WorldWideScience

Sample records for high deductible health

  1. Deductibles in health insurance

    Science.gov (United States)

    Dimitriyadis, I.; Öney, Ü. N.

    2009-11-01

    This study is an extension to a simulation study that has been developed to determine ruin probabilities in health insurance. The study concentrates on inpatient and outpatient benefits for customers of varying age bands. Loss distributions are modelled through the Allianz tool pack for different classes of insureds. Premiums at different levels of deductibles are derived in the simulation and ruin probabilities are computed assuming a linear loading on the premium. The increase in the probability of ruin at high levels of the deductible clearly shows the insufficiency of proportional loading in deductible premiums. The PH-transform pricing rule developed by Wang is analyzed as an alternative pricing rule. A simple case, where an insured is assumed to be an exponential utility decision maker while the insurer's pricing rule is a PH-transform is also treated.

  2. Employee choice of a high-deductible health plan across multiple employers.

    Science.gov (United States)

    Lave, Judith R; Men, Aiju; Day, Brian T; Wang, Wei; Zhang, Yuting

    2011-02-01

    To determine factors associated with selecting a high-deductible health plan (HDHP) rather than a preferred provider plan (PPO) and to examine switching and market segmentation after initial selection. Claims and benefit information for 2005-2007 from nine employers in western Pennsylvania first offering HDHP in 2006. We examined plan growth over time, used logistic regression to determine factors associated with choosing an HDHP, and examined the distribution of healthy and sick members across plan types. We linked employees with their dependents to determine family-level variables. We extracted risk scores, covered charges, employee age, and employee gender from claims data. We determined census-level race, education, and income information. Health status, gender, race, and education influenced the type of individual and family policies chosen. In the second year the HDHP was offered, few employees changed plans. Risk segmentation between HDHPs and PPOs existed, but it did not increase. When given a choice, those who are healthier are more likely to select an HDHP leading to risk segmentation. Risk segmentation did not increase in the second year that HDHPs were offered. © Health Research and Educational Trust.

  3. Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?

    NARCIS (Netherlands)

    K.P.M. Winssen van (Kayleigh); R.C. van Kleef (Richard); W.P.M.M. van de Ven (Wynand)

    2016-01-01

    textabstractIn health insurance, voluntary deductibles are offered to the insured in return for a premium rebate. Previous research has shown that 11 % of the Dutch insured opted for a voluntary deductible (VD) in health insurance in 2014, while the highest VD level was financially profitable for

  4. Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

    Directory of Open Access Journals (Sweden)

    Galbraith Alison A

    2011-05-01

    Full Text Available Abstract Background Recent increases in patient cost-sharing for health care have lent increasing importance to monitoring cost-related changes in health care use. Despite the widespread use of survey questions to measure changes in health care use and related behaviors, scant data exists on the reliability of such questions. Methods We administered a cross-sectional survey to a stratified random sample of families in a New England health plan's high deductible health plan (HDHP with ≥ $500 in annualized out-of-pocket expenditures. Enrollees were asked about their knowledge of their plan, information seeking, behavior change associated with having a deductible, experience of delay in care due in part to cost, and hypothetical delay in care due in part to cost. Initial respondents were mailed a follow-up survey within two weeks of each family returning the original survey. We computed several agreement statistics to measure the test-retest reliability for select questions. We also conducted continuity adjusted chi-square, and McNemar tests in both the original and follow-up samples to measure the degree to which our results could be reproduced. Analyses were stratified by self-reported income. Results The test-retest reliability was moderate for the majority of questions (0.41 - 0.60 and the level of test-retest reliability did not differ substantially across each of the broader domains of questions. The observed proportions of respondents with delayed or foregone pediatric, adult, or any family care were similar when comparing the original and follow-up surveys. In the original survey, respondents in the lower-income group were more likely to delay or forego pediatric care, adult care, or any family care. All of the tests comparing income groups in the follow-up survey produced the same result as in the original survey. Conclusions In this population of HDHP beneficiaries, we found that survey questions concerning plan knowledge, information

  5. 42 CFR 417.158 - Payroll deductions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payroll deductions. 417.158 Section 417.158 Public....158 Payroll deductions. Each employing entity that provides payroll deductions as a means of paying... employee's contribution, if any, to be paid through payroll deductions. [59 FR 49841, Sept. 30, 1994] ...

  6. Health insurance subsidies and deductible choice: Evidence from regional variation in subsidy schemes.

    Science.gov (United States)

    Kaufmann, Cornel; Schmid, Christian; Boes, Stefan

    2017-09-01

    The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy. We discuss our results in the light of potential extra-marginal effects on the demand for health care services, which are however not supported by our data. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. 42 CFR 408.44 - Deduction from civil service annuities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Deduction from civil service annuities. 408.44... § 408.44 Deduction from civil service annuities. (a) Responsibility for deductions. If an enrollee is... service annuity, the premiums are deducted from that annuity by the Office of Personnel Management (OPM...

  8. Exploring the Rate and Causes of Inpatient Records Deductions Covered by Iran Health Insurance: The Case of a Public Hospital in Tabriz

    Directory of Open Access Journals (Sweden)

    Yalda Mousa Zadeh

    2017-10-01

    Full Text Available Background and Objectives: Today, a major part of health system resources are allocated to hospitals. So, the control of these resources and correct and efficient use of them are the important tasks of management. This study was conducted to determine the deductions of Iran health insurance in the first half of 2014 in a public hospital in Tabriz. Material and Methods: This was a cross sectional study. The study population included records of patients hospitalized in the first half of 2014.  All cases with deduction were selected as sample. Data collection was performed using a researcher-made checklist. Checklist information was collected through records of patients and interview. Then, data were analyzed using Excel software. Results: Most deductions were related to physician visits (61116000 Rials, laboratory (46881797 Rials and surgery commission (26114487 Rials, respectively. Most of the deductions were in October (70613244 Rials and lowest deductions were in February (6838945 Rials. The most important factor of deductions was related to additional request.   Conclusion: According to deduction cases and the most important factor related to it (additional request, It can be concluded that greatest amount of deductions are due to employees' mistakes. In this regard, emphasis on clinical guidelines and physicians’ training is necessary. Negotiations and clarifying the amount of liability of insurance organizations can prevent deductions.

  9. 78 FR 19949 - The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers

    Science.gov (United States)

    2013-04-02

    ... 26 CFR Part 1 The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance... limitation for remuneration provided by certain health insurance providers under section 162(m)(6) of the Internal Revenue Code (Code). These regulations affect health insurance providers that pay such...

  10. HEALTH INFO SANTE ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS: HINTS FOR USE

    CERN Multimedia

    1999-01-01

    Information from the CHIS Board and the Personnel DivisionOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and not by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 55, 000 in 1998 - is part of the cost of our insurance.Help keep administrative costs down : do not submit reimbursement claims for amounts less than the annual deductible unless your claims...

  11. Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?

    Science.gov (United States)

    van Winssen, K P M; van Kleef, R C; van de Ven, W P M M

    2016-12-01

    In health insurance, voluntary deductibles are offered to the insured in return for a premium rebate. Previous research has shown that 11 % of the Dutch insured opted for a voluntary deductible (VD) in health insurance in 2014, while the highest VD level was financially profitable for almost 50 % of the population in retrospect. To explain this discrepancy, this paper identifies and discusses six potential determinants of the decision to opt for a VD from the behavioral economic literature: loss aversion, risk attitude, ambiguity aversion, debt aversion, omission bias, and liquidity constraints. Based on these determinants, five potential strategies are proposed to increase the number of insured opting for a VD. Presenting the VD as the default option and providing transparent information regarding the VD are the two most promising strategies. If, as a result of these strategies, more insured would opt for a VD, moral hazard would be reduced.

  12. Exploring the Rate and Causes of Deductions Imposed on Social Security and Health Insurance`s Bills Related to Inpatients in Two Hospitals Affiliated with Tabriz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hossein Rezvanjou

    2017-02-01

    Full Text Available Background and Objectives: Annually, a large amount of fees that are paid by hospitals, will not be reimbursed as deductions by health insurance which imposes irreparable financial losses on hospitals. The purpose of this study was to determine the amount of deductions imposed on social security and health insurance`s bills and its causes related to inpatients in two hospitals affiliated with Tabriz University of Medical Sciences. Material and Methods: This was a cross-sectional study conducted in Alavi and Madani hospitals affiliated with Tabriz University of Medical Sciences by using 2015 data.  Researcher-designed checklist was used for data collecting. According to population size, census method and random sampling were used in Alavi and Madani hospitals, respectively. Gathered data were analyzed through descriptive statistics assisted by Excel v.13 software. Results: In the studied hospitals, most of the deductions in the Alavi and Madani hospitals were related to charge of surgeon and angioplasty, respectively. Also, in Alavi Hospital among deductions factors, the most repeated one was extra application in contrary to determined tariffs. In both hospitals, the role of the human factor in cases of error cannot be denied. Extra applications, inaccuracy in registration costs and lack of knowledge of the approved insurance tariffs are the main important factors influential on the deduction. Conclusion: Due to high rates of preventable deductions in both hospitals and being given the multiplicity and variety of services offered at the health centers, establishing income monitoring unit in hospitals and use of experienced staff is inevitable.

  13. Diagrams of natural deductions

    Energy Technology Data Exchange (ETDEWEB)

    Popov, S V

    1982-01-01

    The concept of natural deductions was investigated by the author in his analysis of the complexity of deductions in propositional computations (1975). Here some natural deduction systems are considered, and an analytical procedure proposed which results in a deduction diagram for each system. Each diagram takes the form of an orientated, charge graph, features of which can be used to establish the equivalence of classes of deductions. For each of the natural deduction systems considered, a system of equivalent transformation schemes is derived, which is complete with respect to the given definition of equivalence. 2 references.

  14. HEALTH INFO SANTÉ – REMINDER ANNUAL DEDUCTIBLE AND REIMBURSEMENT CLAIMS HINTS FOR USE

    CERN Multimedia

    CHIS Board

    2000-01-01

    Information from the CHIS Board and the Human Resources Division:Annual deductible and reimbursement claims: hints for useOne should bear in mind that the annual deductible is an amount (currently CHF 100) charged automatically by the Administrator of the scheme for every adult aged 18 and above. This is what happens: The amount is deducted annually for all medical services received over a calendar year.It is triggered by the date of the treatment and neither by the date of the bill nor that of the reimbursement claim.In other words, if you receive medical treatment in December for the first time in a given year, the CHF 100 will be deducted from the claim for that treatment. So, except for urgent cases, it would be better to wait till the following month, thus avoiding one annual deductible.It is also worth remembering that the cost of processing our reimbursement claims - and there were 54, 000 in 1999 - is part of the cost of our insurance.Help keep administrative costs down: do not submit reimbursement cl...

  15. A voluntary deductible in health insurance: the more years you opt for it, the lower your premium?

    NARCIS (Netherlands)

    K.P.M. Winssen van (Kayleigh); R.C. van Kleef (Richard); W.P.M.M. van de Ven (Wynand)

    2017-01-01

    textabstractAdverse selection regarding a voluntary deductible (VD) in health insurance implies that insured only opt for a VD if they expect no (or few) healthcare expenses. This paper investigates two potential strategies to reduce adverse selection: (1) differentiating the premium to the duration

  16. Putting Health Back Into Health Insurance Choice.

    Science.gov (United States)

    Atanasov, Pavel; Baker, Tom

    2014-08-01

    What are the barriers to voluntary take-up of high-deductible plans? We address this question using a large-scale employer survey conducted after an open-enrollment period in which a new high-deductible plan was first introduced. Only 3% of the employees chose this plan, despite the respondents' recognition of its financial advantages. Employees who believed that the high-deductible plan provided access to top physicians in the area were three times more likely to choose it than employees who did not share this belief. A framed field experiment using a similar choice menu showed that displaying additional financial information did not increase high-deductible plan take-up. However, when plans were presented as identical except for the deductible, respondents were highly likely to choose the high-deductible plan, especially in a two-way choice. These results suggest that informing plan choosers about high-deductible plans' health access provisions may affect choice more strongly than focusing on their financial advantages. © The Author(s) 2014.

  17. Risk preferences over small stakes: Evidence from deductible choice

    OpenAIRE

    Janko Gorter; Paul Schilp

    2012-01-01

    This paper provides new field evidence on risk preferences over small stakes. Using unique population and survey data on deductible choice in Dutch universal health insurance, we find that risk preferences are a dominant factor in decision aking. In fact, our results indicate that risk preferences are both statistically and quantitatively more significant in explaining deductible choice behavior than risk type. This finding contrasts with classical expected utility theory, as it implies risk ...

  18. THE WORLD OF TAx DEDUCTIONS

    Directory of Open Access Journals (Sweden)

    Alexei V. Dujov

    2015-01-01

    Full Text Available In this article a study and methodological foundations of the structure of taxes and fees. Disclosed the concept of elements of tax and duty. Focuses on the nature of the concept of «tax deduction». Provides legal and the author’s interpretation of the term «tax deduction». Examples of application of a tax deduction in the value-added tax and the tax to incomes of physical persons. the conclusions about the multilateral nature of the tax deduction.

  19. Semiotic labelled deductive systems

    Energy Technology Data Exchange (ETDEWEB)

    Nossum, R.T. [Imperial College of Science, Technology and Medicine, London (United Kingdom)

    1996-12-31

    We review the class of Semiotic Models put forward by Pospelov, as well as the Labelled Deductive Systems developed by Gabbay, and construct an embedding of Semiotic Models into Labelled Deductive Systems.

  20. Deductive way of reasoning about the internet AS level topology

    International Nuclear Information System (INIS)

    Szabó, Dávid; Kőrösi, Attila; Bíró, József; Gulyás, András

    2015-01-01

    Our current understanding about the AS level topology of the Internet is based on measurements and inductive-type models which set up rules describing the behavior (node and edge dynamics) of the individual ASes and generalize the consequences of these individual actions for the complete AS ecosystem using induction. In this paper we suggest a third, deductive approach in which we have premises for the whole AS system and the consequences of these premises are determined through deductive reasoning. We show that such a deductive approach can give complementary insights into the topological properties of the AS graph. While inductive models can mostly reflect high level statistics (e.g., degree distribution, clustering, diameter), deductive reasoning can identify omnipresent subgraphs and peering likelihood. We also propose a model, called YEAS, incorporating our deductive analytical findings that produces topologies contain both traditional and novel metrics for the AS level Internet. (paper)

  1. 26 CFR 1.832-2 - Deductions.

    Science.gov (United States)

    2010-04-01

    ... companies, other than mutual fire insurance companies described in § 1.831-1, are also allowed a deduction... TAXES Other Insurance Companies § 1.832-2 Deductions. (a) The deductions allowable are specified in... capital losses provided in subchapter P (section 1201 and following), chapter 1 of the Code, insurance...

  2. Are the healthy behaviors of US high-deductible health plan enrollees driven by people who chose these plans? Smoking as a case study.

    Directory of Open Access Journals (Sweden)

    Jeffrey T Kullgren

    Full Text Available To determine whether negative associations between enrollment in a high-deductible health plan (HDHP and one exemplar unhealthy behavior--daily smoking--are found only among people who chose these plans.Cross-sectional analysis of nationally-representative data.United States from 2007 to 2008.6,941 privately insured non-elderly adult participants in the 2007 Health Tracking Household Survey.Self-reported smoking status.We classified subjects as HDHP or traditional health plan enrollees with employer-sponsored insurance (ESI and no choice of plans, ESI with a choice of plans, or coverage through the non-group market. We used multivariate logistic regression to measure associations between HDHP enrollment and daily smoking within each of the 3 coverage source groups while controlling for potential confounders.HDHP enrollment was associated with lower odds of smoking among individuals with ESI and a choice of plans (AOR 0.55, 95% CI 0.33-0.90 and those with non-group coverage (AOR 0.64, 95% CI 0.34-1.22, though the latter association was not statistically significant. HDHP enrollment was not associated with lower odds of smoking among individuals with ESI and no choice of plans (AOR 1.04, 95% CI 0.69-1.56.HDHP enrollment is associated with lower odds of smoking only among individuals who chose to enroll in an HDHP. Lower rates of unhealthy behaviors among HDHP enrollees may be a reflection of individuals who choose these plans.

  3. 29 CFR 1450.23 - Deduction from pay.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Deduction from pay. 1450.23 Section 1450.23 Labor... OWED THE UNITED STATES Salary Offset § 1450.23 Deduction from pay. (a) Deduction by salary offset, from an employee's current disposable pay, shall be subject to the following conditions: (1) Ordinarily...

  4. 22 CFR 512.22 - Deduction from pay.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Deduction from pay. 512.22 Section 512.22... 1982 Salary Offset § 512.22 Deduction from pay. (a) Deduction by salary offset, from an employee's disposable current pay, shall be subject to the following circumstances: (1) When funds are available, the...

  5. How to Shop for Health Insurance

    Science.gov (United States)

    ... health insurance kicks in. As a general rule, insurance plans with low premiums have high deductibles, and plans with high premiums ... other plans due to hardship. This type of insurance can have low premiums but very high deductibles. Plans generally cover less ...

  6. 26 CFR 1.108-3 - Intercompany losses and deductions.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Intercompany losses and deductions. 1.108-3... Intercompany losses and deductions. (a) General rule. This section applies to certain losses and deductions... attributes to which section 108(b) applies, a loss or deduction not yet taken into account under section 267...

  7. 7 CFR 1000.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1000.86 Section 1000... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE GENERAL PROVISIONS OF FEDERAL MILK MARKETING ORDERS Administrative Assessment and Marketing Service Deduction § 1000.86 Deduction for...

  8. Deductive biocomputing.

    Directory of Open Access Journals (Sweden)

    Jeff Shrager

    Full Text Available BACKGROUND: As biologists increasingly rely upon computational tools, it is imperative that they be able to appropriately apply these tools and clearly understand the methods the tools employ. Such tools must have access to all the relevant data and knowledge and, in some sense, "understand" biology so that they can serve biologists' goals appropriately and "explain" in biological terms how results are computed. METHODOLOGY/PRINCIPAL FINDINGS: We describe a deduction-based approach to biocomputation that semiautomatically combines knowledge, software, and data to satisfy goals expressed in a high-level biological language. The approach is implemented in an open source web-based biocomputing platform called BioDeducta, which combines SRI's SNARK theorem prover with the BioBike interactive integrated knowledge base. The biologist/user expresses a high-level conjecture, representing a biocomputational goal query, without indicating how this goal is to be achieved. A subject domain theory, represented in SNARK's logical language, transforms the terms in the conjecture into capabilities of the available resources and the background knowledge necessary to link them together. If the subject domain theory enables SNARK to prove the conjecture--that is, to find paths between the goal and BioBike resources--then the resulting proofs represent solutions to the conjecture/query. Such proofs provide provenance for each result, indicating in detail how they were computed. We demonstrate BioDeducta by showing how it can approximately replicate a previously published analysis of genes involved in the adaptation of cyanobacteria to different light niches. CONCLUSIONS/SIGNIFICANCE: Through the use of automated deduction guided by a biological subject domain theory, this work is a step towards enabling biologists to conveniently and efficiently marshal integrated knowledge, data, and computational tools toward resolving complex biological queries.

  9. 26 CFR 1.642(g)-2 - Deductions included.

    Science.gov (United States)

    2010-04-01

    ... tax purposes. Section 642(g) has no application to deductions for taxes, interest, business expenses... 642(g) is applicable to deductions for interest, business expenses, and other items not accrued at the... administration expenses under section 2053(a)(2). Although deductible under section 2053(a)(3) in determining the...

  10. 26 CFR 1.832-5 - Deductions.

    Science.gov (United States)

    2010-04-01

    ... companies, other than mutual fire insurance companies described in section 831(a)(3)(A) and the regulations... TAXES Other Insurance Companies § 1.832-5 Deductions. (a) The deductions allowable are specified in... capital losses provided in subchapter P (section 1201 and following), chapter 1 of the Code, insurance...

  11. Deductive systems for BigData integration

    Directory of Open Access Journals (Sweden)

    Radu BUCEA-MANEA-TONIS

    2018-03-01

    Full Text Available The globalization is associated with an increased data to be processed from E-commerce transactions. The specialists are looking for different solutions, such as BigData, Hadoop, Datawarehoues, but it seems that the future is the predicative logic implemented through deductive database technology. It has to be done the swift from imperative languages, to not declaratively languages used for the application development. The deductive databases are very useful in the student teaching programs, too. Thus, the article makes a consistent literature review in the field and shows practical examples of using predicative logic in deductive systems, in order to integrate different kind of data types.

  12. 34 CFR 32.10 - Deductions process.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Deductions process. 32.10 Section 32.10 Education Office of the Secretary, Department of Education SALARY OFFSET TO RECOVER OVERPAYMENTS OF PAY OR ALLOWANCES FROM DEPARTMENT OF EDUCATION EMPLOYEES § 32.10 Deductions process. (a) Debts must be collected in...

  13. 26 CFR 20.2053-10 - Deduction for certain foreign death taxes.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Deduction for certain foreign death taxes. 20... § 20.2053-10 Deduction for certain foreign death taxes. (a) General rule. A deduction is allowed the... for foreign death taxes. (b) Condition for allowance of deduction. (1) The deduction is not allowed...

  14. 26 CFR 1.274-3 - Disallowance of deduction for gifts.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Disallowance of deduction for gifts. 1.274-3... TAX (CONTINUED) INCOME TAXES Items Not Deductible § 1.274-3 Disallowance of deduction for gifts. (a) In general. No deduction shall be allowed under section 162 or 212 for any expense for a gift made...

  15. Deductive Puzzling

    Science.gov (United States)

    Wanko, Jeffrey J.

    2010-01-01

    To help fifth- through eighth-grade students develop their deductive reasoning skills, the author used a ten-week supplementary curriculum so that students could answer logic questions. The curriculum, a series of lessons built around language-independent logic puzzles, has been used in classrooms of fifth through eighth grades. In most cases,…

  16. 5 CFR 831.1003 - Deductions from pay.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Deductions from pay. 831.1003 Section 831.1003 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT CSRS Offset § 831.1003 Deductions from pay. (a) Except as otherwise provided in this...

  17. 17 CFR 256.426.5 - Other deductions.

    Science.gov (United States)

    2010-04-01

    ... deductible before determining total income before interest charges. (b) Records shall be so maintained by...) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Income and Expense Accounts § 256.426.5 Other deductions. (a) This account...

  18. Relations between inductive reasoning and deductive reasoning.

    Science.gov (United States)

    Heit, Evan; Rotello, Caren M

    2010-05-01

    One of the most important open questions in reasoning research is how inductive reasoning and deductive reasoning are related. In an effort to address this question, we applied methods and concepts from memory research. We used 2 experiments to examine the effects of logical validity and premise-conclusion similarity on evaluation of arguments. Experiment 1 showed 2 dissociations: For a common set of arguments, deduction judgments were more affected by validity, and induction judgments were more affected by similarity. Moreover, Experiment 2 showed that fast deduction judgments were like induction judgments-in terms of being more influenced by similarity and less influenced by validity, compared with slow deduction judgments. These novel results pose challenges for a 1-process account of reasoning and are interpreted in terms of a 2-process account of reasoning, which was implemented as a multidimensional signal detection model and applied to receiver operating characteristic data. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  19. 26 CFR 20.2053-9 - Deduction for certain State death taxes.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Deduction for certain State death taxes. 20... § 20.2053-9 Deduction for certain State death taxes. (a) General rule. A deduction is allowed a... death taxes. However, see section 2058 to determine the deductibility of state death taxes by estates to...

  20. 77 FR 45480 - Deductions for Entertainment Use of Business Aircraft

    Science.gov (United States)

    2012-08-01

    ... Deductions for Entertainment Use of Business Aircraft AGENCY: Internal Revenue Service (IRS), Treasury... business aircraft for entertainment. These final regulations affect taxpayers that deduct expenses for... section 274 of the Internal Revenue Code (Code) of deductions for the use of business aircraft for...

  1. 29 CFR 783.45 - Deductions from wages.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Deductions from wages. 783.45 Section 783.45 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL... TO EMPLOYEES EMPLOYED AS SEAMEN Computation of Wages and Hours § 783.45 Deductions from wages. Where...

  2. 25 CFR 163.25 - Forest management deductions.

    Science.gov (United States)

    2010-04-01

    ... that are paid from funds appropriated for fire suppression or pest control or otherwise offset federal... 25 Indians 1 2010-04-01 2010-04-01 false Forest management deductions. 163.25 Section 163.25... Forest Management and Operations § 163.25 Forest management deductions. (a) Pursuant to the provisions of...

  3. 26 CFR 1.873-1 - Deductions allowed nonresident alien individuals.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Deductions allowed nonresident alien individuals... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.873-1 Deductions allowed nonresident alien individuals. (a) General provisions—(1) Allocation of deductions. In...

  4. 29 CFR 3.9 - Prohibited payroll deductions.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Prohibited payroll deductions. 3.9 Section 3.9 Labor Office of the Secretary of Labor CONTRACTORS AND SUBCONTRACTORS ON PUBLIC BUILDING OR PUBLIC WORK FINANCED IN WHOLE OR IN PART BY LOANS OR GRANTS FROM THE UNITED STATES § 3.9 Prohibited payroll deductions...

  5. Differential involvement of left prefrontal cortex in inductive and deductive reasoning.

    Science.gov (United States)

    Goel, Vinod; Dolan, Raymond J

    2004-10-01

    While inductive and deductive reasoning are considered distinct logical and psychological processes, little is known about their respective neural basis. To address this issue we scanned 16 subjects with fMRI, using an event-related design, while they engaged in inductive and deductive reasoning tasks. Both types of reasoning were characterized by activation of left lateral prefrontal and bilateral dorsal frontal, parietal, and occipital cortices. Neural responses unique to each type of reasoning determined from the Reasoning Type (deduction and induction) by Task (reasoning and baseline) interaction indicated greater involvement of left inferior frontal gyrus (BA 44) in deduction than induction, while left dorsolateral (BA 8/9) prefrontal gyrus showed greater activity during induction than deduction. This pattern suggests a dissociation within prefrontal cortex for deductive and inductive reasoning.

  6. 29 CFR 4.168 - Wage payments-deductions from wages paid.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Wage payments-deductions from wages paid. 4.168 Section 4... Standards Compliance with Compensation Standards § 4.168 Wage payments—deductions from wages paid. (a) The wage requirements of the Act will not be met where unauthorized deductions, rebates, or refunds reduce...

  7. Itemised Deductions : A Device to Reduce Tax Evasion

    NARCIS (Netherlands)

    Piolatto, A.

    2010-01-01

    Direct incentives and punishments are the most common instruments to fight tax evasion. The theoretical literature disregarded indirect schemes, such as itemised deductions, in which an agent has an interest in that other agents declare their revenue. Itemised deductions provide an incentive for

  8. 7 CFR 1131.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1131.86 Section 1131... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE ARIZONA MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1131.86...

  9. 7 CFR 1005.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1005.86 Section 1005... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE APPALACHIAN MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1005.86...

  10. 7 CFR 1007.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1007.86 Section 1007... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE SOUTHEAST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1007.86...

  11. 7 CFR 1001.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1001.86 Section 1001... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE NORTHEAST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1001.86...

  12. 7 CFR 1126.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1126.86 Section 1126... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE SOUTHWEST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1126.86...

  13. 7 CFR 1032.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1032.86 Section 1032... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1032.86...

  14. 7 CFR 1006.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1006.86 Section 1006... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE FLORIDA MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1006.86...

  15. 7 CFR 1033.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1033.86 Section 1033... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE MIDEAST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1033.86...

  16. 7 CFR 1030.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1030.86 Section 1030... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE UPPER MIDWEST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1030.86...

  17. 7 CFR 1124.86 - Deduction for marketing services.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1124.86 Section 1124... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE PACIFIC NORTHWEST MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1124.86...

  18. Evaluating the effect of tax deductions on training

    NARCIS (Netherlands)

    Oosterbeek, H.; Leuven, E.

    2004-01-01

    Dutch employers can claim an extra tax deduction when they train employees older than age 40. This discontinuity in a firm's training cost is exploited to identify the tax deduction's effects on training participation and of training participation on wages. The results show that the training rate of

  19. Deductive Error Diagnosis and Inductive Error Generalization for Intelligent Tutoring Systems.

    Science.gov (United States)

    Hoppe, H. Ulrich

    1994-01-01

    Examines the deductive approach to error diagnosis for intelligent tutoring systems. Topics covered include the principles of the deductive approach to diagnosis; domain-specific heuristics to solve the problem of generalizing error patterns; and deductive diagnosis and the hypertext-based learning environment. (Contains 26 references.) (JLB)

  20. Deductive multiscale simulation using order parameters

    Science.gov (United States)

    Ortoleva, Peter J.

    2017-05-16

    Illustrative embodiments of systems and methods for the deductive multiscale simulation of macromolecules are disclosed. In one illustrative embodiment, a deductive multiscale simulation method may include (i) constructing a set of order parameters that model one or more structural characteristics of a macromolecule, (ii) simulating an ensemble of atomistic configurations for the macromolecule using instantaneous values of the set of order parameters, (iii) simulating thermal-average forces and diffusivities for the ensemble of atomistic configurations, and (iv) evolving the set of order parameters via Langevin dynamics using the thermal-average forces and diffusivities.

  1. 26 CFR 1.167(a)-10 - When depreciation deduction is allowable.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false When depreciation deduction is allowable. 1.167... Corporations § 1.167(a)-10 When depreciation deduction is allowable. (a) A taxpayer should deduct the proper depreciation allowance each year and may not increase his depreciation allowances in later years by reason of...

  2. 26 CFR 1.615-4 - Limitation of amount deductible.

    Science.gov (United States)

    2010-04-01

    ... 1.615-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.615-4 Limitation of amount deductible. (a) Taxable... lease with respect to certain coal lands. A has deducted exploration expenditures under section 615 for...

  3. MANAGEMENT OF AN ATYPICAL ANKLE SPRAIN PATIENT THROUGH HYPOTHETICO DEDUCTIVE REASONING MODEL OF CLINICAL REASONING IMPLEMENTED BY INTERNATIONAL CLASSIFICATION OF FUNCTIONING DISABILITY AND HEALTH A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Mohammad Habibur Rahman

    2016-09-01

    Full Text Available Background: Clinical reasoning is a process by which physiotherapists interacted with patients, their family and other health- care professionals. It is the thinking process that professionals tend to apply in clinical practice. Given that novice as well as expert practitioners prefer to go through some steps while they were dealing with unfamiliar cases. This process is known as hypothetico deductive reasoning. This reasoning approach involved the generation of hypothesis based on clinical data and knowledge and testing of hypothesis through further inquiry. We are expert in musculoskeletal physiotherapy treatment and favoring the atypical history of patient we went through step by step from assessment to discharge Methods: A case based study through hypothetico deductive reasoning model of clinical reasoning. The objective of the study was to investigate the physiotherapy management strategies of an atypical ankle sprain patient through hypothetico deductive reasoning which comprised of cue acquisition, hypothesis generation, cue interpretation and hypothesis evaluation by implementing International Classification of Functioning, Disability and Health (ICF. Results: The patient responded well to treatment as patient reported that 100% swelling decreased, could bear more weight (95% on foot, decrease pain (1 cm on 10 cm VAS scale, improved muscle strength by manual muscle testing by grade V in ankle planter flexors (PF as well as dorsiflexors (DF, invertors as well as evertors and the functional status of patient was improved by 80% according to lower extremity functional scale. Conclusion: Clinical reasoning is an important approach in physiotherapy. It helps the practitioners in decision making and choosing the best alternative options for the well being of patients. We think it is necessary for all practitioners to have sound propositional and non-propositional knowledge in order to provide effective management protocol for patients focusing

  4. Greek classicism in living structure? Some deductive pathways in animal morphology.

    Science.gov (United States)

    Zweers, G A

    1985-01-01

    Classical temples in ancient Greece show two deterministic illusionistic principles of architecture, which govern their functional design: geometric proportionalism and a set of illusion-strengthening rules in the proportionalism's "stochastic margin". Animal morphology, in its mechanistic-deductive revival, applies just one architectural principle, which is not always satisfactory. Whether a "Greek Classical" situation occurs in the architecture of living structure is to be investigated by extreme testing with deductive methods. Three deductive methods for explanation of living structure in animal morphology are proposed: the parts, the compromise, and the transformation deduction. The methods are based upon the systems concept for an organism, the flow chart for a functionalistic picture, and the network chart for a structuralistic picture, whereas the "optimal design" serves as the architectural principle for living structure. These methods show clearly the high explanatory power of deductive methods in morphology, but they also make one open end most explicit: neutral issues do exist. Full explanation of living structure asks for three entries: functional design within architectural and transformational constraints. The transformational constraint brings necessarily in a stochastic component: an at random variation being a sort of "free management space". This variation must be a variation from the deterministic principle of the optimal design, since any transformation requires space for plasticity in structure and action, and flexibility in role fulfilling. Nevertheless, finally the question comes up whether for animal structure a similar situation exists as in Greek Classical temples. This means that the at random variation, that is found when the optimal design is used to explain structure, comprises apart from a stochastic part also real deviations being yet another deterministic part. This deterministic part could be a set of rules that governs

  5. 20 CFR 226.35 - Deductions from regular annuity rate.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Deductions from regular annuity rate. 226.35... COMPUTING EMPLOYEE, SPOUSE, AND DIVORCED SPOUSE ANNUITIES Computing a Spouse or Divorced Spouse Annuity § 226.35 Deductions from regular annuity rate. The regular annuity rate of the spouse and divorced...

  6. 26 CFR 1.941-1 - Special deduction for China Trade Act corporations.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES China Trade Act Corporations § 1.941-1 Special deduction for China Trade Act corporations. In addition to the deductions from taxable income otherwise allowed such a corporation, a China Trade Act corporation is, under certain conditions, allowed an additional deduction in...

  7. 26 CFR 1.179-3 - Carryover of disallowed deduction.

    Science.gov (United States)

    2010-04-01

    ... deduction are selected by the taxpayer in the year the properties are placed in service. This selection must... no selection is made, the total carryover of disallowed deduction is apportioned equally over the... restaurant business. During 1992, ABC purchases and places in service two items of section 179 property—a...

  8. 29 CFR 2509.99-1 - Interpretive Bulletin Relating to Payroll Deduction IRAs.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Interpretive Bulletin Relating to Payroll Deduction IRAs... SECURITY ACT OF 1974 § 2509.99-1 Interpretive Bulletin Relating to Payroll Deduction IRAs. (a) Scope. This...), as applied to payroll deduction programs established by employers 1 for the purpose of enabling...

  9. 20 CFR 361.11 - Procedures for salary offset: When deductions may begin.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Procedures for salary offset: When deductions... § 361.11 Procedures for salary offset: When deductions may begin. (a) Deductions to liquidate an... a debt is completed, offset shall be made from subsequent payments of any nature (e.g., final salary...

  10. The introduction of deductibles for prescription drugs in a national health insurance: Compulsory or voluntary?

    NARCIS (Netherlands)

    F.M. Bakker (Frank); R.C.J.A. van Vliet (René)

    1995-01-01

    textabstractWe consider a situation of full insurance coverage for prescription drugs where, at a certain point in time, people are given the opportunity to take a deductible in exchange for a lower premium. Four determinants of this premium reduction can be considered: expected out-of-pocket

  11. 7 CFR 3.81 - Procedures for salary offset: when deductions may begin.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Procedures for salary offset: when deductions may... Salary Offset § 3.81 Procedures for salary offset: when deductions may begin. (a) Deductions to liquidate... Offset Salary to collect from the employee's current pay. (b) If the employee filed a petition for a...

  12. Uncertain deduction and conditional reasoning.

    Science.gov (United States)

    Evans, Jonathan St B T; Thompson, Valerie A; Over, David E

    2015-01-01

    There has been a paradigm shift in the psychology of deductive reasoning. Many researchers no longer think it is appropriate to ask people to assume premises and decide what necessarily follows, with the results evaluated by binary extensional logic. Most every day and scientific inference is made from more or less confidently held beliefs and not assumptions, and the relevant normative standard is Bayesian probability theory. We argue that the study of "uncertain deduction" should directly ask people to assign probabilities to both premises and conclusions, and report an experiment using this method. We assess this reasoning by two Bayesian metrics: probabilistic validity and coherence according to probability theory. On both measures, participants perform above chance in conditional reasoning, but they do much better when statements are grouped as inferences, rather than evaluated in separate tasks.

  13. 37 CFR 251.73 - Deduction of costs of distribution proceedings.

    Science.gov (United States)

    2010-07-01

    ... OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE Royalty Fee Distribution Proceedings § 251.73 Deduction of costs of... distributions of royalty fees are made, deduct the reasonable costs incurred by the Library of Congress and the...

  14. Temporal Deductive Verification of Basic ASM Models

    OpenAIRE

    Daho, Hocine El-Habib; University of Oran; Benhamamouch, Djillali; University of Oran

    2010-01-01

    Abstract State Machines (ASMs, for short) provide a practical new computational model which has been applied in the area of software engineering for systems design and analysis. However, reasoning about ASM models occurs, not within a formal deductive system, but basically in the classical informal proofs style of mathematics. Several formal verification approaches for proving correctness of ASM models have been investigated. In this paper we consider the use of the TLA+logic for the deductive...

  15. Consumer preferences in social health insurance.

    Science.gov (United States)

    Kerssens, Jan J; Groenewegen, Peter P

    2005-03-01

    Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans which differed in 12 characteristics (premium, deductibles, no-claim discount, extension of insurance and financial services, red tape involved, medical help-desk, choice of family physicians and hospitals, dental benefits, physical therapy benefits, benefits for prescription drugs and homeopathy). In 90% the health plan with the most attractive characteristics was preferred, indicating a predominantly rational kind of choice. The most decisive characteristics for preference were: complete dental benefits, followed by zero deductibles, and free choice of hospitals.

  16. Advances in natural deduction a celebration of Dag Prawitz's work

    CERN Document Server

    Haeusler, Edward; Paiva, Valeria

    2014-01-01

    This collection of papers celebrating the contributions of Swedish logician Dag Prawitz to Proof Theory, has been assembled from those presented at the Natural Deduction conference organized in Rio de Janeiro to honour his  seminal  research. Dag Prawitz’s work forms the basis of intuitionistic type theory and his inversion principle constitutes the foundation of most modern accounts of proof-theoretic semantics in Logic, Linguistics and  Theoretical Computer Science. The range of contributions includes material on the extension of natural deduction with higher-order rules, as opposed to higher-order connectives, and a paper discussing the application of natural deduction rules to dealing with equality in predicate calculus. The volume continues with a key chapter summarizing work on the extension of the Curry-Howard isomorphism (itself a by-product of the work on natural deduction), via methods of category theory that have been successfully applied to linear logic, as well as many other contributions fr...

  17. Consumer's preferences in social health insurance.

    NARCIS (Netherlands)

    Kerssens, J.J.; Groenewegen, P.P.

    2005-01-01

    Allowing consumers greater choice of health plans is believed to be the key to high quality and low costs in social health insurance. This study investigates consumer preferences (361 persons, response rate 43%) for hypothetical health plans with differed in 12 characteristics (premium, deductibles,

  18. 26 CFR 1.249-1 - Limitation on deduction of bond premium on repurchase.

    Science.gov (United States)

    2010-04-01

    ... A issues a callable 20-year convertible bond at face for $1,000 bearing interest at 10 percent per... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Limitation on deduction of bond premium on... deduction of bond premium on repurchase. (a) Limitation—(1) General rule. No deduction is allowed to the...

  19. A system for deduction-based formal verification of workflow-oriented software models

    Directory of Open Access Journals (Sweden)

    Klimek Radosław

    2014-12-01

    Full Text Available The work concerns formal verification of workflow-oriented software models using the deductive approach. The formal correctness of a model’s behaviour is considered. Manually building logical specifications, which are regarded as a set of temporal logic formulas, seems to be a significant obstacle for an inexperienced user when applying the deductive approach. A system, along with its architecture, for deduction-based verification of workflow-oriented models is proposed. The process inference is based on the semantic tableaux method, which has some advantages when compared with traditional deduction strategies. The algorithm for automatic generation of logical specifications is proposed. The generation procedure is based on predefined workflow patterns for BPMN, which is a standard and dominant notation for the modeling of business processes. The main idea behind the approach is to consider patterns, defined in terms of temporal logic, as a kind of (logical primitives which enable the transformation of models to temporal logic formulas constituting a logical specification. Automation of the generation process is crucial for bridging the gap between the intuitiveness of deductive reasoning and the difficulty of its practical application when logical specifications are built manually. This approach has gone some way towards supporting, hopefully enhancing, our understanding of deduction-based formal verification of workflow-oriented models.

  20. Differential Involvement of Left Prefrontal Cortexin Inductive and Deductive Reasoning

    Science.gov (United States)

    Goel, Vinod; Dolan, Raymond J.

    2004-01-01

    While inductive and deductive reasoning are considered distinct logical and psychological processes, little is known about their respective neural basis. To address this issue we scanned 16 subjects with fMRI, using an event-related design, while they engaged in inductive and deductive reasoning tasks. Both types of reasoning were characterized by…

  1. The Right for Deducting VAT

    Directory of Open Access Journals (Sweden)

    Constantin Sergiu-Bogdan Constantin

    2017-01-01

    Full Text Available Romania must comply with the VAT Directive, the judgments of the Court of Justice of theEuropean Union and the European Court of Human Rights on VAT matter, that includes the matterof VAT deduction. The right to deduct VAT, in principle, cannot be limited for a taxable person andit is an abuse of law made by tax authorities when refusing this right. There are exceptions though,when the substantive and/or formal requirements are not met, the taxable person was involved in aVAT fraud or its supplier incorrectly drawn-up the invoice. The substantive requirements are: thepurchases must be from a taxable person and must be used for taxable activities. The formalrequirements are the obligations relating to accounting, invoicing and tax declarations. If taxauthorities discover a VAT fraud or/and that a VAT liability has not been declared they must takeimmediate measures, impose compliance and collect the corresponding sums from the responsibleperson.

  2. Inductive and deductive reasoning in obsessive-compulsive disorder.

    Science.gov (United States)

    Liew, Janice; Grisham, Jessica R; Hayes, Brett K

    2018-06-01

    This study examined the hypothesis that participants diagnosed with obsessive-compulsive disorder (OCD) show a selective deficit in inductive reasoning but are equivalent to controls in deductive reasoning. Twenty-five participants with OCD and 25 non-clinical controls made inductive and deductive judgments about a common set of arguments that varied in logical validity and the amount of positive evidence provided (premise sample size). A second inductive reasoning task required participants to make forced-choice decisions and rate the usefulness of diverse evidence or non-diverse evidence for evaluating arguments. No differences in deductive reasoning were found between participants diagnosed with OCD and control participants. Both groups saw that the amount of positive evidence supporting a conclusion was an important guide for evaluating inductive arguments. However, those with OCD showed less sensitivity to premise diversity in inductive reasoning than controls. The findings were similar for both emotionally neutral and OCD-relevant stimuli. The absence of a clinical control group means that it is difficult to know whether the deficit in diversity-based reasoning is specific to those with OCD. People with OCD are impaired in some forms of inductive reasoning (using diverse evidence) but not others (use of sample size). Deductive reasoning appears intact in those with OCD. Difficulties using evidence diversity when reasoning inductively may maintain OCD symptoms through reduced generalization of learned safety information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Deductive Updating Is Not Bayesian

    Science.gov (United States)

    Markovits, Henry; Brisson, Janie; de Chantal, Pier-Luc

    2015-01-01

    One of the major debates concerning the nature of inferential reasoning is between counterexample-based theories such as mental model theory and probabilistic theories. This study looks at conclusion updating after the addition of statistical information to examine the hypothesis that deductive reasoning cannot be explained by probabilistic…

  4. Deductive Reasoning to Teach Newton's Law of Motion

    Science.gov (United States)

    Lee, Han Su; Park, Jongwon

    2013-01-01

    Finding out about and then understanding the forces acting on a moving object, based on a description of the change in motion of this object, is an important part of the conceptual understanding of Newton's law of motion. Using Hempel's deductive-normative model for scientific explanation, we developed a deductive explanation task (DET),…

  5. Proof Construction: Adolescent Development from Inductive to Deductive Problem-Solving Strategies.

    Science.gov (United States)

    Foltz, Carol; And Others

    1995-01-01

    Studied 100 adolescents' approaches to problem-solving proofs and reasoning competence tasks. Found that a formal level of reasoning competence is associated with a deductive approach. Results support the notion of a cognitive development progression from an inductive approach to a deductive approach. (ETB)

  6. Children's and adults' judgments of the certainty of deductive inferences, inductive inferences, and guesses.

    Science.gov (United States)

    Pillow, Bradford H; Pearson, Raeanne M; Hecht, Mary; Bremer, Amanda

    2010-01-01

    Children and adults rated their own certainty following inductive inferences, deductive inferences, and guesses. Beginning in kindergarten, participants rated deductions as more certain than weak inductions or guesses. Deductions were rated as more certain than strong inductions beginning in Grade 3, and fourth-grade children and adults differentiated strong inductions, weak inductions, and informed guesses from pure guesses. By Grade 3, participants also gave different types of explanations for their deductions and inductions. These results are discussed in relation to children's concepts of cognitive processes, logical reasoning, and epistemological development.

  7. 76 FR 64879 - Deduction for Qualified Film and Television Production Costs

    Science.gov (United States)

    2011-10-19

    ... Deduction for Qualified Film and Television Production Costs AGENCY: Internal Revenue Service (IRS... regulations relating to deductions for the costs of producing film and television productions. Those temporary... production costs. (a) * * * (1) * * * (ii) [The text of this proposed amendment to Sec. 1.181- 1(a)(1)(ii) is...

  8. 26 CFR 1.168(k)-1 - Additional first year depreciation deduction.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Additional first year depreciation deduction. 1... Corporations § 1.168(k)-1 Additional first year depreciation deduction. (a) Scope and definitions—(1) Scope. This section provides the rules for determining the 30-percent additional first year depreciation...

  9. The deductive spreadsheet

    CERN Document Server

    Cervesato, Iliano

    2013-01-01

    This book describes recent multidisciplinary research at the confluence of the fields of logic programming, database theory and human-computer interaction. The goal of this effort was to develop the basis of a deductive spreadsheet, a user productivity application that allows users without formal training in computer science to make decisions about generic data in the same simple way they currently use spreadsheets to make decisions about numerical data. The result is an elegant design supported by the most recent developments in the above disciplines.The first half of the book focuses on the

  10. 38 CFR 8.5 - Authorization for deduction of premiums from compensation, retirement pay, or pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Authorization for deduction of premiums from compensation, retirement pay, or pension. 8.5 Section 8.5 Pensions, Bonuses, and... Authorization for deduction of premiums from compensation, retirement pay, or pension. Deductions from benefits...

  11. 76 FR 71450 - Deduction for Qualified Film and Television Production Costs; Correction

    Science.gov (United States)

    2011-11-18

    ... Deduction for Qualified Film and Television Production Costs; Correction AGENCY: Internal Revenue Service... Register on Wednesday, October 19, 2011 (76 FR 64816) relating to deductions for the cost of producing film and television productions. DATES: This correction is effective on November 18, 2011, and is...

  12. The Consistent Preferences Approach to Deductive Reasoning in Games

    CERN Document Server

    Asheim, Geir B

    2006-01-01

    "The Consistent Preferences Approach to Deductive Reasoning in Games" presents, applies, and synthesizes what my co-authors and I have called the 'consistent preferences' approach to deductive reasoning in games. Briefly described, this means that the object of the analysis is the ranking by each player of his own strategies, rather than his choice. The ranking can be required to be consistent (in different senses) with his beliefs about the opponent's ranking of her strategies. This can be contrasted to the usual 'rational choice' approach where a player's strategy choice is (in dif

  13. Job-based health insurance: costs climb at a moderate pace.

    Science.gov (United States)

    Claxton, Gary; DiJulio, Bianca; Whitmore, Heidi; Pickreign, Jeremy; McHugh, Megan; Finder, Benjamin; Osei-Anto, Awo

    2009-01-01

    Each year the Kaiser/HRET Survey of Employer Health Benefits takes a snapshot of the state of employee benefits in the United States, based on interviews with public and private employers. Our findings for 2009 show that families continue to face higher premiums, up about 5 percent from last year, and that cost sharing in the form of deductibles and copayments for office visits is greater as well. Average annual premiums in 2009 were $4,824 for single coverage and $13,375 for family coverage. Enrollment in high-deductible health plans held steady. We offer new insights about health risk assessments and how firms responded to the economic downturn.

  14. Advanced Query Formulation in Deductive Databases.

    Science.gov (United States)

    Niemi, Timo; Jarvelin, Kalervo

    1992-01-01

    Discusses deductive databases and database management systems (DBMS) and introduces a framework for advanced query formulation for end users. Recursive processing is described, a sample extensional database is presented, query types are explained, and criteria for advanced query formulation from the end user's viewpoint are examined. (31…

  15. What is the role of induction and deduction in reasoning and scientific inquiry?

    Science.gov (United States)

    Lawson, Anton E.

    2005-08-01

    A long-standing and continuing controversy exists regarding the role of induction and deduction in reasoning and in scientific inquiry. Given the inherent difficulty in reconstructing reasoning patterns based on personal and historical accounts, evidence about the nature of human reasoning in scientific inquiry has been sought from a controlled experiment designed to identify the role played by enumerative induction and deduction in cognition as well as from the relatively new field of neural modeling. Both experimental results and the neurological models imply that induction across a limited set of observations plays no role in task performance and in reasoning. Therefore, support has been obtained for Popper's hypothesis that enumerative induction does not exist as a psychological process. Instead, people appear to process information in terms of increasingly abstract cycles of hypothetico-deductive reasoning. Consequently, science instruction should provide students with opportunities to generate and test increasingly complex and abstract hypotheses and theories in a hypothetico-deductive manner. In this way students can be expected to become increasingly conscious of their underlying hypothetico-deductive thought processes, increasingly skilled in their application, and hence increasingly scientifically literate.

  16. 24 CFR 17.134 - Procedures for salary offset: when deductions may begin.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Procedures for salary offset: when deductions may begin. 17.134 Section 17.134 Housing and Urban Development Office of the Secretary, Department... Government Salary Offset Provisions § 17.134 Procedures for salary offset: when deductions may begin. (a...

  17. Understanding Loss Deductions for Timber

    Science.gov (United States)

    John Greene; Michael Jacobson

    1998-01-01

    Forestland owners whose timber has been destroyed may be eligible to take a deduction for the loss on their federal income tax. The loss must be physical in nature and caused by an identifiable event or combination of events that has run its course. There are two types of losses from natural events. Casualty losses are sudden, unexpected, and unusual - as from a fire...

  18. 19 CFR 152.105 - Deductive value.

    Science.gov (United States)

    2010-04-01

    ... its importation, and any Federal excise tax on, or measured by the value of, the merchandise for which... paragraph (c)(3) of this section, the value added by the processing of the merchandise after importation to...) of this section, deductions made for the value added by that processing will be based on objective...

  19. 20 CFR 404.1085 - Net operating loss deduction.

    Science.gov (United States)

    2010-04-01

    ... DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Self-Employment Income § 404.1085 Net operating loss deduction. When determining your net earnings from self-employment...

  20. 26 CFR 1.162-25 - Deductions with respect to noncash fringe benefits.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Deductions with respect to noncash fringe... Corporations § 1.162-25 Deductions with respect to noncash fringe benefits. (a) [Reserved] (b) Employee. If an employer provides the use of a vehicle (as defined in § 1.61-21(e)(2)) to an employee as a noncash fringe...

  1. 26 CFR 1.111-1 - Recovery of certain items previously deducted or credited.

    Science.gov (United States)

    2010-04-01

    ... including deductions with respect to depreciation, depletion, amortization, or amortizable bond premiums... reserve by a taxpayer on the reserve method of treating bad debts, it was not deducted, and it is... of such recovery exclusion, consideration must be given to the effect of net operating loss...

  2. Effectiveness of Inductive and Deductive Methods in Teaching Grammar

    Directory of Open Access Journals (Sweden)

    Mohammad Akram Alzu’bi

    2015-04-01

    • What is the effect of inductive method on grammar achievement compared with deductive method at elementary stage? To answer the questions of the study, the researcher prepares two programs based on inductive and deductive methods for each level based on its syllabus. The sample consists 180 students; eighty at the 1st year level in English departments at university level and one hundred at the elementary stage. The participants of the study consisted of four assigned sections. Firstly, at the university level, two colleges are randomly selected out of the eighteen faculties of Albalqa' Applied University; two sections are randomly selected; one group is randomly assigned as the 1st experimental group (by using inductive method and the second experimental group (by using deductive method. Similar process is adopted in the case of school students at the elementary stage.  The relevant pre-tests are administered to the students of both groups at each stage (university and school to make sure that the groups are equivalent at the time of starting the experiment. The researcher designs two grammar achievement tests as the instruments of this study (one for the elementary stage and one for university level. The instrument of each stage consists of two achievement tests (pre- test and post-test. At the end of the treatment period, relevant post-tests are administered to the students of both the groups. The results of the study revealed that there were significant statistical differences at (α≤0.09 among the grammar performance means of both groups at both levels due to inductive method. Keywords: Inductive method, Deductive method, Elementary stage, University level, Academic achievement

  3. Cultural Difference in Stereotype Perceptions and Performances in Nonverbal Deductive Reasoning and Creativity

    Science.gov (United States)

    Wong, Regine; Niu, Weihua

    2013-01-01

    A total of 182 undergraduate students from China and the United States participated in a study examining the presence of stereotypical perceptions regarding creativity and deductive reasoning abilities, as well as the influence of stereotype on participants' performance on deductive reasoning and creativity in nonverbal form. The results showed…

  4. The interplay of deductive and inductive reasoning in psychoanalytic theorizing.

    Science.gov (United States)

    Hanly, Charles

    2014-10-01

    Deductive and inductive reasoning both played an essential part in Freud's construction of psychoanalysis. In this paper, the author explores the happy marriage of empiricism and rationalism in Freud's use of deductive reasoning in the construction of psychoanalytic theory. To do this, the author considers three major amendments Freud made to his theory: (i) infant and childhood sexuality, (ii) the structural theory, and (iii) the theory of signal anxiety. Ultimately, the author argues for, and presents Freud as a proponent of, the epistemological position that he calls critical realism. © 2014 The Psychoanalytic Quarterly, Inc.

  5. Cost of Capital when Dividends are Deductible

    Directory of Open Access Journals (Sweden)

    Ignacio Velez-Pareja

    2011-09-01

    Full Text Available Tax savings and the discount rate we use to calculate their value are involved in the calculation of cost of capital. Based on previous findings, we derive a general approach to cash flow valuation that take into account any kind of tax shields related to the financing decision of a firm and any date when they are earned. They can be used to introduce any type of externality that creates value through tax savings not captured by neither the cost of debt nor the cost of equity. This paper develops the formulations for the cost of capital when dividends, interest on equity or monetary correction of equity are deductible as it happens in Brazil. It shows that when properly done most known valuation methods are consistent and give identical results. Also, the paper argues that when dividends are tax deductible, optimal leverage is lower and equity value is higher.

  6. The Dimensionality of Reasoning: Inductive and Deductive Inference can be Explained by a Single Process.

    Science.gov (United States)

    Hayes, Brett K; Stephens, Rachel G; Ngo, Jeremy; Dunn, John C

    2018-02-01

    Three-experiments examined the number of qualitatively different processing dimensions needed to account for inductive and deductive reasoning. In each study, participants were presented with arguments that varied in logical validity and consistency with background knowledge (believability), and evaluated them according to deductive criteria (whether the conclusion was necessarily true given the premises) or inductive criteria (whether the conclusion was plausible given the premises). We examined factors including working memory load (Experiments 1 and 2), individual working memory capacity (Experiments 1 and 2), and decision time (Experiment 3), which according to dual-processing theories, modulate the contribution of heuristic and analytic processes to reasoning. A number of empirical dissociations were found. Argument validity affected deduction more than induction. Argument believability affected induction more than deduction. Lower working memory capacity reduced sensitivity to argument validity and increased sensitivity to argument believability, especially under induction instructions. Reduced decision time led to decreased sensitivity to argument validity. State-trace analyses of each experiment, however, found that only a single underlying dimension was required to explain patterns of inductive and deductive judgments. These results show that the dissociations, which have traditionally been seen as supporting dual-processing models of reasoning, are consistent with a single-process model that assumes a common evidentiary scale for induction and deduction. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  7. Deductive databases and P systems

    Directory of Open Access Journals (Sweden)

    Miguel A. Gutierrez-Naranjo

    2004-06-01

    Full Text Available In computational processes based on backwards chaining, a rule of the type is seen as a procedure which points that the problem can be split into the problems. In classical devices, the subproblems are solved sequentially. In this paper we present some questions that circulated during the Second Brainstorming Week related to the application of the parallelism of P systems to computation based on backwards chaining on the example of inferential deductive process.

  8. Modeling the Effects of Argument Length and Validity on Inductive and Deductive Reasoning

    Science.gov (United States)

    Rotello, Caren M.; Heit, Evan

    2009-01-01

    In an effort to assess models of inductive reasoning and deductive reasoning, the authors, in 3 experiments, examined the effects of argument length and logical validity on evaluation of arguments. In Experiments 1a and 1b, participants were given either induction or deduction instructions for a common set of stimuli. Two distinct effects were…

  9. 38 CFR 8.4 - Deduction of insurance premiums from compensation, retirement pay, or pension.

    Science.gov (United States)

    2010-07-01

    ...' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Premiums § 8.4 Deduction of insurance premiums from compensation, retirement pay, or pension. The insured under a National Service life insurance policy which is not lapsed may authorize the monthly deduction of premiums from disability...

  10. The application of automated deductive reasoning to power plant diagnostics

    International Nuclear Information System (INIS)

    Filshtein, E.L.; Rzasa, P.W.

    1986-01-01

    A module which incorporates the application of deductive reasoning to diagnostics has been developed. This module is a part of a generic diagnostic expert system prototype developed for power plant operations at Combustion Engineering. This paper is one of a series of papers which will describe the activities of the project. Specifically, this paper describes the deductive reasoning module which determines and classifies root cause malfunctions. The concept of 'perfect instruments' is introduced. These instruments are imaginary instruments which bridge the gap between real world inputs and the generic diagnostic shell. The prototype, its application, and future developments are discussed

  11. Service contract of Renault Kerax 440 truck with deductible and policy limit coverage modification

    Science.gov (United States)

    Bustami, Pasaribu, Udjianna. S.; Husniah, Hennie

    2016-02-01

    In this paper we discuss a service contracts with coverage modification that only offer preventive maintenance and corrective maintenance for Renault Kerax 440 Truck by service contract provider. Corrective maintenance costs is modified with deductible and policy limit during the period of the service contract. Demand for a service contract is only influenced by the price of the service contract, deductible, and policy limit offered by producer to consumer. The main problem in this thesis is determining the price of a service contract, deductible, and policy limit to get maximum profit for producer for each of service contract.

  12. 26 CFR 25.2523(e)-1 - Marital deduction; life estate with power of appointment in donee spouse.

    Science.gov (United States)

    2010-04-01

    ... satisfied and S is treated as having a general power to appoint 100/250 of the entire interest in the 250... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Marital deduction; life estate with power of... Deductions § 25.2523(e)-1 Marital deduction; life estate with power of appointment in donee spouse. (a) In...

  13. A Logical Deduction Based Clause Learning Algorithm for Boolean Satisfiability Problems

    Directory of Open Access Journals (Sweden)

    Qingshan Chen

    2017-01-01

    Full Text Available Clause learning is the key component of modern SAT solvers, while conflict analysis based on the implication graph is the mainstream technology to generate the learnt clauses. Whenever a clause in the clause database is falsified by the current variable assignments, the SAT solver will try to analyze the reason by using different cuts (i.e., the Unique Implication Points on the implication graph. Those schemes reflect only the conflict on the current search subspace, does not reflect the inherent conflict directly involved in the rest space. In this paper, we propose a new advanced clause learning algorithm based on the conflict analysis and the logical deduction, which reconstructs a linear logical deduction by analyzing the relationship of different decision variables between the backjumping level and the current decision level. The logical deduction result is then added into the clause database as a newly learnt clause. The resulting implementation in Minisat improves the state-of-the-art performance in SAT solving.

  14. 26 CFR 1.170A-1 - Charitable, etc., contributions and gifts; allowance of deduction.

    Science.gov (United States)

    2010-04-01

    ..., and the deduction for, amounts paid to maintain certain students as members of the taxpayer's... money, the amount of the contribution is the fair market value of the property at the time of the... performing donated services is deductible. Similarly, out-of-pocket transportation expenses necessarily...

  15. Are there reasons to challenge a symbolic computationalist approach in explaining deductive reasoning?

    Science.gov (United States)

    Faiciuc, Lucia E

    2008-06-01

    The majority of the existing theories explaining deductive reasoning could be included in a classic computationalist approach of the cognitive processes. In fact, deductive reasoning could be seen to be the pinnacle of the symbolic computationalism, its last fortress to be defended in the face of new, dynamic, and ecological perspectives over cognition. But are there weak points in that position regarding deductive reasoning? What would be the reasons for which new perspectives could gain in credibility? What could be their most important tenets? The answers given to those questions in the paper include two main points. The first one is that the present empirical data could not sustain unambiguously one view over the other, that they are obtained in artificial experimental conditions, and that there are data that are not easily explainable using the traditional computationalist paradigm. The second one is that approaching the deductive reasoning from dynamic and ecological perspectives could have significant advantages. The most obvious one is the possibility to integrate more easily the research regarding the deductive reasoning with the results obtained in other domains of the psychology (especially in what respects the lower cognitive processes), in artificial intelligence or in neurophysiology. The reasons for that would be that such perspectives, as they are sketched in the paper, would imply, essentially, processes of second-order pattern formation and recognition (as it is the case for perception), embodied cognition, and dynamic processes as the brain ones are.

  16. Interest Deductibility and the BEPS Action Plan: nihil novi sub sole?

    OpenAIRE

    Traversa, Edoardo

    2013-01-01

    Interest payments between affiliated companies which aim at shifting profit from high to low tax countries are a well-known and frequently used tool in international tax planning. It is therefore not surprising that in the OECD Action Plan on Base Erosion and Profit Shifting (BEPS) (Action Plan) considerable attention is given to the measures limiting the deductibility of (excessive) intra-group interest payments.1 The Action Plan does not, however, provide any clear guidance as to which, amo...

  17. 42 CFR 100.2 - Average cost of a health insurance policy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2... VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining..., less certain deductions. One of the deductions is the average cost of a health insurance policy, as...

  18. The responsiveness of training participation to tax deductability

    NARCIS (Netherlands)

    Leuven, E.; Oosterbeek, H.

    2006-01-01

    To stimulate investment in training by individuals, the Dutch tax system allows a deduction of direct training expenditures from taxable income. This paper investigates to what extent the resulting cost reduction encourages training investments. Two different identification strategies are used. The

  19. 关于企业所得税扣除的几个问题%Several Issues Concerning Deduction of Enterprise Income Tax

    Institute of Scientific and Technical Information of China (English)

    谭珩

    2012-01-01

    本文对企业所得税扣除的概念、分类和意义进行了理论探讨。认为,传统的税前扣除概念不足以涵盖扣除的全部内容,所得税扣除既包括税前扣除,也包括税额扣除。关于扣除的种类,可以划分为税基式扣除与税额式扣除;对人的扣除与对物的扣除;全额扣除、限额扣除和超额扣除;收益性支出扣除和资本性支出扣除;经济性扣除与政策性扣除。关于扣除的意义,本文认为,扣除是所得税原理的必然要求;扣除可以避免侵蚀资本,维持社会简单再生产;扣除可以为企业获取适当利润提供制度保障,使企业扩大再生产成为可能;扣除是政府实现某种宏观调控目标的重要手段;扣除是消除国际重复征税的重要方式。%This paper explores theoretically the concept, category and significance of deduction of enterprise income tax. The author holds that deduction of income tax includes not only deduction before tax but also deduction from tax payable, while traditional concept of deduction before tax cannot cover the entire content. Deduction can be categorized into: deduction from tax base and deduction from tax payable; person-based deductions and object-based deductions; deduction in full amounts, limited deduction and excess deduction; deduction of profitable expenses and deduction of capital expenses; economic deduction and policy-based deduction. For the significance of deduction, this paper holds that deduction is required by the theory of income tax. Deduction can prevent the capital from eroding and maintain the simple reproduction of society. It provides institutional guarantee for enterprise to earn appropriate profit and makes it possible to expand reproduction. Deduction is an important vehicle for the government to achieve the goal of macroeconomic adjustments and controls. It is also an important method to eliminate international double taxation.

  20. Relations between Inductive Reasoning and Deductive Reasoning

    Science.gov (United States)

    Heit, Evan; Rotello, Caren M.

    2010-01-01

    One of the most important open questions in reasoning research is how inductive reasoning and deductive reasoning are related. In an effort to address this question, we applied methods and concepts from memory research. We used 2 experiments to examine the effects of logical validity and premise-conclusion similarity on evaluation of arguments.…

  1. 26 CFR 1.162-25T - Deductions with respect to noncash fringe benefits (temporary).

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Deductions with respect to noncash fringe... Individuals and Corporations § 1.162-25T Deductions with respect to noncash fringe benefits (temporary). (a) Employer. If an employer includes the value of a noncash fringe benefit in an employee's gross income, the...

  2. Investigating Primary School Mathematics Teachers’ Deductive Reasoning Ability through Varignon’s Theorem

    Science.gov (United States)

    Jupri, A.

    2017-09-01

    The responsibility to promote the growth of deductive reasoning ability of school students through learning mathematics is in the hand of mathematics teachers and particularly primary school mathematics teachers. However, how we can make sure whether teachers are able to do so. To investigate this issue, we conducted a three-step of an exploratory survey study. First, we designed tasks from the Varignon’s theorem. Second, we administered an individual written test involving twenty master students of primary education program, in which they are prospective of and primary school mathematics teachers. Finally, we address the results in the light of Van Hiele theory. The results showed that participated students lack of deductive reasoning ability in the context of geometry. For further research, we wonder whether the designed tasks are also applicable to assess student deductive reasoning ability if the students have acquired appropriate teaching.

  3. 46 CFR 69.119 - Spaces deducted from gross tonnage.

    Science.gov (United States)

    2010-10-01

    ... equipment plus a two foot maximum working space on each side of the equipment, if available, is deductible.... (ix) Oil skin lockers. (x) Pantries. (xi) Recreation rooms. (xii) Smoking rooms. (xiii) Galleys below...

  4. Student Teachers’ Proof Schemes on Proof Tasks Involving Inequality: Deductive or Inductive?

    Science.gov (United States)

    Rosyidi, A. H.; Kohar, A. W.

    2018-01-01

    Exploring student teachers’ proof ability is crucial as it is important for improving the quality of their learning process and help their future students learn how to construct a proof. Hence, this study aims at exploring at the proof schemes of student teachers in the beginning of their studies. Data were collected from 130 proofs resulted by 65 Indonesian student teachers on two proof tasks involving algebraic inequality. To analyse, the proofs were classified into the refined proof schemes level proposed by Lee (2016) ranging from inductive, which only provides irrelevant inferences, to deductive proofs, which consider addressing formal representation. Findings present several examples of each of Lee’s level on the student teachers’ proofs spanning from irrelevant inferences, novice use of examples or logical reasoning, strategic use examples for reasoning, deductive inferences with major and minor logical coherence, and deductive proof with informal and formal representation. Besides, it was also found that more than half of the students’ proofs coded as inductive schemes, which does not meet the requirement for doing the proof for the proof tasks examined in this study. This study suggests teacher educators in teacher colleges to reform the curriculum regarding proof learning which can accommodate the improvement of student teachers’ proving ability from inductive to deductive proof as well from informal to formal proof.

  5. 26 CFR 1.1400L(b)-1 - Additional first year depreciation deduction for qualified New York Liberty Zone property.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Additional first year depreciation deduction for... to Individuals' Title 11 Cases § 1.1400L(b)-1 Additional first year depreciation deduction for...-percent additional first year depreciation deduction allowable under section 1400L(b) for qualified New...

  6. Deductive Synthesis of the Unification Algorithm,

    Science.gov (United States)

    1981-06-01

    DEDUCTIVE SYNTHESIS OF THE I - UNIFICATION ALGORITHM Zohar Manna Richard Waldinger I F? Computer Science Department Artificial Intelligence Center...theorem proving," Artificial Intelligence Journal, Vol. 9, No. 1, pp. 1-35. Boyer, R. S. and J S. Moore [Jan. 19751, "Proving theorems about LISP...d’Intelligence Artificielle , U.E.R. de Luminy, Universit6 d’ Aix-Marseille II. Green, C. C. [May 1969], "Application of theorem proving to problem

  7. The legitimating fact in the transcendental deduction of the categories: on Dieter Henrich's reading of Kant

    Directory of Open Access Journals (Sweden)

    Christian Klotz

    Full Text Available This article reconstructs the principal moments of Dieter Henrich's work on Immanuel Kant's theoretical philosophy. Henrich seeks to clarify and regain the fundaments of Kant's theory of knowledge - from which his followers, according to him, have distanced themselves - based on the analysis of the "transcendental deduction of the categories". Firstly, Henrich investigates the proof structure of deduction, comparing the first and the second edition of Critique of Pure Reason. Secondly, he investigates, in the Kantian argument, the relationship between the identity principle of self-consciousness and objectivity. Finally, extending the comparison to Critique of Practical Reason, Henrich elucidates the program and methodology in deduction, showing that the idea of a legitimating fact, borrowed from the juridical notion of a deduction, becomes the fundamental element. We analyse the problems raised by the conception of a philosophical argument based on fundamental "facts".

  8. 26 CFR 1.1382-3 - Taxable income of cooperatives; special deductions for exempt farmers' cooperatives.

    Science.gov (United States)

    2010-04-01

    ... deductions for exempt farmers' cooperatives. 1.1382-3 Section 1.1382-3 Internal Revenue INTERNAL REVENUE... Patrons § 1.1382-3 Taxable income of cooperatives; special deductions for exempt farmers' cooperatives. (a) In general. (1) Section 1382(c) provides that in determining the taxable income of a farmers', fruit...

  9. 26 CFR 20.2056(b)-4 - Marital deduction; valuation of interest passing to surviving spouse.

    Science.gov (United States)

    2010-04-01

    ... surviving spouse. (a) In general. The value, for the purpose of the marital deduction, of any deductible... expenses could include executor commissions and attorney fees (except to the extent of commissions or fees... executor properly makes an election under section 2056(b)(7) to treat as qualified terminable interest...

  10. Are there two processes in reasoning? The dimensionality of inductive and deductive inferences.

    Science.gov (United States)

    Stephens, Rachel G; Dunn, John C; Hayes, Brett K

    2018-03-01

    Single-process accounts of reasoning propose that the same cognitive mechanisms underlie inductive and deductive inferences. In contrast, dual-process accounts propose that these inferences depend upon 2 qualitatively different mechanisms. To distinguish between these accounts, we derived a set of single-process and dual-process models based on an overarching signal detection framework. We then used signed difference analysis to test each model against data from an argument evaluation task, in which induction and deduction judgments are elicited for sets of valid and invalid arguments. Three data sets were analyzed: data from Singmann and Klauer (2011), a database of argument evaluation studies, and the results of an experiment designed to test model predictions. Of the large set of testable models, we found that almost all could be rejected, including all 2-dimensional models. The only testable model able to account for all 3 data sets was a model with 1 dimension of argument strength and independent decision criteria for induction and deduction judgments. We conclude that despite the popularity of dual-process accounts, current results from the argument evaluation task are best explained by a single-process account that incorporates separate decision thresholds for inductive and deductive inferences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. 29 CFR 541.603 - Effect of improper deductions from salary.

    Science.gov (United States)

    2010-07-01

    ... REGULATIONS DEFINING AND DELIMITING THE EXEMPTIONS FOR EXECUTIVE, ADMINISTRATIVE, PROFESSIONAL, COMPUTER AND OUTSIDE SALES EMPLOYEES Salary Requirements § 541.603 Effect of improper deductions from salary. (a) An...

  12. 26 CFR 1.642(f)-1 - Amortization deductions.

    Science.gov (United States)

    2010-04-01

    ....642(f)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Estates, Trusts, and Beneficiaries § 1.642(f)-1 Amortization deductions. An estate... respect to qualified railroad rolling stock as defined in section 184(d), with respect to certified coal...

  13. The Deductions of Freedom/Morality-as-Autonomy and the Categorical Imperative in Groundwork III and Their Problems

    Directory of Open Access Journals (Sweden)

    Fernando Rudy Hiller

    2015-12-01

    Full Text Available The first objective of this paper is to present an interpretation of Groundwork III which aims to establish two main points: first, that Kant offers there a theoretically-grounded deduction (in Kantian sense of freedom/morality-as-autonomy; second, that Kant also offers a separate deduction of the categorical imperative. Thus, contrary to what several commentators have claimed, Groundwork III contains a theoretically-grounded double deduction. The second objective of the paper is to examine and criticize in detail one crucial step in these deductions, namely, Kant’s inference from the speculative spontaneity of reason to the noumenal existence of the subject as a free will. I show that Kant himself came to reject this inference in the B edition of the Critique of Pure Reason, and argue that this explains Kant’s rejection, in the Critique of Practical Reason, of the deduction of the moral law he previously offered. Thus, contrary to the “reconciliationist” reading, there is indeed a great reversal in the latter work.

  14. Formal verification of Simulink/Stateflow diagrams a deductive approach

    CERN Document Server

    Zhan, Naijun; Zhao, Hengjun

    2017-01-01

    This book presents a state-of-the-art technique for formal verification of continuous-time Simulink/Stateflow diagrams, featuring an expressive hybrid system modelling language, a powerful specification logic and deduction-based verification approach, and some impressive, realistic case studies. Readers will learn the HCSP/HHL-based deductive method and the use of corresponding tools for formal verification of Simulink/Stateflow diagrams. They will also gain some basic ideas about fundamental elements of formal methods such as formal syntax and semantics, and especially the common techniques applied in formal modelling and verification of hybrid systems. By investigating the successful case studies, readers will realize how to apply the pure theory and techniques to real applications, and hopefully will be inspired to start to use the proposed approach, or even develop their own formal methods in their future work.

  15. Mental Health Services Utilization and Expenditures Among Children Enrolled in Employer-Sponsored Health Plans.

    Science.gov (United States)

    Walter, Angela Wangari; Yuan, Yiyang; Cabral, Howard J

    2017-05-01

    Mental illness in children increases the risk of developing mental health disorders in adulthood, and reduces physical and emotional well-being across the life course. The Mental Health Parity and Addiction Equity Act (MHPAEA, 2008) aimed to improve access to mental health treatment by requiring employer-sponsored health plans to include insurance coverage for behavioral health services. Investigators used IBM Watson/Truven Analytics MarketScan claims data (2007-2013) to examine: (1) the distribution of mental illness; (2) trends in utilization and out-of-pocket expenditures; and (3) the overall effect of the MHPAEA on mental health services utilization and out-of-pocket expenditures among privately-insured children aged 3 to 17 with mental health disorders. Multivariate Poisson regression and linear regression modeling techniques were used. Mental health services use for outpatient behavioral health therapy (BHT) was higher in the years after the implementation of the MHPAEA (2010-2013). Specifically, before the MHPAEA implementation, the annual total visits for BHT provided by mental health physicians were 17.1% lower and 2.5% lower for BHT by mental health professionals, compared to years when MHPAEA was in effect. Children covered by consumer-driven and high-deductible plans had significantly higher out-of-pocket expenditures for BHT compared to those enrolled PPOs. Our findings demonstrate increased mental health services use and higher out-of-pocket costs per outpatient visit after implementation of the MHPAEA. As consumer-driven and high-deductible health plans continue to grow, enrollees need to be cognizant of the impact of health insurance benefit designs on health services offered in these plans. Copyright © 2017 by the American Academy of Pediatrics.

  16. 29 CFR 3.6 - Payroll deductions permissible with the approval of the Secretary of Labor.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Payroll deductions permissible with the approval of the Secretary of Labor. 3.6 Section 3.6 Labor Office of the Secretary of Labor CONTRACTORS AND SUBCONTRACTORS ON....6 Payroll deductions permissible with the approval of the Secretary of Labor. Any contractor or...

  17. Compare and Contrast Inductive and Deductive Research Approaches

    Science.gov (United States)

    Soiferman, L. Karen

    2010-01-01

    This discussion paper compares and contrasts "inductive" and "deductive" research approaches as described by Trochim (2006) and Plano Clark and Creswell (2007). It also examines the "exploratory" and "confirmatory" approaches by Onwueghuzie and Leech (2005) with respect to the assumption each holds about the nature of knowledge. The paper starts…

  18. The Possibility of Deduction of Environmental Liabilities in Expropriation for Each Breach of Environmental Rural Property

    Directory of Open Access Journals (Sweden)

    Ricardo Nasser Sefer

    2016-10-01

    Full Text Available This study aims to address the deductibility of environmental liability indemnification of quantum measured in the expropriation of rural property that failed to fulfill its environmental function. The Federal Constitution of 1988, provided for the possibility to expropriate rural property that failed to comply with its social and environmental role. On the subject, the Federal Regional Court of the 1st Region does not signed a single position on this opportunity to deduct the environmental liability, generating as a result, legal uncertainty for landowners and the community itself, being the Institute of Colonization and Agrarian Reform - INCRA the correct deduction.

  19. 26 CFR 1.280C-1 - Disallowance of certain deductions for wage or salary expenses.

    Science.gov (United States)

    2010-04-01

    ... salary expenses. 1.280C-1 Section 1.280C-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... certain deductions for wage or salary expenses. If an employer elects to claim the targeted jobs credit... deduction for wage or salary expenses paid or incurred in the year the credit is earned by the amount...

  20. Automated Generation of User Guidance by Combining Computation and Deduction

    Directory of Open Access Journals (Sweden)

    Walther Neuper

    2012-02-01

    Full Text Available Herewith, a fairly old concept is published for the first time and named "Lucas Interpretation". This has been implemented in a prototype, which has been proved useful in educational practice and has gained academic relevance with an emerging generation of educational mathematics assistants (EMA based on Computer Theorem Proving (CTP. Automated Theorem Proving (ATP, i.e. deduction, is the most reliable technology used to check user input. However ATP is inherently weak in automatically generating solutions for arbitrary problems in applied mathematics. This weakness is crucial for EMAs: when ATP checks user input as incorrect and the learner gets stuck then the system should be able to suggest possible next steps. The key idea of Lucas Interpretation is to compute the steps of a calculation following a program written in a novel CTP-based programming language, i.e. computation provides the next steps. User guidance is generated by combining deduction and computation: the latter is performed by a specific language interpreter, which works like a debugger and hands over control to the learner at breakpoints, i.e. tactics generating the steps of calculation. The interpreter also builds up logical contexts providing ATP with the data required for checking user input, thus combining computation and deduction. The paper describes the concepts underlying Lucas Interpretation so that open questions can adequately be addressed, and prerequisites for further work are provided.

  1. 18 CFR 367.4350 - Account 435, Extraordinary deductions.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 435, Extraordinary deductions. 367.4350 Section 367.4350 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT...

  2. 26 CFR 301.6682-1 - False information with respect to withholding allowances based on itemized deductions.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false False information with respect to withholding allowances based on itemized deductions. 301.6682-1 Section 301.6682-1 Internal Revenue INTERNAL REVENUE... Amounts § 301.6682-1 False information with respect to withholding allowances based on itemized deductions...

  3. An analytic tableaux model for Deductive Mastermind empirically tested with a massively used online learning system

    NARCIS (Netherlands)

    Gierasimczuk, N.; van der Maas, H.L.J.; Raijmakers, M.E.J.

    2013-01-01

    The paper is concerned with the psychological relevance of a logical model for deductive reasoning. We propose a new way to analyze logical reasoning in a deductive version of the Mastermind game implemented within a popular Dutch online educational learning system (Math Garden). Our main goal is to

  4. 18 CFR 367.4082 - Account 408.2, Taxes other than income taxes, other income and deductions.

    Science.gov (United States)

    2010-04-01

    ... ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT Income Statement Chart of Accounts Service Company Operating Income § 367.4082 Account 408.2, Taxes other than income taxes, other income and deductions. This... other than income taxes, other income and deductions. 367.4082 Section 367.4082 Conservation of Power...

  5. A Generalized Deduction of the Ideal-Solution Model

    Science.gov (United States)

    Leo, Teresa J.; Perez-del-Notario, Pedro; Raso, Miguel A.

    2006-01-01

    A new general procedure for deriving the Gibbs energy of mixing is developed through general thermodynamic considerations, and the ideal-solution model is obtained as a special particular case of the general one. The deduction of the Gibbs energy of mixing for the ideal-solution model is a rational one and viewed suitable for advanced students who…

  6. 18 CFR 367.4112 - Account 411.2, Provision for deferred income taxes-Credit, other income and deductions.

    Science.gov (United States)

    2010-04-01

    ..., Provision for deferred income taxes-Credit, other income and deductions. 367.4112 Section 367.4112... deferred taxes and deferrals of taxes, credit, that relate to other income and deductions. ... Accounts Service Company Operating Income § 367.4112 Account 411.2, Provision for deferred income taxes...

  7. Bounds for phase-shifts and deductions in potential scattering

    International Nuclear Information System (INIS)

    Sidharth, B.G.

    1979-01-01

    Starting from the radial Schroedinger equation and using the Cauchy-Schwarz inequality, expressions have been derived for bounds for phase-shifts in potential scattering and the deductions are verified in special cases such as the spherically symmetric square-well potential, where exact solutions are already known. (K.B.)

  8. 26 CFR 1.617-2 - Limitation on amount deductible.

    Science.gov (United States)

    2010-04-01

    ... 1.617-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Natural Resources § 1.617-2 Limitation on amount deductible. (a... 1967, 1968, 1969, and 1970 A had exploration costs of $80,000 all with respect to coal deposits located...

  9. 26 CFR 1.162-10T - Questions and answers relating to the deduction of employee benefits under the Tax Reform Act of...

    Science.gov (United States)

    2010-04-01

    ... of employee benefits under the Tax Reform Act of 1984; certain limits on amounts deductible... and Corporations § 1.162-10T Questions and answers relating to the deduction of employee benefits... amendment of section 404(b) by the Tax Reform Act of 1984 affect the deduction of employee benefits under...

  10. Analysis of Tax-deductible Interest Payments for Re-advanceable Canadian Mortgages

    Science.gov (United States)

    Naseem, Almas; Reesor, Mark

    2011-11-01

    According to Canadian tax law the interest on loans used for investment purposes is tax deductible while interest on personal mortgage loans is not. One way of transforming from non-tax deductible to tax deductible interest expenses is to borrow against home equity to make investments. A re-advanceable mortgage is a product specifically designed to take advantage of this tax discrepancy. Using simulation we study the risk associated with the re-advanceable mortgage strategy to provide a better description of the mortgagor's position. We assume that the mortgagor invests the borrowings secured by home equity into a single risky asset (e.g., stock or mutual fund) whose evolution is described by geometric Brownian motion (GBM). With a re-advanceable mortgage we find that the average mortgage payoff time is less than the original mortgage term. However, there is considerable variation in the payoff times with a significant probability of a payoff time exceeding the original mortgage term. Higher income homeowners enjoy a payoff time distribution with both a lower average and a lower standard deviation than low-income homeowners. Thus this strategy is most beneficial to those with the highest income. We also find this strategy protects the homeowner in the event of job loss. This work is important to lenders, financial planners and homeowners to more fully understand the benefits and risk associated with this strategy.

  11. Note on Deduction Theorems in contraction-free logics

    Czech Academy of Sciences Publication Activity Database

    Chvalovský, Karel; Cintula, Petr

    2012-01-01

    Roč. 58, č. 3 (2012), s. 236-243 ISSN 0942-5616 R&D Projects: GA ČR GAP202/10/1826 Grant - others:Austrian Science Fund (FWF)(AT) START Y544-N23 Institutional research plan: CEZ:AV0Z10300504 Keywords : Local Deduction Theorem * BCI-logic * Substructural logics * Rule of contraction Subject RIV: BA - General Mathematics Impact factor: 0.376, year: 2012

  12. Seeing Health Insurance and HealthCare.gov Through the Eyes of Young Adults.

    Science.gov (United States)

    Wong, Charlene A; Asch, David A; Vinoya, Cjloe M; Ford, Carol A; Baker, Tom; Town, Robert; Merchant, Raina M

    2015-08-01

    We describe young adults' perspectives on health insurance and HealthCare.gov, including their attitudes toward health insurance, health insurance literacy, and benefit and plan preferences. We observed young adults aged 19-30 years in Philadelphia from January to March 2014 as they shopped for health insurance on HealthCare.gov. Participants were then interviewed to elicit their perceived advantages and disadvantages of insurance and factors considered important for plan selection. A 1-month follow-up interview assessed participants' plan enrollment decisions and intended use of health insurance. Data were analyzed using qualitative methodology, and salience scores were calculated for free-listing responses. We enrolled 33 highly educated young adults; 27 completed the follow-up interview. The most salient advantages of health insurance for young adults were access to preventive or primary care (salience score .28) and peace of mind (.27). The most salient disadvantage was the financial strain of paying for health insurance (.72). Participants revealed poor health insurance literacy with 48% incorrectly defining deductible and 78% incorrectly defining coinsurance. The most salient factors reported to influence plan selection were deductible (.48) and premium (.45) amounts as well as preventive care (.21) coverage. The most common intended health insurance use was primary care. Eight participants enrolled in HealthCare.gov plans: six selected silver plans, and three qualified for tax credits. Young adults' perspective on health insurance and enrollment via HealthCare.gov can inform strategies to design health insurance plans and communication about these plans in a way that engages and meets the needs of young adult populations. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. State trends in premiums and deductibles, 2003-2009: how building on the Affordable Care Act will help stem the tide of rising costs and eroding benefits.

    Science.gov (United States)

    Schoen, Cathy; Stremikis, Kristof; How, Sabrina K H; Collins, Sara R

    2010-12-01

    Rapidly rising health insurance costs have strained U.S. families and employers in recent years. This issue brief examines data for all states on changes in private employer premiums and deductibles for 2003 and 2009. The analysis finds that premiums for businesses and their employees increased 41 percent across states from 2003 to 2009, while per-person deductibles jumped 77 percent in large as well as small firms. If these trends continue at the rate prior to enactment of the Affordable Care Act, the average premium for family coverage will rise 79 percent by 2020, to more than $23,000. The authors describe how health reform offers the potential to reduce insurance cost growth while improving value and protection. If reforms succeed in slowing premium growth by 1 percentage point annually in all states, by 2020 employers and families together will save $2,323 annually for family coverage, compared with projected trends.

  14. Workplace Financial Wellness Programs Help Employees Manage Health Care Changes.

    Science.gov (United States)

    Meyer, Cynthia; Smith, Michael C

    Employers and employees are navigating major changes in health insurance benefits, including the move to high-deductible health plans in conjunction with health savings accounts (HSAs). The HSA offers unique benefits that could prove instrumental in helping workers both navigate current health care expenses and build a nest egg for much larger health care costs in retirement. Yet employees often don't understand the HSA and how to best use it. How can employers help employees make wise benefits choices that work for their personal financial circumstances?

  15. Travel Expenses in Connection with Tax-Deductible Education Expenses

    Science.gov (United States)

    Bottiglieri, William A.; Reville, Patrick J.

    2012-01-01

    Trade or business expenses are deductible if they are ordinary and necessary with respect to the trade or business in which they were incurred. Treasury Regulations bring education expenses into this purview but only if they maintain or improve skills already acquired or allow a taxpayer to maintain his current position. Related travel expenses in…

  16. 29 CFR 3.5 - Payroll deductions permissible without application to or approval of the Secretary of Labor.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Payroll deductions permissible without application to or approval of the Secretary of Labor. 3.5 Section 3.5 Labor Office of the Secretary of Labor CONTRACTORS AND... STATES § 3.5 Payroll deductions permissible without application to or approval of the Secretary of Labor...

  17. A Conservative Look at Term Deduction Systems with Variable Binding

    NARCIS (Netherlands)

    Fokkink, W.J.; Verhoef, C.

    We set up a formal framework to describe term deduction systems, such as transition system specifications in the style of Plotkin, and conditional term rewriting systems. This framework has the power to express many-sortedness, general binding mechanisms and substitutions, among other notions such

  18. Inductive vs. Deductive Grammar Instruction and the Grammatical Performance of EFL Learners

    Directory of Open Access Journals (Sweden)

    Fatemeh Behjat

    2008-02-01

    Full Text Available Learning a foreign language offers a great challenge to students since it involves learning different skills and subskills. Quite a few number of researches have been done so far on the relationship between gender and learning a foreign language. On the other hand, two major approaches in teaching grammar have been offered by language experts, inductive and deductive. The present study examines which method of teaching grammar is more fruitful for Iranian male and female students. For this purpose, 150 freshman students, 110 females and 40 males, majoring in English were selected from all available students at Abadeh and Shiraz Azad universities. All the subjects took the NTC's grammar test prior to the instruction as pre-test. Then, they were divided into two groups and were taught grammar inductively and deductively in each group for one semester. At the end of the instruction, the same test was taken as post-test. The comparison between the students' pre and post-test indicated that there was a significant improvement in their knowledge of grammar. By the way, through a two-way ANOVA, it was found out that males learned grammar better when they were taught inductively and females showed a better performance when they were taught deductively.

  19. 26 CFR 1.163-3 - Deduction for discount on bond issued on or before May 27, 1969.

    Science.gov (United States)

    2010-04-01

    ... case of a callable bond, at the earlier call date) over the issue price of the bond (as defined in... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Deduction for discount on bond issued on or... and Corporations § 1.163-3 Deduction for discount on bond issued on or before May 27, 1969. (a...

  20. On the Difference between Traditional and Deductive Fuzzy Logic

    Czech Academy of Sciences Publication Activity Database

    Běhounek, Libor

    2008-01-01

    Roč. 159, č. 10 (2008), s. 1153-1164 ISSN 0165-0114 R&D Projects: GA AV ČR KJB100300502 Institutional research plan: CEZ:AV0Z10300504 Keywords : deductive fuzzy logic * fuzzy elements * gradual sets * entropy of fuzzy sets * aggregation * membership degrees * methodology of fuzzy mathematics Subject RIV: BA - General Mathematics Impact factor: 1.833, year: 2008

  1. 26 CFR 1.825-1 - Unused loss deduction; in general.

    Science.gov (United States)

    2010-04-01

    ... TAX (CONTINUED) INCOME TAXES Mutual Insurance Companies (other Than Life and Certain Marine Insurance Companies and Other Than Fire Or Flood Insurance Companies Which Operate on Basis of Perpetual Policies Or...) provides that the unused loss deduction of a mutual insurance company subject to the tax imposed by section...

  2. Acute mental health care according to recent mental health ...

    African Journals Online (AJOL)

    Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...

  3. Imaging deductive reasoning and the new paradigm

    Science.gov (United States)

    Oaksford, Mike

    2015-01-01

    There has been a great expansion of research into human reasoning at all of Marr’s explanatory levels. There is a tendency for this work to progress within a level largely ignoring the others which can lead to slippage between levels (Chater et al., 2003). It is argued that recent brain imaging research on deductive reasoning—implementational level—has largely ignored the new paradigm in reasoning—computational level (Over, 2009). Consequently, recent imaging results are reviewed with the focus on how they relate to the new paradigm. The imaging results are drawn primarily from a recent meta-analysis by Prado et al. (2011) but further imaging results are also reviewed where relevant. Three main observations are made. First, the main function of the core brain region identified is most likely elaborative, defeasible reasoning not deductive reasoning. Second, the subtraction methodology and the meta-analytic approach may remove all traces of content specific System 1 processes thought to underpin much human reasoning. Third, interpreting the function of the brain regions activated by a task depends on theories of the function that a task engages. When there are multiple interpretations of that function, interpreting what an active brain region is doing is not clear cut. It is concluded that there is a need to more tightly connect brain activation to function, which could be achieved using formalized computational level models and a parametric variation approach. PMID:25774130

  4. 26 CFR 1.179B-1T - Deduction for capital costs incurred in complying with Environmental Protection Agency sulfur...

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Deduction for capital costs incurred in... capital costs incurred in complying with Environmental Protection Agency sulfur regulations (temporary... the deduction allowable under section 179B(a) for qualified capital costs paid or incurred by a small...

  5. 26 CFR 1.611-1 - Allowance of deduction for depletion.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Allowance of deduction for depletion. 1.611-1... depletion. (a) Depletion of mines, oil and gas wells, other natural deposits, and timber—(1) In general... mines, oil and gas wells, other natural deposits, and timber, a reasonable allowance for depletion. In...

  6. Using the deductible for patient channeling: did preferred providers gain patient volume?

    Science.gov (United States)

    van der Geest, Stéphanie A; Varkevisser, Marco

    2016-06-01

    In market-based health care systems, channeling patients to designated preferred providers can increase payer's bargaining clout, other things being equal. In the unique setting of the new Dutch health care system with regulated competition, this paper evaluates the impact of a 1-year natural experiment with patient channeling on providers' market shares. In 2009 a large regional Dutch health insurer designated preferred providers for two different procedures (cataract surgery and varicose veins treatment) and gave its enrollees a positive financial incentive for choosing them. That is, patients were exempted from paying their deductible when they went to a preferred provider. Using claims data over the period 2007-2009, we apply a difference-in-difference approach to study the impact of this channeling strategy on the allocation of patients across individual providers. Our estimation results show that, in the year of the experiment, preferred providers of varicose veins treatment on average experienced a significant increase in patient volume relative to non-preferred providers. However, for cataract surgery no significant effect is found. Possible explanations for the observed difference between both procedures may be the insurer's selection of preferred providers and the design of the channeling incentive resulting in different expected financial benefits for both patient groups.

  7. Deductive and inductive reasoning in obsessive-compulsive disorder.

    Science.gov (United States)

    Pélissier, Marie-Claude; O'Connor, Kieron P

    2002-03-01

    This study tested the hypothesis that people with obsessive-compulsive disorder (OCD) show an inductive reasoning style distinct from people with generalized anxiety disorder (GAD) and from participants in a non-anxious (NA) control group. The experimental procedure consisted of administering a range of six deductive and inductive tasks and a probabilistic task in order to compare reasoning processes between groups. Recruitment was in the Montreal area within a French-speaking population. The participants were 12 people with OCD, 12 NA controls and 10 people with GAD. Participants completed a series of written and oral reasoning tasks including the Wason Selection Task, a Bayesian probability task and other inductive tasks, designed by the authors. There were no differences between groups in deductive reasoning. On an inductive "bridging task", the participants with OCD always took longer than the NA control and GAD groups to infer a link between two statements and to elaborate on this possible link. The OCD group alone showed a significant decrease in their degree of conviction about an arbitrary statement after inductively generating reasons to support this statement. Differences in probabilistic reasoning replicated those of previous authors. The results pinpoint the importance of examining inference processes in people with OCD in order to further refine the clinical applications of behavioural-cognitive therapy for this disorder.

  8. 26 CFR 1.280F-2T - Limitations on recovery deductions and the investment tax credit for certain passenger...

    Science.gov (United States)

    2010-04-01

    ... investment tax credit for certain passenger automobiles (temporary). 1.280F-2T Section 1.280F-2T Internal... TAXES Items Not Deductible § 1.280F-2T Limitations on recovery deductions and the investment tax credit for certain passenger automobiles (temporary). (a) Limitation on amount of investment tax credit—(1...

  9. How is a categorical imperative possible? : Kant’s deduction of the categorical imperative (GMS, III,4)

    OpenAIRE

    Schönecker, Dieter

    2016-01-01

    Kant’s deduction of the categorical imperative is the answer to the following question: “How is a categorical imperative possible?” The answer is given in subsection 4 (Sec. 4) of chapter three of the Groundwork. It is impossible to understand this answer, and hence impossible to understand Kant’s deduction of the moral law, without taking into account the overall context of Groundwork III (GMS III). However, here I can only sketch the overall structure of GMS III, and there...

  10. Sherlock Holmes' methods of deductive reasoning applied to medical diagnostics.

    Science.gov (United States)

    Miller, L

    1985-03-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics.

  11. 26 CFR 1.280F-1T - Limitations on investment tax credit and recovery deductions under section 168 for passenger...

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 3 2010-04-01 2010-04-01 false Limitations on investment tax credit and... Limitations on investment tax credit and recovery deductions under section 168 for passenger automobiles and... the amount of investment tax credit determined under section 46(a) and recovery deductions under...

  12. 26 CFR 1.179A-1 - Recapture of deduction for qualified clean-fuel vehicle property and qualified clean-fuel vehicle...

    Science.gov (United States)

    2010-04-01

    ... the benefit of the section 179A deduction allowable multiplied by the recapture percentage. The... property. The recapture amount is equal to the benefit of the section 179A deduction allowable multiplied... allowance for depreciation, this increase in basis is recoverable over its remaining recovery period...

  13. 26 CFR 1.221-2 - Deduction for interest due and paid on qualified education loans before January 1, 2002.

    Science.gov (United States)

    2010-04-01

    ... Individuals § 1.221-2 Deduction for interest due and paid on qualified education loans before January 1, 2002... interest due and paid by the taxpayer during the taxable year on a qualified education loan. The deduction is allowed only with respect to interest due and paid on a qualified education loan during the first...

  14. You can't buy insurance when the house is on fire. Community rating kills health insurance.

    Science.gov (United States)

    Hartnedy, J A

    1994-05-15

    Why does health insurance cost so much? According to the vice president at the insurance company that pioneered high-deductible health insurance to go with medical savings accounts, a big factor is that insurance companies are being asked to solve social problems. Mr Hartnedy offers a solution to America's healthcare-delivery plight that includes empowerment of individuals and preservation of choice.

  15. Health Benefits In 2015: Stable Trends In The Employer Market.

    Science.gov (United States)

    Claxton, Gary; Rae, Matthew; Panchal, Nirmita; Whitmore, Heidi; Damico, Anthony; Kenward, Kevin; Long, Michelle

    2015-10-01

    The annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey found that in 2015, average annual premiums (employer and worker contributions combined) were $6,251 for single coverage and $17,545 for family coverage. Both premiums rose 4 percent from 2014, continuing several years of modest growth. The percentage of firms offering health benefits and the percentage of workers covered by their employers' plans remained statistically unchanged from 2014. Eighty-one percent of covered workers were enrolled in a plan with a general annual deductible. Among those workers, the average deductible for single coverage was $1,318. Half of large employers either offered employees the opportunity or required them to complete biometric screening. Of firms that offer an incentive for completing the screening, 20 percent provide employees with incentives or penalties that are tied to meeting those biometric outcomes. The 2015 survey included new questions on financial incentives to complete wellness programs and meet specified biometric outcomes as well as questions about narrow networks and employers' strategies related to the high-cost plan tax and the employer shared-responsibility provisions of the Affordable Care Act. Project HOPE—The People-to-People Health Foundation, Inc.

  16. 26 CFR 1.911-6 - Disallowance of deductions, exclusions, and credits.

    Science.gov (United States)

    2010-04-01

    ... related to a class of gross income are personal and family medical expenses, qualified retirement... place of work is in a foreign country, deductible moving expenses will be allocable to foreign earned... received or accrued. This rule applies for all individuals, regardless of their method of accounting. (iii...

  17. Sherlock Holmes's Methods of Deductive Reasoning Applied to Medical Diagnostics

    Science.gov (United States)

    Miller, Larry

    1985-01-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics. PMID:3887762

  18. 76 FR 60721 - Deduction for Qualified Film and Television Production Costs

    Science.gov (United States)

    2011-09-30

    ... which the costs are paid (for an owner who uses the cash receipts and disbursements method of accounting) or incurred (for an owner who uses an accrual method of accounting). The deduction under section 181... Bernard P. Harvey, Office of Associate Chief Counsel (Income Tax and Accounting). However, other personnel...

  19. The direct and immediate link test regarding deduction of input VAT

    DEFF Research Database (Denmark)

    Jensen, Dennis Ramsdahl; Stensgaard, Henrik

    2014-01-01

    It follows explicitly from the EC VAT Directive that the deduction of input VAT depends on a positive link between on the one hand the incurred expenses and on the other hand the planned or actually completed taxed output transactions. In theory and in practice the deeper nature of this link...

  20. Opinions on Tax Deductions and the Consensus Effect in a Survey-Experiment

    NARCIS (Netherlands)

    van der Heijden, E.C.M.; Nelissen, J.H.M.; Potters, J.J.M.

    2004-01-01

    We present the results of a survey-experiment using a representative sample of the Dutch population in which we relate respondents' opinion about the tax deductibility of mortgages to their estimates about other people's opinion.The experiment employs three treatment variables: monetary incentives,

  1. 26 CFR 20.2053-3 - Deduction for expenses of administering estate.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Taxable Estate... permitted by § 20.2053-1 even though the deduction, as such, was not claimed on the estate tax return or in... expenses include such expenses as court costs, surrogates' fees, accountants' fees, appraisers' fees, clerk...

  2. 48 CFR 1352.228-71 - Deductibles under required insurance coverage-cost reimbursement.

    Science.gov (United States)

    2010-10-01

    ... insurance coverage-cost reimbursement. 1352.228-71 Section 1352.228-71 Federal Acquisition Regulations... Provisions and Clauses 1352.228-71 Deductibles under required insurance coverage—cost reimbursement. As... Coverage—Cost Reimbursement (APR 2010) (a) The contractor is required to present evidence of the amount of...

  3. Consumer decision making in the individual health insurance market.

    Science.gov (United States)

    Marquis, M Susan; Buntin, Melinda Beeuwkes; Escarce, José J; Kapur, Kanika; Louis, Thomas A; Yegian, Jill M

    2006-01-01

    This paper summarizes the results from a study of consumer decision making in California's individual health insurance market. We conclude that price subsidies will have only modest effects on participation and that efforts to reduce nonprice barriers might be just as effective. We also find that there is substantial pooling in the individual market and that it increases over time because people who become sick can continue coverage without new underwriting. Finally, we show that people prefer more-generous benefits and that it is difficult to induce people in poor health to enroll in high-deductible health plans.

  4. Taxation Human Rights – a Concrete Case: the right to the full income tax deduction of expenses with medicines

    Directory of Open Access Journals (Sweden)

    Carlos Araújo Leonetti

    2015-06-01

    Full Text Available This article is intended to address aspecific aspect related to the taxation humanrights:  the right to full deduction of expenseswith medicines from the basis for calculat-ing the income tax. After a brief introductionto the topic of taxation human rights a rela-tively new vision in universal law, the articlemakes a foray into the income tax-individual,revisiting its basic concepts and principles. Ispresented, also, a brief history of the IRPF inBrazil, in order to better situate the subject infocus. In the sequel, the article faces the ques-tion about the deductions allowed, on the ba-sis of calculation of the tax. Finally, the articleanalizes the possible inclusion of spending onmedicines among these deductions, conclud-ing that it is an imperative of Fairness and re-spect to the Constitution

  5. Controlling Health Care Costs

    Science.gov (United States)

    Dessoff, Alan

    2009-01-01

    This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…

  6. Deductive Reasoning and Social Anxiety : Evidence for a Fear-confirming Belief Bias

    NARCIS (Netherlands)

    Vroling, Maartje S.; de Jong, Peter J.

    2009-01-01

    This study investigated the relationship between belief bias and fear of negative evaluation. Belief bias refers to a bias in deductive reasoning that acts to confirm rather than falsify prior beliefs. Participants (N = 52) with varying levels of fear of negative evaluation completed a belief bias

  7. 26 CFR 20.2056A-1 - Restrictions on allowance of marital deduction if surviving spouse is not a United States citizen.

    Science.gov (United States)

    2010-04-01

    ... tax marital deduction is not allowed for property passing to or for the benefit of a surviving spouse..., inheritance, or gift taxes, the amendments made by section 5033 of the Technical and Miscellaneous Revenue Act... inconsistent with the provisions of such treaty relating to estate, inheritance, or gift tax marital deductions...

  8. 38 CFR 1.991 - Procedures for salary offset: when deductions may begin.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Procedures for salary offset: when deductions may begin. 1.991 Section 1.991 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS GENERAL PROVISIONS Salary Offset Provisions § 1.991 Procedures for salary offset...

  9. NaDeA: A Natural Deduction Assistant with a Formalization in Isabelle

    DEFF Research Database (Denmark)

    Villadsen, Jørgen; Jensen, Alexander Birch; Schlichtkrull, Anders

    2017-01-01

    We present a new software tool for teaching logic based on natural deduction. Its proof system is formalized in the proof assistant Isabelle such that its definition is very precise. Soundness of the formalization has been proved in Isabelle. The tool is open source software developed in TypeScript...

  10. NaDeA: A Natural Deduction Assistant with a Formalization in Isabelle

    DEFF Research Database (Denmark)

    Villadsen, Jørgen; Jensen, Alexander Birch; Schlichtkrull, Anders

    2015-01-01

    We present a new software tool for teaching logic based on natural deduction. Its proof system is formalized in the proof assistant Isabelle such that its definition is very precise. Soundness of the formalization has been proved in Isabelle. The tool is open source software developed in TypeScript...

  11. Language Learning of Children with Typical Development Using a Deductive Metalinguistic Procedure

    Science.gov (United States)

    Finestack, Lizbeth H.

    2014-01-01

    Purpose: In the current study, the author aimed to determine whether 4- to 6-year-old typically developing children possess requisite problem-solving and language abilities to produce, generalize, and retain a novel verb inflection when taught using an explicit, deductive teaching procedure. Method: Study participants included a cross-sectional…

  12. Childhood and Health

    DEFF Research Database (Denmark)

    From, Ditte-Marie

    During the past decades, the number of overweight and obese individuals has increased throughout the Danish population. This fact has led to a strong political focus on health promotion especially among children and adolescents to prevent further escalation. The prevailing political point of view...... on the matter has deducted the following conclusion: Expansion on the waistline equals expansion on the state budget due to low labour capacity and high costs on social services and health care. Where the food industry finds profit potential in the population’s love for (good) food, the State fears chaos...... and a need to act before the so-called obesity epidemic becomes uncontrollable. Governmental health priorities are reproduced in local council family programmes where children and their parents are offered a chance to gain inspiration and knowledge about a healthier lifestyle and are provided tools to re...

  13. 7 CFR 400.136 - Procedures for salary offset; when deductions may begin.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Procedures for salary offset; when deductions may... Management-Regulations for the 1986 and Succeeding Crop Years § 400.136 Procedures for salary offset; when... amount outlined in the Notice of Intent to collect from the employee's salary, as provided for in § 400...

  14. Individuality and social influence in groups : Inductive and deductive routes to group identity

    NARCIS (Netherlands)

    Postmes, T; Spears, R; Lee, AT; Novak, RJ

    2005-01-01

    A distinction between forms of social identity formation in small interactive groups is investigated. In groups in which a common identity is available or given, norms for individual behavior may be deduced; from group properties (deductive identity). In groups in which interpersonal relations are

  15. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... Cure Your tax-deductible gift today can fund critical diabetes research and support vital diabetes education services ... or other emergency, the medical ID can provide critical information about the person's health status, such as ...

  16. A work-site weight control program using financial incentives collected through payroll deduction.

    Science.gov (United States)

    Forster, J L; Jeffery, R W; Sullivan, S; Snell, M K

    1985-11-01

    In a work-site weight control program using a self-motivational program of financial incentives implemented through payroll deduction, 131 university employees chose weight loss goals (0 to 60 lb) and incentives (+5 to +30) to be deducted from each paycheck for six months. Return of incentive money was contingent on progress toward weight goals. Participants were assigned randomly to one of four protocols, involving group educational sessions v self-instruction only and required v optional attendance at weigh-ins and sessions. Overall, dropout rates (21.4%) and mean weight loss (12.2 lb) were encouraging, especially compared with those of other work-site programs. Weight loss was positively associated with attendance at weigh-ins and educational sessions. However, requiring attendance did not increase program effectiveness and seemed also to discourage enrollment among men. The weight control program was equally effective when offered with professionally led educational sessions or when accompanied by self-instructional materials only.

  17. Human Long Jump — A Deductive Approach

    Directory of Open Access Journals (Sweden)

    Miloš Jovanović

    2012-10-01

    Full Text Available This paper presents a useful application of a generalized approach to the modelling of human and humanoid motion using the deductive approach. It starts with formulating a completely general problem and deriving different real situations as special cases. The concept and the software realization are verified by comparing the results with the ones obtained using “classical” software for one well-known particular problem – biped walking. New applicability and potentials of the proposed method are demonstrated by simulation of a selected example – the long jump. The simulated motion included jumping and landing on the feet (after a jump. Additional analysis is done in the paper regarding the joint torque and joint angle during the jumping. Separate stages of the simulation are defined and explained.

  18. Employee health benefit redesign at the academic health center: a case study.

    Science.gov (United States)

    Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

    2013-03-01

    The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

  19. 18 CFR 367.4092 - Account 409.2, Income taxes, other income and deductions.

    Science.gov (United States)

    2010-04-01

    ... POWER ACT AND NATURAL GAS ACT Income Statement Chart of Accounts Service Company Operating Income § 367... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 409.2, Income taxes, other income and deductions. 367.4092 Section 367.4092 Conservation of Power and Water Resources...

  20. Independent effects of relevance and arousal on deductive reasoning.

    Science.gov (United States)

    Caparos, Serge; Blanchette, Isabelle

    2017-08-01

    Emotional content can have either a deleterious or a beneficial impact on logicality. Using standard deductive-reasoning tasks, we tested the hypothesis that the interplay of two factors - personal relevance and arousal - determines the nature of the effect of emotional content on logicality. Arousal was assessed using measures of skin conductance. Personal relevance was manipulated by asking participants to reason about semantic contents linked to an emotional event that they had experienced or not. Findings showed that (1) personal relevance exerts a positive effect on logicality while arousal exerts a negative effect, and that (2) these effects are independent of each other.

  1. 26 CFR 1.276-1 - Disallowance of deductions for certain indirect contributions to political parties.

    Science.gov (United States)

    2010-04-01

    .... Notwithstanding any other provision of law, no deduction shall be allowed for income tax purposes in respect of... entertainment, food, and the ballroom, and all proceeds are paid to the hotel where the function is held, with...

  2. Inferential Role and the Ideal of Deductive Logic

    Directory of Open Access Journals (Sweden)

    Thomas Hofweber

    2010-11-01

    Full Text Available Although there is a prima facie strong case for a close connection between the meaning and inferential role of certain expressions, this connection seems seriously threatened by the semantic and logical paradoxes which rely on these inferential roles. Some philosophers have drawn radical conclusions from the paradoxes for the theory of meaning in general, and for which sentences in our language are true. I criticize these overreactions, and instead propose to distinguish two conceptions of inferential role. This distinction is closely tied to two conceptions of deductive logic, and it is the key, I argue, for understanding first the connection between meaning and inferential role, and second what the paradoxes show more generally.

  3. Offshore decommissioning issues: Deductibility and transferability

    International Nuclear Information System (INIS)

    Parente, Virginia; Ferreira, Doneivan; Moutinho dos Santos, Edmilson; Luczynski, Estanislau

    2006-01-01

    Dealing with the decommissioning of petroleum installations is a relatively new challenge to most producer countries. It is natural to expect that industry's experience in building platforms is much greater than the one of dismantling them. Even if manifold and varied efforts are underway towards establishing international 'best practices' standards in this sector, countries still enjoy rather extensive discretionary power as they practice a particular national style in the regulation of decommissioning activities in their state's jurisdiction. The present paper offers a broad panorama of this discussion, concentrating mainly on two controversial aspects. The first one analyses the ex-ante deductibility of decommissioning costs as they constitute an ex-post expense. The second discussion refers to the assignment of decommissioning responsibility in the case of transfer of exploration and production rights to new lessees during the project's life. Finally the paper applies concepts commonly used in project financing as well as structures generally used in organising pension funds to develop insights into these discussions

  4. The Great Recession and Workers' Health Benefits.

    Science.gov (United States)

    Koh, Kanghyock

    2018-03-01

    During a recession, cost-sharing of employer-sponsored health benefits could increase to reduce labor costs in the U.S. Using a variation in the severity of recession shocks across industries, I find evidence that the enrollment rate of high deductible health plans (HDHPs) among workers covered by employer-sponsored health benefits increased more among firms in industries that experienced severe recession shocks. As potential mechanisms, I study employer-side and worker-side mechanisms. I find that employers changed health benefit offerings to force or incentivize workers to enroll in HDHPs. But I find little evidence of an increase in workers' demand for HDHPs due to a reduction in income. These results suggest that the HDHP enrollment rate increased during the Great Recession, as employers tried to save costs of offering health benefits. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Interpreting clinical trial results by deductive reasoning: In search of improved trial design.

    Science.gov (United States)

    Kurbel, Sven; Mihaljević, Slobodan

    2017-10-01

    Clinical trial results are often interpreted by inductive reasoning, in a trial design-limited manner, directed toward modifications of the current clinical practice. Deductive reasoning is an alternative in which results of relevant trials are combined in indisputable premises that lead to a conclusion easily testable in future trials. © 2017 WILEY Periodicals, Inc.

  6. 76 FR 81059 - Guidance Regarding Deduction and Capitalization of Expenditures Related to Tangible Property

    Science.gov (United States)

    2011-12-27

    ... and necessary trade or business expenses) and section 263(a) (relating to the capitalization... is not deductible as a business expense. Section 1.162-11(b) of the existing regulations also... court explained that repair and maintenance expenses are incurred for the purpose of keeping property in...

  7. Optimal Premium as a Function of the Deductible: Customer Analysis and Portfolio Characteristics

    Directory of Open Access Journals (Sweden)

    Julie Thøgersen

    2016-11-01

    Full Text Available An insurance company offers an insurance contract ( p , K , consisting of a premium p and a deductible K. In this paper, we consider the problem of choosing the premium optimally as a function of the deductible. The insurance company is facing a market of N customers, each characterized by their personal claim frequency, α, and risk aversion, β. When a customer is offered an insurance contract, she/he will, based on these characteristics, choose whether or not to insure. The decision process of the customer is analyzed in detail. Since the customer characteristics are unknown to the company, it models them as i.i.d. random variables; A 1 , … , A N for the claim frequencies and B 1 , … , B N for the risk aversions. Depending on the distributions of A i and B i , expressions for the portfolio size n ( p ; K ∈ [ 0 , N ] and average claim frequency α ( p ; K in the portfolio are obtained. Knowing these, the company can choose the premium optimally, mainly by minimizing the ruin probability.

  8. Health benefits in 2013: moderate premium increases in employer-sponsored plans.

    Science.gov (United States)

    Claxton, Gary; Rae, Matthew; Panchal, Nirmita; Damico, Anthony; Whitmore, Heidi; Bostick, Nathan; Kenward, Kevin

    2013-09-01

    Employer-sponsored health insurance premiums rose moderately in 2013, the annual Kaiser Family Foundation/Health Research and Educational Trust (Kaiser/HRET) Employer Health Benefits Survey found. In 2013 single coverage premiums rose 5 percent to $5,884, and family coverage premiums rose 4 percent to $16,351. The percentage of firms offering health benefits (57 percent) was similar to that in 2012, as was the percentage of workers at offering firms who were covered by their firm's health benefits (62 percent). The share of workers with a deductible for single coverage increased significantly from 2012, as did the share of workers in small firms with annual deductibles of $1,000 or more. Most firms (77 percent), including nearly all large employers, continued to offer wellness programs, but relatively few used incentives to encourage employees to participate. More than half of large employers offering health risk appraisals to workers offered financial incentives for completing the appraisal.

  9. Natural representation of the deduction; applying to the temporal reasoning for expert systems based on production rules

    International Nuclear Information System (INIS)

    Baudin, Patrick

    1990-01-01

    The expert systems development within a real time context, requires both to master the necessary reasoning about the time as well as to master the necessary response time for reasoning. Although rigorous temporal logic formalisms exist, strategies for temporal reasoning are either incomplete or else imply unacceptable response times. The first part presents the logic formalism upon which is based the production system. This formalism contains a three-valued logic system with truth-valued matrix, and a deductive system with a formal system. It does a rigorous work for this no standard logic, where the notions of consistency and completeness can be studied. Its development supports itself on the will to formalise the reasoning used at the elaboration time of the strategies to make them more explicit as the natural deduction method. The second part proposes an extension for the source logic formalism to take explicitly the time into account. The approach proposed through 'TANIS', the prototype of such an expert system shell, using a natural reasoning application is proposed. It allows, at the generation time, the implementation within the expert system, of an adapted deduction strategy to the symbolic temporal reasoning which is complete and ease the determination of the response time. (author) [fr

  10. Functional Orientation and Practice of Inductive and Deductive Approaches to Grammar Teaching in EFL

    Institute of Scientific and Technical Information of China (English)

    邵阳

    2011-01-01

    To solve the ambiguous understanding of Grammar Teaching position,based on explicit grammatical knowledge,this paper discusses the grammar position in EFL,compares both its pros and cons between deductive and inductive approaches,and indicates that grammar teaching by either approach alone has disadvantages,should adopt a combination technique.

  11. 26 CFR 1.270-1 - Limitation on deductions allowable to individuals in certain cases.

    Science.gov (United States)

    2010-04-01

    ... cultivates, operates, or manages a farm for gain or profit, either as owner or tenant. An individual who... provisions relating to activities not engaged in for profit applicable to taxable years beginning after... THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Items Not Deductible § 1.270-1 Limitation...

  12. TAX DEDUCTION THROUGH ZAKAT: AN EMPIRICAL INVESTIGATION ON MUSLIM IN MALAYSIA

    OpenAIRE

    Abdullah Al-Mamun; Ahasanul Haque

    2015-01-01

    The aim of this study is to explore the factors which are affecting Muslim consumer's perception towards tax deduction through zakat in Malaysia. A conceptual framework was drawn based on the literature. Six factors were extracted through principal component analysis and SEM was run to test the hypotheses. This research found that halal-haram aspect of Islamic Shariah has a very positive influence on Muslim consumers’ perception towards the tax rebate system. In addition, legal consciousness ...

  13. The effect of private health insurance on medical care utilization and self-assessed health in Germany

    NARCIS (Netherlands)

    Hullegie, P.G.J.; Klein, T.J.

    2010-01-01

    In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance

  14. 78 FR 18235 - Treatment of Services Under Section 482; Allocation of Income and Deductions From Intangible...

    Science.gov (United States)

    2013-03-26

    ... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 Treatment of Services Under Section 482; Allocation of Income and Deductions From Intangible Property; Stewardship Expense CFR...; 8:45 am] BILLING CODE 1505-01-D ...

  15. Celf – A Logical Framework for Deductive and Concurrent Systems (System Description)

    DEFF Research Database (Denmark)

    Schack-Nielsen, Anders; Schürmann, Carsten

    2008-01-01

    CLF (Concurrent LF) [CPWW02a] is a logical framework for specifying and implementing deductive and concurrent systems from areas, such as programming language theory, security protocol analysis, process algebras, and logics. Celf is an implementation of the CLF type theory that extends the LF type...... ML and compiles with MLton, MLKit, and SML/NJ. The source code and a collection of examples are available from http://www.twelf.org/~celf ....

  16. Insurance Accounts: The Cultural Logics of Health Care Financing.

    Science.gov (United States)

    Mulligan, Jessica

    2016-03-01

    The financial exuberance that eventually culminated in the recent world economic crisis also ushered in dramatic shifts in how health care is financed, administered, and imagined. Drawing on research conducted in the mid-2000s at a health insurance company in Puerto Rico, this article shows how health care has been financialized in many ways that include: (1) privatizing public services; (2) engineering new insurance products like high deductible plans and health savings accounts; (3) applying financial techniques to premium payments to yield maximum profitability; (4) a managerial focus on shareholder value; and (5) prioritizing mergers and financial speculation. The article argues that financial techniques obfuscate how much health care costs, foster widespread gaming of reimbursement systems that drives up prices, and "unpool" risk by devolving financial and moral responsibility for health care onto individual consumers. © 2015 by the American Anthropological Association.

  17. Conflicting deductions from machining and other tests, concerning flow stress at high strain rates and temperatures

    International Nuclear Information System (INIS)

    Childs, T.H.C.

    1974-01-01

    This paper is concerned with the friction interaction between an En1A chip and a cemented tungsten--titanium carbide cutting tool during turning En1A on a lathe at speeds between 0.25 and 7.5 m s -1 and at feeds of 0.13 and 0.26 mm rev -1 . The mean friction stress has been measured and deductions made from chip shape measurements about the variation of the friction stress over the rake face. Three regimes of continuous chip formation were seen. In the first, the mean friction stress was independent of strain rate and temperature, in the second it depended on temperature and in the third, at the highest cutting speeds, it depended on temperature and feed. In the third regime, softening of the chip material caused by frictional heating limited the friction force, but the softening temperature depended on the heating rate of the chip material. Softening occurred at 700 0 C when the rate of heating from room temperature was 5.4 x 10 5 0 C s -1 and at 1160 0 C when the rate was 1.7 x 10 7 0 C s -1 . (U.S.)

  18. Bursar Accounts, Payroll Deduction, and Debt Collection: A Three-Channel Approach to Lost Item Reimbursement

    Science.gov (United States)

    Snowman, Ann MacKay

    2005-01-01

    In 2003, Penn State Libraries implemented payroll deduction and collection agency programs to gain better control of accounts receivable. The author reports on the implementation processes and first year outcomes of the programs. She recommends careful consideration of several questions before implementing such measures.

  19. 26 CFR 20.2044-1 - Certain property for which marital deduction was previously allowed.

    Science.gov (United States)

    2010-04-01

    ... inclusion of property in the decedent-spouse's gross estate under this section, the executor of the spouse's... interest. For example, to establish that a deduction was not taken, the executor may produce a copy of the..., the executor may establish that no return was filed on the original transfer by the decedent because...

  20. Aristotle’s Theory of Deduction and Paraconsistency

    Directory of Open Access Journals (Sweden)

    Evandro L. Gomes

    2010-04-01

    Full Text Available In the Organon Aristotle describes some deductive schemata in which inconsistencies do not entail the trivialization of the logical theory involved. This thesis is corroborated by three different theoretical topics by him discussed, which are presented in this paper. We analyse inference schema used by Aristotle in the Protrepticus and the method of indirect demonstration for categorical syllogisms. Both methods exemplify as Aristotle employs classical reductio ad absurdum strategies. Following, we discuss valid syllogisms from opposite premises (contrary and contradictory studied by the Stagerian in the Analytica Priora (B15. According to him, the following syllogisms are valid from opposite premises, in which small Latin letters stand for terms such as subject and predicate, and capital Latin letters stand for the categorical propositions such as in the traditional notation: (i in the second figure, Eba,Aba ` Eaa (Cesare, Aba, Eba ` Eaa (Camestres, Eba, I ba ` Oaa (Festino, and Aba,Oba ` Oaa (Baroco; (ii in the third one, Eab,Aab ` Oaa (Felapton, Oab,Aab ` Oaa (Bocardo and Eab, Iab ` Oaa (Ferison. Finally, we discuss the passage from the Analytica Posteriora (A11 in which Aristotle states that the Principle of Non-Contradiction is not generally presupposed in all demonstrations (scientific syllogisms, but only in those in which the conclusion must be proved from the Principle; the Stagerian states that if a syllogism of the first figure has the major term consistent, the other terms of the demonstration can be each one separately inconsistent. These results allow us to propose an interpretation of his deductive theory as a broad sense paraconsistent theory. Firstly, we proceed to a hermeneutical analysis, evaluating its logical significance and the interplay of the results with some other points of Aristotle’s philosophy. Secondly, we point to a logical interpretation of the Aristotelian syllogisms from opposite premises in the antilogisms

  1. Determinants of the demand for health insurance coverage

    NARCIS (Netherlands)

    K.P.M. Winssen van (Kayleigh)

    2017-01-01

    markdownabstractThe health insurance density in the Netherlands is among the highest in the world. This is shown by the fact that, in 2016, only 12 per cent of the Dutch insured opted for a reduction of health insurance coverage in the form of a voluntary deductible, while, at the same time, 84 per

  2. Offshore decommissioning issues: deductibility and transferability

    Energy Technology Data Exchange (ETDEWEB)

    Parente, V.; Santos, M. dos [University of Sao Paulo (Brazil). Instituto de Electrotecnica; Ferreira, D. [State University of Campinas (Brazil). Dept. of Geology and Natural Resources; Luczynski, E. [Grupo de Estudos e Pesquisas Economico-Energeticas, Belem (Brazil)

    2006-10-15

    Dealing with the decommissioning of petroleum installations is a relatively new challenge to most producer countries. It is natural to expect that industry's experience in building platforms is much greater than the one of dismantling them. Even if manifold and varied efforts are underway towards establishing international ''best practices'' standards in this sector, countries still enjoy rather extensive discretionary power as they practice a particular national style in the regulation of decommissioning activities in their state's jurisdiction. The present paper offers a broad panorama of this discussion, concentrating mainly on two controversial aspects. The first one analyses the ex-ante deductibility of decommissioning costs as they constitute an ex-post expense. The second discussion refers to the assignment of decommissioning responsibility in the case of transfer of exploration and production rights to new lessees during the project's life. Finally the paper applies concepts commonly used in project financing as well as structures generally used in organising pension funds to develop insights into these discussions. (author)

  3. Rainfall Deduction Method for Estimating Non-Point Source Pollution Load for Watershed

    OpenAIRE

    Cai, Ming; Li, Huai-en; KAWAKAMI, Yoji

    2004-01-01

    The water pollution can be divided into point source pollution (PSP) and non-point source pollution (NSP). Since the point source pollution has been controlled, the non-point source pollution is becoming the main pollution source. The prediction of NSP load is being increasingly important in water pollution controlling and planning in watershed. Considering the monitoring data shortage of NPS in China, a practical estimation method of non-point source pollution load --- rainfall deduction met...

  4. Jelly Views : Extending Relational Database Systems Toward Deductive Database Systems

    Directory of Open Access Journals (Sweden)

    Igor Wojnicki

    2004-01-01

    Full Text Available This paper regards the Jelly View technology, which provides a new, practical methodology for knowledge decomposition, storage, and retrieval within Relational Database Management Systems (RDBMS. Intensional Knowledge clauses (rules are decomposed and stored in the RDBMS founding reusable components. The results of the rule-based processing are visible as regular views, accessible through SQL. From the end-user point of view the processing capability becomes unlimited (arbitrarily complex queries can be constructed using Intensional Knowledge, while the most external queries are expressed with standard SQL. The RDBMS functionality becomes extended toward that of the Deductive Databases

  5. 26 CFR 20.2106-2 - Estates of nonresidents not citizens; deductions for expenses, losses, etc.

    Science.gov (United States)

    2010-04-01

    ... deductions, the executor should submit a certified copy of the schedule of liabilities, claims against the... schedule was filed, the executor should submit a certified copy of the schedule of these liabilities... schedules were filed, then there should be submitted a written statement of the foreign executor containing...

  6. Representation of the deduction with tetravalent logic: realisation of fast inference motors

    International Nuclear Information System (INIS)

    Terrier, F.

    1987-05-01

    Building automats for surveillance, control or diagnosis, can be done by artificial intelligence. They function according to the formalism of O ordre propositional logic. Deduction modes can then easily be represented in a trivalent logic with both efficiency and concision. One can obtain workable codes with low storage of high speed (env. 5000 rules per second). This leads us to develop and entry langage with extremely simple statement rules which can be learnt by experts in practically no time. Finally in order to generalize this principle and draw rules with multi-choice conclusions, (if... then the motor stops or the pressure goes down), rewriting these processes enable to return to an equivalent system without multi-choice conclusions, providing the same amount of informations with the possibility of deciding. This study has been used on 2 different cases: first it served as a tool to analyse reliability, (OLAF), second to help diagnosis breakdown of pressurized water-reactors [fr

  7. 17 CFR 240.15c3-1e - Deductions for market and credit risk for certain brokers or dealers (Appendix E to 17 CFR 240...

    Science.gov (United States)

    2010-04-01

    ... credit risk for certain brokers or dealers (Appendix E to 17 CFR 240.15c3-1). 240.15c3-1e Section 240....15c3-1(c)(2)(vi) and (c)(2)(vii) and to compute deductions for credit risk pursuant to this Appendix E... the broker or dealer will use to calculate deductions for market and credit risk on those categories...

  8. 26 CFR 1.642(h)-2 - Excess deductions on termination of an estate or trust.

    Science.gov (United States)

    2010-04-01

    ... trust. 1.642(h)-2 Section 1.642(h)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Estates, Trusts, and Beneficiaries § 1.642(h)-2...)) in excess of gross income, the excess is allowed under section 642(h)(2) as a deduction to the...

  9. 26 CFR 1.691(b)-1 - Allowance of deductions and credit in respect to decedents.

    Science.gov (United States)

    2010-04-01

    ... TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Income in Respect of Decedents § 1.691(b)-1..., and taxes described in sections 162, 163, 164, and 212 for which the decedent (or a prior decedent... to pay such obligation, as a deduction by the person who by bequest, devise, or inheritance from the...

  10. Calculating the Weather: Deductive Reasoning and Disciplinary "Telos" in Cleveland Abbe's Rhetorical Transformation of Meteorology

    Science.gov (United States)

    Majdik, Zoltan P.; Platt, Carrie Anne; Meister, Mark

    2011-01-01

    This paper explores the rhetorical basis of a major paradigm change in meteorology, from a focus on inductive observation to deductive, mathematical reasoning. Analysis of Cleveland Abbe's "The Physical Basis of Long-Range Weather Forecasts" demonstrates how in his advocacy for a new paradigm, Abbe navigates the tension between piety to tradition…

  11. National trends in the cost of employer health insurance coverage, 2003-2013.

    Science.gov (United States)

    Collins, Sara R; Radley, David C; Schoen, Cathy; Beutel, Sophie

    2014-12-01

    Looking at trends in private employer-based health insurance from 2003 to 2013, this issue brief finds that premiums for family coverage increased 73 percent over the past decade--faster than median family income. Employees' contributions to their premiums climbed by 93 percent over that time frame. At the same time, deductibles more than doubled in both large and small firms. Workers are thus paying more but getting less protective benefits. However, the study also finds that while premiums continued to rise through 2013, the rate of growth slowed between 2010 and 2013, following implementation of the Affordable Care Act. While families experienced slower growth in premium contributions and deductibles over this period, sluggish growth in median family income means families are paying more in premiums and deductibles as a share of their income than ever before.

  12. Estimating workers' marginal valuation of employer health benefits: would insured workers prefer more health insurance or higher wages?

    Science.gov (United States)

    Royalty, Anne Beeson

    2008-01-01

    In recent years the cost of health insurance has been increasing much faster than wages. In the face of these rising costs, many employers will have to make difficult decisions about whether to cut back health benefits or to compensate workers with lower wages or lower wage growth. In this paper, we ask the question, "Which do workers value more -- one additional dollar's worth of health benefits or one more dollar in their pockets?" Using a new approach to obtaining estimates of insured workers' marginal valuation of health benefits this paper estimates how much, on average, employees value the marginal dollar paid by employers for their workers' health insurance. We find that insured workers value the marginal health premium dollar at significantly less than the marginal wage dollar. However, workers value insurance generosity very highly. The marginal dollar spent on health insurance that adds an additional dollar's worth of observable dimensions of plan generosity, such as lower deductibles or coverage of additional services, is valued at significantly more than one dollar.

  13. Spectral-ratio radon background correction method in airborne γ-ray spectrometry based on compton scattering deduction

    International Nuclear Information System (INIS)

    Gu Yi; Xiong Shengqing; Zhou Jianxin; Fan Zhengguo; Ge Liangquan

    2014-01-01

    γ-ray released by the radon daughter has severe impact on airborne γ-ray spectrometry. The spectral-ratio method is one of the best mathematical methods for radon background deduction in airborne γ-ray spectrometry. In this paper, an advanced spectral-ratio method was proposed which deducts Compton scattering ray by the fast Fourier transform rather than tripping ratios, the relationship between survey height and correction coefficient of the advanced spectral-ratio radon background correction method was studied, the advanced spectral-ratio radon background correction mathematic model was established, and the ground saturation model calibrating technology for correction coefficient was proposed. As for the advanced spectral-ratio radon background correction method, its applicability and correction efficiency are improved, and the application cost is saved. Furthermore, it can prevent the physical meaning lost and avoid the possible errors caused by matrix computation and mathematical fitting based on spectrum shape which is applied in traditional correction coefficient. (authors)

  14. 26 CFR 1.642(c)-1 - Unlimited deduction for amounts paid for a charitable purpose.

    Science.gov (United States)

    2010-04-01

    ... the election was made, (iii) The office of the district director, or the service center, where the....642(c)-1 Unlimited deduction for amounts paid for a charitable purpose. (a) In general. (1) Any part... election, to a related estate, as defined under § 1.645-1(b), for the amount so paid. (2) In determining...

  15. 18 CFR 367.4102 - Account 410.2, Provision for deferred income taxes, other income and deductions.

    Science.gov (United States)

    2010-04-01

    ... COMPANY ACT OF 2005, FEDERAL POWER ACT AND NATURAL GAS ACT Income Statement Chart of Accounts Service Company Operating Income § 367.4102 Account 410.2, Provision for deferred income taxes, other income and..., Provision for deferred income taxes, other income and deductions. 367.4102 Section 367.4102 Conservation of...

  16. Automated Reuse of Scientific Subroutine Libraries through Deductive Synthesis

    Science.gov (United States)

    Lowry, Michael R.; Pressburger, Thomas; VanBaalen, Jeffrey; Roach, Steven

    1997-01-01

    Systematic software construction offers the potential of elevating software engineering from an art-form to an engineering discipline. The desired result is more predictable software development leading to better quality and more maintainable software. However, the overhead costs associated with the formalisms, mathematics, and methods of systematic software construction have largely precluded their adoption in real-world software development. In fact, many mainstream software development organizations, such as Microsoft, still maintain a predominantly oral culture for software development projects; which is far removed from a formalism-based culture for software development. An exception is the limited domain of safety-critical software, where the high-assuiance inherent in systematic software construction justifies the additional cost. We believe that systematic software construction will only be adopted by mainstream software development organization when the overhead costs have been greatly reduced. Two approaches to cost mitigation are reuse (amortizing costs over many applications) and automation. For the last four years, NASA Ames has funded the Amphion project, whose objective is to automate software reuse through techniques from systematic software construction. In particular, deductive program synthesis (i.e., program extraction from proofs) is used to derive a composition of software components (e.g., subroutines) that correctly implements a specification. The construction of reuse libraries of software components is the standard software engineering solution for improving software development productivity and quality.

  17. Research of General Deduction Optimization on PEMFC Manufacturing with Fuzzy Linguistic Analysis

    Directory of Open Access Journals (Sweden)

    Tian-Syung Lan

    2014-01-01

    Full Text Available In control questions, multiquality parameters are the most suitable, as they are everlasting in highly complex misalignment relations; the relationship between the parameter and quality of mutual influence is complex, and often massive redundant operations must be achievable by the test installation. Because the most suitable multiquality parameter is difficult to achieve, this study designates the proton exchange membrane fuel cell as the topic, takes the inlet temperature, inlet pressure, and incoming flow speed as the controlling elements, uses conformity fuzzy meaning analysis and the ideal solution similar order by chance law (TOPSIS, and discusses the parameters to control the influences of the quality goal. As outlet temperature, outlet pressure, pressure drop do not operate after the experiment, this study uses the meaning deduction method and develops a set of the most suitable control mechanisms. The research results show that this study develops a quality decision scheme for a set of meanings by using the misalignment and a high order complexity question. It also penetrates the meaning method, which guarantees that the quality and experimental efficiency may elevate the competitive power of science and technological undertakings development, effectively economize costs, and provide a set of economies and perspectives. The multiqualities are the most suitable control plan which meets the demands of practice.

  18. Take the "Ow!" Out of Taxes Now: How to Plan for and Increase Your Medical Deductions

    Science.gov (United States)

    Medisky, Shannon M.

    2009-01-01

    Each year countless taxpayers overpay simply because they're not taking full advantage of medical deductions. Individuals with disabilities are especially at risk. Time and energy spent running around to doctor visits, therapy sessions, and the like can leave little left to spend on preparing taxes. Fortunately, with a little effort year round and…

  19. TAX DEDUCTION THROUGH ZAKAT: AN EMPIRICAL INVESTIGATION ON MUSLIM IN MALAYSIA

    Directory of Open Access Journals (Sweden)

    Abdullah Al-Mamun

    2015-12-01

    Full Text Available The aim of this study is to explore the factors which are affecting Muslim consumer's perception towards tax deduction through zakat in Malaysia. A conceptual framework was drawn based on the literature. Six factors were extracted through principal component analysis and SEM was run to test the hypotheses. This research found that halal-haram aspect of Islamic Shariah has a very positive influence on Muslim consumers’ perception towards the tax rebate system. In addition, legal consciousness and knowledge about tax and zakat have a positive significant impact on Muslim consumers’ perceptions towards this system. Due to the limited literature available on this subject matter, this study offers unique findings that may help in capitalizing the practices in Muslim countries and to understand their consumers’ perception regarding the tax deduction system. In conclusion, zakat institutions in Malaysia will also be better benefitted through this research finding. =========================================== Tujuan penelitian ini adalah untuk menggali faktor- faktor yang mempengaruhi persepsi para konsumen muslim terkait dengan pengurangan pajak melalui zakat di Malaysia. Suatu kerangka konseptual telah digambarkan berdasarkan literatur. Penelitian ini menemukan bahwa aspek halal- haram dalam Syariah Islami memiliki pengaruh yang sangat positif terhadap persepsi para konsumen muslim terkait dengan sistem pengurangan pajak. Sebagai tambahan, kesadaran hukum dan pengetahuan tentang pajak dan zakat memiliki pengaruh positif yang signifikan pada persepsi konsumen muslim yang terkait dengan sistem ini. Sehubungan dengan terbatasnya literatur yang tersedia terkait dengan masalah ini, penelitian ini menawarkan temuan- temuan yang menarik yang dapat mendukung pengembangan praktik- praktik di negara- negara muslim dan untuk memahami persepsi para konsumennya terkait dengan sistem pengurangan pajak.

  20. Sustainable development at tax-deductible costs or how to assure sustainable development by one’s way of living

    Directory of Open Access Journals (Sweden)

    Willem Adrianus de Bruijn

    2006-08-01

    Full Text Available The purpose of this paper is to demonstrate that an imperative demand for an existence in harmony with Nature is created when the costs incurred for such an existence can be deducted from taxable income. All reasonable consumers who pay income taxes will then be driven to buy tax-deductible products. Producers will have to satisfy this demand. They will also have to justify their products’ characteristics, which assure sustainable development and to identify the costs which are associated with these qualities. The consumer needs to know which percentage of the purchase price he paid corresponds with the environmental cost free quality of the merchandise, in order for him to deduct the consequent amount from his taxable income. The theory underlying the deductibility of costs of living from taxable income is based on the following three assumptions: The goal of development is constantly determined by the purchases of consumers. Currently, the only goal with which consumers spend their income seems to be the one of consuming more. The recurring ecological crises reveal that it is impossible to continue to consume more of limited resources without eventually exhausting them. One of the functions of the consumer in the economy is to maintain a way of living which assures sustainable development. The principle of efficiency of economy, according to which the efficient place to manage any cost is at the source of the revenues which costs sustain. This paper also presents a practical and feasible application of our ideas. The creation of a way of living qualifies as research if it is achieved within the context of a scientific project with the cooperation of, in particular, academic institutions. Such a project could be operated within the context of the UNECE 1998 Aarhus Convention on Access to Information, Public Participation in Decision-making and Access to Justice in Environmental Matters, signed by Romania on 25 June 1998 and already ratified

  1. 26 CFR 1.642(c)-3 - Adjustments and other special rules for determining unlimited charitable contributions deduction.

    Science.gov (United States)

    2010-04-01

    ... the gross income of the estate for 1972, and N University receives $100,000 from the estate in such... INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES... unlimited charitable contributions deduction. (a) Income in respect of a decedent. For purposes of §§ 1.642...

  2. 26 CFR 1.221-1 - Deduction for interest paid on qualified education loans after December 31, 2001.

    Science.gov (United States)

    2010-04-01

    ... Individuals § 1.221-1 Deduction for interest paid on qualified education loans after December 31, 2001. (a) In... interest paid by the taxpayer during the taxable year on a qualified education loan. See paragraph (b)(4... paid on qualified education loans after December 31, 2001, in taxable years ending after December 31...

  3. 26 CFR 1.269-4 - Power of district director to allocate deduction, credit, or allowance in part.

    Science.gov (United States)

    2010-04-01

    ... evasion or avoidance of Federal income tax for which the acquisition was made. The district director is..., DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Items Not Deductible § 1.269-4...(a), but only to such extent as he determines will not result in the evasion or avoidance of Federal...

  4. The Role of Argumentation in Hypothetico-Deductive Reasoning during Problem-Based Learning in Medical Education: A Conceptual Framework

    Science.gov (United States)

    Ju, Hyunjung; Choi, Ikseon

    2018-01-01

    One of the important goals of problem-based learning (PBL) in medical education is to enhance medical students' clinical reasoning--hypothetico-deductive reasoning (HDR) in particular--through small group discussions. However, few studies have focused on explicit strategies for promoting students' HDR during group discussions in PBL. This paper…

  5. 26 CFR 1.170-1 - Charitable, etc., contributions and gifts; allowance of deduction (before amendment by Tax Reform...

    Science.gov (United States)

    2010-04-01

    ... constitute allowable deductions as trade or business expenses rather than as charitable contributions. See... for charitable contributions as trade or business expenses and rules with respect to treatment of... in property of a type which the taxpayer sells in the course of his business, the fair market value...

  6. 20 CFR 404.417 - Deductions because of noncovered remunerative activity outside the United States; 45 hour and 7...

    Science.gov (United States)

    2010-04-01

    ... deduction is for an amount equal to the benefit payable to the individual for that month. (2) From May 1983... insured individual's earnings record because of the beneficiary's marriage to the insured individual. (2... required by this paragraph (b) is equal to the wife's, husband's or child's benefit. (4) From January 1985...

  7. 26 CFR 1.163-4 - Deduction for original issue discount on certain obligations issued after May 27, 1969.

    Science.gov (United States)

    2010-04-01

    ... be includible in the gross income of such taxpayer for such taxable year. (b) Examples. The rules in... Board of Governors of the Federal Reserve. See 12 CFR § 217.4(d). The stated redemption price at... any amount of original issue discount deducted prior to repurchase, or minus any amount of premium...

  8. On the deduction of chemical reaction pathways from measurements of time series of concentrations.

    Science.gov (United States)

    Samoilov, Michael; Arkin, Adam; Ross, John

    2001-03-01

    We discuss the deduction of reaction pathways in complex chemical systems from measurements of time series of chemical concentrations of reacting species. First we review a technique called correlation metric construction (CMC) and show the construction of a reaction pathway from measurements on a part of glycolysis. Then we present two new improved methods for the analysis of time series of concentrations, entropy metric construction (EMC), and entropy reduction method (ERM), and illustrate (EMC) with calculations on a model reaction system. (c) 2001 American Institute of Physics.

  9. High-performance work systems in health care, part 3: the role of the business case.

    Science.gov (United States)

    Song, Paula H; Robbins, Julie; Garman, Andrew N; McAlearney, Ann Scheck

    2012-01-01

    Growing evidence suggests the systematic use of high-performance work practices (HPWPs), or evidence-based management practices, holds promise to improve organizational performance, including improved quality and efficiency, in health care organizations. However, little is understood about the investment required for HPWP implementation, nor the business case for HPWP investment. The aim of this study is to enhance our understanding about organizations' perspectives of the business case for HPWP investment, including reasons for and approaches to evaluating that investment. We used a multicase study approach to explore the business case for HPWPs in U.S. health care organizations. We conducted semistructured interviews with 67 key informants across five sites. All interviews were recorded, transcribed, and subjected to qualitative analysis using both deductive and inductive methods. The organizations in our study did not appear to have explicit financial return expectations for investments in HPWPs. Instead, the HPWP investment was viewed as an important factor contributing to successful execution of the organization's strategic priorities and a means for competitive differentiation in the market. Informants' characterizations of the HPWP investment did not involve financial terms; rather, descriptions of these investments as redeployment of existing resources or a shift of managerial time redirected attention from cost considerations. Evaluation efforts were rare, with organizations using broad organizational metrics to justify HPWP investment or avoiding formal evaluation altogether. Our findings are consistent with prior studies that have found that health care organizations have not systematically evaluated the financial outcomes of their quality-related initiatives or tend to forget formal business case analysis for investments they may perceive as "inevitable." In the absence of a clearly described association between HPWPs and outcomes or some other external

  10. Automatic Deduction in Dynamic Geometry using Sage

    Directory of Open Access Journals (Sweden)

    Francisco Botana

    2012-02-01

    Full Text Available We present a symbolic tool that provides robust algebraic methods to handle automatic deduction tasks for a dynamic geometry construction. The main prototype has been developed as two different worksheets for the open source computer algebra system Sage, corresponding to two different ways of coding a geometric construction. In one worksheet, diagrams constructed with the open source dynamic geometry system GeoGebra are accepted. In this worksheet, Groebner bases are used to either compute the equation of a geometric locus in the case of a locus construction or to determine the truth of a general geometric statement included in the GeoGebra construction as a boolean variable. In the second worksheet, locus constructions coded using the common file format for dynamic geometry developed by the Intergeo project are accepted for computation. The prototype and several examples are provided for testing. Moreover, a third Sage worksheet is presented in which a novel algorithm to eliminate extraneous parts in symbolically computed loci has been implemented. The algorithm, based on a recent work on the Groebner cover of parametric systems, identifies degenerate components and extraneous adherence points in loci, both natural byproducts of general polynomial algebraic methods. Detailed examples are discussed.

  11. Exploring Qualitatively-Derived Concepts: Inductive—Deductive Pitfalls

    Directory of Open Access Journals (Sweden)

    Janice M. Morse

    2002-12-01

    Full Text Available Analytic induction is a sacred tenet of qualitative inquiry. 1 Therefore, when one begins a project focusing on concept of interest (rather than allowing the concepts to emerge from the data per se, how does one maintain a valid approach? When commencing inquiry with a chosen concept or phenomena of interest, rather than with a question from the data per se about what is going on, how does one control deductive tendencies to see what one desires to see and which threaten validity? Difficulties stem from the nature of induction itself – Is analytic induction an impossible operation in qualitative research, as Popper (1963/65 suggests? In this section, we first discuss Popper's concern, followed by a discussion of two major threats that may prevent an inductive approach in qualitative research.2 The first threat is the “pink elephant paradox;? the second is the avoidance of conceptual tunnel vision or, specifically, how does the researcher decontextualize the concept of interest from the surrounding context and thereby avoid the tendency to consider all data to be pertinent to the concept of interest? As we explore each of these pitfalls, and we present methodological strategies to maintain both the integrity of the concept and the integrity of the research.

  12. Diagnosing Allergic Contact Dermatitis Through Elimination, Perception, Detection and Deduction.

    Science.gov (United States)

    Pongpairoj, Korbkarn; Puangpet, Pailin; Thaiwat, Supitchaya; McFadden, John P

    2017-10-01

    Several authors have commented upon the skills of detection required in making a diagnosis of allergic contact dermatitis. Here, we emphasise the search for clues in a systematic manner. We describe four stages as part of a systematic method for diagnosing allergic contact dermatitis. Firstly, elimination (or inclusion) of non-allergic diagnoses. Secondly, perception: the pre-patch test diagnosis and the 'three scenarios' principle. Thirdly, detection: optimising the sensitivity of the patch test process. Fourthly, deduction: diagnosing allergic contact dermatitis by associating the dermatitis with the allergen exposure. We further compare and contrast the pre-patch test history and examination with the markedly different one ('microhistory' and 'microexamination') used after patch testing. The importance of knowledge of contact dermatitis literature is emphasised with a review of recent publications. Finally, we also highlight the use of contact allergy profiling as an investigative tool in the diagnosis of allergic contact dermatitis.

  13. Health behaviors and personality in burnout: a third dimension

    Directory of Open Access Journals (Sweden)

    Osama M. Mustafa

    2015-09-01

    Full Text Available The high prevalence of burnout among healthcare professionals warrants a thorough examination aimed at improving the current understanding of its predictors and preventive measures. Cecil et al. have underscored the alarming prevalence of burnout among medical students and assessed its association with demographic, lifestyle, and behavioral factors. Of interest, health behaviors were found to be predictive of burnout. The study suggests certain behaviors (such as high physical activity to be protective, and thus, calls for their establishment early in college life to prevent the development of this professionally-disabling mental state. Although the adoption of advisable health behaviors may independently reduce the risk of burnout, recognition of the existence and influence of closely related factors allows for an enhanced understanding and a greater precision for any conclusions to be made. Personality, through deductive and inductive reasoning, is likely to exert significant influence on both the student's behavior and his/her susceptibility to burnout. Thus, with personality representing – in and of itself – a principal model for prediction of burnout risk, controlling for personality traits when addressing health behaviors’ influence per se on burnout is essential.

  14. Premium growth and its effect on employer-sponsored insurance.

    Science.gov (United States)

    Vistnes, Jessica; Selden, Thomas

    2011-03-01

    We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers' health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.

  15. More choice in health insurance marketplaces may reduce the value of the subsidies available to low-income enrollees.

    Science.gov (United States)

    Taylor, Erin A; Saltzman, Evan; Bauhoff, Sebastian; Pacula, Rosalie L; Eibner, Christine

    2015-01-01

    Federal subsidies available to enrollees in health insurance Marketplaces are pegged to the premium of the second-lowest-cost silver plan available in each rating area (as defined by each state). People who qualify for the subsidy contribute a percentage of their income to purchase coverage, and the federal government covers the remaining cost up to the price of that premium. Because the number of plans offered and plan premiums vary substantially across rating areas, the effective value of the subsidy may vary geographically. We found that the availability of more plans in a rating area was associated with lower premiums but higher deductibles for enrollees in the second-lowest-cost silver plan. In rating areas with more than twenty plans, the average deductible in the second-lowest-cost silver plan was nearly $1,000 higher than it was in rating areas with fewer than thirteen plans. Because premium costs for second-lowest-cost silver plans are capped, deductibles may be a more salient measure of plan value for enrollees than premiums are. Greater standardization of plans or an alternative approach to calculating the subsidy could provide a more consistent benefit to enrollees across various rating areas. Project HOPE—The People-to-People Health Foundation, Inc.

  16. 26 CFR 1.280F-3T - Limitations on recovery deductions and the investment tax credit when the business use percentage...

    Science.gov (United States)

    2010-04-01

    ... investment tax credit when the business use percentage of listed property is not greater than 50 percent... recovery deductions and the investment tax credit when the business use percentage of listed property is... limitations with respect to the amount allowable as an investment tax credit under section 46(a) and the...

  17. The development of cause analysis system for CPCS trip using the rule-base deduction

    International Nuclear Information System (INIS)

    Park, Hee Seok; Kim, Dong Hoon; Seo, Ho Joon; Koo, In Soo; Park, Suk Joon

    1992-01-01

    The Core Protection Calculator System(CPCS) was developed to initiate a Reactor Trip under the circumstance of certain transients by Combustion Engineering Company. The major function of the CPCS is to generate contact outputs for the Departure from Nucleate Boiling Ratio(DNBR) Trip and Local Power Density(LPD) Trip. But in CPCS the trip causes can not be identified, only trip status is displayed. It may take much time and efforts for plant operator to analyse the trip causes of CPCS. So, the Cause Analysis System for CPCS(CASCPCS) has been developed using the rule-base deduction method to aid the operators in Nuclear Power Plant

  18. Lessons from Canada's health program.

    Science.gov (United States)

    Terris, M

    1990-01-01

    The Canadian health program is described and analyzed. Positive features include financing through progressive taxation; complete coverage of physician and hospital services; complete absence of deductibles, copayments, and extra charges by physicians and hospitals; lower administrative costs because private insurance companies are excluded from the program; and avoidance of the straitjacket of a single federal program by decentralization to the provinces. Negative features include ever-rising costs due to the almost complete dominance of fee-for-service payment to physicians; failure to monitor the quality of care; and neglect of serious support for preventive services and improved living standards--the two most important determinants of health status. Recommendations are made for a U.S. national health program that would incorporate the positive features of the Canadian program and avoid its deficiencies.

  19. Health Benefits In 2016: Family Premiums Rose Modestly, And Offer Rates Remained Stable.

    Science.gov (United States)

    Claxton, Gary; Rae, Matthew; Long, Michelle; Damico, Anthony; Whitmore, Heidi; Foster, Gregory

    2016-10-01

    The annual Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey found that in 2016, average annual premiums (employer and worker contributions combined) were $6,435 for single coverage and $18,142 for family coverage. The family premium in 2016 was 3 percent higher than that in 2015. On average, workers contributed 18 percent of the premium for single coverage and 30 percent for family coverage. The share of firms offering health benefits (56 percent) and of workers covered by their employers' plans (62 percent) remained statistically unchanged from 2015. Employers continued to offer financial incentives for completing wellness or health promotion activities. Almost three in ten covered workers were enrolled in a high-deductible plan with a savings option-a significant increase from 2014. The 2016 survey included new questions on cost sharing for specialty drugs and on the prevalence of incentives for employees to seek care at alternative settings. Project HOPE—The People-to-People Health Foundation, Inc.

  20. Deductible expenses for effects of the income tax. A business approach

    Directory of Open Access Journals (Sweden)

    Juan Santiváñez Guarniz

    2009-06-01

    Full Text Available The fiscal charges of the income tax state that if we want to consider an expense as deductible it must fulfill the causality principle, apart from that, they state rules that expenses are necessary to generate income and fulfill the criterion of reasonable expenses, majority among others.Showing that an expense is a necessity is a complicated task that in many cases will force — the person to determine that necessity — to examine internal aspects of the company, as business strategies, internal policies, etc. Apart from the analytical complexity of these topics, there will be the subjective aspect from the point of view of the outside observer.This article pretends to show the difficulty to decide if an expense is necessary or not, through the analysis of a real case where the tax system denies expenses of a taxpayer because they were not considered necessary for that kind of business.

  1. 26 CFR 20.2011-2 - Limitation on credit if a deduction for State death taxes is allowed under section 2053(d).

    Science.gov (United States)

    2010-04-01

    ... son with the direction that the son bear the State death taxes on the bequest. The residuary estate... payable out of the residuary estate. The State imposed death taxes of $60,000 on the son's bequest and... Charitable deduction: Gross estate $925,000.00 Expenses, etc $25,000.00 Bequest to son 400,000.00 State death...

  2. Using dual-process theory and analogical transfer to explain facilitation on a hypothetico-deductive reasoning task.

    Science.gov (United States)

    Koenig, Cynthia S; Platt, Richard D; Griggs, Richard A

    2007-07-01

    Using the analogical transfer paradigm, the present study investigated the competing explanations of Girotto and Legrenzi (Psychological Research 51: 129-135, 1993) and Griggs, Platt, Newstead, and Jackson (Thinking and Reasoning 4: 1-14, 1998) for facilitation on the SARS version of the THOG problem, a hypothetico-deductive reasoning task. Girotto and Legrenzi argue that facilitation is based on logical analysis of the task [System 2 reasoning in Evans's (Trends in Cognitive Sciences 7: 454-459, 2003) dual-process account of reasoning] while Griggs et al. maintain that facilitation is due to an attentional heuristic produced by the wording of the problem (System 1 reasoning). If Girotto and Legrenzi are correct, then System 2 reasoning, which is volitional and responsible for deductive reasoning, should be elicited, and participants should comprehend the solution principle of the THOG task and exhibit analogical transfer. However, if Griggs et al. are correct, then System 1 reasoning, which is responsible for heuristic problem solving strategies such as an attentional heuristic, should occur, and participants should not abstract the solution principle and transfer should not occur. Significant facilitation (68 and 82% correct) was only observed for the two SARS source problems, but significant analogical transfer did not occur. This lack of transfer suggests that System 1 reasoning was responsible for the facilitation observed in the SARS problem, supporting Griggs et al.'s attentional heuristic explanation. The present results also underscore the explanatory value of using analogical transfer rather than facilitation as the criterion for problem understanding.

  3. Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences.

    Science.gov (United States)

    Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

    2016-01-01

    Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. 'Health app' was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26-35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers' data. The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring

  4. The Effectiveness of Guided Induction versus Deductive Instruction on the Development of Complex Spanish "Gustar" Structures: An Analysis of Learning Outcomes and Processes

    Science.gov (United States)

    Cerezo, Luis; Caras, Allison; Leow, Ronald P.

    2016-01-01

    Meta-analytic research suggests an edge of explicit over implicit instruction for the development of complex L2 grammatical structures, but the jury is still out as to which type of explicit instruction--"deductive" or "inductive," where rules are respectively provided or elicited--proves more effective. Avoiding this…

  5. Price-transparency and cost accounting: challenges for health care organizations in the consumer-driven era.

    Science.gov (United States)

    Hilsenrath, Peter; Eakin, Cynthia; Fischer, Katrina

    2015-01-01

    Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers. © The Author(s) 2015.

  6. The Distinction between Direct and General Costs with Regard to the Deduction of Input VAT - The Case of Acquisition, Holding and Sale of Shares

    DEFF Research Database (Denmark)

    Jensen, Dennis Ramsdahl; Stensgaard, Henrik

    2012-01-01

    of distinguishing between direct and general costs. On the other hand the aim is to describe and analyse the law as it stands regarding the treatment of shares in the EU VAT system, with a special focus on the right to deduct input VAT on costs re-lating to transactions in shares. As a part of this analysis the aim......In revealing the conditions for the deduction of input VAT, the essential questions concern the nature of the so-called ‘direct and immediate link’ test and thus also the criteria for the important distinction between direct costs and general costs. The ‘direct and immediate link’ test...... is of general importance to all types of costs, but judged from the case law of the ECJ it has especially materialised itself when it comes to costs related to the acquisition, holding or sales of shares. The purpose of this article is therefore twofold. On the one hand it deals with the difficult question...

  7. Understanding place and health: a heuristic for using administrative data.

    Science.gov (United States)

    Frohlich, Katherine L; Dunn, James R; McLaren, Lindsay; Shiell, Alan; Potvin, Louise; Hawe, Penelope; Dassa, Clément; Thurston, Wilfreda E

    2007-06-01

    The increasing availability, use and limitations of administrative data for place-based population health research, and a lack of theory development, created the context for the current paper. We developed a heuristic to interrogate administrative data sets and to help us develop explanatory pathways for linking place and health. Guided by a worked example, we argue that some items in administrative data sets lend themselves to multiple theories, creating problems of inference owing to the implications of using inductive versus deductive reasoning during the research process, and that certain types of theories are privileged when used administrative data bases.

  8. Implementing GraphQL as a Query Language for Deductive Databases in SWI-Prolog Using DCGs, Quasi Quotations, and Dicts

    Directory of Open Access Journals (Sweden)

    Falco Nogatz

    2017-01-01

    Full Text Available The methods to access large relational databases in a distributed system are well established: the relational query language SQL often serves as a language for data access and manipulation, and in addition public interfaces are exposed using communication protocols like REST. Similarly to REST, GraphQL is the query protocol of an application layer developed by Facebook. It provides a unified interface between the client and the server for data fetching and manipulation. Using GraphQL's type system, it is possible to specify data handling of various sources and to combine, e.g., relational with NoSQL databases. In contrast to REST, GraphQL provides a single API endpoint and supports flexible queries over linked data. GraphQL can also be used as an interface for deductive databases. In this paper, we give an introduction of GraphQL and a comparison to REST. Using language features recently added to SWI-Prolog 7, we have developed the Prolog library GraphQL.pl, which implements the GraphQL type system and query syntax as a domain-specific language with the help of definite clause grammars (DCG, quasi quotations, and dicts. Using our library, the type system created for a deductive database can be validated, while the query system provides a unified interface for data access and introspection.

  9. Job-based health benefits in 2002: some important trends.

    Science.gov (United States)

    Gabel, Jon; Levitt, Larry; Holve, Erin; Pickreign, Jeremy; Whitmore, Heidi; Dhont, Kelley; Hawkins, Samantha; Rowland, Diane

    2002-01-01

    Based on a national survey of 2,014 randomly selected public and private firms with three or more workers, this paper reports changes in employer-based health insurance from spring 2001 to spring 2002. The cost of health insurance rose 12.7 percent, the highest rate of growth since 1990. Employee contributions for health insurance rose in 2002, from $30 to $38 for single coverage and from $150 to $174 for family coverage. Deductibles and copayments rose also, and employers adopted formularies and three-tier cost-sharing formulas to control prescription drug expenses. PPO and HMO enrollment rose, while the percentage of small employers offering health benefits fell. Because increasing claims expenses rather than the underwriting cycle are the major driver of rising premiums, double-digit growth appears likely to continue.

  10. Keeping up with the Cadillacs: What Health Insurance Disparities, Moral Hazard, and the Cadillac Tax Mean to The Patient Protection and Affordable Care Act.

    Science.gov (United States)

    Fletcher, Rebecca Adkins

    2016-03-01

    A major goal of The Patient Protection and Affordable Care Act is to broaden health care access through the extension of insurance coverage. However, little attention has been given to growing disparities in access to health care among the insured, as trends to reduce benefits and increase cost sharing (deductibles, co-pays) reduce affordability and access. Through a political economic perspective that critiques moral hazard, this article draws from ethnographic research with the United Steelworkers (USW) at a steel mill and the Retail, Wholesale and Department Store Union (RWDSU) at a food-processing plant in urban Central Appalachia. In so doing, this article describes difficulties of health care affordability on the eve of reform for differentially insured working families with employer-sponsored health insurance. Additionally, this article argues that the proposed Cadillac tax on high-cost health plans will increase problems with appropriate health care access and medical financial burden for many families. © 2014 by the American Anthropological Association.

  11. Deduction of the in-medium gluon distribution from photon-gluon fusion processes in peripheral ultrarelativistic heavy-ion collisions

    International Nuclear Information System (INIS)

    Greiner, M.; Hofmann, C.; Schaefer, A.; Soff, G.

    1994-08-01

    The photon-gluon fusion process into a pair of heavy quarks is studied for peripheral Pb+Pb collisions at LHC energies. The double differential cross section with respect to the invariant mass and the rapidity of the produced quark pair at zero rapidity is directly proportional to the gluon distribution in the nuclear medium. Differential cross sections for the b-quark production lie well in the μbarn/GeV regime which will allow the deduction of the gluon distribution at low x. Rapidity cuts for the actual detectors are also considered. (orig.)

  12. Many Mobile Health Apps Target High-Need, High-Cost Populations, But Gaps Remain.

    Science.gov (United States)

    Singh, Karandeep; Drouin, Kaitlin; Newmark, Lisa P; Lee, JaeHo; Faxvaag, Arild; Rozenblum, Ronen; Pabo, Erika A; Landman, Adam; Klinger, Elissa; Bates, David W

    2016-12-01

    With rising smartphone ownership, mobile health applications (mHealth apps) have the potential to support high-need, high-cost populations in managing their health. While the number of available mHealth apps has grown substantially, no clear strategy has emerged on how providers should evaluate and recommend such apps to patients. Key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources. To help stakeholders overcome barriers to reviewing and recommending apps, we evaluated 137 patient-facing mHealth apps-those intended for use by patients to manage their health-that were highly rated by consumers and recommended by experts and that targeted high-need, high-cost populations. We found that there is a wide variety of apps in the marketplace but that few apps address the needs of the patients who could benefit the most. We also found that consumers' ratings were poor indications of apps' clinical utility or usability and that most apps did not respond appropriately when a user entered potentially dangerous health information. Going forward, data privacy and security will continue to be major concerns in the dissemination of mHealth apps. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Right Judicialization to Health and key Taken by CNJ Measures for Settlement

    Directory of Open Access Journals (Sweden)

    Thiago Allisson Cardoso De Jesus

    2016-10-01

    Full Text Available Conducts a study on the legalization of health. At the scope and complexity surrounding the issue, the central focus of the research is to investigate the main measures taken by the CNJ to resolve it. To accomplish this task, the right to health as a fundamental social right. Soon after, looking at its effectiveness in the Brazilian legal system and highlights the judiciary's role on the issue. For that, analyze the main measures taken by the CNJ, considering the recommendations and resolutions issued. To do so, used the deductive method of approach, through the techniques of documentary and bibliographical research.

  14. Prélèvement extérieur et norme de salaire Deductions Due to Externat Causes and Salary Standards

    Directory of Open Access Journals (Sweden)

    Chaouat A.

    2006-11-01

    Full Text Available L'article résume une thèse ayant trait aux problèmes macroéconomiques des prélèvements extérieurs (hausse du prix du pétrole, choc dollar, etc. et de l'évolution des salaires réels. Deux questions ont été plus particulièrement étudiées : d'une part, la courbe optimale de progression des salaires réels en cas de prélèvement extérieur, et d'autre part, l'évolution actuelle à préconiser en France, compte tenu de l'historique de la répartition sur les revenus des agents intérieurs des ponctions induites par les deux chocs pétroliers. This article sums up a doctoral thesis on the macroeconomic problems of deductions due to externat causes (oil price increase, impact of the dollar exchange rate, etc. and the evolution of real wages. Two subjects are give more specific attention: (1 the optimum curve of the progression of real wages if a deduction due to externat causes occurs; (2 the present evolution to be recommended in France, taking into account the history of the impact on incomes of the interior agents caused by the drains induced by the two oil price shocks.

  15. High-Reliability Health Care: Getting There from Here

    Science.gov (United States)

    Chassin, Mark R; Loeb, Jerod M

    2013-01-01

    Context Despite serious and widespread efforts to improve the quality of health care, many patients still suffer preventable harm every day. Hospitals find improvement difficult to sustain, and they suffer “project fatigue” because so many problems need attention. No hospitals or health systems have achieved consistent excellence throughout their institutions. High-reliability science is the study of organizations in industries like commercial aviation and nuclear power that operate under hazardous conditions while maintaining safety levels that are far better than those of health care. Adapting and applying the lessons of this science to health care offer the promise of enabling hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations. Methods We combined the Joint Commission's knowledge of health care organizations with knowledge from the published literature and from experts in high-reliability industries and leading safety scholars outside health care. We developed a conceptual and practical framework for assessing hospitals’ readiness for and progress toward high reliability. By iterative testing with hospital leaders, we refined the framework and, for each of its fourteen components, defined stages of maturity through which we believe hospitals must pass to reach high reliability. Findings We discovered that the ways that high-reliability organizations generate and maintain high levels of safety cannot be directly applied to today's hospitals. We defined a series of incremental changes that hospitals should undertake to progress toward high reliability. These changes involve the leadership's commitment to achieving zero patient harm, a fully functional culture of safety throughout the organization, and the widespread deployment of highly effective process improvement tools. Conclusions Hospitals can make substantial progress toward high reliability by undertaking several specific

  16. Elderly health and implementation of the Brazilian National Health Policy for Elderly Persons on the performed actions in basic healthcare

    Directory of Open Access Journals (Sweden)

    SCHMINSKI VIEIRA, Roseli

    2016-06-01

    Full Text Available The Brazilian National Health Policy for Elderly Persons (PNSPI – in Portuguese was formulated by the Ministry of Health through Ordinance No. 2.528/2006 in line with the 1988 Brazilian Constitution. The study investigated whether municipalities from the South region of the State of Santa Catarina had knowledge and applied the PNSPI, on the performed actions in basic healthcare, especially on the Units of Family Healthcare Services based on what the Constitution and the Statute of the Elderly comprise. A deductive method with a qualitative approach and a descriptive research were used. As a result, some difficulties experienced by the research subjects related to two important points of policies and strategies of PNSPI were identified: the lack of a planned policy and of a continuous health education for the elderly; and the lack of a stimulating exercise of social control, whether in the health sector, or in the Municipal Council of Elderly People.

  17. High-reliability health care: getting there from here.

    Science.gov (United States)

    Chassin, Mark R; Loeb, Jerod M

    2013-09-01

    Despite serious and widespread efforts to improve the quality of health care, many patients still suffer preventable harm every day. Hospitals find improvement difficult to sustain, and they suffer "project fatigue" because so many problems need attention. No hospitals or health systems have achieved consistent excellence throughout their institutions. High-reliability science is the study of organizations in industries like commercial aviation and nuclear power that operate under hazardous conditions while maintaining safety levels that are far better than those of health care. Adapting and applying the lessons of this science to health care offer the promise of enabling hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations. We combined the Joint Commission's knowledge of health care organizations with knowledge from the published literature and from experts in high-reliability industries and leading safety scholars outside health care. We developed a conceptual and practical framework for assessing hospitals' readiness for and progress toward high reliability. By iterative testing with hospital leaders, we refined the framework and, for each of its fourteen components, defined stages of maturity through which we believe hospitals must pass to reach high reliability. We discovered that the ways that high-reliability organizations generate and maintain high levels of safety cannot be directly applied to today's hospitals. We defined a series of incremental changes that hospitals should undertake to progress toward high reliability. These changes involve the leadership's commitment to achieving zero patient harm, a fully functional culture of safety throughout the organization, and the widespread deployment of highly effective process improvement tools. Hospitals can make substantial progress toward high reliability by undertaking several specific organizational change initiatives. Further research

  18. Rationing in health systems: A critical review.

    Science.gov (United States)

    Keliddar, Iman; Mosadeghrad, Ali Mohammad; Jafari-Sirizi, Mehdi

    2017-01-01

    Background: It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied. This study aimed at critically examining the concept of rationing in health sector and identifying its purposes, influencing factors, mechanisms, and outcomes. Methods: The critical interpretive synthesis methodology was used in this study. PubMed, Cochrane, and Proquest databases were searched using the related key words to find related documents published between 1970 and 2015. In total, 161 published reports were reviewed and included in the study. Thematic content analysis was applied for data analysis. Results: Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing. Rationing can be applied in 4 levels: health care policy- makers, health care managers, health care providers, and patients. Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles. Conclusion: This paper enriched our understanding of health services rationing and its mechanisms at various levels and contributed to the literature by broadly conceptualizing health services rationing.

  19. Reliability assessments in qualitative health promotion research.

    Science.gov (United States)

    Cook, Kay E

    2012-03-01

    This article contributes to the debate about the use of reliability assessments in qualitative research in general, and health promotion research in particular. In this article, I examine the use of reliability assessments in qualitative health promotion research in response to health promotion researchers' commonly held misconception that reliability assessments improve the rigor of qualitative research. All qualitative articles published in the journal Health Promotion International from 2003 to 2009 employing reliability assessments were examined. In total, 31.3% (20/64) articles employed some form of reliability assessment. The use of reliability assessments increased over the study period, ranging from qualitative articles decreased. The articles were then classified into four types of reliability assessments, including the verification of thematic codes, the use of inter-rater reliability statistics, congruence in team coding and congruence in coding across sites. The merits of each type were discussed, with the subsequent discussion focusing on the deductive nature of reliable thematic coding, the limited depth of immediately verifiable data and the usefulness of such studies to health promotion and the advancement of the qualitative paradigm.

  20. Evaluating the roles of the inferior frontal gyrus and superior parietal lobule in deductive reasoning: an rTMS study.

    Science.gov (United States)

    Tsujii, Takeo; Sakatani, Kaoru; Masuda, Sayako; Akiyama, Takekazu; Watanabe, Shigeru

    2011-09-15

    This study used off-line repetitive transcranial magnetic stimulation (rTMS) to examine the roles of the superior parietal lobule (SPL) and inferior frontal gyrus (IFG) in a deductive reasoning task. Subjects performed a categorical syllogistic reasoning task involving congruent, incongruent, and abstract trials. Twenty four subjects received magnetic stimulation to the SPL region prior to the task. In the other 24 subjects, TMS was administered to the IFG region before the task. Stimulation lasted for 10min, with an inter-pulse frequency of 1Hz. We found that bilateral SPL (Brodmann area (BA) 7) stimulation disrupted performance on abstract and incongruent reasoning. Left IFG (BA 45) stimulation impaired congruent reasoning performance while paradoxically facilitating incongruent reasoning performance. This resulted in the elimination of the belief-bias. In contrast, right IFG stimulation only impaired incongruent reasoning performance, thus enhancing the belief-bias effect. These findings are largely consistent with the dual-process theory of reasoning, which proposes the existence of two different human reasoning systems: a belief-based heuristic system; and a logic-based analytic system. The present findings suggest that the left language-related IFG (BA 45) may correspond to the heuristic system, while bilateral SPL may underlie the analytic system. The right IFG may play a role in blocking the belief-based heuristic system for solving incongruent reasoning trials. This study could offer an insight about functional roles of distributed brain systems in human deductive reasoning by utilizing the rTMS approach. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Consumer directed healthcare: except for the healthy and wealthy it's unwise.

    Science.gov (United States)

    Woolhandler, Steffie; Himmelstein, David U

    2007-06-01

    Many politicians and business leaders are advocating high deductible health insurance plans linked with health savings accounts--so-called consumer-directed healthcare. These policies penalize the sick, discourage needed care (especially primary and preventive care), and direct tax subsidies towards the wealthiest Americans. They offer little hope of slowing the growth of health care costs and add further bureaucratic costs and complexity to our health care financing system.

  2. Ethnic Differences for Public Health Knowledge, Health Advocacy Skills, and Health Information Seeking Among High School Students: Community Agents of Change.

    Science.gov (United States)

    Kratzke, Cynthia; Rao, Satya; Marquez, Ruben

    2018-03-06

    Although adult health advocacy programs have been examined in communities, little is known about integrated adolescent health advocacy programs in high schools. The purpose of this study was to examine the health advocacy program impact and ethnic differences among high school students. Using a cross-sectional study, high school students participating in the school-based program completed evaluation surveys. The program domains included upstream causes of health, community assets, and public health advocacy. Bivariate analyses were conducted to examine ethnic differences for public health knowledge, health advocacy skills, and health information seeking behaviors. Using thematic analysis, open-ended survey item responses were coded to identify themes for students' perceptions of community health. Non-Hispanic (n = 72) and Hispanic high school students (n = 182) in ten classes reported owning smartphones (95%) and laptops (76%). Most students (72%) reported seeking online health information. Non-Hispanic students reported significantly higher health advocacy skills for speaking with the class about health issues, identifying community services, or creating health awareness at school than Hispanic students. Non-Hispanic students were more likely to seek health information from fathers and television than Hispanic students. Hispanic students were more likely to seek health information from hospital or clinic staff than non-Hispanic students. Emergent themes included health advocacy skills, community awareness, and individual and community health changes. High schools benefit from integrating health advocacy programs into the core curriculum. Adolescents gain important skills to improve their individual health and engage in changing community health.

  3. Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.

    Science.gov (United States)

    Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P

    2017-01-01

    The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.

  4. Bases y aplicación del método hipotético-deductivo en el diagnóstico Rules and implementation of the deductive-hypothetical method in diagnosis

    Directory of Open Access Journals (Sweden)

    José Díaz Novás

    2011-09-01

    Full Text Available La identificación correcta de los problemas de salud del paciente constituye la base en que descansa la actuación profesional de los médicos y la clave para una atención de calidad. El propósito de este trabajo es describir el método hipotético-deductivo y su utilización en el proceso del diagnóstico, mostrando ejemplos prácticos de casos clínicos que pueden ser similares a los vistos en la atención primaria. Se realizó un trabajo de revisión de artículos nacionales y algunos extranjeros que abordan el diagnóstico médico y la aplicación del método hipotético-deductivo en el proceso del diagnóstico. Los médicos a medida que ganan en conocimientos y experiencias simplifican el proceso del diagnóstico y con pocos datos elaboran sus hipótesis diagnósticas (método hipotético-deductivo, dirigiendo el interrogatorio, el examen físico y las exploraciones complementarias hacia la comprobación o rechazo de los diagnósticos iniciales. Si se rechaza el diagnóstico inicial hay que comenzar de nuevo el proceso. El método hipotético-deductivo es muy eficiente siempre que se aplique correctamente, por un personal experimentado y con las condiciones necesarias. Este método no está exento de errores si se violan sus principios.ABSTRACT The proper identification of health problems of patient is the basis supporting the professional performance of physicians and the key for a quality care. The purpose of present paper is to describe the deductive-hypothetical method and its use in the diagnostic process, showing practical examples of clinical cases that could be similar to that observed in the primary care. A review work was made of national and foreign papers approaching the medical diagnosis y the implementation of the above mentioned method in the process of diagnosis. The physicians according to a increase in knowledges and experiences may to simplify the process of diagnosis and with a few data they made its diagnostic

  5. Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

    Science.gov (United States)

    Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

    2016-01-01

    Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

  6. Assessing capacity for sustainability of effective programs and policies in local health departments

    Science.gov (United States)

    Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

    2015-01-01

    Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

  7. Health Resources and Strategies among Employed Women in Norway during Pregnancy and Early Motherhood

    Science.gov (United States)

    Alstveit, Marit; Karlsen, Bjørg

    2015-01-01

    The number of women in paid employment is increasing. However, when becoming a mother for the first time, many seem unprepared for the challenge of balancing motherhood and work as well as for the impact on their health. The aim of this study was to investigate the health resources and strategies of employed women in Norway during pregnancy and early motherhood by means of salutogenic theory. A hypothetical-deductive interpretive approach based on Antonovsky's salutogenic theory was applied in a secondary analysis. A total of six themes were identified; three were classified as health resources when experiencing tension and three as health strategies. Salutogenic theory seems to be a useful framework for illuminating the health resources and strategies adopted by employed women who become mothers. The identified health resources when experiencing tension and the health strategies applied may have implications for maternity care professionals and employers in promoting the health of such women and supporting them to combine work and family life. PMID:25945258

  8. Exploring the feelings of Iranian women of reproductive age about health care seeking behavior: a qualitative study

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Morowatisharifabad

    2018-01-01

    Full Text Available Background: Despite the important role of feelings in health care seeking behavior (HCSB, this subject has not yet been adequately investigated. HCSB-related feelings begin with the onset of disease symptoms and persist in different forms after treatment. The aim of current study was to explore the feelings that women of reproductive age experience when they seek health care.Methods: In this deductive, qualitative content analysis, participants were selected by purposeful sampling. Semi-structured, in-depth interviews with 17 women of reproductive age and 5 healthcare staffs in Qom, Iran were carried out until data saturation was achieved. Qualitative data were concurrently analyzed by deductive content analysis, using the Health Promotion Model (HPM. The MAXQDA10 software was used to manage qualitative data analysis.Results: Three main categories were drawn from data to explain the HCSB-related feelings of participants consisting of (1 feeling of inner satisfaction with the treatment with 2 subcategories including "peace of mind" and "feeling alive", (2 multiple roles of fear with 5 subcategories including "fear about the consequences of delay", "fear of having hidden diseases", "fear of unknown experiences", "fear of hearing bad news" and "fear of medical errors" and (3uncomfortable feelings with 3 subcategories including "feeling uneasy when attending health facility", "feeling embarrassed" and "feeling worthless due to dealing the doctor".Conclusion: This study revealed that the inner feelings of women varied widely, ranging from positive or motivating feelings to negative or inhibitory ones, given their experiences with the formal health care system and the current situation of medical and health services. Highlighting patients’ perceived inner satisfaction and reducing fear and uncomfortable feelings by adopting culture-based practical strategies can enhance women’s HCSB.

  9. Deduction and Analysis of the Interacting Stress Response Pathways of Metal/Radionuclide-reducing Bacteria

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jizhong [University of Oklahoma; He, Zhili [University of Oklahoma

    2010-02-28

    Project Title: Deduction and Analysis of the Interacting Stress Response Pathways of Metal/Radionuclide-reducing Bacteria DOE Grant Number: DE-FG02-06ER64205 Principal Investigator: Jizhong (Joe) Zhou (University of Oklahoma) Key members: Zhili He, Aifen Zhou, Christopher Hemme, Joy Van Nostrand, Ye Deng, and Qichao Tu Collaborators: Terry Hazen, Judy Wall, Adam Arkin, Matthew Fields, Aindrila Mukhopadhyay, and David Stahl Summary Three major objectives have been conducted in the Zhou group at the University of Oklahoma (OU): (i) understanding of gene function, regulation, network and evolution of Desulfovibrio vugaris Hildenborough in response to environmental stresses, (ii) development of metagenomics technologies for microbial community analysis, and (iii) functional characterization of microbial communities with metagenomic approaches. In the past a few years, we characterized four CRP/FNR regulators, sequenced ancestor and evolved D. vulgaris strains, and functionally analyzed those mutated genes identified in salt-adapted strains. Also, a new version of GeoChip 4.0 has been developed, which also includes stress response genes (StressChip), and a random matrix theory-based conceptual framework for identifying functional molecular ecological networks has been developed with the high throughput functional gene array hybridization data as well as pyrosequencing data from 16S rRNA genes. In addition, GeoChip and sequencing technologies as well as network analysis approaches have been used to analyze microbial communities from different habitats. Those studies provide a comprehensive understanding of gene function, regulation, network, and evolution in D. vulgaris, and microbial community diversity, composition and structure as well as their linkages with environmental factors and ecosystem functioning, which has resulted in more than 60 publications.

  10. Health behaviors and mental health of students attending alternative high schools: a review of the research literature.

    Science.gov (United States)

    Johnson, Karen E; Taliaferro, Lindsay A

    2012-04-01

    The purpose of this review is to describe current knowledge about health-risk behaviors and mental health among alternative high school students. Substance use, diet and/or physical activity, sexual-risk behaviors, mental health, and violence were reviewed. Students were described as marginalized youth facing significant social environmental challenges. Findings from 43 studies published from 1997-2010 suggested a high prevalence of health-risk behaviors among alternative high school students. Very few studies were conducted by nurse researchers. Suggestions for future research include addressing social environmental factors, resiliency, and emotional/mental health outcomes. Alternative high schools offer a venue to conduct research and implement nursing interventions with high-risk, yet resilient, youth. © 2011, Wiley Periodicals, Inc.

  11. OGC Geographic Information Service Deductive Semantic Reasoning Based on Description Vocabularies Reduction

    Directory of Open Access Journals (Sweden)

    MIAO Lizhi

    2015-09-01

    Full Text Available As geographic information interoperability and sharing developing, more and more interoperable OGC (open geospatial consortium Web services (OWS are generated and published through the internet. These services can facilitate the integration of different scientific applications by searching, finding, and utilizing the large number of scientific data and Web services. However, these services are widely dispersed and hard to be found and utilized with executive semantic retrieval. This is especially true when considering the weak semantic description of geographic information service data. Focusing on semantic retrieval and reasoning of the distributed OWS resources, a deductive and semantic reasoning method is proposed to describe and search relevant OWS resources. Specifically, ①description words are extracted from OWS metadata file to generate GISe ontology-database and instance-database based on geographic ontology according to basic geographic elements category, ②a description words reduction model is put forward to implement knowledge reduction on GISe instance-database based on rough set theory and generate optimized instances database, ③utilizing GISe ontology-database and optimized instance-database to implement semantic inference and reasoning of geographic searching objects is used as an example to demonstrate the efficiency, feasibility and recall ration of the proposed description-word-based reduction model.

  12. Health behaviors of Bydgoszcz high school graduates

    Directory of Open Access Journals (Sweden)

    Alicja Kostencka

    2016-10-01

    Full Text Available Lifestyle affects the physical, mental, social development, health and learning ability. It seems that there are differences in the health behaviors  of young females and males, however these differences are not well described. The aim of the current study was to assess the lifestyle of eighteen-years old and to compare their health behaviors of young persons according to their gender. The study was conducted among 98 students of high schools in Bydgoszcz (35 females and 68 males. All participants were 18 years old. The questionnaire was prepared especially for the purposes of the study, a part of the questions of this questionnaire was taken from the Canada Fitness Survey. The physical activity, mode of nutrition, use of stimulants, hours of sleep, time spent in front of screens and the level of stress were taken into consideration while assessing the teenagers’ lifestyle. The lifestyle of high school graduates is worrisome. It is characterized by low level of physical activity, irregular nutrition, not enough fruits, vegetables and water consumed. A large group of young people drink alcohol, smoke tobacco and marijuana, sleep too short. Males also spend too many hours in front of a television, computer or other similar device. Differences in the health behaviors of  women and men appear to be significant. The prevalence of alcohol abuse in this group is very high and affects both sexes. The sex differences in the health-promoting behaviors among men and women in this group of adolescents seems to diminish. Observed unhealthy behaviors indicates the urgent need for health education, especially those that educate the student about the value of the person, the value of health, and the development of social skills that underlie personal development. The foremost priority is  risk prevention implementation in primary schools. Further research and continuous monitoring of health behaviors in different age groups  is needed as well as  to

  13. Examining A Health Care Price Transparency Tool: Who Uses It, And How They Shop For Care.

    Science.gov (United States)

    Sinaiko, Anna D; Rosenthal, Meredith B

    2016-04-01

    Calls for transparency in health care prices are increasing, in an effort to encourage and enable patients to make value-based decisions. Yet there is very little evidence of whether and how patients use health care price transparency tools. We evaluated the experiences, in the period 2011-12, of an insured population of nonelderly adults with Aetna's Member Payment Estimator, a web-based tool that provides real-time, personalized, episode-level price estimates. Overall, use of the tool increased during the study period but remained low. Nonetheless, for some procedures the number of people searching for prices of services (called searchers) was high relative to the number of people who received the service (called patients). Among Aetna patients who had an imaging service, childbirth, or one of several outpatient procedures, searchers for price information were significantly more likely to be younger and healthier and to have incurred higher annual deductible spending than patients who did not search for price information. A campaign to deliver price information to consumers may be important to increase patients' engagement with price transparency tools. Project HOPE—The People-to-People Health Foundation, Inc.

  14. Determination of the potential radiation exposure of the population close to the Asse II mine caused by deduction of radioactive substances with the discharge air in the normal operation using the ''Atmospheric Radionuclide-Transport-Model'' (ARTM)

    International Nuclear Information System (INIS)

    Esch, D.; Wittwer, C.

    2014-01-01

    Between 1967 and 1978 125.787 packages filled with low-level and intermediate-level radioactive waste were emplaced in the mining plant Asse II. Volatile radioactive substances like H-3, C-14 and Rn-222 are released from the emplaced waste. These substances reach the ventilated parts of the mine and are released with the discharge air. The potential radiation exposure of the population caused by deduction of radioactive substances with the discharge air in the normal operation is determined by the ''Atmospheric Radionuclide-Transport-Model'' (ARTM). As result the maximal deductions of volatile radioactive substances with the discharge air in the normal operation of the Asse II mine lead to radiation exposure of the population, which is considerably lower than the permissible values of application rate.

  15. A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda.

    Science.gov (United States)

    Tetui, Moses; Coe, Anna-Britt; Hurtig, Anna-Karin; Bennett, Sara; Kiwanuka, Suzanne N; George, Asha; Kiracho, Elizabeth Ekirapa

    2017-12-28

    Many approaches to improving health managers' capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers' capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers' capacity in Eastern Uganda. This was a qualitative study that used open-ended key informant interviews, combined with review of meeting minutes and observations to collect data. Both inductive and deductive thematic analysis was undertaken. The Competing Values Framework of organisational management functions guided the deductive process of analysis and the interpretation of the findings. The framework builds on four earlier models of management and regards them as complementary rather than conflicting, and identifies four managers' capacities (collaborate, create, compete and control) by categorising them along two axes, one contrasting flexibility versus control and the other internal versus external organisational focus. The findings indicate that the participatory action research approach enhanced health managers' capacity to collaborate with others, be creative, attain goals and review progress. The enablers included expanded interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability. Tension and conflict across different management functions was apparent; for example, while there was a need to collaborate, maintaining control over processes was also needed. These tensions meant that managers needed to learn to simultaneously draw upon and use different capacities as reflected by the Competing Values Framework in order to maximise their effectiveness. Improved health manager capacity is

  16. 76 FR 21852 - Defense Federal Acquisition Regulation Supplement; Responsibility and Liability for Government...

    Science.gov (United States)

    2011-04-19

    ... regulatory approaches that maximize net benefits (including potential economic, environmental, public health... substantial cash reserves may be in a financial position that enables those firms to select a high insurance deductible in order to garner lower premiums by electing to become self-insuring for potential property loss...

  17. Improving high quality, equitable maternal health services in Malawi ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Improving high quality, equitable maternal health services in Malawi (IMCHA) ... In response, the Ministry of Health implemented a Standards-Based Management and Recognition for Reproductive Health initiative to improve ... Total funding.

  18. Group-theoretical deduction of a dyadic Tamm-Dancoff equation by using a matrix-valued generator coordinate

    International Nuclear Information System (INIS)

    Nishiyama, Seiya; Morita, Hiroyuki; Ohnishi, Hiromasa

    2004-01-01

    The traditional Tamm-Dancoff (TD) method is one of the standard procedures for solving the Schroedinger equation of fermion many-body systems. However, it meets a serious difficulty when an instability occurs in the symmetry-adapted ground state of the independent particle approximation (IPA) and when the stable IPA ground state becomes of broken symmetry. If one uses the stable but broken symmetry IPA ground state as the starting approximation, TD wave functions also become of broken symmetry. On the contrary, if we start from a symmetry-adapted but unstable wave function, the convergence of the TD expansion becomes bad. Thus, the requirements of symmetry and rapid convergence are not in general compatible in the conventional TD expansion of the systems with strong collective correlations. Along the same line as Fukutome's, we give a group-theoretical deduction of a U(n) dyadic TD equation by using a matrix-valued generator coordinate

  19. Explaining regional variations in health care utilization between Swiss cantons using panel econometric models.

    Science.gov (United States)

    Camenzind, Paul A

    2012-03-13

    In spite of a detailed and nation-wide legislation frame, there exist large cantonal disparities in consumed quantities of health care services in Switzerland. In this study, the most important factors of influence causing these regional disparities are determined. The findings can also be productive for discussing the containment of health care consumption in other countries. Based on the literature, relevant factors that cause geographic disparities of quantities and costs in western health care systems are identified. Using a selected set of these factors, individual panel econometric models are calculated to explain the variation of the utilization in each of the six largest health care service groups (general practitioners, specialist doctors, hospital inpatient, hospital outpatient, medication, and nursing homes) in Swiss mandatory health insurance (MHI). The main data source is 'Datenpool santésuisse', a database of Swiss health insurers. For all six health care service groups, significant factors influencing the utilization frequency over time and across cantons are found. A greater supply of service providers tends to have strong interrelations with per capita consumption of MHI services. On the demand side, older populations and higher population densities represent the clearest driving factors. Strategies to contain consumption and costs in health care should include several elements. In the federalist Swiss system, the structure of regional health care supply seems to generate significant effects. However, the extent of driving factors on the demand side (e.g., social deprivation) or financing instruments (e.g., high deductibles) should also be considered.

  20. Relationship between Female Pre University Students' Critical Thinking Skills and Their Mental Health

    Directory of Open Access Journals (Sweden)

    Y. Maroofi

    2012-04-01

    Full Text Available Introduction & Objective: Critical thinking is simply defined as ability for analysis and evaluation of information. Today, this skill is considered as an undeniable necessity for social life. So fostering critical thinking ability is one of the basic goals of different levels of education from primary school to higher education. Each conscious behavior is related to the theoretical and intellectual foundation and origin. Therefore, the quality and types of thought play an important role in human mental health. This research studies the relationship between female pre-university students' critical thinking skills and their mental health in the academic year 2009-2010 in Hamadan city. Materials & Methods: This study is a cross sectional research and our method is based on correlation. Using random multiple stages clustering method, we selected 331 students as statistical sample. The data gathering instruments are two standard questionnaires: California form b critical thinking questionnaire and 28-question Goldberg and Hilier general health questionnaire. The data were analyzed using descriptive statistic indexes such as frequency, percent, mean and standard deviation and inferential tests such as Pearson correlation coefficient and multiple regressions. Results: Research findings show that the average point of students' critical thinking skills is (6.51 out of 34 and their average point of mental health is (31.52 .About 61 persons(18.4 percent have not any psychological disorder, about 270 person (81.6 percent seemed to have psychological disorder symptoms. There are negative and significant differences between critical thinking skills and disorder in mental health. Multiple regression analysis show that: there is negative and significant differences between critical analysis and deductive rational skills with psychological disorder symptoms, that is when students' critical thinking skills increases, the psychological disorder symptoms decrease

  1. Using payroll deduction to shelter individual health insurance from income tax.

    Science.gov (United States)

    Hall, Mark A; Hager, Christie L; Orentlicher, David

    2011-02-01

    To assess the impact of state laws requiring or encouraging employers to establish "section 125" cafeteria plans that shelter employees' premium contributions from tax. Available descriptive statistics, 65 key-informant interviews, and relevant documents in study states and nationally, 2008-2009. Case studies were conducted in Indiana, Massachusetts, and Missouri--three states adopting laws in 2007. Descriptive quantitative information came from insurers, regulators, and surveys of employers. In each state, 15-17 semistructured but open-ended interviews were conducted with insurance agents, insurers, government officials, and third-party administration firms, and 29 informed sources were interviewed from a national perspective or other states. Key informants were selected based on their known or reported experience, in a "snowball" fashion until saturation was reached. Interview notes were coded for systematic analysis. Finally, relevant rulings, brochures, instructions, marketing materials, and other documents were collected and analyzed. Despite the potential for substantial cost savings, use of section 125 plans to purchase individual insurance remained low in these states after 1 or 2 years. Absent a mandate, few employers were strongly motivated to offer these plans in order to retain an adequate workforce, and uncertainty about federal legality deterred doing so. For smaller employers, benefits to owners did not outweigh administrative complexities. Nevertheless, few downsides were found to states mandating or encouraging these plans. In particular, there is little evidence that many employers dropped group coverage as a result. Section 125 plans remain a limited tool for states to reduce the inequitable tax treatment of individually purchased insurance, but a complete remedy requires reform of federal tax law. © Health Research and Educational Trust.

  2. [Sustainable Implementation of Evidence-Based Programmes in Health Promotion: A Theoretical Framework and Concept of Interactive Knowledge to Action].

    Science.gov (United States)

    Rütten, A; Wolff, A; Streber, A

    2016-03-01

    This article discusses 2 current issues in the field of public health research: (i) transfer of scientific knowledge into practice and (ii) sustainable implementation of good practice projects. It also supports integration of scientific and practice-based evidence production. Furthermore, it supports utilisation of interactive models that transcend deductive approaches to the process of knowledge transfer. Existing theoretical approaches, pilot studies and thoughtful conceptual considerations are incorporated into a framework showing the interplay of science, politics and prevention practice, which fosters a more sustainable implementation of health promotion programmes. The framework depicts 4 key processes of interaction between science and prevention practice: interactive knowledge to action, capacity building, programme adaptation and adaptation of the implementation context. Ensuring sustainability of health promotion programmes requires a concentrated process of integrating scientific and practice-based evidence production in the context of implementation. Central to the integration process is the approach of interactive knowledge to action, which especially benefits from capacity building processes that facilitate participation and systematic interaction between relevant stakeholders. Intense cooperation also induces a dynamic interaction between multiple actors and components such as health promotion programmes, target groups, relevant organisations and social, cultural and political contexts. The reciprocal adaptation of programmes and key components of the implementation context can foster effectiveness and sustainability of programmes. Sustainable implementation of evidence-based health promotion programmes requires alternatives to recent deductive models of knowledge transfer. Interactive approaches prove to be promising alternatives. Simultaneously, they change the responsibilities of science, policy and public health practice. Existing boundaries

  3. Some health aspects of high-energy society

    International Nuclear Information System (INIS)

    Cook, E.

    1975-01-01

    The intensive use of inanimate energy in industrialized or high-energy society has subsidized research, development, and higher education and has brought about changes in nutrition and life-style that have led to great advances in public health and medicine. The emergence of high-energy society, however, has brought with it a new set of health problems, within which the direct effects of measurable pollution may turn out to be more easily dealt with than some of the indirect and hard-to-calculate consequences of high energy use. High-energy society is critically dependent on energy-intensive transport systems, and these systems in turn are dependent upon a continual supply of petroleum products. In the short-term, the aorta of any industrialized nation is its petroleum-supply network. In the longer run, high-energy society faces the depletion and exhaustion of all the nonrenewable resources on which it has fed. Even if technology provides adequate substitute energy systems, high-energy society may deteriorate socially from inability to cope with affluence

  4. State trends in the cost of employer health insurance coverage, 2003-2013.

    Science.gov (United States)

    Schoen, Cathy; Radley, David; Collins, Sara R

    2015-01-01

    From 2010 to 2013--the years following the implementation of the Affordable Care Act--there has been a marked slowdown in premium growth in 31 states and the District of Columbia. Yet, the costs employees and their families pay out-of-pocket for deductibles and their share of premiums continued to rise, consuming a greater share of incomes across the country. In all but a handful of states, average deductibles more than doubled over the past decade for employees working in large and small firms. Workers are paying more but getting less protective benefits. Costs are particularly high, compared with median income, in Southern and South Central states, where incomes are below the national average. Based on recent forecasts that predict an uptick in private insurance growth rates starting in 2015, securing slow cost growth for workers, families, and employers will likely require action to address rising costs of medical care services.

  5. Energy Savings Modeling and Inspection Guidelines for Commercial Building Federal Tax Deductions for Buildings in 2016 and Later

    Energy Technology Data Exchange (ETDEWEB)

    Deru, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States); Field-Macumber, Kristin [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-01

    This document provides guidance for modeling and inspecting energy-efficient property in commercial buildings for certification of the energy and power cost savings related to Section 179D of the Internal Revenue Code (IRC) enacted in Section 1331 of the 2005 Energy Policy Act (EPAct) of 2005, noted in Internal Revenue Service (IRS) Notices 2006-52 (IRS 2006), 2008-40 (IRS 2008) and 2012-26 (IRS 2012), and updated by the Protecting Americans from Tax Hikes (PATH) Act of 2015. Specifically, Section 179D provides federal tax deductions for energy-efficient property related to a commercial building's envelope; interior lighting; heating, ventilating, and air conditioning (HVAC); and service hot water (SHW) systems. This document applies to buildings placed in service on or after January 1, 2016.

  6. [Occupational hearing loss--problem of health and safety].

    Science.gov (United States)

    Denisov, É I; Adeninskaia, E E; Eremin, A L; Kur'erov, N N

    2014-01-01

    On the basis of the literature review the critical analysis of the recommendations (the letter of Ministry of Health of Russia from 6/11/2012 N 14-1/10/2-3508) on occupation noise-induced hearing loss (HL) assessment is presented. Need of more strict criteria of HL assessment for workers, than for the general population according to ICF (WHO, 2001), in order to avoid growth of accidents and injury rate is proved. The illegitimacy of a deduction of statistical presbiacusia values from individual audiograms as human rights violation is stressed. Some terminological defects are noted. It is necessary to cancel recommendations and to develop the sanitary norms or state standard with the program of hearing conservation at work.

  7. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... tax-deductible gift today can fund critical diabetes research and support vital diabetes ... deaths a year than breast cancer and AIDS combined. Your gift today will help us get ...

  8. Health-related quality of life in children with high-functioning autism.

    Science.gov (United States)

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism (n = 30) and peers (n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves (p children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child's perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child's life that promote or hinder their sense of well-being. © The Author(s) 2013.

  9. Demystifying patient price estimates. The advantages of transparency.

    Science.gov (United States)

    Kane, Cheri S; Harvey, Gayla

    2015-05-01

    With the increase of high-deductible health plans, more consumers want to know the cost of their health care before they purchase services. A healthcare organization should formulate transparent price policies that: Fit with its intentions, processes, and goals. Ensure consumers are thoroughly educated about their financial responsibilities. Include the use of consumer pricing tools that help patients feel like empowered consumers. Reflect an enterprisewide culture of transparency.

  10. 76 FR 12080 - TRICARE Access to Care Demonstration Project

    Science.gov (United States)

    2011-03-04

    ... parties of a Military Health System (MHS) Demonstration project under the authority of Title 10, U.S. Code... of Service (POS) deductibles and cost shares shall apply to these four unmanaged visits. Additionally... TRICARE authorized provider or UCC without incurring POS deductibles and cost shares. The ADSM and family...

  11. Health Food Supplements (Health Food Highly Nutritious From Chlorella And Oil Catfish (Pangasius hypopthalmus

    Directory of Open Access Journals (Sweden)

    Syahrul Syahrul

    2017-02-01

    Full Text Available AbstractThe utilization of microalgae as a food ingredient considered effective, because in addition to alternative food sources also contains nutrients chlorella microalgae in particular is very good for health. This microalgae rich in protein (60.5%, fat (11%, carbohydrates (20.1%, water, dietary fiber, vitamins and minerals Besides these microalgae contain pigments (chlorophyll, tocopherol and the active component (antimicrobial and antioxidants. This is what underlies microalgae is very useful to be used as a source of raw materials of health food supplements. Currently the health food supplements have become a necessity for people to maintain their health in order to remain vibrant. This study aims to produce high nutritious health food supplements from raw material chlorella enriched with fish protein concentrate and oil catfish. The method used in the manufacture of high nutritious health food supplement is a method of microencapsulation with different formulations. The results showed that the best formulations based on the profile of amino acids, fatty acids and standards AAE per day especially essential fatty acids oleic and linoleic is formulation B (chlorella 2%, 1% fish oil and fish protein concentrate 1%.

  12. Increased health risk in subjects with high self-reported seasonality.

    Directory of Open Access Journals (Sweden)

    Nicolas M Øyane

    Full Text Available BACKGROUND: Seasonal variations in mood and behaviour, termed seasonality, are commonly reported in the general population. As a part of a large cross-sectional health survey in Hordaland, Norway, we investigated the relationship between seasonality, objective health measurements and health behaviours. METHODOLOGY/PRINCIPAL FINDINGS: A total of 11,545 subjects between 40-44 years old participated, completing the Global Seasonality Score, measuring seasonality. Waist/hip circumference, BMI and blood pressure were measured, and blood samples were analyzed for total cholesterol, HDL cholesterol, triglycerides and glucose. Subjects also completed a questionnaire on miscellaneous health behaviours (exercise, smoking, alcohol consumption. Hierarchical linear regression analyses were used to investigate associations between seasonality and objective health measurements, while binary logistic regression was used for analysing associations between seasonality and health behaviours. Analyses were adjusted for sociodemographic factors, month of questionnaire completion and sleep duration. Seasonality was positively associated with high waist-hip-ratio, BMI, triglyceride levels, and in men high total cholesterol. Seasonality was negatively associated with HDL cholesterol. In women seasonality was negatively associated with prevalence of exercise and positively associated with daily cigarette smoking. CONCLUSIONS/SIGNIFICANCE: High seasonality was associated with objective health risk factors and in women also with health behaviours associated with an increased risk for cardiovascular disease.

  13. Future health physics prospects in high-level nuclear waste management

    International Nuclear Information System (INIS)

    Waite, D.A.; Mayberry, J.J.

    1986-01-01

    The objective of this presentation is to provide an overview of health physics activities anticipated to be required at a high-level nuclear waste repository and to project the numbers of health physics personnel expected to be required to carry out these activities. Health physics personnel receiving consideration in the projections include the health physics manager, shift supervisors, area supervisors, health physicists, and technologists. Phases of the repository addressed are construction, operation, retrieval, and decommissioning. Specific topics discussed in the process of developing the projections are: (a) the basic features of a geologic repository, (b) the staffing requirements of such a repository, (c) health physics involvement in repository operations, and (d) the anticipated schedule for operation of repositories in the United States. A quantitative assessment of future health physics prospects in high-level nuclear waste management is included

  14. Hyperglycemia (High Blood Glucose)

    Medline Plus

    Full Text Available ... Us in the Fight for a Cure Your tax-deductible gift today can fund critical diabetes research and support vital diabetes education services that improve the lives of those with diabetes. $ ...

  15. An examination of sleep health, lifestyle and mental health in junior high school students.

    Science.gov (United States)

    Tanaka, Hideki; Taira, Kazuhiko; Arakawa, Masashi; Masuda, Atushi; Yamamoto, Yukari; Komoda, Yoko; Kadegaru, Hathuko; Shirakawa, Shuichiro

    2002-06-01

    The factors that influence sleep health and mental health in junior high school students' lifestyles was examined. The proportion of students who replied that they feel bad in the morning, and who do not have breakfast was significantly higher in poor sleepers. The proportion of students who regularly take exercise was significantly lower among poor sleepers. Compared with good sleepers, poor sleepers had a higher number of illnesses and their General Health Questionnaire score was worse. The study's results suggest that sleep health is closely related to both physical and mental health, and that habits such as exercise, and regular sleeping and eating, are important for maintaining and improving students' sleep health.

  16. High Cholesterol and Complementary Health Practices: What the Science Says

    Science.gov (United States)

    ... professionals High Cholesterol and Complementary Health Practices: What the Science Says Share: February 2013 Dietary Supplements Red Yeast ... to exploring complementary health products and practices in the context of rigorous ... health researchers, and disseminating authoritative information ...

  17. Implementation of preventive mental health services for children of physically ill parents: experiences in seven European countries and health care systems.

    Science.gov (United States)

    Kühne, Franziska; Haagen, Miriam; Baldus, Christiane; Diareme, Stavroula; Grether, Andrea; Schmitt, Florence; Stanescu, Dan; Stöckl, Margit; Thastum, Mikael; Möller, Birgit; Romer, Georg

    2013-01-01

    Parental physical disease is a family issue, but families' minor children are seldom considered. The current study analyzed experiences with implementation of counseling for families with physically ill parents and minor children during a European multisite pilot project. Implementation protocols of seven European partner centers collaborating in a joint research project were analyzed by Mayring's qualitative content analysis. Both an inductive approach and a deductive approach were chosen. Satisfaction of families and therapists was considered based on information from three partner centers. Satisfaction with counseling was rather high. Mentioned problems referred to aspects related to liaison partners, family-related aspects and physicians' concerns. Recommendations related to contacting families, liaising with other professions, implementing counseling together with a research project, and training. Results are integrated in the current dissemination literature. Successful implementation was mostly determined by aspects of interdisciplinary cooperation and communication, perceived relative advantage and organizational premises. With regard to this kind of innovative child-centered family mental health services, top-down and bottom-up implementation strategies should be combined, and strategies of maintenance and sustainability should be considered from the very beginning. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.

    Science.gov (United States)

    Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W

    2016-02-01

    U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician

  19. Spousal Caregiving for Partners With Dementia: A Deductive Literature Review Testing Calasanti's Gendered View of Care Work.

    Science.gov (United States)

    Hong, Sung-Chull; Coogle, Constance L

    2016-07-01

    Spousal caregiving allows stressed couples to continue living in the community rather than seeking institutional solutions. Dr. Toni Calasanti has postulated that there are gender differences in the care work styles and coping strategies used by spousal caregivers dealing with dementia. While caregiving husbands tend to adopt task-oriented (masculine) approaches, caregiving wives are more likely to take an emotionally focused (feminine) orientation. These differences result in the need for varied interventions. Male caregivers tend toward a managerial approach, whereas female caregivers generally adopt a relational approach. This distinction was examined in the course of a literature review through the deductive process. It was determined that the core thesis of such a gender-based view of care work as a tiered entity threaded with masculinity/femininity remains quite plausible in contrast to models based on self-perceived gender identity of caregivers that require more exploration. Recommendations for future investigations are offered as new questions arise. © The Author(s) 2014.

  20. Health Insurance without Single Crossing : Why Healthy People have High Coverage

    NARCIS (Netherlands)

    Boone, J.; Schottmuller, C.

    2011-01-01

    Standard insurance models predict that people with high (health) risks have high insurance coverage. It is empirically documented that people with high income have lower health risks and are better insured. We show that income differences between risk types lead to a violation of single crossing in

  1. Health-Related Quality of Life in Children with High-Functioning Autism

    Science.gov (United States)

    Potvin, Marie-Christine; Snider, Laurie; Prelock, Patricia A.; Wood-Dauphinee, Sharon; Kehayia, Eva

    2015-01-01

    The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of…

  2. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Us in the Fight for a Cure Your tax-deductible gift today can fund critical diabetes research ... breast cancer and AIDS combined. Your gift today will help us get closer to curing diabetes and ...

  3. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Us in the Fight for a Cure Your tax-deductible gift today can fund critical diabetes research ... for ketones. If you have ketones, do not exercise. Exercising when ketones are present may make your ...

  4. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... Us in the Fight for a Cure Your tax-deductible gift today can fund critical diabetes research ... Type 2 Diabetes Program Food & Fitness Food Recipes Planning Meals What Can I Eat Weight Loss Fitness ...

  5. Hyperglycemia (High Blood Glucose)

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    Full Text Available ... the Fight for a Cure Your tax-deductible gift today can fund critical diabetes research and support ... year than breast cancer and AIDS combined. Your gift today will help us get closer to curing ...

  6. Hyperglycemia (High Blood Glucose)

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  7. Health literacy profile of high school students based on knowledge, attitude and behavior to health of respiration

    Science.gov (United States)

    Widiyawati, W.; Fitriani, A.; Priyandoko, D.

    2018-05-01

    This research aims to describe the high school student’s health literacy profile based on their knowledge, attitude, and behavior to health of respiration. This descriptive study involved 65 participants of senior high school students of Ciamis city. Research instruments for collecting data are test and questionnaires sheets. The data were analyzed using quantitative descriptive analysis. The results showed that student’s health literacy of respiration get mean 109.94, moderate category. Based on the above results, it can be concluded that student’s health literacy of respiration is enough because student’s health literacy are in the moderate category, but it needs to be improved by the classroom learning in accompanied by changing some of the lesser habits in maintaining respiratory health.

  8. Does public health advocacy seek to redress health inequities? A scoping review.

    Science.gov (United States)

    Cohen, Benita E; Marshall, Shelley G

    2017-03-01

    The public health (PH) sector is ideally situated to take a lead advocacy role in catalysing and guiding multi-sectoral action to address social determinants of health inequities, but evidence suggests that PH's advocacy role has not been fully realised. The purpose of this review was to determine the extent to which the PH advocacy literature addresses the goal of reducing health and social inequities, and to increase understanding of contextual factors shaping the discourse and practice of PH advocacy. We employed scoping review methods to systematically examine and chart peer-reviewed and grey literature on PH advocacy published from January 1, 2000 to June 30, 2015. Databases and search engines used included: PubMed, CINAHL, PsycINFO, Social Sciences Citation Index, Google Scholar, Google, Google Books, ProQuest Dissertations and Theses, Grey Literature Report. A total of 183 documents were charted, and included in the final analysis. Thematic analysis was both inductive and deductive according to the objectives. Although PH advocacy to address root causes of health inequities is supported theoretically and through professional practice standards, the empirical literature does not reflect that this is occurring widely in PH practice. Tensions within the discourse were noted and multiple barriers to engaging in PH advocacy for health equity were identified, including a preoccupation with individual responsibilities for healthy lifestyles and behaviours, consistent with the emergence of neoliberal governance. If the PH sector is to fulfil its advocacy role in catalysing action to reduce health inequities, it will be necessary to address advocacy barriers at multiple levels, promote multi-sectoral efforts that implicate the state and corporations in the production of health inequities, and rally state involvement to redress these injustices. © 2016 John Wiley & Sons Ltd.

  9. Barriers to health education in adolescents: health care providers' perspectives compared to high school adolescents.

    Science.gov (United States)

    Abedian, Kobra; Shahhosseini, Zohreh

    2015-11-01

    Although adolescence is marked by profound and dynamic changes, it is virtually neglected by health care providers, by society, and even by most parents, teachers, and health professionals. The aim of this study was to investigate barriers to health education in adolescents from health care providers' views compared to teens. The study population consisted of 72 health care providers and 402 high school female students in Northern Iran in 2012. They completed a self-administered questionnaire about their views on barriers to adolescents' health education. It is revealed that the major barrier to adolescents' health education from a health care providers' perspective is "Lack of private room for adolescents' health education", while "Lack of adolescents' interest to content of educational programs" is a significantly greater barrier to health education among adolescents. The results suggest that for adolescent health education, specific strategies should be used in adolescent health promotion programs.

  10. Cost-Effectiveness Thresholds in Global Health: Taking a Multisectoral Perspective.

    Science.gov (United States)

    Remme, Michelle; Martinez-Alvarez, Melisa; Vassall, Anna

    2017-04-01

    Good health is a function of a range of biological, environmental, behavioral, and social factors. The consumption of quality health care services is therefore only a part of how good health is produced. Although few would argue with this, the economic framework used to allocate resources to optimize population health is applied in a way that constrains the analyst and the decision maker to health care services. This approach risks missing two critical issues: 1) multiple sectors contribute to health gain and 2) the goods and services produced by the health sector can have multiple benefits besides health. We illustrate how present cost-effectiveness thresholds could result in health losses, particularly when considering health-producing interventions in other sectors or public health interventions with multisectoral outcomes. We then propose a potentially more optimal second best approach, the so-called cofinancing approach, in which the health payer could redistribute part of its budget to other sectors, where specific nonhealth interventions achieved a health gain more efficiently than the health sector's marginal productivity (opportunity cost). Likewise, other sectors would determine how much to contribute toward such an intervention, given the current marginal productivity of their budgets. Further research is certainly required to test and validate different measurement approaches and to assess the efficiency gains from cofinancing after deducting the transaction costs that would come with such cross-sectoral coordination. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. An analysis of local government health policy against state priorities and a social determinants framework.

    Science.gov (United States)

    Browne, Geoffrey R; Davern, Melanie T; Giles-Corti, Billie

    2016-04-01

    Victorian local governments are required to develop Municipal Public Health and Wellbeing Plans that incorporate state-level health planning priorities and address the social determinants of health. This paper describes a novel method for evaluating councils' performance against these requirements. Deductive content analysis was used to categorise all actions in 14 local government MPHWPs against Victorian state priorities as well as against social determinants of health policy areas. More than 1,000 actions were identified. However, fewer than half directly addressed a state priority, with many actions addressing policy areas known to be broader determinants of health. In particular, there was a marked focus on leisure and culture, and on building social cohesion through changes to living and working conditions. Councils are working beyond state priorities and there was a clear emphasis on addressing the diverse upstream 'causes of the causes' of health, rather than health promotion behaviour change programs. The approach for data analysis and presentation provides a useful method for rapid appraisal of health and wellbeing actions relative to councils', and the State's, responsibility and efficacy in public health. © 2015 Public Health Association of Australia.

  12. Transdisciplinary Higher Education—A Challenge for Public Health Science

    Directory of Open Access Journals (Sweden)

    Alexandra Krettek

    2011-01-01

    Full Text Available This paper highlights and discusses issues associated with transdisciplinary teaching and suggests ways to overcome the challenges posed by different epistemologies, methods, and ethical positions. Our own transdisciplinary teaching experience in public health helped us identify some important questions including (i what is transdisciplinary research in practice, and does methods triangulation yield more valid results?, (ii from a teaching perspective, how do biopsychosocial and medical research differ?, (iii what is the difference between deductive and inductive research, and does each discipline represent a different ethical position?, and (iv does pure inductive research lack theories, and does it require a hypothesis—a “rule of thumb”—on how to proceed? We also suggest ways to facilitate and enhance transdisciplinary teaching, focusing on what unites us and not on what sets us apart, openly underlining and highlighting our differences. Using diverse methodologies, a newly educated transdisciplinary workforce will likely extend current knowledge and facilitate solutions for complex public health issues.

  13. Evaluation of a health system strengthening initiative in the Zambian prison system

    Science.gov (United States)

    Sharma, Anjali; Moonga, Clement N; Chileshe, Chisele; Magwende, George; Henostroza, German

    2018-01-01

    Introduction In 2013, the Zambian Correctional Service (ZCS) partnered with the Centre for Infectious Disease Research in Zambia on the Zambian Prisons Health System Strengthening project, seeking to tackle structural, organisational and cultural weaknesses within the prison health system. We present findings from a nested evaluation of the project impact on high, mid-level and facility-level health governance and health service arrangements in the Zambian Correctional Service. Methods Mixed methods were used, including document review, indepth interviews with ministry (11) and prison facility (6) officials, focus group discussions (12) with male and female inmates in six of the eleven intervention prisons, and participant observation during project workshops and meetings. Ethical clearance and verbal informed consent were obtained for all activities. Analysis incorporated deductive and iterative inductive coding. Results Outcomes: Improved knowledge of the prison health system strengthened political and bureaucratic will to materially address prison health needs. This found expression in a tripartite Memorandum of Understanding between the Ministry of Home Affairs, Ministry of Health (MOH) and Ministry of Community Development, and in the appointment of a permanent liaison between MOH and ZCS. Capacity-building workshops for ZCS Command resulted in strengthened health planning and management outcomes, including doubling ZCS health professional workforce (from 37 to78 between 2014 and 2016), new preservice basic health training for incoming ZCS officers and formation of facility-based prison health committees with a mandate for health promotion and protection. Mechanisms: continuous and facilitated communication among major stakeholders and the emergence of interorganisational trust were critical. Enabling contextual factors included a permissive political environment, a shift within ZCS from a ‘punitive’ to ‘correctional’ organisational culture, and

  14. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders.

    Science.gov (United States)

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-10-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were assessed for ASD at 3-years. Parent stress and proband mental health difficulties predicted concurrent toddler mental health difficulties at 2-years, but only baseline proband internalising problems continued to predict toddler internalising problems at 3-years; high-risk status did not confer additional risk. Baseline toddler mental health difficulties robustly predicted later difficulties, while high-risk status and diagnostic outcome conferred no additional risk. A family systems perspective may be useful for understanding toddler mental health difficulties.

  15. [Quality management is associated with high quality services in health care].

    Science.gov (United States)

    Nielsen, Tenna Hassert; Riis, Allan; Mainz, Jan; Jensen, Anne-Louise Degn

    2013-12-09

    In these years, quality management has been the focus in order to meet high quality services for the patients in Danish health care. This article provides information on quality management and quality improvement and it evaluates its effectiveness in achieving better organizational structures, processes and results in Danish health-care organizations. Our findings generally support that quality management is associated with high quality services in health care.

  16. Three years in - changing plan features in the U.S. health insurance marketplace.

    Science.gov (United States)

    McKillop, Caitlin N; Waters, Teresa M; Kaplan, Cameron M; Kaplan, Erin K; Thompson, Michael P; Graetz, Ilana

    2018-06-15

    A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act's (ACA) Health Insurance Marketplace, has been to increase access to stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about the marketplaces' ability to provide a stable source of healthcare for Americans that rely on them. By looking at the effect of instability on changes in the consumer choice set, we can analyze potential incentives to switch plans among price-sensitive enrollees, which can then be used to inform policy going forward. Data on health plan features for non-tobacco users in 2512 counties in 34 states participating in federally-facilitated exchanges from 2014 to 2016 was obtained from the Centers for Medicaid & Medicare Services. We examined how changes in individual plan features, including premiums, deductibles, issuers, and plan types, impact consumers who had purchased the lowest-cost silver or bronze plan in their county the previous year. We calculated the cost of staying in the same plan versus switching to another plan the following year, and analyzed how costs vary across geographic regions. In most counties in 2015 and 2016 (53.7 and 68.2%, respectively), the lowest-cost silver plan from the previous year was still available, but was no longer the cheapest plan. In these counties, consumers who switched to the new lowest-cost plan would pay less in monthly premiums on average, by $51.48 and $55.01, respectively, compared to staying in the same plan. Despite potential premium savings from switching, however, the majority would still pay higher average premiums compared to the previous year, and most would face higher deductibles and an increased probability of having to change provider networks. While the ACA has shown promise in expanding healthcare access, continued changes in the availability and affordability of health

  17. Hyperglycemia (High Blood Glucose)

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  18. Environmental, Nutrition and Health Issues in a US Refugee Resettlement Community.

    Science.gov (United States)

    Sastre, Lauren; Haldeman, Lauren

    2015-10-01

    INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them. METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants. RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups. CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as

  19. Health Food Supplements (“Health Food” Highly Nutritious From Chlorella And Oil Catfish (Pangasius hypopthalmus

    Directory of Open Access Journals (Sweden)

    Syahrul Syahrul

    2016-12-01

    Full Text Available The utilization of microalgae as a food ingredient considered effective, because in addition to alternativefood sources also contains nutrients chlorella microalgae in particular is very good for health. This microalgaerich in protein (60.5%, fat (11%, carbohydrates (20.1%, water, dietary fiber, vitamins and minerals Besidesthese microalgae contain pigments (chlorophyll, tocopherol and the active component (antimicrobial andantioxidants. This is what underlies microalgae is very useful to be used as a source of raw materials ofhealth food supplements. Currently the health food supplements have become a necessity for people tomaintain their health in order to remain vibrant. This study aims to produce high nutritious health foodsupplements from raw material chlorella enriched with fish protein concentrate and oil catfish. The methodused in the manufacture of high nutritious health food supplement is a method of microencapsulation withdifferent formulations. The results showed that the best formulations based on the profile of amino acids,fatty acids and standards AAE per day especially essential fatty acids oleic and linoleic is formulation B(chlorella 2%, 1% fish oil and fish protein concentrate 1%.

  20. Paying for individual health insurance through tax-sheltered cafeteria plans.

    Science.gov (United States)

    Hall, Mark A; Monahan, Amy B

    2010-01-01

    When employees without group health insurance buy individual coverage, they do so using after-tax income--costing them from 20% to 50% more than others pay for equivalent coverage. Prior to the passage of the Patient Protection and Affordable Care Act (PPACA), several states promoted a potential solution that would allow employees to buy individual insurance through tax-sheltered payroll deduction. This technical but creative approach would allow insurers to combine what is known as "list-billing" with a Section 125 "cafeteria plan." However, these state-level reform attempts have failed to gain significant traction because state small-group reform laws and federal restrictions on medical underwriting cloud the legality of tax-sheltered list-billing. Several authorities have taken the position that insurance paid for through a cafeteria plan must meet the nondiscrimination requirements of the Health Insurance Portability and Accountability Act with respect to eligibility, premiums, and benefits. The recently enacted Patient Protection and Affordable Care Act addresses some of the legal uncertainty in this area, but much remains. For health reform to have its greatest effect, federal regulators must clarify whether individual health insurance can be purchased on a pre-tax basis through a cafeteria plan.

  1. Predictors of High eHealth Literacy in Primary Lung Cancer Survivors.

    Science.gov (United States)

    Milne, Robin A; Puts, Martine T E; Papadakos, Janet; Le, Lisa W; Milne, Victoria C; Hope, Andrew J; Catton, Pamela; Giuliani, Meredith E

    2015-12-01

    Lung cancer survivors are likely to have low health literacy which is an independent risk factor for poorer health outcomes. The eHealth literacy in lung cancer survivors has not been reported. The purposes of this study were to determine self-perceived eHealth literacy levels in lung cancer survivors and to explore predictors of higher eHealth literacy. A cross-sectional study was conducted at the Princess Margaret Cancer Centre in Toronto, Canada. Survivors completed a survey that collected demographic, self-perceived eHealth literacy (using the eHealth Literacy Scale), and quality of life information. Tumor and treatment details were extracted from medical records. Demographic data was summarized using descriptive statistics and compared against those with high and low eHealth literacy using Fisher's exact test. Eighty-three survivors were enrolled over 7 months. Median age was 71 years (range 44-89); 41 survivors (49%) were male. Forty-six (55%) survivors had some college education or higher. Most had access to eResources (78%) via computer, Internet, or smartphone. Fifty-seven (69%) scored 5 or greater (7=excellent) on the overall health scale. Twenty-eight (33.7%) perceived themselves to have high eHealth literacy. There was no statistically significant correlation between eHealth literacy groups and age (p=1.00), gender (p=0.82), living situation (p=1.00), overall health (p=1.00), overall quality of life (QoL) (p=1.00), or histology (p=0.74). High eHealth literacy correlated with the level of education received (p=0.003) and access to eResources (p=0.004). The self-perceived eHealth literacy of lung cancer survivors is generally low.

  2. Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers.

    Science.gov (United States)

    Bird, Victoria; Leamy, Mary; Tew, Jerry; Le Boutillier, Clair; Williams, Julie; Slade, Mike

    2014-07-01

    Mental health services in the UK, Australia and other Anglophone countries have moved towards supporting personal recovery as a primary orientation. To provide an empirically grounded foundation to identify and evaluate recovery-oriented interventions, we previously published a conceptual framework of personal recovery based on a systematic review and narrative synthesis of existing models. Our objective was to test the validity and relevance of this framework for people currently using mental health services. Seven focus groups were conducted with 48 current mental health consumers in three NHS trusts across England, as part of the REFOCUS Trial. Consumers were asked about the meaning and their experience of personal recovery. Deductive and inductive thematic analysis applying a constant comparison approach was used to analyse the data. The analysis aimed to explore the validity of the categories within the conceptual framework, and to highlight any areas of difference between the conceptual framework and the themes generated from new data collected from the focus groups. Both the inductive and deductive analysis broadly validated the conceptual framework, with the super-ordinate categories Connectedness, Hope and optimism, Identity, Meaning and purpose, and Empowerment (CHIME) evident in the analysis. Three areas of difference were, however, apparent in the inductive analysis. These included practical support; a greater emphasis on issues around diagnosis and medication; and scepticism surrounding recovery. This study suggests that the conceptual framework of personal recovery provides a defensible theoretical base for clinical and research purposes which is valid for use with current consumers. However, the three areas of difference further stress the individual nature of recovery and the need for an understanding of the population and context under investigation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  3. [Body condition and metabolic stability as the basis for high milk yield and undisturbed fertility in dairy cows--a contribution for deduction of reference values].

    Science.gov (United States)

    Staufenbiel, R; Arndt, G; Schröder, U; Gelfert, C C

    2004-05-01

    The target of this study was to describe the interactions between body condition and various descriptors of yield and fertility. It was aimed to identify an optimal conditional range to be used in herd management which combines high milk yield with acceptable fertility traits and general health. For this purpose, backfat thickness was measured by ultrasound at 46111 dairy cows on 78 different farms and was subsequently related to production variables. Negative energy balance is getting more intense and prolonged with increasing milk yield. However a conditional nadir below 10 mm leads to decreased milk production. To reach a high production level without an increasing incidence of health disorders, conditional nadir should not decline below 13 mm backfat thickness on herd average. Lower value only lead to negligibly higher milk yield but cause a distinctively higher risk of fertility problems and culling. High herd yields do not have to be at expense of reproduction performance and can be achieved without extreme body condition losses. An efficient herd management can offset depression in fertility, which commonly is combined with increasing milk yield. A standard curve for backfat thickness throughout lactation is suggested to be used in dairy herd management.

  4. Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries.

    Science.gov (United States)

    Shmueli, Amir; Israeli, Avi

    2013-02-20

    Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted). We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

  5. Potential Roles of Mhealth for Community Health Workers: Formative Research With End Users in Uganda and Mozambique.

    Science.gov (United States)

    Thondoo, Meelan; Strachan, Daniel Ll; Nakirunda, Maureen; Ndima, Sozinho; Muiambo, Abel; Källander, Karin; Hill, Zelee

    2015-07-23

    Community health workers are reemerging as an essential component of health systems in low-income countries. However, there are concerns that unless they are adequately supported, their motivation and performance will be suboptimal. mHealth presents an opportunity to improve support for community health workers; however, most interventions to date have been designed through a top-down approach, rarely involve the end user, and have not focused on motivation. To use formative research to explore the views of community health workers in Uganda and Mozambique on the potential role of mHealth in their work delivering integrated community case management of children. We conducted 24 in-depth interviews and 5 focus group discussions with community health workers in Uganda and Mozambique. Data were collected on: current phone use, preferred phone and charger characteristics, and perceptions of a range of potential mHealth interventions. Interviews were conducted in the local language, were audio recorded and converted into expanded notes. Interviews were coded for key thematic areas using both deductive and inductive codes. Deductive codes included mHealth's potential impact on motivation and performance. The most salient roles of mHealth in improving performance and motivation were reducing the need for travel, improving efficiency and planning, receiving feedback and information, and improving communication with supervisors and other community health workers. This was mostly through improved voice and short message service (SMS) text communication. Specific components of mHealth interventions that participants felt could improve motivation included increasing their visibility and credibility through branding of phones; providing an SMS response to data submission; and sending SMS messages about the importance of their work and achievements, rather than just reminders or technical messages. Participants identified feasibility issues related to the language of SMS

  6. Alternative definition of electronic equilibrium: from the analysis of Spencer deduction of the Bragg-Gray cavity theory

    International Nuclear Information System (INIS)

    Moranchel y Rodriguez, M.; Alvarez R, J.T.

    2007-01-01

    The definition of the spectral fluence of the electrons used in the Spencer deduction for the Bragg-Gray cavity theory (BG) it assumes the additional condition of electronic equilibrium (EE). Such condition leaves to that the absorbed doses ratio of the means regarding that of the cavity is expressed in function of the total mass stopping power of the means. In this work it is shown that, more that the total mass stopping power should be in function of the collisional mass stopping power of the means, in accordance with the assumed EE condition. As consequence, an expression is obtained for this absorbed dose ratio that it depends exclusively on the collisional mass stopping powers of both means, being a more representative expression of the physical phenomena that happen. Also, an expression for the primary electrons spectral fluence is obtained reflecting thoroughly the physical processes that will give origin to the absorbed dose in the means. Finally, an additional condition for the existence of the EE in function of the fraction of the energy lost by the electrons in the stopping radiation. (Author)

  7. Violence Prevention after Columbine: A Survey of High School Mental Health Professionals

    Science.gov (United States)

    Crepeau-Hobson, M. Franci; Filaccio, Marylynne; Gottfried, Linda

    2005-01-01

    The authors examined changes in mental health services and violence prevention strategies in public high schools since the shootings at Columbine High School. Surveys were mailed to school mental health professionals at public high schools in Colorado. Respondents included school counselors, school psychologists, school social workers, principals,…

  8. Wage theft as a neglected public health problem: an overview and case study from San Francisco's Chinatown District.

    Science.gov (United States)

    Minkler, Meredith; Salvatore, Alicia L; Chang, Charlotte; Gaydos, Megan; Liu, Shaw San; Lee, Pam Tau; Tom, Alex; Bhatia, Rajiv; Krause, Niklas

    2014-06-01

    Wage theft, or nonpayment of wages to which workers are legally entitled, is a major contributor to low income, which in turn has adverse health effects. We describe a participatory research study of wage theft among immigrant Chinatown restaurant workers. We conducted surveys of 433 workers, and developed and used a health department observational tool in 106 restaurants. Close to 60% of workers reported 1 or more forms of wage theft (e.g., receiving less than minimum wage [50%], no overtime pay [> 65%], and pay deductions when sick [42%]). Almost two thirds of restaurants lacked required minimum wage law signage. We discuss the dissemination and use of findings to help secure and enforce a wage theft ordinance, along with implications for practice.

  9. The 'global health' education framework: a conceptual guide for monitoring, evaluation and practice

    Science.gov (United States)

    2011-01-01

    Background In the past decades, the increasing importance of and rapid changes in the global health arena have provoked discussions on the implications for the education of health professionals. In the case of Germany, it remains yet unclear whether international or global aspects are sufficiently addressed within medical education. Evaluation challenges exist in Germany and elsewhere due to a lack of conceptual guides to develop, evaluate or assess education in this field. Objective To propose a framework conceptualising 'global health' education (GHE) in practice, to guide the evaluation and monitoring of educational interventions and reforms through a set of key indicators that characterise GHE. Methods Literature review; deduction. Results and Conclusion Currently, 'new' health challenges and educational needs as a result of the globalisation process are discussed and linked to the evolving term 'global health'. The lack of a common definition of this term complicates attempts to analyse global health in the field of education. The proposed GHE framework addresses these problems and presents a set of key characteristics of education in this field. The framework builds on the models of 'social determinants of health' and 'globalisation and health' and is oriented towards 'health for all' and 'health equity'. It provides an action-oriented construct for a bottom-up engagement with global health by the health workforce. Ten indicators are deduced for use in monitoring and evaluation. PMID:21501519

  10. Men: good health and high mortality. Sex differences in health and aging

    DEFF Research Database (Denmark)

    Oksuzyan, Anna; Juel, Knud; Vaupel, James W

    2008-01-01

    with women: the so-called male-female health-survival paradox. A number of proposed explanations for this paradox are rooted in biological, social, and psychological interpretations. It is likely to be due to multiple causes that include fundamental biological differences between the sexes such as genetic...... factors, immune system responses, hormones, and disease patterns. Behavioral differences such as risk-taking and reluctance to seek and comply with medical treatment may also play a role. Another consideration is that part of the difference may be due to methodological challenges, such as selective non......-participation and under-reporting of health problems, and delayed seeking of treatment by men. The Nordic countries provide a unique opportunity for such studies, as they have good-quality data in their national health registers, which cover the whole population, and a long tradition of high participation rates...

  11. How Can Health Information Technologies Contribute to Improve Health Care Services for High-Need Patients?

    Science.gov (United States)

    Nøhr, Christian; Botin, Lars; Zhu, Xinxin

    2017-01-01

    This paper discusses how health information technologies like tele-care, tele-health and tele-medicine can improve the condition for high-need patients, specifically in relation to access. The paper addresses specifically the values of timeliness and equity and how tele technological solutions can support and enhance these values. The paper introduces to the concept of scaffolding, which constitutes the framework for dynamic, appropriate, caring and embracing approaches for engaging and involving high-need patients that are vulnerable and exposed. A number of specific considerations for designing tele-technologies for high-need patients are derived, and the paper concludes that ethical and epistemological criterions for design are needed in order to meet the needs and requirements of the weak and exposed.

  12. Quantified safety objectives in high technology: Meaning and demonstration

    International Nuclear Information System (INIS)

    Vinck, W.F.; Gilby, E.; Chicken, J.

    1986-01-01

    An overview and trends-analysis is given of the types of quantified criteria and objectives which are presently applied or envisaged and discussed in Europe in the nuclear application, more specifically Nuclear Power Plants (NPPs), and in non-nuclear applications, more specifically in the chemical and petrochemical process industry. Some comparative deductions are made. Attention is paid to the similarities or discrepancies between such criteria and objectives and to problems associated with the demonstration that they are implemented. The role of cost-effectiveness of Risk deduction is briefly discussed and mention made of a search made into combining the technical, economic and socio-political factors playing a role in Risk acceptance

  13. Tax incentives as a solution to the uninsured: evidence from the self-employed.

    Science.gov (United States)

    Gumus, Gulcin; Regan, Tracy L

    2013-11-01

    Between 1996 and 2003, a series of amendments were made to the Tax Reform Act of 1986 that gradually increased the tax deduction for health insurance purchases by the self-employed (SE) from 25 to 100 percent. We study how these changes have influenced the likelihood that a SE person has health insurance coverage as the policyholder. The Current Population Survey is used to construct a data set corresponding to 1995-2005. Both the difference-in-differences and price elasticity of demand estimates suggest that the series of tax deductions did not provide sufficient incentives for the SE to obtain health insurance coverage. © The Author(s) 2014.

  14. The Eye of the Beholder: A Discussion of Value and Quality From the Perspective of Families of Children and Youth With Special Health Care Needs.

    Science.gov (United States)

    Anderson, Betsy; Beckett, Julie; Wells, Nora; Comeau, Meg

    2017-05-01

    There is broad agreement that increasing the cost-effectiveness and quality of health care services, thereby achieving greater value, is imperative given this country's current spiraling costs and poor health outcomes. However, how individuals or stakeholder groups define value may differ significantly. Discussion of value in the context of health care, in particular value-based purchasing and value-based insurance design, must acknowledge that there is no universal consensus definition as to what constitutes value. To date, the consumer perspective has been underrepresented in discussions of value-based strategies such as pay for performance, capitated and bundled payments, and high-deductible health plans, which have been driven primarily by payers and providers. This article will discuss 3 elements of value from the perspective of families of children and youth with special health care needs: the role of families in the delivery of care, consumer perspectives on what constitutes quality for children and youth with special health care needs, and health care and health care financing literacy, decision-making, and costs. The undervalued contributions made by family members in the delivery and oversight of pediatric care and the importance of partnering with them to achieve the goals of the Triple Aim are stressed. The article closes with a discussion of recommendations for a future policy and research agenda related to advancing the integration of the consumer perspective into value-based purchasing and value-based insurance design. Copyright © 2017 by the American Academy of Pediatrics.

  15. Wage Theft as a Neglected Public Health Problem: An Overview and Case Study From San Francisco’s Chinatown District

    Science.gov (United States)

    Salvatore, Alicia L.; Chang, Charlotte; Gaydos, Megan; Liu, Shaw San; Lee, Pam Tau; Tom, Alex; Bhatia, Rajiv; Krause, Niklas

    2014-01-01

    Wage theft, or nonpayment of wages to which workers are legally entitled, is a major contributor to low income, which in turn has adverse health effects. We describe a participatory research study of wage theft among immigrant Chinatown restaurant workers. We conducted surveys of 433 workers, and developed and used a health department observational tool in 106 restaurants. Close to 60% of workers reported 1 or more forms of wage theft (e.g., receiving less than minimum wage [50%], no overtime pay [> 65%], and pay deductions when sick [42%]). Almost two thirds of restaurants lacked required minimum wage law signage. We discuss the dissemination and use of findings to help secure and enforce a wage theft ordinance, along with implications for practice. PMID:24825200

  16. Health effects in residents of regions with high background radiation

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Possible health problems created by high natural levels of background radiation are hard to detect, partly because the health problems involved would exist to some degree irrespective of radiation exposure, partly because other factors affect the incidence of such problems, and partly because the differences between normal background radiation levels and radiation levels found in most high-radiation areas are not extreme. Nevertheless, the need to know about such health effects is evident, and so various studies conducted over the past 30 years have sought to determine whether those effects exist and what they are. Overall, however, the fragmentary and uncertain nature of many of these findings makes it hard to draw firm conclusions about the health risks involved or the desirability of countermeasures. So despite considerable efforts and some progress over the past three decades, the need for a clear quantitative assessment of the consequences is as great as ever

  17. 45 CFR 148.124 - Certification and disclosure of coverage.

    Science.gov (United States)

    2010-10-01

    ... method of counting creditable coverage, and the requesting entity may identify specific information that... a payroll deduction for health coverage, a health insurance identification card, a certificate of...

  18. Adverse health effects of high-effort/low-reward conditions.

    Science.gov (United States)

    Siegrist, J

    1996-01-01

    In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.

  19. The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population.

    Science.gov (United States)

    Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo

    2013-05-01

    Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving of future prospective research studies to

  20. Internal procedures, Trojan horses, and the right to deduct input VAT. Remarks concerning the judgment of the Supreme Administrative Court of 25 July 2017 (I FSK 1798/15

    Directory of Open Access Journals (Sweden)

    Krzysztof Lasiński-Sulecki

    2018-03-01

    Full Text Available According to the Supreme Administrative Court, Art. 86(1, Art. 88(3a and Art. 99(12 of the Goods and Services Tax Act are to be interpreted as meaning that the introduction by the taxpayer of procedures for verifying suppliers and recipients of goods or services does not constitute good faith and, consequently, does not allow the right to deduct input tax on the basis of invoices which do not reflect actual economic events, if those procedures have not been followed in a transaction with a particular supplier or recipient.

  1. Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

    Science.gov (United States)

    Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

    2018-01-01

    Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating

  2. Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

    Directory of Open Access Journals (Sweden)

    R Scott Braithwaite

    2010-02-01

    Full Text Available BACKGROUND: Evidence suggests that cost sharing (i.e.,copayments and deductibles decreases health expenditures but also reduces essential care. Value-based insurance design (VBID has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. METHODS AND FINDINGS: We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1 applying VBID solely to pharmacy benefits and (2 applying VBID to both pharmacy benefits and other health care services (e.g., devices. We assumed that cost sharing would be eliminated for high-value services ($300,000 per life-year. All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80% of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase. CONCLUSION: Broader diffusion of VBID may amplify benefits from

  3. Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

    Science.gov (United States)

    Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

    2010-02-16

    Evidence suggests that cost sharing (i.e.,copayments and deductibles) decreases health expenditures but also reduces essential care. Value-based insurance design (VBID) has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1) applying VBID solely to pharmacy benefits and (2) applying VBID to both pharmacy benefits and other health care services (e.g., devices). We assumed that cost sharing would be eliminated for high-value services (value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-value services (>$300,000 per life-year). All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80%) of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase

  4. Increased Patient Cost-Sharing, Weak US Economy, and Poor Health Habits: Implications for Employers and Insurers.

    Science.gov (United States)

    Haren, Melinda C; McConnell, Kirk; Shinn, Arthur F

    2009-04-01

    Many healthcare stakeholders, including insurers and employers, agree that growth in healthcare costs is inevitable. But the current trend toward further cost-shifting to employees and other health plan members is unsustainable. In 2008, the Zitter Group conducted a large national study on the relationship between insurers and employers, to understand how these 2 healthcare stakeholders interact in the creation of health benefit design. The survey results were previously summarized and discussed in the February/March 2009 issue of this journal. The present article aims to assess the implications of those results in the context of the growing tendency to increase patient cost-sharing, a weak US economy, and poor health habits. Increasing cost-sharing is a blunt instrument: although it may reduce utilization of frivolous services, it may also result in individuals forgoing medically necessary care. Increases in deductibles will lead to an overall decrease in optimal care-seeking behavior as families juggle healthcare costs with a weak economy and stagnating wages.

  5. How to Prevent High Blood Pressure: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Understanding Blood Pressure Readings (American Heart Association) Weightlifting: Bad for Your Blood Pressure? (Mayo Foundation for ... High Blood Pressure High Blood Pressure in Pregnancy Nutrition Quitting Smoking Stress National Institutes of Health The ...

  6. Adjusting health expenditure for military spending and interest payment: Israel and the OECD countries

    Directory of Open Access Journals (Sweden)

    Shmueli Amir

    2013-02-01

    Full Text Available Abstract Background Compared to OECD countries, Israel has a remarkably low percentage of GDP and of government expenditure spent on health, which are not reflected in worse national outcomes. Israel is also characterized by a relatively high share of GDP spent on security expenses and payment of public debt. Objectives To determine to what extent differences between Israel and the OECD countries in security expenses and payment of the public debt might account for the gaps in the percentage of GDP and of government expenditures spent on health. Methods We compare the percentages of GDP and of government expenditures spent on health in the OECD countries with the respective percentages when using primary civilian GDP and government expenditures (i.e., when security expenses and interest payment are deducted. We compared Israel with the OECD average and examined the ranking of the OECD countries under the two measures over time. Results While as a percentage of GDP, the national expenditure on health in Israel was well below the average of the OECD countries, as a percentage of primary civilian GDP it was above the average until 2003 and below the average thereafter. When the OECD countries were ranked according to decreasing percent of GDP and of government expenditure spent on health, adjusting for security and debt payment expenditures changed the Israeli rank from 23rd to 17th and from 27th to 25th, respectively. Conclusions Adjusting for security expenditures and interest payment, Israel's low spending on health as a percentage of GDP and as a percentage of government's spending increases and is closer to the OECD average. Further analysis should explore the effect of additional population and macroeconomic differences on the remaining gaps.

  7. [Relationship between four components of assertiveness and mental health among high school students].

    Science.gov (United States)

    Watanabe, Asami

    2009-04-01

    This study examines the relationship between four components of assertiveness ("open expression", "control of emotion", "consideration for others" and "self-direction") and mental health. In Study 1, the analysis of interviews with thirteen high school students suggested that some components did not have a positive relationship with mental health. In Study 2, 176 high school students completed a questionnaire which included the UCLA isolation scale, the General Health Questionnaire (GHQ) and a scale to measure the four components of assertiveness. The results showed that an excessively high score for "consideration for others" was associated with mental unhealthiness. This component probably has an optimum level to maintain mental health.

  8. High Intensity Interval Training for Maximizing Health Outcomes.

    Science.gov (United States)

    Karlsen, Trine; Aamot, Inger-Lise; Haykowsky, Mark; Rognmo, Øivind

    Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT. Copyright © 2017. Published by Elsevier Inc.

  9. Advancing organizational health literacy in health care organizations serving high-needs populations: a case study.

    Science.gov (United States)

    Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri

    2012-01-01

    Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.

  10. Optimizing diabetes management: managed care strategies.

    Science.gov (United States)

    Tzeel, E Albert

    2013-06-01

    Both the prevalence of type 2 diabetes mellitus (DM) and its associated costs have been rising over time and are projected to continue to escalate. Therefore, type 2 DM (T2DM) management costs represent a potentially untenable strain on the healthcare system unless substantial, systemic changes are made. Managed care organizations (MCOs) are uniquely positioned to attempt to make the changes necessary to reduce the burdens associated with T2DM by developing policies that align with evidence-based DM management guidelines and other resources. For example, MCOs can encourage members to implement healthy lifestyle choices, which have been shown to reduce DM-associated mortality and delay comorbidities. In addition, MCOs are exploring the strengths and weaknesses of several different benefit plan designs. Value-based insurance designs, sometimes referred to as value-based benefit designs, use both direct and indirect data to invest in incentives that change behaviors through health information technologies, communications, and services to improve health, productivity, quality, and financial trends. Provider incentive programs, sometimes referred to as "pay for performance," represent a payment/delivery paradigm that places emphasis on rewarding value instead of volume to align financial incentives and quality of care. Accountable care organizations emphasize an alignment between reimbursement and implementation of best practices through the use of disease management and/ or clinical pathways and health information technologies. Consumer-directed health plans, or high-deductible health plans, combine lower premiums with high annual deductibles to encourage members to seek better value for health expenditures. Studies conducted to date on these different designs have produced mixed results.

  11. Enlightenment and measurement - a way to improve health among high school students

    DEFF Research Database (Denmark)

    Greve, Jane; Andersen, Lars Bo

    2012-01-01

    Abstract This paper examines the effect of participating in a web-based health programme that promotes personal tracking of high school students' own measurements of a number of health-related parameters. Danish cross-sectional survey data were used to examine the effects of the health programme...... feeling of wellbeing among students, especially those with high BMI levels and poor aerobic fitness. As the schools participated in the health programme on voluntary basis and at a financial cost to themselves, the positive effects of participation found can only be stated to be valid among students from...... on various health measures. Both quantile regression models and standard ordinary least squares (OLS) models were used to explore the correlations between the students' participation in the health programme and their body mass index (BMI), body fat percentage, aerobic fitness, and well-being. Participation...

  12. Public Health Education: Teaching Epidemiology in High School Classrooms.

    Science.gov (United States)

    D'Agostino, Emily

    2018-03-01

    Epidemiology instruction has expanded at the undergraduate level in part because it increases student critical thinking and scientific literacy, promotes students' perception of public health as both practical and relevant, and empowers students as independent, lifelong learners. Why then are more high schools not adopting epidemiology as a course requirement for students? Although prior iterations of high school epidemiology courses are noteworthy for incorporating active and participatory learning, embedding them into existing and continually shifting curricula is challenging and time-consuming, especially for teachers not trained in the field. It also may be argued that currently available epidemiology teaching resources emphasize content rather than thinking skills and therefore do not optimally promote students' personal engagement with, and in-depth understanding of, the mission and goals of public health. I propose a new framework for high school epidemiology that draws from progressive education ideology, including three critical elements: empowerment, authenticity, and transfer. I provide multiple examples to show how this framework has been used across a wide array of settings to hone epidemiology thinking skills in high school students.

  13. Characterising the extent of misreporting of high blood pressure, high cholesterol, and diabetes using the Australian Health Survey.

    Science.gov (United States)

    Peterson, Karen Louise; Jacobs, Jane Philippa; Allender, Steven; Alston, Laura Veronica; Nichols, Melanie

    2016-08-02

    Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD) in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD. This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011-12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor. Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn't report a diagnosis), 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes. Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain groups and implications for patients who may be unaware of their

  14. Characterising the extent of misreporting of high blood pressure, high cholesterol, and diabetes using the Australian Health Survey

    Directory of Open Access Journals (Sweden)

    Karen Louise Peterson

    2016-08-01

    Full Text Available Abstract Background Measuring and monitoring the true prevalence of risk factors for chronic conditions is essential for evidence-based policy and health service planning. Understanding the prevalence of risk factors for cardiovascular disease (CVD in Australia relies heavily on self-report measures from surveys, such as the triennial National Health Survey. However, international evidence suggests that self-reported data may substantially underestimate actual risk factor prevalence. This study sought to characterise the extent of misreporting in a large, nationally-representative health survey that included objective measures of clinical risk factors for CVD. Methods This study employed a cross-sectional analysis of 7269 adults aged 18 years and over who provided fasting blood samples as part of the 2011–12 Australian Health Survey. Self-reported prevalence of high blood pressure, high cholesterol and diabetes was compared to measured prevalence, and univariate and multivariate logistic regression analyses identified socio-demographic characteristics associated with underreporting for each risk factor. Results Approximately 16 % of the total sample underreported high blood pressure (measured to be at high risk but didn’t report a diagnosis, 33 % underreported high cholesterol, and 1.3 % underreported diabetes. Among those measured to be at high risk, 68 % did not report a diagnosis for high blood pressure, nor did 89 % of people with high cholesterol and 29 % of people with high fasting plasma glucose. Younger age was associated with underreporting high blood pressure and high cholesterol, while lower area-level disadvantage and higher income were associated with underreporting diabetes. Conclusions Underreporting has important implications for CVD risk factor surveillance, policy planning and decisions, and clinical best-practice guidelines. This analysis highlights concerns about the reach of primary prevention efforts in certain

  15. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.

    Science.gov (United States)

    Maritz, Roxanne; Aronsky, Dominik; Prodinger, Birgit

    2017-09-20

    The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline ® , CINAHL ® , Scopus ® , and ProQuest ® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.

  16. Scientific Approach for Optimising Performance, Health and Safety in High-Altitude Observatories

    Science.gov (United States)

    Böcker, Michael; Vogy, Joachim; Nolle-Gösser, Tanja

    2008-09-01

    The ESO coordinated study “Optimising Performance, Health and Safety in High-Altitude Observatories” is based on a psychological approach using a questionnaire for data collection and assessment of high-altitude effects. During 2007 and 2008, data from 28 staff and visitors involved in APEX and ALMA were collected and analysed and the first results of the study are summarised. While there is a lot of information about biomedical changes at high altitude, relatively few studies have focussed on psychological changes, for example with respect to performance of mental tasks, safety consciousness and emotions. Both, biomedical and psychological changes are relevant factors in occupational safety and health. The results of the questionnaire on safety, health and performance issues demonstrate that the working conditions at high altitude are less detrimental than expected.

  17. An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.

    Science.gov (United States)

    Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas

    2016-03-11

    To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland. Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey. Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'Alcohol & Drug Helpline' (4%); 'ambulance' (3%); 'A&E' (3%); and hospitalisation (3%). Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.

  18. Heterogeneity of Mental Health Service Utilization and High Mental Health Service Use Among Women Eight Years After Initiating Substance Use Disorder Treatment.

    Science.gov (United States)

    Evans, Elizabeth; Padwa, Howard; Li, Libo; Lin, Veronique; Hser, Yih-Ing

    2015-12-01

    The aim of this study was to determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. Data were provided by 4447 women treated for SUD in California during 2000-2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women's high use of services (>6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (8.7%), increased immediately following SUD treatment and then decreased (9.3%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, pwomen with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. Mental health services utilization patterns among women treated for SUD are heterogeneous and dynamic. Understanding factors related to women's utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Who pays for health care in Ghana?

    Directory of Open Access Journals (Sweden)

    McIntyre Diane

    2011-06-01

    Full Text Available Abstract Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33, which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI levy (part of VAT is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and

  20. Who pays for health care in Ghana?

    Science.gov (United States)

    Akazili, James; Gyapong, John; McIntyre, Diane

    2011-06-27

    Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National

  1. Major health service transformation and the public voice: conflict, challenge or complicity?

    Science.gov (United States)

    Martin, Graham P; Carter, Pam; Dent, Mike

    2018-01-01

    Objectives Calls for major reconfigurations of health services have been accompanied by recommendations that wide ranging stakeholders be involved. In particular, patients and the wider public are seen as critical contributors as both funders and beneficiaries of public health care. But public involvement is fraught with challenges, and little research has focused on involvement in the health service transformation initiatives. This paper examines the design and function of public involvement in reconfiguration of health services within the English NHS. Methods Qualitative data including interviews, observation and documents were collected in two health service 'transformation' programmes; interviews include involved public and professional participants. Data were analysed using parallel deductive and inductive approaches. Results Public involvement in the programmes was extensive but its terms of reference, and the individuals involved, were restricted by policy pressures and programme objectives. The degree to which participants descriptively or substantively represented the wider public was limited; participants sought to 'speak for' this public but their views on what was 'acceptable' and likely to influence decision-making led them to constrain their contributions. Conclusions Public involvement in two major service reconfiguration programmes in England was seen as important and functional, and could not be characterized as tokenistic. Yet involvement in these programmes fell short of normative ideals, and could inadvertently reduce, rather than enlarge, public influence on health service reconfiguration decisions.

  2. Use of the Management Oversight and Risk Tree (MORT) methodology in health-physics program appraisals

    International Nuclear Information System (INIS)

    Essig, T.H.; Gilchrist, R.L.

    1981-06-01

    In January 1980, Pacific Northwest Laboratory (PNL) assumed a major role in helping the Nuclear Regulatory Commission (NRC) conduct comprehensive health physics appraisals at 47 operating nuclear power plants. These appraisals required the development of an analytical technique that permitted a deductive analysis of a health-physics program on an element-by-element basis. The technique employed was a modification of the Management Oversight and risk Tree (MORT) analytical logic methodology used in probabilistic assessments. This paper includes the method used in establishing the appraisal guidelines and assigning the proper level of importance within the analytical tree structure. The system for ensuring the proper subdivision necessary for an adequate assessment of each area (e.g., exposure controls and radioactive waste management) will also be discussed. In addition to these major subjects, the generation of specific review questions that correspond to the analytical trees is addressed

  3. High-Protein Diets and Renal Health

    DEFF Research Database (Denmark)

    Marckmann, Peter; Osther, Palle; Pedersen, Agnes N.

    2015-01-01

    High-protein diets (i.e., protein content of more than 25% of energy or more than 2 g/kg body weight per day) based on meat and dairy products are repeatedly promoted for weight reduction and better health, but the evidence supporting these notions is quite dubious. As described in the present...... in the prevalence of chronic kidney disease in the general population without preexisting kidney disease. Accordingly, we find medical reasons to refrain from promoting high-protein diets, in particular those based on meat and dairy products, until clear-cut evidence for the safety and for the superiority...... review, there is a reason to be concerned about adverse effects of such diets, including glomerular hyperfiltration, hypertensive effects of a concomitant increase in dietary sodium, and an increased risk of nephrolithiasis. These diet-induced physiological consequences might lead to an increase...

  4. Facebook Addiction and Its Relationship with Mental Health among Thai High School Students.

    Science.gov (United States)

    Hanprathet, Nitt; Manwong, Mereerat; Khumsri, Jiraporn; Yingyeun, Rungmanee; Phanasathit, Muthita

    2015-04-01

    To investigate the relationship between Facebook addiction and mental health among high school students. This cross-sectional analytic study was performed among 972 high school students from four provinces associated with high economic prosperity in Thailand: Bangkok, ChiangMai, Ubon Ratchathani and Songkhla, utilizing a multistage cluster sampling technique. Facebook addiction was assessed using the Thai version of the Bergen-Facebook Addiction Scale (Thai-BFAS), while a Thai version ofthe General Health Questionnaire (Thai GHQ-28) was used for mental health evaluation. The relationship between Facebook addiction and mental health was analyzed through multiple logistic regressions. The prevalence of Facebook addiction and abnormal mental health were 41.9% (95% CI; 38.6, 45.2), and 21.9% (95% CI; 19.2, 24.8), respectively. After adjustment for confounding factors (sufficiency of household income, school location, level of education, GPAX learning deficits and attention deficit hyperactivity disorder), the individuals identified as having Facebook addiction were discovered to be at a high risk of developing abnormal general mental health (ORadj = 1.7, 95% CI: 1.1, 2.4), somatic symptoms (OR = 1.2, 95% CI: 0.9, 1.7), anxiety and insomnia (ORadj = 1.3, 95% CI: 0.9, 1.8), social dysfunction (OR = 1.5, 95% CI: 1.1, 2.1) and severe depression (ORadj = 1.5, 95% CI: 1.0, 2.2). Moreover; there were pronounced trends of increasing risk according to the level of Facebook addiction (Ptrend students could be associated with abnormal, general mental health status, somatic symptoms, anxiety & insomnia, social dysfunction, and severe depression. Therefore, it is essential that the relevant authorities educate young people about the mental health impacts linked with Facebook addictive usage and impose appropriate public health policies by screening Facebook addiction and mental health issues in risk groups.

  5. [Survey regarding mental health conditions of high school students and attitudes of students and their teachers toward students' mental health issues].

    Science.gov (United States)

    Hattori, Isao; Fujii, Chiyo; Fukuzawa, Ayako

    2013-01-01

    We administered a self-reporting questionnaire survey regarding the mental health conditions of high school students and attitudes of students and their teachers toward students' mental health issues. In addition, we discussed the requirements for high school students' mental health support system. The subjects were 3,312 students and 208 teachers in four Shizuoka prefectural public high schools in 2009. University Personality Inventory (UPI) is usually conducted to assess university students' mental state and is a questionnaire that high school students can answer easily. Therefore, we adopted UPI for this survey. UPI was composed of 56 unhealthy and 4 healthy condition items. High school students completed the UPI and determined the sum of unhealthy condition items; a higher score indicated a poorer mental health status. The average UPI score of all students (n = 3,312) was 12.7 points, and that of females (n = 1,217)was 15.2 points, which was significantly higher than the 11.3 points of males (n = 2,095). Those with scores > or = 30 points (7.5%), which was more than half of the maximum score, were designated as the High Score (HS) group and considered to have poor mental health. Those with scores of > or = 40 (1.4%) seemed to have very poor mental health, and there was concern that they may be suffering from psychosis. Our observations indicated that HS students were likely to avoid seeking help regarding mental health issues, which was especially true for male HS students. The majority of students chose their friends and parents as advisers, but HS students were significantly more likely to choose advisers who were engaged in jobs related to medical work. Students in both the HS and non-HS groups who did not wish to consult anyone else about their mental conditions wanted to be approached by those around them. High school teachers hesitated to intervene with mentally disturbed students and attempted to resolve problems within the school. Thus, it appears

  6. Mind the public health leadership gap: the opportunities and challenges of engaging high-profile individuals in the public health agenda.

    Science.gov (United States)

    Shickle, Darren; Day, Matthew; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

    2014-12-01

    Public health leadership has been criticized as being ineffective. The public health profession is relatively small. Critics have argued that there is over-emphasis on technical aspects and insufficient use of the 'community as a source of public health actions'. The paper analyses the resources, motivations and skills utilized by high-profile individuals who have made contributions to the public health agenda. The phenomenon of celebrity diplomacy is critiqued. Two exemplars are discussed: Jamie Oliver and Michael Bloomberg. The risks of involving celebrities are also considered. Leaders for public health demonstrate 'a paradoxical blend of personal humility and professional will' to make the 'right decisions happen'. While they may have ego or self-interest, in this context, at least, they channel their ambition for the public health cause, not themselves. Leaders from outside public health may have no understanding of what public health is nor consider their work as part of a wider public health agenda. It is important to understand why they become leaders for public health. This will inform a strategy for how others may be encouraged to collaborate for public health causes. Some key points for working with high-profile leaders for public health are identified. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

    Science.gov (United States)

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-06-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

  8. Association of Wage With Employee Participation in Health Assessments and Biometric Screening.

    Science.gov (United States)

    Sherman, Bruce W; Addy, Carol

    2018-02-01

    To understand differences in health risk assessment (HRA) and biometric screening participation rates among benefits-enrolled employees in association with wage category. Cross-sectional analysis of employee eligibility file and health benefits (wellness and claims) data. Data from self-insured employers participating in the RightOpt private exchange (Conduent HR Services) during 2014. Active employees from 4 companies continuously enrolled in health insurance for which wage data were available. Measures included HRA and biometric screening participation rates and wage status, with employee age, sex, employer, job tenure, household income, geographic location, and health benefits deductible as a percentage of total wages serving as covariates. Employees were separated into 5 groups based on wage status. Logistic regression analysis incorporated other measures as covariates to adjust for differences between groups, with HRA and biometric screening participation rates determined as binary outcomes. Participation rates for HRA and biometric screening were 90% and 87%, respectively, in the highest wage category, decreasing to 67% and 60%, respectively, among the lowest wage category. Employee wage status is associated with significant differences in HRA and biometric participation rates. Generalizing the results generated by modest participation in these offerings to entire populations may risk misinterpretation of results based on variable participation rates across wage categories.

  9. Mental health first aid training for high school teachers: a cluster randomized trial.

    Science.gov (United States)

    Jorm, Anthony F; Kitchener, Betty A; Sawyer, Michael G; Scales, Helen; Cvetkovski, Stefan

    2010-06-24

    Mental disorders often have their first onset during adolescence. For this reason, high school teachers are in a good position to provide initial assistance to students who are developing mental health problems. To improve the skills of teachers in this area, a Mental Health First Aid training course was modified to be suitable for high school teachers and evaluated in a cluster randomized trial. The trial was carried out with teachers in South Australian high schools. Teachers at 7 schools received training and those at another 7 were wait-listed for future training. The effects of the training on teachers were evaluated using questionnaires pre- and post-training and at 6 months follow-up. The questionnaires assessed mental health knowledge, stigmatizing attitudes, confidence in providing help to others, help actually provided, school policy and procedures, and teacher mental health. The indirect effects on students were evaluated using questionnaires at pre-training and at follow-up which assessed any mental health help and information received from school staff, and also the mental health of the student. The training increased teachers' knowledge, changed beliefs about treatment to be more like those of mental health professionals, reduced some aspects of stigma, and increased confidence in providing help to students and colleagues. There was an indirect effect on students, who reported receiving more mental health information from school staff. Most of the changes found were sustained 6 months after training. However, no effects were found on teachers' individual support towards students with mental health problems or on student mental health. Mental Health First Aid training has positive effects on teachers' mental health knowledge, attitudes, confidence and some aspects of their behaviour. ACTRN12608000561381.

  10. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.

    1984-01-01

    Although the health effects of radiation doses in occupationally exposed persons had received attention, it was not until the 1950s, when the atmospheric atom bomb tests of the United States and the Soviet Union had raised the level of environmental radioactivity, that the long-term effects of low-level radiation dosage became a matter of popular concern throughout the world. The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) was created, and the World Health Organization (WHO) appointed an expert committee to provide advice concerning radiation and human health. In its first report, the WHO expert committee identified several areas of high natural radiation where studies of the exposed population might possibly provide information concerning the effects of chromic low-level radiation dosage

  11. The effect of high and low assertiveness on locus of control and health problems.

    Science.gov (United States)

    Williams, J M; Stout, J K

    1985-03-01

    The effect of high and low assertiveness on locus of control and health problems was examined with 78 direct-service workers in mental health and mental retardation settings in northeastern Pennsylvania. The direct-service workers completed the Rathus (1973) Assertiveness Schedule, the Rotter (1966) Internal-External Locus of Control Scale, and a health-problems inventory. Highly assertive individuals were found to be more internally controlled and to experience fewer health problems than were individuals low in assertiveness.

  12. The effect of morning exercise on mental health of female police employees

    Directory of Open Access Journals (Sweden)

    Hassani Mohammad

    2015-06-01

    Full Text Available       Background & Aims of the Study: According to the report of world health, organization mental disorder is one of the important causes of disability in the world and it can result in decrease in the success and advancement of employees. Thus, the purpose of this research is evaluation and comparison of mental health status and its related factors in female employees who take part in morning exercise and who are exempt in one of the police units. This is a descriptive-analytic and cross sectional study. Materials & Methods: The population of this research included 85 female employees who took part in morning exercise as one group and the other group included 65 inactive people who were ill and exempt from exercise. The measurement tool in the research was the Goldberg and Hiller questionnaire of mental health that was consisted of 28 questions. Various studies in the world and in Iran suggest the high validity and reliability of the GHQ-28 questionnaire. The validity of the questionnaire has been approved in more than 70 countries and its reliability has been estimated to be between 82% and 92% in different researches and in different social groups. The data were analyzed using the descriptive statistics (frequency, mean and standard of deviation and deduction statistics (independent t-test in SPSS 16 software. Results: Analysis of the research hypotheses at significant level (p<0.05 showed that morning exercise had significant effect on mental health and its subscales such as physical complaint, anxiety, social dysfunction and depression in employees. Moreover, a significant difference was observed by comparing the active and inactive groups in relation to mental health and its subscales. Conclusions: The results of the research show that the effect of exercise and physical activities on mental health can't be denied. According to the researches that have been done, exercise is effective in two aspects of physical and mental.       

  13. Millennium development goal four and child health inequities in indonesia: a systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Julia Schröders

    Full Text Available Millennium Development Goal (MDG 4 calls for reducing mortality of children under-five years by two-thirds by 2015. Indonesia is on track to officially meet the MDG 4 targets by 2015 but progress has been far from universal. It has been argued that national level statistics, on which MDG 4 relies, obscure persistent health inequities within the country. Particularly inequities in child health are a major global public health challenge both for achieving MDG 4 in 2015 and beyond. This review aims to map out the situation of MDG 4 with respect to disadvantaged populations in Indonesia applying the Social Determinants of Health (SDH framework. The specific objectives are to answer: Who are the disadvantaged populations? Where do they live? And why and how is the inequitable distribution of health explained in terms of the SDH framework?We retrieved studies through a systematic review of peer-reviewed and gray literature published in 1995-2014. The PRISMA-Equity 2012 statement was adapted to guide the methods of this review. The dependent variables were MDG 4-related indicators; the independent variable "disadvantaged populations" was defined by different categories of social differentiation using PROGRESS. Included texts were analyzed following the guidelines for deductive content analysis operationalized on the basis of the SDH framework. We identified 83 studies establishing evidence on more than 40 different determinants hindering an equitable distribution of child health in Indonesia. The most prominent determinants arise from the shortcomings within the rural health care system, the repercussions of food poverty coupled with low health literacy among parents, the impact of low household decision-making power of mothers, and the consequences of high persistent use of traditional birth attendants among ethnic minorities.This review calls for enhanced understanding of the determinants and pathways that create, detain, and overcome inequities in

  14. Implementation of eMental Health care: viewpoints from key informants from organizations and agencies with eHealth mandates.

    Science.gov (United States)

    Wozney, Lori; Newton, Amanda S; Gehring, Nicole D; Bennett, Kathryn; Huguet, Anna; Hartling, Lisa; Dyson, Michele P; McGrath, Patrick

    2017-06-02

    The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care. From September to November 2015, we conducted 31 interviews with key informants responsible for leadership, policy, research, and/ or information technology in organizations influential in the adoption of technology for eMental Health care. Deductive and inductive thematic analyses of transcripts were conducted using the Behavior Change Wheel as an organizing framework. Frequency and intensity effect sizes were calculated for emerging themes to further explore patterns within the data. Key informant responses (n = 31) representing 6 developed countries and multiple organizations showed consensus on common factors impacting implementation: individual and organizational capacities (e.g., computer literacy skills [patients and providers], knowledge gaps about cyber security, limited knowledge of available services); motivational drivers of technology-based care (e.g., extending care, data analytics); and opportunities for health systems to advance eMental Health care implementation (e.g., intersectoral research, rapid testing cycles, sustainable funding). Frequency effect sizes showed strong associations between implementation and credibility, knowledge, workflow, patient empowerment, electronic medical record (EMR) integration, sustained funding and intersectoral networks. Intensity effect sizes showed the highest concentration of statements (>10% of all comments) related to funding, credibility, knowledge gaps, and patient empowerment. This study

  15. Social and material aspects of life and their impact on the physical health of people diagnosed with mental illness.

    Science.gov (United States)

    Ewart, Stephanie B; Happell, Brenda; Bocking, Julia; Platania-Phung, Chris; Stanton, Robert; Scholz, Brett

    2017-10-01

    People diagnosed with mental illness have shorter lives and poorer physical health, compared to the general population. These health inequities are usually viewed at an individual and clinical level, yet there is little research on the views of mental health consumers on clinical factors in broader contexts. To elicit the views of consumers of mental health services regarding their physical health and experiences of accessing physical health-care services. Qualitative exploratory design involving focus groups. The research was conducted in the Australian Capital Territory. Participants were consumers of mental health services. The Commission on Social Determinants of Health Framework was drawn on to lead deductive analysis of focus group interview transcripts. Issues impacting consumers included poverty, the neglect of public services and being treated as second-class citizens because of diagnosis of mental illness and/or experiencing a psychosocial disability. These factors were connected with significant barriers in accessing physical health care, including the quality and relevance of health provider communication, especially when the broader contexts of mental health consumer's lives are not well understood. These findings suggest the Commission on Social Determinants of Health Framework could be utilized in research and policy, and may provide an effective platform for exploring better health communication with mental health consumers regarding this neglected health inequity. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  16. Evaluation of health and safety impacts of defense high-level waste in geologic repositories

    International Nuclear Information System (INIS)

    Smith, E.D.; Kocher, D.C.; Witherspoon, J.P.

    1985-02-01

    Pursuant to the requirement of the Nuclear Waste Policy Act of 1982 that the President evaluate the use of commercial high-level waste repositories for the disposal of defense high-level wastes, a comparative assessment has been performed of the potential health and safety impacts of disposal of defense wastes in commercial or defense-only repositories. Simplified models were used to make quantitative estimates of both long- and short-term health and safety impacts of several options for defense high-level waste disposal. The results indicate that potential health and safety impacts are not likely to vary significantly among the different disposal options for defense wastes. Estimated long-term health and safety impacts from all defense-waste disposal options are somewhat less than those from commercial waste disposal, while short-term health and safety impacts appear to be insensitive to the differences between defense and commercial wastes. In all cases, potential health and safety impacts are small because of the need to meet stringent standards promulgated by the US Environmental Protection Agency and the US Nuclear Regulatory Commission. We conclude that health and safety impacts should not be a significant factor in the choice of a disposal option for defense high-level wastes. 20 references, 14 tables

  17. Mental health first aid training for high school teachers: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2010-06-01

    Full Text Available Abstract Background Mental disorders often have their first onset during adolescence. For this reason, high school teachers are in a good position to provide initial assistance to students who are developing mental health problems. To improve the skills of teachers in this area, a Mental Health First Aid training course was modified to be suitable for high school teachers and evaluated in a cluster randomized trial. Methods The trial was carried out with teachers in South Australian high schools. Teachers at 7 schools received training and those at another 7 were wait-listed for future training. The effects of the training on teachers were evaluated using questionnaires pre- and post-training and at 6 months follow-up. The questionnaires assessed mental health knowledge, stigmatizing attitudes, confidence in providing help to others, help actually provided, school policy and procedures, and teacher mental health. The indirect effects on students were evaluated using questionnaires at pre-training and at follow-up which assessed any mental health help and information received from school staff, and also the mental health of the student. Results The training increased teachers' knowledge, changed beliefs about treatment to be more like those of mental health professionals, reduced some aspects of stigma, and increased confidence in providing help to students and colleagues. There was an indirect effect on students, who reported receiving more mental health information from school staff. Most of the changes found were sustained 6 months after training. However, no effects were found on teachers' individual support towards students with mental health problems or on student mental health. Conclusions Mental Health First Aid training has positive effects on teachers' mental health knowledge, attitudes, confidence and some aspects of their behaviour. Trial registration ACTRN12608000561381

  18. Everyday life innovation potential: when technology has to make sense. Citizens living in high-risk areas for health, using health-promoting technologies

    DEFF Research Database (Denmark)

    Madsen, Jacob Østergaard

    2014-01-01

    ) to contribute, along with other health professionals, in dealing with the problem of inequality in health. In this study health promoting technologies for adult citizens living in high risk areas of health, is chosen as one particular area of interest for occupational therapists within the field of health...

  19. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

    Science.gov (United States)

    Topp, Stephanie M; Chipukuma, Julien M

    2016-03-01

    Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational

  20. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

    Science.gov (United States)

    Topp, Stephanie M; Chipukuma, Julien M

    2016-01-01

    Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

  1. Amortized deduction as a source of the real financing of industrial modernization

    Directory of Open Access Journals (Sweden)

    Sergey Ivanovich Tatynov

    2011-06-01

    Full Text Available In the process of creating a new concept of the financial mechanism, it is important, in our opinion, to construct a mechanism for depreciation of fixed assets of enterprises, adequate to the goals of the national economy modernization. It seems appropriate to establish a depreciation model which will allow the state to conduct depreciation policy differentiated by branches of the national economy and on specific territories. In addition, depreciation deductibles must be real, that means, they should be accumulated on the accounts and not just be tax exemptions. There are expressions of the Russian economists, that it is possible to ensure the realization of revenues depreciation on special accounts under threat of possible penalties. The solution of this problem, it seems, can be achieved through mandatory enrollment of depreciation amounts into the escrow bank accounts without withdrawing the funds before the expiration of the depreciation period of fixed assets of the owners. The yield on bank deposits in the Russian market, as a rule, does not exceed the Central Bank refinancing rate. Keeping money in the long term on such conditions is not economically feasible - a negative return on these investments is guaranteed, but if the federal government has helped to ensure a nominal rate of return of deposits to 10% (in a given period of time at the expense of its resources, then our proposal could have lost the character of economic voluntarism. If all accrued depreciation (2 348 641 million rubles will be placed on deposit accounts and the credit system of the Russian Federation will provide holders an annual yield of 10% (at the rate of inflation 8.8%, the annual subsidy amount will be 28 183.7 million rubles. In this case, the credit system receives a resource for the issuance of long-term loans. Taking into account the banking margin of 2%, the annual interest on long-term loans could amount (in terms of the current time 10-12% of annual

  2. Young Adults' Perceptions of Calcium Intake and Health: A Qualitative Study.

    Science.gov (United States)

    Marcinow, Michelle L; Randall Simpson, Janis A; Whiting, Susan J; Jung, Mary E; Buchholz, Andrea C

    2017-12-01

    Many young Canadian adults are not meeting dietary calcium recommendations. This is concerning as adequate calcium is important throughout young adulthood to maximize peak bone mass for osteoporosis prevention. There are limited studies that have explored young adults' perceptions toward calcium and health. Our objectives were to determine young adults' (18-34 years) knowledge of calcium in relation to health, facilitators and barriers to adequate calcium intake, and to explore both their suggestions for individual strategies to increase calcium intake and ways to communicate calcium-related messaging to this population. Eight gender-specific focus groups (18 men; 35 women) were conducted using a semistructured interview guide, guided by social cognitive theory. Deductive thematic analysis was used to generate themes. Participants perceived adequate calcium intake to be important for children and older adults but were uncertain of the benefits for their own age group. Perceived positive outcomes (e.g., aesthetics such as strong nails) associated with adequate calcium intake were cited as a motivator to increase intake. Perceived barriers to achieving increased calcium intake included the high cost and inconvenience of milk products and negative practices of dairy farmers. Participants suggested planning healthy well-balanced meals and forming a habit of consuming calcium-rich foods as individual strategies to increase calcium intake. Strategies to convey calcium-related information to young adults included increasing awareness of the importance of calcium via credible sources of information and developing nutrition education curricula. Social media and advertising were perceived as ineffective. Our findings provide key information for nutrition education initiatives.

  3. Severe obesity and high blood pressure among children, Philadelphia health centers, 2010.

    Science.gov (United States)

    Nguyen, John V; Robbins, Jessica M; Houck, Kevin L; Nobis, Elizabeth A; Inman, Katelyn A; Khan, Khudsiya S; Robbins, Susan W

    2014-04-01

    Child obesity is a major health problem particularly affecting disadvantaged population groups. Severe obesity carries additional health risks for children. In the context of the childhood obesity epidemic, high blood pressure among children is of increasing concern. Chart reviews were carried out to examine the prevalence of severe obesity and its association with high blood pressure measurements among randomly selected patients aged 3 to 17 years who had well-child care visits at 8 public community health centers during 2010. A majority of the 691 patients reviewed were African American (58%); an additional 16% were Hispanic. The prevalence of severe obesity was 7.7% (95% confidence interval = 5.8% to 9.9%) and the prevalence of high blood pressure measurements was 17.5% (95% confidence interval = 14.8% to 20.6%). Patients who were severely obese were more than twice as likely as other children to have high blood pressure values. Severe obesity is associated with substantially increased frequency of high blood pressure measurements in children, and should be investigated further as a potential marker for hypertension in children. Primary care providers should be prepared to diagnose and treat hypertension in severely obese children.

  4. 75 FR 77517 - National Influenza Vaccination Week, 2010

    Science.gov (United States)

    2010-12-10

    ... doctors' offices, clinics, State and local health departments, pharmacies, college and university health... private health plans have no co-payment or deductible for influenza vaccinations. While the flu can make... complications from the flu. Pregnant women, young children, older adults, as well as people living with HIV...

  5. Low- and high-anxious hypermobile Ehlers-Danlos syndrome patients: comparison of psychosocial and health variables.

    Science.gov (United States)

    Baeza-Velasco, Carolina; Bourdon, Caroline; Montalescot, Lucile; de Cazotte, Cécile; Pailhez, Guillem; Bulbena, Antonio; Hamonet, Claude

    2018-05-01

    Despite the frequent co-ocurrence of hypermobile Ehler-Danlos syndrome (hEDS) and pathological anxiety, little is known about the psychosocial and health implications of such comorbidity. Our aim was to explore the association between high levels of anxiety and psychosocial (catastrophizing, kinesiophobia, somatosensory amplification, social support and functioning), health (pain, fatigue, BMI, tobacco/alcohol use, depression, diagnosis delay, general health), and sociodemographic factors in people with hEDS. In this cross-sectional study, 80 hEDS patients were divided into two groups according to self-reported anxiety levels: low and high. Psychosocial, sociodemographic and health variables were compared between the groups. Forty-one participants reported a high level of anxiety (51.2%). No differences were found in the sociodemographic variables between high-anxious and low-anxious patients. The percentage of participants with severe fatigue and high depressive symptomatology was significantly higher in the high-anxious group (80.5 vs 56.4; 26.8 vs 12.8%, respectively). High-anxious hEDS patients also showed significantly higher levels of pain catastrophizing, somatosensory amplification as well as a poorer social functioning and general health. Multivariate analyses showed that somatosensory amplification, pain catastrophizing and poor social functioning are variables that increase the probability of belonging to the high-anxious group. Despite limitations, this first study comparing high-anxious versus low-anxious hEDS patients with respect to health aspects, highlight the importance of considering the psychosocial factors (many susceptible to modification), to improve the adjustment to this chronic condition and provide support to those affected through a biopsychosocial approach.

  6. Nurse practitioners' focus on health care in terms of cure and care: analysis of graduate theses using the International Classification of Functioning, Disability and Health.

    Science.gov (United States)

    Stallinga, Hillegonda A; Jansen, Gerard J; Kastermans, Marijke C; Pranger, Albert; Dijkstra, Pieter U; Roodbol, Petrie F

    2016-07-01

    To explore the focus of nurse practitioners on health care in terms of cure and care. Nurse practitioners are expected to act on the intersection of cure and care. However, in clinical practice and education, a clear model covering this area is lacking; therefore, it is unknown to what extent nurse practitioners are focused on this specific area. Graduate theses may reflect the focus of nurse practitioners. Sequential exploratory mixed method. In total, 413 published abstracts of graduate theses of a Dutch Master of Advanced Nursing Practice (2000-2015) were analysed using the International Classification of Functioning, Disability and Health. Data source included aim, question and outcome of each thesis and graduates' characteristics. A qualitative deductive approach was used for the analyses. Theses were classified as focused on cure, care, or on the intersection of cure and care. A small majority of 53% (N = 219) of the graduate theses addressed patient's health status and could be classified in the International Classification of Functioning, Disability and Health. Of the classified theses, 48% were focused on cure, 39% on the intersection of cure and care and 13% on care. While the percentage of theses addressing health status increased significantly over the 15-year period, the percentage of theses focused on cure, care and on the intersection of cure and care remained the same. The graduate theses reflected that nurse practitioners are increasingly oriented towards patients' health status. However, their focus is predominantly on cure rather than on the intersection of cure and care. © 2016 John Wiley & Sons Ltd.

  7. Health. Nevada Competency-Based Adult High School Diploma Project.

    Science.gov (United States)

    Nevada Univ., Las Vegas. Coll. of Education.

    This document is one of ten curriculum guides developed by the Nevada Competency-Based Adult High School Diploma (CBAHSD) Project. This curriculum guide on health is divided into ten topics. The topics included are Nutrition, Reproduction, Menstruation, Contraception, Alcohol Abuse, Tobacco, Immunization, Disease, Accident Prevention, and…

  8. Health disparities among highly vulnerable populations in the United States: a call to action for medical and oral health care

    Directory of Open Access Journals (Sweden)

    Allison A. Vanderbilt

    2013-03-01

    Full Text Available Healthcare in the United States (US is burdened with enormous healthcare disparities associated with a variety of factors including insurance status, income, and race. Highly vulnerable populations, classified as those with complex medical problems and/or social needs, are one of the fastest growing segments within the US. Over a decade ago, the US Surgeon General publically challenged the nation to realize the importance of oral health and its relationship to general health and well-being, yet oral health disparities continue to plague the US healthcare system. Interprofessional education and teamwork has been demonstrated to improve patient outcomes and provide benefits to participating health professionals. We propose the implementation of interprofessional education and teamwork as a solution to meet the increasing oral and systemic healthcare demands of highly vulnerable US populations.

  9. Framing health for land-use planning legislation: A qualitative descriptive content analysis.

    Science.gov (United States)

    Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Thow, Anne Marie

    2016-01-01

    Framing health as a relevant policy issue for other sectors is not well understood. A recent review of the New South Wales (Australia) land-use planning system resulted in the drafting of legislation with an internationally unprecedented focus on human health. We apply a political science approach to investigate the question 'how and to what extent were health and wider issues framed in submissions to the review?' We investigated a range of stakeholder submissions including health focussed agencies (n = 31), purposively identified key stakeholders with influence on the review (n = 24), and a random sample of other agencies and individuals (n = 47). Using qualitative descriptive analysis we inductively coded for the term 'health' and sub-categories. We deductively coded for 'wider concerns' using a locally endorsed 'Healthy Urban Development Checklist'. Additional inductive analysis uncovered further 'wider concerns'. Health was explicitly identified as a relevant issue for planning policy only in submissions by health-focussed agencies. This framing concerned the new planning system promoting and protecting health as well as connecting health to wider planning concerns including economic issues, transport, public open space and, to a slightly lesser extent, environmental sustainability. Key stakeholder and other agency submissions focussed on these and other wider planning concerns but did not mention health in detail. Health agency submissions did not emphasise infrastructure, density or housing as explicitly as others. Framing health as a relevant policy issue has the potential to influence legislative change governing the business of other sectors. Without submissions from health agencies arguing the importance of having health as an objective in the proposed legislation it is unlikely health considerations would have gained prominence in the draft bill. The findings have implications for health agency engagement with legislative change processes and beyond in

  10. Oral health status of women with high-risk pregnancies.

    Science.gov (United States)

    Merglova, Vlasta; Hecova, Hana; Stehlikova, Jaroslava; Chaloupka, Pavel

    2012-12-01

    The aim of this study was to investigate the oral health status of women with high-risk pregnancies. A case-control study of 142 pregnant women was conducted. The case group included 81 pregnant women with high-risk pregnancies, while 61 women with normal pregnancies served as controls. The following variables were recorded for each woman: age, general health status, DMF, CPITN, and PBI index, amounts of Streptococcus mutans in the saliva and dental treatment needs. The Mann-Whitney test, Kruskal-Wallis test, t-test and chi-squared test were used for statistical analyses. Statistically significant differences were detected between the PBI indices and dental treatment needs of the two groups. Out of the entire study cohort, 77% of the women in the case group and 52% of the women in the control group required dental treatment. In this study, women with complications during pregnancy had severe gingivitis and needed more frequent dental treatment than those in the control group.

  11. Reaching High-Need Youth Populations With Evidence-Based Sexual Health Education in California.

    Science.gov (United States)

    Campa, Mary I; Leff, Sarah Z; Tufts, Margaret

    2018-02-01

    To explore the programmatic reach and experience of high-need adolescents who received sexual health education in 3 distinct implementation settings (targeted-prevention settings, traditional schools, and alternative schools) through a statewide sexual health education program. Data are from youth surveys collected between September 2013 and December 2014 in the California Personal Responsibility Education Program. A sample of high-need participants (n = 747) provided data to examine the impact of implementation setting on reach and program experience. Implementation in targeted-prevention settings was equal to or more effective at providing a positive program experience for high-need participants. More than 5 times as many high-need participants were served in targeted-prevention settings compared with traditional schools. Reaching the same number of high-need participants served in targeted-prevention settings over 15 months would take nearly 7 years of programming in traditional schools. To maximize the reach and experience of high-need youth populations receiving sexual health education, state and local agencies should consider the importance of implementation setting. Targeted resources and efforts should be directed toward high-need young people by expanding beyond traditional school settings.

  12. Student Bedtimes, Academic Performance, and Health in a Residential High School.

    Science.gov (United States)

    Wernette, Maliah J; Emory, Jan

    2017-08-01

    Inadequate sleep among adolescents is considered an epidemic in the United States. Late night bedtimes could be an important factor in academic performance and health with consequences continuing throughout adulthood. The purpose of this study was to explore the relationships between late night bedtimes, academic performance (grade point average [GPA]), and utilization of health care (school nurse visits) in a residential high school. The data were collected from archival records for one academic semester. The statistical analysis employed the nonparametric Pearson's correlation coefficient ( r) with the standard level of significance (α = .05). Positive and inverse linear relationships were found between bedtime and school nurse visits ( p < .00001) and bedtime and GPA ( p = .007). The findings suggest students' late night bedtimes may be related to increased school nurse visits and lower academic performance. Adolescent late night bedtimes may be an important consideration for academic success and maintaining health in residential high schools.

  13. 76 FR 76573 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    Science.gov (United States)

    2011-12-07

    ... the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit... policies; (2) rules governing how ICD-10 conversion costs, fraud reduction expenses, and community benefit... turnover; (2) shorter enrollment periods; and (3) lower incurred claims due to high deductibles and limited...

  14. Health care expenditure in the Islamic Republic of Iran versus other high spending countries.

    Science.gov (United States)

    Khosravi, Bahman; Soltani, Shahin; Javan-Noughabi, Javad; Faramarzi, Ahmad

    2017-01-01

    Background: In all countries, health expenditures are a main part of government expenditure, and governments try to find policies and strategies to reduce this expenditure. Overall expenditure index has been raised 30 times during the past 20 years in Iran, while in the health sector, the growth in health expenditures index has been 71 times. The present study aimed at examining health care expenditure in the Islamic Republic of Iran versus other high spending countries. Methods: A comparative panel study was conducted in selected countries with the high mean of health expenditure per capita. Data were collected from the WORLD BANK. Out- of- pocket (OOP), health expenditure per capita, public and private health expenditure, and total health expenditure were compared among the selected counties. Results: Iran has the lowest health expenditure per capita compared to other countries and the USA has the highest health expenditures per capita. In Iran, out- of- pocket expenditure, with more than 50%, was the most cost, while in Luxembourg it was the least cost during 2004 to 2014, with less than 12%. Conclusion: Our findings revealed that politicians and health care executives should find a stable source to finance the health system. Stable sources of financing lead to having a steady trend in health expenditure.

  15. The Prevalence of Postgraduate Education in Youth Health Among High School Clinicians and Associated Student Health Outcomes.

    Science.gov (United States)

    Denny, Simon; Farrant, Bridget; Utter, Jennifer; Fleming, Theresa; Bullen, Pat; Peiris-John, Roshini; Clark, Terryann

    2016-11-01

    Despite numerous calls to improve training in adolescent health, there is little known about the prevalence or effectiveness of specialized training in adolescent health. A two-stage random sampling cluster design was used to collect nationally representative data from 8,500 students from 91 high schools. Student data were linked to data from a survey of school health clinicians from participating schools on their level of training in youth health. Multilevel models accounting for demographic characteristics of students were used to estimate the association between nurses and physicians training in youth health and health outcomes among students. Almost all nurses and physicians reported some training in youth health, either having attended lectures or study days in youth health (n = 60, 80%) or completed postgraduate papers in youth health (n = 13, 17.3%). Students in schools where the nurses and physicians had received postgraduate training in youth health were less likely than students from schools with clinicians having attended lectures or study days in youth health to report emotional and behavior difficulties (11.8 vs. 12.7, p = .002) and binge drinking (19.6% vs. 24.9%, p = .03). There were no significant associations between depressive symptoms, suicide risk, cigarette, marijuana, contraception use, or motor vehicle risk behaviors among students and level of training among clinicians in their schools' health service. Postgraduate training in youth health among nurses and physicians in school health services is associated with fewer students reporting mental health difficulties and binge alcohol use. These findings support specialized training in youth health for clinicians working predominantly with young people. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. High performance work systems: the gap between policy and practice in health care reform.

    Science.gov (United States)

    Leggat, Sandra G; Bartram, Timothy; Stanton, Pauline

    2011-01-01

    Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved care delivery and patient outcomes have been reported in international health care studies. The purpose of this paper is to bring together the results from a series of studies conducted within Australian health care organisations. First, the authors seek to demonstrate the link found between high performance work systems and organisational performance, including the perceived quality of patient care. Second, the paper aims to show that the hospitals studied do not have the necessary aspects of HPWS in place and that there has been little consideration of HPWS in health system reform. The paper draws on a series of correlation studies using survey data from hospitals in Australia, supplemented by qualitative data collection and analysis. To demonstrate the link between HPWS and perceived quality of care delivery the authors conducted regression analysis with tests of mediation and moderation to analyse survey responses of 201 nurses in a large regional Australian health service and explored HRM and HPWS in detail in three casestudy organisations. To achieve the second aim, the authors surveyed human resource and other senior managers in all Victorian health sector organisations and reviewed policy documents related to health system reform planned for Australia. The findings suggest that there is a relationship between HPWS and the perceived quality of care that is mediated by human resource management (HRM) outcomes, such as psychological empowerment. It is also found that health care organisations in Australia generally do not have the necessary aspects of HPWS in place, creating a policy and practice gap. Although the chief executive officers of health

  17. The spectrum of ethical issues in a Learning Health Care System: a systematic qualitative review.

    Science.gov (United States)

    McLennan, Stuart; Kahrass, Hannes; Wieschowski, Susanne; Strech, Daniel; Langhof, Holger

    2018-04-01

    To determine systematically the spectrum of ethical issues that is raised for stakeholders in a 'Learning Health Care System' (LHCS). The systematic review was conducted in PubMed and Google Books between the years 2007 and 2015. The literature search retrieved 1258 publications. Each publication was independently screened by two reviewers for eligibility for inclusion. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or two principles come into conflict. A total of 65 publications were included in the final analysis and were analysed using an adapted version of qualitative content analysis. A coding frame was developed inductively from the data, only the highest-level categories were generated deductively for a life-cycle perspective. A total of 67 distinct ethical issues could be categorized under different phases of the LHCS life-cycle. An overarching theme that was repeatedly raised was the conflict between the current regulatory system and learning health care. The implementation of a LHCS can help realize the ethical imperative to continuously improve the quality of health care. However, the implementation of a LHCS can also raise a number of important ethical issues itself. This review highlights the importance for health care leaders and policy makers to balance the need to protect and respect individual participants involved in learning health care activities with the social value of improving health care.

  18. Health behavior and health-related quality of life in patients with a high risk of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Petek Davorina

    2018-01-01

    Full Text Available Health-related quality of life (HRQoL is measuring a patient’s experience of his health status and represents an outcome of medical interventions. Existing data proves that a healthy lifestyle is positively associated with HRQoL in all age groups. Patients with a high risk for cardiovascular disease typically led an unhealthy lifestyle combined with risk diseases. We aimed to analyse these characteristics and their reflection in HRQoL.

  19. High-Risk Health and Credit Behavior among 18- to 25-Year-Old College Students

    Science.gov (United States)

    Adams, Troy; Moore, Monique

    2007-01-01

    The number of students accumulating credit card debt--and the amount of debt itself--on college campuses is increasing. If high-risk credit and health behavior are associated, health behavior interventions might apply to high-risk credit behavior. Objective: The authors' purpose was to examine these possible associations. Participants and Methods:…

  20. Turbulent times: effects of turbulence and violence exposure in adolescence on high school completion, health risk behavior, and mental health in young adulthood.

    Science.gov (United States)

    Boynton-Jarrett, Renée; Hair, Elizabeth; Zuckerman, Barry

    2013-10-01

    Turbulent social environments are associated with health and developmental risk, yet mechanisms have been understudied. Guided by a life course framework and stress theory, this study examined the association between turbulent life transitions (including frequent residential mobility, school transitions, family structure disruptions, and homelessness) and exposure to violence during adolescence and high school completion, mental health, and health risk behaviors in young adulthood. Participants (n = 4834) from the U.S. National Longitudinal Survey of Youth, 1997 cohort were followed prospectively from age 12-14 years for 10 years. We used structural equation models to investigate pathways between turbulence and cumulative exposure to violence (CEV), and high school completion, mental health, and health risk behaviors, while accounting for early life socio-demographics, family processes, and individual characteristics. Results indicated that turbulence index was associated with cumulative exposure to violence in adolescence. Both turbulence index and cumulative exposure to violence were positively associated with higher health risk behavior, poorer mental health, and inversely associated with high school completion. These findings highlight the importance of considering the cumulative impact of turbulent and adverse social environments when developing interventions to optimize health and developmental trajectory for adolescents transitioning into adulthood. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Comparing Health Literacy in High School Female Students and Their Mothers Regarding Women’s Health

    Directory of Open Access Journals (Sweden)

    Marzieh Saeedi Koupai

    2017-03-01

    Full Text Available Methods: the present study is descriptive-analytical with comparative type and the statistical population included 200 secondary female school students and their mothers who were randomly selected. The tool to collect data was a two-part researcher-made questionnaire the first part whereof involved demographic information and the second part includes 41 questions of health literacy about women’s health in 5 aspects of menstruation hygiene, nutrition, breast self-examination, body activity, iron deficiency anemia. Reliability and validity of the questionnaire were confirmed and the data were analyzed via SPSS22 software. Results: there was not observed any significant difference in three aspects of menstruation hygiene, nutrition and breast self-examination between mean scores of two female groups and their mothers according to Mann-Whitney instability test (p>0.05; however, there was a significant difference in the aspects of body activities and iron deficiency anomia (p<0.05. Conclusion: taking the results of the study, high school female students under study and their mothers have average healthy literacy level regarding women’s health. Therefore, considering the fact that the girls receive greatest education in the field of women’s hygiene from their mothers in the adolescence, the necessity of diagnosing limiters of health literacy in the society and specific attention to the mothers’ teaching and including curriculum of health literacy for female students are advised to promote health. Paper Type: Research Article.

  2. A student manual for promoting mental health among high school students.

    Science.gov (United States)

    Gigantesco, Antonella; Del Re, Debora; Cascavilla, Isabella

    2013-01-01

    We describe a school program based on a student manual for promoting mental health and preventing mental illness. A preliminary version of the manual was assessed for face validity by two focus groups. The final version was evaluated for acceptability among 253 students in 10 high schools and 1 middle school in Italy. The manual included 18 chapters (or "units") which address skills for enabling students to cope with their daily lives: communication skills, problem-solving, assertive skills, negotiation, stress management, anger management and conflict resolution. The manual was found to have been acceptable by high school students. The effectiveness of the manual in actually promoting mental health and preventing mental illness is currently being evaluated.

  3. High and rising health care costs.

    Science.gov (United States)

    Ginsburg, Paul B

    2008-10-01

    The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.

  4. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health, and Physical Activity.

    Science.gov (United States)

    Heo, Moonseong; Irvin, Erica; Ostrovsky, Natania; Isasi, Carmen; Blank, Arthur E; Lounsbury, David W; Fredericks, Lynn; Yom, Tiana; Ginsberg, Mindy; Hayes, Shawn; Wylie-Rosett, Judith

    2016-02-01

    HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health, and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health, and physical activity knowledge and behavior. Pre- and postsurvey data were collected (N = 2255) during the 2012-2013 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh 1-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. The HealthCorps program significantly increased all 3 knowledge domains (p mental health, and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth. © 2016, American School Health Association.

  5. Registered nurses views of caring in coronary care--a deductive and inductive content analysis.

    Science.gov (United States)

    Andersson, Ewa K; Sjöström-Strand, Annica; Willman, Ania; Borglin, Gunilla

    2015-12-01

    To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic--particularly in the context of coronary care--is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Qualitative descriptive study. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values. © 2015 John Wiley & Sons Ltd.

  6. Student Engagement in High-Performing Schools: Relationships to Mental and Physical Health

    Science.gov (United States)

    Conner, Jerusha O.; Pope, Denise

    2014-01-01

    This chapter examines how the three most common types of engagement found among adolescents attending high-performing high schools relate to indicators of mental and physical health. [This article originally appeared as NSSE Yearbook Vol. 113, No. 1.

  7. 42 CFR 433.68 - Permissible health care-related taxes.

    Science.gov (United States)

    2010-10-01

    ... any deducted amounts for bad debts, charity care, and payer discounts. (iv) The tax is imposed on... all revenues (including Medicare and Medicaid) but excludes teaching hospitals would have to meet this... the State; (2) Providers that do not charge for services within the class; (3) Rural hospitals...

  8. How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

    Science.gov (United States)

    Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

    2018-03-01

    Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of

  9. Physical fitness and health indices in children, adolescents and adults with high or low motor competence.

    Science.gov (United States)

    Cantell, Marja; Crawford, Susan G; Tish Doyle-Baker, P K

    2008-04-01

    The overall purpose of the study was to examine if individuals with low motor competence achieve age-adequate fitness and health. A group of 149 children, adolescents, and adults with low or high motor competence participated in motor, fitness, and health assessments. Individuals with low motor competence did not differ on their basic physiological health parameters, but they had less optimal levels of overall health and fitness indices than those with high motor competence. As a function of age, musculoskeletal fitness was significantly compromised for the low motor competence group. The metabolic indices suggested that the low motor competence group had significantly higher BMI's compared to the high motor competence group. Motor skills and static balance were significant predictors of the BMI. Exercise intensity differed between children in the low and high motor competence group. The findings suggest that individuals with low motor competence have compromised health-related fitness. In order to discriminate between individuals with high and low motor competence, fitness assessment should include at least back extension, curl ups, and sit and reach. In addition, health-related fitness measurements such as BMI, waist circumference, blood lipid profile and bone mineral density are also recommended.

  10. Declining amenable mortality: a reflection of health care systems?

    Science.gov (United States)

    Gianino, Maria Michela; Lenzi, Jacopo; Fantini, Maria Pia; Ricciardi, Walter; Damiani, Gianfranco

    2017-11-15

    Some studies have analyzed the association of health care systems variables, such as health service resources or expenditures, with amenable mortality, but the association of types of health care systems with the decline of amenable mortality has yet to be studied. The present study examines whether specific health care system types are associated with different time trend declines in amenable mortality from 2000 to 2014 in 22 European OECD countries. A time trend analysis was performed. Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74 years per 100,000 inhabitants. We classified health care systems according to a deductively generated classification by Böhm. This classification identifies three dimensions that are not entirely independent of each other but follow a clear order: the regulation dimension is first, followed by the financing dimension and finally service provision. We performed a hierarchical semi-log polynomial regression analysis on the annual SDRs to determine whether specific health care systems were associated with different SDR trajectories over time. The results showed a clear decline in SDRs in all 22 health care systems between 2000 and 2014 although at different annual changes (slopes). Regression analysis showed that there was a significant difference among the slopes according to provision dimension. Health care systems with a private provision exhibited a slowdown in the decline of amenable mortality over time. It therefore seems that ownership is the most relevant dimension in determining a different pattern of decline in mortality. All countries experienced decreases in amenable mortality between 2000 and 2014; this decline seems to be partially a reflection of health care systems, especially when affected by the provision dimension. If the private ownership is maintained or promoted by health systems, these findings might be

  11. An in-depth mixed-methods approach to Ryan White HIV/AIDS care program comprehensive needs assessment from the Northeast Georgia Public Health District: the significance of patient privacy, psychological health, and social stigma to care.

    Science.gov (United States)

    Huff, Amber; Chumbler, Neale; Cherry, Colleen O'Brien; Hill, Miranda; Veguilla, Vic

    2015-04-01

    We apply a social-ecological interpretive framework to understanding relationships among patient privacy, psychological health, social stigma, and continuity in care in the HIV treatment cascade in the rural southeastern US. This research was conducted as part of the 2013 comprehensive needs assessment for the Northeast Georgia Ryan White Consortium using an anthropologically informed mixed-methods design, and a deductive-inductive approach to thematic analysis of qualitative data obtained in interviews and focus groups with service providers and service utilizers. Our comprehensive needs assessment yielded two key components. First, we identified salient phenomena influencing introduction to, retention among, and satisfaction of patients in the Ryan White-coordinated treatment cascade in NE-GA. Second, we formulated actionable recommendations around leverage points identified in the current district-wide system of care. Results highlight spatial, institutional, and interpersonal aspects of the system of care that intersect around issues of patient privacy, psychological health, and social stigma. These intersections constitute pathways by which persons living with HIV are exposed to stigma and other negative social signals regarding their health status without sufficient access to behavioral health services. These negative issues, in turn, can erect significant barriers to long-term continuity in care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Health approaches in a widely adopted Brazilian high school biology textbook

    Directory of Open Access Journals (Sweden)

    Liziane Martins

    2012-05-01

    Full Text Available Considering the long tradition of discussing health in the Brazilian school curriculum, it is important to investigate how this topic is addressed by the textbooks, the main resource used by most schools in the country. In particular, it is relevant to verify if this content is presented in a manner that contributes to the development of the students as active and critical members of the society. We analyze how health is treated in the textbook Biology, by Laurence (2005, which has been the high school Biology textbook most chosen by public school teachers among those certified by the National Program for High School Textbooks (PNLEM/2007, sponsored by the Brazilian Ministry of Education (MEC. We used categorical content analysis techniques, involving the decomposition of the texts into units of analysis, the categories, which were built in this work through analogical regroupings, by using semantic criteria. In order to investigate the treatment given to health, we applied an analytical table to the units of recording, which consist of sentences, paragraphs, and sections of the textbook that discuss contents related to health and disease. This table systematizes eight health indicators, seeking to identify three health approaches: biomedical, behavioral, and socioecological. We found 267 units of recording in the textbook and, based on their analysis, it was possible to categorize the textbook as one in which the biomedical approach prevails. Our findings are consistent with other works that indicate the prevalence of this approach in Brazilian education, and Brazilian and international textbooks. Another important finding of the work is that the behavioral approach does not hold, at least for the analyzed textbook, as a view of health different from the biomedical and socioecological approaches. After all, when the book mentions behaviors and habits of life associated with health, it generally emphasizes biological dimensions, aligning with a

  13. Leisure as a resource for successful aging by older adults with chronic health conditions.

    Science.gov (United States)

    Hutchinson, Susan L; Nimrod, Galit

    2012-01-01

    Drawing on the model of Selective Optimization with Compensation (SOC) (Baltes & Baltes, 1990), the purpose of this article is to examine leisure-related goals of older adults with chronic conditions and the strategies they use to not only successfully manage their chronic health conditions but live well with them. Semi-structured in-person interviews were conducted with 18 community-dwelling older adults (nine males, nine females, ages 58-87 years) with a variety of chronic conditions. Inductive and deductive within and cross-case thematic analyses resulted in descriptions of changes and continuity in participants' leisure participation following the onset of their chronic condition and construction of four themes: drawing on existing resources for continued involvement, setting leisure-based goals, using strategies to get more out of life, and more than managing: living a life of meaning. Implications for promoting successful aging are discussed, specifically the benefits of incorporating information and skill-building to help older adults recognize that leisure can be a resource for healthy aging and self-managing their chronic health condition.

  14. Influence of physical activity on psychosomatic health in obese women.

    Science.gov (United States)

    Menzyk, K; Cajdler, A; Pokorski, M

    2008-12-01

    It is unclear to what extent the known psychosomatic benefits of exercise hold true for the obese. In the present study, we investigated the hypothesis that the psychosomatic health and components of general intelligence, such as the capacity for logical-deductive tasks, would be better in regularly exercising than non-exercising obese women. We addressed the issue in a self-reported survey study, comprising two groups of middle-aged obese women (age 30-50 years, BMI >30 kg/m(2)) of 25 persons each. The criterion for the group division was regular exercise, minimum twice a week, for at least 2 months. The following psychometric tools were used: Physical Fitness and Exercise Scale, Patient Health Questionnaire-9 for depression, Life Satisfaction Scale, General Health Inventory-28, Raven's Matrices Test for intelligence, and a test for selfcontentment with one's body figure shape. The exercising obese women scored significantly better in Life Satisfaction Scale (17.1 +/- 1.2 vs.12.0 +/- 0.9), had a lower level of depression (8.1 +/- 0.6 vs. 13.4 +/- 0.7), and a better assessment of the health status (24.6 +/- 1.6 vs. 36.4 +/- 2.2) (reversed score) compared with non-exercising ones (Pexercising obese women also appreciably better assessed their bodily looks. Interestingly, if depression was present in exercising women, it had more detrimental health effects than in physically inactive ones. The study failed to substantiate appreciable changes in general intelligence between active and non-active obese women. In conclusion, physical activity is of benefit for the psychosomatic health in obese women, which should be considered in behavioral counseling.

  15. The implementation of health promotion in primary and community care: a qualitative analysis of the 'Prescribe Vida Saludable' strategy.

    Science.gov (United States)

    Martinez, Catalina; Bacigalupe, Gonzalo; Cortada, Josep M; Grandes, Gonzalo; Sanchez, Alvaro; Pombo, Haizea; Bully, Paola

    2017-02-17

    The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices. Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable) is focused on designing, planning, implementing and evaluating innovative programs to promote multiple healthy habits, feasible to be performed in routine primary health care conditions. After 2 years of piloting, centers were categorized as having high, medium, or low implementation effectiveness. We completed qualitative inductive and deductive analysis of five focus groups with the staff of the centers. Themes generated through consensual grounded qualitative analysis were compared between centers to identify the dimensions that explain the variation in actual implementation of PVS, and retrospectively organized and assessed against the Consolidated Framework for Implementation Research (CFIR). Of the 36 CFIR constructs, 11 were directly related to the level of implementation performance: intervention source, evidence strength and quality, adaptability, design quality and packaging, tension for change, learning climate, self-efficacy, planning, champions, executing, and reflecting and evaluating, with -organizational tracking added as a new sub-construct. Additionally, another seven constructs emerged in the participants' discourse but were not related to center performance: relative advantage, complexity, patients' needs and resources, external policy and incentives, structural characteristics, available resources, and formally appointed internal implementation

  16. [A functional analysis of healthcare auditors' skills in Venezuela, 2008].

    Science.gov (United States)

    Chirinos-Muñoz, Mónica S

    2010-10-01

    Using functional analysis for identifying the basic, working, specific and generic skills and values which a health service auditor must have. Implementing the functional analysis technique with 10 experts, identifying specific, basic, generic skills and values by means of deductive logic. A functional map was obtained which started by establishing a key purpose based on improving healthcare and service quality from which three key functions emerged. The main functions and skills' units were then broken down into the competitive elements defining what a health service auditor is able to do. This functional map (following functional analysis methodology) shows in detail the simple and complex tasks which a healthcare auditor should apply in the workplace, adopting a forward management approach for improving healthcare and health service quality. This methodology, expressing logical-deductive awareness raising, provides expert consensual information validating each element regarding overall skills.

  17. Developing family rooms in mental health inpatient units: an exploratory descriptive study.

    Science.gov (United States)

    Isobel, Sophie; Foster, Kim; Edwards, Clair

    2015-06-19

    Family-friendly spaces for children and families to visit inpatient mental health units are recommended in international mental health guidelines as one way to provide service delivery that is responsive to the needs of parent-consumers and families. There is a lack of evidence on the implementation of family-friendly spaces or Family Rooms. This study aimed to explore the development, role, and function of Family Rooms in four mental health inpatient units in a local health district in NSW Australia. An exploratory descriptive inductive-deductive design using multiple data sources was employed. Methods included Family Room usage and parental status data over a 12 week period, an open-ended questionnaire, and semi-structured interviews with 20 nurses. Available parental status data indicated that between 8-14 % of inpatients were parents of dependent children under 18. Family Room usage was multipurpose and used specifically for children & families 29 % of the time. As spaces in the units, Family Rooms were perceived as acknowledging of the importance of family, and providing comfortable, secure spaces for parent-consumers and their children and family to maintain connections. Units did not have local policies or guidelines on the development, maintenance, and/or use of the rooms. Despite long-standing recognition of the need to identify consumers' parental status, there remains a lack of systematic processes for identifying parents in mental health inpatient services nationally. Family Rooms as spaces within inpatient units acknowledge the importance of families and are a step towards provision of family-focused mental health care. Recommendations for establishing and maintaining Family Rooms are outlined.

  18. A student manual for promoting mental health among high school students

    Directory of Open Access Journals (Sweden)

    Antonella Gigantesco

    2013-03-01

    Full Text Available OBJECTIVES. We describe a school program based on a student manual for promoting mental health and preventing mental illness. METHODS. A preliminary version of the manual was assessed for face validity by two focus groups. The final version was evaluated for acceptability among 253 students in 10 high schools and 1 middle school in Italy. RESULTS. The manual included 18 chapters (or "units" which address skills for enabling students to cope with their daily lives: communication skills, problem-solving, assertive skills, negotiation, stress management, anger management and conflict resolution. The manual was found to have been acceptable by high school students. CONCLUSIONS. The effectiveness of the manual in actually promoting mental health and preventing mental illness is currently being evaluated.

  19. High-intensity exercise interventions in cancer survivors: a systematic review exploring the impact on health outcomes.

    Science.gov (United States)

    Toohey, Kellie; Pumpa, Kate; McKune, Andrew; Cooke, Julie; Semple, Stuart

    2018-01-01

    There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors. The aim of this study was to, (1) evaluate the efficacy and (2) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors. Design Systematic review. Data sources Google Scholar and EBSCO, CINAHL Plus, Computers and Applied Sciences Complete, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition, MEDLINE, Web of Science and SPORTDiscuss from inception up until August 2017. Eligibility criteria Randomized controlled trials of high-intensity exercise interventions in cancer survivors (all cancer types) with health-related outcome measures. The guidelines adopted for this review were the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The search returned 447 articles, of which nine articles (n = 531 participants mean, age 58 ± 9.5 years) met the eligibility criteria. Exercise interventions of between 4 and 18 weeks consisting of high-intensity interval bouts of up to 4-min were compared with a continuous moderate intensity (CMIT) intervention or a control group. High-intensity exercise interventions elicited significant improvements in VO 2 max, strength, body mass, body fat and hip and waist circumference compared with CMIT and/or control groups. The studies reviewed showed low risk in participating in supervised high-intensity exercise interventions. Mixed mode high-intensity interventions which included both aerobic and resistance exercises were most effective improving the aerobic fitness levels of cancer survivors by 12.45-21.35%, from baseline to post-intervention. High-intensity exercise interventions improved physical and physiological health-related outcome measures such as cardiovascular fitness and strength in cancer survivors. Given that high-intensity exercise sessions require a

  20. Concept of waste and its impact on human health.

    Science.gov (United States)

    Pashkov, Vitalii M; Batyhina, Olena M; Trotska, Maryna V

    Impact of the environment on human health is increasingly being paid attention both at the international level and at the level of individual countries. Among the factors that anyhow can affect it negatively, various objects are distinguished and waste is not of the last consequence. It has different nature of origin, ways of further utilization and a degree of impact on human health and the environment. Its generation, utilization and neutralization are determined by the relevant processes; their research allows continuous improvement and reduction of their negative impact on human health and the environment. To analyze provisions of the international legislation concerning the concept of waste and its classification, as well as its potential impacts on human health and the environment. The study analyzes and uses international legal documents, data of international organizations and scientists' deductions. Furthermore, the study integrates information from scientific journals with scientific methods from the medical and legal point of view. Within the framework of the system approach, as well as analysis and synthesis, the concept of waste, its classification and impact on human health and the environment have been researched. In consequence of the conducted study, it has been found that at the European level, considerable attention is paid to waste in the context of its possible negative impact on human health and the environment. Solution of this problem is carried out with the integrated approach, which is expressed both in enacting statutory acts and amending existing ones, as well as elucidating various aspects at the scientific, methodological, statistical and other levels. Waste in itself has different nature of origin, negative impact, ways of its further utilization. Some kinds of it can be used further in order to achieve other goals and needs that are not related to their generation, others can no longer be used for human benefits taking into account

  1. Association of a behaviorally based high school health education curriculum with increased exercise.

    Science.gov (United States)

    Annesi, James J; Trinity, John; Mareno, Nicole; Walsh, Stephanie M

    2015-06-01

    Increasing exercise in children and adolescents through academic classes is an understudied area. Potential benefits include associated improvements in health, psychosocial, and quality-of-life factors. A sample of 98 students (M(age) = 14.3) from high school health education classes received six, 40-min lessons incorporating cognitive-behavioral methods to increase exercise over 6 weeks. Significant within-group improvements in exercise, mood, and body satisfaction were found, with slightly larger effect sizes identified for the boys. Increase in exercise was significantly associated with reduced mood distress (β = -.17, p goal setting and self-regulation within high school health education classes may foster increased exercise and associated improvements in mood and body satisfaction. For girls, the positive effects may reinforce one another. © The Author(s) 2014.

  2. Health effects in residents of high background radiation regions

    International Nuclear Information System (INIS)

    Hanson, G.P.; Komarov, E.

    1983-01-01

    Studies carried out in various countries and by the World Health Organization on health effects of exposure of populations to high levels of natural background radiation result in observations of different significance. There are indications of changes in chromosome aberration rate; Down's syndrome has been observed to be possibly related to radiation exposure; malignant neoplasms in bone apparently correspond to high concentrations of 226 Ra in drinking water. Although various researchers have looked for them, effects have not been demonstrated regarding cancer mortality (other than malignant neoplasms involving bone), gross congenital abnormalities, fertility index, growth and development, hereditary disease (other than the possibility of Down's syndrome), infant mortality, longevity, multiple births, sex ratio, or spontaneous abortion rate. On the basis of reported data clear quantitative conception of the risk of low-level radiation from natural sources could not be developed and feasibility studies of further epidemiological programmes should be organized. The possibility of reducing the collective population dose from natural sources could be further explored and a basis for necessary legal action on establishment of standards for possible sources of natural radiation, such as building materials, fertilizers, natural gas and water, might be developed. (author)

  3. Position of Social Determinants of Health in Urban Man-Made Lakes

    Science.gov (United States)

    Shojaei, Parisa; Karimlou, Masoud; Mohammadi, Farahnaz; Afzali, Hosein Malek; Forouzan, Ameneh Setareh

    2013-01-01

    Background and Objective: A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. Method: This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Results: Participants’ points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. Conclusion: This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community’s health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration

  4. Development of a cause analysis system for a CPCS trip by using the rule-base deduction method.

    Science.gov (United States)

    Park, Je-Yun; Koo, In-Soo; Sohn, Chang-Ho; Kim, Jung-Seon; Cho, Gi-Ho; Park, Hee-Seok

    2009-07-01

    A Core Protection Calculator System (CPCS) was developed to initiate a Reactor Trip under the circumstance of certain transients by a Combustion Engineering Company. The major function of the Core Protection Calculator System is to generate contact outputs for the Departure from Nucleate Boiling Ratio (DNBR) Trip and a Local Power Density (LPD) Trip. But in a Core Protection Calculator System, a trip cause cannot be identified, thus only trip signals are transferred to the Plant Protection System (PPS) and only the trip status is displayed. It could take a considerable amount of time and effort for a plant operator to analyze the trip causes of a Core Protection Calculator System. So, a Cause Analysis System for a Core Protection Calculator System (CASCPCS) has been developed by using the rule-base deduction method to assist operators in a Nuclear Power Plant. CASCPCS consists of three major parts. Inference engine has a role of controlling the searching knowledge base, executing the rules and tracking the inference process by using the depth-first searching method. Knowledge base consists of four major parts: rules, data base constants, trip buffer variables and causes. And a user interface is implemented by using menu-driven and window display techniques. The advantage of CASCPCS is that it saves time and effort to diagnose the trip causes of a Core Protection Calculator System, it increases a plant's availability and reliability, and it makes it easy to manage CASCPCS because of using only a cursor control.

  5. Danger zone: Men, masculinity and occupational health and safety in high risk occupations

    OpenAIRE

    Stergiou-Kita, Mary; Mansfield, Elizabeth; Bezo, Randy; Colantonio, Angela; Garritano, Enzo; Lafrance, Marc; Lewko, John; Mantis, Steve; Moody, Joel; Power, Nicole; Theberge, Nancy; Westwood, Eleanor; Travers, Krista

    2015-01-01

    The workplace is a key setting where gender issues and organizational structures may influence occupational health and safety practices. The enactment of dominant norms of masculinity in high risk occupations can be particularly problematic, as it exposes men to significant risks for injuries and fatalities. To encourage multi-disciplinary collaborations and advance knowledge in the intersecting areas of gender studies, men’s health, work and workplace health and safety, a national network of...

  6. Association of a Behaviorally Based High School Health Education Curriculum with Increased Exercise

    Science.gov (United States)

    Annesi, James J.; Trinity, John; Mareno, Nicole; Walsh, Stephanie M.

    2015-01-01

    Increasing exercise in children and adolescents through academic classes is an understudied area. Potential benefits include associated improvements in health, psychosocial, and quality-of-life factors. A sample of 98 students (M[subscript age] = 14.3) from high school health education classes received six, 40-min lessons incorporating…

  7. School Violence, Social Support and Psychological Health among Taiwanese Junior High School Students

    Science.gov (United States)

    Chen, Ji-Kang; Wei, Hsi-Sheng

    2013-01-01

    Objectives: This paper examines how peer social support mediates the association between school victimization and student psychological health among junior-high students in an Asian context (Taiwan), and further examines how gender and ethnicity differ in the interrelationships of school violence, peer social support and psychological health.…

  8. Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation

    Directory of Open Access Journals (Sweden)

    Hyun-Soo Kim

    2016-01-01

    Full Text Available Objectives: The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Methods: Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. Results: The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. Conclusions: It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

  9. Determinants of Mental Health Care Utilization in a Suicide High-risk Group With Suicidal Ideation.

    Science.gov (United States)

    Kim, Hyun-Soo; Lee, Moo-Sik; Hong, Jee-Young

    2016-01-01

    The suicide rate in Korea is increasing every year, and is the highest among the Organization for Economic Cooperation and Development countries. Psychiatric patients in particular have a higher risk of suicide than other patients. This study was performed to evaluate determinants of mental health care utilization among individuals at high risk for suicide. Korea Health Panel data from 2009 to 2011 were used. Subjects were individuals at high risk of suicide who had suicidal ideation, a past history of psychiatric illness, or had utilized outpatient services for a psychiatric disorder associated with suicidal ideation within the past year. The chi-square test and hierarchical logistic regression were used to identify significant determinants of mental health care utilization. The total number of subjects with complete data on the variables in our model was 989. Individuals suffering from three or more chronic diseases used mental health care more frequently. Mental health care utilization was higher in subjects who had middle or high levels of educational attainment, were receiving Medical Aid, or had a large family size. It is important to control risk factors in high-risk groups as part of suicide prevention strategies. The clinical approach, which includes community-based intervention, entails the management of reduction of suicidal risk. Our study identified demographic characteristics that have a significant impact on mental health care utilization and should be considered in the development of suicide prevention strategies. Further studies should examine the effect of mental health care utilization on reducing suicidal ideation.

  10. Dating violence and associated health risks among high school students with disabilities.

    Science.gov (United States)

    Mitra, Monika; Mouradian, Vera E; McKenna, Maria

    2013-08-01

    Children with disabilities are at a higher risk for various forms of violence including sexual violence, bullying, and physical violence compared to those without disabilities. However there are no studies documenting the prevalence of dating violence amongst a population-based sample of adolescents with disabilities. The purpose of this study is to assess the prevalence of dating violence victimization against high schools students with and without disabilities and to examine associations of dating violence with health risks by disability status among high school girls. Data from the 2009 Massachusetts Youth Health Survey were analyzed in 2011 using bivariate and multivariate logistic regression. Among high school students who had ever been on a date, girls (25.9 %, 95 % CI 19.9-31.5) and boys (9.1 %, 95 % CI 5.8-12.4) with disabilities were more likely than girls (8.8 %, 95 % CI 6.8-10.8) and boys (4.5 %, 95 % CI 3.1-5.8) without disabilities to report dating violence. Multivariate analyses indicated that high school girls with disabilities who experienced dating violence were more likely to report feeling sad or hopeless for 2 weeks or more in the past year, suicide ideation in the past 12 months, and drug use in the past 30 days compared to those with disabilities who did not report dating violence and those without disabilities who reported and did not report dating violence. High school students with disabilities are at a greater risk for dating violence victimization compared to those without disabilities and high school girls with disabilities who experience dating violence are at increased risk for experiencing poor mental health outcomes and substance abuse.

  11. Proband Mental Health Difficulties and Parental Stress Predict Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders

    Science.gov (United States)

    Crea, Katherine; Dissanayake, Cheryl; Hudry, Kristelle

    2016-01-01

    Family-related predictors of mental health problems were investigated among 30 toddlers at familial high-risk for autism spectrum disorders (ASD) and 28 controls followed from age 2- to 3-years. Parents completed the self-report Depression Anxiety Stress Scales and the parent-report Behavior Assessment System for Children. High-risk toddlers were…

  12. Flexible High Energy-Conversion Sensing Materials for Structural Health Monitoring, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The applicant is developing flexible highly-efficient piezoelectric materials for use in structural health monitoring (SHM) as contemplated in the solicitation...

  13. The mismatch between high effort and low reward in household and family work predicts impaired health among mothers.

    Science.gov (United States)

    Sperlich, Stefanie; Arnhold-Kerri, Sonja; Siegrist, Johannes; Geyer, Siegfried

    2013-10-01

    So far, Siegrist's model of effort-reward imbalance (ERI) has been tested almost exclusively for paid employment. This article reports results on a newly developed questionnaire measuring ERI in unpaid household and family work. Using data of a population-based sample of 3129 German mothers, logistic regression analyses were performed to test the following three main assumptions: (i) high effort combined with low reward in household and family work increases the risk of poor health; (ii) a high level of overcommitment may enhance the risk of poor health; and (iii) mothers reporting an extrinsic high ERI and a high level of overcommitment have an even higher risk of poor health. ERI was significantly related to self-rated health, somatic complaints and mental health. A high level of overcommitment increased the risk of poor health, whereas ERI and overcommitment combined was associated with the highest risk of poor health. Statistically significant synergy effects of combined exposure of ERI and overcommitment were found for 'anxiety'. With some limitations, all three assumptions underlying the ERI model were confirmed. Thus, we conclude that ERI is applicable to domestic work and may provide an explanatory framework to assess stress experiences in mothers.

  14. Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries

    OpenAIRE

    Peltzer, Karl; Pengpid, Supa

    2014-01-01

    Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate...

  15. Position of social determinants of health in urban man-made lakes plans.

    Science.gov (United States)

    Shojaei, Parisa; Karimloo, Masoud; Mohammadi, Farahnaz; Malek Afzali, Hossein; Forouzan, Ameneh Setareh

    2013-09-04

    A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Participants' points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community's health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration.

  16. High Temperatures Health Monitoring of the Condensed Water Height in Steam Pipe Systems

    Science.gov (United States)

    Lih, Shyh-Shiuh; Bar-Cohen, Yoseph; Lee, Hyeong Jae; Badescu, Mircea; Bao, Xiaoqi; Sherrit, Stewart; Takano, Nobuyuki; Ostlund, Patrick; Blosiu, Julian

    2013-01-01

    Ultrasonic probes were designed, fabricated and tested for high temperature health monitoring system. The goal of this work was to develop the health monitoring system that can determine the height level of the condensed water through the pipe wall at high temperature up to 250 deg while accounting for the effects of surface perturbation. Among different ultrasonic probe designs, 2.25 MHz probes with air backed configuration provide satisfactory results in terms of sensitivity, receiving reflections from the target through the pipe wall. A series of tests were performed using the air-backed probes under irregular conditions, such as surface perturbation and surface disturbance at elevated temperature, to qualify the developed ultrasonic system. The results demonstrate that the fabricated air-backed probes combined with advanced signal processing techniques offer the capability of health monitoring of steam pipe under various operating conditions.

  17. Relationships between Sports Team Participation and Health-Risk Behaviors among Alternative High School Students

    Science.gov (United States)

    Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.

    2014-01-01

    Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…

  18. Adolescent use of school-based health centers and high school dropout.

    Science.gov (United States)

    Kerns, Suzanne E U; Pullmann, Michael D; Walker, Sarah Cusworth; Lyon, Aaron R; Cosgrove, T J; Bruns, Eric J

    2011-07-01

    To determine the association between use of school-based health centers (SBHCs) and school dropout. Quasi-experimental longitudinal analysis of a retrospective student cohort, with SBHC use as the independent variable. We statistically controlled for dropout risk and used propensity score regression adjustment to control for several factors associated with SBHC use. Integrated database from an urban public school district (academic outcomes) and department of public health (SBHC use). District-enrolled students in their first semester of ninth grade in 2005 (N = 3334), followed up through their anticipated on-time graduation semester of 12th grade in 2009. Students were divided into 4 groups: never used (47%); low use (23%); moderate use (20%); and high users (10%). Time to nongraduation (described as dropout). Low to moderate SBHC use (0.125-2.5 visits per semester) was associated with a 33% reduction in dropout compared with non-SBHC users. The high-use group (>2.5 visits per semester) did not have dropout rates that differed from nonusers. For SBHC users who did drop out, dropout occurred approximately 1 semester later than nonusers. Exploratory analyses revealed that the association between SBHC use and prevention of dropout was greatest for higher-risk students. This study found an association between low to moderate SBHC use and reductions in dropout for high school students in an urban school district, especially for students at higher risk for dropout. This study supports the theory that benefits of SBHCs extend beyond managing physical and mental health needs to include academic outcomes.

  19. Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

    Science.gov (United States)

    Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

    2017-03-01

    Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

  20. From Emancipation through Employment to Emancipation through Entrepreneurship: An Analysis of the Special Labor Market Initiatives (BRYT and Tax Deduction for Domestic Services (RUT in Sweden

    Directory of Open Access Journals (Sweden)

    Elin Kvist

    2015-10-01

    Full Text Available Debates on gender equality policy in Sweden assume that women’s labor market participation is central to gender equality and should be promoted via special initiatives and programs. This paper examines how gender equality discourses have changed over time, analyzing Swedish state labor market policy in the 1980s and 1990s, special labor market initiatives to eliminate gender segregation and encourage nontraditional gendered work choices, and contemporary state subsidies for paid domestic work (i.e., tax deduction for domestic services. Critically interpreting these reforms reveals consistencies and continuities in how labor market participation is viewed as the key promoter of gender equality, revealing transformations in how gender equality is understood and constructed. A transition is discernible from state-funded programs and reforms to governmental agencies/authorities and state subsidies to promote enterprise and the growth of specific labor market sectors.

  1. Governance in community based health programmes in I.R of Iran.

    Science.gov (United States)

    Falahat, Katayoun; Eftekhari, Monir Baradaran; Malekafzali, Hossein; Forouzan, Ameneh Setareh; Dejman, Masoumeh

    2013-02-01

    To assess the nature of community-based health programme experience in Iran, and use the results in order to advocate more friendly policies in community, academy and funding organisations. The qualitative study was done in 2010-11 at various locations in Iran using semi structural in-depth interviews with the principals and managers of programmes, and focus group discussions with volunteers and service users of 13 Community Based Health Programmes which were active for at least five years. A total of 21 in-depth interviews and 20 focus group discussions were conducted. Data analysis was based on deductive-inductive content analysis approach considering the pre-determined structure in accordance with the study questions. The participants' views were analysed within the main category of governance, including the three sub-categories of leadership, monitoring and evaluation, and resource mobilisation. According to the participants, governmental programmes have centralised decision-making and management processes and local volunteers have no role in selecting managers at different levels of a programme. Such programmes are funded by the governmental core resources. In non-government organisations, resources available for such purposes mainly come through charitable individuals, service delivery fees and profitable economical activities, financial participation of volunteers and by using other organisations' facilities. In most programmes, there were no systematic process for monitoring and evaluation. Community-based Health programmes in Iran need to be revised in line with the positive input.There is a need to have community-based units within the Ministry of Health and Medical Education and other relevant organisations.

  2. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    DEFF Research Database (Denmark)

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT perfor...

  3. Correlation between Health Perception, Body Image, and Eating Habits in High School Students

    Directory of Open Access Journals (Sweden)

    Abdullah Ichsan

    2016-06-01

    Full Text Available Background: Mental disorders, including eating disorders, mostly begin during youth. Moreover, negative body image is found to cause unhealthy eating habits in the context of several cross-cultural settings. This study aimed to examine the correlation between health perception and body image with eating habits among high school students. Methods: A structured, anonymous questionnaire was distributed to students of a private high school in Bandung, Indonesia in June-October 2014. The questionnaire included questions about health perception, body image, eating habits, body weight and height, and also other demographic parameters. The school was selected as the study object through purposive sampling, and 140 high school students (72 male and 68 female were ramdomly selected. Results: Male and female did not show considerable differences in health perceptions. Out of 13 statements, 12 statements of male respondents showed better body image than female. While in eating habits statements, female respondents seemed to maintain healthier eating habits than male respondents. No significant correlation was observed between body image and eating habits (r=-0.015, p=0.858. There was significant correlation between health perception and eating habits (r=0.374, p<0.001. Correlation between sex and eating habits was found (p=0.020, there was not significant relationship between eating habits and Body Mass Index (BMI (p=0.368. Conclusions: The negative relationship between body image and eating habits is not significant. However there was a significant positive relationship between health perception and eating habits. Furthermore, there was correlation between sex and eating habits, while the positive relationship between eating habits and BMI was still not found.

  4. The local translation of a top-down football-based initiative for health

    DEFF Research Database (Denmark)

    Bennike, Søren; Ottesen, Laila

    and document analysis. 4 cases have been conducted resulting in a cross-case synthesis. The data has been coded and condensed with pre-existing codes directing the coding in a hermeneutic deductive way (Creswell, 2007). The findings conclude that the implementation is heavily influenced by the unique...

  5. The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS study: systematic review of reviews and additional primary studies

    Directory of Open Access Journals (Sweden)

    Max Barnish

    2017-08-01

    Full Text Available Abstract Background High-heeled shoes (high heels are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. Methods We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. Results A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men’s behaviour associated with high heel wear. With regard to second

  6. Sexual coercion and health-risk behaviors among urban Chinese high school students

    Directory of Open Access Journals (Sweden)

    Yi Song

    2014-05-01

    Full Text Available Objective: To determine the association between health-risk behaviors and a history of sexual coercion among urban Chinese high school students. Design: A cross-sectional study was performed among 109,754 high school students who participated in the 2005 Chinese Youth Risk Behavior Survey. Data were analyzed for 5,215 students who had experienced sexual intercourse (1,483 girls, 3,732 boys. Multivariate logistic regression was used to determine the relationship between sexual coercion and the related covariates, and data were stratified by gender. Results: Of those students who had had sexual intercourse, 40.9% of the females and 29.6% of the males experienced sexual coercion (p<0.01. When analyses controlled for demographic characteristics, in the study sample, that is, students who had sexual intercourse, drug use (odds ratios [OR], 2.44, attempted suicide (OR, 2.30, physical abuse (OR, 1.74, binge drinking (OR, 1.62, verbal abuse (OR, 1.29, experience of being drunk (OR, 0.68, and smoking of cigarettes (OR, 0.52 were related to a history of sexual coercion. Patterns of health-risk behaviors also differed among female and male students who had experienced sexual coercion. Conclusions: Sexual coercion is associated with health-risk behaviors. Initiatives to reduce the harm associated with sexual coercion among high school students are needed.

  7. Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2009-12-01

    FIFTH ANNUAL SURVEY: This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21-64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21-64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment

  8. Do beneficiaries' views matter in healthcare purchasing decisions? Experiences from the Nigerian tax-funded health system and the formal sector social health insurance program of the National Health Insurance Scheme.

    Science.gov (United States)

    Ibe, Ogochukwu; Honda, Ayako; Etiaba, Enyi; Ezumah, Nkoli; Hanson, Kara; Onwujekwe, Obinna

    2017-12-28

    Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations. A case study approach was adopted in which each financing mechanism is a case. Sixteen (16) in-depth interviews with purchasers and eight (8) focus group discussions with beneficiaries were held. Agency and organizational behavioural theories were used to characterise the purchaser-citizen relationships. A deductive framework approach was used to assess whether actions identified in a model of 'ideal' strategic purchasing actions were undertaken in each case. For both cases, mechanisms exist to reflect people's health needs in purchasing decisions, including quantitative and qualitative needs assessment, mechanisms to raise awareness of benefit entitlements and allow choice. However, purchasers do not use the mechanisms to effectively engage with and hold themselves accountable to the people. In the tax-funded system, weak information systems and unclear communication channels between the purchaser and citizens constrain assessment of needs; while timeliness of health information and poor engagement practices of Health Maintenance Organisations (HMOs) are the main constraints in FSSHIP. Inadequate information sharing in both mechanisms limits beneficiaries' awareness of entitlements. Although beneficiaries of FSSHIP can choose providers, lack of information on the quality of services offered by providers constrains rational decision-making and the inability to change HMOs reduces HMO responsiveness to

  9. Light-intensity and high-intensity interval training improve cardiometabolic health in rats.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Connolly, Kylie J; Fenning, Andrew S

    2016-09-01

    Physical activity has the potential to reduce cardiometabolic risk factors but evaluation of different intensities of physical activity and the mechanisms behind their health effects still need to be fully established. This study examined the effects of sedentary behaviour, light-intensity training, and high-intensity interval training on biometric indices, glucose and lipid metabolism, inflammatory and oxidative stress markers, and vascular and cardiac function in adult rats. Rats (12 weeks old) were randomly assigned to 1 of 4 groups: control (CTL; no exercise), sedentary (SED; no exercise and housed in small cages to reduce activity), light-intensity trained (LIT; four 30-min exercise bouts/day at 8 m/min separated by 2-h rest period, 5 days/week), and high-intensity interval trained (HIIT, four 2.5-min work bouts/day at 50 m/min separated by 3-min rest periods, 5 days/week). After 12 weeks of intervention, SED had greater visceral fat accumulation (p HIIT demonstrated beneficial changes in body weight, visceral and epididymal fat weight, glucose regulation, low-density lipoprotein cholesterol, total cholesterol, and mesenteric vessel contractile response compared with the CTL group (p HIIT had significant improvements in systolic blood pressure and endothelium-independent vasodilation to aorta and mesenteric artery compared with the CTL group (p HIIT induce health benefits by improving traditional cardiometabolic risk factors. LIT improves cardiac health while HIIT promotes improvements in vascular health.

  10. Health-related quality of life in patients with high-grade gliomas

    DEFF Research Database (Denmark)

    Piil, K; Jakobsen, J; Christensen, Karl Bang

    2015-01-01

    follow-up after 1 year. Scores of Karnofsky Performance Status (KPS), physical activity, anxiety and depression and health-related quality of life (FACT-Br) are obtained. Patients' physical activity level and KPS decrease during the disease- and treatment trajectory. The majority of patients did......The diagnosis of a high-grade glioma usual is followed by functional impairment(s), cognitive decline and an impaired psycho-social well-being. This might well have a significant and negative impact on the health related quality of life. The purpose of this study was to explore physical activity...... levels, prevalence and severity of anxiety and depressive symptoms and health-related quality of life among patients with a highgrade glioma. This paper is based on a longitudinal mixed methods study. Patients (n = 30) completed questionnaires at 5 time points from time of diagnosis until the final...

  11. Healthy offshore workforce? A qualitative study on offshore wind employees' occupational strain, health, and coping.

    Science.gov (United States)

    Mette, Janika; Velasco Garrido, Marcial; Harth, Volker; Preisser, Alexandra M; Mache, Stefanie

    2018-01-23

    Offshore work has been described as demanding and stressful. Despite this, evidence regarding the occupational strain, health, and coping behaviors of workers in the growing offshore wind industry in Germany is still limited. The purpose of our study was to explore offshore wind employees' perceptions of occupational strain and health, and to investigate their strategies for dealing with the demands of offshore work. We conducted 21 semi-structured telephone interviews with employees in the German offshore wind industry. The interviews were transcribed and analyzed in a deductive-inductive approach following Mayring's qualitative content analysis. Workers generally reported good mental and physical health. However, they also stated perceptions of stress at work, fatigue, difficulties detaching from work, and sleeping problems, all to varying extents. In addition, physical health impairment in relation to offshore work, e.g. musculoskeletal and gastrointestinal complaints, was documented. Employees described different strategies for coping with their job demands. The strategies comprised of both problem and emotion-focused approaches, and were classified as either work-related, health-related, or related to seeking social support. Our study is the first to investigate the occupational strain, health, and coping of workers in the expanding German offshore wind industry. The results offer new insights that can be utilized for future research in this field. In terms of practical implications, the findings suggest that measures should be carried out aimed at reducing occupational strain and health impairment among offshore wind workers. In addition, interventions should be initiated that foster offshore wind workers' health and empower them to further expand on effective coping strategies at their workplace.

  12. IMPACT OF HEALTH TECHNOLOGY ASSESSMENT IN LITIGATION CONCERNING ACCESS TO HIGH-COST DRUGS.

    Science.gov (United States)

    Aleman, Alicia; Perez Galan, Ana

    2017-01-01

    The impact of health technology assessment (HTA) in the judicialization of the right of health has not been deeply studied in Latin American countries. The purpose of this study is to review the process of judicialization of the access to high cost drugs in Uruguay and assess the impact HTAs have had on this process. The methodology used for this study included a comprehensive literature search in electronic databases, local journals, internal documents developed in the Ministry of Health, as well as conducting interviews with key informants. Judicialization of the access of high cost drugs has been increasing since 2010. The strategy of the Ministry of Health of Uruguay to decrease this problem included the organization of roundtables with judges and other stakeholders on the basis of HTA, the training of defense lawyers in the use and interpretation of HTA, and the participation of a professional who develops HTA in the preparation of the defense arguments. A year after the implementation of this strategy, 25 percent of writs of protection were won by the Ministry of Health. Even though the strategy implemented was effective in reducing the loss of litigations, it was not effective in reducing the growing number of writs of protection. It is essential to address this problem in a broad debate and to promote understanding between the parties.

  13. Use of a screening tool and primary health care gerontology nurse specialist for high-needs older people.

    Science.gov (United States)

    King, Anna; Boyd, Michal; Dagley, Lynelle

    2017-02-01

    To describe implementation of an innovative gerontology nurse specialist role within one primary health organisation in Auckland, New Zealand. Quantitative outcomes of the screening tool as well as the nurse specialist assessment will be presented. The intervention involved use of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify high-needs older people with subsequent comprehensive geriatric assessment (CGA) performed by the gerontology nurse specialist. A total 384 of the 416 BRIGHTs were completed (92% response rate) and 15% of these were identified as high risk (n = 57). The BRIGHTs for high-risk older people revealed the highest scoring question was 'needing help with housework' (26%). The most frequent intervention by the gerontology nurse specialist was education (30%). The primary health care gerontology nurse specialist model delivers a proactive case finding and specialist gerontology intervention for older people at high risk of functional or health decline.

  14. Principles of Child Health Care Financing.

    Science.gov (United States)

    Hudak, Mark L; Helm, Mark E; White, Patience H

    2017-09-01

    After passage of the Patient Protection and Affordable Care Act, more children and young adults have become insured and have benefited from health care coverage than at any time since the creation of the Medicaid program in 1965. From 2009 to 2015, the uninsurance rate for children younger than 19 years fell from 9.7% to 5.3%, whereas the uninsurance rate for young adults 19 to 25 years of age declined from 31.7% to 14.5%. Nonetheless, much work remains to be done. The American Academy of Pediatrics (AAP) believes that the United States can and should ensure that all children, adolescents, and young adults from birth through the age of 26 years who reside within its borders have affordable access to high-quality and comprehensive health care, regardless of their or their families' incomes. Public and private health insurance should safeguard existing benefits for children and take further steps to cover the full array of essential health care services recommended by the AAP. Each family should be able to afford the premiums, deductibles, and other cost-sharing provisions of the plan. Health plans providing these benefits should ensure, insofar as possible, that families have a choice of professionals and facilities with expertise in the care of children within a reasonable distance of their residence. Traditional and innovative payment methodologies by public and private payers should be structured to guarantee the economic viability of the pediatric medical home and of other pediatric specialty and subspecialty practices to address developing shortages in the pediatric specialty and subspecialty workforce, to promote the use of health information technology, to improve population health and the experience of care, and to encourage the delivery of evidence-based and quality health care in the medical home, as well as in other outpatient, inpatient, and home settings. All current and future health care insurance plans should incorporate the principles for child

  15. Evaluation of health alerts from an early illness warning system in independent living.

    Science.gov (United States)

    Rantz, Marilyn J; Scott, Susan D; Miller, Steven J; Skubic, Marjorie; Phillips, Lorraine; Alexander, Greg; Koopman, Richelle J; Musterman, Katy; Back, Jessica

    2013-06-01

    Passive sensor networks were deployed in independent living apartments to monitor older adults in their home environments to detect signs of impending illness and alert clinicians so they can intervene and prevent or delay significant changes in health or functional status. A retrospective qualitative deductive content analysis was undertaken to refine health alerts to improve clinical relevance to clinicians as they use alerts in their normal workflow of routine care delivery to older adults. Clinicians completed written free-text boxes to describe actions taken (or not) as a result of each alert; they also rated the clinical significance (relevance) of each health alert on a scale of 1 to 5. Two samples of the clinician's written responses to the health alerts were analyzed after alert algorithms had been adjusted based on results of a pilot study using health alerts to enhance clinical decision-making. In the first sample, a total of 663 comments were generated by seven clinicians in response to 385 unique alerts; there are more comments than alerts because more than one clinician rated the same alert. The second sample had a total of 142 comments produced by three clinicians in response to 88 distinct alerts. The overall clinical relevance of the alerts, as judged by the content of the qualitative comments by clinicians for each alert, improved from 33.3% of the alerts in the first sample classified as clinically relevant to 43.2% in the second. The goal is to produce clinically relevant alerts that clinicians find useful in daily practice. The evaluation methods used are described to assist others as they consider building and iteratively refining health alerts to enhance clinical decision making.

  16. Public health human resources: a comparative analysis of policy documents in two Canadian provinces

    Science.gov (United States)

    2014-01-01

    Background Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. Methods A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Results Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. Conclusion This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be

  17. Public health human resources: a comparative analysis of policy documents in two Canadian provinces.

    Science.gov (United States)

    Regan, Sandra; MacDonald, Marjorie; Allan, Diane E; Martin, Cheryl; Peroff-Johnston, Nancy

    2014-02-24

    Amidst concerns regarding the capacity of the public health system to respond rapidly and appropriately to threats such as pandemics and terrorism, along with changing population health needs, governments have focused on strengthening public health systems. A key factor in a robust public health system is its workforce. As part of a nationally funded study of public health renewal in Canada, a policy analysis was conducted to compare public health human resources-relevant documents in two Canadian provinces, British Columbia (BC) and Ontario (ON), as they each implement public health renewal activities. A content analysis of policy and planning documents from government and public health-related organizations was conducted by a research team comprised of academics and government decision-makers. Documents published between 2003 and 2011 were accessed (BC = 27; ON = 20); documents were either publicly available or internal to government and excerpted with permission. Documentary texts were deductively coded using a coding template developed by the researchers based on key health human resources concepts derived from two national policy documents. Documents in both provinces highlighted the importance of public health human resources planning and policies; this was particularly evident in early post-SARS documents. Key thematic areas of public health human resources identified were: education, training, and competencies; capacity; supply; intersectoral collaboration; leadership; public health planning context; and priority populations. Policy documents in both provinces discussed the importance of an educated, competent public health workforce with the appropriate skills and competencies for the effective and efficient delivery of public health services. This policy analysis identified progressive work on public health human resources policy and planning with early documents providing an inventory of issues to be addressed and later documents providing

  18. Toward a More Robust and Efficient Usability Testing Method of Clinical Decision Support for Nurses Derived From Nursing Electronic Health Record Data.

    Science.gov (United States)

    Lopez, Karen Dunn; Febretti, Alessandro; Stifter, Janet; Johnson, Andrew; Wilkie, Diana J; Keenan, Gail

    2017-10-01

    To develop methods for rapid and simultaneous design, testing, and management of multiple clinical decision support (CDS) features to aid nurse decision-making. We used quota sampling, think-aloud and cognitive interviews, and deductive and inductive coding of synchronized audio video data and archival libraries. Our methods and organizational tools allowed us to rapidly improve the usability, understandability, and usefulness of CDS in a generalizable sample of practicing nurses. The method outlined allows the rapid integration of nursing terminology based electronic health record data into routine workflow and holds strong potential for improving patient outcomes. The methods and organizational tools for development of multiple CDS system features can be used to translate knowledge into practice. © 2016 NANDA International, Inc.

  19. Facilitators of community participation in an Aboriginal sexual health promotion initiative.

    Science.gov (United States)

    Hulme Chambers, Alana; Tomnay, Jane; Stephens, Kylie; Crouch, Alan; Whiteside, Mary; Love, Pettina; McIntosh, Leonie; Waples Crowe, Peter

    2018-04-01

    Community participation is a collaborative process aimed at achieving community-identified outcomes. However, approaches to community participation within Aboriginal health promotion initiatives have been inconsistent and not well documented. Smart and Deadly was a community-led initiative to develop sexual health promotion resources with young Aboriginal people in regional Victoria, Australia. The principles of community-centred practice, authentic participatory processes and respect for the local cultural context guided the initiative. The aim of this article is to report factors that facilitated community participation undertaken in the Smart and Deadly initiative to inform future projects and provide further evidence in demonstrating the value of such approaches. A summative evaluation of the Smart and Deadly initiative was undertaken approximately 2 years after the initiative ended. Five focus groups and 13 interviews were conducted with a purposive sample of 32 participants who were involved with Smart and Deadly in one of the following ways: project participant, stakeholder or project partner, or project developer or designer. A deductive content analysis was undertaken and themes were compared to the YARN model, which was specifically created for planning and evaluating community participation strategies relating to Aboriginal sexual health promotion. A number of factors that facilitated community participation approaches used in Smart and Deadly were identified. The overarching theme was that trust was the foundation upon which the facilitators of community participation ensued. These facilitators were cultural safety and cultural literacy, community control, and legacy and sustainability. Whilst the YARN model was highly productive in identifying these facilitators of community participation, the model did not have provision for the element of trust between workers and community. Given the importance of trust between the project team and the Aboriginal

  20. Are there differences in oral health and oral health behavior between individuals with high and low dental fear?

    NARCIS (Netherlands)

    Schuller, A.A.; Willumsen, T.; Holst, D.

    2003-01-01

    Epidemiological studies of the relationship between dental fear, use of dental services, and oral health in different age groups in a common population are scarce. Dental fear and its relationships are usually described in individuals with high dental fear only. The purposes of this study were to

  1. Family socioeconomic status, family health, and changes in students' math achievement across high school: A mediational model.

    Science.gov (United States)

    Barr, Ashley Brooke

    2015-09-01

    In response to recent calls to integrate understandings of socioeconomic disparities in health with understandings of socioeconomic disparities in academic achievement, this study tested a mediational model whereby family socioeconomic status predicted gains in academic achievement across high school through its impact on both student and parent health. Data on over 8000 high school students in the U.S. were obtained from wave 1 (2009-2010) and wave 2 (2012) of the High School Longitudinal Study of 2009 (HSLS:09), and structural equation modeling with latent difference scores was used to determine the role of family health problems in mediating the well-established link between family SES and gains in academic achievement. Using both static and dynamic indicators of family SES, support was found for this mediational model. Higher family SES in 9th grade reduced the probability of students and their parents experiencing a serious health problem in high school, thereby promoting growth in academic achievement. In addition, parent and student health problems mediated the effect of changes in family SES across high school on math achievement gains. Results emphasize the importance of considering the dynamic nature of SES and that both student and parent health should be considered in understanding SES-related disparities in academic achievement. This relational process provides new mechanisms for understanding the intergenerational transmission of socioeconomic status and the status attainment process more broadly. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. East Los High: Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans

    Science.gov (United States)

    Singhal, Arvind

    2016-01-01

    Latina/o Americans are at high risk for sexually transmitted infections and adolescent pregnancies. Needed urgently are innovative health promotion approaches that are engaging and culturally sensitive. East Los High is a transmedia edutainment program aimed at young Latina/o Americans. It embeds educational messages in entertainment narratives across digital platforms to promote sexual and reproductive health. We employed online analytics tracking (2013–2014), an online viewer survey (2013), and a laboratory experiment (El Paso, TX, 2014) for season 1 program evaluation. We found that East Los High had a wide audience reach, strong viewer engagement, and a positive cognitive, emotional, and social impact on sexual and reproductive health communication and education. Culturally sensitive transmedia edutainment programs are a promising health promotion strategy for minority populations and warrant further investigation. PMID:27077336

  3. Focus in High School Mathematics: Reasoning and Sense Making in Geometry

    Science.gov (United States)

    National Council of Teachers of Mathematics, 2010

    2010-01-01

    Classically, geometry has been the subject in which students encounter mathematical proof based on formal deduction. Attention to proof in the geometry curriculum is strengthened by a focus on reasoning and sense making. This book examines the four key elements (conjecturing about geometric objects, construction and evaluation of geometric…

  4. Human Factors in Green Office Building Design: The Impact of Workplace Green Features on Health Perceptions in High-Rise High-Density Asian Cities

    Directory of Open Access Journals (Sweden)

    Fei Xue

    2016-10-01

    Full Text Available There is a growing concern about human factors in green building, which is imperative in high-rise high-density urban environments. This paper describes our attempts to explore the influence of workplace green features (such as green certification, ventilation mode, and building morphology on health perceptions (personal sensation, sensorial assumptions, healing performance based on a survey in Hong Kong and Singapore. The results validated the relationship between green features and health perceptions in the workplace environment. Remarkably, participants from the air-conditioned offices revealed significant higher concerns about health issues than those participants from the mixed-ventilated offices. The mixed-ventilation design performs as a bridge to connect the indoor environment and outdoor space, which enables people to have contact with nature. Additionally, the preferred building morphology of the workplace is the pattern of a building complex instead of a single building. The complex form integrates the configuration of courtyards, podium gardens, green terrace, public plaza, and other types of open spaces with the building clusters, which contributes to better health perceptions. This research contributes to the rationalization and optimization of passive climate-adaptive design strategies for green buildings in high-density tropical or subtropical cities.

  5. Health Care Spending in the United States and Other High-Income Countries.

    Science.gov (United States)

    Papanicolas, Irene; Woskie, Liana R; Jha, Ashish K

    2018-03-13

    Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations. Analysis of data primarily from 2013-2016 from key international organizations including the Organisation for Economic Co-operation and Development (OECD), comparing underlying differences in structural features, types of health care and social spending, and performance between the United States and 10 high-income countries. When data were not available for a given country or more accurate country-level estimates were available from sources other than the OECD, country-specific data sources were used. In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population ≥15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant

  6. Professional development programs in health promotion: tools and processes to favor new practices.

    Science.gov (United States)

    Torres, Sara; Richard, Lucie; Guichard, Anne; Chiocchio, François; Litvak, Eric; Beaudet, Nicole

    2017-06-01

    Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants. © The Author 2015. Published by

  7. Fix These First: How the World's Leading Companies Point the Way Toward High Reliability in the Military Health System.

    Science.gov (United States)

    Beauvais, Brad; Richter, Jason; Brezinski, Paul

    The 2014 Military Health System Review calls for healthcare system leaders to implement effective strategies used by other high-performing organizations. The authors state, " the [military health system] MHS can create an optimal healthcare environment that focuses on continuous quality improvement where every patient receives safe, high-quality care at all times" (Military Health System, 2014, p. 1). Although aspirational, the document does not specify how a highly reliable health system is developed or what systemic factors are necessary to sustain highly reliable performance. Our work seeks to address this gap and provide guidance to MHS leaders regarding how high-performing organizations develop exceptional levels of performance.The authors' expectation is that military medicine will draw on these lessons to enhance leadership, develop exceptional organizational cultures, onboard and engage employees, build customer loyalty, and improve quality of care. Leaders from other segments of the healthcare field likely will find this study valuable given the size of the military healthcare system (9.6 million beneficiaries), the United States' steady progression toward population-based health, and the increasing need for highly reliable systems and performance.

  8. The Use of Telehealth to Teach Reproductive Health to Female Rural High School Students.

    Science.gov (United States)

    Yoost, Jennie Lee; Starcher, Rachael Whitley; King-Mallory, Rebecca Ann; Hussain, Nafeeza; Hensley, Christina Ann; Gress, Todd William

    2017-04-01

    To evaluate the use of telehealth to teach reproductive health to rural areas with high rates of teen pregnancy. Prospective cohort study. Two high schools in rural West Virginia. High school female students who attended telehealth sessions. Teleconferencing equipment connected rural high schools to a distal academic institution. Telehealth sessions included reproductive health and life skills topics. Demographic information, session pre- and post-tests, and 6- month assessment was obtained. Reproductive health knowledge, behavior, and self-efficacy were assessed at intervention and at 6 months, along with Likert scale evaluation of telehealth as an educational tool. Fifty-five students participated in the program with an average age of 16.14 (SD 1.24) years. Only 20% (10/50) of subjects' mothers and 12% (6/50) of subjects' fathers had achieved education beyond high school, and 20% (10/50) of subject's mothers had experienced teen pregnancies (age 18 or younger). Sexual activity was reported among 52% (26/50) of subjects, 4/50 (8%) reported desire to become pregnant within the next year, and 4/50 (8%) reported already pregnant. Thirty-seven students completed the 6-month follow-up survey. Reported condom use increased from 20% (10/50) at baseline to 40% (15/37) at 6 months (P = .04) and hormonal contraception use increased from 22% (11/50) to 38% (14/37) (P = .12). Report of human papillomavirus vaccination increased from 38% (10/26) to 70% (26/37) (P = .001) among all subjects. At 6 months, 91.8% (34/37) reported the use of telehealth was "very effective" as a means to teach the material. Telehealth is an effective tool to teach reproductive health to rural areas. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  9. Health state utility values of high prevalence mental disorders in Australia: results from the National Survey of Mental Health and Wellbeing.

    Science.gov (United States)

    Mihalopoulos, Cathrine; Engel, Lidia; Le, Long Khanh-Dao; Magnus, Anne; Harris, Meredith; Chatterton, Mary Lou

    2018-04-09

    High prevalence mental disorders including depression, anxiety and substance use disorders are associated with high economic and disease burden. However, there is little information regarding the health state utility values of such disorders according to their clinical severity using comparable instruments across all disorders. This study reports utility values for high prevalence mental disorders using data from the 2007 Australian National Survey of Mental Health and Wellbeing (NSMHWB). Utility values were derived from the AQoL-4D and analysed by disorder classification (affective only (AD), anxiety-related only (ANX), substance use only (SUB) plus four comorbidity groups), severity level (mild, moderate, severe), symptom recency (reported in the past 30 days), and comorbidity (combination of disorders). The adjusted Wald test was applied to detect statistically significant differences of weighted means and the magnitude of difference between groups was presented as a modified Cohen's d. In total, 1526 individuals met criteria for a 12-month mental disorder. The mean utility value was 0.67 (SD = 0.27), with lower utility values associated with higher severity levels and some comorbidities. Utility values for AD, ANX and SUB were 0.64 (SD = 0.25), 0.71 (SD = 0.25) and 0.81 (SD = 0.19), respectively. No differences in utility values were observed between disorders within disorder groups. Utility values were significantly lower among people with recent symptoms (within past 30 days) than those without; when examined by diagnostic group, this pattern held for people with SUB, but not for people with ANX or AD. Health state utility values of people with high prevalence mental disorders differ significantly by severity level, number of mental health comorbidities and the recency of symptoms, which provide new insights on the burden associated with high prevalence mental disorders in Australia. The derived utility values can be used to populate future

  10. Line broadening interference for high-resolution nuclear magnetic resonance spectra under inhomogeneous magnetic fields

    International Nuclear Information System (INIS)

    Wei, Zhiliang; Yang, Jian; Lin, Yanqin; Chen, Zhong; Chen, Youhe

    2015-01-01

    Nuclear magnetic resonance spectroscopy serves as an important tool for analyzing chemicals and biological metabolites. However, its performance is subject to the magnetic-field homogeneity. Under inhomogeneous fields, peaks are broadened to overlap each other, introducing difficulties for assignments. Here, we propose a method termed as line broadening interference (LBI) to provide high-resolution information under inhomogeneous magnetic fields by employing certain gradients in the indirect dimension to interfere the magnetic-field inhomogeneity. The conventional spectral-line broadening is thus interfered to be non-diagonal, avoiding the overlapping among adjacent resonances. Furthermore, an inhomogeneity correction algorithm is developed based on pattern recognition to recover the high-resolution information from LBI spectra. Theoretical deductions are performed to offer systematic and detailed analyses on the proposed method. Moreover, experiments are conducted to prove the feasibility of the proposed method for yielding high-resolution spectra in inhomogeneous magnetic fields

  11. The Relationship between Health Literacy, Perceived Self-efficacy and Self-care Performance of Female Senior High School Students in Health Promoting Schools of Miyaneh, 2016-2017

    Directory of Open Access Journals (Sweden)

    Mahnaz Khodabandeh

    2017-12-01

    Full Text Available Background and objective: Self-care in adolescents is considered as an effective measure in line with the promotion of health in each community. In this regard, the role of health promoting schools is of great importance. Furthermore, health literacy, as one of the basic tools for promoting community health, has been given much attention by policymakers. The present study aimed to investigate the relationship between the health literacy, perceived self-efficacy and self-care performance of female senior high school students in the health promoting schools of Miyaneh in 2016-2017. Methods: In this descriptive-correlational study, 320 female senior high school students were selected randomly using the multi –stage cluster sampling method. Data were collected by using the questionnaires of Health Literacy Measure for Adolescents (HELMA, General Self-efficacy Scale, and the Adolescent Health Promotion (AHP scale. Data were analyzed by SPSS software (version 21 using the statistical tests of Pearson correlation coefficient and Multiple Regression (ENTER method. Results: The results showed that there is a positive and significant relationship between the health literacy and perceived self-efficacy and the self-care performance of female students in the health promoting schools, as well as between the components of health literacy and self-care components. No significant relationship was found between the component of health literacy calculation and the self-care components of nutrition, responsibility for health, spiritual growth, and physical activity. The results of regression analysis indicated that the dimensions of self-efficacy, use and correlation of health literacy are good predictors of self-care performance (R2 = 0.605. Moreover, the health literacy and the perceived self-efficacy can predict the self-care performance of students by 51 percent. Conclusion: The results of the present study indicated that a student with high levels of

  12. Exploring inequalities in access to and use of maternal health services in South Africa

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    Silal Sheetal P

    2012-05-01

    Full Text Available Abstract Background South Africa’s maternal mortality rate (625 deaths/100,000 live births is high for a middle-income country, although over 90% of pregnant women utilize maternal health services. Alongside HIV/AIDS, barriers to Comprehensive Emergency Obstetric Care currently impede the country’s Millenium Development Goals (MDGs of reducing child mortality and improving maternal health. While health system barriers to obstetric care have been well documented, “patient-oriented” barriers have been neglected. This article explores affordability, availability and acceptability barriers to obstetric care in South Africa from the perspectives of women who had recently used, or attempted to use, these services. Methods A mixed-method study design combined 1,231 quantitative exit interviews with sixteen qualitative in-depth interviews with women (over 18 in two urban and two rural health sub-districts in South Africa. Between June 2008 and September 2009, information was collected on use of, and access to, obstetric services, and socioeconomic and demographic details. Regression analysis was used to test associations between descriptors of the affordability, availability and acceptability of services, and demographic and socioeconomic predictor variables. Qualitative interviews were coded deductively and inductively using ATLAS ti.6. Quantitative and qualitative data were integrated into an analysis of access to obstetric services and related barriers. Results Access to obstetric services was impeded by affordability, availability and acceptability barriers. These were unequally distributed, with differences between socioeconomic groups and geographic areas being most important. Rural women faced the greatest barriers, including longest travel times, highest costs associated with delivery, and lowest levels of service acceptability, relative to urban residents. Negative provider-patient interactions, including staff inattentiveness, turning

  13. Reducing high calorie snack food in young adults: a role for social norms and health based messages.

    Science.gov (United States)

    Robinson, Eric; Harris, Ellis; Thomas, Jason; Aveyard, Paul; Higgs, Suzanne

    2013-06-05

    Consumption of high calorie junk foods has increased recently, especially among young adults and higher intake may cause weight gain. There is a need to develop public health approaches to motivate people to reduce their intake of junk food. To assess the effect of health and social norm messages on high calorie snack food intake (a type of junk food) as a function of usual intake of junk food. In a between-subjects design, 129 young adults (45 men and 84 women, mean age = 22.4 years, SD = 4.5) were assigned to one of three conditions: 1) a social norm condition, in which participants saw a message about the junk food eating habits of others; 2) a health condition, in which participants saw a message outlining the health benefits of reducing junk food consumption and; 3) a control condition, in which participants saw a non-food related message. After exposure to the poster messages, participants consumed a snack and the choice and amount of snack food consumed was examined covertly. We also examined whether usual intake of junk food moderated the effect of message type on high calorie snack food intake. The amount of high calorie snack food consumed was significantly lower in both the health and the social norm message condition compared with the control message condition (36% and 28%, both p food or energy intake between the health and social norm message conditions. There was no evidence that the effect of the messages depended upon usual consumption of junk food. Messages about the health effects of junk food and social normative messages about intake of junk food can motivate people to reduce their consumption of high calorie snack food.

  14. Surveillane of Middle and High School Mental Health Risk by Student Self-Report Screener

    Directory of Open Access Journals (Sweden)

    Bridget V Dever

    2013-08-01

    Full Text Available Introduction: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER for surveying community risk among 7 schools. Methods: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student. The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status.Results: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14% than boys (12%; middle school students reported fewer difficulties than high school students.Conclusion: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening viastudent self-report is potentially useful for identifying aggregated community

  15. Health-illness transition among persons using advanced medical technology at home.

    Science.gov (United States)

    Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

    2011-06-01

    This study aimed to elucidate meanings of health-illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health-illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health-illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health-illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health-illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition. © 2010 The Authors. Scandinavian Journal of

  16. Should We Be Afraid of Simple Messages? The Effects of Text Difficulty and Illustrations in People With Low or High Health Literacy.

    Science.gov (United States)

    Meppelink, Corine S; Smit, Edith G; Buurman, Bianca M; van Weert, Julia C M

    2015-01-01

    It is often recommended that health information should be simplified for people with low health literacy. However, little is known about whether messages adapted to low health literacy audiences are also effective for people with high health literacy, or whether simple messages are counterproductive in this group. Using a two (illustrated vs. text-only) by two (nondifficult vs. difficult text) between-subjects design, we test whether older adults with low (n = 279) versus high health literacy (n = 280) respond differently to colorectal cancer screening messages. Results showed that both health literacy groups recalled information best when the text was nondifficult. Reduced text difficulty did not lead to negative attitudes or less intention to have screening among people with high health literacy. Benefits of illustrations, in terms of improved recall and attitudes, were only found in people with low health literacy who were exposed to difficult texts. This was not found for people with high health literacy. In terms of informed decisions, nondifficult and illustrated messages resulted in the best informed decisions in the low health literacy group, whereas the high health literacy group benefited from nondifficult text in general, regardless of illustrations. Our findings imply that materials adapted to lower health literacy groups can also be used for a more general audience, as they do not deter people with high health literacy.

  17. Applying the lessons of high risk industries to health care.

    Science.gov (United States)

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks.

  18. Big data in health care: using analytics to identify and manage high-risk and high-cost patients.

    Science.gov (United States)

    Bates, David W; Saria, Suchi; Ohno-Machado, Lucila; Shah, Anand; Escobar, Gabriel

    2014-07-01

    The US health care system is rapidly adopting electronic health records, which will dramatically increase the quantity of clinical data that are available electronically. Simultaneously, rapid progress has been made in clinical analytics--techniques for analyzing large quantities of data and gleaning new insights from that analysis--which is part of what is known as big data. As a result, there are unprecedented opportunities to use big data to reduce the costs of health care in the United States. We present six use cases--that is, key examples--where some of the clearest opportunities exist to reduce costs through the use of big data: high-cost patients, readmissions, triage, decompensation (when a patient's condition worsens), adverse events, and treatment optimization for diseases affecting multiple organ systems. We discuss the types of insights that are likely to emerge from clinical analytics, the types of data needed to obtain such insights, and the infrastructure--analytics, algorithms, registries, assessment scores, monitoring devices, and so forth--that organizations will need to perform the necessary analyses and to implement changes that will improve care while reducing costs. Our findings have policy implications for regulatory oversight, ways to address privacy concerns, and the support of research on analytics. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Conceptualizing High School Students' Mental Health through a Dual-Factor Model

    Science.gov (United States)

    Suldo, Shannon M; Thalji-Raitano, Amanda; Kiefer, Sarah M.; Ferron, John M.

    2016-01-01

    Mental health is increasingly viewed as a complete state of being, consisting of the absence of psychopathology and the presence of positive factors such as subjective well-being (SWB). This cross-sectional study analyzed multimethod and multisource data for 500 high school students (ages 14-18 years, M = 15.27 years, SD = 1.0 years) to examine…

  20. Comparison of high- versus low-intensity community health worker intervention to promote newborn and child health in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    Findley SE

    2013-10-01

    the five prior years (baseline: n = 6,906; follow-up: n = 2,310. The follow-up respondents were grouped by level of intensity of the CHW interventions in their community, with “low” including group activities led only by a trained community volunteer and “high” including the community volunteer activities plus CBSD from a CHW providing one-on-one advice and assistance. t-tests were used to test for significant differences from baseline to follow-up, and F-statistics, which adjust for the stratified cluster design, were used to test for significant differences between the control, low-intensity, and high-intensity intervention groups at follow-up. These analyses focused on changes in newborn and sick child care practices.Results: Anti-tetanus vaccination coverage during pregnancy increased from 69.2% at baseline to 85.7% at follow-up in the intervention areas. Breastfeeding within 24 hours increased from 42.9% to 59.0% in the intervention areas, and more newborns were checked by health workers within 48 hours (from 16.8% at baseline to 26.8% at follow-up in the intervention areas. Newborns were more likely to be checked by trained health personnel, and they received more comprehensive newborn care. Compared to the control communities, more than twice as many women in intervention communities knew to watch for specific newborn danger signs. Compared to the control and low-intensity intervention communities, more mothers in the high-intensity communities learned about the care of sick children from CHWs, with a corresponding decline those seeking advice from family or friends or traditional birth attendants. Significantly fewer mothers did nothing when their child was sick. High-intensity intervention communities experienced the most decline. Those who did nothing for children with fever or cough declined from 35% to 30%, and with diarrhea from 40% to 31%. Use of medications, both traditional and modern, increased from baseline to follow-up, with no