ormond Street Hospital for Children, Department of Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

    2014-03-15

    The use of post-mortem imaging, including skeletal radiography, CT and MRI, is increasing, providing a minimally invasive alternative to conventional autopsy techniques. The development of clinical guidelines and national standards is being encouraged, particularly for cross-sectional techniques. To outline the current practice of post-mortem imaging amongst members of the European Society of Paediatric Radiology (ESPR). We e-mailed an online questionnaire of current post-mortem service provisions to members of the ESPR in January 2013. The survey included direct questions about what services were offered, the population imaged, current techniques used, imaging protocols, reporting experience and intended future involvement. Seventy-one percent (47/66) of centres from which surveys were returned reported performing some form of post-mortem imaging in children, of which 81 % perform radiographs, 51% CT and 38% MRI. Eighty-seven percent of the imaging is performed within the radiology or imaging departments, usually by radiographers (75%), and 89% is reported by radiologists, of which 64% is reported by paediatric radiologists. Overall, 72% of positive respondents have a standardised protocol for radiographs, but only 32% have such a protocol for CT and 27% for MRI. Sixty-one percent of respondents wrote that this is an important area that needs to be developed. Overall, the majority of centres provide some post-mortem imaging service, most of which is performed within an imaging department and reported by a paediatric radiologist. However, the populations imaged as well as the details of the services offered are highly variable among institutions and lack standardisation. We have identified people who would be interested in taking this work forwards. (orig.)

  20. 42 CFR 424.54 - Payment to the beneficiary's legal guardian or representative payee.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to the beneficiary's legal guardian or... Ordinarily Made § 424.54 Payment to the beneficiary's legal guardian or representative payee. Medicare may pay amounts due a beneficiary to the beneficiary's legal guardian or representative payee. ...

  1. A survey of current practice of vascular surgeons in venous disease management.

    Science.gov (United States)

    Bush, Ruth L; Gloviczki, Peter

    2013-01-01

    Acute venous thromboembolism and chronic venous diseases are common conditions that affect a large proportion of the United States population. The diagnosis of venous disease has improved, and the treatment options have rapidly evolved over the past decade. To date, it is unclear to what extent vascular surgeons have become involved in the modern management of venous disorders. This survey was undertaken to explore the current interest and practice of vascular surgeons in the contemporary care of venous disease. A survey was administered via a web-based platform to active and candidate members of the Society for Vascular Surgery (SVS). The survey included 30 questions investigating the characteristics of venous surgeons and scope of venous practice. Open-ended questions were also included for commentary. A total of 1879 surveys were sent to SVS members nationwide, and 385 members participated (response rate of 20.5%). The participants were mostly men (89.6%) with 37.7% practicing in an academic setting and 59.2% in private practice. The respondents treated superficial veins (92.9%) and deep veins (85.8%) in clinical practice, with 89.9% having their own vascular laboratory. A wide spectrum of interventions for superficial (91.9%), deep (85.8%), and perforator veins (52.7% endovenous, 19.4% subfascial endoscopic perforator surgery) are being performed by respondents. Only 26.2% had learned endovenous thermal ablation in their training program; however, over 96% of those performing venous interventions utilized this technique. Overall, the majority (85.5%) devoted 50% or less of practice to venous disorders. Respondents indicated that limitations to expansion of vein practices mainly involved challenges with third party payers, local competition, and existing large volumes of arterial interventions needing to be performed. Despite the widespread incorporation of venous disease into current vascular practices, 66.1% are not members of the American Venous Forum (AVF

  2. Cancer pain management in China: current status and practice implications based on the ACHEON survey

    Directory of Open Access Journals (Sweden)

    Xia Z

    2017-08-01

    Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

  3. Beneficiary price sensitivity in the Medicare prescription drug plan market.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D

    2010-01-01

    The Medicare stand-alone prescription drug plan (PDP) came into existence in 2006 as part of the Medicare prescription drug benefit. It is the most popular plan type among Medicare drug plans and large numbers of plans are available to all beneficiaries. In this article we present the first analysis of beneficiary price sensitivity in the PDP market. Our estimate of elasticity of enrollment with respect to premium, -1.45, is larger in magnitude than has been found in the Medicare HMO market. This high degree of beneficiary price sensitivity for PDPs is consistent with relatively low product differentiation, low fixed costs of entry in the PDP market, and the fact that, in contrast to changing HMOs, beneficiaries can select a PDP without disrupting doctor-patient relationships.

  4. Basic Stand Alone Skilled Nursing Facility Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Skilled Nursing Facility (SNF) Beneficiary Public Use Files (PUF) with information from Medicare SNF claims. The...

  5. U.S. Outpatient Beneficiary Satisfaction at Korean Hospitals

    National Research Council Canada - National Science Library

    Hayman, Alex L

    2008-01-01

    .... The analysis measured overall patient satisfaction as it relates to beneficiary category, gender and command sponsorship. The project data was utilized to verify and/or identify potential target areas of patient satisfaction.

  6. Familial determinants of current smoking among adolescents of Lithuania: a cross-sectional survey 2014.

    Science.gov (United States)

    Zaborskis, Apolinaras; Sirvyte, Dainora

    2015-09-14

    Understanding the role of the family in shaping adolescent health risk behaviours has recently been given increased attention. This study investigated association between current smoking and a range of familial factors in a representative sample of Lithuanian adolescents. Study subjects (N = 3696) were adolescents aged 13- and 15-years from the schools in Lithuania who were surveyed in Spring 2014 according to the methodology of the cross-national Health Behaviour in School-aged Children (HBSC). A standard HBSC international questionnaire was translated into Lithuanian and used anonymously to obtain information about current smoking patterns and family life (family structure, quality of communication in family, parental monitoring, bonding, parenting style, family time, etc.). Logistic regression was used to assess association between smoking and familial variables. The prevalence of current smoking was 16.5 % (20.8 % in boys and 11.9 % in girls; P parental support (OR = 1.40; 95 % CI: 1.01-1.95), easy communication with the father (OR = 0.56; 95 % CI: 0.38-0.80) and often use of electronic media for communication with parents (OR = 0.66; 95 % CI: 0.50-0.88). The last two determinants showed an inverse effect than it was hypothesized. Higher prevalence of smoking among adolescents of Lithuania is associated with a non- intact family structure as well as weaker parental support and bonding. Family life practices are critical components to be incorporated in prevention and intervention programs for adolescent smoking in Lithuania.

  7. Observation Status, Poverty, and High Financial Liability Among Medicare Beneficiaries.

    Science.gov (United States)

    Goldstein, Jennifer N; Zhang, Zugui; Schwartz, J Sanford; Hicks, LeRoi S

    2018-01-01

    Medicare beneficiaries hospitalized under observation status are subject to cost-sharing with no spending limit under Medicare Part B. Because low-income status is associated with increased hospital use, there is concern that such beneficiaries may be at increased risk for high use and out-of-pocket costs related to observation care. Our objective was to determine whether low-income Medicare beneficiaries are at risk for high use and high financial liability for observation care compared with higher-income beneficiaries. We performed a retrospective, observational analysis of Medicare Part B claims and US Census Bureau data from 2013. Medicare beneficiaries with Part A and B coverage for the full calendar year, with 1 or more observation stay(s), were included in the study. Beneficiaries were divided into quartiles representing poverty level. The associations between poverty quartile and high use of observation care and between poverty quartile and high financial liability for observation care were evaluated. After multivariate adjustment, the risk of high use was higher for beneficiaries in the poor (Quartile 3) and poorest (Quartile 4) quartiles compared with those in the wealthiest quartile (Quartile 1) (adjusted odds ratio [AOR], 1.21; 95% confidence interval [CI], 1.13-1.31; AOR, 1.24; 95% CI, 1.16-1.33). The risk of high financial liability was higher in every poverty quartile compared with the wealthiest and peaked in Quartile 3, which represented the poor but not the poorest beneficiaries (AOR, 1.17; 95% CI, 1.10-1.24). Poverty predicts high use of observation care. The poor or near poor may be at highest risk for high liability. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

    Science.gov (United States)

    Eggers, Paul W.; Prihoda, Ronald

    1982-01-01

    The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre

  9. Teaching Intercultural Communication in a Basic Technical Writing Course: A Survey of Our Current Practices and Methods

    Science.gov (United States)

    Matveeva, Natalia

    2008-01-01

    This research article reports the results of an online survey distributed among technical writing instructors in 2006. The survey aimed to examine how we teach intercultural communication in basic technical writing courses: our current practices and methods. The article discusses three major challenges that instructors may face when teaching about…

  10. Continuous improvement in the Netherlands: A survey-based study into the current practices of continuous improvement

    NARCIS (Netherlands)

    Middel, H.G.A.; op de Weegh, S.; Gieskes, J.F.B.; Schuring, R.W.

    2004-01-01

    Continuous Improvement is a well-known and consolidated concept in literature and practice and is considered vital in today¿s business environment. In 2003 a survey, as part of the international CINet survey, has been performed in the Netherlands in order to gain insight into the current practices

  11. Current integrated cardiothoracic surgery residents: a Thoracic Surgery Residents Association survey.

    Science.gov (United States)

    Tchantchaleishvili, Vakhtang; LaPar, Damien J; Stephens, Elizabeth H; Berfield, Kathleen S; Odell, David D; DeNino, Walter F

    2015-03-01

    After approval by the Thoracic Surgery Residency Review Committee in 2007, 6-year integrated cardiothoracic surgery (I-6) residency programs have gained in popularity. We sought to assess and objectively quantify the level of satisfaction I-6 residents have with their training and to identify areas of improvement for future curriculum development. A completely anonymous, electronic survey was created by the Thoracic Surgery Residents Association that asked the responders to provide demographic information, specialty interest, and lifestyle priorities, and to rate their experience and satisfaction with I-6 residency. The survey was distributed nationwide to all residents in I-6 programs approved by the Accreditation Council for Graduate Medical Education. Of a total of 88 eligible I-6 residents, 49 completed the survey (55.7%). Career choice satisfaction was high (75.5%), as was overall satisfaction with integrated training (83.7%). The majority (77.6%) were interested in cardiac surgery. Overall, the responders reported sufficient time for life outside of the hospital (57.1%), but experienced conflicts between work obligations and personal life at least sometimes (75.5%). Early exposure to cardiothoracic surgery was reported as the dominant advantage of the I-6 model, whereas variable curriculum structure and unclear expectations along with poor integration with general surgery training ranked highest among perceived disadvantages. Current I-6 residents are largely satisfied with the integrated training model and report a reasonable work/life balance. The focused nature of training is the primary perceived advantage of the integrated pathway. Curriculum variability and poor integration with general surgery training are identified by residents as primary areas of concern. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Physiotherapy for plantar fasciitis: a UK-wide survey of current practice.

    Science.gov (United States)

    Grieve, Rob; Palmer, Shea

    2017-06-01

    To identify how United Kingdom (UK) physiotherapists currently diagnose, assess and manage plantar fasciitis in routine practice. Online questionnaire survey. Practising physiotherapists across the UK who treat patients with plantar fasciitis. Physiotherapists were approached via 'interactive Chartered Society of Physiotherapy (CSP)' online networks and an email database of clinical educators in South West England. An online questionnaire was developed by reviewing similar existing physiotherapy surveys and consultation with experienced musculoskeletal researchers/clinicians. Descriptive statistics were used to analyse the data. 285 physiotherapists responded, with 257 complete survey responses. Pain on palpation and early morning pain were the most common diagnostic criteria, with some physiotherapists using no formal test criteria. Advice (237/257, 92%), plantar fasciitis pathology education (207/257, 81%) and general stretching exercises (189/257, 74%) were most routinely used. Prefabricated orthotics, custom made orthotics and night splints were seldom always used. For the manual therapy approach, the most frequently used modalities were massage, myofascial release, specific soft tissue mobilisations and myofascial trigger point therapy. Commonly used outcome measures were pain assessment, functional tests and range of movement. Physiotherapists appeared to follow most of the established diagnostic criteria for PF, but have not followed established outcome measure guidelines. Advice as well as education with an emphasis on self-management including calf/hamstring stretching was the most commonly reported treatment approach. There was uncertainty whether this approach accurately reflected clinical practice used throughout the UK, owing to potential response bias/unknown response rate and the low number of patients with PF treated by the respondents. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  13. Current Ketamine Practice: Results of the 2016 American Society of Pain Management Nursing Survey on Ketamine.

    Science.gov (United States)

    Klaess, Cynthia C; Jungquist, Carla R

    2018-06-01

    Ketamine is increasingly utilized for a variety of pain management challenges. Audience comments from a ketamine presentation at the 2015 American Society of Pain Management Nursing (ASPMN) Conference reflected wide variation in ketamine practices as well as barriers to use. The goal was to gain a greater understanding of ASPMN member practice patterns and barriers related to ketamine as adjunctive therapy for pain management. A questionnaire survey design was used. Respondents represented 35 states and 2 countries. The participants were 146 respondents from ASPMN membership (1,485 members). The survey was distributed by ASPMN on SurveyMonkey. Practice setting and ketamine administration practices were assessed with areas for comments. Results were reviewed using frequencies to describe responses and formatted into tables. Comments were individually reviewed and grouped into common themes. Administration of ketamine as an analgesic was reported by 63% of respondents. Continuous intravenous ketamine infusions were the most common route of administration (65%); however, wide variability in dosing and length of therapy was reported. A wide variety of practices and challenges related to ketamine utilization were noted. Numerous studies have indicated the analgesic benefits of ketamine in pain management. The lack of practice standardization has created challenges to its consistent use and outcome measurement. Additionally, the off-label use of ketamine for pain management creates its own unique challenges. However, given the current national climate with intense focus on pain management, interdisciplinary practitioners have an ideal opportunity to evaluate ketamine's use in a comprehensive approach to pain management. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Prospect and current situation survey of nuclear agricultural research in china

    International Nuclear Information System (INIS)

    Chai Lihong; Ye Qingfu; Hua Yuejin

    2008-01-01

    Based on the survey result, which investigated 22 related institutes and universities in the field of nuclear agricultural sciences in China in Sep. 2007, this paper introduces the current status of research conditions, existing facilities and research progress on isotope tracing technology, new biological resources creation, research of nuclear irradiation and irradiation processing technology form 1996 to 2006. Due to not enough financial supports on this field, the development of nuclear agricultural sciences was slow down. However, the solid basis set up during last several decades, and the great efforts made by all the researchers, significant social and economic achievements were gained. Some of the researches have already taken the leading position in the world. (authors)

  15. Support time-dependent transformations for surveying and GIS : current status and upcoming challenges

    Science.gov (United States)

    Mahmoudabadi, H.; Lercier, D.; Vielliard, S.; Mein, N.; Briggs, G.

    2016-12-01

    The support of time-dependent transformations for surveying and GIS is becoming a critical issue. We need to convert positions from the realizations of the International Terrestrial Reference Frame to any national reference frame. This problem is easy to solve when all of the required information is available. But it becomes really complicated in a worldwide context. We propose an overview of the current ITRF-aligned reference frames and we describe a global solution to support time-dependent transformations between them and the International Terrestrial Reference Frame. We focus on the uncertainties of station velocities used. In a first approximation, we use a global tectonic plate model to calculate point velocities. We show the impact of the velocity model on the coordinate accuracies. Several countries, particularly in active regions, are developing semi-dynamic reference frames. These frames include local displacement models updated regularly and/or after major events (such as earthquakes). Their integration into surveying or GIS applications is an upcoming challenge. We want to encourage the geodetic community to develop and use standard formats.

  16. Speech pathologists' current practice with cognitive-communication assessment during post-traumatic amnesia: a survey.

    Science.gov (United States)

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne

    2013-01-01

    To investigate speech pathologists' current practice with adults who are in post-traumatic amnesia (PTA). Speech pathologists with experience of adults in PTA were invited to take part in an online survey through Australian professional email/internet-based interest groups. Forty-five speech pathologists responded to the online survey. The majority of respondents (78%) reported using informal, observational assessment methods commencing at initial contact with people in PTA or when patients' level of alertness allowed and initiating formal assessment on emergence from PTA. Seven respondents (19%) reported undertaking no assessment during PTA. Clinicians described using a range of techniques to monitor cognitive-communication during PTA, including static, dynamic, functional and impairment-based methods. The study confirmed that speech pathologists have a key role in the multidisciplinary team caring for the person in PTA, especially with family education and facilitating interactions with the rehabilitation team and family. Decision-making around timing and means of assessment of cognitive-communication during PTA appeared primarily reliant on speech pathologists' professional experience and the culture of their workplace. The findings support the need for further research into the nature of cognitive-communication disorder and resolution over this period.

  17. A survey on the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai.

    Science.gov (United States)

    Lu, Wenliang; Zhou, Ping; Zheng, Songbai; Xue, Di

    2017-01-01

    Although many studies have discussed burnout in clinical physicians, the evidence literature about physical rehabilitation professionals is still limited in China. To understand the current status of rehabilitation services and burnout of rehabilitation professionals in Shanghai. Twenty-four hospitals located in three districts of Shanghai were selected for this study. The questionnaire surveys of 24 hospitals and their 221 rehabilitation professionals and 235 other medical professionals were conducted. The percentages of the hospitals that had rehabilitation departments in three districts of Shanghai ranged from 25.0% to 88.9%, suggesting a great variation in distribution of rehabilitation resources. Only one tertiary general hospital had 12 beds for inpatient rehabilitation. The surveyed rehabilitation professionals who had graduate or undergraduate education accounted for 64.90% as a whole, but 49.32% in community health centers, 66.67% in secondary general hospitals, and 77.78% in tertiary general hospitals. The average scores for emotional exhaustion, cynicism and low professional efficacy were 11.66, 7.48, and 10.36 respectively. This study reveals that the resources in the field of rehabilitation in Shanghai need to be enhanced to meet its future demands. It is also recommended that the managers in secondary general hospitals and the local government pay more attention to the rehabilitation professionals in the secondary general hospitals because they are reporting higher emotional exhaustion. Finally, the value of rehabilitation services to help persons with disabilities need to be better conveyed to all interested parties.

  18. Aspirin desensitization in patients undergoing percutaneous coronary intervention: a survey of current practice.

    Science.gov (United States)

    Chapman, Andrew R; Rushworth, Gordon F; Leslie, Stephen J

    2013-01-01

    Aspirin remains the mainstay of anti-platelet therapy in cardiac patients. However, if a patient is allergic to aspirin and dual anti-platelet therapy is indicated - such as with percutaneous coronary intervention (PCI), then there is no clear guidance. One possibility is aspirin desensitization. A variety of protocols exist for the rapid desensitization of patients with aspirin allergy. The aim of this survey was to assess current knowledge and practice regarding aspirin desensitization in the UK. We conducted a UK wide survey of all UK 116 PCI centers and obtained complete responses from 40 (35.4%) centers. Of these, just 7 (17.5%) centers had previously desensitised patients; 29 (87.9%) centers suggested a lack of a local protocol prevented them from desensitizing, with 10 (30.3%) unsure of how to conduct desensitization. Only 5 (12.5%) centers had a local policy for aspirin desensitization although 25 (64.1%) units had a clinical strategy for dealing with aspirin allergy; the majority (72%) giving higher doses of thienopyridine class drugs. In the UK, there appears to be no consistent approach to patients with aspirin allergy. Patients undergoing PCI benefit from dual anti-platelet therapy (including aspirin), and aspirin desensitization in those with known allergy may facilitate this. Sustained effort should be placed on encouraging UK centers to use desensitization as a treatment modality prior to PCI rather than avoiding aspirin altogether.

  19. The current state of radiation education in schools and results of the opinion survey on radiation

    International Nuclear Information System (INIS)

    Murai, Kenji

    2013-01-01

    In 2008, a new guideline about radioactivity was added to the government guidelines for teaching junior high school science. Since then people involved with school education have been trying to spread correct information about radioactivity. On the other hand, people's confusion in the aftermath of the Fukushima Daiichi Nuclear Power Plant accident has clearly shown that people do not know much about radioactivity. Considering the situation, the author conducted an investigation about the current state of radiation education and carried out an opinion survey about radioactivity among adults. The investigation about education showed the following: (1) the nature of radiation, such as its permeability, and its uses were described in the government-approved textbooks; (2) basic knowledge, such as what are radiation effects, were described comprehensively in the supplementary reading recommendations made by the Ministry of Education, Culture, Sports, Science, and Technology; and (3) locale education committees created teaching materials such as guidance to present topics. The opinion survey had questions to judge: (1) current public understanding of radioactivity; (2) the degree of general information that people collected for themselves; (3) the degree of specific knowledge about radioactivity that people had; and (4) people's attitudes toward various problems with radioactivity in the environment. The results suggested that for radiation education the following items are important: (1) to learn that radioactivity exists in people's daily lives and is used safely in various field; (2) to get basic knowledge and better quantitative understanding of such things as radioactivity units, radiation dose and radiation effects; and (3) to acquire practical experience to use the information effectively. (author)

  20. Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology

    Directory of Open Access Journals (Sweden)

    Eun Ji Oh

    2017-11-01

    Full Text Available Background Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015. Methods A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015. Results Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%. The most common cytology specimens were gynecologic samples (81.3%. Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7% and 2,094,426 (25.3% cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%, category B (moderate clinical impact, 10.2%, and category C (major clinical impact, 1.9%. The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories. Conclusions This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

  1. The Impact of Survey and Response Modes on Current Smoking Prevalence Estimates Using TUS-CPS: 1992-2003

    Directory of Open Access Journals (Sweden)

    Julia Soulakova

    2009-12-01

    Full Text Available This study identified whether survey administration mode (telephone or in-person and respondent type (self or proxy result in discrepant prevalence of current smoking in the adult U.S. population, while controlling for key sociodemographic characteristics and longitudinal changes of smoking prevalence over the 11-year period from 1992-2003. We used a multiple logistic regression analysis with replicate weights to model the current smoking status logit as a function of a number of covariates. The final model included individual- and family-level sociodemographic characteristics, survey attributes, and multiple two-way interactions of survey mode and respondent type with other covariates. The respondent type is a significant predictor of current smoking prevalence and the magnitude of the difference depends on the age, sex, and education of the person whose smoking status is being reported. Furthermore, the survey mode has significant interactions with survey year, sex, and age. We conclude that using an overall unadjusted estimate of the current smoking prevalence may result in underestimating the current smoking rate when conducting proxy or telephone interviews especially for some sub-populations, such as young adults. We propose that estimates could be improved if more detailed information regarding the respondent type and survey administration mode characteristics were considered in addition to commonly used survey year and sociodemographic characteristics. This information is critical given that future surveillance is moving toward more complex designs. Thus, adjustment of estimates should be contemplated when comparing current smoking prevalence results within a given survey series with major changes in methodology over time and between different surveys using various modes and respondent types.

  2. [A national survey on current status of the important parasitic diseases in human population].

    Science.gov (United States)

    2005-10-30

    In order to understand the current status and trends of the important parasitic diseases in human population, to evaluate the effect of control activities in the past decade and provide scientific base for further developing control strategies, a national survey was carried out in the country (Taiwan, Hongkong and Macau not included) from June, 2001 to 2004 under the sponsorship of the Ministry of Health. The sample sizes of the nationwide survey and of the survey in each province (autonomous region and municipality, P/A/M) were determined following a calculating formula based on an estimation of the sample size of random sampling to the rate of population. A procedure of stratified cluster random sampling was conducted in each province based on geographical location and economical condition with three strata: county/city, township/town, and spot, each spot covered a sample of 500 people. Parasitological examinations were conducted for the infections of soil-transmitted nematodes, Taenia spp, and Clonorchis sinensis, including Kato-Katz thick smear method, scotch cellulose adhesive tape technique and test tube-filter paper culture (for larvae). At the same time, another sampled investigation for Clonorchis sinensis infection was carried out in the known endemic areas in 27 provinces. Serological tests combined with questionnaire and/or clinical diagnosis were applied for hydatid disease, cysticercosis, paragonimiasis, trichinosis, and toxoplasmosis. A total sampled population of 356 629 from the 31 P/A/M was examined by parasitological methods and 26 species of helminth were recorded. Among these helminth, human infections of Metorchis orientalis and Echinostoma aegypti were detected in Fujian Province which seemed to be the first report in the world, and Haplorchis taichui infection in Guangxi Region was the first human infection record in the country. The overall prevalence of helminth infections was 21.74%. The prevalence of soil-transmitted nematodes was 19

  3. Survey of large-amplitude flapping motions in the midtail current sheet

    Directory of Open Access Journals (Sweden)

    V. A. Sergeev

    2006-08-01

    Full Text Available We surveyed fast current sheet crossings (flapping motions over the distance range 10–30 RE in the magnetotail covered by the Geotail spacecraft. Since the local tilts of these dynamic sheets are large and variable in these events, we compare three different methods of evaluating current sheet normals using 4-s/c Cluster data and define the success criteria for the single-spacecraft-based method (MVA to obtain the reliable results. Then, after identifying more than ~1100 fast CS crossings over a 3-year period of Geotail observations in 1997–1999, we address their parameters, spatial distribution and activity dependence. We confirm that over the entire distance covered and LT bins, fast crossings have considerable tilts in the YZ plane (from estimated MVA normals which show a preferential appearance of one (YZ kink-like mode that is responsible for these severe current sheet perturbations. Their occurrence is highly inhomogeneous; it sharply increases with radial distance and has a peak in the tail center (with some duskward shift, resembling the occurrence of the BBFs, although there is no one-to-one local correspondence between these two phenomena. The crossing durations typically spread around 1 min and decrease significantly where the high-speed flows are registered. Based on an AE index superposed epoch study, the flapping motions prefer to appear during the substorm expansion phase, although a considerable number of events without any electrojet and auroral activity were also observed. We also present statistical distributions of other parameters and briefly discuss what could be possible mechanisms to generate the flapping motions.

  4. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  5. Current use and acceptability of novel diagnostic tests for active tuberculosis: a worldwide survey

    Directory of Open Access Journals (Sweden)

    Massimo Amicosante

    Full Text Available ABSTRACT Objective: To determine the current use and potential acceptance (by tuberculosis experts worldwide of novel rapid tests for the diagnosis of tuberculosis that are in line with World Health Organization target product profiles. Methods: A multilingual survey was disseminated online between July and November of 2016. Results: A total of 723 individuals from 114 countries responded to the survey. Smear microscopy was the most commonly used rapid tuberculosis test (available to 90.9% of the respondents, followed by molecular assays (available to 70.7%. Only a small proportion of the respondents in middle- and low-income countries had access to interferon-gamma-release assays. Serological and lateral flow immunoassays were used by more than a quarter (25.4% of the respondents. Among the respondents who had access to molecular tests, 46.7% were using the Xpert assay overall, that proportion being higher in lower middle-income countries (55.6% and low-income countries (76.6%. The data also suggest that there was some alignment of pricing for molecular assays. Respondents stated they would accept novel rapid tuberculosis tests if available, including molecular assays (acceptable to 86.0% or biomarker-based serological assays (acceptable to 81.7%. Simple biomarker-based assays were more commonly deemed acceptable in middle- and low-income countries. Conclusions: Second-generation molecular assays have become more widely available in high- and low-resource settings. However, the development of novel rapid tuberculosis tests continues to be considered important by tuberculosis experts. Our data also underscore the need for additional training and education of end users.

  6. Current status and perceived needs of information technology in Critical Access Hospitals: a survey study

    Directory of Open Access Journals (Sweden)

    George Demiris

    2007-01-01

    Full Text Available The US Congress established the designation of Critical Access Hospitals in 1997, recognising rural hospitals as vital links to health for rural and underserved populations. The intent of the reimbursement system is to improve financial performance, thereby reducing hospital closures. Informatics applications are thought to be tools that can enable the sustainability of such facilities. The aim of this study is to identify the current use of information and communication technology in Critical Access Hospitals, and to assess their readiness and receptiveness for the use of new software and hardware applications and their perceived information technology (IT needs. A survey was mailed to the administrators of all Critical Access Hospitals in one US state (Missouri and a reminder was mailed a few weeks later. Twenty-seven out of 33 surveys were filled out and returned (response rate 82%. While most respondents (66.7% stated that their employees have been somewhat comfortable in using new technology, almost 15% stated that their employees have been somewhat uncomfortable. Similarly, almost 12% of the respondents stated that they themselves felt somewhat uncomfortable introducing new technology. While all facilities have computers, only half of them have a specific IT plan. Findings indicate that Critical Access Hospitals are often struggling with lack of resources and specific applications that address their needs. However, it is widely recognised that IT plays an essential role in the sustainability of their organisations. The study demonstrates that IT applications have to be customised to address the needs and infrastructure of the rural settings in order to be accepted and properly utilised.

  7. Current practice in abdominoperineal resection: an email survey of the membership of the Association of Coloproctology

    Science.gov (United States)

    Dabbas, N; Adams, K; Chave, H; Branagan, G

    2012-01-01

    INTRODUCTION This study aimed to gain insight into current preferences for type of surgical approach and patient positioning in abdominoperineal excision of the rectum (APER), to identify whether these factors affect self-reported oncological outcomes and complication rates, and to assess the opinions of members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) with regards to the benefit of a national training programme for APER surgery. METHODS Members of the ACPGBI were surveyed using a questionnaire designed to examine surgeon/departmental demographics, type of APER practised, audit of results and complications, opinions regarding extralevator APER (ELAPER) and opinions regarding the potential benefit of a national training programme. RESULTS According to the survey, 62% of surgeons perform perineal dissection in the supine position and 57% perform a standard APER technique. Surgeons who only practise colorectal surgery (p=0.002) and surgeons performing prone dissection (/xO.0001) are more likely to perform ELAPER. Three-quarters (76%) audit their results for perineal wound complication rates. Over 80% audit their oncological outcomes. The vast majority (94.6%) of those who perform ELAPER believe there is a benefit to this method while 59.6% of those who do not perform ELAPER still believe there is a benefit to ELAPER. Only 50% feel that there should be a national training programme. CONCLUSIONS There is a distinct discordance with regards to the APER technique. Among UK colorectal surgeons, although a significant proportion favours ELAPER, there remains a larger proportion still performing standard APER techniques. PMID:22507721

  8. A survey of current clinical practice of permanent prostate brachytherapy in the United States

    International Nuclear Information System (INIS)

    Prestidge, Bradley R.; Prete, James J.; Buchholz, Thomas A.; Friedland, Jay L.; Stock, Richard G.; Grimm, Peter D.; Bice, William S.

    1998-01-01

    Purpose: To help establish standards of care for transperineal interstitial permanent prostate brachytherapy (TIPPB) by obtaining data regarding current clinical practice among the most experienced TIPPB brachytherapists in the United States. Methods and Materials: The 70 brachytherapists who performed the greatest number of TIPPB cases in 1995 in the U.S. were surveyed. Each received a comprehensive four page questionnaire that included sections on training and experience, patient and isotope selection criteria, manpower, technique, and follow-up. Thirty-five (50%) surveys were ultimately returned after three mailings and follow-up phone calls. The cumulative experience of the 35 respondents represented approximately 45% of the total TIPPB volume in the U.S. for 1995. Respondents included 29 from the private sector and six from academic programs. Results: The median physician experience with TIPPB was reported as 4.9 years. Each performed an average of 73 TIPPB procedures in 1995 (range 40-300). This represented an increase in volume for most (74%) of the respondents. Sixty-three percent of the respondents attended a formal training course, 54% had TIPPB-specific residency training, and 31% had been proctored (16 had received two or more types of training experience). The most commonly reported selection criteria for implant alone was on Gleason score ≤7, PSA 125 I prescribed to 120 Gy (75%) or 103 Pd to 90 Gy (50%). Sixty percent reported using a Mick applicator, 46% prefer using preloaded needles, and (11%) use both techniques. Real-time imaging was usually performed with ultrasound (94%); most included fluoroscopy (60%). Definitions of PSA control varied widely. Conclusions: TIPPB clinical practice in the U.S. demonstrates similarities in technique, but differences in patient selection and definitions of biochemical control. It is, therefore, incumbent on those beginning TIPPB programs to carefully review the specific practice details of those institutions

  9. Current use of pharmacogenetic testing: a national survey of thiopurine methyltransferase testing prior to azathioprine prescription.

    Science.gov (United States)

    Fargher, E A; Tricker, K; Newman, W; Elliott, R; Roberts, S A; Shaffer, J L; Bruce, I; Payne, K

    2007-04-01

    Azathioprine is an immunosuppressant prescribed for the treatment of inflammatory conditions and after organ transplantation. Risk of neutropaenia has limited the effective use of azathioprine (AZA) and driven requirements for careful monitoring and blood tests. Thiopurine methyltransferase (TPMT) is a genetically moderated key enzyme involved in the metabolism of AZA that can be used to stratify individuals into different levels of risk of developing neutropaenia. Two techniques can be used to measure TPMT status: enzyme-level testing (phenotype testing) and DNA based testing (genotype testing). To identify the current uptake of TPMT enzyme-level testing, TPMT genotype testing, and, the role of guidelines; to inform the prescribing and monitoring of AZA. A survey was mailed to a consultant dermatologist, gastroenterologist, and rheumatologist at every NHS Hospital Trust in England. The survey comprised mainly closed questions exploring: use of AZA and monitoring; use of TPMT enzyme-level testing and genotype testing; and, the role of guidelines to guide prescribing practice. A 70% (n=287) response rate was obtained. The majority of respondents reported prescribing AZA (99%, n=283). Prescribing and monitoring patterns differed between individual respondents and between the three disciplines. TPMT enzyme-level testing was reportedly used by 67% (n=189) of respondents, but this differed by discipline (dermatologists 94%, gastroenterologists 60%, rheumatologists 47%). In 91% of cases enzyme-level testing was carried out prior to prescribing AZA. Genotype testing is not typically available to NHS clinicians but 15 clinicians (six dermatologists, six gastroenterologists, three rheumatologists) reported using it. Most consultants (82%) reported using guidelines to inform their AZA prescribing and monitoring (dermatologists 81%, gastroenterologists 75%, rheumatologists 94%). Two-thirds of the consultants surveyed in England are using TPMT enzyme-level testing, prior to

  10. Seaglider surveys at Ocean Station Papa: Circulation and water mass properties in a meander of the North Pacific Current

    Science.gov (United States)

    Pelland, Noel A.; Eriksen, Charles C.; Cronin, Meghan F.

    2016-09-01

    A Seaglider autonomous underwater vehicle augmented the Ocean Station Papa (OSP; 50°N, 145°W) surface mooring, measuring spatial structure on scales relevant to the monthly evolution of the moored time series. During each of three missions from June 2008 to January 2010, a Seaglider made biweekly 50 km × 50 km surveys in a bowtie-shaped survey track. Horizontal temperature and salinity gradients measured by these surveys were an order of magnitude stronger than climatological values and sometimes of opposite sign. Geostrophically inferred circulation was corroborated by moored acoustic Doppler current profiler measurements and AVISO satellite altimetry estimates of surface currents, confirming that glider surveys accurately resolved monthly scale mesoscale spatial structure. In contrast to climatological North Pacific Current circulation, upper-ocean flow was modestly northward during the first half of the 18 month survey period, and weakly westward during its latter half, with Rossby number O>(0.01>). This change in circulation coincided with a shift from cool and fresh to warm, saline, oxygen-rich water in the upper-ocean halocline, and an increase in vertical fine structure there and in the lower pycnocline. The anomalous flow and abrupt water mass transition were due to the slow growth of an anticyclonic meander within the North Pacific Current with radius comparable to the scale of the survey pattern, originating to the southeast of OSP.

  11. 76 FR 39260 - Direct Investment Surveys: Alignment of Regulations With Current Practices

    Science.gov (United States)

    2011-07-06

    ... are eliminated from the regulations are: A survey of foreign direct investment in the U.S. seafood... requirements for two surveys of new foreign direct investment in the United States. BEA suspended collection of... Enters into a Joint Venture With, a Foreign Person BE-21, Survey of Foreign Direct Investment in U.S...

  12. 76 FR 19282 - Direct Investment Surveys: Alignment of Regulations With Current Practices

    Science.gov (United States)

    2011-04-07

    ... surveys that would be eliminated from the regulations are: a survey of foreign direct investment in the U... foreign direct investment in the United States (BE-13 and BE-14). BEA suspended collection of these... a Joint Venture With, a Foreign Person BE-21, Survey of Foreign Direct Investment in U.S. Business...

  13. Current State of Laparoscopic Colonic Surgery in Austria: A National Survey.

    Science.gov (United States)

    Klugsberger, Bettina; Haas, Dietmar; Oppelt, Peter; Neuner, Ludwig; Shamiyeh, Andreas

    2015-12-01

    Several studies have demonstrated that laparoscopic colonic resection has significant benefits in comparison with open approaches in patients with benign and malignant disease. The proportion of colonic and rectal resections conducted laparoscopically in Austria is not currently known; the aim of this study was to evaluate the current status of laparoscopic colonic surgery in Austria. A questionnaire was distributed to all general surgical departments in Austria. In collaboration with IMAS, an Austrian market research institute, an online survey was used to identify laparoscopic and open colorectal resections performed in 2013. The results were compared with data from the National Hospital Morbidity Database (NHMD), in which administrative in-patient data were also collected from all general surgical departments in Austria in 2013. Fifty-three of 99 surgical departments in Austria responded (53.5%); 4335 colonic and rectal resections were carried out in the participating departments, representing 50.5% of all NHMD-recorded colorectal resections (n = 8576) in Austria in 2013. Of these 4335 colonic and rectal resections, 2597 (59.9%) were carried out using an open approach, 1674 (38.6%) were laparoscopic, and an exact classification was not available for 64 (1.5%). Among the NHMD-recorded colonic and rectal resections, 6342 (73.9%) were carried out with an open approach, and 2234 (26.1%) were laparoscopic. The proportion of colorectal resections that are carried out laparoscopically is low (26.1%). Technical challenges and a learning curve with a significant number of cases may be reasons for the slow adoption of laparoscopic colonic surgery.

  14. A Survey on Renewable Energy Development in Malaysia: Current Status, Problems and Prospects

    Directory of Open Access Journals (Sweden)

    Alam Syed Shah

    2016-05-01

    Full Text Available Energy demand in Malaysia is increasing over seven per cent a year, while forty per cent of the energy is supplied from conventional fossil fuel. However, a number of social barriers have mired the social acceptance of renewable energy among the users. This study investigates the current status of renewable energy, problems and future outlook of renewable energy in Malaysia. A total of 200 respondents were surveyed from Klang Valley in Malaysia. Majority of the respondents use energy to generate electricity. Although some respondents reported using solar energy, there is lack of retail availability for solar energy. The findings show that limited information on renewable energy technologies, lack of awareness, and limited private sector engagement emerged as major barriers to sustainable renewable energy development. In addition, the respondents suggest for increasing policy support from the government to make information more accessible to mass users, provide economic incentives to investors and users, and promote small-community based renewable energy projects. The study suggests that the government begin small scale projects to build awareness on renewable energy, while academically, higher learning institutions include renewable energy syllabus in their academic curriculum. The study concluded that to have sustainable renewable energy development, government’s initiative, private sector engagement and users awareness must be given priority.

  15. A Survey on Renewable Energy Development in Malaysia: Current Status, Problems and Prospects

    Science.gov (United States)

    Alam, Syed Shah; Nor, Nor Fariza Mohd; Ahmad, Maisarah; Hashim, Nik Hazrul Nik

    2016-05-01

    Energy demand in Malaysia is increasing over seven per cent a year, while forty per cent of the energy is supplied from conventional fossil fuel. However, a number of social barriers have mired the social acceptance of renewable energy among the users. This study investigates the current status of renewable energy, problems and future outlook of renewable energy in Malaysia. A total of 200 respondents were surveyed from Klang Valley in Malaysia. Majority of the respondents use energy to generate electricity. Although some respondents reported using solar energy, there is lack of retail availability for solar energy. The findings show that limited information on renewable energy technologies, lack of awareness, and limited private sector engagement emerged as major barriers to sustainable renewable energy development. In addition, the respondents suggest for increasing policy support from the government to make information more accessible to mass users, provide economic incentives to investors and users, and promote small-community based renewable energy projects. The study suggests that the government begin small scale projects to build awareness on renewable energy, while academically, higher learning institutions include renewable energy syllabus in their academic curriculum. The study concluded that to have sustainable renewable energy development, government's initiative, private sector engagement and users awareness must be given priority.

  16. Current and future delivery of diagnostic electron microscopy in the UK: results of a national survey.

    Science.gov (United States)

    de Haro, Tracey; Furness, Peter

    2012-04-01

    Electron microscopy (EM) remains essential to delivering several specialist areas of diagnosis, especially the interpretation of native renal biopsies. However, there is anecdotal evidence of EM units struggling to survive, for a variety of reasons. The authors sought to obtain objective evidence of the extent and the causes of this problem. An online survey was undertaken of Fellows of the Royal College of Pathologists who use EM in diagnosis. A significant number of EM units anticipate having to close and hence outsource their EM work in the coming years. Yet most existing units are working to full capacity and would be unable to take on the substantial amounts of extra work implied by other units outsourcing their needs. Equipment and staffing are identified by most EM units as the major barriers to growth and are also the main reasons cited for units facing potential closure. In the current financial climate it seems unlikely that units will be willing to make the large investment in equipment and staff needed to take on extra work, unless they can be reasonably confident of an acceptable financial return as a result of increased external referral rates. The case is thus made for a degree of national coordination of the future provision of this specialist service, possibly through the National Commissioning Group or the new National Commissioning Board. Without this, the future of diagnostic EM services in the UK is uncertain. Its failure would pose a threat to good patient care.

  17. Laparoscopic simulation training in gynaecology: Current provision and staff attitudes - a cross-sectional survey.

    Science.gov (United States)

    Burden, Christy; Fox, Robert; Hinshaw, Kim; Draycott, Timothy J; James, Mark

    2016-01-01

    The objectives of this study were to explore current provision of laparoscopic simulation training, and to determine attitudes of trainers and trainees to the role of simulators in surgical training across the UK. An anonymous cross-sectional survey with cluster sampling was developed and circulated. All Royal College of Obstetricians and Gynaecologists (RCOG) Training Programme Directors (TPD), College Tutors (RCT) and Trainee representatives (TR) across the UK were invited to participate. One hundred and ninety-six obstetricians and gynaecologists participated. Sixty-three percent of hospitals had at least one box trainer, and 14.6% had least one virtual-reality simulator. Only 9.3% and 3.6% stated that trainees used a structured curriculum on box and virtual-reality simulators, respectively. Respondents working in a Large/Teaching hospital (p = 0.008) were more likely to agree that simulators enhance surgical training. Eighty-nine percent agreed that simulators improve the quality of training, and should be mandatory or desirable for junior trainees. Consultants (p = 0.003) and respondents over 40 years (p = 0.011) were more likely to hold that a simulation test should be undertaken before live operation. Our data demonstrated, therefore, that availability of laparoscopic simulators is inconsistent, with limited use of mandatory structured curricula. In contrast, both trainers and trainees recognise a need for greater use of laparoscopic simulation for surgical training.

  18. Analysis of Satisfaction Degree of the Public Insurance System Beneficiaries

    Directory of Open Access Journals (Sweden)

    Manuela PANAITESCU

    2013-08-01

    Full Text Available The public insurance system provides financial benefits to individuals that are obtained by collecting the due contributions. The analysis of satisfaction degree of the beneficiaries of the system was carried out to determine the challenges the system is facing and for determining the needs of the beneficiaries. In order to reduce the financial constraints the public insurance system is facing, it is necessary to create an appropriate insurance system that meets the needs of the beneficiaries. The research took into account that the public insurance system determines the quality of life of the population and has a strong influence on the economy, particularly on the labour market and the capital market.

  19. Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.

    Science.gov (United States)

    Jennings, B M; Loan, L A

    1999-11-01

    A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.

  20. The current status of pediatric radiology in India: A conference-based survey

    Directory of Open Access Journals (Sweden)

    Jacob Therakathu

    2017-01-01

    Full Text Available Introduction: Like most other developing countries, India has a large proportion of children among its population. However, the facilities for adequate treatment of this large population is inadequate. The development of pediatric radiology as a subspecialty is still at an infant stage in India. The goal of our study was to assess the awareness about the current status of pediatric radiology in India. Materials and Methods: A questionnaire was handed over to all attendees of a pediatric radiology conference to assess their opinion regarding the adequacy of pediatric training and practice in India. The questionnaire consisted of 10 multiple-choice and two descriptive questions. Descriptive statistical methods were used for analyzing the results. Results: Eighty-one out of 400 delegates responded to the questionnaire. Among these 81 respondents, 50 (61.7% felt that exposure to pediatric cases during postgraduate course was inadequate. Sixty-three out of 81 (77.7% respondents thought that specialized training is required for practicing pediatric radiology, and 79 respondents (97% felt that the number of such training programmes should increase. Forty-five out of 81 respondents (55.5% were interested in pursuing pediatric radiology as a career. Conclusion: According to the opinion of the respondents of our survey, pediatric radiology remains an underdeveloped speciality in India. Considering the proportion of the population in the pediatric age and the poor health indicators in this age group, elaborate measures, as suggested, need to be implemented to improve pediatric radiology training and the care of sick children in India.

  1. Test result communication in primary care: a survey of current practice.

    Science.gov (United States)

    Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

    2015-11-01

    The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the

  2. Current status of iodine intake in Croatia--the results of 2009 survey.

    Science.gov (United States)

    Kusić, Zvonko; Jukić, Tomislav; Rogan, Suncica Andreja; Juresa, Vesna; Dabelić, Nina; Stanicić, Josip; Borić, Marta; Lukinac, Ljerka; Mihaljević, Ivan; Punda, Ante; Smokvina, Aleksandar; Topalović, Zlatko; Katalenić, Marijan

    2012-03-01

    In 1996, due to persistence of mild to moderate iodine deficiency, new law on obligatory salt iodination with 25 mg of potassium iodide (KI) per kg of salt was implemented in Croatia. Along with a new law, a new program for monitoring of iodine prophylaxis was implemented. Investigations of goiter and iodine intake performed in 2002, demonstrated sufficient iodine intake in Croatia with overall median of urinary iodine concentration (UIC) for schoolchildren in Croatia of 140 microg/L. In 2002, thyroid volumes (TV) measured by ultrasound in schoolchildren from all four geographic regions of Croatia were for the first time within the normal range according to ICCIDD reference values. Nowadays, Croatia is internationally recognized as iodine sufficient country. The aim of the present study was to assess current status of iodine intake in Croatia. The investigation was carried out in 2009. A total of 386 schoolchildren aged 7-10 years from all four major geographic regions of Croatia, 103 euthyroid pregnant women and 36 women of child-bearing age from Zagreb, the capital, were included in the survey. Urinary iodine concentration (UIC) was measured in all participants. Thyroid volumes were measured by ultrasound in schoolchildren from the capital of Zagreb (N = 101) and the village of Rude (N = 56). In the time period 2002-2009, the content of KI was analyzed in 384 salt samples from Croatian salt plants and samples of imported salt. An overall median UIC for schoolchildren in Croatia was 248 microg/L. Median UIC in pregnant women was 159 microg/L, with 50% of samples below and under 150 microg/L. Median UIC in women of child-bearing age was 136 microg/L. Thyroid volumes in schoolchildren were within the normal range according to the new reference values. Mean value of KI/kg of salt in samples from Croatian salt plants was 25.5 mg/kg and 24.9 mg/kg in samples of imported salt. A total of 72/384 (18.8%) of salt samples didn't corresponded to the Croatian law on

  3. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    rounds of data collection during their panel period. MEPS captures medication utilization by surveying individuals on current and previous medication use and verifies this information at the pharmacy level, so prescription fills can be observed irrespective of payment by an insurer or a filed claim. Pharmaceutical utilization was assessed at the individual level for each year of the study period, and LCGP use was recorded as a binary variable for each individual. An LCGP medication fill was identified if the total cost of the drug was paid out of pocket and matched the cost of medications listed on LCGP formularies available from major pharmacy retailers during these years. Cohort demographics and characteristics of interest included age, gender, race, employment status, marital status, family income level, education level, residence in a metropolitan statistical area, geographic region, prescription drug coverage, Medicare type, comorbidities, number of unique medications used, and number of medication fills. Comparisons were made between users and nonusers using chi-square and t-tests. Multivariable logistic regression was used to identify factors associated with LCGP use. From the most recent MEPS panel, 1,861 individuals were included in the study cohort, of which 53.5% were observed to be LCGP users. The 995 LCGP users in this cohort represented over 20 million Medicare beneficiaries who used LCGPs from 2011 to 2012. Significant differences between LCGP users and nonusers existed in terms of race, educational attainment, comorbidity burden, type of Medicare insurance, number of unique medications used, and number of medication fills. Each additional unique medication filled increased the odds of LCGP use by 12% (95% CI = 1.09-1.14). Individuals with insurance in addition to Medicare (i.e., Tricare/Veteran's Affairs or Medicaid) had less than half the odds of using LCGPs compared with those with Medicare or Medicare managed care insurance coverage only. The

  4. 78 FR 53507 - Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form...

    Science.gov (United States)

    2013-08-29

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form) Activity Under OMB Review AGENCY: Veterans Health... Control No. 2900- NEW (Beneficiary Travel Mileage Reimbursement Application Form)'' in any correspondence...

  5. 7 CFR 1710.104 - Service to non-RE Act beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... GUARANTEES Loan Purposes and Basic Policies § 1710.104 Service to non-RE Act beneficiaries. (a) To the... made to finance electric facilities to serve consumers that are not RE Act beneficiaries. (b) Loan...

  6. Current technological clinical practice in breast radiotherapy; results of a survey in EORTC-Radiation Oncology Group affiliated institutions

    NARCIS (Netherlands)

    van der Laan, Hans Paul; Hurkmans, Coen W; Kuten, Abraham; Westenberg, Helen A

    PURPOSE: To evaluate the current technological clinical practice of radiation therapy of the breast in institutions participating in the EORTC-Radiation Oncology Group (EORTC-ROG). MATERIALS AND METHODS: A survey was conducted between August 2008 and January 2009 on behalf of the Breast Working

  7. Studies in Income Distribution. Estimation of Social Security Taxes on the March Current Population Survey. No. 4.

    Science.gov (United States)

    Bridges, Benjamin, Jr.; Johnston, Mary P.

    The impact of the tax-transfer system on the distribution of income among economic units is the subject of a number of studies by the Office of Research and Statistics of the Social Security Administration. One of the most important data sources for the work is the Census Bureau's March Current Population Survey (CPS). To conduct such studies, the…

  8. 32 CFR 728.59 - Peace Corps beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... beneficiaries seeking dental care will be requested, whenever possible, to furnish advanced authorization. (5... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE... sponsor. (4) Dental care. Limit dental care to emergencies. Render only that care essential to relieve...

  9. 29 CFR 4.133 - Beneficiary of contract services.

    Science.gov (United States)

    2010-07-01

    ... service and laundry and dry cleaning service for personnel at military installations. Furthermore, there... 29 Labor 1 2010-07-01 2010-07-01 true Beneficiary of contract services. 4.133 Section 4.133 Labor Office of the Secretary of Labor LABOR STANDARDS FOR FEDERAL SERVICE CONTRACTS Application of the...

  10. Wellbeing of Beneficiaries of the University Based Agricultural ...

    African Journals Online (AJOL)

    E M IGBOKWE

    The possibility of doing this won't be without the efforts of ... Nigeria in different higher institutions of learning have been adopted in different ... of UBAES and ADP are to engage in programmes that will see to the ... 6 months span) and weighted mean was used to rate beneficiaries access to these ... cars, farm size etc.

  11. Micronutrient deficiencies in food aid beneficiaries: A review of ...

    African Journals Online (AJOL)

    African Journal of Food, Agriculture, Nutrition and Development ... in food aid beneficiary populations and to guide the formulation of food aid products, this ... In some cases, food aid rations provide insufficient quantity and quality of ... studies found documenting the nutritional status of non-emergency food aid recipients.

  12. Differences between paid and unpaid social services for beneficiaries

    NARCIS (Netherlands)

    Metz, Judith; Roza, Lonneke; Meijs, Lucas; van Baren, Eva; Hoogervorst, Niek

    2017-01-01

    In many Western welfare states, social work services that have traditionally been provided by paid employees are being replaced by family support, community support, informal networks and volunteering. For the field of social work, it is relevant to know what it matters to beneficiaries whether

  13. 42 CFR 478.40 - Beneficiary's right to a hearing.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.40 Beneficiary's right to a... under the Hospital Insurance Program, of part 405 of this chapter apply to hearings and appeals under...

  14. 42 CFR 412.507 - Limitation on charges to beneficiaries.

    Science.gov (United States)

    2010-10-01

    ... prospective payment system. If Medicare has paid the full LTC-DRG payment, that payment applies to the... SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.507 Limitation on charges to beneficiaries. (a) Prohibited...

  15. A Marketing Assessment of Beneficiaries at Kimbrough Army Community Hospital

    Science.gov (United States)

    1993-05-01

    environment, organizational goal formulation, strategy formulation, Marketing Assessment 10 organization and systems design ( Kotler , 1987). Second...environmental analysis itself is concerned with identifying marketing opportunities, threats, environmental trends and their implications ( Kotler , 1987...decision to develop beneficiary subgroups was based on the marketing principle of market segmentation which assumes that no one strategy will work for

  16. Body Pain Reporting in Tricare Eligible Beneficiaries with Orofacial Pain

    Science.gov (United States)

    2015-06-01

    provider performed a standard orofacial pain clinical examination. This included at a minimum a cranial nerve exam, shoulder and cervical range of...Attachment 2 Date The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled: Body pain reporting in...Tricare eligible beneficiaries with orofacial pain

  17. A survey of current and anticipated use of standard and specialist equipment by UK optometrists.

    Science.gov (United States)

    Dabasia, Priya L; Edgar, David F; Garway-Heath, David F; Lawrenson, John G

    2014-09-01

    To investigate current and anticipated use of equipment and information technology (IT) in community optometric practice in the UK, and to elicit optometrists' views on adoption of specialist equipment and IT. An anonymous online questionnaire was developed, covering use of standard and specialist diagnostic equipment, and IT. The survey was distributed to a random sample of 1300 UK College of Optometrists members. Four hundred and thirty-two responses were received (response rate = 35%). Enhanced (locally commissioned) or additional/separately contracted services were provided by 73% of respondents. Services included glaucoma repeat measures (30% of respondents), glaucoma referral refinement (22%), fast-track referral for wet age-related macular degeneration (48%), and direct cataract referral (40%). Most respondents (88%) reported using non-contact/pneumo tonometry for intra-ocular pressure measurement, with 81% using Goldmann or Perkins tonometry. The most widely used item of specialist equipment was the fundus camera (74% of respondents). Optical Coherence Tomography (OCT) was used by 15% of respondents, up from 2% in 2007. Notably, 43% of those anticipating purchasing specialist equipment in the next 12 months planned to buy an OCT. 'Paperless' records were used by 39% of respondents, and almost 80% of practices used an electronic patient record/practice management system. Variations in responses between parts of the UK reflect differences in the provision of the General Ophthalmic Services contract or community enhanced services. There was general agreement that specialised equipment enhances clinical care, permits increased involvement in enhanced services, promotes the practice and can be used as a defence in clinico-legal cases, but initial costs and ongoing maintenance can be a financial burden. Respondents generally agreed that IT facilitates administrative flow and secure exchange of health information, and promotes a state-of-the-art practice image

  18. 5 CFR 1651.4 - How to change or cancel a designation of beneficiary.

    Science.gov (United States)

    2010-01-01

    ... of beneficiary, the participant must submit to the TSP record keeper a new TSP designation of beneficiary form meeting the requirements of § 1651.3 to the TSP record keeper. If the TSP receives more than... the participant. A participant may change a TSP beneficiary at any time, without the knowledge or...

  19. Current status of in-hospital donation coordinators in Japan: nationwide survey.

    Science.gov (United States)

    Konaka, S; Shimizu, S; Iizawa, M; Ohkawara, H; Kato, O; Ashikari, J; Fukushima, N

    2013-05-01

    When the Japanese Organ Transplantation Act was issued, the Japanese Organ Transplantation Network (JOT) was established in 1997. JOT lists recipients, assesses and manages organ donors, and educates publics and headquarters for organ donations. JOT procurement transplant coordinators (PTC) play roles in obtaining consent from relatives for organ donation, donor evaluation and management, organ recovery management, organ transport, and care of donor families during and after donation. Every prefecture has at least one PTC who is mainly working in public education and hospital development. They also help the JOT PTC at the time of organ procurement. Most prefectures commission hospital staff in the procurement hospital to be an in-hospital PTC (In-Hp PTC), who make their hospital staff aware of organ donation and support organ procurement. Although the Act was revised in 2010 with brain-dead organ donation increased from 13 to 44 cases yearly, the number was still extremely smaller than other developed countries. In these circumstances, In-Hp PTC may play greater roles to increase donation and smooth procurement procedures Our primary aim was to describe the current status of In-Hp PTC in Japan. Between December 15, 2011, and January 31, 2012, we invited 1889 In-Hp PTC to complete a letter survey using a self-designed questionnaire. In all, 56 In-Hp PTC (40%) completed and returned it. The occupation of the respondents was nurse (66%), physician (18%), or other (16%). Although 52% of respondents belonged to the hospital, which was designated for brain-death organ donation by the government, only 46% had any experience with a cadaveric donor. Only 2% were full-time In-Hp PTC. They mainly played a role in preparing their own manual for organ procurement (57%), providing in-hospital lectures (44%) or their own simulation exercise (29%), as well as coordinating donation cases. Although 77% had attended seminar about organ donation provided by JOT or the prefecture PTC

  20. Inhaled anticholinergic use and all-cause mortality among elderly Medicare beneficiaries with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2013-06-01

    Full Text Available Mayank Ajmera,1 Chan Shen,2 Xiaoyun Pan,1 Patricia A Findley,3 George Rust,4 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA; 3School of Social Work, Rutgers University, New Brunswick, NJ, USA; 4Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA, USA Background: The purpose of this study was to examine the association between use of inhaled anticholinergics and all-cause mortality among elderly individuals with chronic obstructive pulmonary disease (COPD, after controlling for demographic, socioeconomic, health, functional status, smoking, and obesity. Methods: We used a retrospective longitudinal panel data design. Data were extracted for multiple years (2002–2009 of the Medicare Current Beneficiary Survey (MCBS linked with fee-for-service Medicare claims. Generic and brand names of inhaled anticholinergics were used to identify inhaled anticholinergic utilization from the self-reported prescription medication files. All-cause mortality was assessed using the vital status variable. Unadjusted group differences in mortality rates were tested using the chi-square statistic. Multivariable logistic regressions with independent variables entered in separate blocks were used to analyze the association between inhaled anticholinergic use and all-cause mortality. All analyses accounted for the complex design of the MCBS. Results: Overall, 19.4% of the elderly Medicare beneficiaries used inhaled anticholinergics. Inhaled anticholinergic use was significantly higher (28.5% among those who reported poor health compared with those reporting excellent or very good health (12.7%. Bivariate analyses indicated that inhaled anticholinergic use was associated with significantly higher rates of all-cause mortality (18.7% compared with nonusers (13.6%. However

  1. Promoting pneumococcal immunizations among rural Medicare beneficiaries using multiple strategies.

    Science.gov (United States)

    Johnson, Elizabeth A; Harwell, Todd S; Donahue, Peg M; Weisner, M'liss A; McInerney, Michael J; Holzman, Greg S; Helgerson, Steven D

    2003-01-01

    Vaccine-preventable diseases among adults are major contributing causes of morbidity and mortality in the United States. However, adult immunizations continue to be underutilized in both urban and rural areas. To evaluate the effectiveness of a community-wide education campaign and mailed reminders promoting pneumococcal immunizations to rural Medicare beneficiaries. We implemented a community-wide education campaign, and mailed reminders were sent to Medicare beneficiaries in 1 media market in Montana to increase pneumococcal immunizations. In a second distinct media market, mailed reminders only were sent to beneficiaries. The proportion of respondents aged 65 years and older aware of pneumococcal immunizations increased significantly from baseline to follow-up among respondents both in the education-plus-reminder (63% to 78%, P = 0.04) and the reminder-only (64% to 74%, P = 0.05) markets. Overall from 1998 to 1999, there was a 3.7-percentage-point increase in pneumococcal immunization claims for Medicare beneficiaries in the education-plus-reminder market and a 1.5-percentage-point increase in the reminder-only market. Medicare beneficiaries sent reminders in the education-plus-reminder market compared to those in the reminder-only market were more likely to have a claim for pneumococcal immunization in 1999 (odds ratio 1.18, 95% confidence interval 1.08 to 1.28). The results suggest that these quality improvement strategies (community education plus reminders and reminders alone) modestly increased pneumococcal immunization awareness and pneumococcal immunization among rural adults. Mailed reminder exposure was associated with an increased prevalence of pneumococcal immunizations between 1998 and 1999 and was augmented somewhat by the education campaign.

  2. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background.

    Science.gov (United States)

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E; Rogers, Ann E

    2014-05-15

    To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through "on the job" training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap.

  3. A survey of previous and current industry-wide efforts regarding burnup credit

    International Nuclear Information System (INIS)

    Jones, R.H.

    1989-01-01

    Sandia has examined the matter of burnup credit from the perspective of physics, logistics, risk, and economics. A limited survey of the nuclear industry has been conducted to get a feeling for the actual application of burnup credit. Based on this survey, it can be concluded that the suppliers of spent fuel storage and transport casks are in general agreement that burnup credit offers the potential for improvements in cask efficiency without increasing the risk of accidental criticality. The actual improvement is design-specific but limited applications have demonstrated that capacity increases in the neighborhood of 20 percent are not unrealistic. A number of these vendors acknowledge that burnup credit has not been reduced to practice in cask applications and suggest that operational considerations may be more important to regulatory acceptance than to the physics. Nevertheless, the importance of burnup credit to the nuclear industry as a cask design and analysis tool has been confirmed by this survey

  4. Emerging roles for biomedical librarians: a survey of current practice, challenges, and changes.

    Science.gov (United States)

    Crum, Janet A; Cooper, I Diane

    2013-10-01

    This study is intended to (1) identify emerging roles for biomedical librarians and determine how common these roles are in a variety of library settings, (2) identify barriers to taking on new roles, and (3) determine how librarians are developing the capacity to take on new roles. A survey was conducted of librarians in biomedical settings. Most biomedical librarians are taking on new roles. The most common roles selected by survey respondents include analysis and enhancement of user experiences, support for social media, support for systematic reviews, clinical informationist, help for faculty or staff with authorship issues, and implementation of researcher profiling and collaboration tools. Respondents in academic settings are more likely to report new roles than hospital librarians are, but some new roles are common in both settings. Respondents use a variety of methods to free up time for new roles, but predominant methods vary between directors and librarians and between academic and hospital respondents. Lack of time is the biggest barrier that librarians face when trying to adopt new roles. New roles are associated with increased collaboration with individuals and/or groups outside the library. This survey documents the widespread incorporation of new roles in biomedical libraries in the United States, as well as the barriers to adopting these roles and the means by which librarians are making time for them. The results of the survey can be used to inform strategic planning, succession planning, library education, and career development for biomedical librarians.

  5. The TRacking Adolescents' Individual Lives Survey (TRAILS) : Design, Current Status, and Selected Findings

    NARCIS (Netherlands)

    Ormel, Johan; Oldehinkel, Albertine J; Sijtsema, Jelle; van Oort, Floor; Raven, Dennis; Veenstra, Rene; Vollebergh, Wilma A M; Verhulst, Frank C

    2012-01-01

    Objectives: The objectives of this study were as follows: to present a concise overview of the sample, outcomes, determinants, non-response and attrition of the ongoing TRacking Adolescents' Individual Lives Survey (TRAILS), which started in 2001; to summarize a selection of recent findings on

  6. Current and Developing Conceptions of Use: Evaluation Use TIG Survey Results.

    Science.gov (United States)

    Preskill, Hallie; Caracelli, Valerie

    1997-01-01

    A survey was sent to members of the Evaluation Use Topical Interest Group (TIG) to determine their perceptions about and experiences with evaluation use. Responses from 282 members show agreement on the major purposes of evaluation and an increased use of performance-results oriented and formative evaluations. (SLD)

  7. 78 FR 77646 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Basic...

    Science.gov (United States)

    2013-12-24

    ... age, marital status, gender, Armed Forces status, education, race, origin, and family income. We use... sponsor the basic monthly survey. The Census Bureau also prepares and conducts all the field work. At the.... Some of the information within that portion includes employment status, number of hours worked, job...

  8. 75 FR 78676 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Basic...

    Science.gov (United States)

    2010-12-16

    ... age, marital status, gender, Armed Forces status, education, race, origin, and family income. We use... sponsor the basic monthly survey. The Census Bureau also prepares and conducts all the field work. At the.... Some of the information within that portion includes employment status, number of hours worked, job...

  9. 78 FR 45910 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Email Address...

    Science.gov (United States)

    2013-07-30

    ... Population Survey (CPS) Email Address Collection Test Supplement AGENCY: U.S. Census Bureau, Commerce. ACTION... request clearance for the collection of data concerning the November 2013 Email Address Collection Test... tool to help increase response rates. We foresee that in the future, we could collect email addresses...

  10. 77 FR 27020 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Voting and...

    Science.gov (United States)

    2012-05-08

    ... distinct from independent surveys, media polls, or other outside agencies. Federal, state, and local election officials use these data to formulate policies relating to the voting and registration process. College institutions, political party committees, research groups, and other private organizations also...

  11. The TRacking Adolescents' Individual Lives Survey (TRAILS): Design, Current Status, and Selected Findings

    Science.gov (United States)

    Ormel, Johan; Oldehinkel, Albertine J.; Sijtsema, Jelle; van Oort, Floor; Raven, Dennis; Veenstra, Rene; Vollebergh, Wilma A. M.; Verhulst, Frank C.

    2012-01-01

    Objectives: The objectives of this study were as follows: to present a concise overview of the sample, outcomes, determinants, non-response and attrition of the ongoing TRacking Adolescents' Individual Lives Survey (TRAILS), which started in 2001; to summarize a selection of recent findings on continuity, discontinuity, risk, and protective…

  12. A Survey of Privacy Awareness and Current Online Practices of Indian Users

    DEFF Research Database (Denmark)

    Dhotre, Prashant Shantaram; Olesen, Henning

    2015-01-01

    Today, users with their smart devices can communicate and access a wide range of services via the Internet to make their life easier. However, loss of privacy is becoming a major issue for architects or policy makers, accelerated by the rapid development of mobile and wireless technologies...... that eases the collection, storage, sharing, analysis, and manipulation of the individual’s information. The main objective of this paper is to study the privacy perception and awareness of Internet users in an Indian context. Results of comprehensive survey with 297 users are presented, focusing...... on their perception and awareness towards personal information privacy (PIP). The survey responses show that the user’s perception is noticeably low considering PIP and that the privacy awareness is not the same as their understanding. The results indicate the need for a solution for PIP protection where the users...

  13. Relevance of the futron/zogby survey conclusions to the current space tourism industry

    Science.gov (United States)

    Ziliotto, Véronique

    2010-06-01

    Thanks to recent technological achievements such as Burt Rutan's SpaceShipOne in 2004, Bigelow's Genesis I in July 2006 and Genesis II in July 2007 and the success of space adventures' flights to the ISS, space tourism is leaving the realm of science-fiction. It is now becoming increasingly familiar to the general public and even recognized by institutional bodies. The Futron/Zogby survey, revised in 2006 and completed with the 2006. Adventurers survey constitutes a good basis to understanding the characteristics of the nascent suborbital market and the profile of the potential customers for both suborbital and orbital travel. The previsions of these studies will be contrasted with recent market and customers' data that was not available at the time.

  14. Current smoking and secondhand smoke exposure and depression among Korean adolescents: analysis of a national cross-sectional survey.

    Science.gov (United States)

    Lee, Kyung-Jae

    2014-02-06

    To examine the association between cigarette smoke exposure and depression among Korean adolescents using the seventh Korea Youth Risk Behavior Web-based Survey (KYRBWS). Cross-sectional study. A nationally representative sample of middle and high school students across South Korea. 75 643 eligible participants across the country. Current smoking, secondhand smoke exposure and depression. Data were analysed from a nationally representative survey of 75 643 participants (37 873 men and 37 770 women). Data were gathered on extensive information including current smoking, secondhand smoke exposure and depression in adolescence. Multiple logistic regression analysis was used to estimate the association between current smoking, secondhand smoke exposure and depression in Korean adolescents. Among those who had never smoked, secondhand smoke exposure was positively associated with depression in male and female adolescents in a dose-response relation (OR 1.27, OR 1.52 in males; OR 1.25, OR 1.72 in females). Similar associations were observed among currently smoking men and women in a dose-response manner (OR 1.29, OR 1.55 in males; OR 1.22, OR 1.41 in females). These significant trends were consistently observed even after adjustments. We suggested that current smoking and secondhand smoke exposure were positively associated with depression in male and female adolescents. Efforts to encourage no smoking and no secondhand smoke exposure will be established for adolescents.

  15. Adult Nutrient Intakes from Current National Dietary Surveys of European Populations

    Directory of Open Access Journals (Sweden)

    Holly L. Rippin

    2017-11-01

    Full Text Available The World Health Organization (WHO encourages countries to undertake national dietary survey (NDS but implementation and reporting is inconsistent. This paper provides an up-to-date review of adult macro and micronutrient intakes in European populations as reported by NDS. It uses WHO Recommended Nutrient Intakes (RNIs to assess intake adequacy and highlight areas of concern. NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. Survey characteristics and adult intakes by gender/age group were extracted for selected nutrients and weighted means calculated by region. Of the 53 WHO Europe countries, over a third (n = 19, mainly Central & Eastern European countries (CEEC, had no identifiable NDS. Energy and nutrient intakes were extracted for 21 (40% countries but differences in age group, methodology, under-reporting and nutrient composition databases hindered inter-country comparisons. No country met more than 39% WHO RNIs in all age/gender groups; macronutrient RNI achievement was poorer than micronutrient. Overall RNI attainment was slightly worse in CEEC and lower in women and female elderly. Only 40% countries provided adult energy and nutrient intakes. The main gaps lie in CEEC, where unknown nutrient deficiencies may occur. WHO RNI attainment was universally poor for macronutrients, especially for women, the female elderly and CEEC. All countries could be encouraged to report a uniform nutrient set and sub-analyses of nationally representative nutrient intakes.

  16. Current educational status of paediatric rheumatology in Europe: the results of PReS survey.

    Science.gov (United States)

    Demirkaya, E; Ozen, S; Türker, T; Kuis, W; Saurenmann, R K

    2009-01-01

    To understand the status of education and problems in paediatric rheumatology practice in Europe, through a survey. A 26-item questionnaire was conducted during the 14th Congress of the Paediatric Rheumatology European Society in Istanbul, 2007. Physicians who were practicing or studying within the field of paediatric rheumatology for at least one year were included in the survey. One hundred and twenty eight physicians, 79 paediatric rheumatologists (including 5 paediatric immunologists and 10 paediatric nephrologists), 34 paediatric rheumatology fellows and 15 adult rheumatologists completed the survey. The physicians were from: Europe 95 (81.9%), South America 12 (10.4%), Middle East 5 (4.3%), Asia 2 (1.7%), Africa 2 (1.7%). The duration of training for paediatric rheumatology ranged between 1-5 years (mean: 3.12+/-1.11). Sixty physicians scored their education as unsatisfactory and among those, 48 physicians were from Europe. Physicians reported good skills in the following items; intraarticular injections (83.3%); soft tissue injections (47.6%); evaluation of radiographs (67.5%); whereas competence in the evaluation of computed tomography/magnetic resonance imaging (30.5%); and musculoskeletal sonography (16.7%) was much lower. A need for improved basic science and rotations among relevant fields were specifically expressed. Being a relatively new speciality in the realm of paediatrics, paediatric rheumatology education at the European level needs to be further discussed, revised and uniformed.

  17. 2016 Summer California Current Ecosystem CPS Survey (RL1606, EK60)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The cruise sampled the California Current Ecosystem from San Diego, CA to Vancouver Island, BC, CA. Multi-frequency (18-, 38-, 70-, 120-, 200-, and 333-) General...

  18. 2016 Summer California Current Ecosystem CPS Survey (RL1606, EK80)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The cruise sampled the California Current Ecosystem from San Diego, CA to Vancouver Island, BC, CA. Multi-frequency (18-, 38-, 70-, 120-, 200-, and 333-) General...

  19. Acellular Dermal Matrix in Reconstructive Breast Surgery: Survey of Current Practice among Plastic Surgeons

    Directory of Open Access Journals (Sweden)

    Ahmed M. S. Ibrahim, MD

    2015-04-01

    Conclusions: Plastic surgeons currently use ADM in breast reconstruction for both immediate and staged procedures. Of those responding, a majority of plastic surgeons will incorporate drains and use postoperative antibiotics for more than 48 hours.

  20. National Law Restrictions on Family Reunification Rights of International Protection Beneficiaries from a ECHR/EU Perspective

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    n light of the refugee crisis, European countries are exploring new ways to restrict access of migrants to their territory. One such restriction relates to family reunification rights of international protection beneficiaries. Proposals in this area have already been adopted or are currently being...... considered in countries such as Norway, Denmark, Sweden, Austria and Germany most commonly in the form of waiting periods before applications for family reunification can be submitted and/or age requirements. The personal scope of these proposals differs. In some countries the restrictions apply/are intended...... to apply to international beneficiaries in general while they in other countries are applicable/envisaged applicable only to persons with subsidiary protection status or persons fleeing from generalised violence. The intention of the paper is to examine whether this legislative trend is in conformity...

  1. The affordable care ACT on loyalty programs for federal beneficiaries.

    Science.gov (United States)

    Piacentino, Justin J; Williams, Karl G

    2014-02-01

    To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

  2. The phenomenon of factoring, benefits for beneficiary and national economy

    Directory of Open Access Journals (Sweden)

    Kasavica Petar

    2015-01-01

    Full Text Available The essay encompasses three thematic units focused on the phenomenon of factoring and its benefits for beneficiaries and national economies. In the first part the essay analyses background, concept and participants, types of factoring products, and how factoring functions from the perspective of involved risks. In the second part the essay analyses benefits of factoring for beneficiaries, especially their financial performances and how factoring decreases collection risk and costs of working capital financing. In the third part the essay analyses benefits of factoring for national economies tackling its capabilities to support declining companies and how factoring upgrades macroeconomic figures and features of financial sector. This part explains the way how national economies are organized through international factoring based on two factor systems. The goal of the essay is to pinpoint micro benefits and their impact on macro environment, i.e. national economy.

  3. Ensonifying Change: Repeat Ultra-High-Resolution Surveys in Monterey Canyon before and after Passage of a Turbidity Current

    Science.gov (United States)

    Wolfson-Schwehr, M.; Paull, C. K.; Caress, D. W.; Carvajal, C.; Thomas, H. J.; Maier, K. L.; Parsons, D. R.; Simmons, S.

    2017-12-01

    Turbidity currents are one of the primary means of global sediment transport, yet our understanding of how they interact with the seafloor is hindered by the limited number of direct measurements. The Coordinated Canyon Experiment (CCE; October 2015 - April 2017) has made great strides in addressing this issue by providing direct measurements of turbidity currents and detailed observations of the resulting seafloor change in Monterey Canyon, offshore California. Here we focus on a section of the canyon at 1850-m water depth, where a Seafloor Instrument Node (SIN) recorded passage of three turbidity currents using a range of sensors, including three upward-looking acoustic Doppler current profilers. The fastest event at this site had a maximum velocity of 2.8 m/s, and dragged the 430-Kg SIN 26 m down-canyon. Repeat mapping surveys were conducted four times during the CCE, utilizing a prototype ultra-high-resolution mapping system mounted on the ROV Doc Ricketts. The survey platform hosts a 400-kHz Reson 7125 multibeam sonar, a 3DatDepth SL1 subsea LiDAR, two stereo color cameras, and a Kearfott SeaDevil INS. At a survey altitude of 2.5 m above the bed, the system provides remarkable 5-cm resolution multibeam bathymetry, 1-cm resolution LiDAR bathymetry, and 2-mm resolution photomosaics, and can cover a 100-m2 survey area. Surveys of the SIN site prior to and after the fastest event show areas of net deposition/erosion of 60 cm and 20 cm, respectively. Net deposition occurred in the topographic lows between bedforms, while erosion was focused on the bedform crests. At the end of the experiment, transects of sediment cores were taken by ROV within areas of net deposition. The cores show a variety of sedimentary facies, including muds, sands, gravel, and organic rich layers. Gravel layers have sharp erosive bases. The repeat surveys document the dynamic nature of flute-like scours as the flow events erode and deposit material along the canyon floor, as well as the

  4. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys.

    Science.gov (United States)

    Zhu, Shu-Hong; Zhuang, Yue-Lin; Wong, Shiushing; Cummins, Sharon E; Tedeschi, Gary J

    2017-07-26

    Objective  To examine whether the increase in use of electronic cigarettes in the USA, which became noticeable around 2010 and increased dramatically by 2014, was associated with a change in overall smoking cessation rate at the population level. Design  Population surveys with nationally representative samples. Setting  Five of the US Current Population Survey-Tobacco Use Supplement (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15. Participants  Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from 2014-15 CPS-TUS were then compared with those from 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys. Main outcome measures  Rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months. Results  Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3-4.5%). Conclusion  The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant increase in the smoking cessation rate at the population level. These findings need to be weighed carefully in regulatory policy making regarding e-cigarettes and in planning tobacco

  5. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    OpenAIRE

    Mondli S. Hlatshwayo

    2017-01-01

    Scholarship on the Expanded Public Works Programme (EPWP) in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary source...

  6. Assessment of surgical competence in North American graduate periodontics programs: a survey of current practices.

    Science.gov (United States)

    Ghiabi, Edmond; Taylor, K Lynn

    2010-08-01

    This cross-sectional study was designed to document the methods utilized by North American graduate periodontics programs in assessing their residents' surgical skills. A survey of clinical skills assessment was mailed to directors of all fifty-eight graduate periodontics programs in Canada and the United States. Thirty-four programs (59 percent) responded. The data collected were analyzed using SPSS version 15.0. The results demonstrate that the most common practice for providing feedback and documenting residents' surgical skills in the programs surveyed was daily one-on-one verbal feedback given by an instructor. The next two most commonly reported methods were a standard checklist developed at program level and a combination of a checklist and verbal comments. The majority of the programs reported that the instructors met collectively once per term to evaluate the residents' progress. The results suggest that graduate periodontics programs provide their residents frequent opportunities for daily practice with verbal feedback from instructors. However, assessment strategies identified in other health professions as beneficial in fostering the integration of clinical skills practices are not employed.

  7. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

    Directory of Open Access Journals (Sweden)

    Abdelazeem Eldawlatly

    2013-01-01

    Full Text Available Background: This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB in 2012. Methods: We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine "first choice" use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT, type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. Results: A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively. From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. Conclusions: We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20% and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  8. The adequacy of measures of gender roles attitudes: a review of current measures in omnibus surveys.

    Science.gov (United States)

    Walter, Jessica Gabriele

    2018-01-01

    The measures of attitudes toward gender roles included in many representative international and national omnibus surveys were developed mostly in the 1970s and 1980s with a focus on the male breadwinner model. This article deals with the issue of whether the measures provided in these omnibus surveys need to be adjusted to specific social changes. A review of these measures has found that adjustments have occurred in a limited way that focused on the role of women and disregarded the role of men. Furthermore, most of these measures only examined the traditional roles of men and women. More egalitarian role models have not been considered sufficiently. In addition, most items that have been measured are phrased in a general form and, for example, do not specify parents' employment or the ages of children. A specification of these aspects of measurement would help to clarify the conceptual meaning of the results and increase the possibility of more accurately analyzing gender role attitudes over time.

  9. Library instruction in medical education: a survey of current practices in the United States and Canada.

    Science.gov (United States)

    Nevius, Amanda M; Ettien, A'Llyn; Link, Alissa P; Sobel, Laura Y

    2018-01-01

    The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians' provision of instruction in multiple formats on multiple topics is increasingly common.

  10. Current trends in endodontic treatment by general dental practitioners: report of a United States national survey.

    Science.gov (United States)

    Savani, Gina M; Sabbah, Wael; Sedgley, Christine M; Whitten, Brian

    2014-05-01

    In the United States almost 70% of root canal treatment (RCT) is performed by general dentists (GPs), yet little is known about their treatment protocols. A paper survey was mailed to 2000 United States GPs with questions about the types of endodontic cases treated, routine treatment protocols, use of newer technologies, and endodontic continuing education (CE). Completed surveys were returned by 479 respondents (24%). GPs who perform RCT (84%) reported providing anterior (99%), bicuspid (95%), and molar (62%) RCT and retreatment (18%). Rubber dam was used always (60%), usually (16%), sometimes (13%), and never (11%). Newer technologies used by GPs included digital radiography (72%), magnification (80%), electronic apex locator (70%), and nickel-titanium rotary instrumentation (74%). Compared with GPs with >20 years of experience, those in practice for ≤10 years were more likely to use rubber dam (P 20 years were more likely to perform retreatments (P 5 hours of CE were more likely to use rotary instrumentation (P irrigant activation devices (P 20 years. More experienced GPs were more likely to take on complicated cases than those with fewer years of practice. There was no association between hours of CE and compliance with rubber dam usage. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  11. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists.

    Science.gov (United States)

    Eldawlatly, Abdelazeem; El-Tahan, Mohamed R

    2013-04-01

    This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB) in 2012. We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine first choice use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT), type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively). From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20%) and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  12. A national survey of current practices of preparation and management of radical prostate radiotherapy patients during treatment

    International Nuclear Information System (INIS)

    Nightingale, H.; Conroy, R.; Elliott, T.; Coyle, C.; Wylie, J.P.; Choudhury, A.

    2017-01-01

    Aims: Radiotherapy is an important radical treatment for prostate cancer patients with services continually evolving. This survey aims to gain an insight in to the variation of radiotherapy practices in the UK, focussing on pre-treatment preparations, on-treatment review and management of radical prostate cancer patients undergoing radiotherapy. To our knowledge this is the first survey reported focussing on prostate radiotherapy practices with responses from a mix of health professionals. Materials and methods: A national survey was designed based on current known practices in supportive care and management of prostate cancer patients. The survey was distributed to lead radiotherapy personnel in radiotherapy services across the UK with a 77% response rate (n = 54). Results: Pre-treatment protocols were mandated in the majority of departments. Use of bladder filling (98%) and bowel emptying (66%) were frequently deployed. Bowel preparation varied between use of laxatives (13%) or enemas (41%) to achieve consistency. On-treatment reviews were carried out by a mix of health professionals; most commonly shared between oncologists and radiographers (20%). Radiographers reviewing patients were independent prescribers in 22% of departments. Toxicity grading tools were not used by almost half of departments (47%) either at baseline and/or on-treatment reviews. Written information about follow-up was given to patients towards the end of their radiotherapy; however, fewer departments included the length of hormone duration (13%). Conclusion: This survey has demonstrated variations in practice exist across the UK. These variations suggest that important questions about the best methods for treatment accuracy and patient management need to be established through further research. - Highlights: • Results of a national survey demonstrate wide variations in UK practice. • Lack of a clear evidence base could be a contributing factor to such variation. • Practices are

  13. [Survey on the current situation of the young neurologists in Spain: analysis of their current working stability and degree of social protection].

    Science.gov (United States)

    Arenillas, J F; Cisteré, V; Bonaventura, I; Coll-Cantí, J; Luquin, M R; Martínez-Vila, E

    2006-03-01

    The aims of this study were to evaluate the working stability and degree of social protection of the Spanish young neurologists, and to know their opinion about their own situation. The 343 neurologists that became specialists in Spain between 2000 and 2004 were asked to participate in two consecutive surveys. The first, conducted online, included questions about the availability to change the place of work and the opinion about the situation of young neurologists, and obtained 66 answers. The second was a telephonic and online survey, answered by 217 neurologists, whose questions referred to: places of neurological education and work, type of working contract, and degree of social protection (estimated by the percentage of worked time during which they paid Social Security contributions). Sixty-three per cent (136/217) of the Spanish young neurologists had an unstable job. The most frequent unstable working contracts were: eventual (n=65; 31%), on-call contracts (n=54; 25%) and grants (n=53; 24%). Forty-eight per cent of the neurologists who ended their specialization in 2000 still remained working-unstable. The mean percentage of worked time with full social protection was 71.01+/-36.74%. Less than a half (n=101; 46%) had social protection during the entire worked time, 60 (28.6%) were socially protected during protection. A direct relationship was observed 68 between working instability and lower social protection (p=0.0002). The working situation of the Spanish young neurologists was seen as problematic by 97% of the 66 participants in the first survey. The current situation of the Spanish young neurologists, attending their working stability and degree of social protection, seems precarious and problematic. Urgent actions should be taken by the Administration to improve it.

  14. Current Evaluation of Upper Oesophageal Sphincter Opening in Dysphagia Practice: An International SLT Survey

    Science.gov (United States)

    Regan, Julie; Walshe, Margaret; McMahon, Barry P.

    2012-01-01

    Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. Aims: To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS…

  15. Surveys of current status in biomedical science grant review: funding organisations' and grant reviewers' perspectives

    DEFF Research Database (Denmark)

    Schroter, Sara; Groves, Trish; Højgaard, Liselotte

    2010-01-01

    The objectives of this research were (a) to describe the current status of grant review for biomedical projects and programmes from the perspectives of international funding organisations and grant reviewers, and (b) to explore funders' interest in developing uniform requirements for grant review...

  16. Determination of Death and the Dead Donor Rule: A Survey of the Current Law on Brain Death

    Science.gov (United States)

    Nikas, Nikolas T.; Bordlee, Dorinda C.; Moreira, Madeline

    2016-01-01

    Despite seeming uniformity in the law, end-of-life controversies have highlighted variations among state brain death laws and their interpretation by courts. This article provides a survey of the current legal landscape regarding brain death in the United States, for the purpose of assisting professionals who seek to formulate or assess proposals for changes in current law and hospital policy. As we note, the public is increasingly wary of the role of organ transplantation in determinations of death, and of the variability of brain death diagnosing criteria. We urge that any attempt to alter current state statutes or to adopt a national standard must balance the need for medical accuracy with sound ethical principles which reject the utilitarian use of human beings and are consistent with the dignity of the human person. Only in this way can public trust be rebuilt. PMID:27097648

  17. Fellowship training in radiation oncology: an Australian survey of current teaching and perceived needs

    International Nuclear Information System (INIS)

    Izard, M.A.; Berry, M.P.; Bosch, C.

    1994-01-01

    Thirty Australian and New Zealand Radiation Oncology registrars, who were preparing for their final qualifying examinations, were surveyed about their attitudes to their training programmes. While two (7%) indicated that they had no structured tuition whatsoever, the majority 19 (63%) received on average 1-2h per week, which was much less than their perceived need. Other areas of training considered deficient included exposure to curriculum requirements, peer support and access to other hospital specialty meetings. When asked about the concept of job rotation between training centres, 23 (77%) considered it to be potentially advantageous, with a majority preferring one such rotation of 6-12 months duration occurring in their third year, with a return to their base unit prior to final qualifying examinations. Limitations and potential benefits of the job rotation concept are discussed. 12 refs., 3 tabs., 3 figs

  18. Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey.

    Science.gov (United States)

    Kattan, Abdullah E; AlShomer, Feras; Alhujayri, Abdulaziz K; Addar, Abdullah; Aljerian, Albaraa

    2016-01-01

    Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender ( r  = 0.87, P  first aid. Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.

  19. Household food security in Isfahan based on current population survey adapted questionnaire

    Directory of Open Access Journals (Sweden)

    Morteza Rafiei

    2013-01-01

    Full Text Available Background: Food security is a state in which all people at every time have physical and economic access to adequate food to obviate nutritional needs and live a healthy and active life. Therefore, this study was performed to quantitatively evaluate the household food security in Esfahan using the localized version of US Household Food Security Survey Module (US HFSSM. Methods: This descriptive cross-sectional study was performed in year 2006 on 3000 households of Esfahan. The study instrument used in this work is 18-item US food security module, which is developed into a localized 15-item questionnaire. This study is performed in two stages of families with no children (under 18 years old and families with children over 18 years old. Results: The results showed that item severity coefficient, ratio of responses given by households and item infit and outfit coefficient in adult′s and children′s questionnaire respectively. According to obtained data, scale score of +3 in adults group is described as determination limit of slight food insecurity and +6 is stated as the limit for severe food insecurity. For children′s group, scale score of +2 is defined to be the limit of slight food insecurity and +5 is the determination limit of severe food insecurity. Conclusions: The main hypothesis of this survey analysis is based on the raw scale score of USFSSM The item of "lack of enough money for buying food" (item 2 and the item of "lack of balanced meal" (3 rd item have the lowest severity coefficient. Then, the ascending rate of item severity continues in first item, 4 th item and keeps increasing into 10 th item.

  20. A survey of electron Bernstein wave heating and current drive potential for spherical tokamaks

    Czech Academy of Sciences Publication Activity Database

    Urban, Jakub; Decker, J.; Peysson, Y.; Preinhaelter, Josef; Shevchenko, V.; Taylor, G.; Vahala, L.; Vahala, G.

    2011-01-01

    Roč. 51, č. 8 (2011), 083050-083050 ISSN 0029-5515 R&D Projects: GA ČR GA202/08/0419; GA MŠk 7G10072 Institutional research plan: CEZ:AV0Z20430508 Keywords : spherical tokamak * electron Bernstein wave (EBW) * heating * current drive * electron cyclotron wave Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 4.090, year: 2011 http://iopscience.iop.org/0029-5515/51/8/083050/pdf/0029-5515_51_8_083050.pdf

  1. Current Uses (and Potential Misuses) of Facebook: An Online Survey in Physiotherapy.

    Science.gov (United States)

    Laliberté, Maude; Beaulieu-Poulin, Camille; Campeau Larrivée, Alexandre; Charbonneau, Maude; Samson, Émilie; Ehrmann Feldman, Debbie

    2016-01-01

    In recent years, the use of social media such as Facebook has become extremely popular and widespread in our society. Among users are health care professionals, who must develop ways to extend their professionalism online. Before issuing formal guidelines, policies, or recommendations to guide online behaviours, there is a need to know to what extent Facebook influences the professional life of physiotherapy professionals. Our goal was to explore knowledge and behaviour that physiotherapists and physical rehabilitation therapists practicing in Quebec have of Facebook. We used an empirical cross-sectional online survey design (n=322, response rate 4.5%). The results showed that 84.3% of physiotherapy professionals had a Facebook account. Almost all had colleagues or former colleagues as Facebook friends, 21% had patients as friends, and 27% had employers as friends. More than a third of workplaces had clinic pages with information intended for the public. Regarding workplace Facebook policies, 37.3% said that there was no policy and another 41.6% were not aware whether there was one or not. There appears to be a need to establish guidelines regarding the use of social media for physiotherapy professionals to ensure maintenance of professionalism and ethical conduct.

  2. Tobacco point-of-sale displays in England: a snapshot survey of current practices.

    Science.gov (United States)

    Rooke, Catriona; Cheeseman, Hazel; Dockrell, Martin; Millward, Deborah; Sandford, Amanda

    2010-08-01

    Tobacco displays at the point of sale (PoS) are an important means for the tobacco industry to communicate with consumers. With regulations prohibiting PoS displays recently having come into force in Ireland, passed into law in England, Wales and Northern Ireland and some Australian states, and being considered in New Zealand, Finland and Brazil, this is an increasingly important issue. This study explores the nature of displays, the extent to which they are tobacco industry funded, and the relation between the tobacco companies and retailers. Three areas were chosen to gain a snapshot of PoS displays in England. Over 100 retailers were visited, with interviews taking place on site. Information was gathered on the type and size of tobacco display, who was paying for the display, requirements and incentives, and visits by industry representatives. The majority of retailers had gantries provided by tobacco companies. A minority of these were fitted with automated dispensers called retail vending machines. Attractive lighting and colour were often used to highlight particular products. Most retailers were being visited by industry representatives who checked displays. Some retailers also reported incentives offered to them for displaying products. The results suggest that the tobacco industry presence and control in the retail environment is significant. Tobacco companies overwhelmingly provided tobacco gantries in the shops surveyed and influenced displays through a combination of requirements and incentives. The extensive involvement of tobacco companies in providing and monitoring retail displays suggests the importance of implementing policies to end this form of advertising.

  3. Current status of rodenticide intoxication in Brazil: a preliminary survey from 2009 to 2011

    Directory of Open Access Journals (Sweden)

    Solange Papini

    2014-10-01

    Full Text Available The chemical control of rodents with anticoagulant products, especially derivatives of the coumarin chemical group, is legally authorised in Brazil. These products provide effective control and are safe for humans. However, the use of illegal 'rodenticides' has increased in many Brazilian cities recently, accompanied by increased numbers of suicides, homicides, and intoxications. The National Toxicology Information System (Sinitox registers the number of rodenticide intoxications, including suicides, but does not differentiate between the legal and illegal rodenticides. Intoxications by rodenticides outnumber those by illicit drugs and pesticides. A survey of data from 2005-2011 revealed an average of about 3,800 intoxications per year, about 60% of which were suicides. Many of these intoxications probably involved illegal rodenticides, some with unknown chemical compositions, which confound the data on rodenticide intoxication. This evaluation of Sinitox data highlighted the need to ensure the proper use of the term 'rodenticide' when registering intoxication cases. Intoxication by-products that are not rodenticides, but are erroneously used for this purpose, should be classified separately to improve the quality of information.

  4. Antismoking messages and current cigarette smoking status in Somaliland: results from the Global Youth Tobacco Survey 2004

    Directory of Open Access Journals (Sweden)

    Muula Adamson S

    2008-05-01

    Full Text Available Abstract Background Tobacco is a leading cause of death globally. There are limited reports on current cigarette smoking prevalence and its associated-antismoking messages among adolescents in conflict zones of the world. We, therefore, conducted secondary analysis of data to estimate the prevalence of current cigarette smoking, and to determine associations of antismoking messages with smoking status. Methods We used data from the Somaliland Global Youth Tobacco Survey (GYTS of 2004 to estimate the prevalence of smoking. We also assessed whether being exposed to anti-smoking media, education and having discussed with family members on the harmful effects of smoking were associated with smoking. Logistic regression analysis was used to assess these associations. Current smoking was defined as having reported smoking cigarettes, even a single puff, in the last 30 days preceding the survey (main outcome. Results Altogether 1563 adolescents participated in the survey. However, 1122 had data on the main outcome. Altogether, 15.8% of the respondents reported having smoked cigarettes (10.3% among males, and 11.1% among females. Factors that were associated with reported non-smoking were: discussing harmful effects of smoking cigarettes with their family members (OR = 0.61, 95% CI 0.52, 0.71; being taught that smoking makes teeth yellow, causes wrinkles and smokers smell badly (OR = 0.62, 95% CI 0.52, 0.74; being taught that people of the respondent's age do not smoke (OR = 0.81, 95% CI 0.69, 0.95; and having reported that religious organizations discouraged young people smoking (OR = 0.70, 95% CI 0.60, 0.82. However, exposure to a lot many antismoking messages at social gatherings was associated with smoking. Exposure to antismoking print media was not associated with smoking status. Conclusion A combination of school and home based antismoking interventions may be effective in controlling adolescent smoking in Somaliland.

  5. [Survey of current situation of schistosomiasis health education in Wuxi City].

    Science.gov (United States)

    Meng, Xiao-jun; Gao, Dong-lin; Zhang, Xuan; Lu, Bing

    2015-04-01

    To understand the current situation of schistosomiasis health education in in Wuxi City where schistosomiasis transmission has been interrupted, so as to provide the evidence for formulating the health education strategies. Face to face interviews and a professional designed questionnaire were used to collect the information of the current schistosomiasis health education and investigate the awareness of schistosomiasis knowledge in primary and middle schools and in communities. The total awareness rate of schistosomiasis knowledge was 87.7% among 873 students and the figure was 83.0% among 693 community residents. The students who studied in the schools with more than 1 class hour of schistosomiasis health education, completed schistosomiasis health education material or teaching plan, and implementing health education through multiple ways had higher knowledge awareness rates compared with the schools without (χ2 = 291.408, 709.622, 13.751, all P <0.001). The residents living in the communities with schistosomiasis health education through broadcast/TV or square propaganda had a higher knowledge awareness rate compared with the communities without (χ2= 90.772, 47.436, all P < 0.001). The awareness rates of schistosomiasis knowledge among both students and community residents in Wuxi City are low. Therefore, the schistosomiasis control health education should be strengthened.

  6. A survey of electron Bernstein wave heating and current drive potential for spherical tokamaks

    Science.gov (United States)

    Urban, Jakub; Decker, Joan; Peysson, Yves; Preinhaelter, Josef; Shevchenko, Vladimir; Taylor, Gary; Vahala, Linda; Vahala, George

    2011-08-01

    The electron Bernstein wave (EBW) is typically the only wave in the electron cyclotron (EC) range that can be applied in spherical tokamaks for heating and current drive (H&CD). Spherical tokamaks (STs) operate generally in high-β regimes, in which the usual EC O- and X-modes are cut off. In this case, EBWs seem to be the only option that can provide features similar to the EC waves—controllable localized H&CD that can be used for core plasma heating as well as for accurate plasma stabilization. The EBW is a quasi-electrostatic wave that can be excited by mode conversion from a suitably launched O- or X-mode; its propagation further inside the plasma is strongly influenced by the plasma parameters. These rather awkward properties make its application somewhat more difficult. In this paper we perform an extensive numerical study of EBW H&CD performance in four typical ST plasmas (NSTX L- and H-mode, MAST Upgrade, NHTX). Coupled ray-tracing (AMR) and Fokker-Planck (LUKE) codes are employed to simulate EBWs of varying frequencies and launch conditions, which are the fundamental EBW parameters that can be chosen and controlled. Our results indicate that an efficient and universal EBW H&CD system is indeed viable. In particular, power can be deposited and current reasonably efficiently driven across the whole plasma radius. Such a system could be controlled by a suitably chosen launching antenna vertical position and would also be sufficiently robust.

  7. National survey on the current status of salvage radiotherapy on holidays by the JASTRO committee for future scope

    International Nuclear Information System (INIS)

    Nagata, Yasushi; Ashino, Yasuo

    2002-01-01

    Recently, the impact of the overall treatment time on local tumor control has been reported by several authors. However, we in Japan have a long radiotherapy break because of the two large national holiday seasons in April-May and December-January. Therefore, a national survey on the current status of salvage radiotherapy on holidays was performed in 2001. Fifty-three % of the all institutes performed salvage radiotherapy on holidays. However, there are several problems to be solved, and a national consensus and an authorized proposal by the JASTRO are waited. (author)

  8. A national survey on current practice of preanaesthetic assessment in elective surgery patients in Spain.

    Science.gov (United States)

    Mata, J; Cabrera, S; Valldeperas, M I; Fernández, S; Aguilar, J L; Atanassoff, P G

    2012-01-01

    To analyse the preanaesthetic assessment prior to elective surgery in hospitals of the Spanish National Health Care System. A prospective cross-sectional descriptive observational survey was performed. Primary variables were patient characteristics, type of preanaesthetic evaluation and the evaluator, as well as type of support the evaluator received during patient assessment. Secondary variables included the number of operating rooms available for elective surgery, as well as preanaesthesia clinic facilities. Data were analysed by univariate and bivariate descriptive analysis. A total of 214 hospitals of the Spanish Health Care System were invited to participate, and 203 centres responded, with all of them having a preanaesthesia assessment clinic. In 183 of them (90%), elective surgerypatients were interviewed prior to their surgical intervention, and in 202 hospitals (99.5%) a anaesthesiologist physician performed the interview. In 128 hospitals (63%), anaesthesiologists were helped during preoperative assessment by nurses alone (49%) or together with auxillary nurses (14%). In 68 of hospitals (33%) they were supported only by auxillary nurses and in 7 hospitals (3%) they obtained no help at all. In 14 centres (7%) anaesthesia nurses assessed patients directly (under supervision of an anaesthesiologist physician). Hospitals with a higher volume of patients performed more preanaesthesia interviews. Hospitals with more running operating rooms received more nurse support in the preanaesthesia assessment clinic. Some kind of preanaesthesia assessment clinic exists in all Anaesthesia Departments of public Spanish hospitals, although there are differences in design and organisation. Copyright © 2011 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  9. Report on the Biodigester User Survey 2008

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, U.W.; Jordan, A.

    2008-07-15

    Since April 2006, the Ministry of Agriculture, Forestry and Fisheries of the Kingdom of Cambodia (MAFF) and The Netherlands Development Organisation (SNV) are cooperating in the implementation of a National Biodigester Programme (NBP), the overall objective of which is 'the dissemination of domestic biodigesters as an indigenous, sustainable energy source through the development of a commercial, market oriented, biodigester sector in selected provinces of Cambodia'. In order to assess the socio-economic structure of beneficiary households, and reception, acceptance and impact of biodigesters, the Programme, which is currently operational in seven provinces, commissioned a Biodigester User Survey (BUS). The survey was carried out in March 2008 (including enumerator training, field testing and data entry), and data processing and reporting took place in April 2008.

  10. A survey of the current status of web-based databases indexing Iranian journals.

    Science.gov (United States)

    Merat, Shahin; Khatibzadeh, Shahab; Mesgarpour, Bita; Malekzadeh, Reza

    2009-05-01

    The scientific output of Iran is increasing rapidly during the recent years. Unfortunately, most papers are published in journals which are not indexed by popular indexing systems and many of them are in Persian without English translation. This makes the results of Iranian scientific research unavailable to other researchers, including Iranians. The aim of this study was to evaluate the quality of current web-based databases indexing scientific articles published in Iran. We identified web-based databases which indexed scientific journals published in Iran using popular search engines. The sites were then subjected to a series of tests to evaluate their coverage, search capabilities, stability, accuracy of information, consistency, accessibility, ease of use, and other features. Results were compared with each other to identify strengths and shortcomings of each site. Five web sites were indentified. None had a complete coverage on scientific Iranian journals. The search capabilities were less than optimal in most sites. English translations of research titles, author names, keywords, and abstracts of Persian-language articles did not follow standards. Some sites did not cover abstracts. Numerous typing errors make searches ineffective and citation indexing unreliable. None of the currently available indexing sites are capable of presenting Iranian research to the international scientific community. The government should intervene by enforcing policies designed to facilitate indexing through a systematic approach. The policies should address Iranian journals, authors, and indexing sites. Iranian journals should be required to provide their indexing data, including references, electronically; authors should provide correct indexing information to journals; and indexing sites should improve their software to meet standards set by the government.

  11. Survey on paediatric tumour boards in Europe: current situation and results from the ExPo-r-Net project.

    Science.gov (United States)

    Juan Ribelles, A; Berlanga, P; Schreier, G; Nitzlnader, M; Brunmair, B; Castel, V; Essiaf, S; Cañete, A; Ladenstein, R

    2018-01-08

    Under the ExPO-r-NeT project (European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment), we aimed to identify paediatric oncology tumour boards in Europe to investigate the kind of technologies and logistics that are in place in different countries and to explore current differences between regions. A 20-question survey regarding several features of tumor boards was designed. Data collected included infrastructure, organization, and clinical decision-making information from the centres. The survey was distributed to the National Paediatric Haematology and Oncology Societies that forwarded the survey to the sites. For comparative analysis, respondents were grouped into four geographical regions. The questionnaire was distributed amongst 30 countries. Response was obtained from 23 (77%) that altogether have 212 paediatric oncology treating centres. A total of 121 institutions answered (57%). Ninety-one percent of the centres hold multidisciplinary boards; however, international second consultations are performed in 36% and only 15% participate on virtual tumor boards. Videoconferencing facilities and standard operational procedures (SOPs) are available in 49 and 43% of the centres, respectively. There were statistically significant differences between European regions concerning meeting infrastructure and organization/logistics: specific room, projecting equipment, access to medical records, videoconferencing facilities, and existence of SOPs. Paediatric tumor boards are a common feature in Europe. To reduce inequalities and have equal access to healthcare, a virtual network is needed. Important differences on the functioning and access to technology between regions in Europe have been observed and need to be addressed.

  12. Study and Redefining Beneficiary Participation in Process Of House Design

    Directory of Open Access Journals (Sweden)

    Monshizadeh Morteza

    2016-01-01

    Full Text Available Since housing has a special place in human life and his physical, psychological and interactions, so in addition the unity of humans, multiplicity and diversity of them must be considered. This possible only by beneficiary participation in the design process, but because society has different economic and social texture and classes; and settling suit because of the time and place of special indexes are entitled, so prepare a comprehensive model includes the testimony and circumstances; identify factors influencing participation optimum need to selection population and certain species of private construction. Standard tool to study topic does not exist, so in order to produce tools using qualitative research methods; interpretation - historical correlation to extract components and variables and their effects on each other and enjoyed target table Content consisting of four domains of general knowledge - specialized knowledge of participation - participation mechanisms and factors influencing participation achieved. Extracted factors are: the initial formation of partnership - partnership executive process - the role of participant - optimal participation; by study and analyze the theoretical model. Due to history and social aspects; cultural participation in Shiraz; promote scientific and participatory approach designed to make operating housing; bed and new horizons of development of facilities and areas in the design of residential environment created and due consultation and decision making in addition to beneficiary participation to promote optimum utility of space; mutual flexibility and utilization of space; increase fixation and motivation will lead beneficiary reside” and the main question: “how is the model of scientific position optimal participation planning instrument in private housing in the city of Shiraz, in the process of design, implementation and use”.

  13. Current status of sperm banking for young cancer patients in Japanese nationwide survey.

    Science.gov (United States)

    Yumura, Yasushi; Tsujimura, Akira; Okada, Hiroshi; Ota, Kuniaki; Kitazawa, Masahumi; Suzuki, Tatsuya; Kakinuma, Tosiyuki; Takae, Seido; Suzuki, Nao; Iwamoto, Teruaki

    2018-02-02

    This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questionnaires requesting information on the number of patients, age, precryopreservation chemotherapy, semen analyses results and diagnoses, cryopreservation success rate, and causes of unsuccessful cryopreservation. Of these 695 institutes, 92 had cryopreserved sperm before chemotherapy within the study period. In all, 820 cancer patients (237 testicular, 383 hematological, 46 bone and soft tissue, 20 brain, and 134 other malignancy) consulted the responding institutes for sperm cryopreservation. Except for testicular tumor, the number of patients whose sperm was preserved before cancer treatment was low compared to that of young cancer patients. Approximately 20% of patients with malignancies other than testicular tumor underwent chemotherapy before cryopreservation. The success rate of cryopreservation in hematological malignancy was 82.5%, significantly lower than that of both the testicular cancer (93.6%) and other malignancy groups (95.6%) (P < 0.05). The primary reasons for preservation failure were azoospermia and poor semen quality. Patients with hematological malignancies had a higher rate of unsuccessful cryopreservation compared to those in other groups, possibly due to the large number of patients requesting sperm cryopreservation after chemotherapy induction. In Japan, information regarding sperm banking prior to cancer treatment appears to be lacking. Information regarding sperm preservation before chemotherapy should be provided to all Japanese oncologists.

  14. Economic burden of hospitalizations of Medicare beneficiaries with heart failure

    Directory of Open Access Journals (Sweden)

    Kilgore M

    2017-05-01

    Full Text Available Meredith Kilgore,1 Harshali K Patel,2 Adrian Kielhorn,2 Juan F Maya,2 Pradeep Sharma1 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 2Amgen, Inc., Thousand Oaks, CA, USA Objective: The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF.Methods: This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011. The primary end point was the average per-patient cost of hospitalization for individuals with HF. Secondary end points included the cumulative rate of hospitalization, the average length of hospital stay, and the cumulative 30-, 60-, and 90-day readmission rates.Results: Data from 63,678 patients with a mean age of 81.8 years were included in the analysis. All costs were inflated to $2,015 based on the medical care component of the Consumer Price Index. The mean per-patient cost of an HF-related hospitalization was $14,631. The mean per-patient cost of a cardiovascular (CV-related or all-cause hospitalization was $16,000 and $15,924, respectively. The cumulative rate of all-cause hospitalization was 218.8 admissions per 100 person-years, and the median length of stay for HF-related, CV-related, and all-cause hospitalizations was 5 days. Also, 22.3% of patients were readmitted within 30 days, 33.3% were readmitted within 60 days, and 40.2% were readmitted within 90 days.Conclusion: The costs associated with hospitalization for Medicare beneficiaries with HF are substantial and are compounded by a high rate of readmission. Keywords: heart failure, Medicare, health economics, hospitalization, costs

  15. Current status of core and advanced adult gastrointestinal endoscopy training in Canada: Survey of existing accredited programs.

    Science.gov (United States)

    Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

    2013-01-01

    To determine the current status of core and advanced adult gastroenterology training in Canada. A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed. All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery. Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula.

  16. Current opinion on clip placement after breast biopsy: A survey of practising radiologists in France and Quebec

    International Nuclear Information System (INIS)

    Thomassin-Naggara, I.; Jalaguier-Coudray, A.; Chopier, J.; Tardivon, A.; Trop, I.

    2013-01-01

    Aim: To investigate current practice regarding clip placement after breast biopsy. Materials and methods: In June 2011, an online survey instrument was designed using an Internet-based survey site ( (www.surveymonkey.com)) to assess practices and opinions of breast radiologists regarding clip placement after breast biopsy. Radiologists were asked to give personal practice data, describe their current practice regarding clip deployment under stereotactic, ultrasonographic, and magnetic resonance imaging (MRI) guidance, and describe what steps are taken to ensure quality control with regards to clip deployment. Results: The response rate was 29.9% in France (131 respondents) and 46.7% in Quebec (50 respondents). The great majority of respondents used breast markers in their practice (92.1% in France and 96% in Quebec). In both countries, most reported deploying a clip after percutaneous biopsy under stereotactic or MRI guidance. Regarding clip deployment under ultrasonography, 38% of Quebec radiologists systematically placed a marker after each biopsy, whereas 30% of French radiologists never placed a marker in this situation, mainly due to its cost. Finally, 56.4% of radiologists in France and 54% in Quebec considered that their practice regarding clip deployment after breast percutaneous biopsy had changed in the last 5 years. Conclusion: There continues to be variations in the use of biopsy clips after imaging-guided biopsies, particularly with regards to sonographic techniques. These variations are likely to decrease over time, with the standardization of relatively new investigation protocols

  17. Current status of portal vein thrombosis in Japan: Results of a questionnaire survey by the Japan Society for Portal Hypertension.

    Science.gov (United States)

    Kojima, Seiichiro; Watanabe, Norihito; Koizumi, Jun; Kokubu, Shigehiro; Murashima, Naoya; Matsutani, Shoichi; Obara, Katsutoshi

    2018-03-01

    To investigate the current status of portal vein thrombosis (PVT) in Japan, the Clinical Research Committee of the Japan Society of Portal Hypertension undertook a questionnaire survey. A questionnaire survey of 539 cases of PVT over the previous 10 years was carried out at institutions affiliated with the Board of Trustees of the Japan Society of Portal Hypertension. The most frequent underlying etiology of PVT was liver cirrhosis in 75.3% of patients. Other causes included inflammatory diseases of the hepatobiliary system and the pancreas, malignant tumors, and hematologic diseases. The most frequent site was the main trunk of the portal vein (MPV) in 70.5%, and complete obstruction of the MPV was present in 11.5%. Among the medications for PVT, danaparoid was given to 45.8%, warfarin to 26.2%, heparin to 17.3%, and anti-thrombin III to 16.9%. Observation of the course was practiced in 22.4%. Factors contributing to therapeutic efficacy were implementation of various medications, thrombi localized to either the right or left portal vein only, non-complete obstruction of the MPV and Child-Pugh class A liver function. A survival analysis showed that the prognosis was favorable with PVT disappearance regardless of treatment. The questionnaire survey showed the current status of PVT in Japan. Any appropriate medication should be given to a patient with PVT when PVT is recognized. It is necessary to compile a large amount of information and reach a consensus on safe and highly effective management of PVT. © 2017 The Japan Society of Hepatology.

  18. Tracheal cuff pressure monitoring in the ICU: a literature review and survey of current practice in Queensland.

    Science.gov (United States)

    Talekar, C R; Udy, A A; Boots, R J; Lipman, J; Cook, D

    2014-11-01

    The application of tracheal cuff pressure monitoring is likely to vary between institutions. The aim of this study was therefore to review current evidence concerning this intervention in the intensive care unit (ICU) and to appraise regional practice by performing a state-wide survey. Publications for review were identified through searches of PubMed, EMBASE and Cochrane (1977 to 2014). All studies in English relevant to critical care and with complete data were included. Survey questions were developed by small-group consensus. Public and private ICUs across Queensland were contacted, with responses obtained from a representative member of the medical or nursing staff. Existing literature suggests significant variability in tracheal cuff pressure monitoring in the ICU, particularly in the applied technique, frequency of assessment and optimal intra-cuff pressures. Twenty-nine respondents completed the survey, representing 80.5% (29/36) of ICUs in Queensland. Twenty-eight out of twenty-nine respondents reported routinely monitoring tracheal cuff function, primarily employing cuff pressure measurement (26/28). Target cuff pressures varied, with 3/26 respondents aiming for 10 to 20 cmH2O, 10/26 for 21 to 25 cmH2O, and 13/26 for 26 to 30 cmH2O. Fifteen out of twenty-nine reported they had no current guideline or protocol for tracheal cuff management and only 16/29 indicated there was a dedicated area in the clinical record for reporting cuff intervention. Our results indicate that many ICUs across Queensland routinely measure tracheal cuff function, with most utilising pressure monitoring devices. Consistent with existing literature, the optimum cuff pressure remains uncertain. Most, however, considered that this should be a routine part of ICU care.

  19. Antenatal screening for aneuploidy--surveying the current situation and planning for non-invasive prenatal diagnosis in New Zealand.

    Science.gov (United States)

    Eastwood, Ashley; Webster, Dianne; Taylor, Juliet; Mckay, Richard; McEwen, Alison; Sullivan, Jan; Pope-Couston, Rachel; Stone, Peter

    2016-01-29

    To gauge clinical opinion about the current system and possible changes as well as providing a forum for education about Non-Invasive Prenatal Testing (NIPT). A series of workshops for doctors and midwives, supported by the National Screening Unit of the Ministry of Health and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, were held in the main centres of New Zealand. Following a brief education session, a structured evaluation of current screening and future possibilities was undertaken by questionnaire. One hundred and eight maternity carers participated in 5 workshops. Over 40% identified barriers to current screening. More than 60% would support NIPT in the first trimester. The majority of carers provided their own counselling support for women. The survey has shown general enthusiasm for the introduction of publically funded NIPT into prenatal screening in New Zealand. Barriers to utilisation of the current system have been identified and enhancements to screening performance with guidelines around conditions to be screened for would be supported.

  20. Current Hormonal Contraceptive Use Predicts Female Extra-Pair and Dyadic Sexual Behavior: Evidence Based on Czech National Survey Data

    Directory of Open Access Journals (Sweden)

    Kateřina Klapilová

    2014-01-01

    Full Text Available Data from 1155 Czech women (493 using oral contraception, 662 non-users, obtained from the Czech National Survey of Sexual Behavior, were used to investigate evolutionary-based hypotheses concerning the predictive value of current oral contraceptive (OC use on extra-pair and dyadic (in-pair sexual behavior of coupled women. Specifically, the aim was to determine whether current OC use was associated with lower extra-pair and higher in-pair sexual interest and behavior, because OC use suppresses cyclical shifts in mating psychology that occur in normally cycling women. Zero-inflated Poisson (ZIP regression and negative binomial models were used to test associations between OC use and these sexual measures, controlling for other relevant predictors (e.g., age, parity, in-pair sexual satisfaction, relationship length. The overall incidence of having had an extra-pair partner or one-night stand in the previous year was not related to current OC use (the majority of the sample had not. However, among the women who had engaged in extra-pair sexual behavior, OC users had fewer one-night stands than non-users, and tended to have fewer partners, than non-users. OC users also had more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. These results suggest that suppression of fertility through OC use may alter important aspects of female sexual behavior, with potential implications for relationship functioning and stability.

  1. Current Status of Huntington’s Disease in Korea: A Nationwide Survey and National Registry Analysis

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    Hyun Sook Kim

    2015-01-01

    Full Text Available Objective Huntington’s disease (HD is a rare neurological disorder, and its current status in Korea is not well investigated. This study aims to determine the prevalence and incidence of HD and to investigate the clinical features of HD patients in Korea. Methods We estimated the crude prevalence and annual incidence of HD based on the databases of the Rare Diseases Registry (RDR and the National Health Insurance (NHI. The clinical data of genetically confirmed HD patients was collected from 10 referral hospitals and analyzed. Results The mean calculated annual incidence was 0.06 cases per 100,000 persons, and the mean calculated prevalence was 0.38 based on the NHI database. The estimated crude prevalence based on the RDR was 0.41. Of the sixty-eight HD patients recruited, the mean age of onset was 44.16 ± 14.08 years and chorea was most frequently reported as the initial symptom and chief complaint. The mean CAG repeat number of the expanded allele was 44.7 ± 4.8 and correlated inversely with the age of onset (p < 0.001. About two-thirds of the patients have a positive family history, and HD patients without positive family history showed a delay in onset of initial symptoms, a prolonged interval between initial symptom onset and genetic diagnosis and a delay in the age of genetic diagnosis. Conclusions To the best of our knowledge, this is the first study to estimate the prevalence and incidence of HD in Korea and the largest HD series in the Asian population. Our analyses might be useful for further studies and large-scale investigations in HD patients.

  2. A comparative study of mid-day meal beneficiaries and private school attendees

    Directory of Open Access Journals (Sweden)

    Madhavi Bhargava

    2014-12-01

    Full Text Available Background: India is undergoing a rapid demographic transition accompanied by an epidemiologic and nutritional transition. The nutritional status of school-going children who form a major section of the population, can give an indication of the changing trends in nutritional profile of the population. According to Planning Commission report, 2010, Mid Day Meal (MDM Program has been successful in addressing classroom hunger and the objective of social equity in government school attendees. Aims & Objectives: To study the pattern of school lunch intake and nutritional status in private and government school-going children of district Dehradun. Material & Methods: This was an observational cross-sectional study in district Dehradun in government and private schools, with participants from class 1 to 12. A 24-hour dietary recall was done to measure caloric intake. Height and weight were measured using Microtoise (accuracy 0.1cm and digital weighing machine (Omron Model: HN286, accuracy 100 gm. Statistical analysis was done using SPSS, version 22. Nutritional status was classified using WHO cut-offs and analyzed using AnthroPlus Software. Student t-test was used to compare caloric intake of subgroups. Association between nutritional status and other variables was assessed using Chi-squared test. Results: Using WHO cut-offs, the proportion of thin children was 5.4% in private school and 21.5% in MDM beneficiaries of government schools. The proportion of children who were overweight was 27.7% in private schools and 3.6% in government schools (p<.0.05. The caloric content of school lunch was 271 Kcal in private school attendees and 375 Kcal in MDM beneficiaries. Proportion of children who skipped school lunch increased as they progressed in higher classes, and this proportion was greater in students of government schools beyond class VIII. Conclusion: The study highlights the need for more large scale nutritional surveys with school lunch in focus.

  3. Current Management of Patients With Diverticulosis and Diverticular Disease: A Survey From the 2nd International Symposium on Diverticular Disease.

    Science.gov (United States)

    Tursi, Antonio; Picchio, Marcello; Elisei, Walter; Di Mario, Francesco; Scarpignato, Carmelo; Brandimarte, Giovanni

    2016-10-01

    Management of diverticular disease (DD) remains a point of debate. To investigate the current opinion of participants of the 2nd International Symposium on Diverticular Disease, on real-life management of patients with DD of the colon. Twelve questions were aimed at the diagnosis, treatment, and management options for diverticulosis and symptomatic DD. In total, 115 surveys from 8 European Countries were filled out. High fiber diet was widely prescribed in diverticulosis (59.1%). Probiotics (25%) were the most frequent prescribed drug, whereas 29.8% of participants did not prescribe any treatment in diverticulosis. Colonoscopy was frequently prescribed in symptomatic patients (69.3%), whereas 72.9% of participants did not prescribe any instrumental tool in their follow-up. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs both in symptomatic patients (28.1, 14.9%, and 11.4%, respectively) and to prevent recurrence of the disease (42.5%, 12.4%, and 28.2%, respectively). With respect to laboratory exams, 57.9% of participants prescribed them during follow-up. The majority of participants (64.9%) managed suspected acute diverticulitis at home. Rifaximin, probiotics, and mesalazine were the most frequent prescribed drugs to prevent recurrence of the disease (32.2%, 13.2%, and 11.4%, respectively), whereas 25.4% of participants did not prescribe any drugs. Finally, no differences were found among gastroenterologists, surgeons, and general practitioners in managing this disease. This surveys shows that current management of DD is similar between different medical specialities, generally in line with current literature.

  4. Impact of HIV Infection on Medicare Beneficiaries with Lung Cancer

    International Nuclear Information System (INIS)

    Lee, J. Y.; Moore, P. C.; Lensing, S. Y.

    2012-01-01

    The incidence of lung cancer among individuals infected with the human immunodeficiency virus (HIV) is elevated compared to that among the general population. This study examines the prevalence of HIV and its impact on outcomes among Medicare beneficiaries who are 65 years of age or older and were diagnosed with non small cell lung cancer (NSCLC) between 1997 and 2008. Prevalence of HIV was estimated using the Poisson point estimate and its 95% confidence interval. Relative risks for potential risk factors were estimated using the log-binomial model. A total of 111,219 Medicare beneficiaries met the study criteria. The prevalence of HIV was 156.4 per 100,000 (95% CI: 140.8 to 173.8) and has increased with time. Stage at NSCLC diagnosis did not vary by HIV status. Mortality rates due to all causes were 44%, 76%, and 88% for patients with stage I/II, III, and IV NSCLC, respectively. Across stages of disease, there was no difference between those who were HIV-infected and those who were not with respect to overall mortality. HIV patients, however, were more likely to die of causes other than lung cancer than their immunocompetent counterparts.

  5. Medication adherence and Medicare expenditure among beneficiaries with heart failure.

    Science.gov (United States)

    Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce

    2012-09-01

    To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.

  6. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    Directory of Open Access Journals (Sweden)

    Mondli S. Hlatshwayo

    2017-09-01

    Full Text Available Scholarship on the Expanded Public Works Programme (EPWP in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary sources, including in-depth interviews, newspaper reports and internet sources, this article seeks to provide a qualitative review of the EPWP from the perspective of the beneficiaries of municipal EPWP projects. Various South African government sectors hire EPWP workers to provide local services such as cleaning and maintaining infrastructure, but the employment of these workers can still be regarded as precarious, in the sense that they have no job security, earn low wages and have no benefits such as medical aid or pension fund. The interviewees indicated that, although they appreciate the temporary employment opportunities provided by the EPWP, they also experience health and safety risks and lack the advantages of organised labour groupings. Their main disadvantage, however, is that they cannot access permanent employment, which offers better wages and concomitant benefits.

  7. Offering lung cancer screening to high-risk medicare beneficiaries saves lives and is cost-effective: an actuarial analysis.

    Science.gov (United States)

    Pyenson, Bruce S; Henschke, Claudia I; Yankelevitz, David F; Yip, Rowena; Dec, Ellynne

    2014-08-01

    beneficiaries had been screened and treated consistently from age 55 years, approximately 358,134 additional individuals with current or past lung cancer would be alive in 2014. LDCT screening is a low-cost and cost-effective strategy that fits well within the standard Medicare benefit, including its claims payment and quality monitoring.

  8. Acoustic Doppler current profiler applications used in rivers and estuaries by the U.S. Geological Survey

    Science.gov (United States)

    Gotvald, Anthony J.; Oberg, Kevin A.

    2009-01-01

    The U.S. Geological Survey (USGS) has collected streamflow information for the Nation's streams since 1889. Streamflow information is used to predict floods, manage and allocate water resources, design engineering structures, compute water-quality loads, and operate water-control structures. The current (2007) size of the USGS streamgaging network is over 7,400 streamgages nationwide. The USGS has progressively improved the streamgaging program by incorporating new technologies and techniques that streamline data collection while increasing the quality of the streamflow data that are collected. The single greatest change in streamflow measurement technology during the last 100 years has been the development and application of high frequency acoustic instruments for measuring streamflow. One such instrument, the acoustic Doppler current profiler (ADCP), is rapidly replacing traditional mechanical current meters for streamflow measurement (Muste and others, 2007). For more information on how an ADCP works see Simpson (2001) or visit http://hydroacoustics.usgs.gov/. The USGS has used ADCPs attached to manned or tethered boats since the mid-1990s to measure streamflow in a wide variety of conditions (fig. 1). Recent analyses have shown that ADCP streamflow measurements can be made with similar or greater accuracy, efficiency, and resolution than measurements made using conventional current-meter methods (Oberg and Mueller, 2007). ADCPs also have the ability to measure streamflow in streams where traditional current-meter measurements previously were very difficult or costly to obtain, such as streams affected by backwater or tides. In addition to streamflow measurements, the USGS also uses ADCPs for other hydrologic measurements and applications, such as computing continuous records of streamflow for tidally or backwater affected streams, measuring velocity fields with high spatial and temporal resolution, and estimating suspended-sediment concentrations. An overview

  9. Inequity in access to dental care services explains current socioeconomic disparities in oral health: the Swedish National Surveys of Public Health 2004-2005.

    Science.gov (United States)

    Wamala, Sarah; Merlo, Juan; Boström, Gunnel

    2006-12-01

    To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index (SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Swedish population-based sample of 17 362 men and 20 037 women. Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7 (95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8 (95% CI 6.2 to 7.5). The corresponding values among women were 2.3 (95% CI 2.1 to 2.5) and 6.8 (95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7-9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden. Results call for urgent public health interventions to increase equitable access to dental care services.

  10. Current practices in clinical neurofeedback with functional MRI-Analysis of a survey using the TIDieR checklist.

    Science.gov (United States)

    Randell, Elizabeth; McNamara, Rachel; Subramanian, Leena; Hood, Kerenza; Linden, David

    2018-04-01

    A core principle of creating a scientific evidence base is that results can be replicated in independent experiments and in health intervention research. The TIDieR (Template for Intervention Description and Replication) checklist has been developed to aid in summarising key items needed when reporting clinical trials and other well designed evaluations of complex interventions in order that findings can be replicated or built on reliably. Neurofeedback (NF) using functional MRI (fMRI) is a multicomponent intervention that should be considered a complex intervention. The TIDieR checklist (with minor modification to increase applicability in this context) was distributed to NF researchers as a survey of current practice in the design and conduct of clinical studies. The aim was to document practice and convergence between research groups, highlighting areas for discussion and providing a basis for recommendations for harmonisation and standardisation. The TIDieR checklist was interpreted and expanded (21 questions) to make it applicable to neurofeedback research studies. Using the web-based Bristol Online Survey (BOS) tool, the revised checklist was disseminated to researchers in the BRAINTRAIN European research collaborative network (supported by the European Commission) and others in the fMRI-neurofeedback community. There were 16 responses to the survey. Responses were reported under eight main headings which covered the six domains of the TIDieR checklist: What, Why, When, How, Where and Who. This piece of work provides encouraging insight into the ability to be able to map neuroimaging interventions to a structured framework for reporting purposes. Regardless of the considerable variability of design components, all studies could be described in standard terms of diagnostic groups, dose/duration, targeted areas/signals, and psychological strategies and learning models. Recommendations are made which include providing detailed rationale of intervention design in

  11. 42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

  12. 26 CFR 1.501(c)(8)-1 - Fraternal beneficiary societies.

    Science.gov (United States)

    2010-04-01

    ... beneficiary societies. (a) A fraternal beneficiary society is exempt from tax only if operated under the lodge system or for the exclusive benefit of the members so operating. Operating under the lodge system means... parent organization and largely self-governing, called lodges, chapters, or the like. In order to be...

  13. 42 CFR 411.51 - Beneficiary's responsibility with respect to no-fault insurance.

    Science.gov (United States)

    2010-10-01

    ...-fault insurance. 411.51 Section 411.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PAYMENT Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.51 Beneficiary's responsibility with respect to no-fault insurance. (a) The beneficiary is...

  14. [Characteristics of beneficiaries of a GP-centred health care contract in Germany].

    Science.gov (United States)

    Freund, Tobias; Szecsenyi, Joachim; Ose, Dominik

    2010-11-01

    Since 2004, primary care in Germany has increasingly been provided in special general practitioner (GP)-centred health care contracts (HZV). To date there is limited evidence about the characteristics of their beneficiaries regarding morbidity burden and health care utilization. We analysed insurance claims data from all beneficiaries of the "Allgemeine Ortskrankenkasse (AOK) Baden-Württemberg" listed in 10 general practices that contracted in a special GP-centred health care contract (HZV). We compared beneficiaries enrolled in the HZV with those who were not enrolled in the contract. Comparisons included the number of hospital admissions in 2007-2008 and the Charlson comorbidity index. Insurance claims data of 6,026 beneficiaries were available for analysis. In the third quarter of 2009, 51% (3,066) of the beneficiaries were enrolled in the HZV. They were significantly older (mean 61 years [SD 18 years] vs. 49 years [SD 22 years]; p contract tended to be older and suffered from a higher morbidity burden when compared with beneficiaries of the same health care fund who were not enrolled in the contract. Besides, beneficiaries of the contract had higher numbers of hospital admissions during the two year period before enrolment. These findings have substantial implications for individualized care management approaches that may be offered to beneficiaries of GP-centred health care contracts.

  15. Developing standardised treatment for adults with myositis and different phenotypes: an international survey of current prescribing preferences.

    Science.gov (United States)

    Tansley, Sarah; Shaddick, Gavin; Christopher-Stine, Lisa; Sharp, Charlotte; Dourmishev, Lyubomir; Maurer, Britta; Chinoy, Hector; McHugh, Neil

    2016-01-01

    The evidence base for treatment of the idiopathic inflammatory myopathies is extremely limited. The rarity and heterogeneity of these diseases has hampered the development of good quality clinical trials and while a range of immunomodulatory treatments are commonly used in clinical practice, as yet there are no clear guidelines directing their use. We aimed to establish current prescribing regimens used to treat adults with myositis internationally. An electronic survey based on different clinical scenarios was distributed internationally to clinicians involved in the treatment of patients with myositis. Participants were asked to select their first-line treatment preferences in each situation. A multinomial regression analysis was used to assess the influence of clinical scenario, respondent expertise and country of origin on first-line treatment choice. 107 survey responses were received. 57% of respondents considered themselves an expert in myositis and the majority of respondents were rheumatologists although responses from other specialities were also received. Pharmacological treatment with steroids and additional immunotherapy was the preference in most scenarios. First-line immunosuppressant choice was significantly influenced by the clinical scenario, the expertise of the treating physician and country of practice. Azathioprine, methotrexate and mycophenolate mofetil were the most commonly chosen agents. In the absence of available evidence, clinical experience and expert consensus often forms the basis of treatment guidelines. These results suggest that an international consensus approach would be possible in myositis and would overcome an urgent, yet unmet need for patients suffering with this difficult disease.

  16. Lithium-air batteries: survey on the current status and perspectives towards automotive applications from a battery industry standpoint

    Energy Technology Data Exchange (ETDEWEB)

    Park, Myounggu; Sun, Heeyoung; Lee, Hyungbok; Lee, Junesoo [Battery R and D, SK Innovation, Wonchon-dong, Yuseong-gu, Daejeon (Korea, Republic of); Cho, Jaephil [Interdisciplinary School of Green Energy, Ulsan National Institute of Science and Technology (UNIST), Ulsan (Korea, Republic of)

    2012-07-15

    Li-air rechargeable batteries theoretically have advantages from both secondary batteries and fuel cells, which can be viewed as the best technological blends for automotive applications resolving the so called mileage anxiety problem due to the limited driving range of electrical vehicles based upon Li-ion batteries; this problem is rooted in the intrinsically small energy density of Li-ion batteries. This very scientific trait of Li-air batteries, which is apparently suited to the requirements of batteries for future electric vehicles, has induced quite a strong surge of research recently. This occurrence has motivated the authors to undertake a thorough review in an effort to understand the current status of Li-air battery related technologies. A comprehensive survey from a battery industry standpoint has been conducted on the fundamentals of chemistry, utilized Li-air cell configurations (or types) vs. performance, and major components comprising Li-air batteries using various sources of previously published peer-reviewed journal papers, book chapters, patents, and industrial reports. The survey results are presented here. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  17. Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

    Science.gov (United States)

    McGregor, Alison H

    2016-01-01

    Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

  18. The National Asthma Survey--New York State: association of the home environment with current asthma status.

    Science.gov (United States)

    Nguyen, Trang; Lurie, Melissa; Gomez, Marta; Reddy, Amanda; Pandya, Kruti; Medvesky, Michael

    2010-01-01

    The National Asthma Survey--New York State (NYS), a telephone survey of NYS residents, was conducted in 2002-2003 to further understand the burden of asthma among adults and children and to identify health, socioeconomic, behavioral, and environmental factors associated with asthma. A total of 1,412 households with at least one member with current asthma and 2,290 control households answered questions about their home environment (e.g., presence of asthma triggers and practices that promote or reduce common asthma triggers). RESULTS; For children younger than 18 years of age, we found statistically significant positive associations between current asthma and the presence of mold (adjusted odds ratio [AOR] = 2.1, 95% confidence interval [CI] 1.3, 3.3), air cleaners (AOR = 1.5, 95% CI 1.1, 2.1), dehumidifiers (AOR = 2.0, 95% CI 1.4, 2.7), and humidifiers (AOR = 1.6, 95% CI 1.1, 2.3). For adults, there were statistically significant positive associations with the presence of mold (AOR = 2.5, 95% CI 1.8, 3.4), air cleaners (AOR = 2.2, 95% CI 1.7, 2.8), and humidifiers (AOR = 1.4, 95% CI 1.1, 1.8). There were no statistically significant associations with the presence of cockroaches, pets, or tobacco smoke, while use of a wood-burning stove or fireplace was significantly more prevalent in control homes. Asthma guidelines emphasize the importance of reducing triggers in the home as part of a multifaceted approach to asthma control. Despite these guidelines, many asthma triggers (specifically, mold) were as prevalent or more so in the homes of New Yorkers with asthma as compared with control households. Public health interventions in NYS should focus on educating households about potential asthma triggers and their sources and teach methods to prevent, reduce, or eliminate them.

  19. Nuclear Medicine Technologists' Perception and Current Assessment of Quality: A Society of Nuclear Medicine and Molecular Imaging Technologist Section Survey.

    Science.gov (United States)

    Mann, April; Farrell, Mary Beth; Williams, Jessica; Basso, Danny

    2017-06-01

    In 2015, the Society of Nuclear Medicine and Molecular Imaging Technologist Section (SNMMI-TS) launched a multiyear quality initiative to help prepare the technologist workforce for an evidence-based health-care delivery system that focuses on quality. To best implement the quality strategy, the SNMMI-TS first surveyed technologists to ascertain their perception of quality and current measurement of quality indicators. Methods: An internet survey was sent to 27,989 e-mail contacts. Questions related to demographic data, perceptions of quality, quality measurement, and opinions on the minimum level of education are discussed in this article. Results: A total of 4,007 (14.3%) responses were received. When asked to list 3 words or phrases that represent quality, there were a plethora of different responses. The top 3 responses were image quality, quality control, and technologist education or competency. Surveying patient satisfaction was the most common quality measure (80.9%), followed by evaluation of image quality (78.2%). Evaluation of image quality (90.3%) and equipment functionality (89.4%) were considered the most effective measures. Technologists' differentiation between quality, quality improvement, quality control, quality assurance, and quality assessment seemed ambiguous. Respondents were confident in their ability to assess and improve quality at their workplace (91.9%) and agreed their colleagues were committed to delivering quality work. Of note, 70.7% of respondents believed that quality is directly related to the technologist's level of education. Correspondingly, respondents felt there should be a minimum level of education (99.5%) and that certification or registry should be required (74.4%). Most respondents (59.6%) felt that a Bachelor's degree should be the minimum level of education, followed by an Associate's degree (40.4%). Conclusion: To best help nuclear medicine technologists provide quality care, the SNMMI-TS queried technologists to

  20. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    International Nuclear Information System (INIS)

    McMahon, Michelle A.; Fenwick, Alison; Banks, Amelia; Dineen, Robert A.

    2009-01-01

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  1. He said, she said: The gender wage gap according to self and proxy reports in the Current Population Survey.

    Science.gov (United States)

    Reynolds, Jeremy; Wenger, Jeffrey B

    2012-03-01

    Roughly half the labor force data in the Current Population Survey (CPS) are provided by proxy respondents, and since 1979, men's reliance on proxies has dropped dramatically while women's reliance on proxies has increased. Few authors, however, have examined how combining these first-hand and second-hand reports may influence our understanding of long-term economic trends. We exploit the outgoing rotation group structure of the CPS by matching individual records one year apart, and we find that self-reported wages are higher than proxy-reported wages even after controlling for all time invariant characteristics. Furthermore, we find that changes in the use of proxy respondents by men and women since 1979 have made current estimates of the gender wage gap larger than they would have been without changes in reporting status. This suggests that the gender wage gap has closed more than previously estimated. We recommend that researchers combine self and proxy responses with great care, especially when analyzing time trends or making gender comparisons. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Prevention of supine hypotensive syndrome in pregnant women undergoing computed tomography - A national survey of current practice

    Energy Technology Data Exchange (ETDEWEB)

    McMahon, Michelle A.; Fenwick, Alison [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom); Banks, Amelia [Department of Anaesthesia, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB (United Kingdom); Dineen, Robert A. [Department of Diagnostic Imaging, Queen' s Medical Centre Campus, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH (United Kingdom)], E-mail: Robert.dineen@nhs.net

    2009-05-15

    Aim: Supine hypotensive syndrome (SHS) can occur in women in the second half of pregnancy due to compression of the aorta and inferior vena cava by the gravid uterus. This results in a decrease in cardiac output with effects ranging from transient asymptomatic hypotension to cardiovascular collapse. SHS can be easily avoided by left lateral tilt positioning. We undertook a nationwide survey to assess the awareness amongst senior computed tomography (CT) radiographers of the potential risk of SHS in women in this patient group, and to identify the extent to which preventative practices and protocols are in place. Methods and materials: A questionnaire was sent to superintendent CT radiographers at all acute NHS Trusts in England and Wales examining awareness of the risk of SHS and the preventative practices and protocols currently used. Results: Completed questionnaires were received from 64% institutions. Of respondents who scan women in this patient group, only 44% were aware of the risk of SHS. No institution had a written protocol specifying positioning of women in this patient group. Seventy-five percent of institutions never employed oblique positioning. Eighty-five percent felt that specific guidelines from the Society of Radiographers or Royal College of Radiologists would be helpful. Conclusion: Current awareness and practices for preventing this easily avoidable but potentially harmful condition are inadequate. Central guidance would be welcomed by a large majority of respondents.

  3. Disease management for chronically ill beneficiaries in traditional Medicare.

    Science.gov (United States)

    Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M

    2009-01-01

    We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.

  4. Doctors currently in jobs with academic content and their future intentions to pursue clinical academic careers: questionnaire surveys.

    Science.gov (United States)

    Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

    2015-02-01

    Our aim was to report on doctors' descriptions of their current post at about 12 years after qualification, in respect of academic content, and to compare this with their long-term intentions. By academic content, we mean posts that are designated as clinical academic posts or clinical service posts that include research and/or teaching commitments. Questionnaire survey. All UK medical graduates of 1996 contacted in 2007, graduates of 1999 in 2012, and graduates of 2000 in 2012. UK. Responses about current posts and future intentions. Postal and email questionnaires. The response rate was 61.9% (6713/10844). Twenty eight per cent were working in posts with academic content (3.3% as clinical academics, 25% in clinical posts with some academic content). Seventeen per cent of women were working in clinical posts with some teaching and research, compared with 29% of men. A higher percentage of men than women intended to be clinical academics as their eventual career choice (3.9% overall, 5.4% of men, 2.7% of women). More doctors wished to move to a job with an academic component than away from one (N = 824 compared with 236). This was true for both men (433 compared with 118) and women (391 compared with 118). Women are under-represented both in holding posts with academic content and in aspirations to do so. It is noteworthy that many more doctors hoped to move into an academic role than to move out of one. Policy should facilitate this wish in order to address current shortfalls in clinical academic medicine.

  5. Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey.

    Science.gov (United States)

    Eltaybani, Sameh; Noguchi-Watanabe, Maiko; Igarashi, Ayumi; Saito, Yumiko; Yamamoto-Mitani, Noriko

    2018-04-01

    Keeping long-term care nurses employed is necessary to sustain the current and future demand for high-quality long-term care services. Understanding the factors relating to intention to stay among long-term care nurses is limited by the scarcity of studies in long-term care settings, lack of investigation of multiple factors, and the weakness of existing explanatory models. To identify the factors associated with long-term care nurses' intention to stay in their current workplace. A cross-sectional questionnaire survey. Two hundred and fifty-seven hospitals with long-term care wards across Japan. A total of 3128 staff nurses and 257 nurse managers from the long-term care wards of the participating hospitals. The questionnaire assessed nurses' intention to continue working in the current workplace as well as potential related factors, including individual factors (demographic data, reason for choosing current workplace, burnout, work engagement, somatic symptom burden) and unit factors (unit size, nurse-manager-related data, patients' medical acuity, average number of overtime hours, recreational activities, social support, perceived quality of care process, educational opportunities, feeling of loneliness, and ability to request days off). Multilevel logistic regression analysis was used to determine which variables best explained nurses' intention to stay in their workplace. Only 40.1% of the respondents reported wanting to continue working at their current workplace. The regression analysis revealed that long-term care nurses' intention to stay was positively associated with nurses' age (odds ratio [95% confidence interval]: 1.02 [1.01-1.03]), work engagement (1.24 [1.14-1.35]), getting appropriate support from nurse managers (2.78 [1.60-4.82]), perceived quality of care process (1.04 [1.01-1.06]), educational opportunities (1.06 [1.0-1.13]), and various specific reasons for choosing their workplace (e.g., a good workplace atmosphere, being interested in

  6. Current cigarette smoking among in-school American youth: results from the 2004 National Youth Tobacco Survey.

    Science.gov (United States)

    Rudatsikira, Emmanuel; Muula, Adamson S; Siziya, Seter

    2009-04-03

    Tobacco use is a leading cause of preventable morbidity and mortality. In the developed nations where the burden from infectious diseases is lower, the burden of disease from tobacco use is especially magnified. Understanding the factors that may be associated with adolescent cigarette smoking may aid in the design of prevention programs. A secondary analysis of the 2004 United States National Youth Tobacco Survey was carried out to estimate the association between current cigarette smoking and selected smoking-related variables. Study participants were recruited from middle and high schools in the United States. Logistic regression analysis using SUDAAN software was conducted to estimate the association between smoking and the following explanatory variables: age, sex, race-ethnicity, peer smoking, living in the same household as a smoker, amount of pocket money at the disposal of the adolescents, and perception that smoking is not harmful to health. Of the 27727 respondents whose data were analysed, 15.9% males and 15.3% females reported being current cigarette smokers. In multivariate analysis, compared to Whites, respondents from almost all ethnic groups were less likely to report current cigarette smoking: Blacks (OR = 0.52; 95% CI [0.44, 0.60]), Asians (OR = 0.45; 95% CI [0.35, 0.58]), Hispanic (OR = 0.81; 95% CI [0.71, 0.92]), and Hawaii/Pacific Islanders (OR = 0.69; 95% CI [0.52, 0.93]). American Indians were equally likely to be current smokers as whites, OR = 0.98 [95% CI; 0.79, 1.22]. Participants who reported living with a smoker were more than twice as likely to smoke as those who did not live with a cigarette smoker (OR = 2.73; 95% CI [2.21, 3.04]). Having friends who smoked was positively associated with smoking (OR = 2.27; 95% CI [1.91, 2.71] for one friend who smoked, and OR = 2.71; 95% CI [2.21, 3.33] for two or more friends who smoked). Subjects who perceived that it was safe to smoke for one or two years were more likely to smoke than those who

  7. The Profile of Patients and Current Practice of Treatment of Upper Limb Muscle Spasticity with Botulinum Toxin Type A: An International Survey

    Science.gov (United States)

    Bakheit, Abdel Magid

    2010-01-01

    To document the current practice in relation with the treatment of patients with upper limb spasticity with botulinum toxin type A to inform future research in this area. We designed an international, cross-sectional, noninterventional survey of current practice. Nine hundred and seventy-four patients from 122 investigational centres in 31…

  8. Current models of care for disorders of sex development – results from an International survey of specialist centres

    Directory of Open Access Journals (Sweden)

    Andreas Kyriakou

    2016-11-01

    Full Text Available Abstract Background To explore the current models of practice in centres delivering specialist care for children with disorders of sex development (DSD, an international survey of 124 clinicians, identified through DSDnet and the I-DSD Registry, was performed in the last quarter of 2014. Results A total of 78 (63 % clinicians, in 75 centres, from 38 countries responded to the survey. A formal national network for managing DSD was reported to exist in 12 (32 % countries. The paediatric specialists routinely involved in the initial evaluation of a newborn included: endocrinologist (99 %, surgeon/urologist (95 %, radiologist (93 %, neonatologist (91 %, clinical geneticist (81 % and clinical psychologist (69 %. A team consisting of paediatric specialists in endocrinology, surgery/urology, clinical psychology, and nursing was only possible in 31 (41 % centres. Of the 75 centres, 26 (35 % kept only a local DSD registry and 40 (53 % shared their data in a multicentre DSD registry. Attendance in local, national and international DSD-related educational programs was reported by 69, 78 and 84 % clinicians, respectively. Participation in audits/quality improvement exercises in DSD care was reported by 14 (19 % centres. In addition to complex biochemistry and molecular genetic investigations, 40 clinicians (51 % also had access to next generation sequencing. A genetic test was reported to be more preferable than biochemical tests for diagnosing 5-alpha reductase deficiency and 17-beta hydroxysteroid dehydrogenase 3 deficiency by 50 and 55 % clinicians, respectively. Conclusion DSD centres report a high level of interaction at an international level, have access to specialist staff and are increasingly relying on molecular genetics for routine diagnostics. The quality of care provided by these centres locally requires further exploration.

  9. The current provision of community-based teaching in UK medical schools: an online survey and systematic review.

    Science.gov (United States)

    Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

    2014-12-01

    To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors' knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for 'Tomorrow's Doctors', a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed in a consistent and comprehensive way. However, a weakness is that data from the online survey was obtained from

  10. The current provision of community-based teaching in UK medical schools: an online survey and systematic review

    Science.gov (United States)

    Lee, Sandra W W; Clement, Naomi; Tang, Natalie; Atiomo, William

    2014-01-01

    Objective To evaluate the current provision and outcome of community-based education (CBE) in UK medical schools. Design and data sources An online survey of UK medical school websites and course prospectuses and a systematic review of articles from PubMed and Web of Science were conducted. Articles in the systematic review were assessed using Rossi, Lipsey and Freeman's approach to programme evaluation. Study selection Publications from November 1998 to 2013 containing information related to community teaching in undergraduate medical courses were included. Results Out of the 32 undergraduate UK medical schools, one was excluded due to the lack of course specifications available online. Analysis of the remaining 31 medical schools showed that a variety of CBE models are utilised in medical schools across the UK. Twenty-eight medical schools (90.3%) provide CBE in some form by the end of the first year of undergraduate training, and 29 medical schools (93.5%) by the end of the second year. From the 1378 references identified, 29 papers met the inclusion criteria for assessment. It was found that CBE mostly provided advantages to students as well as other participants, including GP tutors and patients. However, there were a few concerns regarding the lack of GP tutors’ knowledge in specialty areas, the negative impact that CBE may have on the delivery of health service in education settings and the cost of CBE. Conclusions Despite the wide variations in implementation, community teaching was found to be mostly beneficial. To ensure the relevance of CBE for ‘Tomorrow's Doctors’, a national framework should be established, and solutions sought to reduce the impact of the challenges within CBE. Strengths and limitations of this study This is the first study to review how community-based education is currently provided throughout Medical Schools in the UK. The use of Rossi, Lipsey and Freeman's method of programme evaluation means that the literature was analysed

  11. Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

    Science.gov (United States)

    Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

    2014-01-01

    Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

  12. National nutrition surveys in Europe: a review on the current status in the 53 countries of the WHO European region.

    Science.gov (United States)

    Rippin, Holly L; Hutchinson, Jayne; Evans, Charlotte E L; Jewell, Jo; Breda, Joao J; Cade, Janet E

    2018-01-01

    The objectives of this study were (1) to determine the coverage of national nutrition surveys in the 53 countries monitored by the World Health Organization (WHO) Regional Office for Europe and identify gaps in provision, (2) to describe relevant survey attributes and (3) to check whether energy and nutrients are reported with a view to providing information for evidence-based nutrition policy planning. Dietary survey information was gathered using three methods: (1) direct email to survey authors and other relevant contacts, (2) systematic review of literature databases and (3) general web-based searches. Survey characteristics relating to time frame, sampling and dietary methodology and nutrients reported were tabled from all relevant surveys found since 1990. Fifty-three countries of the WHO Regional Office for Europe, which have need for an overview of dietary surveys across the life course. European individuals (adults and children) in national diet surveys. A total of 109 nationally representative dietary surveys undertaken post-1990 were found across 34 countries. Of these, 78 surveys from 33 countries were found post-2000, and of these, 48 surveys from 27 countries included children and 60 surveys from 30 countries included adults. No nationally representative surveys were found for 19 of 53 countries, mainly from Central and Eastern Europe. Multiple 24hr recall and food diaries were the most common dietary assessment methods. Only 22 countries reported energy and nutrient intakes from post-2000 surveys; macronutrients were more widely reported than micronutrients. Less than two-thirds of WHO Europe countries have nationally representative diet surveys, mainly collected post-2000. The main availability gaps lie in Central and Eastern European countries, where nutrition policies may therefore lack an appropriate evidence base. Dietary methodological differences may limit the scope for inter-country comparisons.

  13. National nutrition surveys in Europe: a review on the current status in the 53 countries of the WHO European region

    Directory of Open Access Journals (Sweden)

    Holly L. Rippin

    2018-04-01

    Full Text Available Objectives: The objectives of this study were (1 to determine the coverage of national nutrition surveys in the 53 countries monitored by the World Health Organization (WHO Regional Office for Europe and identify gaps in provision, (2 to describe relevant survey attributes and (3 to check whether energy and nutrients are reported with a view to providing information for evidence-based nutrition policy planning. Design: Dietary survey information was gathered using three methods: (1 direct email to survey authors and other relevant contacts, (2 systematic review of literature databases and (3 general web-based searches. Survey characteristics relating to time frame, sampling and dietary methodology and nutrients reported were tabled from all relevant surveys found since 1990. Setting: Fifty-three countries of the WHO Regional Office for Europe, which have need for an overview of dietary surveys across the life course. Subjects: European individuals (adults and children in national diet surveys. Results: A total of 109 nationally representative dietary surveys undertaken post-1990 were found across 34 countries. Of these, 78 surveys from 33 countries were found post-2000, and of these, 48 surveys from 27 countries included children and 60 surveys from 30 countries included adults. No nationally representative surveys were found for 19 of 53 countries, mainly from Central and Eastern Europe. Multiple 24hr recall and food diaries were the most common dietary assessment methods. Only 22 countries reported energy and nutrient intakes from post-2000 surveys; macronutrients were more widely reported than micronutrients. Conclusions: Less than two-thirds of WHO Europe countries have nationally representative diet surveys, mainly collected post-2000. The main availability gaps lie in Central and Eastern European countries, where nutrition policies may therefore lack an appropriate evidence base. Dietary methodological differences may limit the scope for

  14. Determination of death after circulatory arrest by intensive care physicians: A survey of current practice in the Netherlands.

    Science.gov (United States)

    Wind, Jentina; van Mook, Walther N K A; Dhanani, Sonny; van Heurn, Ernest W L

    2016-02-01

    Determination of death is an essential part of donation after circulatory death (DCD). We studied the current practices of determination of death after circulatory arrest by intensive care physicians in the Netherlands, the availability of guidelines, and the occurrence of the phenomenon of autoresuscitation. The Determination of Cardiac Death Practices in Intensive Care Survey was sent to all intensive care physicians. Fifty-five percent of 568 Dutch intensive care physicians responded. Most respondents learned death determination from clinical practice. The most commonly used tests for death determination were flat arterial line tracing, flat electrocardiogram (standard 3-lead electrocardiogram), and fixed and dilated pupils. Rarely used tests were absence pulse by echo Doppler, absent blood pressure by noninvasive monitoring, and unresponsiveness to painful stimulus. No diagnostic test or procedure was uniformly performed, but 80% of respondents perceived a need for standardization of death determination. Autoresuscitation was witnessed by 37%, after withdrawal of treatment or after unsuccessful resuscitation. Extensive variability in the practice of determining death after circulatory arrest exists, and a need for guidelines and standardization, especially if organ donation follows death, is reported. Autoresuscitation is reported; this observation requires attention in further prospective observational studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Model-independent constraints on modified gravity from current data and from the Euclid and SKA future surveys

    International Nuclear Information System (INIS)

    Taddei, Laura; Martinelli, Matteo; Amendola, Luca

    2016-01-01

    The aim of this paper is to constrain modified gravity with redshift space distortion observations and supernovae measurements. Compared with a standard ΛCDM analysis, we include three additional free parameters, namely the initial conditions of the matter perturbations, the overall perturbation normalization, and a scale-dependent modified gravity parameter modifying the Poisson equation, in an attempt to perform a more model-independent analysis. First, we constrain the Poisson parameter Y (also called G eff ) by using currently available f σ 8 data and the recent SN catalog JLA. We find that the inclusion of the additional free parameters makes the constraints significantly weaker than when fixing them to the standard cosmological value. Second, we forecast future constraints on Y by using the predicted growth-rate data for Euclid and SKA missions. Here again we point out the weakening of the constraints when the additional parameters are included. Finally, we adopt as modified gravity Poisson parameter the specific Horndeski form, and use scale-dependent forecasts to build an exclusion plot for the Yukawa potential akin to the ones realized in laboratory experiments, both for the Euclid and the SKA surveys.

  16. Model-independent constraints on modified gravity from current data and from the Euclid and SKA future surveys

    Energy Technology Data Exchange (ETDEWEB)

    Taddei, Laura; Martinelli, Matteo; Amendola, Luca, E-mail: taddei@thphys.uni-heidelberg.de, E-mail: martinelli@lorentz.leidenuniv.nl, E-mail: amendola@thphys.uni-heidelberg.de [Institut für Theoretische Physik, Ruprecht-Karls-Universität Heidelberg, Philosophenweg 16, 69120 Heidelberg (Germany)

    2016-12-01

    The aim of this paper is to constrain modified gravity with redshift space distortion observations and supernovae measurements. Compared with a standard ΛCDM analysis, we include three additional free parameters, namely the initial conditions of the matter perturbations, the overall perturbation normalization, and a scale-dependent modified gravity parameter modifying the Poisson equation, in an attempt to perform a more model-independent analysis. First, we constrain the Poisson parameter Y (also called G {sub eff}) by using currently available f σ{sub 8} data and the recent SN catalog JLA. We find that the inclusion of the additional free parameters makes the constraints significantly weaker than when fixing them to the standard cosmological value. Second, we forecast future constraints on Y by using the predicted growth-rate data for Euclid and SKA missions. Here again we point out the weakening of the constraints when the additional parameters are included. Finally, we adopt as modified gravity Poisson parameter the specific Horndeski form, and use scale-dependent forecasts to build an exclusion plot for the Yukawa potential akin to the ones realized in laboratory experiments, both for the Euclid and the SKA surveys.

  17. Interventions to improve recruitment and retention in clinical trials: a survey and workshop to assess current practice and future priorities.

    Science.gov (United States)

    Bower, Peter; Brueton, Valerie; Gamble, Carrol; Treweek, Shaun; Smith, Catrin Tudur; Young, Bridget; Williamson, Paula

    2014-10-16

    Despite significant investment in infrastructure many trials continue to face challenges in recruitment and retention. We argue that insufficient focus has been placed on the development and testing of recruitment and retention interventions. In this current paper, we summarize existing reviews about interventions to improve recruitment and retention. We report survey data from Clinical Trials Units in the United Kingdom to indicate the range of interventions used by these units to encourage recruitment and retention. We present the views of participants in a recent workshop and a priority list of recruitment interventions for evaluation (determined by voting among workshop participants). We also discuss wider issues concerning the testing of recruitment interventions. Methods used to encourage recruitment and retention were categorized as: patient contact, patient convenience, support for recruiters, monitoring and systems, incentives, design, resources, and human factors. Interventions felt to merit investigation by respondents fell into three categories: training site staff, communication with patients, and incentives. Significant resources continue to be invested into clinical trials and other high quality studies, but recruitment remains a significant challenge. Adoption of innovative methods to develop, test, and implement recruitment interventions are required.

  18. Development of a towing tank PIV system and a wake survey of a marine current turbine under steady conditions

    Science.gov (United States)

    Lust, Ethan; Luznik, Luksa; Flack, Karen

    2015-11-01

    A submersible particle image velocimetry (PIV) system was designed and built at the U.S. Naval Academy. The system was used to study the wake of a scale-independent horizontal axis marine current turbine. The turbine is a 1/25th scale model of the U.S. National Renewable Energy Laboratory's Reference Model 1 (RM1) tidal turbine. It is a two-bladed turbine measuring 0.8 m in diameter and featuring a NACA 63-618 airfoil cross-section. The wake survey was conducted over an area extending 0.25D forward of the turbine tip path to 2.0D aft to a depth of 1.0D beneath the turbine output shaft in the streamwise plane. Each field of view was approximately 30 cm by 30 cm, and each overlapped the adjacent fields of view by 5 cm. The entire flow field was then reconstructed by registering the resultant vector fields together into a single field of investigation. Results include the field of investigation from a representative case, for the mean velocity field averaged over approximately 1,000 realizations, and turbulent statistics including turbulence intensities, Reynolds shear stresses, and turbulent kinetic energy. This research was funded by the Office of Naval Research.

  19. Current cigarette smoking among in-school American youth: results from the 2004 National Youth Tobacco Survey

    Directory of Open Access Journals (Sweden)

    Muula Adamson S

    2009-04-01

    Full Text Available Abstract Background Tobacco use is a leading cause of preventable morbidity and mortality. In the developed nations where the burden from infectious diseases is lower, the burden of disease from tobacco use is especially magnified. Understanding the factors that may be associated with adolescent cigarette smoking may aid in the design of prevention programs. Methods A secondary analysis of the 2004 United States National Youth Tobacco Survey was carried out to estimate the association between current cigarette smoking and selected smoking-related variables. Study participants were recruited from middle and high schools in the United States. Logistic regression analysis using SUDAAN software was conducted to estimate the association between smoking and the following explanatory variables: age, sex, race-ethnicity, peer smoking, living in the same household as a smoker, amount of pocket money at the disposal of the adolescents, and perception that smoking is not harmful to health. Results Of the 27727 respondents whose data were analysed, 15.9% males and 15.3% females reported being current cigarette smokers. In multivariate analysis, compared to Whites, respondents from almost all ethnic groups were less likely to report current cigarette smoking: Blacks (OR = 0.52; 95% CI [0.44, 0.60], Asians (OR = 0.45; 95% CI [0.35, 0.58], Hispanic (OR = 0.81; 95% CI [0.71, 0.92], and Hawaii/Pacific Islanders (OR = 0.69; 95% CI [0.52, 0.93]. American Indians were equally likely to be current smokers as whites, OR = 0.98 [95% CI; 0.79, 1.22]. Participants who reported living with a smoker were more than twice as likely to smoke as those who did not live with a cigarette smoker (OR = 2.73; 95% CI [2.21, 3.04]. Having friends who smoked was positively associated with smoking (OR = 2.27; 95% CI [1.91, 2.71] for one friend who smoked, and OR = 2.71; 95% CI [2.21, 3.33] for two or more friends who smoked. Subjects who perceived that it was safe to smoke for one or

  20. Current state of professional and core competency in pediatric residency program at Shiraz University of Medical Sciences: A local survey

    Directory of Open Access Journals (Sweden)

    SEDIGHEH EBRAHIMI

    2015-10-01

    Full Text Available Introduction: Accreditation assesses performance, or capacity to perform, against predetermined standards. It typically combines external quality assurance, through a process of peers review, with elements of self-regulation through internal and selfdirected assessment. This study is an attempt to identify the quality of pediatrics residency educational programs regarding predetermined standards. Methods: This descriptive-analytical evaluation study of applied type was conducted during 2010 and 2011 in the pediatrics department of Shiraz Medical School, Iran. The assessment process occurred in several phases; at first an assessment model for a residency educational development and a series of educational criteria and indices were created based on WFME Standards. Multiple methods including a self-assessment questionnaire and several checklists were used to collect data, whereas systematic site visit, peer review and document reviewing were conducted with survey team. Due to limitation of the statistical society, all faculty members (n=34 and residents (n=41 of the pediatric department were asked to complete the survey. At last, descriptive and deductive statistics data analysis was performed using SPSS version 14. Results: According to the records available in assessing program quality, it seems that the input criteria were desirable for the program based on the residents’ viewpoints (86.6%.There were proper physical facilities for them to meet the residency program goals. The study indicated that the learning environment needed to be revised for the educational needs (Likert scale: 2.96±1.05. The peer evaluation team demonstrated achievement of mission fulfillment in the context of the objectives and indicators by meeting the desired themes. In spite of some weaknesses in the process criteria, the criteria for output indicators were good according to the report (more than desired level of 75-80%. Conclusion: Accreditation is an important step

  1. Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  2. 78 FR 78342 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2013-12-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... (the Department) Enhanced Access to Autism Services Demonstration Project (Autism Demonstration) under the Extended Care Health Option (ECHO) for beneficiaries diagnosed with an Autism Spectrum Disorder...

  3. 76 FR 80903 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2011-12-27

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... Enhanced Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department...

  4. Current Practice Patterns Surrounding Fertility Concerns in Stage I Seminoma Patients: Survey of United States Radiation Oncologists.

    Science.gov (United States)

    Post, Carl M; Jain, Aditya; Degnin, Catherine; Chen, Yiyi; Craycraft, Mike; Hung, Arthur Y; Jaboin, Jerry J; Thomas, Charles R; Mitin, Timur

    2018-01-16

    Patients with testicular seminoma may face fertility issues because of their underlying disease as well as treatments they undergo. The current patterns of practice among U.S. radiation oncologists aimed at assessing and preserving fertility in patients with Stage I seminoma are unknown. We surveyed practicing U.S. radiation oncologists via an Institutional Review Board-approved online questionnaire. Respondents' characteristics and perceived patient infertility rates were analyzed for association with treatment recommendations. We received 353 responses, of whom one quarter (23%) consider themselves experts. A vast majority (84%) recommend observation as a default strategy. Fifty-two percent routinely advise fertility assessment for patients before observation or chemotherapy, and 74% routinely do so before adjuvant radiation therapy (RT). Forty-one percent and 43% believe that 10% and 30% of patients are infertile following orchiectomy, respectively. Thirty-seven percent and 22% believe infertility rates following para-aortic RT to be 30% and 50%, respectively. Eighty percent routinely use clamshell scrotal shielding. Responders with higher perceived infertility rates are more likely to recommend fertility assessment/sperm banking (Fisher's exact p < 0.0001). Responders who routinely advised fertility assessment were more likely to use clamshell shielding (Cochran-Armitage trend test p = 0.0007). Clamshell use was positively correlated with higher perceived infertility rates following para-aortic RT (Spearman's correlation coefficient = 0.006). Despite a clear knowledge of fertility issues in men diagnosed with seminoma, there is no universal adoption of fertility assessment among U.S. radiation oncologists.

  5. Current status of collaborative relationships between dialysis facilities and dental facilities in Japan: results of a nationwide survey.

    Science.gov (United States)

    Yoshioka, Masami; Shirayama, Yasuhiko; Imoto, Issei; Hinode, Daisuke; Yanagisawa, Shizuko; Takeuchi, Yuko

    2015-02-12

    Recent studies have reported an association between periodontal disease and mortality among dialysis patients. Therefore, preventive dental care should be considered very important for this population. In Japan, no systematic education has been undertaken regarding the importance of preventive dental care for hemodialysis patients--even though these individuals tend to have oral and dental problems. The aim of this study was to investigate the current state of collaborative relationships between hemodialysis facilities and dental services in Japan and also to identify strategies to encourage preventive dental visits among hemodialysis outpatients. A nationwide questionnaire on the collaborative relationship between dialysis facilities and dental facilities was sent by mail to all medical facilities in Japan offering outpatient hemodialysis treatment. Responses were obtained from 1414 of 4014 facilities (35.2%). Among the 1414 facilities, 272 (19.2%) had a dental service department. Approximately 100,000 dialysis outpatients were receiving treatment at these participating facilities, which amounts to one-third of all dialysis patients in Japan. Of those patients, 82.9% received hemodialysis at medical facilities without dental departments. Only 87 of 454 small clinics without in-house dental departments (19.2%) had collaborative registered dental clinics. Medical facilities with registered dental clinics demonstrated a significantly more proactive attitude to routine collaboration on dental matters than facilities lacking such clinics. Our nationwide survey revealed that most dialysis facilities in Japan have neither an in-house dental department nor a collaborative relationship with a registered dental clinic. Registration of dental clinics appears to promote collaboration with dental facilities on a routine basis, which would be beneficial for oral health management in hemodialysis patients.

  6. The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association

    Energy Technology Data Exchange (ETDEWEB)

    Millward, S.F.; Holley, M.L. [Univ. of Western Ontario, London Health Sciences Centre, Dept. of Radiology, London, Ontario (Canada)

    2001-04-01

    To evaluate the current status of interventional radiology in Canada. A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to

  7. Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists.

    Science.gov (United States)

    Bishop, A; Holden, M A; Ogollah, R O; Foster, N E

    2016-03-01

    Pregnancy-related low back pain (LBP) is very common. Evidence from a systematic review supports the use of exercise and acupuncture, although little is known about the care received by women with pregnancy-related back pain in the U.K. To describe current acupuncture and standard care management of pregnancy-related LBP by U.K. physiotherapists. Cross-sectional survey of physiotherapists with experience of treating women with pregnancy-related LBP from three professional networks of the Chartered Society of Physiotherapy. In total, 1093 physiotherapists were mailed a questionnaire. The questionnaire captured respondents' demographic and practice setting information, and experience of managing women with pregnancy-related back pain, and investigated the reported management of pregnancy-related LBP using a patient case vignette of a specific, 'typical' case. The overall response rate was 58% (629/1093). Four hundred and ninety-nine physiotherapists had experience of treating women with pregnancy-related LBP and were included in the analysis. Most respondents worked wholly or partly in the U.K. National Health Service (78%). Most respondents reported that they treat patients with pregnancy-related LBP in three to four one-to-one treatment sessions over 3 to 6 weeks. The results show that a range of management strategies are employed for pregnancy-related LBP, and multimodal management is common. The most common reported treatment was home exercises (94%), and 24% of physiotherapists reported that they would use acupuncture with the patient described in the vignette. This study provides the first robust data on the management of pregnancy-related LBP by U.K. physiotherapists. Multimodal management is common, although exercise is the most frequently used treatment for pregnancy-related LBP. Acupuncture is used less often for this patient group. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Educational priorities and current involvement in genetic practice: a survey of midwives in the Netherlands, UK and Sweden.

    Science.gov (United States)

    Benjamin, Caroline M; Anionwu, Elizabeth N; Kristoffersson, Ulf; ten Kate, Leo P; Plass, Anne Marie C; Nippert, Irmgard; Julian-Reynier, Claire; Harris, Hilary J; Schmidtke, Joerg; Challen, Kirsty; Calefato, Jean Marc; Waterman, Christine; Powell, Eileen; Harris, Rodney

    2009-10-01

    to investigate whether practising midwives are adequately prepared to integrate genetic information into their practice. a cross-sectional, postal, structured questionnaire survey was sent to practising midwives. practising midwives from the Netherlands (NL), Sweden (SE) and the United Kingdom (UK). 1021 replies were received, achieving a response rate of 62%. 79% (799/1015) of midwives reported attending courses with some 'genetic content' during their initial training. Sixty-eight per cent (533/784) judged this to have been useful for clinical practice. Variation was seen between countries in the amount of genetic content in post-registration training (SE 87%, NL 44%, UK 17%) and most was considered useful. Questions assessing clinical activity identified a current need for genetic knowledge. Midwives described low levels of self-reported confidence both in overtly genetic procedures and in everyday tasks that were underpinned by genetic knowledge. For eight of the 12 procedures, fewer than 20% of midwives considered themselves to be confident. Differences were apparent between countries. Midwives identified psychosocial, screening and risk assessment aspects of genetic education as being important to them, rather than technical aspects or genetic science. given the low reported confidence with genetic issues in clinical practice, it is essential that this is addressed in terms of the amount, content and targeting of genetic education. This is especially important to ensure the success of national antenatal and baby screening programmes. The results of this study suggest that midwives would welcome further training in genetics, addressing genetic topics most relevant to their clinical practice.

  9. Report of the survey on current opinions and practice of German Society for Gynecologic Endoscopy (AGE) members regarding the laparoscopic treatment of ovarian malignancies.

    Science.gov (United States)

    Radosa, Julia Caroline; Radosa, Marc Philipp; Schweitzer, Pascal Albert; Juhasz-Boess, Ingolf; Rimbach, Stefan; Solomayer, Erich-Franz

    2018-05-01

    The purpose of this survey was to assess the opinions of members of the German Society of Gynecologic Endoscopy (AGE) regarding the laparoscopic treatment of ovarian malignancies and current practice at their institutions. Between February and October 2015, the AGE sent an anonymous online survey via mail to its members. The questionnaire solicited participants' opinions about the laparoscopic treatment of ovarian cancers according to T stage and borderline tumors, and information about current practice at their institutions. Participants were also asked their opinions on currently available data on this issue. Of 228 AGE members who completed the survey, 132 (58%) were fellows or attending physicians and 156 (68%) worked at university hospitals or tertiary referral centers. Most [212 (93%)] respondents stated that < 10% of all ovarian cancer cases were currently treated laparoscopically at their institutions. Most participants indicated that T1 (a, b, c) tumors [145 (64%)] and ovarian borderline tumors [206 (90%)], but not T2 [48 (21%)] or T3/4 [9 (4%) ovarian tumors] should or could be treated laparoscopically. One hundred seventy-two (75%) participants considered currently available data on this topic to be insufficient and 152 (66%) stated that they would take part in a clinical trial assessing a laparoscopic approach to T1/2 ovarian cancer. According to this survey, to the opinion of the majority of AGE members, laparoscopy might be a considerable option for the treatment of early ovarian malignancies and borderline tumors and should be evaluated further in future studies.

  10. The price sensitivity of Medicare beneficiaries: a regression discontinuity approach.

    Science.gov (United States)

    Buchmueller, Thomas C; Grazier, Kyle; Hirth, Richard A; Okeke, Edward N

    2013-01-01

    We use 4 years of data from the retiree health benefits program of the University of Michigan to estimate the effect of price on the health plan choices of Medicare beneficiaries. During the period of our analysis, changes in the University's premium contribution rules led to substantial price changes. A key feature of this 'natural experiment' is that individuals who had retired before a certain date were exempted from having to pay any premium contributions. This 'grandfathering' creates quasi-experimental variation that is ideal for estimating the effect of price. Using regression discontinuity methods, we compare the plan choices of individuals who retired just after the grandfathering cutoff date and were therefore exposed to significant price changes to the choices of a 'control group' of individuals who retired just before that date and therefore did not experience the price changes. The results indicate a statistically significant effect of price, with a $10 increase in monthly premium contributions leading to a 2 to 3 percentage point decrease in a plan's market share. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Gesture and Body-Movement as Teaching and Learning Tools in the Classical Voice Lesson: A Survey into Current Practice

    Science.gov (United States)

    Nafisi, Julia

    2013-01-01

    This article discusses the use of gesture and body-movement in the teaching of singing and reports on a survey amongst professional singing teachers in Germany regarding their use of gesture and body movement as pedagogic tools in their teaching. The nomenclature of gestures and movements used in the survey is based on a previous study by the…

  12. How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

    Science.gov (United States)

    Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

    2017-09-07

    The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes ( p traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers ( p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

  13. A Survey of Current and Future Perceived Multi-National Corporation Manufacturing Training Needs in Tianjin, (T.E.D.A.) China.

    Science.gov (United States)

    Hickey, Will

    2001-01-01

    Describes a study that surveyed current and perceived future employer-provided training practices among multinational corporations manufacturing companies in the Tianjin Economic Development Area (T.E.D.A.) of China. Highlights include labor market; human resources management in China; workforce productivity; and return on investment. (Author/LRW)

  14. Oral contraception and menstrual bleeding during treatment of venous thromboembolism: Expert opinion versus current practice: Combined results of a systematic review, expert panel opinion and an international survey

    NARCIS (Netherlands)

    Klok, F. A.; Schreiber, K.; Stach, K.; Ageno, W.; Middeldorp, S.; Eichinger, S.; Delluc, A.; Blondon, M.; Ay, C.

    2017-01-01

    The optimal management of oral contraception and menstrual bleeding during treatment of venous thromboembolism (VTE) is largely unknown. We aimed to elicit expert opinion and compare that to current practice as assessed by a world-wide international web-based survey among physicians. 10

  15. Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

    Science.gov (United States)

    Toth, Thomas L; Lee, Malinda S; Bendikson, Kristin A; Reindollar, Richard H

    2017-04-01

    To better understand practice patterns and opportunities for standardization of ET. Cross-sectional survey. Not applicable. Not applicable. An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Educational priorities and current involvement in genetic practice: a survey of midwives in the Netherlands, UK and Sweden.

    NARCIS (Netherlands)

    Benjamin, C.M.; Anionwu, E.N.; Kristoffersson, U.; Kate, L.P. ten; Plass, A.M.C.; Nippert, I.; Julian-Reynier, C.; Harris, H.J.; Schmidtke, J.; Challen, K.; Calefato, J.M.; Waterman, C.; Powell, E.; Harris, R.

    2009-01-01

    OBJECTIVE: to investigate whether practising midwives are adequately prepared to integrate genetic information into their practice. DESIGN: a cross-sectional, postal, structured questionnaire survey was sent to practising midwives. SETTING: practising midwives from the Netherlands (NL), Sweden (SE)

  17. Preclinical Pharmacokinetic/Pharmacodynamic Modeling and Simulation in the Pharmaceutical Industry: An IQ Consortium Survey Examining the Current Landscape

    OpenAIRE

    Schuck, Edgar; Bohnert, Tonika; Chakravarty, Arijit; Damian-Iordache, Valeriu; Gibson, Christopher; Hsu, Cheng-Pang; Heimbach, Tycho; Krishnatry, Anu Shilpa; Liederer, Bianca M; Lin, Jing; Maurer, Tristan; Mettetal, Jerome T; Mudra, Daniel R; Nijsen, Marjoleen JMA; Raybon, Joseph

    2015-01-01

    The application of modeling and simulation techniques is increasingly common in preclinical stages of the drug discovery and development process. A survey focusing on preclinical pharmacokinetic/pharmacodynamics (PK/PD) analysis was conducted across pharmaceutical companies that are members of the International Consortium for Quality and Innovation in Pharmaceutical Development. Based on survey responses, ~68% of companies use preclinical PK/PD analysis in all therapeutic areas indicating its...

  18. Are Press Depictions of Affordable Care Act Beneficiaries Favorable to Policy Durability?

    Science.gov (United States)

    Chattopadhyay, Jacqueline

    2015-01-01

    If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability--meaning both avoidance of outright retrenchment and fidelity to its policy aims--is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability. This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary "deservingness" in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Using manual and automated methods, this paper analyzes newspaper text from August 2013 through January 2014 to trace portrayals of two ACA "target populations" before and during the new law's first open-enrollment period: those newly eligible for Medicaid, and those eligible for subsidies to assist in the purchase of private health insurance under the ACA. This paper also studies newspaper text portrayals of two groups informally crafted by the ACA in this timeframe: those gaining health insurance and those losing it. The text data uncover the following answers to the three descriptive questions for the timeframe studied: (1) Portrayals may underplay beneficiaries' economic heterogeneity. (2) Portrayals pay little attention to young adults. (3) Portrayals emphasize themes of workforce participation, economic self-sufficiency, and insider status. Health

  19. Factors influencing Poverty Alleviation among Women Credit Beneficiaries in Tanzania: A Case Study of FINCA’s Women Credit beneficiaries in Mwanza

    Directory of Open Access Journals (Sweden)

    Samuel Nyambega Nyang’au

    2014-04-01

    Full Text Available Many credit schemes in Tanzania channel their funds to womenwith the objective of alleviating poverty among them. Despite this, majority ofwomen in the country continue to wallow in poverty. The present research wascarried out among the Foundation for International Community Assistance’s womencredit beneficiaries in Mwanza. The study set out to address the followingobjectives: to analyze the influence of the husband’s cooperation, relevanttraining and interest rate on poverty alleviation among women creditbeneficiaries in Tanzania taking Foundation for International CommunityAssistance in Mwanza as a case study. Using simple regression model, resultsshowed that cooperation from the husband as well as relevant training influencespoverty alleviation among women credit beneficiaries in Tanzania by 56 and 36percent respectively. But interest rate was found to have no significantinfluence at all. The paper recommends that seminars be conducted so thathusbands can be taught the importance of cooperating with their wives. Aboveall giving training to women credit beneficiaries will go a long way insharpening their business skills. Future researchers should research onlaziness and complacency among women credit beneficiaries and the influence onpoverty.

  20. SWFSC/MMTD/CCE: Oregon, California, and Washington Line-transect Experiment (ORCAWALE) 1996, 2001, 2008 and CA Current Cetacean and Ecosystem Assessment Survey (CalCurCEAS) 2014

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The California Current Cetacean and Ecosystem Assessment Survey (CalCurCEAS) is a marine mammal assessment survey of the U.S. West Coast waters. Similar research in...

  1. Hospice utilization of Medicare beneficiaries in Hawai‘i compared to other states

    Directory of Open Access Journals (Sweden)

    Deborah Taira

    2017-11-01

    Full Text Available The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian (57% vs. 1%, p < .001 and “other race” (10% vs. 0.1%, p < .001, and less likely to be White (28% vs. 84%, p < .001. Hawai‘i beneficiaries were also more likely to have Medicare Advantage (55% vs. 30%, p = .05. Regarding primary diagnoses, hospice users in Hawai‘i were significantly more likely to have a primary diagnosis of stroke (11% vs. 8%, p = .03 and less likely to have respiratory disease (5% vs. 11%, p = .003. In addition, hospice users in Hawai‘i were more likely to use services in their homes (74% vs. 52%, p = .03. Hawai‘i hospice users were also less likely to die while in hospice (42% vs. 47%, p = .002. Characteristics of Medicare beneficiaries in Hawai‘i differ from those in other states, regarding demographic characteristics, type of coverage, primary diagnoses, likelihood of using services in their homes, and death rates. Further research is needed to better understand factors affecting these differences and whether these differences warrant changes in policy or practice.

  2. Racial disparities in poverty account for mortality differences in US medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Paul L. Kimmel

    2016-12-01

    Full Text Available Higher mortality in Blacks than Whites has been consistently reported in the US, but previous investigations have not accounted for poverty at the individual level. The health of its population is an important part of the capital of a nation. We examined the association between individual level poverty and disability and racial mortality differences in a 5% Medicare beneficiary random sample from 2004 to 2010. Cox regression models examined associations of race with all-cause mortality, adjusted for demographics, comorbidities, disability, neighborhood income, and Medicare “Buy-in” status (a proxy for individual level poverty in 1,190,510 Black and White beneficiaries between 65 and 99 years old as of January 1, 2014, who had full and primary Medicare Part A and B coverage in 2004, and lived in one of the 50 states or Washington, DC.Overall, black beneficiaries had higher sex-and-age adjusted mortality than Whites (hazard ratio [HR] 1.18. Controlling for health-related measures and disability reduced the HR for Black beneficiaries to 1.03. Adding “Buy-in” as an individual level covariate lowered the HR for Black beneficiaries to 0.92. Neither of the residential measures added to the predictive model. We conclude that poorer health status, excess disability, and most importantly, greater poverty among Black beneficiaries accounts for racial mortality differences in the aged US Medicare population. Poverty fosters social and health inequalities, including mortality disparities, notwithstanding national health insurance for the US elderly. Controlling for individual level poverty, in contrast to the common use of area level poverty in previous analyses, accounts for the White survival advantage in Medicare beneficiaries, and should be a covariate in analyses of administrative databases. Keywords: USA, Poverty, Socioeconomic status, Mortality, Race, Neighborhood, Disability, Disparities, Buy-in, Dual-eligible, Medicare, Medicaid, USRDS

  3. Using Surveys to Track Student Sexual Behavior and Attitudes in the Public Schools: Current Case Law and Future Implications

    Science.gov (United States)

    Bullis, Ronald K.

    2008-01-01

    Two recent federal court cases have addressed the constitutionality of using sexual surveys in public schools. This article compares these cases with an earlier case dealing with the same issue but reaching different results. This article also describes the constitutional rights of parents to educate their children and the school's rights to…

  4. A State-Wide Survey of South Australian Secondary Schools to Determine the Current Emphasis on Ergonomics and Computer Use

    Science.gov (United States)

    Sawyer, Janet; Penman, Joy

    2012-01-01

    This study investigated the pattern of teaching of healthy computing skills to high school students in South Australia. A survey approach was used to collect data, specifically to determine the emphasis placed by schools on ergonomics that relate to computer use. Participating schools were recruited through the Department for Education and Child…

  5. The role of hospital payments in the adoption of new medical technologies: an international survey of current practice.

    Science.gov (United States)

    Sorenson, Corinna; Drummond, Michael; Torbica, Aleksandra; Callea, Giuditta; Mateus, Ceu

    2015-04-01

    This study examined the role of prospective payment systems in the adoption of new medical technologies across different countries. A literature review was conducted to provide background for the study and guide development of a survey instrument. The survey was disseminated to hospital payment systems experts in 15 jurisdictions. Fifty-one surveys were disseminated, with 34 returned. The surveys returned covered 14 of the 15 jurisdictions invited to participate. The majority (71%) of countries update the patient classification system and/or payment tariffs on an annual basis to try to account for new technologies. Use of short-term separate or supplementary payments for new technologies occurs in 79% of countries to ensure adequate funding and facilitate adoption. A minority (43%) of countries use evidence of therapeutic benefit and/or costs to determine or update payment tariffs, although it is somewhat more common in establishing short-term payments. The main barrier to using evidence is uncertain or unavailable clinical evidence. Almost three-fourths of respondents believed diagnosis-related group systems incentivize or deter technology adoption, depending on the particular circumstances. Improvements are needed, such as enhanced strategies for evidence generation and linking evidence of value to payments, national and international collaboration and training to improve existing practice, and flexible timelines for short-term payments. Importantly, additional research is needed to understand how different payment policies impact technology uptake as well as quality of care and costs.

  6. HIV/AIDS Course Content in CSWE-Accredited Social Work Programs: A Survey of Current Curricular Practices

    Science.gov (United States)

    Rowan, Diana; Shears, Jeffrey

    2011-01-01

    The authors surveyed program directors at all bachelor of social work and master of social work programs accredited by the Council on Social Work Education using an online tool that assessed whether and how their respective social work programs are covering content related to HIV/AIDS. Of the 650 program directors, 153 (24%) participated in the…

  7. Repeat survey of current practice regarding corticosteroid prophylaxis for patients at increased risk of adverse reaction to intravascular contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)]. E-mail: sureshradhakrish@hotmail.com; Manoharan, S. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom); Fleet, M. [Department of Radiology, Wishaw General Hospital, Lanarkshire Acute Hospitals NHS Trust, 50, Netherton Street, Wishaw, Lanarkshire ML2 0DP (United Kingdom)

    2005-01-01

    AIM: To compare the findings of a survey undertaken by us in 2002 regarding steroid premedication given in radiology departments to reduce the risk of adverse reactions in patients at increased risk of intravascular contrast media reactions with a similar survey published in 1994 by R. Seymour et al. The high risk patients considered in our survey were patients with history of asthma, drug allergies, hay fever and eczema. MATERIALS AND METHODS: A total of 225 questionnaires were sent to the consultant in charge for audit for radiology departments from the list given by the Royal College of Radiologists. 175 of the 225 questionnaires were returned (response rate 77.8%) and of these 172 were analysed with respect to the type, dose and duration of steroids. RESULTS: Compared to the survey in 1994, it was found that the number of departments who use steroid cover for all category of risk factors had increased compared to previous survey (73.8% in 2002 versus 55.3% in 1994 (p=0.001). There is now almost universal use of non-ionic contrast 98.8% versus 82.4% in 1994 (p=0.001). There is no agreed policy among radiology departments for the need or the dose or duration of steroid cover. CONCLUSION: Despite the more widespread use of non-ionic contrast media, the use of steroid premedication has increased which is contrary to what is expected as the incidence of adverse reaction to non ionic media is less than ionic contrast media.

  8. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    Science.gov (United States)

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%). Among hypertensive beneficiaries, 95.2% of those with an ABPM claim were taking antihypertensive medication. Age 75-84 versus 65-74 years, having coronary heart disease, chronic kidney disease, multiple prior hypertension diagnoses, and having filled multiple classes of antihypertensive medication were associated with an increased odds for an ABPM claim among hypertensive beneficiaries. ABPM use was very low among Medicare beneficiaries and was not primarily used for diagnosing white coat hypertension in untreated individuals. PMID:25492832

  9. Classification of the financial sustainability of health insurance beneficiaries through data mining techniques

    Directory of Open Access Journals (Sweden)

    Sílvia Maria Dias Pedro Rebouças

    2016-09-01

    Full Text Available Advances in information technologies have led to the storage of large amounts of data by organizations. An analysis of this data through data mining techniques is important support for decision-making. This article aims to apply techniques for the classification of the beneficiaries of an operator of health insurance in Brazil, according to their financial sustainability, via their sociodemographic characteristics and their healthcare cost history. Beneficiaries with a loss ratio greater than 0.75 are considered unsustainable. The sample consists of 38875 beneficiaries, active between the years 2011 and 2013. The techniques used were logistic regression and classification trees. The performance of the models was compared to accuracy rates and receiver operating Characteristic curves (ROC curves, by determining the area under the curves (AUC. The results showed that most of the sample is composed of sustainable beneficiaries. The logistic regression model had a 68.43% accuracy rate with AUC of 0.7501, and the classification tree obtained 67.76% accuracy and an AUC of 0.6855. Age and the type of plan were the most important variables related to the profile of the beneficiaries in the classification. The highlights with regard to healthcare costs were annual spending on consultation and on dental insurance.

  10. Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.

    Science.gov (United States)

    Keohane, Laura M; Rahman, Momotazur; Mor, Vincent

    2016-04-01

    To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.

  11. Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Romano, Patrick S

    2013-10-01

    Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

  12. Understanding Statin Use in America and Gaps in Patient Education (USAGE): an internet-based survey of 10,138 current and former statin users.

    Science.gov (United States)

    Cohen, Jerome D; Brinton, Eliot A; Ito, Matthew K; Jacobson, Terry A

    2012-01-01

    Statins substantially reduce the risk of cardiovascular disease and are generally well-tolerated. Despite this, many patients discontinue therapy. A better understanding of the characteristics of current and former statin users may be helpful for formulating strategies to improve long-term adherence. The Understanding Statin Use in America and Gaps in Education (USAGE) survey assessed the attitudes, beliefs, practices, and behavior of current and former statin users. Individuals 18 years or older who reported a history of high cholesterol and current or former statin use were identified within a registered consumer panel cohort in the United States and invited to participate in an Internet survey. Of the 10,138 respondents, 8918 (88%) were current statin users and 1220 (12%) were former users. Participants (mean age 61 years) were predominantly white (92%), female (61%), of middle income (median $44,504/yr), and had health insurance (93%). Among current users, 95% took a statin alone, and 70% had not missed a dose in the past month. Although ∼70% reported that their physicians had explained the importance of cholesterol levels for their heart health former users were less satisfied with the discussions (65% vs. 83%, P users, respectively (P users was cost (32%) and the primary reason for discontinuation was side effects (62%). This survey provides important insights into behavior and attitudes among current and former statin users and the results suggest that more effective dialogue between healthcare providers and patients may increase persistence of statin use, particularly when the patient has concerns about side effects and drug costs. Copyright © 2012 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  13. Survey on the Labour Market Position of PhD Graduates: Competence comparison and relation between PhD and current employment

    Energy Technology Data Exchange (ETDEWEB)

    Heuritsch, J.; Waaijer, C.J.F.; Van der Weijden, I.C.M.

    2016-07-01

    We compared the skills PhD graduates acquired during their PhDs to the ones they need in their current job. We also studied the relation between PhD topic and content of the current job of recent PhD graduates. Data was collected in a survey of 1,133 respondents with a PhD from five Dutch universities between early 2008 and mid-2012. We show that scientific skills and independence are developed sufficiently during the PhD education, whereas PhDs are lacking in management and communication skills. These competence discrepancies were compared to the educational level required for the PhD holder’s current job and the relatedness of the current job to the PhD topic. (Author)

  14. Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data

    OpenAIRE

    Polis, Chelsea B.; Cox, Carie M.; Tun?alp, ?zge; McLain, Alexander C.; Thoma, Marie E.

    2017-01-01

    Abstract STUDY QUESTION Can infertility prevalence be estimated using a current duration (CD) approach when applied to nationally representative Demographic and Health Survey (DHS) data collected routinely in low- or middle-income countries? SUMMARY ANSWER Our analysis suggests that a CD approach applied to DHS data from Nigeria provides infertility prevalence estimates comparable to other smaller studies in the same region. WHAT IS KNOWN ALREADY Despite associations with serious negative hea...

  15. Proficiency Testing for Bacterial Whole Genome Sequencing: An End-User Survey of Current Capabilities, Requirements and Priorities

    DEFF Research Database (Denmark)

    Moran-Gilad, Jacob; Sintchenko, Vitali; Karlsmose Pedersen, Susanne

    2015-01-01

    The advent of next-generation sequencing (NGS) has revolutionised public health microbiology. Given the potential impact of NGS, it is paramount to ensure standardisation of ‘wet’ laboratory and bioinformatic protocols and promote comparability of methods employed by different laboratories...... and their outputs. Therefore, one of the ambitious goals of the Global Microbial Identifier (GMI) initiative (http://​www.​globalmicrobiali​dentifier.​org/​) has been to establish a mechanism for inter-laboratory NGS proficiency testing (PT). This report presents findings from the survey recently conducted...... by Working Group 4 among GMI members in order to ascertain NGS end-use requirements and attitudes towards NGS PT. The survey identified the high professional diversity of laboratories engaged in NGS-based public health projects and the wide range of capabilities within institutions, at a notable range...

  16. Proficiency testing for bacterial whole genome sequencing: an end-user survey of current capabilities, requirements and priorities

    DEFF Research Database (Denmark)

    Moran-Gilad, Jacob; Sintchenko, Vitali; Karlsmose Pedersen, Susanne

    2015-01-01

    The advent of next-generation sequencing (NGS) has revolutionised public health microbiology. Given the potential impact of NGS, it is paramount to ensure standardisation of 'wet' laboratory and bioinformatic protocols and promote comparability of methods employed by different laboratories...... and their outputs. Therefore, one of the ambitious goals of the Global Microbial Identifier (GMI) initiative (http://www.globalmicrobialidentifier.org/) has been to establish a mechanism for inter-laboratory NGS proficiency testing (PT). This report presents findings from the survey recently conducted by Working...... Group 4 among GMI members in order to ascertain NGS end-use requirements and attitudes towards NGS PT. The survey identified the high professional diversity of laboratories engaged in NGS-based public health projects and the wide range of capabilities within institutions, at a notable range of costs...

  17. The current state of introduction of HPV vaccination into national immunisation schedules in Europe: results of the VENICE 2008 survey.

    Science.gov (United States)

    Lévy-Bruhl, D; Bousquet, V; King, L A; O'Flanagan, D; Bacci, S; Lopalco, P L; Salmaso, S

    2009-10-01

    Three surveys have been undertaken in European Union (EU) member states since January 2007, within the European Commission funded Vaccine European New Integrated Collaboration Effort (VENICE) project, to monitor the decision status regarding the introduction of human papillomavirus (HPV) vaccination into national immunisation schedules. A web-based questionnaire was developed and completed online by the 28 countries participating in VENICE. According to the last update (31st December 2008), 15 countries have decided to introduce HPV vaccination into their national immunisation schedule, while another six have started the decision-making process with a recommendation favouring introduction. Varying target populations have been selected by the countries which have introduced vaccination. The number of countries which have made a decision or recommendation has increased from 12 to 21 between October 2007 and December 2008. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe. A further update should be available in the second half of 2009.

  18. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care.

    Science.gov (United States)

    Hill, K B; Chadwick, B; Freeman, R; O'Sullivan, I; Murray, J J

    2013-01-01

    The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.

  19. Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.

    Science.gov (United States)

    Milfort, Roline; Bond, Gary R; McGurk, Susan R; Drake, Robert E

    2015-12-01

    This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work. This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers. Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently. Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.

  20. Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

    Science.gov (United States)

    Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

    2016-01-01

    The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

  1. Out-of-pocket medical expenses for inpatient care among beneficiaries of the National Health Insurance Program in the Philippines.

    Science.gov (United States)

    Tobe, Makoto; Stickley, Andrew; del Rosario, Rodolfo B; Shibuya, Kenji

    2013-08-01

    OBJECTIVE The National Health Insurance Program (NHIP) in the Philippines is a social health insurance system partially subsidized by tax-based financing which offers benefits on a fee-for-service basis up to a fixed ceiling. This paper quantifies the extent to which beneficiaries of the NHIP incur out-of-pocket expenses for inpatient care, and examines the characteristics of beneficiaries making these payments and the hospitals in which these payments are typically made. METHODS Probit and ordinary least squares regression analyses were carried out on 94 531 insurance claims from Benguet province and Baguio city during the period 2007 to 2009. RESULTS Eighty-six per cent of claims involved an out-of-pocket payment. The median figure for out-of-pocket payments was Philippine Pesos (PHP) 3016 (US$67), with this figure varying widely [inter-quartile range (IQR): PHP 9393 (US$209)]. Thirteen per cent of claims involved very large out-of-pocket payments exceeding PHP 19 213 (US$428)-the equivalent of 10% of the average annual household income in the region. Membership type, disease severity, age and residential location of the patient, length of hospitalization, and ownership and level of the hospital were all significantly associated with making out-of-pocket payments and/or the size of these payments. CONCLUSION Although the current NHIP reduces the size of out-of-pocket payments, NHIP beneficiaries are not completely free from the risk of large out-of-pocket payments (as the size of these payments varies widely and can be extremely large), despite NHIP's attempts to mitigate this by setting different benefit ceilings based on the level of the hospital and the severity of the disease. To reduce these large out-of-pocket payments and to increase financial risk protection further, it is essential to ensure more investment for health from social health insurance and/or tax-based government funding as well as shifting the provider payment mechanism from a fee

  2. Weak currents

    International Nuclear Information System (INIS)

    Leite Lopes, J.

    1976-01-01

    A survey of the fundamental ideas on weak currents such as CVC and PCAC and a presentation of the Cabibbo current and the neutral weak currents according to the Salam-Weinberg model and the Glashow-Iliopoulos-Miami model are given [fr

  3. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    OpenAIRE

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%)...

  4. Nonemergency medical transportation and health care visits among chronically ill urban and rural medicaid beneficiaries.

    Science.gov (United States)

    Thomas, Leela V; Wedel, Kenneth R

    2014-01-01

    Inaccessibility to health care services due to lack of transportation affects the most vulnerable segments of the society. The effect of Medicaid-provided nonemergency medical transportation (NEMT) in Oklahoma on health care visits for the management of chronic illnesses is examined. Analyses of claims data show that African Americans are the highest users of NEMT. Medicaid beneficiaries who use NEMT services are significantly more likely to make the recommended number of annual visits for the management of chronic conditions than those who do not use NEMT. Increased use of NEMT by making the services more accommodating and convenient for beneficiaries is proposed.

  5. The Final Beneficiaries are Actors Active Little and Influential in Decisions on Public Policy in Brazil

    Directory of Open Access Journals (Sweden)

    Diolina Rodrigues Santiago Silva

    2016-10-01

    Full Text Available Public policies are government programs that directly influence the citizens' lives. In the formulation and implementation of these policies, there is the presence of political and private actors. The final beneficiaries are between different types of private actors. Some laws require the government listen to society at the time of decision-making in public policy and in national conferences and public consultations. The final beneficiaries, actual users of these public policies have to reach some mechanisms of direct participation in the formulation of these policies, but the number of participants is smaller and doesn't influence in making government decisions.

  6. Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

    Science.gov (United States)

    Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

    2018-06-01

    To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

  7. Cross-Linguistic Variation in the Treatment of Beneficiaries and the Argument vs. Adjunct Distinction

    Directory of Open Access Journals (Sweden)

    Denis Creissels

    2014-01-01

    Full Text Available This paper compares the expression of beneficiaries with that of typical arguments and typical adjuncts in a sample of languages illustrating the variation in the extent to which NPs encoding beneficiaries show a syntactic behavior more or less similar to that of typical arguments or typical adjuncts. The observations support the position according to which semantic argumenthood as a comparative concept must be distinguished from its possible syntactic correlates, and must be defined as a scalar rather than categorical concept reflecting the interaction between the various factors that may contribute to defining the degree of involvement of participants in an event.

  8. Survey of currently available reference materials for use in connection with the determination of trace elements in biological materials

    International Nuclear Information System (INIS)

    Parr, R.M.

    1983-09-01

    Elemental analysis of biological materials is at present the subject of intensive study by many different research groups throughout the world, in view of the importance of these trace elements in health and medical diagnosis. IAEA and other organizations are now making a variety of suitable reference materials available for use in connection with the determination of trace elements in biological materials. To help analysts in making a selection from among these various materials, the present report provides a brief survey of data for all such biological reference materials known to the author. These data are compiled by the author from January 1982 to June 1983

  9. Current protein and amino acid intakes among Japanese people: Analysis of the 2012 National Health and Nutrition Survey.

    Science.gov (United States)

    Ishikawa-Takata, Kazuko; Takimoto, Hidemi

    2018-05-01

    To evaluate protein and amino acid intakes and distribution among Japanese people in terms of prevention of sarcopenia or frailty. We carried out a cross-sectional study using data from Japan's 2012 National Health and Nutrition Survey. From the original dataset, we selected individuals aged ≥30 years, who were not pregnant or lactating, and for whom dietary intake, bodyweight and body height data were available. Protein intake was calculated using exclusive software developed for the survey. Amino acid intake was calculated using the database created by the National Institute for Longevity Sciences. More than 95% of the participants met recommended levels of protein suggested by the Dietary Reference Intake in Japan. However, nearly half of the participants did not meet recommended levels in terms of prevention of sarcopenia. Leucine intake was not sufficient for each sex and age group, probably because of decreased intake of animal protein, especially protein from milk and dairy products. Distribution of protein and leucine in each meal tended toward dinner. The Japanese population might have insufficient quality, quantity and distribution of protein intake required to prevent sarcopenia or frailty. Geriatr Gerontol Int 2018; 18: 723-731. © 2018 Japan Geriatrics Society.

  10. Questionnaire survey of current status and reserve for breast cancer screening in Mie prefecture. Achievement of a 50% participation rate

    International Nuclear Information System (INIS)

    Kobayashi, Shigeki; Tanaka, Yukio; Matsuo, Michiko

    2012-01-01

    Mie Medical Network of Breast Cancer Screening, a NPO, was assigned the task of breast cancer screening in Mie prefecture in April, 2010. For breast cancer screening in Mie prefecture in 2009, a questionnaire survey was performed toward both consigner and consignee. Consigners were local public offices managing breast cancer screening for local inhabitants, and consignees were facilities offering breast cancer screening. The number of breast cancer screening was investigated toward all 29 of consigners in Mie prefecture. The questionnaire survey was conducted toward all 52 of the facilities possessing mammography systems (breast cancer screening being performed at 48 of them) in Mie prefecture in 2009. We investigated the predictive additional number of breast cancer screening and also investigated the requisite number of staff to achieve the predictive maximum number of breast cancer screening. As a result, the total number of breast cancer screenings was 93,525, and the participation rate was 27.5% which was calculated by reduction of continuator in Mie prefecture in 2009. The continuator accounted for over 30% of all breast cancer screenings. The predictive additional number was 126,950, this indicates that a possible participation rate of 75.2% after 2011. To achieve this high participation rate, active support is essential for short-handed facilities, and about 20% increase of medical staff is necessary. To achieve a participation rate of over 50% as a goal, new screenees should be recruited and breast cancer screening of every other year should be enlightened. (author)

  11. 45 CFR 205.25 - Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities.

    Science.gov (United States)

    2010-10-01

    ... beneficiaries for food stamps or surplus commodities. 205.25 Section 205.25 Public Welfare Regulations Relating....25 Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities... XVI of the Social Security Act, the State agency shall make the following determinations: (1) The...

  12. Choice of Personal Assistance Services Providers by Medicare Beneficiaries Using a Consumer-Directed Benefit: Rural-Urban Differences

    Science.gov (United States)

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Van Nostrand, Joan F.; Eggert, Gerald M.

    2010-01-01

    Purpose: To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. Methods: The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19…

  13. 20 CFR 10.17 - Is a beneficiary who defrauds the Government in connection with a claim for benefits still...

    Science.gov (United States)

    2010-04-01

    ... connection with a claim for benefits, the beneficiary's entitlement to any further compensation benefits will... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits? 10.17 Section 10.17...

  14. 76 FR 59663 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2011-09-27

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... Acceleration Act of 2004, Pub. L. 108-274; Division D, Title VI, section 6002 of the Tax Relief and Health Care... beneficiary sub-Saharan African countries. Section 112(b)(3) of TDA 2000 provides duty- and quota-free...

  15. 78 FR 59917 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2013-09-30

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... 6002 of the Tax Relief and Health Care Act of 2006 (TRHCA 2006), Public Law 109-432, and section 1... apparel articles wholly assembled in one or more beneficiary sub-Saharan African countries from fabric...

  16. 20 CFR 411.566 - May an EN use outcome or milestone payments to make payments to the beneficiary?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false May an EN use outcome or milestone payments... an EN use outcome or milestone payments to make payments to the beneficiary? Yes, an EN may use milestone or outcome payments to make payments to a beneficiary. [73 FR 29350, May 20, 2008] ...

  17. Characteristics and healthcare utilisation patterns of high-cost beneficiaries in the Netherlands: a cross-sectional claims database study

    NARCIS (Netherlands)

    Wammes, J.J.G.; Tanke, M.A.C.; Jonkers, W.; Westert, G.P.; Wees, P.J. van der; Jeurissen, P.P.T.

    2017-01-01

    OBJECTIVE: To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%-5% high-cost beneficiaries in the Netherlands. DESIGN: Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most

  18. Current status of Marek’s disease in the United States & worldwide based on a questionnaire survey

    Science.gov (United States)

    A questionnaire was widely distributed in 2011 to estimate the global prevalence of Marek’s disease (MD) and gain a better understanding of current control strategies and future concerns. A total of 112 questionnaires were returned representing 116 countries from sources including national branch s...

  19. Current practice in the management of superficial bladder cancer in the Netherlands and Belgian Flanders: a survey.

    NARCIS (Netherlands)

    Witjes, J.A.; Melissen, D.O.; Kiemeney, L.A.L.M.

    2006-01-01

    OBJECTIVE: Because there is no national guideline for the diagnosis, therapy and follow up of (superficial) bladder cancer in the Netherlands and Belgium, the actual patient management may differ between urologists. The purpose of this study is to get insight in the current way urologists diagnose,

  20. Feeling angry about current health status: using a population survey to determine the association with demographic, health and social factors

    Directory of Open Access Journals (Sweden)

    Tiffany K. Gill

    2016-07-01

    Full Text Available Abstract Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. Methods A population-based Computer Assisted Telephone Interview (CATI survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Results Overall, 18.5 % of the population reported feeling angry about their health “some of the time”, “most of the time” or “all of the time”. People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. Conclusions People living with significant health problems are more likely to feel angry about their health. The path between illness and

  1. Field Surveys of Rare Plants on Santa Cruz Island, California, 2003-2006: Historical Records and Current Distributions

    Science.gov (United States)

    McEachern, A. Kathryn; Chess, Katherine A.; Niessen, Ken

    2010-01-01

    Santa Cruz Island is the largest of the northern Channel Islands located off the coast of California. It is owned and managed as a conservation reserve by The Nature Conservancy and the Channel Islands National Park. The island is home to nine plant taxa listed in 1997 as threatened or endangered under the federal Endangered Species Act, because of declines related to nearly 150 years of ranching on the island. Feral livestock were removed from the island as a major conservation step, which was part of a program completed in early 2007 with the eradication of pigs and turkeys. For the first time in more than a century, the rare plants of Santa Cruz Island have a chance to recover in the wild. This study provides survey information and living plant materials needed for recovery management of the listed taxa. We developed a database containing information about historical collections of the nine taxa and used it to plan a survey strategy. Our objectives were to relocate as many of the previously known populations as possible, with emphasis on documenting sites not visited in several decades, sites that were poorly documented in the historical record, and sites spanning the range of environmental conditions inhabited by the taxa. From 2003 through 2006, we searched for and found 39 populations of the taxa, indicating that nearly 80 percent of the populations known earlier in the 1900s still existed. Most populations are small and isolated, occupying native-dominated habitat patches in a highly fragmented and invaded landscape; they are still at risk of declining through population losses. Most are not expanding beyond the edges of their habitat patches. However, most taxa appeared to have good seed production and a range of size classes in populations, indicating a good capacity for plant recruitment and population growth in these restricted sites. For these taxa, seed collection and outplanting might be a good strategy to increase numbers of populations for species

  2. The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

    Science.gov (United States)

    Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

    2000-01-01

    This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

  3. Current tobacco use and its associated factors among adults in Georgia: findings from Non-Communicable Disease Risk Factors STEPS Survey Georgia 2016

    Directory of Open Access Journals (Sweden)

    Nino Maglaklelidze

    2018-03-01

    Full Text Available Background Tobacco surveys of past decades show that tobacco use prevalence is high in Georgia; According to nationwide Noncommunicable Diseases (NCDC Risk Factors STEPS Survey 2010 30% of adult population are current tobacco users. Another Nationwide Tobacco Survey 2014 reported 28% of tobacco use prevalence among Georgian adults. However, there has been relatively little progress in systematic study of the factors associated with this high tobacco use. The current study aimed to assess the prevalence of tobacco use and its associated sociodemographic, behavioral and environmental factors in Georgia. Methods The current study in Georgia was a population-based STEPS survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Georgia. The. A total of 5554 adults participated in the survey. The overall response rate was 75.7%. We assessed sociodemographics, behavioral and other health-related factors. Results The prevalence of current overall tobacco use was 31.1% (95 % CI: 29.0-33.1 which comprised of smoked tobacco use, smoked cigarettes and use of smokeless tobacco, 31.0% (95% 28.9-33.0 smoked tobacco, 29.9 (95% CI: 27.9-32.0 smoked cigarettes and 0.3 (95% CI: 0.0-0.6 use of smokeless tobacco. Smoking prevalence was significantly higher in men 57.1% (95% CI: 53.7-60.4 compared to women 7.1% (95% CI: 5.9-8.4, especially in younger age groups and with other substance abuse history (predominantly alcohol. Conclusions Despite of some efforts in the field of tobacco control, tobacco use (particularly smoking was high in Georgia. Males, younger age groups, and population with addictions to other substances (especially alcohol should be the primary target of behavioral interventions; The stricter implementation of tobacco control measures, including comprehensive ban of tobacco marketing and smoking in public places, improved health warnings on tobacco packages and anti

  4. Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011–2013 Global Adult Tobacco Surveys

    Science.gov (United States)

    Palipudi, Krishna Mohan; Mbulo, Lazarous; Morton, Jeremy; Mbulo, Lazarous; Bunnell, Rebecca; Blutcher-Nelson, Glenda; Kosen, Soewarta; Tee, Guat Hiong; Abdalla, Amani Mohamed Elkhatim; Al Mutawa, Kholood Ateeq; Barbouni, Anastasia; Antoniadou, Eleni; Fouad, Heba; Khoury, Rula N.; Rarick, James; Sinha, Dhirendra N.; Asma, Samira

    2016-01-01

    Introduction Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Methods Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Results Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. Conclusions E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers. PMID:25895951

  5. Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011-2013 Global Adult Tobacco Surveys.

    Science.gov (United States)

    Palipudi, Krishna Mohan; Mbulo, Lazarous; Morton, Jeremy; Mbulo, Lazarous; Bunnell, Rebecca; Blutcher-Nelson, Glenda; Kosen, Soewarta; Tee, Guat Hiong; Abdalla, Amani Mohamed Elkhatim; Mutawa, Kholood Ateeq Al; Barbouni, Anastasia; Antoniadou, Eleni; Fouad, Heba; Khoury, Rula N; Rarick, James; Sinha, Dhirendra N; Asma, Samira

    2016-04-01

    Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Engineering change management report 2012: Survey results on causes and effects, current practice, problems, and strategies in Brazil

    DEFF Research Database (Denmark)

    Chucholowski, Nepomuk; Langer, Stefan; Ferreira, Marcelo Gitirana Gomes

    Engineering changes (ECs) are well known for generating additional costs and decreasing de-velopment efficiency. Yet, they are a fundamental part of product and service development and they are necessary to keep up with, for example, competitors, market trends or new technolo-gies. The effective...... management of engineering changes is a crucial precondition for Brazilian companies to successfully compete not only on the fast growing Brazilian market, but also on the world market which becomes more interesting due to the rising industrial power of Brazil. To achieve improvements in engineering change...... management practice, industry and universities need to work together. In this report the main findings of our study on Engineering Change Management (ECM) in Brazilian companies are presented, which indicate possible solution strategies and further research needs. Our survey aimed on the investigation...

  7. The Galactic O-Star Catalog (GOSC) and the Galactic O-Star Spectroscopic Survey (GOSSS): current status

    Science.gov (United States)

    Maíz Apellániz, J.; Alonso Moragón, A.; Ortiz de Zárate Alcarazo, L.; The Gosss Team

    2017-03-01

    We present the updates of the Galactic O-Star Catalog (GOSC) that we have undertaken in the last two years: new spectral types, more objects, additional information, and coordination with CDS. We also present updates for the Galactic O-Star Spectroscopic Survey (GOSSS). A new paper (GOSSS-III) has been published and ˜ 1000 targets have been observed since 2014. Four new setups have been added to our lineup and for two of them we have already obtained over 100 spectra: with OSIRIS at the 10.4 m GTC we are observing northern dim stars and with FRODOspec at the 2.0 m Liverpool Telescope we are observing northern bright stars. Finally, we also make available new versions of MGB, the spectral classification tool associated with the project, and of the GOSSS grid of spectroscopic standards.

  8. [Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

    Science.gov (United States)

    Kino, Shuichi; Suwabe, Akira

    2014-12-01

    In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

  9. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician services...

  10. 28 CFR 104.52 - Distribution of award to decedent's beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... VICTIM COMPENSATION FUND OF 2001 Payment of Claims § 104.52 Distribution of award to decedent's beneficiaries. The Personal Representative shall distribute the award in a manner consistent with the law of the decedent's domicile or any applicable rulings made by a court of competent jurisdiction. The Personal...

  11. Substantial Physician Turnover And Beneficiary 'Churn' In A Large Medicare Pioneer ACO.

    Science.gov (United States)

    Hsu, John; Vogeli, Christine; Price, Mary; Brand, Richard; Chernew, Michael E; Mohta, Namita; Chaguturu, Sreekanth K; Weil, Eric; Ferris, Timothy G

    2017-04-01

    Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012-14 contract period studied. When physicians left the ACO, most of their attributed beneficiaries also left the ACO. Conversely, about half of the growth in the beneficiary population was because of new physicians affiliating with the ACO; the remainder joined after switching physicians. These findings may help explain the muted financial impact ACOs have had overall, and they raise the possibility of future gaming on the part of ACOs to artificially control spending. Policy refinements include coordinated and standardized risk-sharing parameters across payers to prevent any dilution of the payment incentives or confusion from a cacophony of incentives across payers. Project HOPE—The People-to-People Health Foundation, Inc.

  12. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Science.gov (United States)

    2010-06-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...

  13. 78 FR 66972 - Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808

    Science.gov (United States)

    2013-11-07

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808 AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day notice and... Retirement System, SF 2808. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C...

  14. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.53 Department of Labor, Office of Workers... injury) incurred while engaged in: (i) Training. (ii) Flight instructions. (iii) Travel to or from... injury.) This category includes but is not limited to: (i) Civilian student employees in training at Navy...

  15. 42 CFR 409.42 - Beneficiary qualifications for coverage of services.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital... home health services, a beneficiary must meet each of the following requirements: (a) Confined to the..., management and evaluation of a patient care plan is considered a reasonable and necessary skilled service...

  16. 75 FR 8927 - Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended Care Health...

    Science.gov (United States)

    2010-02-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...

  17. 26 CFR 1.167(h)-1 - Life tenants and beneficiaries of trusts and estates.

    Science.gov (United States)

    2010-04-01

    ... reserve) allocable to each. For example: (1) If under the trust instrument or local law the income of a... local law the income of a trust is to be distributed to a named beneficiary, but the trustee is directed... otherwise provided in this paragraph when the trust instrument or local law requires or permits the trustee...

  18. 26 CFR 1.679-2 - Trusts treated as having a U.S. beneficiary.

    Science.gov (United States)

    2010-04-01

    ... beneficiaries generally does not include heirs who will benefit from the trust under the laws of intestate... of the trust instrument do not allow the trust to be amended to benefit a U.S. person, but the law... law. A creates and funds FT for the benefit of C. The terms of FT (which, according to the trust...

  19. 38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Incarcerated beneficiaries and fugitive felons-pension. 3.666 Section 3.666 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  20. 38 CFR 3.714 - Improved pension elections-public assistance beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Improved pension elections-public assistance beneficiaries. 3.714 Section 3.714 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  1. 42 CFR 405.1205 - Notifying beneficiaries of hospital discharge appeal rights.

    Science.gov (United States)

    2010-10-01

    ...” is defined as any facility providing care at the inpatient hospital level, whether that care is short... basis, limited to specialty care or providing a broader spectrum of services. This definition includes... beneficiary refuses to sign the notice. The hospital may annotate its notice to indicate the refusal, and the...

  2. 26 CFR 1.673(c)-1 - Reversionary interest after income beneficiary's death.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Reversionary interest after income beneficiary's death. 1.673(c)-1 Section 1.673(c)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Grantors and Others Treated As Substantial Owners § 1.673(c)-1 Reversionary interest after...

  3. 78 FR 36035 - Proposed Information Collection Activity: [Beneficiary Travel Mileage Reimbursement Application...

    Science.gov (United States)

    2013-06-14

    ... provided for their convenience. This collection of information is necessary to enable the VHA to provide... online through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-5870 or Fax (202... use of other forms of information technology. Titles: Beneficiary Travel Mileage Reimbursement...

  4. 19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations performed in... processing operations performed in the beneficiary developing country. (a) Items included in the direct costs of processing operations. As used in § 10.176, the words “direct costs of processing operations...

  5. Habitat and Recreational Fishing Opportunity in Tampa Bay: Linking Ecological and Ecosystem Services to Human Beneficiaries

    Science.gov (United States)

    Estimating value of estuarine habitat to human beneficiaries requires that we understand how habitat alteration impacts function through both production and delivery of ecosystem goods and services (EGS). Here we expand on the habitat valuation technique of Bell (1997) with an es...

  6. Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders

    Directory of Open Access Journals (Sweden)

    Kit Sang Leung

    2015-01-01

    Conclusions: Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.

  7. Correlates of current cigarette smoking among school-going adolescents in Punjab, India: results from the Global Youth Tobacco Survey 2003

    Directory of Open Access Journals (Sweden)

    Rudatsikira Emmanuel

    2008-01-01

    Full Text Available Abstract Background Smoking is a leading cause of morbidity and mortality globally. There is therefore need to identify relevant factors associated with smoking among adolescents in order to better tailor public health interventions aimed at preventing smoking. Methods We used data from the Global Youth Tobacco Survey (GYTS conducted in 2003 in Punjab, India, on 2014 adolescents of whom 58.9% were males. We conducted a weighted logistic regression analysis, adjusting for age and sex, to determine associations between predictor variables and current tobacco smoking status. Results A total of 2014 adolescents participated in the survey in 2003, and of these 58.9% were males. Male respondents tended to be older than females (21.2% of males, and 13.1% of females were of age 16 years or above. The percent of males and females in the other age groups were: 23.0% and 28.6% for Conclusion The observed associations between current smoking on one hand and peer smoking, and perception that boys who smoke are less attractive on the other, deserve further studies. The factors reported in the current study should be considered in the design of public health interventions aimed to reduce adolescent cigarette smoking.

  8. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Science.gov (United States)

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  9. Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

    Science.gov (United States)

    Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

    2016-09-01

    At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

  10. The current state of external quality control surveys in the German Federal Republic in the field of peptide hormone radioimmunoassays

    International Nuclear Information System (INIS)

    Marschner, I.; Scriba, P.C.; Wood, W.G.; Breuer, H.; Jungbluth, D.; Roehle, G.

    1977-01-01

    Two types of quality control surveys (QSC) are performed in the Federal Republic of Germany in the field of hormone assays: 1) The distribution of two lyophilized sera at regular intervals, in which the participants have to determine 7 or 8 different hormones. Because of the lack of reference methods for peptide hormones, the statistical evaluation of the results indicates only whether the results of the participants are 'correct' or contain systematic or nonsystematic errors with respect to the findings of the other participants. 2) The distribution of approximately 20 deep-frozen sera (including a standard curve in hormone-free serum) in which the participant has to assay a single hormone. These 20 sera-QCS are performed only at long intervals for a given hormone. The statistical analysis of the rate of the radioactive counts of the QCS-sera and those of the participants' standard curves allows - together with a methodological inquiry form - detection of probable causes for deviating results. (orig.) [de

  11. Tuberculosis care among refugees arriving in Europe: a ERS/WHO Europe Region survey of current practices.

    Science.gov (United States)

    Dara, Masoud; Solovic, Ivan; Sotgiu, Giovanni; D'Ambrosio, Lia; Centis, Rosella; Tran, Richard; Goletti, Delia; Duarte, Raquel; Aliberti, Stefano; de Benedictis, Fernando Maria; Bothamley, Graham; Schaberg, Tom; Abubakar, Ibrahim; Teixeira, Vitor; Ward, Brian; Gratziou, Christina; Migliori, Giovanni Battista

    2016-09-01

    No evidence exists on tuberculosis (TB) and latent TB infection (LTBI) management policies among refugees in European countries.A questionnaire investigating screening and management practices among refugees was sent to 38 national TB programme representatives of low and intermediate TB incidence European countries/territories of the WHO European Region.Out of 36 responding countries, 31 (86.1%) reported screening for active TB, 19 for LTBI, and eight (22.2%) reporting outcomes of LTBI treatment. Screening for TB is based on algorithms including different combinations of symptom-based questionnaires, bacteriology and chest radiography and LTBI screening on different combinations of tuberculin skin test and interferon-γ release assays. In 22 (61.1%) countries, TB and LTBI screening are performed in refugee centres. In 22 (61.1%) countries, TB services are organised in collaboration with the private sector. 27 (75%) countries answered that screening for TB is performed as per national and international guidelines, while 19 (52.7%) gave the same answer with regards to LTBI screening. Infection control measures are inadequate in several of the countries surveyed.There is need for improved coordination of TB screening in Europe to implement the End TB Strategy and achieve TB elimination. Copyright ©ERS 2016.

  12. Safe use of iodinated and gadolinium-based contrast media in current practice in Japan: a questionnaire survey.

    Science.gov (United States)

    Tsushima, Yoshito; Ishiguchi, Tsuneo; Murakami, Takamichi; Hayashi, Hiromitsu; Hayakawa, Katsumi; Fukuda, Kunihiko; Korogi, Yukunori; Sugimoto, Hideharu; Takehara, Yasuo; Narumi, Yoshifumi; Arai, Yasuaki; Kuwatsuru, Ryohei; Yoshimitsu, Kengo; Awai, Kazuo; Kanematsu, Masayuki; Takagi, Ryo

    2016-02-01

    To help establish consensus on the safe use of contrast media in Japan. Questionnaires were sent to accredited teaching hospitals with radiology residency programs. The reply rate was 45.4% (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6%, respectively, and dehydration in 73.9%. As preventive actions, intravenous hydration (89.1%) and reduction of iodinated contrast media dose (86.9%) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6%, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6%. A renal function test was always (63.5% in iodinated; 65.7% in gadolinium) or almost always (23.1; 19.8%) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6%). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed. Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patients' eGFR. Preventive actions against NSF and AAR still lacked consensus.

  13. Current trends of reproductive immunology practices in in vitro fertilization (IVF) - a first world survey using IVF-Worldwide.com.

    Science.gov (United States)

    Kwak-Kim, Joanne; Han, Ae Ra; Gilman-Sachs, Alice; Fishel, Simon; Leong, Milton; Shoham, Zeev

    2013-01-01

    Reproductive immunology has evolved from basic research studies to clinical applications. In this study, we aim to investigate the actual application of reproductive immunology concepts and findings in clinical reproductive medicine such as recurrent pregnancy losses (RPL), repeated implantation failures (RIF), and failed in vitro fertilization (IVF) cycles. A web-based survey was performed on IVF-Worldwide.com. Collected data were analyzed by the computerized software. A significant proportion of physicians recommend thrombophilia workups (86%), parental genetic study (79%), and immunologic evaluations (69%) to IVF candidates who have a history of RPL or chemical pregnancy losses. IVF physicians consider an immunologic workup when patients have two (30%) or three (21%) failed IVF cycles. Assays for anticardiolipin antibody, lupus anticoagulant, thyroid peroxidase antibody, and antinuclear antibody are the four most commonly ordered immunologic tests for RPL (88, 84, 50, 47% each) and RIF (68, 63, 38, 38% each). Cellular immune evaluations, such as NK assay, human leukocyte antigen study, Th1/Th2 study or immunophenotype assay, are less commonly ordered. Reproductive immunology principles have been applied to the clinical management of RPL, RIF, and failed IVF cycles, and a significant proportion of IVF physicians acknowledge the importance of immunologic alterations with reproductive outcomes. © 2012 John Wiley & Sons A/S.

  14. 'Fast-track' colonic surgery in Austria and Germany--results from the survey on patterns in current perioperative practice.

    Science.gov (United States)

    Hasenberg, T; Keese, M; Längle, F; Reibenwein, B; Schindler, K; Herold, A; Beck, G; Post, S; Jauch, K W; Spies, C; Schwenk, W; Shang, E

    2009-02-01

    'Fast-track' rehabilitation has been shown to accelerate recovery, reduce general morbidity and decrease hospital stay after elective colonic surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts among the entirety of Austrian and German surgeons. In 2006, a questionnaire concerning perioperative routines in elective, open colonic resection was sent to the chief surgeons of 1270 German and 120 Austrian surgical centres. The response rate was 63% in Austria (76 centres) and 30% in Germany (385 centres). Mechanical bowel preparation is used by the majority (Austria, 91%; Germany, 94%); the vertical incision is the standard method of approach to the abdomen in Austria (79%) and Germany (83%), nasogastric decompression tubes are rarely used, one-third of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centres allow the intake of clear fluids on the day of surgery and one-fifth offer solid food on that day. Epidural analgesia is used in three-fourths of the institutions. Although there is an evident benefit of fast-track management, the survey shows that they are not yet widely used as a routine in Austria and Germany.

  15. Current practice trends in allergy: results of a united states survey of otolaryngologists, allergist-immunologists, and primary care physicians.

    Science.gov (United States)

    Ryan, Matthew W; Marple, Bradley F; Leatherman, Bryan; Mims, J Whit; Fornadley, John; Veling, Maria; Lin, Sandra Y

    2014-10-01

    Clinical practices for the diagnosis and treatment of allergic disease evolve over time in response to a variety of forces. The techniques used by various physician specialties are not clearly defined and may vary from published descriptions or recommendations in the literature. This work is a Web-based survey enrolling 250 U.S. physicians in the following specialties: otolaryngology (ENT), allergy-immunology (A/I), and primary care (PCP). Respondents reported that skin-prick testing is the most common diagnostic testing method, followed by in vitro specific immunoglobulin E (IgE) testing. ENTs were more likely to use intradermal testing compared to other specialties (p = 0.0003 vs A/I; p 60). Significant use of home immunotherapy injections (defined as >10% of immunotherapy patients) ranged from 27% to 36% of physicians, with no statistically significant difference noted based upon specialty. PCPs reported greater use of sublingual immunotherapy (PCP, 68%; A/I, 45%; otolaryngology, 35%; A/I vs PCP, p = 0.005; ENT vs PCP p allergy testing and treatment methods are employed by U.S. physicians, with some differences noted based upon specialty. Home immunotherapy continues to be employed in allergy practices, and sublingual immunotherapy is a common form of delivery, especially in primary care practices. © 2014 ARS-AAOA, LLC.

  16. Evaluation of Semi-Automatic Metadata Generation Tools: A Survey of the Current State of the Art

    Directory of Open Access Journals (Sweden)

    Jung-ran Park

    2015-09-01

    Full Text Available Assessment of the current landscape of semi-automatic metadata generation tools is particularly important considering the rapid development of digital repositories and the recent explosion of big data. Utilization of (semiautomatic metadata generation is critical in addressing these environmental changes and may be unavoidable in the future considering the costly and complex operation of manual metadata creation. To address such needs, this study examines the range of semi-automatic metadata generation tools (n=39 while providing an analysis of their techniques, features, and functions. The study focuses on open-source tools that can be readily utilized in libraries and other memory institutions.  The challenges and current barriers to implementation of these tools were identified. The greatest area of difficulty lies in the fact that  the piecemeal development of most semi-automatic generation tools only addresses part of the issue of semi-automatic metadata generation, providing solutions to one or a few metadata elements but not the full range elements.  This indicates that significant local efforts will be required to integrate the various tools into a coherent set of a working whole.  Suggestions toward such efforts are presented for future developments that may assist information professionals with incorporation of semi-automatic tools within their daily workflows.

  17. Direct observation of Medicaid beneficiary attempts to fill prescriptions for nicotine replacement medications.

    Science.gov (United States)

    Richter, Kimber P; Shergina, Elena; Grodie, Amanda; Massey, Justin K; Ellerbeck, Edward F; Applegate, Amanda; Faseru, Babalola

    2018-04-21

    Although many states have expanded Medicaid coverage of cessation medications, utilization remains low. Anecdotal reports suggest that beneficiaries are at times denied coverage of cessation medications at the pharmacy counter. We conducted an observational community-wide case study of Medicaid beneficiary attempts to fill over-the-counter nicotine replacement therapy at pharmacies. We recruited tobacco-using beneficiaries from a Federally Qualified Health Center, whose providers wrote paper prescriptions for nicotine patches. Study staff escorted beneficiaries to all eligible pharmacies (n = 18) in a Midwestern community to observe fill attempts. Study staff recorded encounters via smartphone into a secure database on a university server. Seven of 18 pharmacies (39%) did not fill the prescription on the day of the attempt. Of these, 6 offered to order the patch for pick-up at a later date. All (4/4) chain pharmacies filled the prescription; 2/3 mass merchant pharmacies failed to fill. Combining successful same-day fills with offers to order for pick-up, 17/18 (94%) would ultimately have been able to obtain patches. This pilot study found that many beneficiaries left pharmacies without a prescription in hand. Successful same-day fills varied markedly by store type. For people with low incomes, transportation presents a major barrier for delayed pick-up. In addition, delays can fuel ambivalence toward quitting. Future research based on this pilot study might address whether patients who fail to secure a same-day prescription ever fill the prescription and, if not, the degree to which this barrier contributes to success or failure in quitting. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  18. Variations in Influenza and Pneumonia Immunizations for Medicare Beneficiaries Served by Rural Health Clinics.

    Science.gov (United States)

    Wan, Thomas T H; Lin, Yi-Ling; Ortiz, Judith

    2017-08-01

    The availability of a rural health clinic (RHC) database over the period of 6 years (2008-2013) offers a unique opportunity to examine the trends and patterns of disparities in immunization for influenza and pneumonia among Medicare beneficiaries in the southeastern states. The purpose of this exploratory study was twofold. First, it examined the rural trends and patterns of immunization rates before (2008-2009) and after (2010-2013) the Affordable Care Act (ACA) enactment by state and year. Second, it investigated how contextual, organizational, and aggregate patient characteristics may influence the variations in immunization for influenza and pneumonia of Medicare beneficiaries served by RHCs. Four data sources from federal agencies were merged to perform a longitudinal analysis of the influences of contextual, organizational, and aggregate patient characteristics on the disparities in immunization rates of rural Medicare beneficiaries for influenza and pneumonia. We included both time-varying and time-constant predictors in a multivariate analysis using Generalized Estimating Equation. This study revealed the increased immunization rates for both influenza and pneumonia over a period of 6 years. The ACA had a positive effect on increased immunization rates for pneumonia, but not for influenza, in rural Medicare beneficiaries in the eight states. The RHCs that served more dually-eligible patients had higher immunization rates. For influenza immunization, provider-based RHCs had a higher rate than the independent RHCs. For pneumonia immunization, no organizational variables were relevant in the explanation of the variability. The results also showed that no single dominant factor influenced health care disparities. This investigation suggested further improvements in preventive care are needed to target poor and isolated rural beneficiaries. Furthermore, the integration of immunization data from multiple sources is critically needed for understanding health

  19. Prevention and diagnosis of ventilator-associated pneumonia: a survey on current practices in Southern Spanish ICUs.

    Science.gov (United States)

    Sierra, Rafael; Benítez, Encarnación; León, Cristóbal; Rello, Jordi

    2005-09-01

    To assess the implementation of selected ventilator-associated pneumonia (VAP) prevention strategies, and to learn how VAP is diagnosed in the ICUs of Southern Spain. Multicentric survey. The ICUs of 32 hospitals of the public health-care system of Southern Spain. Directors of ICUs. None. Twenty-eight ICUs (87.5%) returned completed questionnaires. Ventilator circuits were changed every 72 h or longer in 75% of ICUs. Use of heat and moisture exchangers and open endotracheal suction systems were reported in 96% of ICUs. Subglottic secretion drainage was never used, and 57% of ICUs checked endotracheal tube cuff pressure at least daily. Semi-recumbent position was common (93%), and 67.5% of ICUs used frequently noninvasive ventilation. Continuous enteral feeding was reported in all ICUs. Sedative infusions were usually interrupted every day in 11% of ICUs. Seventy-five percent of ICUs had specific guidelines for antibiotic therapy of VAP, but rotation of antibiotics was uncommon (11%). Twenty-nine percent of ICUs diagnosed VAP without microbiological confirmation. The most used technique for microbiologic diagnosis was qualitative culture of endotracheal aspirates (42.8%). The centers with a larger structural complexity reported using VAP therapy guidelines more frequently than the smaller centers, but they did not utilized bronchoscopic techniques for diagnosing VAP. Common prevention and diagnostic procedures in clinical practice, including large teaching institutions, significantly differed from evidence-based recommendations and reports by research groups of excellence. In addition, our study suggests that clinical practice for preventing and diagnosing VAP is variable and many opportunities exist to improve the care of patients receiving mechanical ventilation.

  20. Use of continuous positive airway pressure (CPAP) in neonatal units--a survey of current preferences and practice in Germany.

    Science.gov (United States)

    Roehr, C C; Schmalisch, G; Khakban, A; Proquitté, H; Wauer, R R

    2007-04-26

    There is only limited evidence regarding the equipment or the settings (pressure and flow) at which CPAP should be applied in neonatal care. Aims of this nationwide survey of German neonatal units were to investigate (1) for which clinical indications CPAP was employed, (2) which CPAP equipment was used, (3) which CPAP settings were applied. A questionnaire on the use of CPAP was sent to all children's hospitals in Germany. Data were stratified and compared by level of medical care provided (non-academic children's hospital, academic teaching hospital and university children's hospital). 274 institutions were contacted by mailed questionnaire. The response rate was 86%, 90 non-academic children's hospitals, 119 academic teaching hospitals and 26 university children's hospitals replied. (1) There were no statistically significant difference in CPAP use between the institutions: 231 (98%) used CPAP for treating respiratory distress syndrome, 225 (96%) for treating apnoea-bradycardia-syndrome and 230 (98%) following extubation. (2) Commercial CPAP systems were employed by 71% of units, the others used a combination of different devices. Respirator generated CPAP was most commonly used. Exclusively mononasal CPAP was used by only 9%, and binasal CPAP by 55% of institutions. (3) Median CPAP was 4.5 cm H2O (range 3-7), median maximum CPAP was 7 cm H2O (range 4-10), with no statistically significant differences between the hospitals. Between units, CPAP was given via a broad range of CPAP systems and at varying pressure settings. The reported differences reflects personal experiences and preferences, rather than sound evidence from clinical trials.

  1. Current trends in research and clinical issues in the study of personality and its disorders: a survey of the presentations at the ISSPD anniversary congress.

    Science.gov (United States)

    Simonsen, Erik; Sørensen, Per; Pedersen, Liselotte

    2014-10-01

    The International Society for the Study of Personality Disorders (ISSPD) celebrated its 25th anniversary in September 2013 in Copenhagen and commemorated the First International Congress at the same site. The overall theme of the congress was "Bridging Personality and Psychopathology: The Person Behind the Illness." More than 400 abstracts were submitted, and the program included 8 keynote presentations, 18 invited symposia, a debate on current controversial issues in the classification of personality disorders (Fossati, Tyrer, Livesley, and Krueger), an ISSPD award lecture (Silk), a jubilee lecture (Simonsen), a young researchers' symposium (Hopwood, Sharp, and Kaess), and special lectures on the Danish philosopher Soeren Kierkegaard and the poet Hans Christian Andersen. In this article we will survey the presentations and highlight the important issues in order to underline the current trends in research and clinical interests in personality disorders. The keynote video presentations, invited symposia, and slide presentations are freely available at www.isspd2013.com.

  2. Smoking behaviors and intentions among current e-cigarette users, cigarette smokers, and dual users: A national survey of U.S. high school seniors.

    Science.gov (United States)

    McCabe, Sean Esteban; Veliz, Phil; McCabe, Vita V; Boyd, Carol J

    2017-06-01

    E-cigarette use among adolescents has increased significantly in recent years, but it remains unclear whether cigarette smoking behaviors and intentions for future cigarette smoking differ among current (i.e., 30-day) non-users, only e-cigarette users, only cigarette smokers, and dual users. A nationally representative sample of 4385 U.S. high school seniors were surveyed during the spring of their senior year via self-administered questionnaires in 2014. An estimated 9.6% of U.S. high school seniors reported current e-cigarette use only, 6.3% reported current cigarette smoking only, and 7.2% reported current dual use of e-cigarettes and cigarette smoking. There were no significant differences between current only cigarette smokers and dual users in the odds of early onset of cigarette smoking, daily cigarette smoking, intentions for future cigarette smoking, friends' cigarette smoking behaviors, attempts to quit cigarette smoking, or the inability to quit cigarette smoking. Adolescents who only used e-cigarettes had higher odds of intentions for future cigarette smoking in the next 5years (AOR=2.57, 95% CI: 1.21-5.24) than current non-users. Dual users and only cigarette smokers had higher odds of cigarette smoking behaviors and intentions for future cigarette smoking than non-users or only e-cigarette users. Adolescents who engage in current dual use have cigarette smoking behaviors and intentions for future cigarette smoking that more closely resemble cigarette smokers than e-cigarette users. Adolescents who only use e-cigarettes have higher intentions to engage in future cigarette smoking relative to their peers who do not engage in e-cigarette use or cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey.

    Science.gov (United States)

    Ryan, Christopher; Leatherdale, Scott; Cooke, Martin

    2017-04-01

    First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic

  4. Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

    Science.gov (United States)

    Zulman, Donna M; Piette, John D; Jenchura, Emily C; Asch, Steven M; Rosland, Ann-Marie

    2013-07-10

    Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care. We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving. We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving. Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving. Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest

  5. Current status and temporal trend of heavy metals in farmland soil of the Yangtze River Delta Region: Field survey and meta-analysis.

    Science.gov (United States)

    Shao, Diwei; Zhan, Yu; Zhou, Wenjun; Zhu, Lizhong

    2016-12-01

    While the spatial distributions of heavy metals in farmland soil of China have been comprehensively delineated, their temporal trends are rarely investigated but are important for environmental risk management. In this study, the current status and temporal trends of heavy metals in the farmland soil of Yangtze River Delta (YRD) were evaluated through field survey and meta-analysis. The field survey conducted in 2014 showed that the concentrations of Cd, Pb, Cu, Zn, and Ni in the farmland topsoil were 0.23 ± 0.14, 37.63 ± 15.60, 25.83 ± 41.62, 88.38 ± 43.30, and 29.21 ± 12.41 mg kg -1 (mean ± standard deviation), respectively. The heavy metals showed relatively higher concentrations on the borders among Zhejiang, Jiangsu, and Shanghai. In the meta-analysis, we selected 68 published studies related to heavy metal pollution in farmland topsoil of YRD from 2000 to the year (2014) when the field survey was conducted. The results show an increasing trend for Cd (p soil remediation are needed to protect food safety and ecosystem from heavy metal pollution, especially Cd. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

    Science.gov (United States)

    Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

    2015-05-01

    The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Wolinsky Fredric D

    2011-08-01

    Full Text Available Abstract Background Most prior studies have focused on short-term (≤ 2 years functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines. Methods The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs, instrumental ADLs (IADLs, and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop. Results The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6% on ADL abilities, 32.3% on IADL abilities, and 30.9% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline

  8. A prospective cohort study of long-term cognitive changes in older Medicare beneficiaries.

    Science.gov (United States)

    Wolinsky, Fredric D; Bentler, Suzanne E; Hockenberry, Jason; Jones, Michael P; Weigel, Paula A; Kaskie, Brian; Wallace, Robert B

    2011-09-20

    Promoting cognitive health and preventing its decline are longstanding public health goals, but long-term changes in cognitive function are not well-documented. Therefore, we first examined long-term changes in cognitive function among older Medicare beneficiaries in the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD), and then we identified the risk factors associated with those changes in cognitive function. We conducted a secondary analysis of a prospective, population-based cohort using baseline (1993-1994) interview data linked to 1993-2007 Medicare claims to examine cognitive function at the final follow-up interview which occurred between 1995-1996 and 2006-2007. Besides traditional risk factors (i.e., aging, age, race, and education) and adjustment for baseline cognitive function, we considered the reason for censoring (entrance into managed care or death), and post-baseline continuity of care and major health shocks (hospital episodes). Residual change score multiple linear regression analysis was used to predict cognitive function at the final follow-up using data from telephone interviews among 3,021 to 4,251 (sample size varied by cognitive outcome) baseline community-dwelling self-respondents that were ≥ 70 years old, not in managed Medicare, and had at least one follow-up interview as self-respondents. Cognitive function was assessed using the 7-item Telephone Interview for Cognitive Status (TICS-7; general mental status), and the 10-item immediate and delayed (episodic memory) word recall tests. Mean changes in the number of correct responses on the TICS-7, and 10-item immediate and delayed word recall tests were -0.33, -0.75, and -0.78, with 43.6%, 54.9%, and 52.3% declining and 25.4%, 20.8%, and 22.9% unchanged. The main and most consistent risks for declining cognitive function were the baseline values of cognitive function (reflecting substantial regression to the mean), aging (a strong linear pattern of increased decline

  9. The effect of deformation after backarc spreading between the rear arc and current volcanic front in Shikoku Basin obtained by seismic reflection survey

    Science.gov (United States)

    Yamashita, M.; Takahashi, N.; Nakanishi, A.; Kodaira, S.; Tamura, Y.

    2012-12-01

    Detailed crustal structure information of a back-arc basin must be obtained to elucidate the mechanism of its opening. Especially, the Shikoku Basin, which occupies the northern part of the Philippine Sea Plate between the Kyushu-Palau Ridge and the Izu-Bonin (Ogasawara) Arc, is an important area to understand the evolution of the back-arc basins as a part of the growth process of the Philippine Sea. Especially, the crustal structure oft the east side of Shikoku Basin is complicated by colliding to the Izu Peninsula Japan Agency for Marine-Earth Science and Technology has been carried out many multi-channel seismic reflection surveys since 2004 in Izu-Bonin region. Kodaira et al. (2008) reported the results of a refraction seismic survey along a north-south profile within paleoarc in the rear arc (i.e., the Nishi-shichito ridge) about 150 km west of current volcanic front. According to their results, the variation relationship of crustal thickness between the rear arc and volcanic front is suggested the evidence of rifting from current volcanic arc. There is the en-echelon arrangement is located in the eastern side of Shikoku Basin from current arc to rear arc, and it is known to activate after ceased spreading at 15 Ma (Okino et al., 1994) of Shikoku Basin by geologic sampling of Ishizuka et al. (2003). Our MCS results are also recognized the recent lateral fault zone is located in east side of Shikoku Basin. We carried out high density grid multi-channel seismic reflection (MCS) survey using tuned airgun in order to obtain the relationship between the lateral faults and en-echelon arrangement in KR08-04 cruise. We identified the deformation of sediments in Shikoku Basin after activity of Kanbun seamount at 8 Ma in MCS profile. It is estimated to activate a part of the eastern side of Shikoku Basin after construction of en-echelon arrangement and termination of Shikoku Basin spreading. Based on analyses of magnetic and gravity anomalies, Yamazaki and Yuasa (1998

  10. Advances and current state of the security and privacy in electronic health records: survey from a social perspective.

    Science.gov (United States)

    Tejero, Antonio; de la Torre, Isabel

    2012-10-01

    E-Health systems are experiencing an impulse in these last years, when many medical agencies began to include digital solutions into their platforms. Electronic Health Records (EHRs) are one of the most important improvements, being in its most part a patient-oriented tool. To achieve a completely operational EHR platform, security and privacy problems have to be resolved, due to the importance of the data included within these records. But given all the different methods to address security and privacy, they still remain in most cases as an open issue. This paper studies existing and proposed solutions included in different scenarios, in order to offer an overview of the current state in EHR systems. Bibliographic material has been obtained mainly from MEDLINE and SCOPUS sources, and over 30 publications have been analyzed. Many EHR platforms are being developed, but most of them present weaknesses when they are opened to the public. These architectures gain significance when they cover all the requisites related to security and privacy.

  11. Current Use of E-Cigarettes and Conventional Cigarettes Among US High School Students in Urban and Rural Locations: 2014 National Youth Tobacco Survey.

    Science.gov (United States)

    Noland, Melody; Rayens, Mary Kay; Wiggins, Amanda T; Huntington-Moskos, Luz; Rayens, Emily A; Howard, Tiffany; Hahn, Ellen J

    2017-01-01

    Adolescent tobacco use is higher in rural than in urban areas. While e-cigarette use is increasing rapidly among this age group, differences in prevalence between rural versus urban populations for this relatively novel product have not been explored. The purpose is to investigate whether location of school (rural-urban) is associated with e-cigarette use and dual use (defined as the use of both e-cigarettes and conventional cigarettes) among high school students. Cross-sectional survey obtained using a stratified, 3-stage cluster sample design. United States. A nationally representative sample of US high school students (N = 11 053) who completed the 2014 National Youth Tobacco Survey (NYTS); slightly more than half were urban (54%). The NYTS measures tobacco-related knowledge, attitudes, and use behavior and demographics of students in the United States. Weighted logistic regression assessed the relationships of urban-rural location with current e-cigarette use and dual use, adjusting for demographic factors, perceived risk, and social norms. There were clear differences in patterns of adolescent e-cigarette and cigarette use in rural versus urban areas. Social norms and perceptions may play a role in understanding these differences. Urban youth current cigarette smokers were nearly twice as likely as rural cigarette smokers to also use e-cigarettes. Reasons for urban-rural differences need to be taken into account when designing prevention programs and policy changes.

  12. Management and disposal of alpha-contaminated wastes. A survey of current practices, strategies and R and D activities in some EC countries and the USA

    International Nuclear Information System (INIS)

    Mannone, F.

    1983-01-01

    In view of the rationalization of radwaste treatment, conditioning and storage procedures so far applied at the Ispra Establishment, a survey of alpha-waste management practices and strategies currently in use or under development in some EC countries and in the USA has been carried out. In considering radwastes arising at nuclear research centres and nuclear plants, the most importance has been attached here to their alpha- rather than to their beta- or gamma-contamination degree. Various process technologiques currently practised for pre-treatment, conditioning, storage and/or disposal of alpha-waste at several European nuclear centres and plants, as well as at some US DOE laboratories, have been scrutinized, including also process operations aimed at recovering Pu, both for economical and ecological reasons. The present alpha-waste management and disposal scenario has been completed by the survey of research, development and demonstration work underway in Europe and in the USA in this field. Finally, national organizations, policies and strategies for radwastes management and disposal have been briefly outlined. As main source of information, the proceeding of several technical seminars, symposia, meetings and conferences, individually and jointly organized by the NEA (OECD), IAEA, CEC and published during about the last 20 years have been utilized. This report is intended to give the necessary background for the critical review of waste management practices so far applied at the Ispra Establisment, as well as for their possible modifications according to more up-to-date management schemes

  13. Use of New Commercial, Off-the-Shelf, High-Definition Structure Scanning Fathometer/Depth Finder For Coastal Current Survey Operations

    Science.gov (United States)

    Roggenstein, E. B.; Gray, G.

    2013-12-01

    The National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS) Center for Operational Oceanographic Products and Services (COOPS) manages three national observing system programs. These are the National Water level Observation Network (NWLON) (210 stations), the 23 NOAA/Physical Oceanographic Real-Time Systems (PORTS), and National Currents Observing Program (NCOP) (approximately 70 deployments/year). In support of its mission COOPS operates and maintains a number of small boats. During vessel operations, side-scan sonar data are at times needed to provide information about bottom structure for future work in the area. For example, potential hazards, obstructions, or bottom morphology features that have not been identified on localized charts for a given area could be used to inform decisions on planned installations. Side-scan sonar capability is also important when attempting to reacquire bottom mounts that fail to surface at the conclusion of a current meter survey. Structure mapping and side-scan capabilities have been added to recent consumer-level, commercial, off-the-shelf fathometers, generally intended for recreational, commercial fishing, and diving applications. We are proposing to investigate these systems' viability for meeting survey requirements. We assess their ability to provide a flexible alternative to research/commercial oceanographic level side-scan system at a significant cost savings. Such systems could provide important information to support scientific missions that require qualitative seafloor imagery.

  14. Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract.

    Science.gov (United States)

    McWilliams, J Michael; Landon, Bruce E; Chernew, Michael E

    2013-08-28

    In a multipayer system, new payment incentives implemented by one insurer for an accountable care organization (ACO) may also affect spending and quality of care for another insurer's enrollees served by the ACO. Such spillover effects reflect the extent of organizational efforts to reform care delivery and can contribute to the net impact of ACOs. We examined whether the Blue Cross Blue Shield (BCBS) of Massachusetts' Alternative Quality Contract (AQC), an early commercial ACO initiative associated with reduced spending and improved quality for BCBS enrollees, was also associated with changes in spending and quality for Medicare beneficiaries, who were not covered by the AQC. Quasi-experimental comparisons from 2007-2010 of elderly fee-for-service Medicare beneficiaries in Massachusetts (1,761,325 person-years) served by 11 provider organizations entering the AQC in 2009 or 2010 (intervention group) vs beneficiaries served by other providers (control group). Using a difference-in-differences approach, we estimated changes in spending and quality for the intervention group in the first and second years of exposure to the AQC relative to concurrent changes for the control group. Regression and propensity score methods were used to adjust for differences in sociodemographic and clinical characteristics. The primary outcome was total quarterly medical spending per beneficiary. Secondary outcomes included spending by setting and type of service, 5 process measures of quality, potentially avoidable hospitalizations, and 30-day readmissions. Before entering the AQC, total quarterly spending per beneficiary for the intervention group was $150 (95% CI, $25-$274) higher than for the control group and increased at a similar rate. In year 2 of the intervention group's exposure to the AQC, this difference was reduced to $51 (95% CI, -$109 to $210; P = .53), constituting a significant differential change of -$99 (95% CI, -$183 to -$16; P = .02) or a 3.4% savings

  15. Current Tobacco Smoking and Desire to Quit Smoking Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 61 Countries, 2012-2015.

    Science.gov (United States)

    Arrazola, René A; Ahluwalia, Indu B; Pun, Eugene; Garcia de Quevedo, Isabel; Babb, Stephen; Armour, Brian S

    2017-05-26

    Tobacco use is the world's leading cause of preventable morbidity and mortality, resulting in nearly 6 million deaths each year (1). Smoked tobacco products, such as cigarettes and cigars, are the most common form of tobacco consumed worldwide (2), and most tobacco smokers begin smoking during adolescence (3). The health benefits of quitting are greater for persons who stop smoking at earlier ages; however, quitting smoking at any age has health benefits (4). CDC used the Global Youth Tobacco Survey (GYTS) data from 61 countries across the six World Health Organization (WHO) regions from 2012 to 2015 to examine the prevalence of current tobacco smoking and desire to quit smoking among students aged 13-15 years. Across all 61 countries, the median current tobacco smoking prevalence among students aged 13-15 years was 10.7% (range = 1.7%, Sri Lanka to 35.0%, Timor-Leste). By sex, the median current tobacco smoking prevalence was 14.6% among males (range = 2.9%, Tajikistan to 61.4%, Timor-Leste) and 7.5% among females (range = 1.6%, Tajikistan to 29.0%, Bulgaria). In the majority of countries assessed, the proportion of current tobacco smokers who desired to quit smoking exceeded 50%. These findings could be used by country level tobacco control programs to inform strategies to prevent and reduce youth tobacco use (1,4).

  16. Current practice of transradial approach for coronary procedures: A survey by the Italian Society of Interventional Cardiology (SICI-GISE) and the Italian Radial Club

    International Nuclear Information System (INIS)

    Rigattieri, Stefano; Valsecchi, Orazio; Sciahbasi, Alessandro; Tomassini, Francesco; Limbruno, Ugo; Marchese, Alfredo; La Manna, Alessio; Mauro, Ciro; Varbella, Ferdinando; Berti, Segio; Tarantino, Fabio F.; Musumeci, Giuseppe

    2017-01-01

    Background: Transradial approach (TRA) for percutaneous coronary procedures is associated with improved patient outcome and is being increasingly adopted worldwide. We surveyed Italian interventional cardiologists in order to take a snapshot of the current practice of TRA. Methods: A web-based questionnaire was emailed to all members of the Italian Society of Interventional Cardiology. Results: The survey was taken by 508 respondents. Cardiogenic shock and chronic total occlusions represented the principal limitations to TRA. Right TRA was the default approach for 81% of respondents. Both diagnostic and interventional procedures were routinely performed through 6 Fr sheaths (83% and 93%, respectively); dedicated TRA curves were used in 11% of diagnostic and in about 3% of interventional procedures. Almost 70% of the operators did not assess dual hand circulation. In case of crossover, the contralateral radial artery was the preferred site (57%). Radial artery hemostasis was mostly achieved by pneumatic bracelet (64%) and patency of the radial artery during hemostasis was ensured in 60% of cases. Pre-discharge patency of the radial artery was routinely assessed by almost 60% of respondents. For diagnostic procedures, adequate heparin anticoagulation (5000 IU) was only given by 45% of operators. Most respondents believed that TRA is associated with greater radiation exposure for both the patient (82%) and the operator (98%) as compared to transfemoral approach. Conclusions: This survey provides contemporary data about the adoption of TRA in Italy and gives interesting insights about several technical and clinical issues related to the practice of this vascular approach for coronary procedures. - Highlights: • Transradial approach for coronary procedures is becoming increasingly popular. • We conducted a survey on the contemporary practice of transradial approach in Italy. • We appraised several clinical and technical issues related to transradial approach.

  17. Current advance care planning practice in the Australian community: an online survey of home care package case managers and service managers.

    Science.gov (United States)

    Sellars, Marcus; Detering, Karen M; Silvester, William

    2015-04-23

    Advance care planning (ACP) is the process of planning for future healthcare that is facilitated by a trained healthcare professional, whereby a person's values, beliefs and treatment preferences are made known to guide clinical decision-making at a future time when they cannot communicate their decisions. Despite the potential benefits of ACP for community aged care clients the availability of ACP is unknown, but likely to be low. In Australia many of these clients receive services through Home Care Package (HCP) programs. This study aimed to explore current attitudes, knowledge and practice of advance care planning among HCP service managers and case managers. An invitation to take part in a cross-sectional online survey was distributed by email to all HCP services across Australia in November 2012. Descriptive analyses were used to examine overall patterns of responses to each survey item in the full sample. 120 (response rate 25%) service managers and 178 (response rate 18%) case managers completed the survey. Only 34% of services had written ACP policies and procedures in place and 48% of case managers had previously completed any ACP training. In addition, although most case managers (70%) had initiated an ACP discussion in the past 12 months and viewed ACP as part of their role, the majority of the conversations (80%) did not result in documentation of the client's wishes and most (85%) of the case managers who responded did not believe ACP was done well within their service. This survey shows low organisational ACP systems and support for case managers and a lack of a normative approach to ACP across Australian HCP services. As HCPs become more prevalent it is essential that a model of ACP is developed and evaluated in this setting, so that clients have the opportunity to discuss and document their future healthcare wishes if they choose to.

  18. Current practice of transradial approach for coronary procedures: A survey by the Italian Society of Interventional Cardiology (SICI-GISE) and the Italian Radial Club

    Energy Technology Data Exchange (ETDEWEB)

    Rigattieri, Stefano, E-mail: stefanorigattieri@yahoo.it [Interventional Cardiology Unit, Sandro Pertini Hospital, Roma (Italy); Valsecchi, Orazio [Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo (Italy); Sciahbasi, Alessandro [Interventional Cardiology Unit, Sandro Pertini Hospital, Roma (Italy); Tomassini, Francesco [Cardiology Department, Ospedale degli Infermi, Rivoli (Italy); Limbruno, Ugo [Cardiology Unit, Azienda USL Toscana Sudest, Grosseto (Italy); Marchese, Alfredo [Interventional Cardiology Unit, Anthea Hospital, GVM Care & Research, Bari (Italy); La Manna, Alessio [Cardiovascular Department, Ferrarotto Hospital, University of Catania (Italy); Mauro, Ciro [Cardiovascular Department, Cardarelli Hospital, Napoli (Italy); Varbella, Ferdinando [Cardiology Department, Ospedale degli Infermi, Rivoli (Italy); Berti, Segio [Department of Cardiology, Fondazione Toscana “Gabriele Monasterio”, Ospedale del Cuore, Massa (Italy); Tarantino, Fabio F. [Cardiology Unit, Ospedale G.B. Morgagni-L. Pierantoni, Forlì (Italy); Musumeci, Giuseppe [Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo (Italy)

    2017-04-15

    Background: Transradial approach (TRA) for percutaneous coronary procedures is associated with improved patient outcome and is being increasingly adopted worldwide. We surveyed Italian interventional cardiologists in order to take a snapshot of the current practice of TRA. Methods: A web-based questionnaire was emailed to all members of the Italian Society of Interventional Cardiology. Results: The survey was taken by 508 respondents. Cardiogenic shock and chronic total occlusions represented the principal limitations to TRA. Right TRA was the default approach for 81% of respondents. Both diagnostic and interventional procedures were routinely performed through 6 Fr sheaths (83% and 93%, respectively); dedicated TRA curves were used in 11% of diagnostic and in about 3% of interventional procedures. Almost 70% of the operators did not assess dual hand circulation. In case of crossover, the contralateral radial artery was the preferred site (57%). Radial artery hemostasis was mostly achieved by pneumatic bracelet (64%) and patency of the radial artery during hemostasis was ensured in 60% of cases. Pre-discharge patency of the radial artery was routinely assessed by almost 60% of respondents. For diagnostic procedures, adequate heparin anticoagulation (5000 IU) was only given by 45% of operators. Most respondents believed that TRA is associated with greater radiation exposure for both the patient (82%) and the operator (98%) as compared to transfemoral approach. Conclusions: This survey provides contemporary data about the adoption of TRA in Italy and gives interesting insights about several technical and clinical issues related to the practice of this vascular approach for coronary procedures. - Highlights: • Transradial approach for coronary procedures is becoming increasingly popular. • We conducted a survey on the contemporary practice of transradial approach in Italy. • We appraised several clinical and technical issues related to transradial approach.

  19. Correlates of current cigarette smoking among school-going adolescents in Punjab, India: results from the Global Youth Tobacco Survey 2003.

    Science.gov (United States)

    Siziya, Seter; Muula, Adamson S; Rudatsikira, Emmanuel

    2008-01-14

    Smoking is a leading cause of morbidity and mortality globally. There is therefore need to identify relevant factors associated with smoking among adolescents in order to better tailor public health interventions aimed at preventing smoking. We used data from the Global Youth Tobacco Survey (GYTS) conducted in 2003 in Punjab, India, on 2014 adolescents of whom 58.9% were males. We conducted a weighted logistic regression analysis, adjusting for age and sex, to determine associations between predictor variables and current tobacco smoking status. A total of 2014 adolescents participated in the survey in 2003, and of these 58.9% were males. Male respondents tended to be older than females (21.2% of males, and 13.1% of females were of age 16 years or above). The percent of males and females in the other age groups were: 23.0% and 28.6% for pocket money; adolescents who had parents who smoked, chewed or applied tobacco; adolescents who said that boys or girls who smoke or chew tobacco have more friends; adolescents who said that smoking or chewing tobacco makes boys look less attractive; adolescents who said that there is no difference in weight between smokers and non-smokers; adolescents who said that smoking makes one gain weight; and adolescents who had most or all of their closest friends who smoked. The factors that were negatively associated with smoking were: adolescents who said that boys or girls who smoke or chew tobacco have less number of friends; adolescents who said that girls who smoke or chew tobacco are less attractive; and adolescents who had some of their closest friends who smoked. The observed associations between current smoking on one hand and peer smoking, and perception that boys who smoke are less attractive on the other, deserve further studies. The factors reported in the current study should be considered in the design of public health interventions aimed to reduce adolescent cigarette smoking.

  20. Superallowed 0+→0+ nuclear β decays: A critical survey with tests of the conserved vector current hypothesis and the standard model

    International Nuclear Information System (INIS)

    Hardy, J.C.; Towner, I.S.

    2005-01-01

    A complete and critical survey is presented of all half-life, decay-energy, and branching-ratio measurements related to 20 superallowed 0 + →0 + decays; no measurements are ignored, although some are rejected for cause and others updated. A new calculation of the statistical rate function f is described and experimental ft values determined. The associated theoretical corrections needed to convert these results into 'corrected' Ft values are discussed, and careful attention is paid to the origin and magnitude of their uncertainties. As an exacting confirmation of the conserved vector current hypothesis, the corrected Ft values are seen to be constant to three parts in 10 4 . These data are also used to set a new limit on any possible scalar interaction (assuming maximum parity violation) of C S /C V =-(0.00005±0.00130). The average Ft value obtained from the survey, when combined with the muon lifetime, yields the up-down quark-mixing element of the Cabibbo-Kobayashi-Maskawa (CKM) matrix, V ud =0.9738±0.0004, and the unitarity test on the top row of the matrix becomes vertical bar V ud vertical bar 2 + vertical bar V us vertical bar 2 + vertical bar V ub vertical bar 2 =0.9966±0.0014 using the Particle Data Group's currently recommended values for V us and V ub . If V us comes instead from two recent results on K e3 decay, the unitarity sum becomes 0.9996(11). Either result can be expressed in terms of the possible existence of right-hand currents. Finally, we discuss the priorities for future theoretical and experimental work with the goal of making the CKM unitarity test more definitive

  1. Current perceptions of the term Clinical Pharmacy and its relationship to Pharmaceutical Care: a survey of members of the European Society of Clinical Pharmacy.

    Science.gov (United States)

    Dreischulte, Tobias; Fernandez-Llimos, Fernando

    2016-12-01

    Background The definitions that are being used for the terms 'clinical pharmacy' and 'pharmaceutical care' seem to have a certain overlap. Responsibility for therapy outcomes seems to be especially linked to the latter term. Both terms need clarification before a proper definition of clinical pharmacy can be drafted. Objective To identify current disagreements regarding the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care' and to assess to which extent pharmacists with an interest in Clinical Pharmacy are willing to accept responsibility for drug therapy outcomes. Setting The membership of the European Society of Clinical Pharmacy. Methods A total of 1,285 individuals affiliated with the European Society of Clinical Pharmacy were invited by email to participate in an online survey asking participants to state whether certain professional activities, providers, settings, aims and general descriptors constituted (a) 'Clinical Pharmacy only', (b) 'Pharmaceutical Care only', (c) 'both' or (d) 'neither'. Further questions examined pharmacists' willingness to accept ethical or legal responsibility for drug therapy outcomes, under current and ideal working conditions. Main outcome measures Level of agreement with a number of statements. Results There was disagreement (responsibility under current/ideal working conditions were: safety (32.7%/64.3%), effectiveness (17.9%/49.2%), patient-centeredness (17.1%/46.2%), cost-effectiveness (20.3%/44.0%). Conclusions The survey identified key disagreements around the term 'Clinical Pharmacy' and its relationship to 'Pharmaceutical Care', which future discussions around a harmonised definition of 'Clinical Pharmacy' should aim to resolve. Further research is required to understand barriers and facilitators to pharmacists accepting responsibility for drug therapy outcomes.

  2. Stated preferences for tropical wildlife conservation amongst distant beneficiaries

    DEFF Research Database (Denmark)

    Morse-Jones, Sian; Bateman, Ian J.; Kontoleon, Andreas

    2012-01-01

    Despite heightened awareness of the need to find additional resources for tropical biodiversity conservation, and recognition that the benefits to populations in developed countries may be significant, very few empirical studies have been conducted to estimate these values. In this article, we...... report the results of a choice experiment survey that investigated the preferences of UK residents for the conservation of threatened wildlife in the Eastern Arc Mountains in Tanzania, part of the Eastern Afromontane “biodiversity hotspot”. We examine the sensitivity of values to species types......, the number of species, the number of conservation sites and, more unusually, to potential substitutes/complements. Critically we find some evidence of coherency in preferences. Respondents are willing to pay significant, positive amounts to conserve charismatic and/or endemic species and are scope sensitive...

  3. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Dorota Kaleta

    2017-09-01

    Full Text Available Physical activity (PA has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA and commuting (CPA among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%, lack of time (28.1%, no willingness to exercise (25.4%. Close to 82% of the surveyed population did not practice commuting physical activity (CPA. The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05. Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  4. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland.

    Science.gov (United States)

    Kaleta, Dorota; Kalucka, Sylwia; Szatko, Franciszek; Makowiec-Dąbrowska, Teresa

    2017-09-26

    Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11-1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  5. Assessing asthma control and associated risk factors among persons with current asthma - findings from the child and adult Asthma Call-back Survey.

    Science.gov (United States)

    Zahran, Hatice S; Bailey, Cathy M; Qin, Xiaoting; Moorman, Jeanne E

    2015-04-01

    Monitoring the level of asthma control is important in determining the effectiveness of current treatment which may decrease the frequency and intensity of symptoms and functional limitations. Uncontrolled asthma has been associated with decreased quality of life and increased health care use. The objectives of this study were to assess the level of asthma control and identify related risk factors among persons with current asthma. Using the 2006 to 2010 BRFSS child and adult Asthma Call-back Survey, asthma control was classified as well-controlled or uncontrolled (not-well-controlled or very-poorly-controlled) using three impairment measures: daytime symptoms, night-time symptoms, and taking short-acting β2-agonists for symptom control. Multivariate logistic regression identified predictors of asthma control. Fifty percent of adults and 38.4% of children with current asthma had uncontrolled asthma. About 63% of children and 53% of adults with uncontrolled asthma were on long-term asthma control medications. Among children, uncontrolled asthma was significantly associated with being younger than 5 years, having annual household income asthma (low educational attainment, low income, cigarette smoking, and co-morbid conditions including obesity and depression) could improve asthma control.

  6. A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries

    DEFF Research Database (Denmark)

    Nielsen, Maj Britt D.; Vinsløv Hansen, Jørgen; Aust, Birgit

    2015-01-01

    BACKGROUND: In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM......) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support. METHODS: Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We.......54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17). CONCLUSION: The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities...

  7. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    Directory of Open Access Journals (Sweden)

    Danut Rada

    2013-12-01

    Full Text Available The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 “international standard for certification measures”. In some cases, considering the request of the audit beneficiary, can be applied the provisions of ISA 800, International Audit Standard “Special Considerations-Audit of financial statements prepared in accordance with special purpose frameworks”.

  8. Marine chemistry, fish / shell-fish surveys, benthic organisms, and marine toxic substances and pollutants data from current meter and other instruments in the Gulf of Mexico from 1993-01-26 to 1994-06-13 (NODC Accession 9500088)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Marine chemistry, fish / shell-fish surveys, benthic organisms, and marine toxic substances and pollutants data were collected using current meter and other...

  9. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare

  10. Risk factors for dementia after critical illness in elderly medicare beneficiaries

    OpenAIRE

    Guerra, Carmen; Linde-Zwirble, Walter T; Wunsch, Hannah

    2012-01-01

    Introduction Hospitalization increases the risk of a subsequent diagnosis of dementia. We aimed to identify diagnoses or events during a hospitalization requiring critical care that are associated with a subsequent dementia diagnosis in the elderly. Methods A cohort study of a random 5% sample of Medicare beneficiaries who received intensive care in 2005 and survived to hospital discharge, with three years of follow-up (through 2008) was conducted using Medicare claims files. We defined demen...

  11. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    OpenAIRE

    Danut Rada; Doina Rada

    2013-01-01

    The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 ...

  12. Enhancing and diluting the legal status of subsidiary protection beneficiaries under Union law

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    2016-01-01

    Is it in accordance with the Qualification Directive (QD) to restrict the freedom of movement within the host country of beneficiaries of subsidiary protection (a form of protection parallel to refugee status) in receipt of social security benefits? This question was addressed by the CJEU in its...... and the substantive content of subsidiary protection while it, on the other hand, creates uncertainty about the applicable non-discrimination standard in such cases...

  13. Current practice and perspectives in CRO oversight based on a survey performed among members of the German Association of Research-Based Pharmaceutical Companies (vfa).

    Science.gov (United States)

    Hennig, Michael; Hundt, Ferdinand; Busta, Susanne; Mikus, Stefan; Sanden, Per-Holger; Sörgel, Andrea; Ruppert, Thorsten

    2017-01-01

    In recent years, the number and scope of outsourced activities in the pharmaceutical industry have increased heavily. In addition, also the type of outsourcing has changed significantly in that time. This raises the question of whether and how sponsors retain the capability to select and to control the contract research organizations (CROs) involved and what expertise still has to be present in the development department as well as other relevant departments to ensure adequate oversight, also in line with the expectations of regulators and health authorities. In order to answer these questions, a survey was conducted among the German vfa member companies. The survey describes the latest developments and experiences in outsourcing by 18 German vfa member companies. It concentrates on measures how to implement Quality Assurance (QA) when performing outsourced clinical studies. This study shows that the majority of companies apply a full-outsourcing, preferred-provider model of clinical trial services, with the clinical research department playing the major role in this process. A large amount of guiding documents, processes and tools are used to ensure an adequate oversight of the services performed by the CRO(s). Finally the guiding principles for all oversight processes should be transparent communication, a clearly established expectation for quality, a precise definition of accountability and responsibility while avoiding silo mentality, and a comprehensive documentation of the oversight's evidence. For globally acting and outsourcing sponsors, oversight processes need to be aligned with regards to local and global perspectives. This survey shows that the current implementation of oversight processes in the participating companies covers all relevant areas to ensure highest quality and integrity of the data produced by the outsourced clinical trial.

  14. Current and emerging practice of end-of-life care in British prisons: findings from an online survey of prison nurses.

    Science.gov (United States)

    Papadopoulos, Irena; Lay, Margaret

    2016-03-01

    There are concerns about prisoners and detainees not having equal access to end-of-life care while in prison. There is a lack of existing literature about the standards of end-of-life care in UK prisons. The aim of this study was to investigate the views of current and former prison nurses with regard to the end-of-life care being provided in UK prisons. Prison nurses were invited to participate in an online survey and asked about their role in the prison, prisoners' access to healthcare facilities, and any barriers and good practices to end-of-life care. The survey included open-ended and closed questions. The closed questions were analysed using descriptive statistics. The open-ended responses were coded and grouped into themes. 31 (N=31) prison nurses responded to the survey. The reported barriers to end-of-life care included some prison regimes, lack of appropriate care and visiting facilities, lack of privacy and inadequate visiting hours. Respondents also reported examples of good practice, including having access to specialist palliative care and specialist equipment, and being able to receive visits from family and friends. The findings suggest that there is considerable variability in the end-of-life care provided to prisoners in the UK. Further research is needed in order to reduce the health inequalities and improve the quality of end-of-life care experienced by prisoners in the UK. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Current practice and perspectives in CRO oversight based on a survey performed among members of the German Association of Research-Based Pharmaceutical Companies (vfa

    Directory of Open Access Journals (Sweden)

    Hennig, Michael

    2017-01-01

    Full Text Available In recent years, the number and scope of outsourced activities in the pharmaceutical industry have increased heavily. In addition, also the type of outsourcing has changed significantly in that time. This raises the question of whether and how sponsors retain the capability to select and to control the contract research organizations (CROs involved and what expertise still has to be present in the development department as well as other relevant departments to ensure adequate oversight, also in line with the expectations of regulators and health authorities. In order to answer these questions, a survey was conducted among the German vfa member companies. The survey describes the latest developments and experiences in outsourcing by 18 German vfa member companies. It concentrates on measures how to implement Quality Assurance (QA when performing outsourced clinical studies.This study shows that the majority of companies apply a full-outsourcing, preferred-provider model of clinical trial services, with the clinical research department playing the major role in this process. A large amount of guiding documents, processes and tools are used to ensure an adequate oversight of the services performed by the CRO(s.Finally the guiding principles for all oversight processes should be transparent communication, a clearly established expectation for quality, a precise definition of accountability and responsibility while avoiding silo mentality, and a comprehensive documentation of the oversight’s evidence. For globally acting and outsourcing sponsors, oversight processes need to be aligned with regards to local and global perspectives. This survey shows that the current implementation of oversight processes in the participating companies covers all relevant areas to ensure highest quality and integrity of the data produced by the outsourced clinical trial.

  16. Leadership training for radiologists: a survey of opportunities and participants in MBA and MPH programs by medical students, residents, and current chairpersons.

    Science.gov (United States)

    Baker, Stephen; Daginawala, Naznin

    2011-08-01

    The aim of this study was to determine opportunities for students and trainees to obtain an MPH or MBA degree during either medical school or radiology residency and to determine the prevalence of such degree possession by chairpersons in radiology. All allopathic medical schools in the United States were surveyed to chart the number of MD/MPH and MD/MBA degree programs available to students. Program directors were contacted to assess the number of MPH or MBA courses of study administratively related to their residencies. Also, an e-mail survey was sent to all members of the Society of Chairs of Academic Radiology Departments inquiring whether each chairperson had earned an additional degree. Currently, 81 allopathic medical schools in the United States offer MD/MPH degrees, and 52 offer MD/MBA degrees. Six residencies provide access to MPH programs, and 3 residencies provide the opportunity to pursue an MBA in conjunction with residency. Of these, only 1 MPH program and no MBA programs had trainees enrolled at present. Twenty-six percent of the chairpersons surveyed possessed advanced degrees other than MDs. There has been rapid growth in the number of MD/MPH and MD/MBA programs available to medical students. However, there is a scarcity of similar programs accessible to trainees during or just after residency training. To assist motivated radiologists interested in leading our profession, opportunities should expand both in formal degree-granting programs and through certificate-sanctioned course series to address relevant issues of leadership and management pertinent to our specialty. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Research and development of a high-temperature helium-leak detection system (joint research). Part 1 survey on leakage events and current leak detection technology

    Energy Technology Data Exchange (ETDEWEB)

    Sakaba, Nariaki; Nakazawa, Toshio; Kawasaki, Kozo [Japan Atomic Energy Research Inst., Oarai, Ibaraki (Japan). Oarai Research Establishment; Urakami, Masao; Saisyu, Sadanori [Japan Atomic Power Co., Tokyo (Japan)

    2003-03-01

    In High Temperature Gas-cooled Reactors (HTGR), the detection of leakage of helium at an early stage is very important for the safety and stability of operations. Since helium is a colourless gas, it is generally difficult to identify the location and the amount of leakage when very little leakage has occurred. The purpose of this R and D is to develop a helium leak detection system for the high temperature environment appropriate to the HTGR. As the first step in the development, this paper describes the result of surveying leakage events at nuclear facilities inside and outside Japan and current gas leakage detection technology to adapt optical-fibre detection technology to HTGRs. (author)

  18. Robotic surgery training with commercially available simulation systems in 2011: a current review and practice pattern survey from the society of urologic robotic surgeons.

    Science.gov (United States)

    Lallas, Costas D; Davis, John W

    2012-03-01

    Virtual reality (VR) simulation has the potential to standardize surgical training for robotic surgery. We sought to evaluate all commercially available VR robotic simulators. A MEDLINE(®) literature search was performed of all applicable keywords. Available VR simulators were evaluated with regard to face, content, and construct validation. Additionally, a survey was e-mailed to all members of the Endourological Society, querying the pervasiveness of VR simulators in robotic surgical training. Finally, each company was e-mailed to ask for a price quote for their respective system. There are four VR robotic surgical simulators currently available: RoSS™, dV-Trainer™, SEP Robot™, and da Vinci(®) Skills Simulator™. Each system is represented in the literature and all possess varying degrees of face, content, and construct validity. Although all systems have basic skill sets with performance analysis and metrics software, most do not contain procedural components. When evaluating the results of our survey, most respondents did not possess a VR simulator although almost all believed there to be great potential for these devices in robotic surgical training. With the exception of the SEP Robot, all VR simulators are similar in price. VR simulators have a definite role in the future of robotic surgical training. Although the simulators target technical components of training, their largest impact will be appreciated when incorporated into a comprehensive educational curriculum.

  19. The current status of education and career paths of students after completion of medical physicist programs in Japan: a survey by the Japanese Board for Medical Physicist Qualification.

    Science.gov (United States)

    Kadoya, Noriyuki; Karasawa, Kumiko; Sumida, Iori; Arimura, Hidetaka; Yamada, Syogo

    2015-07-01

    To standardize educational programs and clinical training for medical physics students, the Japanese Board for Medical Physicist Qualification (JBMP) began to accredit master's, doctorate, and residency programs for medical physicists in 2012. At present, 16 universities accredited by the JBMP offer 22 courses. In this study, we aimed to survey the current status of educational programs and career paths of students after completion of the medical physicist program in Japan. A questionnaire was sent in August 2014 to 32 universities offering medical physicist programs. The questionnaire was created and organized by the educational course certification committee of the JBMP and comprised two sections: the first collected information about the university attended, and the second collected information about characteristics and career paths of students after completion of medical physicist programs from 2008 to 2014. Thirty universities (16 accredited and 14 non-accredited) completed the survey (response rate 94 %). A total of 209, 40, and 3 students graduated from the master's, doctorate, and residency programs, respectively. Undergraduates entered the medical physicist program constantly, indicating an interest in medical physics among undergraduates. A large percentage of the students held a bachelor's degree in radiological technology (master's program 94 %; doctorate program 70 %); graduates obtained a national radiological technologist license. Regarding career paths, although the number of the graduates who work as medical physicist remains low, 7 % with a master's degree and 50 % with a doctorate degree worked as medical physicists. Our results could be helpful for improving the medical physicist program in Japan.

  20. Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration.

    Science.gov (United States)

    Escobar, Gabriel J; Baker, Jennifer M; Turk, Benjamin J; Draper, David; Liu, Vincent; Kipnis, Patricia

    2017-01-01

    This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us to broader reflections on hospital benchmarking. We reexamined an issue that has received far less attention from researchers than in the past: How variations in the hospital admission threshold might affect hospital rankings. Considering this threshold made us reconsider what benchmarking is and what future benchmarking studies might be like. Although we recognize that some of our assertions are speculative, they are based on our reading of the literature and previous and ongoing data analyses being conducted in our research unit. We describe the benchmarking analyses that led to these reflections. The Centers for Medicare and Medicaid Services' Hospital Compare Web site includes data on fee-for-service Medicare beneficiaries but does not control for severity of illness, which requires physiologic data now available in most electronic medical records.To address this limitation, we compared hospital processes and outcomes among Kaiser Permanente Northern California's (KPNC) Medicare Advantage beneficiaries and non-KPNC California Medicare beneficiaries between 2009 and 2010. We assigned a simulated severity of illness measure to each record and explored the effect of having the additional information on outcomes. We found that if the admission severity of illness in non-KPNC hospitals increased, KPNC hospitals' mortality performance would appear worse; conversely, if admission severity at non-KPNC hospitals' decreased, KPNC hospitals' performance would appear better. Future hospital benchmarking should consider the impact of variation in admission thresholds.

  1. Parkinson’s Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Sandipan Bhattacharjee

    2015-01-01

    Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

  2. E-WIN Project 2016: Evaluating the Current Gender Situation in Neurosurgery Across Europe-An Interactive, Multiple-Level Survey.

    Science.gov (United States)

    Steklacova, Anna; Bradac, Ondrej; de Lacy, Patricia; Benes, Vladimir

    2017-08-01

    The proportion of women among neurosurgeons appears to be growing worldwide with time. Official data concerning the current situation across Europe have not yet been published. Thus, there are still concerns about gender inequality. The European Women in Neurosurgery Project 2016 was designed to recognize the current situation across Europe. The office holders of the national neurosurgical societies of 39 countries forming the European Association of Neurosurgical Societies were contacted to provide data stating the proportion of women in neurosurgery. Obtained data were supplied with the results of an online survey. The response rate of national office holders was 90%. The number of reported neurosurgeons was 12,985, and overall proportion of women represented was 12%. Two hundred thirty-seven responses to online questionnaire were taken into account. The overall proportion of female respondents was 30%. There was no intergender variability in responses regarding amount of working time per week, exposure to surgeries, or administrative work. Male respondents reported dedicating significantly more time to scientific work and feeling more confident dictating own career direction. Female respondents reported being less often married, having fewer children, a stronger perception of gender significance level, and a higher appreciation of personal qualities. Neurosurgery is a challenging field of medicine. The results of our survey did not imply an overall feeling of gender inequality among European respondents, although women believe that the gender issue to be more important than men do and that they have to sacrifice more of their personal lives. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Current practice of usual clinic blood pressure measurement in people with and without diabetes: a survey and prospective 'mystery shopper' study in UK primary care.

    Science.gov (United States)

    Stevens, Sarah L; McManus, Richard J; Stevens, Richard John

    2018-04-12

    Hypertension trials and epidemiological studies use multiple clinic blood pressure (BP) measurements at each visit. Repeat measurement is also recommended in international guidance; however, little is known about how BP is measured routinely. This is important for individual patient management and because routinely recorded readings form part of research databases. We aimed to determine the current practice of BP measurement during routine general practice appointments. (1) An online cross-sectional survey and (2) a prospective 'mystery shopper' study where patients agreed to report how BP was measured during their next appointment. Primary care. Patient charity/involvement group members completing an online survey between July 2015 and January 2016. 334 participants completed the prospective study (51.5% male, mean age=59.3 years) of which 279 (83.5%) had diabetes. Proportion of patients having BP measured according to guidelines. 217 participants with (183) and without diabetes (34) had their BP measured at their last appointment. BP was measured in line with UK guidance in 63.7% and 60.0% of participants with and without diabetes, respectively. Initial pressures were significantly higher in those who had their BP measured more than once compared with only once (p=0.016/0.089 systolic and p<0.001/p=0.022 diastolic, in patients with/without diabetes, respectively). Current practice of routine BP measurement in UK primary care is often concordant with guidelines for repeat measurement. Further studies are required to confirm findings in broader populations, to confirm when a third repeat reading is obtained routinely and to assess adherence to other aspects of BP measurement guidance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors: A Formal Nutrition Education Course Is Necessary.

    Science.gov (United States)

    Daley, Brian J; Cherry-Bukowiec, Jill; Van Way, Charles W; Collier, Bryan; Gramlich, Leah; McMahon, M Molly; McClave, Stephen A

    2016-01-01

    Nutrition leaders surmised graduate medical nutrition education was not well addressed because most medical and surgical specialties have insufficient resources to teach current nutrition practice. A needs assessment survey was constructed to determine resources and commitment for nutrition education from U.S. graduate medical educators to address this problem. An online survey of 36 questions was sent to 495 Accreditation Council for Graduate Medical Education (ACGME) Program Directors in anesthesia, family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery. Demographics, resources, and open-ended questions were included. There was a 14% response rate (72 programs), consistent with similar studies on the topic. Most (80%) of the program directors responding were from primary care programs, the rest surgical (17%) or anesthesia (3%). Program directors themselves lacked knowledge of nutrition. While some form of nutrition education was provided at 78% of programs, only 26% had a formal curriculum and physicians served as faculty at only 53%. Sixteen programs had no identifiable expert in nutrition and 10 programs stated that no nutrition training was provided. Training was variable, ranging from an hour of lecture to a month-long rotation. Seventy-seven percent of program directors stated that the required educational goals in nutrition were not met. The majority felt an advanced course in clinical nutrition should be required of residents now or in the future. Nutrition education in current graduate medical education is poor. Most programs lack the expertise or time commitment to teach a formal course but recognize the need to meet educational requirements. A broad-based, diverse universal program is needed for training in nutrition during residency. © 2015 American Society for Parenteral and Enteral Nutrition.

  5. Current UK practice of pediatric supraglottic airway devices - a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland.

    Science.gov (United States)

    Bradley, Anthony E D; White, Michelle C; Engelhardt, Thomas; Bayley, Guy; Beringer, Richard M

    2013-11-01

    Over half of general anesthetics in the UK involve supraglottic airway devices (SADs). The National Audit Project 4 undertaken by the Royal College of Anaesthetists demonstrated that aspiration was the most frequent complication relating to SAD use. SADs designed to reduce this risk (second-generation devices) are increasingly recommended in both adults and children. As well as routine use, SADs are recommended for use in cases of 'difficult airway'. This survey assessed current usage of SADs in routine practice and difficult airways. Sixteen questions, approved by the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) survey committee, were distributed to all its members. Two hundred and forty-four members responded. Eighty-eight percent preferentially use first-generation rather than second-generation devices. The most important design feature was the availability of a complete range of sizes (84%). Seventy-seven percent felt that randomized controlled trials assessing SAD safety in children are needed. In cases of failed intubation, classically shaped SADs are preferred (79%). Three percent of responders intubate via an SAD routinely. Eighteen percent have employed this technique in an emergency. Thirty-six percent of responders have found an SAD to function poorly. Pediatric anesthesiologists appear slow to embrace second-generation SADs. The role of SADs in the management of difficult airways is widely accepted. Research currently has little influence over the choice of which SAD to use, which is more likely determined by personal choice and departmental preference. There is a risk that some SADs are unsafe. © 2013 John Wiley & Sons Ltd.

  6. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: survey of GP origins and current place of work.

    Science.gov (United States)

    Dowell, J; Norbury, M; Steven, K; Guthrie, B

    2015-10-01

    Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the

  7. Access to Care for Medicare-Medicaid Dually Eligible Beneficiaries: The Role of State Medicaid Payment Policies.

    Science.gov (United States)

    Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian

    2017-12-01

    Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.

  8. Current manufactured cigarette smoking and roll-your-own cigarette smoking in Thailand: findings from the 2009 Global Adult Tobacco Survey.

    Science.gov (United States)

    Benjakul, Sarunya; Termsirikulchai, Lakkhana; Hsia, Jason; Kengganpanich, Mondha; Puckcharern, Hataichanok; Touchchai, Chitrlada; Lohtongmongkol, Areerat; Andes, Linda; Asma, Samira

    2013-03-27

    Current smoking prevalence in Thailand decreased from 1991 to 2004 and since that time the prevalence has remained flat. It has been suggested that one of the reasons that the prevalence of current smoking in Thailand has stopped decreasing is due to the use of RYO cigarettes. The aim of this study was to examine characteristics of users of manufactured and RYO cigarettes and dual users in Thailand, in order to determine whether there are differences in the characteristics of users of the different products. The 2009 Global Adult Tobacco Survey (GATS Thailand) provides detailed information on current smoking patterns. GATS Thailand used a nationally and regionally representative probability sample of 20,566 adults (ages 15 years and above) who were chosen through stratified three-stage cluster sampling and then interviewed face-to-face. The prevalence of current smoking among Thai adults was 45.6% for men and 3.1% for women. In all, 18.4% of men and 1.0% of women were current users of manufactured cigarettes only, while 15.8% of men and 1.7% of women were current users of RYO cigarettes only. 11.2% of men and 0.1% of women used both RYO and manufactured cigarettes. Users of manufactured cigarettes were younger and users of RYO were older. RYO smokers were more likely to live in rural areas. Smokers of manufactured cigarettes appeared to be more knowledgeable about the health risks of tobacco use. However, the difference was confounded with age and education; when demographic variables were controlled, the knowledge differences no longer remained. Smokers of manufactured cigarettes were more likely than dual users and those who used only RYO to report that they were planning on quitting in the next month. Users of RYO only appeared to be more addicted than the other two groups as measured by time to first cigarette. There appears to be a need for product targeted cessation and prevention efforts that are directed toward specific population subgroups in Thailand and

  9. Management of patients taking antiplatelet or anticoagulant medication requiring invasive breast procedures: United Kingdom survey of radiologists' and surgeons' current practice

    International Nuclear Information System (INIS)

    Pritchard, M.G.; Townend, J.N.; Lester, W.A.; England, D.W.; Kearins, O.; Bradley, S.A.

    2008-01-01

    Aim: To determine the current practice in the UK National Health Service Breast Screening Programme for invasive diagnostic procedures and surgery in patients taking anticoagulant and antiplatelet medication. Materials and methods: Lead radiologists and surgeons at each breast screening service were surveyed to determine current practice. One hundred and five respondents provided information regarding their services, protocols, and willingness to proceed with combinations of procedures and anti-haemostatic medications. Results: Between units there was wide variation in practice. Within 21 services providing more than one response, 10 (48%) disagreed on whether protocols existed. Decisions to perform biopsies were unrelated to professional group. The taking of a drug history was variable. Surgeons reported more adverse effects than radiologists [21 (48%) versus 12 (26%)], but no difference in self-assessment of knowledge. Conclusion: Both radiologists and surgeons have expressed uncertainty about their understanding of anticoagulant and antiplatelet treatment. This is reflected in a wide range of practice. Guidance regarding the management of these patients is suggested

  10. Identifying current training provision and future training needs in allergy available for UK general practice trainees: national cross-sectional survey of General Practitioner Specialist Training programme directors.

    Science.gov (United States)

    Ellis, Jayne; Rafi, Imran; Smith, Helen; Sheikh, Aziz

    2013-03-01

    There are ongoing concerns about the quality of care provision for allergy in primary care. To identify current training provision in allergy to GP trainees and to understand how this could be enhanced. A cross-sectional survey of GP Speciality Training (GPST) programme directors was undertaken. Programme directors of the 174 GPST schemes were sent an online questionnaire which was informed by the content of the Royal College of General Practitioners curriculum. Quantitative data were descriptively analysed and a thematic analysis was undertaken of free text responses. We obtained responses from 146 directors representing 106 training programmes. Responses indicated that two-thirds (62%, 95% CI 53.1 to 71.5) of programmes were providing at least some allergy training, with the remaining third stating that they either provided no training or were unsure. Overall, one-third (33%, 95% CI 22.7 to 42.2) of programme directors believed that all the relevant allergy-related curriculum requirements were being met. Where provided, this training was believed to be best for organ-specific allergic disorders but was thought to be poorer for systemic allergic disorders, particularly food allergy where 67% (95% CI 57.5 to 76.5) of respondents indicated that training was poor. There was considerable interest in increasing the allergy training provided, preferably through eLearning modules and problem-based learning materials supported by those with relevant specialist knowledge. This UK-wide survey has identified important gaps in the training of GP trainees in relation to allergy care. Addressing these gaps, particularly in the management of systemic allergic disorders, should help to improve delivery of primary care-based allergy care.

  11. Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey.

    Science.gov (United States)

    Agrawal, Hitesh; Mery, Carlos M; Day, Patrick E; Sexson Tejtel, S Kristen; McKenzie, E Dean; Fraser, Charles D; Qureshi, Athar M; Molossi, Silvana

    2017-09-01

    Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA. Descriptive statistics were performed. A total of 91 providers (46%) completed the survey including pediatric cardiology subspecialists (40%), general pediatric cardiologists (24%), cardiovascular (CV) surgeons (22%), adult cardiologists (10%), nurse practitioners (8%), cardiology fellows (3%) and CV anesthesiologist (1%). Forty-eight percent had been practicing for over 15 years and 28% were in their first 5 years of practice. Fifty-two percent of the providers cared for adults and 93% cared for children/adolescents. Eighty-eight percent were affiliated with an academic institution. All but one provider practiced in the USA, 62% practiced in Texas. Half of participants (50%) were very comfortable managing AAOCA patients and 36% were somewhat comfortable. Providers utilized various imaging tests to confirm the anatomy including computed tomography angiography 88%, cardiac magnetic resonance imaging 70%, cardiac catheterization 60%, echocardiogram 12%, IVUS 2% and myocardial perfusion scan 1%. The majority felt comfortable in counseling the families and felt that depending on the type of lesion these patients should get surgical referral (85%) vs clinical follow up (67%) with exercise restriction (65%). There is heterogeneity in the way AAOCA patients are currently evaluated and managed. A knowledge gap exists even with participants from academic institutions. Long-term data with a defined approach to management of these patients may help to

  12. Current knowledge, attitude and behaviour of hand and food hygiene in a developed residential community of Singapore: a cross-sectional survey.

    Science.gov (United States)

    Pang, Junxiong; Chua, Shao Wei Jonathan Lumen; Hsu, Liyang

    2015-06-21

    Diarrhoea incidence has been increasing progressively over the past years in developed countries, including Singapore, despite the accessibility and availability to clean water, well-established sanitation infrastructures and regular hygiene promotion. The aim of this study is to determine the current knowledge, attitude and behaviour of hand and food hygiene, and the potential risk factors of diarrhoea in a residential community of Singapore. A cross-sectional study was conducted within a residential area in the west of Singapore from June to August 2013. A total of 1,156 household units were randomly sampled and invited to participate in an interviewer-assisted survey using standardised questionnaires. Descriptive, univariate and multivariate analyses were performed using descriptive statistics, Fisher's Exact test and multivariate logistic regression modelling, respectively. R program was used for all statistical analysis. All tests were conducted at 5% level of significance with 95% confidence intervals (CI) reported where applicable. A total of 240 units (20.8%) consented and responded to the survey invitation. About 77% of the expected knowledge and attitude were observed in at least 80% of the participants, compared to only about 31% of the expected behaviours and practises. Being single [adjusted odds ratio (AOR) = 2.29; 95% CI = 1.16-4.48], having flu in the past six month (AOR = 3.24; 95% CI = 1.74-6.06), preferred self-medication (AOR = 2.07; 95% CI = 1.06-4.12) were risk factors of diarrhoea. Washing hands with water before attending to children or sick persons (AOR = 0.30; 95% CI = 0.11-0.82), washing hands with water (AOR = 0.16; 95% CI = 0.05-0.45) and water with soap (AOR = 0.29; 95% CI = 0.12-0.72) after attending to children or sick persons, and hand washing between 30 s to a minute (AOR = 0.44; 95% CI = 0.20-0.90) were protective factors against diarrhoea. Good knowledge and attitude of the

  13. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Science.gov (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus

    2016-01-01

    Background Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved. PMID:27350748

  14. A synopsis on current practice in the diagnosis and management of patients with Turner syndrome in Turkey: A survey of 18 pediatric endocrinology centers*

    Science.gov (United States)

    Uçar, Ahmet; Abacı, Ayhan; Pirgon, Özgür; Dündar, Bumin; Tütüncüler, Filiz; Çatlı, Gönül; Anık, Ahmet; Kılınç Uğurlu, Aylin; Büyükgebiz, Atilla

    2018-04-27

    A comprehensive survey was conducted courtesy of the Turkish Turner study group to evaluate the shortcomings of clinical care in patients with Turner syndrome (TS) in Turkey. A structured questionnaire prepared by the Turner study group in Turkey, which covers relevant aspects of the care of patients with TS, was sent to all pediatric endocrinology centers. Eighteen centers (41%) returned the questionnaire. In the majority of the centers, diagnostic genetic testing, screening for Y chromosomal material, protocols regarding the timing and posology of growth hormone (GH) and estrogen, thrombophilia screening, fertility information, and screening for glucose intolerance, thyroid, and coeliac diseases in patients with TS were in line with the current consensus. Thirteen centers (72.2%) performed GH stimulation tests. Only four centers (22.2%) used oxandrolone in patients with TS with very short stature. The majority of the centers relied on bone age and breast development to assess estrogen adequacy, though together with variable combinations of oestrogen surrogates. Two centers (11.1%) reported performing serum estradiol measurements. Eight centers (44.4% ) routinely conducted cardiac/thoracic aorta magnetic resonance imaging. Screening for hearing, dental, and ophthalmologic problems were performed by thirteen (72.2%), six (33.3%), and ten (55.6 %) centers, respectively. Psychiatric assessments were made by four centers (22.2%) at diagnosis, with only one center (5.6% ) requiring annual reassessments. Although we found some conformity between the current consensus and practice of the participating centers in Turkey regarding TS, further improvements are mandatory in the multi-disciplinary approach to address co-morbidities, which if unrecognized, may be associated with reduced quality of life, and even mortality.

  15. A Survey of University of Medical Sciences’ Health Care Professionals on the Current and Ideal Role of General Practitioners in Iran

    Directory of Open Access Journals (Sweden)

    Bijan Geraili

    2009-08-01

    Full Text Available Background and purpose: roles and tasks of intended graduates direct medical eductionist for developing the right curriculum. In Iran there has been no systematic study on defining GPs roles. This study is an attempt to systematically clarify the roles of GPs in Iran.Methods: In this questionnaire – based survey health care professionals participated. The subjects were selected through convinient sampling and snowballing. A semi-structured questionnaire was developed which covered the goals and functions of health system as mentioned in World Health Report 2000. For content validity a panel of experts including health care professionals, biostatisticians, and psychometrist evaluated the questionnaire. For the reliability of the questionnaire a pilot study was carried out. Chronbach’s coeficient were calculated as 0.89 .The final revision of the questionnaire included 15 roles in current and ideal states. The respondent should score each role in both states in a range of 0-100.Results: Of 50 subjects who received the questionnaire, 40 (80% completed and returned it. Of all subjects 30% were female and 70% were male. Of all subjects 90% were faculty members. The subjects believe that in the current state “health care provision” (74.7.3±29.7 “health center administration” (37±21.8, and “leading clinical services and coordinating patients care” (29.5±24.4 are more evident while “fund holding” is rather non-existence (1.2±3.7. They believed that in an ideal national health system physicians should play most of these roles in various extents.Conclusion: The participants believed that GPs should play other roles beyond the clinical care provision to enable health system respond to community needs and expectations. The graduate medical degree should be reformed if the gradates are going to play these new roles.Key words: Role Definition, Curriculum Development, GP, Primary Health Care

  16. Understanding the increase in the number of childbirth-related leave beneficiaries in Serbia

    Directory of Open Access Journals (Sweden)

    Stanić Katarina

    2017-01-01

    Full Text Available Over the past number of years, the public expenditures for childbirth-related leave benefits have more than doubled – in 2015 amounted to 0.7% GDP in relation to 0.3% GDP in 2002. This increase can mainly be attributed to the increased number of beneficiaries that grew consistently from 24 thousand in 2002 up to 40 thousand in 2015, despite the fact that the annual number of live births has been almost continually decreasing and the registered employment has dropped by almost 20 per cent in the observed period. One of the clear reasons explaining part of this increase is the extension of 3+ order of birth leaves in 2006, from one to two years, which can explain the increase of around 3.5 thousand of beneficiaries. Another reason is high number of beneficiaries using special child-care leave meant for parents with children with disabilities, but which, in reality, is very often used simply as the extension of parental leave. The average number of special child-care leave beneficiaries in the second half of 2015 amounted to 2.8 thousand. When these two effects are taken into account, we still notice significant increase of beneficiaries of around 10 thousand in the observed period. Fictitious employment during the pregnancy can explain this increase to some extent. Available data unambiguously show that a number of women formally employing during the second and third trimester of pregnancy has increased from 800 in 2002 to almost 3.5 thousand monthly average in the second half of 2015. There are two flaws of the childbirth-related leave programme in Serbia, which together lead to the constant increase of the number of beneficiaries. First is the lack of flexibility of the programme, both in terms of eligibility for acquiring the right as well as in terms of flexibility in use. Maternity/parental leave benefit may acquire only those in „standard employment” i.e. employed under employment contract (and entrepreneurs while other type of

  17. Capacitively coupled and direct-current resistivity surveys of selected reaches of Cozad, Thirty-Mile, Orchard-Alfalfa, Kearney, and Outlet Canals in Nebraska, 2012-13

    Science.gov (United States)

    Hobza, Christopher M.; Burton, Bethany L.; Lucius, Jeffrey E.; Tompkins, Ryan E.

    2014-01-01

    Understanding the spatial characteristics of leakage from canals is critical to effectively managing and utilizing water resources for irrigation and hydroelectric purposes. Canal leakage in some parts of Nebraska is the primary source of water for groundwater recharge and helps maintain the base flow of streams. Because surface-water supplies depend on the streamflow of the Platte River and the available water stored in upstream reservoirs, water managers seek to minimize conveyance losses, which can include canal leakage. The U.S. Geological Survey, in cooperation with the Central Platte Natural Resources District and Nebraska Public Power District, used capacitively coupled (CC) and direct-current (DC) resistivity techniques for continuous resistivity profiling to map near-surface lithologies near and underlying the Cozad, Thirty-Mile, Orchard-Alfalfa, Kearney, and Outlet Canals. Approximately 84 kilometers (km) of CC-resistivity data were collected along the five canals. The CC-resistivity data were compared with results from continuous sediment cores and electrical conductivity logs. Generally, the highest resistivities were recorded at the upstream reaches of the Cozad, Thirty-Mile, and Orchard-Alfalfa canals where flood-plain deposits of silt and clay mantle coarser channel deposits of sand and gravel. The finer grained deposits gradually thicken with increasing distance away from the Platte River. Consequently, for many surveyed reaches the thickness of fine-grained deposits exceeded the 8-meter depth of investigation. A detailed geophysical investigation along a 5-km reach of the Outlet Canal southwest of North Platte, Nebraska, used CC and DC resistivity to examine the condition of a compacted-core bank structure and characterized other potential controls on areas of focused seepage. CC-resistivity data, collected along the 5-km study reach, were compared with continuous sediment cores and DC-resistivity data collected near a selected seep near Outlet

  18. Racial/ethnic and socioeconomic variations in duration of smoking: results from 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey.

    Science.gov (United States)

    Siahpush, M; Singh, G K; Jones, P R; Timsina, L R

    2010-06-01

    Little is known about racial/ethnic and socioeconomic variations in the duration of smoking. The goal of this research was to examine these variations. Data came from the 2003, 2006 and 2007 Tobacco Use Supplement of the Current Population Survey. The analysis was limited to ever-smokers (n = 117,168). The outcome was number of years of daily smoking. Survival analysis was employed to predict smoking duration. American Indians with 32 years had the highest median duration of smoking, followed by Blacks and 'other' races with 30 years, Whites with 28 years and Hispanics with 24 years. The difference in the duration of smoking between Blacks and Whites disappeared after adjusting for poverty. Individuals in poverty had a median duration of smoking of 40 years, while those with a family income of at least three times that of the poverty threshold had a median duration of 22 years. Median duration of smoking was 40 years among individuals without a high-school diploma and 18 years among those with a bachelors or higher degree. This research revealed large variations in smoking duration between racial/ethnic and socioeconomic groups. Longer exposure to tobacco among groups that are already disadvantaged is likely to exacerbate existing health disparities.

  19. Prevalence and Geographic Variations of Polypharmacy Among West Virginia Medicaid Beneficiaries.

    Science.gov (United States)

    Feng, Xue; Tan, Xi; Riley, Brittany; Zheng, Tianyu; Bias, Thomas K; Becker, James B; Sambamoorthi, Usha

    2017-11-01

    West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens. To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries. In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570). We defined polypharmacy as simultaneous use of drugs from five or more different drug classes on a daily basis for at least 60 consecutive days in one year. Multilevel logistic regression was used to explore the individual- and county-level factors associated with polypharmacy. Its relationship with healthcare utilization was assessed using negative binomial regression and logistic regression. The univariate local indicators of spatial association method was applied to explore spatial patterns of polypharmacy in WV. The prevalence of polypharmacy among WV Medicaid beneficiaries was 44.6%. High-high clusters of polypharmacy were identified in southern WV, indicating counties with above-average prevalence surrounded by counties with above-average prevalence. Polypharmacy was associated with being older, female, eligible for Medicaid due to cash assistance or medical eligibility, having any chronic conditions or more chronic conditions, and living in a county with lower levels of education. Polypharmacy was associated with more hospitalizations, emergency department visits, and outpatient visits, as well as higher non-drug medical expenditures. Polypharmacy was prevalent among WV Medicaid beneficiaries and was associated with substantial healthcare utilization and expenditures. The clustering of high prevalence of polypharmacy in southern WV may suggest targeted strategies to reduce polypharmacy burden in these areas.

  20. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Directory of Open Access Journals (Sweden)

    Kenneth J. Bagstad

    2014-06-01

    Full Text Available Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service, sinks (biophysical or anthropogenic features that deplete or alter service flows, users (user locations and level of demand, and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems' capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for

  1. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Science.gov (United States)

    Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

    2014-01-01

    Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic

  2. Current Cigarette Smoking, Access, and Purchases from Retail Outlets Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 45 Countries, 2013 and 2014.

    Science.gov (United States)

    D'Angelo, Denise; Ahluwalia, Indu B; Pun, Eugene; Yin, Shaoman; Palipudi, Krishna; Mbulo, Lazarous

    2016-09-02

    Tobacco use is a leading preventable cause of morbidity and mortality, with nearly 6 million deaths caused by tobacco use worldwide every year (1). Cigarette smoking is the most common form of tobacco use in most countries, and the majority of adult smokers initiate smoking before age 18 years (2,3). Limiting access to cigarettes among youths is an effective strategy to curb the tobacco epidemic by preventing smoking initiation and reducing the number of new smokers (3,4). CDC used the Global Youth Tobacco Survey (GYTS) data from 45 countries to examine the prevalence of current cigarette smoking, purchase of cigarettes from retail outlets, and type of cigarette purchases made among school students aged 13-15 years. The results are presented by the six World Health Organization (WHO) regions: African Region (AFR); Eastern Mediterranean Region (EMR); European Region (EUR); Region of the Americas (AMR); South-East Asian Region (SEAR); and Western Pacific Region (WPR). Across all 45 countries, the median overall current cigarette smoking prevalence among students aged 13-15 years was 6.8% (range = 1.7% [Kazakhstan]-28.9% [Timor-Leste]); the median prevalence among boys was 9.7% (2.0% [Kazakhstan]-53.5% [Timor-Leste]), and among girls was 3.5% (0.0% [Bangladesh]-26.3% [Italy]). The proportion of current cigarette smokers aged 13-15 years who reported purchasing cigarettes from a retail outlet such as a store, street vendor, or kiosk during the past 30 days ranged from 14.9% [Latvia] to 95.1% [Montenegro], and in approximately half the countries, exceeded 50%. In the majority of countries assessed in AFR and SEAR, approximately 40% of cigarette smokers aged 13-15 years reported purchasing individual cigarettes. Approximately half of smokers in all but one country assessed in EUR reported purchasing cigarettes in packs. These findings could be used by countries to inform tobacco control strategies in the retail environment to reduce and prevent marketing and sales of

  3. A survey of U.S. prosthodontists and dental schools on the current materials and methods for final impressions for complete denture prosthodontics.

    Science.gov (United States)

    Petrie, Cynthia S; Walker, Mary P; Williams, Karen

    2005-12-01

    The purpose of this study was to survey members of The American College of Prosthodontists (ACP) to evaluate current materials and methods for final impressions for complete denture prosthodontics in the United States. In addition, those methods were compared with methods and materials taught in U.S. dental schools via a second survey sent to the chairpersons of prosthodontic/restorative departments. An anonymous questionnaire was mailed to all 1762 active ACP members in the United States in 2003. A slightly modified questionnaire was also distributed to chairpersons of prosthodontic/restorative departments in the 54 U.S. dental schools. Data analysis was performed via frequency distribution and chi-square statistics. Nine hundred and forty-five questionnaires were returned by members of the ACP (54% return rate) and 42 questionnaires were returned by the U.S. dental schools (78% return rate). The majority of the reporting prosthodontists (88%) and dental schools (98%) use a border-molded custom tray for final impressions for complete denture prosthodontics. The most popular material for border molding was plastic modeling compound (67% of reporting ACP members, and 95% of the responding dental schools). Variability of the materials used for final impressions was observed, with the most popular materials being polyvinylsiloxane for the ACP members (36%) and polysulfide for the dental schools (64%). Statistically significant differences were found in the materials used for border molding by prosthodontists based on the time elapsed since completion of prosthodontic training. No differences were found in the materials used for impression of edentulous arches based on years of experience. Geographic location did not influence the materials and methods used by prosthodontists for complete denture final impressions. There was variability of the materials and techniques used for final impressions by ACP members and dental schools; however, overall there was an agreement

  4. Lesotho - Enterprise Survey

    Data.gov (United States)

    Millennium Challenge Corporation — The 2011 MCA-Lesotho baseline enterprise survey is a national survey of enterprises. The main objective of the survey was to assess the current status of businesses...

  5. Affiliation of the beneficiaries of a deferred pension to the CERN Health Insurance Scheme

    CERN Multimedia

    2003-01-01

    Subsequent to the modifications to the Rules and Regulations of the Pension Fund allowing members of the personnel having five years of affiliation to the Fund to opt for a deferred retirement pension, the Organization wishes to recall the rules relating to the affiliation of those beneficiaries to the CERN Health Insurance Scheme (CHIS). In accordance with Articles III 2.02 and VIII 4.02 of the CHIS Rules, beneficiaries of a deferred retirement pension can only be Members of the CHIS as CERN pensioners if they applied to remain Members of the Scheme upon termination of their compulsory membership as a member of the personnel and if their membership has been uninterrupted up to the moment they become CERN pensioners. The applicable contribution for this intermediate period is indicated in Articles III 5.03 and X 1.02 of the CHIS Rules. The amount is revised annually, and is set at 936 CHF/ month for 2003. Human Resources Division Tel. 73635

  6. Knowledge, awareness, and utilization pattern of services under Janani Suraksha Yojana among beneficiaries in rural area of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Prem Lal Chauhan

    2015-01-01

    Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.

  7. Current situation regarding central venous port implantation procedures and complications: a questionnaire-based survey of 11,693 implantations in Japan.

    Science.gov (United States)

    Shiono, Masatoshi; Takahashi, Shin; Takahashi, Masanobu; Yamaguchi, Takuhiro; Ishioka, Chikashi

    2016-12-01

    We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure. Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups. We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %). Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

  8. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

    Directory of Open Access Journals (Sweden)

    Br

    2016-06-01

    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  9. A Survey of University of Medical Sciences’ Administrators and GPs on the Current and Ideal Role of General Practitioners in Iran

    Directory of Open Access Journals (Sweden)

    Bijan Geraili

    2009-07-01

    Full Text Available Background and purpose: roles and tasks of intended graduates direct medical eductionist for developing the right curriculum. In Iran there has been no systematic study on defining GPs roles. This study is an attempt to systematically clarify the roles of GPs in Iran.Methods: In this questionnaire – based survey executive directors of Universities of medicine of Iran and general practitioners participated. The subjects were selected through stratified sampling procedure. A semi-structured questionnaire was developed which covered the goals and functions of health system as mentioned in World Health Report 2000. For content validity a panel of experts including health care professionals, biostatisticians, and psychometrist evaluated the questionnaire. For the reliability of the questionnaire a pilot study was carried out. Chronbach’s coeficient were calculated as 0.89 .The final revision of the questionnaire included 15 roles in current and ideal states. The respondent should score each role in both states in a range of 0-100.Results: Of 94 subjects who received the questionnaire, 71 (80% completed and returned it. Of all subjects 42.2% were female and 57.8% were male. Of all subjects 25% were faculty members. The subjects believe that in the current state “health care provision” (85.4±18.6 “health center administration” (57.8±24.8, and “leading clinical services and coordinating patients care” (47.6±26.8 are more evident while “fund holding” had the lowest rank(5.0±10.0. They believed that in an ideal national health system physicians should play most of these roles in various extents.Conclusion: The participants believed that GPs should play other roles beyond the clinical care provision to enable health system respond to community needs and expectations. The graduate medical degree should be reformed if the gradates are going to play these new roles.Key words: Role Definition, Curr iculum Development, GP, Primary Health

  10. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? 411.555 Section 411.555 Employees... Payment Systems § 411.555 Can the EN keep the milestone and outcome payments even if the beneficiary does...

  11. 19 CFR 10.26 - Articles assembled or processed in a beneficiary country in whole of U.S. components or...

    Science.gov (United States)

    2010-04-01

    ..., material, ingredient, or article remained under the control of the customs authority of the non-beneficiary... 19 Customs Duties 1 2010-04-01 2010-04-01 false Articles assembled or processed in a beneficiary... textile components cut to shape in the United States. 10.26 Section 10.26 Customs Duties U.S. CUSTOMS AND...

  12. Estimating infertility prevalence in low-to-middle-income countries: an application of a current duration approach to Demographic and Health Survey data.

    Science.gov (United States)

    Polis, Chelsea B; Cox, Carie M; Tunçalp, Özge; McLain, Alexander C; Thoma, Marie E

    2017-05-01

    Can infertility prevalence be estimated using a current duration (CD) approach when applied to nationally representative Demographic and Health Survey (DHS) data collected routinely in low- or middle-income countries? Our analysis suggests that a CD approach applied to DHS data from Nigeria provides infertility prevalence estimates comparable to other smaller studies in the same region. Despite associations with serious negative health, social and economic outcomes, infertility in developing countries is a marginalized issue in sexual and reproductive health. Obtaining reliable, nationally representative prevalence estimates is critical to address the issue, but methodological and resource challenges have impeded this goal. This cross-sectional study was based on standard information available in the DHS core questionnaire and data sets, which are collected routinely among participating low-to-middle-income countries. Our research question was examined among women participating in the 2013 Nigeria DHS (n = 38 948). Among women eligible for the study, 98% were interviewed. We applied a CD approach (i.e. current length of time-at-risk of pregnancy) to estimate time-to-pregnancy (TTP) and 12-month infertility prevalence among women 'at risk' of pregnancy at the time of interview (n = 7063). Women who were 18-44 years old, married or cohabitating, sexually active within the past 4 weeks and not currently using contraception (and had not been sterilized) were included in the analysis. Estimates were based on parametric survival methods using bootstrap methods (500 bootstrap replicates) to obtain 95% CIs. The estimated median TTP among couples at risk of pregnancy was 5.1 months (95% CI: 4.2-6.3). The estimated percentage of infertile couples was 31.1% (95% CI: 27.9-34.7%)-consistent with other smaller studies from Nigeria. Primary infertility (17.4%, 95% CI: 12.9-23.8%) was substantially lower than secondary infertility (34.1%, 95% CI: 30.3-39.3%) in this population

  13. Epidemiology and Self-Treatment of Travelers’ Diarrhea in a Large, Prospective Cohort of Department of Defense Beneficiaries

    Science.gov (United States)

    Lalani, Tahaniyat; Maguire, Jason D.; Grant, Edward M.; Fraser, Jamie; Ganesan, Anuradha; Johnson, Mark D.; Deiss, Robert G.; Riddle, Mark S.; Burgess, Timothy; Tribble, David R.

    2014-01-01

    Background Infectious diarrhea is a common problem among travelers. Expert guidelines recommend the prompt use of antibiotics for self-treatment of moderate or severe traveler’s diarrhea (TD). There is limited data on whether travelers follow these self-treatment guidelines. We evaluated the risk factors associated with TD, use of TD self-treatment, and risk of irritable bowel syndrome (IBS) during travel. Methods Department of Defense beneficiaries traveling outside the US for ≤ 6.5 months were enrolled in a prospective cohort study. Participants received pre- and post-travel surveys, and could opt into a travel illness diary and follow-up surveys for symptoms of IBS. Standard definitions were used to assess for TD and IBS. Sub-optimal self-treatment was defined as use of antibiotics (with or without antidiarrheal agents) for mild TD, or use of antidiarrheals alone or no self-treatment in cases of moderate or severe TD. Results Twenty-four percent of participants (270/1120) met criteria for TD. The highest incidence was recorded in Africa (8.6 cases/100 person-weeks, 95% CI: 6.7–10.5). Two hundred and twelve TD cases provided information regarding severity and self-treatment: 89 (42%) had mild TD and 123 (58%) had moderate or severe TD. Moderate or severe TD was independently associated with suboptimal self-treatment (OR 10.4 [95% CI: 4.92–22.0]). Time to last unformed stool did not differ between optimal and suboptimal self-treatment. IBS occurred in 4.5% (7/154) of TD cases and 3.1% (16/516) of patients without TD (p=0.39). Among TD cases, a lower incidence of IBS was noted in participants who took antibiotics (4.8% (5/105) vs. 2.2% (1/46)), but the difference did not reach statistical significance (p=0.60). Conclusions Our results suggest the underutilization of antibiotics in travelers with moderate or severe TD. Further studies are needed to systematically evaluate pre-travel instruction and traveler adherence to self-treatment guidelines, and the

  14. Current Views and Perspectives on E-Mental Health: An Exploratory Survey Study for Understanding Public Attitudes Toward Internet-Based Psychotherapy in Germany.

    Science.gov (United States)

    Apolinário-Hagen, Jennifer; Vehreschild, Viktor; Alkoudmani, Ramez M

    2017-02-23

    Despite the advanced development of evidence-based psychological treatment services, help-seeking persons with mental health problems often fail to receive appropriate professional help. Internet-delivered psychotherapy has thus been suggested as an efficient strategy to overcome barriers to access mental health care on a large scale. However, previous research indicated poor public acceptability as an issue for the dissemination of Internet-delivered therapies. Currently, little is known about the expectations and attitudes toward Internet-delivered therapies in the general population. This is especially the case for countries such as Germany where electronic mental health (e-mental health) treatment services are planned to be implemented in routine care. This pilot study aimed to determine the expectations and attitudes toward Internet-based psychotherapy in the general population in Germany. Furthermore, it aimed to explore the associations between attitudes toward Internet-based therapies and perceived stress. To assess public attitudes toward Internet-based psychotherapy, we conducted both Web-based and paper-and-pencil surveys using a self-developed 14-item questionnaire (Cronbach alpha=.89). Psychological distress was measured by employing a visual analogue scale (VAS) and the 20-item German version of the Perceived Stress Questionnaire (PSQ). In addition, we conducted explorative factor analysis (principal axis factor analysis with promax rotation). Spearman's rank correlations were used to determine the associations between attitudes toward Internet-based therapies and perceived stress. Descriptive analyses revealed that most respondents (N=1558; female: 78.95%, 1230/1558) indicated being not aware of the existence of Internet-delivered therapies (83.46%, 1141/1367). The average age was 32 years (standard deviation, SD 10.9; range 16-76). Through exploratory factor analysis, we identified 3 dimensions of public attitudes toward Internet-based therapies

  15. Out of Pocket expenditure among beneficiaries of Janani Shishu Suraksha Karyakaram

    Directory of Open Access Journals (Sweden)

    Jyoti Tyagi

    2016-12-01

    Full Text Available Background: About 67,000 women in India die every year (MoHFW, 2011, due to pregnancy related complications. Similarly, every year more than 13 lacs infants die, within 1 year of the birth and out of these approximately 9 lacs i.e. 2/3rd of the infant deaths take place within the first four weeks of life (1.Out of these, approximately 7 lacs i.e. 75% of the deaths take place within a week of the birth and a majority of these occur in the first two days after birth (1. In view of the difficulty being faced by the pregnant women and parents of sick new-born (MoHFW,2011, along with high out-of-pocket expenses incurred by them on delivery and treatment of sick new-born, Ministry of Health and Family Welfare has taken a major initiative, to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth in Government health institutions in both rural & urban areas. Material & Methods: In this community based descriptive cross-sectional study, data was collected from 100 mothers, who had delivered in last one year at District Hospital Maternal Wing situated at Morar Block of Gwalior District M.P and MO, ANM’s, ASHA’s, using Semi structured close ended Interview schedule and an open ended questionnaire respectively. Data were compared by using SPSS (ver. 22.0 Result: Expenses were divided under two heads, medical and non-medical. 15% of the total beneficiaries incurred the medical expenses in the form of medicines, diagnostics etc. and almost 99% of all the respondents incurred the non-medical expenses in the form of transport, food etc. Conclusion: Based on the outcome of the study the overall impression was that 59% of the beneficiaries were not aware of the JSSK scheme. Only during pregnancies through the initiatives of the ASHAs the beneficiaries came to know about the free entitlements of the scheme. There was unavailability of ambulance when

  16. Prevalence and Determinants of Current Smoking and Intention to Smoke among Secondary School Students: A Cross-Sectional Survey among Han and Tujia Nationalities in China.

    Science.gov (United States)

    Xu, Xianglong; Liu, Dengyuan; Sharma, Manoj; Zhao, Yong

    2017-10-30

    Objectives: This study examined the patterns and determinants of current smoking and intention to smoke among secondary school students of Han and Tujia nationalities in China. Methods: A cross-sectional survey was conducted in three regions, namely, Chongqing, Liaocheng, and Tianjin, of China in 2015. A structured self-administered questionnaire was used for data collection. Results: Of the total subjects ( n = 1805), 78.9% were ethnic Han and 21.1% were ethnic Tujia. Overall 9.4% (Han: 7.7%; Tujia: 15.5%) secondary school students were smokers and 37.28% smoked more than once per day. Of the non-smoker students ( n = 1636), 17.4% have an intention to smoke. A total of 81.1% of students reportedly had never been taught throughout school about smoking or tobacco prevention. When compared to the students who were taught in the school about smoking or tobacco prevention (18.90%) students who were never taught were more likely to smoke (OR = 2.39; 95% CI = 1.14-5.01). As compared to Han nationality students who were from Tujia nationality were more likely to smoke (OR = 2.76; 95% CI = 1.88-4.04) and were more likely to have a higher frequency of smoking (95% CI (0.88, 0.88), p = 0.010). Non-smokers who were high school students (OR = 4.29; 95% CI = 2.12-8.66), whose academic performance were situated in the last 25% (OR = 2.23; 95% CI = 1.48-3.34) and lower than 50% (OR = 1.50; 95% CI = 1.02-2.20) were more likely to have an intention of smoking. Conclusions: About one in ten secondary school students was a smoker, one in three smokers smoked more than one time per day, and a quarter of non-smokers had an intention of smoking in China. Smoking rate was higher among students from Tujia than the Han nationality. This study provided some important information for future tobacco control programs among secondary school students in the ethnic minority autonomous region and minority settlements in a multi-ethnic country.

  17. Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.

    Science.gov (United States)

    Weeks, William B; Goertz, Christine M

    2016-05-01

    The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries. Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user. A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions. Copyright © 2016. Published by Elsevier Inc.

  18. 19 CFR 10.196 - Cost or value of materials produced in a beneficiary country or countries.

    Science.gov (United States)

    2010-04-01

    ... country where it is tanned to create nonperishable “crust leather”. The tanned product is then imported... tanned to create nonperishable “crust leather”. The tanned skin is then imported directly into the U.S... composed is not wholly the growth, product, or manufacture of a beneficiary country and (2) the tanning...

  19. 20 CFR 30.17 - Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits...

    Science.gov (United States)

    2010-04-01

    ... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Rights and Penalties § 30... for benefits under the Act or any other federal or state workers' compensation law, the beneficiary... trial) any entitlement to any further benefits for any injury, illness or death covered by this part for...

  20. 42 CFR 411.12 - Charges imposed by an immediate relative or member of the beneficiary's household.

    Science.gov (United States)

    2010-10-01

    ...) Natural or adoptive parent, child, or sibling. (3) Stepparent, stepchild, stepbrother, or stepsister. (4... if the physician who ordered or supervised the services has an excluded relationship to the... provider or supplier if the owner has an excluded relationship to the beneficiary; and (ii) Charges imposed...

  1. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    Science.gov (United States)

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  2. 75 FR 60066 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA...

    Science.gov (United States)

    2010-09-29

    ... set of Harmonized System lines listed in the Annex to the World Trade Organization Agreement on... COMMITTEE FOR THE IMPLEMENTATION OF TEXTILE AGREEMENTS Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA Countries From Regional Country Fabric AGENCY...

  3. When is a lie acceptable? Work and private life lying acceptance depends on its beneficiary.

    Science.gov (United States)

    Cantarero, Katarzyna; Szarota, Piotr; Stamkou, Eftychia; Navas, Marisol; Dominguez Espinosa, Alejandra Del Carmen

    2018-01-01

    In this article we show that when analyzing attitude towards lying in a cross-cultural setting, both the beneficiary of the lie (self vs other) and the context (private life vs. professional domain) should be considered. In a study conducted in Estonia, Ireland, Mexico, The Netherlands, Poland, Spain, and Sweden (N = 1345), in which participants evaluated stories presenting various types of lies, we found usefulness of relying on the dimensions. Results showed that in the joint sample the most acceptable were other-oriented lies concerning private life, then other-oriented lies in the professional domain, followed by egoistic lies in the professional domain; and the least acceptance was shown for egoistic lies regarding one's private life. We found a negative correlation between acceptance of a behavior and the evaluation of its deceitfulness.

  4. Cruise Tourism in Dominica: Benefits and Beneficiaries Bruno Marques, Romain Cruse

    Directory of Open Access Journals (Sweden)

    Bruno Marques

    2015-09-01

    Full Text Available The impressive growth of cruise tourism in Dominica, inside highly competitive area of the Caribbean basin, gives the island an astonishing flavor of success. By adopting a systemic approach the article demonstrates that three agents concentrate more than 70% of the financial impact of the cruise activity in Dominica: the local travel agencies, souvenir shops and the cruise lines. The low dispersion of the beneficiaries is concomitant with a spatial concentration and a minimal macroeconomic benefit. This case study, devoted to Dominica, suggests a highly concentrated model of cruise tourism in the Caribbean underpinned by organized tours as the main mode of experiencing the stopovers and a source of revenue for cruise lines, whose subcontractor: the local travel agencies are the primary distribution channel of cruise tourism revenue, high level of economic and spatial concentration generating low trickle down macroeconomic effect.

  5. Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

    DEFF Research Database (Denmark)

    Momsen, A H; Nielsen, Claus Vinther; Nielsen, M B D

    2016-01-01

    unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. Conclusions: Sick-listed individuals reporting high levels of symptoms were more......Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. Study design: A cross-sectional study nested in a clinical trial......-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed. Results: Beneficiaries with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being...

  6. Current practice vs. guideline based imaging in abdominal radiology in the German speaking area. Results of an online survey; Versorgungsrealitaet vs. leitliniengerechte Bildgebung in der Abdominalradiologie im deutschsprachigen Raum. Ergebnisse einer Online-Umfrage

    Energy Technology Data Exchange (ETDEWEB)

    Schreyer, A.G. [University Hospital Regenburg (Germany). Dept. of Radiology; Wessling, J. [Clemens Hospital Muenchen (Germany). Dept. of Radiology; Grenacher, L. [Diagnostic Muenchen (Germany). Diagnostic Imaging Center

    2016-03-15

    The working group for abdominal imaging within the German Roentgen Society (DRG) performed an online survey amongst radiologist concerning the current status of techniques for abdominal imaging. The results of this survey were compared with the most recent guidelines. We performed an online survey open for all members of the DRG during a 76-day period with 65 questions and an overall estimated time for finishing the questionnaire of 15 minutes concerning technical specifications for abdominal radiological imaging. The results were evaluated using descriptive statistics. 90 of all participants, who filled out the survey covering more than 80 % of the questions, were included in the statistical evaluation. 27 % of all participants were registered radiologists while 73 % represented radiologists working in a hospital. Most participants worked in a managerial position. The participants gave detailed information regarding the radiological techniques used in dedicated organ systems (esophagus, stomach, pancreas, liver, small intestines, colon) regarding acquired contrast phases and oral and intravenous administration of contrast medium. The results confirm that most radiologists participating in this survey perform their examinations and choose their modalities in conformity with the current existing clinical guidelines. Because most clinical guidelines do not specify radiological examinations in detail, there is a noteworthy heterogeneity of the acquired contrast phases and major divergence in terms of technical parameters. Therefore a joint radiological effort should be initiated for developing and publishing updated radiological parameters for abdominal imaging.

  7. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  8. Variation in Postsepsis Readmission Patterns: A Cohort Study of Veterans Affairs Beneficiaries

    Science.gov (United States)

    2017-01-01

    Rationale: Rehospitalization is common after sepsis, but little is known about the variation in readmission patterns across patient groups and care locations. Objectives: To examine the variation in postsepsis readmission rates and diagnoses by patient age, nursing facility use, admission year, and hospital among U.S. Veterans Affairs (VA) beneficiaries. Methods: Observational cohort study of VA beneficiaries who survived a sepsis hospitalization (2009–2011) at 114 VA hospitals, stratified by age (readmission after sepsis hospitalization and proportion of readmissions resulting from specific diagnoses, including the proportion of “potentially preventable” readmissions. Readmission diagnoses were similar from 2009 to 2011, with little variation in readmission rates across hospitals. The top six readmission diagnoses (heart failure, pneumonia, sepsis, urinary tract infection, acute renal failure, and chronic obstructive pulmonary disease) accounted for 30% of all readmissions. Although about one in five readmissions had a principal diagnosis for infection, 58% of all readmissions received early systemic antibiotics. Infection accounted for a greater proportion of readmissions among patients discharged to nursing facilities compared with patients discharged to home (25.0–27.1% vs. 16.8%) and among older vs. younger patients (22.2% vs. 15.8%). Potentially preventable readmissions accounted for a quarter of readmissions overall and were more common among older patients and patients discharged to nursing facilities. Conclusions: Hospital readmission rates after sepsis were similar by site and admission year. Heart failure, pneumonia, sepsis, and urinary tract infection were common readmission diagnoses across all patient groups. Readmission for infection and potentially preventable diagnoses were more common in older patients and patients discharged to nursing facilities. PMID:27854510

  9. Discontinuity of Medicaid Coverage: Impact on Cost and Utilization Among Adult Medicaid Beneficiaries With Major Depression.

    Science.gov (United States)

    Ji, Xu; Wilk, Adam S; Druss, Benjamin G; Lally, Cathy; Cummings, Janet R

    2017-08-01

    Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression. A total of 139,164 adults (18-64) with major depression was identified using the 2003-2004 Medicaid Analytic eXtract Files. We used generalized linear and two-part models to examine the effect of Medicaid discontinuity on service utilization. To establish causality in this relationship, we used instrumental variables analysis, relying on exogenous variation in a state-level policy for identification. Emergency department (ED) visits, inpatient episodes, inpatient days, and Medicaid-reimbursed costs. Approximately 29.4% of beneficiaries experienced coverage disruptions. In instrumental variables models, those with coverage disruptions incurred an increase of $650 in acute care costs per-person per Medicaid-covered month compared with those with continuous coverage, evidenced by an increase in ED use (0.1 more ED visits per-person-month) and inpatient days (0.6 more days per-person-month). The increase in acute costs contributed to an overall increase in all-cause costs by $310 per-person-month (all P-valuesMedicaid coverage may help prevent acute episodes requiring high-cost interventions.

  10. Utilization of Integrated Child Development Services (ICDS Scheme by child beneficiaries in Coastal Karnataka, India

    Directory of Open Access Journals (Sweden)

    Saranya Sivanesan

    2016-06-01

    Full Text Available Background: India’s main early childhood development intervention the ICDS Scheme has been sustained for 40 years and has been successful in some ways. However, nearly half of the children under six years are still under nourished. The program in reducing the proportion of undernourished children over the past decade has been modest and slower in India than what has been achieved in other countries with comparable socio-economic indicators. Aims & Objectives: 1. To study the utilization of services offered to children under ICDS, 2. To assess the perception about the services. Materials & Methods: A community based cross sectional study was done among mothers of 271 children in the age group three to six years registered in anganwadis. Results: Median duration of absenteeism to anganwadi was five months during the last six months enquired. About 95.9% of registered child beneficiaries utilized supplementary nutrition services and only 48.7% mothers of child beneficiaries were attending nutrition and health education sessions. Among mothers who were aware of growth monitoring, only 73.6% of their children’s weight was checked regularly.  About 60% of mothers were not happy with the quality of food served to their children in the anganwadi. Among children adherent to anganwadi, 72.5% children’s weight remained normal. Conclusion: Only 75% children were regularly attending. Median duration of adherence to anganwadi services was only 12 months and the most common reason for not adhering to the services is due to their simultaneous enrollment in other private nursery school.

  11. Certain aspects of the accounting of the bank guarantee at the principal and the beneficiary

    Directory of Open Access Journals (Sweden)

    L. A. Zimakova

    2016-01-01

    Full Text Available For any kind of business such category as risks is peculiar. The research of this category was conducted by scientists from the different sides, certain approaches of protection against risks were developed and instruments of decrease in financial risks are offered. The bank guarantee is one of the most demanded instruments of additional financial protection today. Its active using of the commercial organizations courses questions of the organization of the detailed accounting of guarantees at the principal and the beneficiary. A little concerning the historical aspect of the bank guarantee, authors provided the overview of the determinations of "bank guarantee" characterizing it as the banking service providing distribution of responsibility between the guarantor and the principal under certain conditions. Having considered the essence of the legal nature and features of the bank guarantee recommendations about the organization of the disaggregated financial accounting on off-balance accounts were developed. In particular, need of allocation of a currency type as the directions of conducting the analytics providing correctness of reflection of cost criterion is proved. For the purpose of control of timeliness of carrying out calculations it is recommended to allocate guarantees: coincident and in coincident with primary obligation; short-term and long-term. From the point of view of nature of guarantees payment guarantees and guarantees of obligation fulfilment were allocated. These recommendations concern the beneficiary, and lack of accounting entries at a principal generates need of creation of additional registers and analytical reports which forms were offered by authors. The provided recommendations will allow obtaining transparent information on bank guarantees for the purpose of its full disclosure in the financial reporting.

  12. Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

    Science.gov (United States)

    Guerino, Paul; Ewald, Erin; Laffan, Alison M.

    2017-01-01

    Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908

  13. Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

    Science.gov (United States)

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

    2015-01-01

    Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

  14. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Science.gov (United States)

    Kent, Shia T; Shimbo, Daichi; Huang, Lei; Diaz, Keith M; Kilgore, Meredith L; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment. We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is), 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs). Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB. These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel Members Appointed to

  15. Current practice in laboratory diagnostics of autoimmune diseases in Croatia. 
Survey of the Working group for laboratory diagnostics of autoimmune diseases of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Kuna, Andrea Tešija; Đerek, Lovorka; Kozmar, Ana; Drvar, Vedrana

    2016-10-15

    With the trend of increasing incidence of autoimmune diseases, laboratories are faced with exponential growth of the requests for tests relating the diagnosis of these diseases. Unfortunately, the lack of laboratory personnel experienced in this specific discipline of laboratory diagnostic, as well as an unawareness of a method limitation often results in confusion for clinicians. The aim was to gain insight into number and type of Croatian laboratories that perform humoral diagnostics with the final goal to improve and harmonize laboratory diagnostics of autoimmune diseases in Croatia. In order to get insight into current laboratory practice two questionnaires, consisting of 42 questions in total, were created. Surveys were conducted using SurveyMonkey application and were sent to 88 medical biochemistry laboratories in Croatia for the first survey. Out of 33 laboratories that declared to perform diagnostic from the scope, 19 were selected for the second survey based on the tests they pleaded to perform. The survey comprised questions regarding autoantibody hallmarks of systemic autoimmune diseases while regarding organ-specific autoimmune diseases was limited to diseases of liver, gastrointestinal and nervous system. Response rate was high with 80 / 88 (91%) laboratories which answered the first questionnaire, and 19 / 19 (1.0) for the second questionnaire. Obtained results of surveys indicate high heterogeneity in the performance of autoantibody testing among laboratories in Croatia. Results indicate the need of creating recommendations and algorithms in order to harmonize the approach to laboratory diagnostics of autoimmune diseases in Croatia.

  16. TCT-82 Evaluation of Current Practices in Transcatheter Aortic Valve Replacement: The WRITTEN (WoRldwIde TAVR ExperieNce) Survey

    DEFF Research Database (Denmark)

    Nombela-Franco, Luis; Cerrato, Enrico; Nazif, Tamim

    2016-01-01

    the main areas of consensus and divergence between centers. Methods An online questionnaire was distributed in centers performing TAVR irrespective of the number of procedures and valve type. The questionnaire was divided in 3 main blocks: pre-procedural evaluation, procedural practices and post......-procedural management. Regional experts were recruited to distribute the survey in each country or region. Results The survey was completed by 250 TAVR centers (with a cumulative experience of nearly 70,000 procedures) from 38 different countries. Heart team meetings were regularly scheduled in most (>95%) centers...

  17. The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009–2013

    Science.gov (United States)

    Palipudi, Krishna M.; Nelson-Blutcher, Glenda; Murty, Komanduri S.; Asma, Samira

    2015-01-01

    We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation. PMID:26378897

  18. The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009-2013.

    Science.gov (United States)

    Mbulo, Lazarous; Palipudi, Krishna M; Nelson-Blutcher, Glenda; Murty, Komanduri S; Asma, Samira

    2015-09-17

    We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation.

  19. The current state of Bayesian methods in medical product development: survey results and recommendations from the DIA Bayesian Scientific Working Group.

    Science.gov (United States)

    Natanegara, Fanni; Neuenschwander, Beat; Seaman, John W; Kinnersley, Nelson; Heilmann, Cory R; Ohlssen, David; Rochester, George

    2014-01-01

    Bayesian applications in medical product development have recently gained popularity. Despite many advances in Bayesian methodology and computations, increase in application across the various areas of medical product development has been modest. The DIA Bayesian Scientific Working Group (BSWG), which includes representatives from industry, regulatory agencies, and academia, has adopted the vision to ensure Bayesian methods are well understood, accepted more broadly, and appropriately utilized to improve decision making and enhance patient outcomes. As Bayesian applications in medical product development are wide ranging, several sub-teams were formed to focus on various topics such as patient safety, non-inferiority, prior specification, comparative effectiveness, joint modeling, program-wide decision making, analytical tools, and education. The focus of this paper is on the recent effort of the BSWG Education sub-team to administer a Bayesian survey to statisticians across 17 organizations involved in medical product development. We summarize results of this survey, from which we provide recommendations on how to accelerate progress in Bayesian applications throughout medical product development. The survey results support findings from the literature and provide additional insight on regulatory acceptance of Bayesian methods and information on the need for a Bayesian infrastructure within an organization. The survey findings support the claim that only modest progress in areas of education and implementation has been made recently, despite substantial progress in Bayesian statistical research and software availability. Copyright © 2013 John Wiley & Sons, Ltd.

  20. Oil royalties payment impact on socio-economic beneficiary countries development; O impacto do pagamento de royalties do petroleo no desenvolvimento socio-economico dos municipios beneficiarios

    Energy Technology Data Exchange (ETDEWEB)

    Lucchesi, Cesar Augusto M.; Anuatti Neto, Francisco [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Economia, Administracao e Contabilidade

    2004-07-01

    This research proposes to evaluate oil royalties payment impact on socio-economic beneficiary counties indicators. In the first step, it has been made royalties payments distribution among beneficiary counties (942), what showed a meaningful paid resources concentration between 1993 and 1999, when 20% of the beneficiaries apportioned of 98,5% from this period paid royalties. For these 188 greatest exaction counties the royalties impact analyses on County Human Development Index (IDH-M) evolution showed the received royalties amount positively influenced the 2000 IDH-M additional comparing to 1991. It indicates the petroleum industry contribution to municipal development of those counties which receive these resources. (author)