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Introduction to IBS

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... Day Art of IBS Gallery Contact Us Search Introduction to IBS Details What is IBS? Last Updated: ... tax-deductible donation. Make Donation What is IBS? Introduction to IBS Symptoms of IBS What Causes IBS? ...

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Billing and insurance-related administrative costs in United States' health care: synthesis of micro-costing evidence.

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Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G

2014-11-13

The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375

Medications (for IBS)

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Prescriptions and Insurance Plans

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... contributed by: familydoctor.org editorial staff Categories: Healthcare Management, Insurance & Bills, Your Health ResourcesTags: brand name, co-pay, drug, formulary, generic, isurance, medicine, ...

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The Status of Billing and Reimbursement in Pediatric Obesity Treatment Programs

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Gray, Jane Simpson; Filigno, Stephanie Spear; Santos, Melissa; Ward, Wendy L.; Davis, Ann M.

2014-01-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service. PMID:23224661

The status of billing and reimbursement in pediatric obesity treatment programs.

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Gray, Jane Simpson; Spear Filigno, Stephanie; Santos, Melissa; Ward, Wendy L; Davis, Ann M

2013-07-01

Pediatric psychologists provide behavioral health services to children and adolescents diagnosed with medical conditions. Billing and reimbursement have been problematic throughout the history of pediatric psychology, and pediatric obesity is no exception. The challenges and practices of pediatric psychologists working with obesity are not well understood. Health and behavior codes were developed as one potential solution to aid in the reimbursement of pediatric psychologists who treat the behavioral health needs of children with medical conditions. This commentary discusses the current state of billing and reimbursement in pediatric obesity treatment programs and presents themes that have emerged from discussions with colleagues. These themes include variability in billing practices from program to program, challenges with specific billing codes, variability in reimbursement from state to state and insurance plan to insurance plan, and a general lack of practitioner awareness of code issues or reimbursement rates. Implications and future directions are discussed in terms of research, training, and clinical service.

Medications (for IBS)

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Full Text Available ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ... with Diarrhea Nausea and IBS Bloating in IBS Sleep and Irritable Bowel Syndrome Gynecological Aspects of Irritable ...

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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

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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.

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Full Text Available ... of IBS Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is IBS? ... and more! Sign up for eNewsletter: Site map | Privacy & Security | Terms of Use | Contact Us This information ...

Cervical Cancer Stage IB

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... hyphen, e.g. -historical Searches are case-insensitive Cervical Cancer Stage IB Add to My Pictures View /Download : ... 1613x1200 View Download Large: 3225x2400 View Download Title: Cervical Cancer Stage IB Description: Stage IB1 and IB2 cervical ...

IBS Diet

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... the most common questions IBS patients have is what food to avoid. This can drive a person to ... Global Treatments IBS Diet What to Do and What to Avoid Foods That Cause Cramping and Diarrhea Foods that Cause ...

Dental insurance! Are we ready?

Directory of Open Access Journals (Sweden)

Ravi SS Toor

2011-01-01

Full Text Available Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI bill which was put forward in the winter session of the Lok Sabha (2008 focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

Insurance coverage of customers induces dishonesty of sellers in markets for credence goods.

Science.gov (United States)

Kerschbamer, Rudolf; Neururer, Daniel; Sutter, Matthias

2016-07-05

Honesty is a fundamental pillar for cooperation in human societies and thus for their economic welfare. However, humans do not always act in an honest way. Here, we examine how insurance coverage affects the degree of honesty in credence goods markets. Such markets are plagued by strong incentives for fraudulent behavior of sellers, resulting in estimated annual costs of billions of dollars to customers and the society as a whole. Prime examples of credence goods are all kinds of repair services, the provision of medical treatments, the sale of software programs, and the provision of taxi rides in unfamiliar cities. We examine in a natural field experiment how computer repair shops take advantage of customers' insurance for repair costs. In a control treatment, the average repair price is about EUR 70, whereas the repair bill increases by more than 80% when the service provider is informed that an insurance would reimburse the bill. Our design allows decomposing the sources of this economically impressive difference, showing that it is mainly due to the overprovision of parts and overcharging of working time. A survey among repair shops shows that the higher bills are mainly ascribed to insured customers being less likely to be concerned about minimizing costs because a third party (the insurer) pays the bill. Overall, our results strongly suggest that insurance coverage greatly increases the extent of dishonesty in important sectors of the economy with potentially huge costs to customers and whole economies.

Medications (for IBS)

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Teaching Billing and Coding to Medical Students: A Pilot Study

Directory of Open Access Journals (Sweden)

Jiaxin Tran

2013-08-01

Full Text Available Complex billing practices cost the US healthcare system billions of dollars annually. Coding for outpatient office visits [known as Evaluation & Management (E&M services] is commonly particularly fraught with errors. The best way to insure proper billing and coding by practicing physicians is to teach this as part of the medical school curriculum. Here, in a pilot study, we show that medical students can learn well the basic principles from lectures. This approach is easy to implement into a medical school curriculum.

[Validation of the IBS-SSS].

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Betz, C; Mannsdörfer, K; Bischoff, S C

2013-10-01

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterised by abdominal pain, associated with stool abnormalities and changes in stool consistency. Diagnosis of IBS is based on characteristic symptoms and exclusion of other gastrointestinal diseases. A number of questionnaires exist to assist diagnosis and assessment of severity of the disease. One of these is the irritable bowel syndrome - severity scoring system (IBS-SSS). The IBS-SSS was validated 1997 in its English version. In the present study, the IBS-SSS has been validated in German language. To do this, a cohort of 60 patients with IBS according to the Rome III criteria, was compared with a control group of healthy individuals (n = 38). We studied sensitivity and reproducibility of the score, as well as the sensitivity to detect changes of symptom severity. The results of the German validation largely reflect the results of the English validation. The German version of the IBS-SSS is also a valid, meaningful and reproducible questionnaire with a high sensitivity to assess changes in symptom severity, especially in IBS patients with moderate symptoms. It is unclear if the IBS-SSS is also a valid questionnaire in IBS patients with severe symptoms because this group of patients was not studied. © Georg Thieme Verlag KG Stuttgart · New York.

Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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

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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.

Hospital billing for blood processing and transfusion for inpatient stays.

Science.gov (United States)

McCue, Michael J; Nayar, Preethy

2009-07-01

Medicare, an important payer for hospitals, reimburses hospitals for inpatient stays using Diagnosis Related Groups (DRGs). Many private insurers also use the DRG methodology to reimburse hospitals for their services. Therefore, those blood service organizations that bill Medicare directly require an understanding of the DRG system of payment to enable them to bill Medicare correctly, and in order to be certain they are adequately reimbursed. Blood centers that do not bill Medicare directly need to understand how hospitals are reimbursed for blood and blood components as this affects a hospital's ability to pay service fees related to these products. This review presents a detailed explanation of how hospitals are reimbursed by the Centers for Medicare and Medicaid Services (CMS) for Medicare inpatient services, including blood services.

Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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Full Text Available ... Tips on Finding a Doctor Doctor Visit Worksheet Words to Know Changing Doctors IBS Symptom Treatments IBS ... arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). All ...

A Regional Analysis of U.S. Insurance Reimbursement Guidelines for Massage Therapy.

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Miccio, Robin S; Cowen, Virginia S

2018-03-01

Massage techniques fall within the scope of many different health care providers. Physical therapists, occupational therapists, and chiropractors receive insurance reimbursement for health care services, including massage. Although many patients pay out of pocket for massage services, it is unclear how the insurance company reimbursement policies factor provider qualifications into coverage. This project examined regional insurance reimbursement guidelines for massage therapy in relation to the role of the provider of massage services. A qualitative content analysis was used to explore guidelines for 26 health insurance policies across seven US companies providing coverage in the northeastern United States. Publicly available information relevant to massage was obtained from insurance company websites and extracted into a dataset for thematic analysis. Data obtained included practice guidelines, techniques, and provider requirements. Information from the dataset was coded and analyzed using descriptive statistics. Of the policies reviewed, 23% explicitly stated massage treatments were limited to 15-minute increments, 19% covered massage as one part of a comprehensive rehabilitation plan, and 27% required physician prescription. Massage techniques mentioned as qualifying for reimbursement included: Swedish, manual lymphatic drainage, mobilization/manipulation, myofascial release, and traction. Chiropractors, physical therapists, and occupational therapists could directly bill for massage. Massage therapists were specifically excluded as covered providers for seven (27%) policies. Although research supports massage for the treatment of a variety of conditions, the provider type has not been separately addressed. The reviewed policies that served the Northeastern states explicitly stated massage therapists could not bill insurance companies directly. The same insurance companies examined reimbursement for massage therapists in their western U.S. state policies. Other

Billing third party payers for pharmaceutical care services.

Science.gov (United States)

Poirier, S; Buffington, D E; Memoli, G A

1999-01-01

To describe the steps pharmacists must complete when seeking compensation from third party payers for pharmaceutical care services. Government publications; professional publications, including manuals and newsletters; authors' personal experience. Pharmacists in increasing numbers are meeting with success in getting reimbursed by third party payers for patient care activities. However, many pharmacists remain reluctant to seek compensation because they do not understand the steps involved. Preparatory steps include obtaining a provider/supplier number, procuring appropriate claim forms, developing data collection and documentation systems, establishing professional fees, creating a marketing plan, and developing an accounting system. To bill for specific patient care services, pharmacists need to collect the patient's insurance information, obtain a statement of medical necessity from the patient's physician, complete the appropriate claim form accurately, and submit the claim with supporting documentation to the insurer. Although many claims from pharmacists are rejected initially, pharmacists who work with third party payers to understand the reasons for denial of payment often receive compensation when claims are resubmitted. Pharmacists who follow these guidelines for billing third party payers for pharmaceutical care services should notice an increase in the number of paid claims.

Medications (for IBS)

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IBS Treatment Options

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... 01 July 2017 Print A short bout of abdominal pain and diarrhea or constipation now and then is not unusual. But long-term or recurring symptoms are not normal. They may signal irritable bowel syndrome (IBS) – and are generally treatable. IBS Treatments Depend ...

Medications (for IBS)

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The ophthalmologist's office: planning and practice. Getting paid and completing insurance forms.

Science.gov (United States)

Byron, H M

1975-01-01

This chapter describes a systematic approach to the art of collection for services rendered, based primarily on a pay-as-you-go philosophy. A system of internal office-controlled billing, timed so that the statements reach the patients on the last day of the billing month instead of the first day of the following month, unequivocally works more smoothly in the author's office than external computerized billing did. Suggestions to effect and maintain a collection ratio of at least 95 percent have been enumerated. The use of a new statement-and-insurance form facilitates billing, keeping ahead of insurance applications for patients, and advising the front office of other internal tasks to be performed. Finally, the importance of the general ledger, under the supervision of the ophthalmologist's accountant and in conjunction with a control procedure (employing the daily master appointment page attached to the ophthalmologist's personal worksheet) is stressed, in order to safeguard the physician's revenue.

School-located influenza vaccination with third-party billing: outcomes, cost, and reimbursement.

Science.gov (United States)

Kempe, Allison; Daley, Matthew F; Pyrzanowski, Jennifer; Vogt, Tara; Fang, Hai; Rinehart, Deborah J; Morgan, Nicole; Riis, Mette; Rodgers, Sarah; McCormick, Emily; Hammer, Anne; Campagna, Elizabeth J; Kile, Deidre; Dickinson, Miriam; Hambidge, Simon J; Shlay, Judith C

2014-01-01

To assess rates of immunization; costs of conducting clinics; and reimbursements for a school-located influenza vaccination (SLIV) program that billed third-party payers. SLIV clinics were conducted in 19 elementary schools in the Denver Public School district (September 2010 to February 2011). School personnel obtained parental consent, and a community vaccinator conducted clinics and performed billing. Vaccines For Children vaccine was available for eligible students. Parents were not billed for any fees. Data were collected regarding implementation costs and vaccine cost was calculated using published private sector prices. Reimbursement amounts were compared to costs. Overall, 30% of students (2784 of 9295) received ≥1 influenza vaccine; 39% (1079 of 2784) needed 2 doses and 80% received both. Excluding vaccine costs, implementation costs were $24.69 per vaccination. The percentage of vaccine costs reimbursed was 62% overall (82% from State Child Health Insurance Program (SCHIP), 50% from private insurance). The percentage of implementation costs reimbursed was 19% overall (23% from private, 27% from Medicaid, 29% from SCHIP and 0% among uninsured). Overall, 25% of total costs (implementation plus vaccine) were reimbursed. A SLIV program resulted in vaccination of nearly one third of elementary students. Reimbursement rates were limited by 1) school restrictions on charging parents fees, 2) low payments for vaccine administration from public payers and 3) high rates of denials from private insurers. Some of these problems might be reduced by provisions in the Affordable Care Act. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

IBS for non-gaussian distributions

International Nuclear Information System (INIS)

Fedotov, A.; Sidorin, A.O.; Smirnov, A.V.

2010-01-01

In many situations distribution can significantly deviate from Gaussian which requires accurate treatment of IBS. Our original interest in this problem was motivated by the need to have an accurate description of beam evolution due to IBS while distribution is strongly affected by the external electron cooling force. A variety of models with various degrees of approximation were developed and implemented in BETACOOL in the past to address this topic. A more complete treatment based on the friction coefficient and full 3-D diffusion tensor was introduced in BETACOOL at the end of 2007 under the name 'local IBS model'. Such a model allowed us calculation of IBS for an arbitrary beam distribution. The numerical benchmarking of this local IBS algorithm and its comparison with other models was reported before. In this paper, after briefly describing the model and its limitations, they present its comparison with available experimental data.

Sensitivity of Billing Claims for Cardiovascular Disease Events among Kidney Transplant Recipients

Science.gov (United States)

Lentine, Krista L.; Schnitzler, Mark A.; Abbott, Kevin C.; Bramesfeld, Kosha; Buchanan, Paula M.; Brennan, Daniel C.

2009-01-01

Background and objectives: Billing claims are increasingly examined beyond administrative functions as outcomes measures in observational research. Few studies have described the performance of billing claims as surrogate measures of clinical events among kidney transplant recipients. Design, setting, participants, & measurements: We investigated the sensitivity of Medicare billing claims for clinically verified cardiovascular diagnoses (five categories) and procedures (four categories) in a novel database linking Medicare claims to electronic medical records of one transplant program. Cardiovascular events identified in medical records for 571 Medicare-insured transplant recipients in 1991 through 2002 served as reference measures. Results: Within a claims-ascertainment period spanning ±30 d of clinically recorded dates, aggregate sensitivity of single claims was higher for case definitions incorporating Medicare Parts A and B for diagnoses and procedures (90.9%) compared with either Part A (82.3%) or Part B (84.6%) alone. Perfect capture of the four procedures was possible within ±30 d or with short claims window expansion, but sensitivity for the diagnoses trended lower with all study algorithms (91.2% with window up to ±90 d). Requirement for additional confirmatory diagnosis claims did not appreciably reduce sensitivity. Sensitivity patterns were similar in the early compared with late periods of the study. Conclusions: Combined use of Medicare Parts A and B billing claims composes a sensitive measure of cardiovascular events after kidney transplant. Further research is needed to define algorithms that maximize specificity as well as sensitivity of claims from Medicare and other insurers as research measures in this population. PMID:19541817

topIb, a phylogenetic hallmark gene of Thaumarchaeota encodes a functional eukaryote-like topoisomerase IB.

Science.gov (United States)

Dahmane, Narimane; Gadelle, Danièle; Delmas, Stéphane; Criscuolo, Alexis; Eberhard, Stephan; Desnoues, Nicole; Collin, Sylvie; Zhang, Hongliang; Pommier, Yves; Forterre, Patrick; Sezonov, Guennadi

2016-04-07

Type IB DNA topoisomerases can eliminate torsional stresses produced during replication and transcription. These enzymes are found in all eukaryotes and a short version is present in some bacteria and viruses. Among prokaryotes, the long eukaryotic version is only observed in archaea of the phylum Thaumarchaeota. However, the activities and the roles of these topoisomerases have remained an open question. Here, we demonstrate that all available thaumarchaeal genomes contain a topoisomerase IB gene that defines a monophyletic group closely related to the eukaryotic enzymes. We show that the topIB gene is expressed in the model thaumarchaeon Nitrososphaera viennensis and we purified the recombinant enzyme from the uncultivated thaumarchaeon Candidatus Caldiarchaeum subterraneum. This enzyme is active in vitro at high temperature, making it the first thermophilic topoisomerase IB characterized so far. We have compared this archaeal type IB enzyme to its human mitochondrial and nuclear counterparts. The archaeal enzyme relaxes both negatively and positively supercoiled DNA like the eukaryotic enzymes. However, its pattern of DNA cleavage specificity is different and it is resistant to camptothecins (CPTs) and non-CPT Top1 inhibitors, LMP744 and lamellarin D. This newly described thermostable topoisomerases IB should be a promising new model for evolutionary, mechanistic and structural studies. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

6 Tips: IBS and Complementary Health Practices

Science.gov (United States)

... health practice for IBS, here are 6 tips: Hypnotherapy (hypnosis). This practice involves the power of suggestion by ... IBS. According to reviews of the scientific literature, hypnotherapy may be a helpful treatment for managing IBS ...

Treatment of cancer of cervix stages IB1 and IB2 in the Hospital Calderon Guardia (2000-2003)

International Nuclear Information System (INIS)

Saenz, Oscar; Picans, Serafin

2004-01-01

The types of treatment applied in patients with stages of cancer of cervix IB1 and IB2, your evolution and prognosis were determined. Different methods of treatment were compared. It was a prospective descriptive and observational study of the patients of Servicio de Ginecologia Oncologica of the Hospital Calderon Guardia, San Jose, Costa Rica. It was carried out from August 2000 to November 2002. The study included all female patients with proved histological diagnosis of cervical cancer IB1 and IB2. All of them had pre-operative studies: plate of thorax, abdomen ultrasound, computerized axial tomography of pelvis and abdomen, at least received primary treatment (surgery) and the following monitoring. The statistical analysis was realized with chi-square evidences, through epi-info software. Of 24 patients only 19 got complete information. It was found a 22% of patients with positives adenopatias to level of histological study with a ganglionic compromise of 32% in general form, a 36% in the stages IB1 and a 25% in stages IB2. Of all the patients that presented ganglionic metastasis illness, did not get to show with the computerized axial tomography and it is concluded that TAC is a bad method for detection of the microscopic metastasis illness, or at least to 2 cm. None of the patients in stages IB1 presented relapse data in the observed period, founding a 100% of survival to 24 months. The patients in stages IB2 presented relapses, with a 75% of survival [es

Effects of the 2013 Psychiatric Current Procedural Terminology Codes Revision on Psychotherapy in Psychiatric Billing.

Science.gov (United States)

Mark, Tami L; Olesiuk, William J; Sherman, Laura J; Ali, Mir M; Mutter, Ryan; Teich, Judith L

2017-11-01

The purpose of this study was to determine whether the changes to the psychiatric Current Procedural Terminology (CPT) codes implemented in 2013 were associated with changes in types of services for which psychiatrists billed. Analyses were conducted using paid private insurance claims from a large commercial database. The participant cohort comprised psychiatrists with at least one psychiatry visit reported in the database in each calendar year studied: 2012 (N of visits=778,445), 2013 (N=748,317), and 2014 (N=754,760). The percentage of visits in which psychiatrists billed for psychotherapy declined from 51.4% in 2012 to 42.1% in 2014. The decline held after the analyses adjusted for patient characteristics, plan type, and region. The update to CPT codes resulted in a decrease in visits for which psychiatrists billed for psychotherapy. Further research should explore whether the change in billing corresponds to changes in service delivery.

IBS SURVEY 2010: DRIVERS, BARRIERS AND CRITICAL SUCCESS FACTORS IN ADOPTING INDUSTRIALISED BUILDING SYSTEM (IBS CONSTRUCTION BY G7 CONTRACTORS IN MALAYSIA

Directory of Open Access Journals (Sweden)

KAMARUL ANUAR MOHAMAD KAMAR

2014-08-01

Full Text Available The industrialised building system (IBS survey has become an essential tool for ensuring the IBS Roadmap (2003 to 2010 meets its goals and target. As part of the process review survey, it also records the trend achievement of Malaysia in the usage of IBS in the building construction industry. The first and second IBS surveys were published in 2003 and 2005, respectively. Afterward, the IBS Roadmap’s midterm review was conducted. The third and the most recent IBS surveys were conducted in 2008 and 2010, respectively. This paper aims to highlight a part of the IBS survey report in 2010, which has been conducted to measure the drivers, barriers and the critical success factors of G7 contractors in adopting IBS construction. G7 is a Construction Industry Development Board contractor grade that can apply tender without limit. The importance of this paper is that it guides the policy and implementation strategy of IBS by G7 contractors. The survey shows that the acceptance, adoption, and deployment of IBS in the Malaysian construction industry are still low and do not address the persisting problems, such as productivity, dependency on foreign workers and high level of construction wastage.

Communications Centre Model in Insurance Business

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Danijel Bara

2013-07-01

Full Text Available The aim of this paper is to define a communications centre model in an insurance company that essentially has two objectives. The first objective is focused on providing quality support with the sales process thereby creating a strategic advantage over the competition while the second objective is focused on improving the link between internal organizational units whose behaviour can often render decision-making at all levels difficult. The function of sales is fundamental for an insurance company. Whether an insurance company will fulfil its basic function, which is transfer of risk from the insured party to the insurer who agrees tonreimburse incidental damages to the damaged party and distribute them among all members of the risk group on the principles of reciprocity and solidarity, depends on successful sales and billing (Andrijašević & Petranović, 1999. For an insurance company to operate successfully in a demanding market, it is necessary to meet the needs of potential clients who then must be at the centre of all the activities of the insurer. A satisfied policy holder, who is respected by the insurer as a partner, is a guarantee that the sales of insurance services will be successful and that the insured party will come back to the same insurance company. In the era of globalization and all-pervading new technologies and modes of communication, policy holders need to be able to communicate with insurance company employees. Quality communication is a good foundation for a sales conversation. A fast flow of all types of information within an organisation using a single communication module makes decision-making at all levels quicker and easier.

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib).

Science.gov (United States)

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2015-05-01

Hypocalcemia and hyperphosphatemia because of resistance toward parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder, which is caused by GNAS methylation changes, resistance can occur toward other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are usually not recognized until PTH-resistant hypocalcemia becomes clinically apparent. We now describe four pediatric patients, first diagnosed with subclinical or overt hypothyroidism between the ages of 0.2 and 15 years, who developed overt PTH-resistance 3 to 20 years later. Although anti-thyroperoxidase (anti-TPO) antibodies provided a plausible explanation for hypothyroidism in one of these patients, this and two other patients revealed broad epigenetic GNAS abnormalities, which included loss of methylation (LOM) at exons AS, XL, and A/B, and gain of methylation at exon NESP55; ie, findings consistent with PHP-Ib. LOM at GNAS exon A/B alone led in the fourth patient to the identification of a maternally inherited 3-kb STX16 deletion, a well-established cause of autosomal dominant PHP-Ib. Although GNAS methylation changes were not detected in additional pediatric and adult patients with subclinical hypothyroidism (23 pediatric and 39 adult cases), hypothyroidism can obviously be the initial finding in PHP-Ib patients. One should therefore consider measuring PTH, along with calcium and phosphate, in patients with unexplained hypothyroidism for extended periods of time to avoid hypocalcemia and associated clinical complications. © 2014 American Society for Bone and Mineral Research.

IBS and Non-GI Functional Disorders

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... of IBS patients have at least one coexisting somatic symptom and many IBS patients meet diagnostic criteria ... up-to-date on the latest news, stories, tips, research highlights, and more! Sign up for eNewsletter: ...

Endocannabinoid and cannabinoid-like fatty acid amide levels correlate with pain-related symptoms in patients with IBS-D and IBS-C: a pilot study.

Directory of Open Access Journals (Sweden)

Jakub Fichna

Full Text Available AIMS: Irritable bowel syndrome (IBS is a functional gastrointestinal (GI disorder, associated with alterations of bowel function, abdominal pain and other symptoms related to the GI tract. Recently the endogenous cannabinoid system (ECS was shown to be involved in the physiological and pathophysiological control of the GI function. The aim of this pilot study was to investigate whether IBS defining symptoms correlate with changes in endocannabinoids or cannabinoid like fatty acid levels in IBS patients. METHODS: AEA, 2-AG, OEA and PEA plasma levels were determined in diarrhoea-predominant (IBS-D and constipation-predominant (IBS-C patients and were compared to healthy subjects, following the establishment of correlations between biolipid contents and disease symptoms. FAAH mRNA levels were evaluated in colonic biopsies from IBS-D and IBS-C patients and matched controls. RESULTS: Patients with IBS-D had higher levels of 2AG and lower levels of OEA and PEA. In contrast, patients with IBS-C had higher levels of OEA. Multivariate analysis found that lower PEA levels are associated with cramping abdominal pain. FAAH mRNA levels were lower in patients with IBS-C. CONCLUSION: IBS subtypes and their symptoms show distinct alterations of endocannabinoid and endocannabinoid-like fatty acid levels. These changes may partially result from reduced FAAH expression. The here reported changes support the notion that the ECS is involved in the pathophysiology of IBS and the development of IBS symptoms.

Paternal uniparental isodisomy of the entire chromosome 20 as a molecular cause of pseudohypoparathyroidism type Ib (PHP-Ib).

Science.gov (United States)

Bastepe, Murat; Altug-Teber, Ozge; Agarwal, Chhavi; Oberfield, Sharon E; Bonin, Michael; Jüppner, Harald

2011-03-01

Pseudohypoparathyoridism type Ib (PHP-Ib) typically defines the presence of end-organ resistance to parathyroid hormone in the absence of Albright's hereditary osteodystrophy. Patients affected by this disorder present with imprinting defects in the complex GNAS locus. Microdeletions within STX16 or GNAS have been identified in familial cases with PHP-Ib, but the molecular cause of the GNAS imprinting defects in sporadic PHP-Ib cases remains poorly defined. We now report a case with sporadic PHP-Ib for whom a SNPlex analysis revealed loss of the maternal GNAS allele. Further analysis of the entire genome with a 100K SNP chip identified a paternal uniparental isodisomy affecting the entire chromosome 20 without evidence for another chromosomal abnormality. Our findings explain the observed GNAS methylation changes and the patient's hormone resistance, and furthermore suggest that chromosome 20 harbors, besides GNAS, no additional imprinted region that contributes to the clinical and laboratory phenotype. Copyright © 2010 Elsevier Inc. All rights reserved.

Medications (for IBS)

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Full Text Available ... Agents Antidepressant Medications Newer IBS Medications Probiotics and Antibiotics Psychological Treatments Understanding Stress Cognitive Behavioral Therapy Relaxation Techniques for ...

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib)†

Science.gov (United States)

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2014-01-01

Hypocalcemia and hyperphosphatemia because of resistance towards parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder that is caused by GNAS methylation changes, resistance can occur towards other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are usually not recognized until PTH-resistant hypocalcemia becomes clinically apparent. We now describe four pediatric patients, first diagnosed with subclinical or overt hypothyroidism between the ages of 0.2 and 15 years, who developed overt PTH-resistance 3-20 years later. Although anti-TPO antibodies provided a plausible explanation for hypothyroidism in one of these patients, this and two other patients revealed broad epigenetic GNAS abnormalities, which included loss of methylation (LOM) at exons AS, XL and A/B, and gain of methylation at exon NESP55, i.e. findings consistent with PHP-Ib. LOM at GNAS exon A/B alone led in the fourth patient to the identification of a maternally inherited 3-kb STX16 deletion, a well-established cause of autosomal dominant PHP-Ib. Although GNAS methylation changes were not detected in additional pediatric and adult patients with subclinical hypothyroidism (23 pediatric and 39 adult cases), hypothyroidism can obviously be the initial finding in PHP-Ib patients. One should therefore consider measuring PTH, along with calcium and phosphate, in patients with unexplained hypothyroidism for extended periods of time to avoid hypocalcemia and associated clinical complications. PMID:25403028

TSH elevations as the first laboratory evidence for pseudohypoparathyroidism type Ib (PHP-Ib)†

OpenAIRE

Molinaro, Angelo; Tiosano, Dov; Takatani, Rieko; Chrysis, Dionisios; Russell, William; Koscielniak, Nikolas; Kottler, Marie-Laure; Agretti, Patrizia; De Marco, Giuseppina; Ahtiainen, Petteri; Christov, Marta; Mäkitie, Outi; Tonacchera, Massimo; Jüppner, Harald

2015-01-01

Hypocalcemia and hyperphosphatemia because of resistance towards parathyroid hormone (PTH) in the proximal renal tubules are the most prominent abnormalities in patients affected by pseudohypoparathyroidism type Ib (PHP-Ib). In this rare disorder that is caused by GNAS methylation changes, resistance can occur towards other hormones, such as thyroid-stimulating hormone (TSH), that mediate their actions through G protein-coupled receptors. However, these additional laboratory abnormalities are...

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS--a case-control study in primary care.

Science.gov (United States)

Grodzinsky, Ewa; Walter, Susanna; Viktorsson, Lisa; Carlsson, Ann-Kristin; Jones, Michael P; Faresjö, Åshild

2015-01-28

Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care. A case-control study in primary care setting among IBS patients meeting the ROME III criteria (n = 140) compared to controls i.e. non-IBS patients (n = 213) without any present or previous gastrointestinal complaints. The data were collected through self-reported questionnaires of psychosocial factors. IBS-patients reported significantly more negative self-esteem (p IBS-cases were also less likely to report 'good' health status (p IBS patients remained statistically significant (p = 0.02), as did the lower scores for sense of coherence among IBS cases (p = 0.04). The more frequently reported negative self-esteem and inferior coping strategies among IBS patients found in this study suggest the possibility that psychological therapies might be helpful for these patients. However these data do not indicate the causal direction of the observed associations. More research is therefore warranted to determine whether these psychosocial constructs are more frequent in IBS patients.

The IB Diploma and UK University Degree Qualifications

Science.gov (United States)

Frank-Gemmill, Gerda

2013-01-01

In recent years the International Baccalaureate (IB) Diploma has become widely accepted as a university-entry qualification in the UK, but there has been little quantitative research into the achievements of IB students at degree level. This study investigates IB students from one selective independent school who entered UK universities between…

Rising Billing for Intermediate Intensive Care among Hospitalized Medicare Beneficiaries between 1996 and 2010.

Science.gov (United States)

Sjoding, Michael W; Valley, Thomas S; Prescott, Hallie C; Wunsch, Hannah; Iwashyna, Theodore J; Cooke, Colin R

2016-01-15

Intermediate care (i.e., step-down or progressive care) is an alternative to the intensive care unit (ICU) for patients with moderate severity of illness. The adoption and current use of intermediate care is unknown. To characterize trends in intermediate care use among U.S. hospitals. We examined 135 million acute care hospitalizations among elderly individuals (≥65 yr) enrolled in fee-for-service Medicare (U.S. federal health insurance program) from 1996 to 2010. We identified patients receiving intermediate care as those with intensive care or coronary care room and board charges labeled intermediate ICU. In 1996, a total of 960 of the 3,425 hospitals providing critical care billed for intermediate care (28%), and this increased to 1,643 of 2,783 hospitals (59%) in 2010 (P billed for intermediate care, but billing steadily increased to 22.8% by 2010 (P billed for ICU care and ward-only care declined. Patients billed for intermediate care had more acute organ failures diagnoses codes compared with general ward patients (22.4% vs. 15.8%). When compared with patients billed for ICU care, those billed for intermediate care had fewer organ failures (22.4% vs. 43.4%), less mechanical ventilation (0.9% vs. 16.7%), lower mean Medicare spending ($8,514 vs. $18,150), and lower 30-day mortality (5.6% vs. 16.5%) (P billing increased markedly between 1996 and 2010. These findings highlight the need to better define the value, specific practices, and effective use of intermediate care for patients and hospitals.

The House of Commons of Canada, Bill C-249: An act to amend the nuclear liability act

International Nuclear Information System (INIS)

1996-01-01

The purpose of this bill is to increase the maximum level of liability for which a private sector nuclear facility operator may be required to have insurance coverage from 75 million dollars to 500 million dollars. If the Governor in Council is of the opinion that liability could exceed the insured amount and a Commission created under Part II of the Act orders that further compensation should be made. At present, the Crown may make such payments but is not required to do so

Integrated Baseline Bystem (IBS) Version 1.03: Models guide

Energy Technology Data Exchange (ETDEWEB)

1993-01-01

The Integrated Baseline System)(IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planning and analysis. This document is the models guide for the IBS and explains how to use the emergency related computer models. This document provides information for the experienced system user, and is the primary reference for the computer modeling software supplied with the system. It is designed for emergency managers and planners, and others familiar with the concepts of computer modeling. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other IBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary.

Medications (for IBS)

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Full Text Available ... IBS Medications Probiotics and Antibiotics Psychological ... With Your Doctor Successful relationships with healthcare providers are an important part of managing life with a long-term digestive disorder. Working with ...

Experience with IBS-suppression lattice in RHIC

International Nuclear Information System (INIS)

Litvinenko, V.N.; Luo, Y.; Ptitsyn, V.; Satogata, T.; Tepikian, S.; Bai, M.; Bruno, D.; Cameron, P.; Connolly, R.; Della Penna, A.; Drees, A.; Fedotov, A.; Ganetis, G.; Hoff, L.; Louie, W.; Malitsky, N.; Marr, G.; Marusic, A.; Montag, C.; Pilat, F.; Roser, T.; Trbojevic, D.; Tsoupas, N.

2008-01-01

An intra-beam scattering (IBS) is the limiting factor of the luminosity lifetime for RHIC operating with heavy ions. In order to suppress the IBS we designed and implemented new lattice with higher betatron tunes. This lattice had been developed during last three years and had been used for gold ions in yellow ring of the RHIC during d-Au part of the RHIC Run-8. The use of this lattice allowed both significant increases in the luminosity lifetime and the luminosity levels via reduction of beta-stars in the IPS. In this paper we report on the development, the tests and the performance of IBS-suppression lattice in RHIC, including the resulting increases in the peak and the average luminosity. We also report on our plans for future steps with the IBS suppression

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Full Text Available ... Read more about antidiarrheal agents. Anti-anxiety medications – can be helpful for some people with IBS, mainly those with emotional distress. There are also effective medications available that relieve ...

[The state and health insurance].

Science.gov (United States)

Lagrave, Michel

2003-01-01

The relationship between the State and the health insurance passes through an institutional and financial crisis, leading the government to decide a new governance of the health care system and of the health insurance. The onset of the institutional crisis is the consequence of the confusion of the roles played by the State and the social partners. The social democracy installed by the French plan in 1945 and the autonomy of management of the health insurance established by the 1967 ordinances have failed. The administration parity (union and MEDEF) flew into pieces. The State had to step in by failing. The light is put on the financial crisis by the evolution of ONDAM (National Objective of the Health Insurance Expenses) which appears in the yearly law financing Social Security. The drift of the real expenses as compared to the passed ONDAM bill is constant and worsening. The question of reform includes the link between social democracy to be restored (social partners) and political democracy (Parliament and Government) to establish a contractual democracy. The Government made the announcement of an ONDAM sincere and medically oriented, based on tools agreed upon by all parties. The region could become a regulating step involving a regional health council. An accounting magistrate would be needed to consider not only the legal aspect but to include economic fallouts of health insurance. The role and the missions of the Social Security Accounting Committee should be reinforced.

Platelet Glycoprotein Ib-IX and Malignancy

Science.gov (United States)

2010-09-01

provide a unique microenvironment supporting the accumulation of more platelets and the elaboration of a fibrin - rich network produced by coagulation...process and can initiate the formation of a platelet - rich thrombus by tethering the platelet to a thrombogenic surface. Several ligands binding to GP Ib... Platelet Glycoprotein Ib-IX and Malignancy PRINCIPAL INVESTIGATOR: Jerry Ware, Ph.D

A CMMS Expert using BIM for IBS Building Maintenance

Directory of Open Access Journals (Sweden)

Hamzah Noraini

2016-01-01

Full Text Available In the IBS building maintenance, the conventional methods to the project delivery and its failure to form effective communication channel between complementary knowledge on IBS construction and related members that is conducted in the sequential manner has resulted in ineffectiveness for managing building maintenance, where a paradigm shift within the IBS traditional approach is necessary. The research results described are concerned with i an integrated system to record, diagnose and analyse information for IBS building maintenance to detect patent or latent defect, select an effective repair method, provide appropriate planning decision and reduce risks of defect throughout the building lifetime. ii building a decision making support in diagnosis in IBS building maintenance based on robust data collection about concrete defects and causes including in the selection of a durable replacement design and material or the proper rehabilitation method. The system development was based on analysis of number of interviews and case studies conducted with professional engineers working in IBS building maintenance departments. The paper concludes that implementing a CMMS Expert using BIM can help improve the performance of IBS building design, construction and maintenance operations.

Medications (for IBS)

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Full Text Available ... be taken on a more long-term basis. These include low dose antidepressant agents or the relatively ... IBS in multi-center, high quality clinical trials. These are prescription medications intended for specific use under ...

Medications (for IBS)

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Full Text Available ... Beth Israel Deaconess Medical Center, Boston, MA. Last modified on February 23, 2015 at 12:18:55 ... Dietary Fiber 12 Week Elimination Diet for IBS Rice-Based Foods Low-FODMAP Diet What Are FODMAPs? ...

Medications (for IBS)

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Full Text Available ... for some people with IBS, mainly those with emotional distress. There are also effective medications available that ... not linked to depression, but rather likely to effects on the brain and the gut. Antidepressant medications ...

Medications (for IBS)

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Full Text Available ... have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if ... Summary The effectiveness of various agents differs between individuals. A medication regimen must be carefully chosen by ...

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Full Text Available ... He or she can help you monitor quality, effectiveness, possible interactions with other medicines you may be ... Read more about newer IBS medications. Summary The effectiveness of various agents differs between individuals. A medication ...

Medications (for IBS)

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Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... limited by prescription only. It might be a drug or a supplement; manufactured or "natural." It might ...

Medications (for IBS)

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Full Text Available ... Newer IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ... take for a therapeutic effect counts as a medicine. It can be readily available over-the-counter, ...

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Full Text Available ... Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and ... About IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working ...

Medications (for IBS)

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Full Text Available ... for some people with IBS, mainly those with emotional distress. There are also effective medications available that ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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Medications (for IBS)

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Full Text Available ... MA. Last modified on February 23, 2015 at 12:18:55 PM Treatment Understanding and Managing Pain ... Foods that Cause Gas and Bloating Dietary Fiber 12 Week Elimination Diet for IBS Rice-Based Foods ...

Medications (for IBS)

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Full Text Available ... depression, but rather likely to effects on the brain and the gut. Antidepressant medications can reduce the intensity of pain signals going from gut to brain. Read more about antidepressant medications. Newer IBS-Targeted ...

Medications (for IBS)

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Full Text Available ... severe symptoms which do not respond to physician counseling and dietary manipulations. What's a medication? Anything you ... Therapy Relaxation Techniques for IBS Take Part in Online Studies Working With Your Doctor Successful relationships with ...

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The Impact of the Twin Peaks Model on the Insurance Industry

Directory of Open Access Journals (Sweden)

Daleen Millard

2017-02-01

Full Text Available Financial regulation in South Africa changes constantly. In the quest to find the ideal regulatory framework for optimal consumer protection, rules change all the time and international trends have an important influence on lawmakers nationally. The Financial Sector Regulation Bill, also known as the "Twin Peaks" Bill, is the latest invention from the table of the legislature, and some expect this Bill to have far-reaching consequences for the financial services industry. The question is, of course, whether the current dispensation will change so quickly and so dramatically that it will literally be the end of the world as we know it or whether there will be a gradual shift in emphasis away from the so-called silo regulatory approach to an approach that distinguishes between prudential regulation on the one hand and market conduct regulation on the other. A further question is whether insurance as a financial service will change dramatically in the light of the expected twin peak dispensation. The purpose of this paper is to discuss the implications of the FSR Bill for the insurance industry. Instead of analysing the Bill feature for feature, the method that will be used in this enquiry is to identify trends and issues from 2014 and to discuss whether the Twin Peaks model, once implemented, can successfully eradicate similar problems in future. The impact of Twin Peaks will of course have to be tested, but at this point in time it may be very useful to take an educated guess by using recent cases as examples. Recent cases before the courts, the Enforcement Committee and the FAIS Ombud will be discussed not only as examples of the most prevalent issues of the past year or so, but also as examples of how consumer issues and systemic risks are currently being dealt with and how this may change with the implementation of the FSR Bill.

Medications (for IBS)

Medline Plus

Full Text Available ... your doctor about it. He or she can help you monitor quality, effectiveness, possible interactions with other ... effectively treat multiple symptoms of IBS. Laxatives – can help treat symptoms of constipation. Laxatives should be used ...

Medications (for IBS)

Medline Plus

Full Text Available ... include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve ... This Article Help You? IFFGD is a nonprofit education and research organization. Our mission is to inform, ...

Medications (for IBS)

Medline Plus

Full Text Available ... of constipation. Laxatives should be used under the supervision of a physician. Read more about laxatives. Bulking ... medications intended for specific use under a doctor’s supervision. Read more about newer IBS medications. Summary The ...

Therapy Caps and Variation in Cost of Outpatient Occupational Therapy by Provider, Insurance Status, and Geographic Region.

Science.gov (United States)

Pergolotti, Mackenzi; Lavery, Jessica; Reeve, Bryce B; Dusetzina, Stacie B

This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12-14 visits. . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Medications (for IBS)

Medline Plus

Full Text Available ... treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain ... problem arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD). ...

Medications (for IBS)

Medline Plus

Full Text Available ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ... doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care. © Copyright 1998- ...

Medications (for IBS)

Medline Plus

Full Text Available ... treatment of IBS symptoms is not linked to depression, but rather likely to effects on the brain ... whenever a health problem arises requiring an expert’s care. © Copyright 1998-2018 International Foundation for Functional Gastrointestinal ...

Medications (for IBS)

Medline Plus

Full Text Available ... IFFGD Our Mission Awareness Activities Advocacy Activities Research Leadership Industry Council Contact us IBS Treatment Working With ... We advise seeing a physician whenever a health problem arises requiring an expert’s care. © Copyright 1998-2018 ...

Explaining the increase in family financial pressures from medical bills between 2003 and 2007: do affordability thresholds change over time?

Science.gov (United States)

Cunningham, Peter J

2011-06-01

This study examines whether affordability thresholds for medical care as defined by families change over time. The results from two nationally representative surveys show that while financial stress from medical bills--defined as the percent with problems paying medical bills--increased between 2003 and 2007, greater out-of-pocket spending accounted for this increase only for higher-income persons with employer-sponsored insurance coverage. Increased spending did not account for an increase in medical bill problems among lower-income persons. Moreover, the increase in medical bill problems among low-income persons occurred at relatively low levels of out-of-pocket spending rather than at higher levels. The results suggest that "affordability thresholds" for medical care as defined by individuals and families are not stable over time, especially for lower-income persons, which has implications for setting affordability standards in health reform.

Turning whine into wine: the fiscal impact of comprehensive documentation and billing for nonoperative pediatric surgical services.

Science.gov (United States)

Gollin, Gerald; Moores, Donald

2006-06-01

Some pediatric surgeons rarely document nonoperative services, believing that the reimbursement provided for such care is negligible. We evaluated the impact of comprehensive documentation and billing for nonoperative, pediatric surgical care. All bills submitted for inpatient, nonoperative care for 1 year were reviewed. Total receipts for documented admissions, consultations, critical care, and daily care were determined. The Evaluation and Management code billed for each service was recorded, and the total and average payments attributable to each Evaluation and Management code were calculated. Fifty-six percent of services were covered by Medicaid and 26% by a commercial insurer. There were 607 billed admission history and physical exams for which reimbursement totaled 43,493 dollars. Critical care services were provided to 49 patients and yielded 8964 dollars in payments. Six hundred thirty-nine inpatient consultations were performed with a reimbursement of 42,830 dollars. Daily care services were billed 1044 times and produced 71,579 dollars in payments. Overall reimbursement for documented, nonoperative services was 166,866 dollars. This represented 16.2% of total, noncontracted income for the practice. Despite a payer mix heavily weighted toward Medicaid, comprehensive documentation and billing for nonoperative services increased total, noncontracted reimbursement by almost 20% over what it would have been had only operative services been billed. The yield from properly documented, nonoperative care can be substantial.

Functional Expression of a DNA-Topoisomerase IB from Cryptosporidium parvum

Directory of Open Access Journals (Sweden)

César Ordóñez

2009-01-01

Full Text Available Cryptosporidium parvum, one of the most important causative organisms of human diarrheas during childhood, contains a monomeric DNA-topoisomerase IB (CpTopIB in chromosome 7. Heterologous expression of CpTopIB gene in a budding yeast strain lacking this activity proves that the cryptosporidial enzyme is functional in vivo. The enzymatic activity is comprised in a single polypeptide, which contains all the structural features defining a fully active TopIB. Relaxation activity of the yeast extracts was detected only when CpTopIB ORF was expressed in a yeast expression system showing time and protein dependence under steady state kinetic conditions. The susceptibility of CpTopIB-transformed yeast to the irreversible inhibitor camptothecin and its water-soluble derivatives (topotecan and SN-38 was assessed.

Reform of the Buy-and-Bill System for Outpatient Chemotherapy Care Is Inevitable: Perspectives from an Economist, a Realpolitik, and an Oncologist

OpenAIRE

Polite, Blase; Conti, Rena M.; Ward, Jeffery C.

2015-01-01

Treating patients with cancer with infused or injected oncolytics is a core component of outpatient oncology practice. Currently, practices purchase drugs and then bill insurers, colloquially called “buy and bill.” Reimbursement for these drugs is the largest source of gross revenue for oncology practices, and as the prices of cancer drugs have grown over time, these purchases have had significant impact on the financial health of practices and pose a risk that jeopardizes the ability of many...

Medications (for IBS)

Medline Plus

Full Text Available ... include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve abdominal pain or discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin). Read ...

A COMPARATIVE ANALYSIS BETWEEN UNIT-LINKED LIFE INSURANCE AND OTHER ALTERNATIVE INVESTMENTS

Directory of Open Access Journals (Sweden)

CRISTINA CIUMAS

2015-07-01

Full Text Available The unit-linked life insurance has two important components: protection and investment. The protection component refers to the insured sum in case of the occurrence of insured risks and the investment component refers to the policyholder’s account that represents the present value of the units from the chosen investment funds.These financial products invest most of the premium paid by the insured person in the funds managed by the insurance company or an external administrator and the lower part of the premium is intended to cover the insured risk (death, disability, etc. An important component of the activity carried out by the insurance companies is the investment of the premiums paid by policyholders in various types of assets, in order to obtain higher yields than those guaranteed by the insurance contracts, while providing the necessary liquidity for the payment of insurance claims in case of occurrence of the assumed risks. This research contributes to the existing literature regarding the study of investment alternatives, with an exclusive focus on the investment in unit-linked life insurance. A special place in this study is the presentation of investments in unit-linked insurance versus other types of financial investments: deposits, treasury bills, shares (BET, currency (EURO and gold.

Exclusion of the GNAS locus in PHP-Ib patients with broad GNAS methylation changes: evidence for an autosomal recessive form of PHP-Ib?

Science.gov (United States)

Fernández-Rebollo, Eduardo; Pérez de Nanclares, Guiomar; Lecumberri, Beatriz; Turan, Serap; Anda, Emma; Pérez-Nanclares, Gustavo; Feig, Denice; Nik-Zainal, Serena; Bastepe, Murat; Jüppner, Harald

2011-08-01

Most patients with autosomal dominant pseudohypoparathyroidism type Ib (AD-PHP-Ib) carry maternally inherited microdeletions upstream of GNAS that are associated with loss of methylation restricted to GNAS exon A/B. Only few AD-PHP-Ib patients carry microdeletions within GNAS that are associated with loss of all maternal methylation imprints. These epigenetic changes are often indistinguishable from those observed in patients affected by an apparently sporadic PHP-Ib form that has not yet been defined genetically. We have now investigated six female patients affected by PHP-Ib (four unrelated and two sisters) with complete or almost complete loss of GNAS methylation, whose healthy children (11 in total) showed no epigenetic changes at this locus. Analysis of several microsatellite markers throughout the 20q13 region made it unlikely that PHP-Ib is caused in these patients by large deletions involving GNAS or by paternal uniparental isodisomy or heterodisomy of chromosome 20 (patUPD20). Microsatellite and single-nucleotide variation (SNV) data revealed that the two affected sisters share their maternally inherited GNAS alleles with unaffected relatives that lack evidence for abnormal GNAS methylation, thus excluding linkage to this locus. Consistent with these findings, healthy children of two unrelated sporadic PHP-Ib patients had inherited different maternal GNAS alleles, also arguing against linkage to this locus. Based on our data, it appears plausible that some forms of PHP-Ib are caused by homozygous or compound heterozygous mutation(s) in an unknown gene involved in establishing or maintaining GNAS methylation. Copyright © 2011 American Society for Bone and Mineral Research.

Who pays the bill: insuring against the risks from low level nuclear waste disposal

International Nuclear Information System (INIS)

Cohen, L.

1981-01-01

Long-range financial liability for low-level waste (LLW) activities is not currently assured. Part of the problem with finding an acceptable solution to liability has been a tendency to lump all long-term financial commitments, both risky and anticipated, together. It is suggested that only risks arising from unforeseen technical problems require special federal policies. Other long-term costs are more efficiently handled by traditional private insurance. Special policies are needed, however, for the unforeseen risks. The analysis concludes that state insurance of operators with federal reinsurance may be the most reasonable concept. Reinsurance levels should be set to balance federal information requirements, relative control of the three main parties over outcomes, and solvency requirements

Integrals for IBS and Beam Cooling

International Nuclear Information System (INIS)

Burov, A.

2005-01-01

Simulation of beam cooling usually requires performing certain integral transformations every time step or so, which is a significant burden on the CPU. Examples are the dispersion integrals (Hilbert transforms) in the stochastic cooling, wake fields and IBS integrals. An original method is suggested for fast and sufficiently accurate computation of the integrals. This method is applied for the dispersion integral. Some methodical aspects of the IBS analysis are discussed

Medications (for IBS)

Medline Plus

Full Text Available ... of a physician. Read more about laxatives. Bulking agents – provided they relieve and don’t worsen symptoms, can ease stool passage. Examples include bran or psyllium. Anticholinergics/Antispasmodics – have limited benefit for treating IBS. In some persons they relieve ...

Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population.

Science.gov (United States)

Doshi, Jalpa A; Cai, Qian; Buono, Jessica L; Spalding, William M; Sarocco, Phil; Tan, Hiangkiat; Stephenson, Judith J; Carson, Robyn T

2014-04-01

The prevalence of irritable bowel syndrome with constipation (IBS-C) is estimated to be between 4.3% and 5.2% among adults in the United States. Little is known about the health care resource utilization and costs associated with IBS-C. To (a) evaluate the annual total all-cause, gastrointestinal (GI)-related, and IBS-C-related health care costs among IBS-C patients seeking medical care in a commercially insured population and (b) estimate the incremental all-cause health care costs among IBS-C patients relative to matched controls. Patients aged ≥ 18 years with continuous medical and pharmacy benefit eligibility in 2010 were identified from the HealthCore Integrated Research Database, which consists of administrative claims from 14 geographically dispersed U.S. health plans representing 45 million lives. IBS-C patients were defined as those with ≥ 1 medical claim with an ICD-9-CM diagnosis code in any position for IBS (ICD-9-CM 564.1x) and either ≥ 2 medical claims for constipation (ICD-9-CM 564.0x) on different service dates or ≥ 1 medical claim for constipation plus ≥ 1 pharmacy claim for a constipation-related prescription on different dates of service during the study period. Controls were defined as patients without any medical claims for IBS, constipation, abdominal pain, or bloating or pharmacy claims for constipation-related prescriptions. Controls were randomly selected and matched with IBS-C patients in a 1:1 ratio based on age (± 4 years), gender, health plan region, and health plan type. Patients with diagnoses or prescriptions suggesting mixed IBS, IBS with diarrhea, chronic diarrhea, or drug-induced constipation were excluded. Total health care costs in 2010 U.S. dollars were defined as the sum of health plan and patient paid costs for prescriptions and medical services, including inpatient visits, emergency room (ER) visits, physician office visits, and other outpatient services. The total cost approach was used to assess

Billing Trends

Indian Academy of Sciences (India)

First page Back Continue Last page Overview Graphics. Billing Trends. Internet access: Bandwidth becoming analogous to electric power. Only maximum capacity (load) is fixed; Charges based on usage (units). Leased line bandwidth: Billing analogous to phone calls. But bandwidth is variable.

Patient educational media preferences for information about irritable bowel syndrome (IBS).

Science.gov (United States)

Halpert, Albena; Dalton, Christine B; Palsson, Olafur; Morris, Carolyn; Hu, Yuming; Bangdiwala, Shrikant; Hankins, Jane; Norton, Nancy; Drossman, Douglas A

2008-12-01

To identify the educational media preferences of patients with irritable bowel syndrome (IBS). The IBS-Patient Education Questionnaire (PEQ) was administered to a national sample of IBS patients. Frequencies of item endorsements were compared and meaningful clinical differences were used to identify differences among subgroups. 1,242 patients completed the survey, mean age 39.3 years, 85% female, IBS duration 6.9 years, 79% had seen an MD for IBS within 6 months, and 92.6% used the web for medical information. The most desired source of education was "my doctor" (68%), followed by Internet (62%) and brochure (45%). Notably, patients favored an increase in use of media in the future (past vs. future): doctor (43 vs. 68%); Internet (36 vs. 62%); and brochures (26 vs. 45%). IBS patients expect more education than they have received. Understanding IBS patients' learning preferences can be highly valuable in the development or implementation of educational interventions.

INFORMATION FROM THE CERN HEALTH INSURANCE SCHEME

CERN Document Server

Tel : 7-3635

2002-01-01

Please note that, from 1 July 2002, the tariff agreement between CERN and the Hôpital de la Tour will no longer be in force. As a result the members of the CERN Health Insurance Scheme will no longer obtain a 5% discount for quick payment of bills. More information on the termination of the agreement and the implications for our Health Insurance Scheme will be provided in the next issue of the CHIS Bull', due for publication in the first half of July. It will be sent to your home address, so, if you have moved recently, please check that your divisional secretariat has your current address. Tel.: 73635 The Organization's Health Insurance Scheme (CHIS) has launched its own Web pages, located on the Website of the Social & Statutory Conditions Group of HR Division (HR-SOC). The address is short and easy-to-remember www.cern.ch/chis The pages currently available concentrate on providing basic information. Over the coming months it is planned to fill out the details and introduce new topics. Please give us ...

A logistic regression model for Ghana National Health Insurance claims

Directory of Open Access Journals (Sweden)

Samuel Antwi

2013-07-01

Full Text Available In August 2003, the Ghanaian Government made history by implementing the first National Health Insurance System (NHIS in Sub-Saharan Africa. Within three years, over half of the country’s population had voluntarily enrolled into the National Health Insurance Scheme. This study had three objectives: 1 To estimate the risk factors that influences the Ghana national health insurance claims. 2 To estimate the magnitude of each of the risk factors in relation to the Ghana national health insurance claims. In this work, data was collected from the policyholders of the Ghana National Health Insurance Scheme with the help of the National Health Insurance database and the patients’ attendance register of the Koforidua Regional Hospital, from 1st January to 31st December 2011. Quantitative analysis was done using the generalized linear regression (GLR models. The results indicate that risk factors such as sex, age, marital status, distance and length of stay at the hospital were important predictors of health insurance claims. However, it was found that the risk factors; health status, billed charges and income level are not good predictors of national health insurance claim. The outcome of the study shows that sex, age, marital status, distance and length of stay at the hospital are statistically significant in the determination of the Ghana National health insurance premiums since they considerably influence claims. We recommended, among other things that, the National Health Insurance Authority should facilitate the institutionalization of the collection of appropriate data on a continuous basis to help in the determination of future premiums.

Lack of dental insurance is correlated with edentulism.

Science.gov (United States)

Simon, Lisa; Nalliah, Romesh P; Seymour, Brittany

2015-01-01

The correlation between insurance status and edentulism has not previously been reported in a population with known access to a dentist, and little is known about patient demographics in corporate dental settings. This study investigated patient demographics of a former dental franchise in Chicopee, Massachusetts, and examined a correlation between dental insurance and edentulism in this group. The correlation of edentulism with age, gender, and dental risk factors (diabetes, temporomandibular disorder, trouble with previous dental work, or oral sores and ulcers) was also examined. This was a retrospective case study. Age, gender, and presence of dental risk factors were recorded from the patient medical history intake form. Dentate status was recorded from patient odontograms. Dental insurance status was obtained from billing records. Data was aggregated and deidentified. Descriptive and bivariate statistics and logistic regression models were used to identify associations (p-value ≤ 0.05 significance). Of 1,123 records meeting inclusion criteria, 52.54 percent of patients had dental insurance, 26.27 percent had at least one dental risk factor, and 18.17 percent were edentulous. Age and insurance status were significantly correlated with edentulism. Correcting for age, individuals without insurance were 1.56 times as likely to be edentulous. This case study provides insight into patient demographics that might seek care in a corporate setting and suggests that access to a dentist alone may not be adequate in preserving the adult dentition; dental insurance may also be important to health. As the corporate dental practice model continues to grow, these topics deserve further study.

Quality of life in patients with Irritable Bowel Syndrome (IBS), assessed using the IBS-Quality of Life (IBS-QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide: results of an international prospective observational cohort study in Poland, Egypt, Mexico and China.

Science.gov (United States)

Hou, Xiaohua; Chen, Shengliang; Zhang, Yali; Sha, Weihong; Yu, Xiaofeng; Elsawah, Hesham; Afifi, Afifi Fahmy; El-Khayat, Hisham Raafat; Nouh, Alaa; Hassan, Mohamed Fathalla; Fatah, Ayman Abdel; Rucker Joerg, Isabel; Sánchez Núñez, Juan Manuel; Osthoff Rueda, Rodolfo; Jurkowska, Grazyna; Walczak, Michal; Malecka-Panas, Ewa; Linke, Krzysztof; Hartleb, Marek; Janssen-van Solingen, Gwendolyn

2014-11-01

Irritable Bowel Syndrome (IBS) has a substantial impact on health-related quality of life (HR-QoL) but high-quality data pre- and post-treatment using the IBS-Quality of Life (IBS-QOL) measure are limited. The objective of this study was to evaluate the changes from baseline of the IBS-QOL scores, symptom scores and health economic data in IBS patients, after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide. This was a prospective observational cohort study in patients with IBS, diagnosed using the Rome III criteria in four countries (Poland, Egypt, Mexico and China). A total of 607 patients were enrolled. At baseline, the IBS-QOL total scores were 52.0 in Poland, 48.9 in Egypt, 51.9 in Mexico, 76.4 in China and 56.4 overall. Increases in IBS-QOL total score were statistically significant at Weeks 4 and 8 overall and in each country (overall: 11.8 at Week 4, 24.3 at Week 8; p < 0.001). Improvements were shown in all IBS-QOL subscales and scores. Symptoms and health economic outcomes were improved. Furthermore, the favourable safety profile of these treatments was confirmed in this study. This study demonstrated that IBS patients have a substantially reduced HR-QoL and that treatment with mebeverine hydrochloride or pinaverium bromide improved HR-QoL.

Randomised controlled trial of mesalazine in IBS.

Science.gov (United States)

Barbara, Giovanni; Cremon, Cesare; Annese, Vito; Basilisco, Guido; Bazzoli, Franco; Bellini, Massimo; Benedetti, Antonio; Benini, Luigi; Bossa, Fabrizio; Buldrini, Paola; Cicala, Michele; Cuomo, Rosario; Germanà, Bastianello; Molteni, Paola; Neri, Matteo; Rodi, Marcello; Saggioro, Alfredo; Scribano, Maria Lia; Vecchi, Maurizio; Zoli, Giorgio; Corinaldesi, Roberto; Stanghellini, Vincenzo

2016-01-01

Low-grade intestinal inflammation plays a role in the pathophysiology of IBS. In this trial, we aimed at evaluating the efficacy and safety of mesalazine in patients with IBS. We conducted a phase 3, multicentre, tertiary setting, randomised, double-blind, placebo-controlled trial in patients with Rome III confirmed IBS. Patients were randomly assigned to either mesalazine, 800 mg, or placebo, three times daily for 12 weeks, and were followed for additional 12 weeks. The primary efficacy endpoint was satisfactory relief of abdominal pain/discomfort for at least half of the weeks of the treatment period. The key secondary endpoint was satisfactory relief of overall IBS symptoms. Supportive analyses were also performed classifying as responders patients with a percentage of affirmative answers of at least 75% or >75% of time. A total of 185 patients with IBS were enrolled from 21 centres. For the primary endpoint, the responder patients were 68.6% in the mesalazine group versus 67.4% in the placebo group (p=0.870; 95% CI -12.8 to 15.1). In explorative analyses, with the 75% rule or >75% rule, the percentage of responders was greater in the mesalazine group with a difference over placebo of 11.6% (p=0.115; 95% CI -2.7% to 26.0%) and 5.9% (p=0.404; 95% CI -7.8% to 19.4%), respectively, although these differences were not significant. For the key secondary endpoint, overall symptoms improved in the mesalazine group and reached a significant difference of 15.1% versus placebo (p=0.032; 95% CI 1.5% to 28.7%) with the >75% rule. Mesalazine treatment was not superior than placebo on the study primary endpoint. However, a subgroup of patients with IBS showed a sustained therapy response and benefits from a mesalazine therapy. ClincialTrials.gov number, NCT00626288. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Insight of Industrialised Building System (IBS By Bumiputera Construction Players

Directory of Open Access Journals (Sweden)

Muhammad W. M. N. W.

2016-01-01

Full Text Available The term Industrialised Building System (IBS is widely recognised by construction players in Malaysia since its first implementation since 1960s for IBS pilot projects of Pekeliling Flats and Rifle Range Flats. The aim for the implementation is to promote better system in delivering construction end-products which offers efficiency and effectiveness. At the same time, Bumiputera construction players are the majority of parties in construction industry especially in Small and Medium Enterprises (SMEs. Therefore, the purpose of this paper is to identify the perception and awareness of IBS implementation among Bumiputera players. It is found that, Bumiputera construction players have sound knowledge on the IBS and optimistic towards further implementation for future projects. Nonetheless, issues on payment methods and coordination of IBS project delivery are found to be the negative perceptions which are considered as hindrance for Bumiputera construction players’ involvement in IBS project.

Pseudohypoparathyroidism type Ib associated with novel duplications in the GNAS locus.

Directory of Open Access Journals (Sweden)

Gustavo Perez-Nanclares

Full Text Available Pseudohypoparathyroidism type 1b (PHP-Ib is characterized by renal resistance to PTH (and, sometimes, a mild resistance to TSH and absence of any features of Albright's hereditary osteodystrophy. Patients with PHP-Ib suffer of defects in the methylation pattern of the complex GNAS locus. PHP-Ib can be either sporadic or inherited in an autosomal dominant pattern. Whereas familial PHP-Ib is well characterized at the molecular level, the genetic cause of sporadic PHP-Ib cases remains elusive, although some molecular mechanisms have been associated with this subtype.The aim of the study was to investigate the molecular and imprinting defects in the GNAS locus in two unrelated patients with PHP-Ib.We have analyzed the GNAS locus by direct sequencing, Methylation-Specific Multiplex Ligation-dependent Probe Amplification, microsatellites, Quantitative Multiplex PCR of Short Fluorescent fragments and array-Comparative Genomic Hybridization studies in order to characterize two unrelated families with clinical features of PHP-Ib.We identified two duplications in the GNAS region in two patients with PHP-Ib: one of them, comprising ∼ 320 kb, occurred 'de novo' in the patient, whereas the other one, of ∼ 179 kb in length, was inherited from the maternal allele. In both cases, no other known genetic cause was observed.In this article, we describe the to-our-knowledge biggest duplications reported so far in the GNAS region. Both are associated to PHP-Ib, one of them occurring 'de novo' and the other one being maternally inherited.

Data Management Guide: Integrated Baseline System (IBS). Version 2.1

Energy Technology Data Exchange (ETDEWEB)

Bower, J.C. [Bower Software Services, Kennewick, Washington (United States); Burford, M.J.; Downing, T.R.; Moise, M.C.; Williams, J.R. [Pacific Northwest Lab., Richland, WA (United States)

1995-01-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Nuclear and Chemical Agency (USANCA). The IBS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain a site-specific map database. Data and system managers use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of the IBS. This document provides a description of the data files and structures necessary for running the IBS software and using the site map database.

Integrated Baseline System (IBS) Version 1.03: Utilities guide

Energy Technology Data Exchange (ETDEWEB)

Burford, M.J.; Downing, T.R.; Pottier, M.C.; Schrank, E.E.; Williams, J.R.

1993-01-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that was developed under the direction of the Federal Emergency Management Agency (FEMA). This Utilities Guide explains how to operate utility programs that are supplied as a part of the IBS. These utility programs are chiefly for managing and manipulating various kinds of IBS data and system administration files. Many of the utilities are for creating, editing, converting, or displaying map data and other data that are related to geographic location.

Integrated Baseline System (IBS) Version 2.0: Utilities Guide

Energy Technology Data Exchange (ETDEWEB)

Burford, M.J.; Downing, T.R.; Williams, J.R. [Pacific Northwest Lab., Richland, WA (United States); Bower, J.C. [Bower Software Services, Kennewick, WA (United States)

1994-03-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool being developed under the direction of the US Army Nuclear and Chemical Agency. This Utilities Guide explains how you can use the IBS utility programs to manage and manipulate various kinds of IBS data. These programs include utilities for creating, editing, and displaying maps and other data that are referenced to geographic location. The intended audience for this document are chiefly data managers but also system managers and some emergency management planners and analysts.

Utilization of healthcare services and renewal of health insurance membership : evidence of adverse selection in Ghana

NARCIS (Netherlands)

Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

Background: Utilization of healthcare in Ghana’s novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme’s financial sustainability. This paper investigates the presence of adverse selection by assessing the effect

Flexibility of Supply Chain in Industrialised Building System (IBS

Directory of Open Access Journals (Sweden)

Kassim U.

2014-01-01

Full Text Available It is irrefutable that the construction industry is in need of a highly technological construction method or system for the simple aim of giving it a push it deserves. In Malaysia this technologically enhanced method is known as the Indutrialised Building System (IBS. Concerted efforts have been made for the past decade by various responsible parties especially by the government. Therefore, the IBS ‘Road Map’ 2003–2010 was introduced and now continues with the IBS ‘road map’ 2011-2015. However, its performance is still at its infancy, which target is only at an initial stage. This study seeks to identify and analyse the factor of the IBS’ system’s supply chain flexibility as a factor on the success of the system itself. It has been a suspicion that there exists a condition and situation where the supply chain is too rigid and is not flexible in fulfilling the needs and demands of the IBS development in Malaysia. This inflexible situation has brought about a broad range of problems and has stood in the way of the development of the industrialised building system, despite it being introduced since 1964, or 49 years ago. Flexibility in the IBS supply chain is very important and is associated with other industries like transportation, manufacturing industry, and others. Up until now, we have yet to discover any special studies related to the flexibility in the IBS supply chain in this country. Responding to this challenge, this research is hoped to be able to provide sufficient feedback to the solution to the IBS supply chain flexibility issue. The researcher is confident that the poor system flow of supply chain has impeded the advancement of the Industrialised Building System that has long been open to debate.

Protein kinase activity associated with the corticosteroid binder IB

International Nuclear Information System (INIS)

Vujicic, M.; Djordjevic-Markovic, R.; Radic, O.; Krstic, M.; Kanazir, D.

1997-01-01

The physiological effects elicited by glucocorticoids are mediated via glucocorticoid receptors (GR). Analysis of specific glucocorticoid binding to radioactively labelled [ 3 H] triamcinolone acetonide in rat liver cytosol and analysis by ion exchange chromatography have revealed the presence of two distinct molecular species. The major form, designated as binder II appears to correspond to the well characterized glucocorticoid receptor by virtue of its size, charge, steroid binding characteristics and ability to bind to DNA.The second form, designated as corticosteroid binder IB, is a minor binding component in the liver. The binder IB differs from the binder II receptor by virtue of its lower molecular weight and its elution in the pre gradient of DEAE-Sephadex A-50 column which retains the un activated binder II receptor complexes. We examined the kinase activity of partially purified corticosteroid binder IB. Using (γ 3 2 P) ATP we detected kinase activity associated with the IB fraction from the rat liver. This kinase phosphorylate mixed histones and and dose not phosphorylate IB protein in vitro. The kinase activity is completely inhibited by the addition of Mg 2 + ions and is partially inhibited by the addition of Ca 2 +ions. (author)

2-Alkynoic fatty acids inhibit topoisomerase IB from Leishmania donovani.

Science.gov (United States)

Carballeira, Néstor M; Cartagena, Michelle; Sanabria, David; Tasdemir, Deniz; Prada, Christopher F; Reguera, Rosa M; Balaña-Fouce, Rafael

2012-10-01

2-Alkynoic fatty acids display antimycobacterial, antifungal, and pesticidal activities but their antiprotozoal activity has received little attention. In this work we synthesized the 2-octadecynoic acid (2-ODA), 2-hexadecynoic acid (2-HDA), and 2-tetradecynoic acid (2-TDA) and show that 2-ODA is the best inhibitor of the Leishmania donovani DNA topoisomerase IB enzyme (LdTopIB) with an EC(50)=5.3±0.7μM. The potency of LdTopIB inhibition follows the trend 2-ODA>2-HDA>2-TDA, indicating that the effectiveness of inhibition depends on the fatty acid carbon chain length. All of the studied 2-alkynoic fatty acids were less potent inhibitors of the human topoisomerase IB enzyme (hTopIB) as compared to LdTopIB. 2-ODA also displayed in vitro activity against Leishmania donovani (IC(50)=11.0μM), but it was less effective against other protozoa, Trypanosoma cruzi (IC(50)=48.1μM) and Trypanosoma brucei rhodesiense (IC(50)=64.5μM). The antiprotozoal activity of the 2-alkynoic fatty acids, in general, followed the trend 2-ODA>2-HDA>2-TDA. The experimental information gathered so far indicates that 2-ODA is a promising antileishmanial compound. Copyright © 2012 Elsevier Ltd. All rights reserved.

Migraine, fibromyalgia, and depression among people with IBS: a prevalence study

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Cabral Howard J

2006-09-01

Full Text Available Abstract Background Case descriptions suggest IBS patients are more likely to have other disorders, including migraine, fibromyalgia, and depression. We sought to examine the prevalence of these conditions in cohorts of people with and without IBS. Methods The source of data was a large U.S. health plan from January 1, 1996 though June 30, 2002. We identified all people with a medical claim associated with an ICD-9 code for IBS. A non-IBS cohort was a random sample of people with an ICD-9 code for routine medical care. In the cohorts, we identified all claims for migraine, depression, and fibromyalgia. We estimated the prevalence odds ratios (PORs of each of the three conditions using the Mantel-Haenszel method. We conducted quantitative sensitivity analyses to quantify the impact of residual confounding and in differential outcome identification. Results We identified 97,593 people in the IBS cohort, and a random sample of 27,402 people to compose the non-IBS comparison cohort. With adjustment, there was a 60% higher odds in the IBS cohort of having any one of the three disorders relative to the comparison cohort (POR 1.6, 95% CI 1.5 – 1.7. There was a 40% higher odds of depression in the IBS cohort (POR 1.4, 95% CI 1.3 – 1.4. The PORs for fibromyalgia and migraine were similar (POR for fibromyalgia 1.8, 95% CI 1.7 – 1.9; POR for migraine 1.6, 95% CI 1.4 – 1.7. Differential prevalence of an unmeasured confounder, or imperfect sensitivity or specificity of outcome detection would have impacted the observed results. Conclusion People in the IBS cohort had a 40% to 80% higher prevalence odds of migraine, fibromyalgia, and depression.

Designing Insurance to Promote Use of Childhood Obesity Prevention Services

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Kimberly J. Rask

2013-01-01

Full Text Available Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

HLA class Ib in pregnancy and pregnancy-related disorders.

Science.gov (United States)

Persson, Gry; Melsted, Wenna Nascimento; Nilsson, Line Lynge; Hviid, Thomas Vauvert F

2017-08-01

The HLA class Ib genes, HLA-E, HLA-F, and HLA-G, were discovered long after the classical HLA class Ia genes. The elucidation of their functions had a modest beginning. However, their basic functions and involvement in pathophysiology and a range of diseases are now emerging. Although results from a range of studies support the functional roles for the HLA class Ib molecules in adult life, especially HLA-G and HLA-F have most intensively been, and were also primarily, studied in relation to reproduction and pregnancy. The expression of HLA class Ib proteins at the feto-maternal interface in the placenta seems to be important for the maternal acceptance of the semi-allogenic fetus. In contrast to the functions of HLA class Ia, HLA-G possesses immune-modulatory and tolerogenic functions. Here, we review an accumulating amount of data describing the functions of HLA class Ib molecules in relation to fertility, reproduction, and pregnancy, and a possible role for these molecules in certain pregnancy complications, such as implantation failure, recurrent spontaneous abortions, and pre-eclampsia. The results from different kinds of studies point toward a role for HLA class Ib, especially HLA-G, throughout the reproductive cycle from conception to the birth weight of the child.

Anti-Inflammatory Activities of a Chinese Herbal Formula IBS-20 In Vitro and In Vivo

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Zhonghan Yang

2012-01-01

Full Text Available Irritable bowel syndrome (IBS is a functional bowel disorder and the etiology is not well understood. Currently there is no cure for IBS and no existing medication induces symptom relief in all patients. IBS-20 is a 20-herb Chinese medicinal formula that offers beneficial effects in patients with IBS; however, the underlying mechanisms are largely unknown. This study showed that IBS-20 potently inhibited LPS- or IFNΓ-stimulated expression of pro-inflammatory cytokines, as well as classically activated macrophage marker nitric oxide synthase 2. Similarly, IBS-20 or the component herb Coptis chinensis decreased LPS-stimulated pro-inflammatory cytokine secretion from JAWS II dendritic cells. IBS-20 or the component herbs also blocked or attenuated the IFNΓ-induced drop in transepithelial electric resistance, an index of permeability, in fully differentiated Caco-2 monolayer. Finally, the up-regulation of key inflammatory cytokines in inflamed colon from TNBS-treated mice was suppressed significantly by orally administrated IBS-20, including IFNΓ and IL-12p40. These data indicate that the anti-inflammatory activities of IBS-20 may contribute to the beneficial effects of the herbal extract in patients with IBS, providing a potential mechanism of action for IBS-20. In addition, IBS-20 may be a potential therapeutic agent against other Th1-dominant gut pathologies such as inflammatory bowel disease.

Ontario electricity bill review

International Nuclear Information System (INIS)

O'Neill, G.

2003-01-01

Findings of an independent review of charges to electricity bills and recommendations to assist in the development of a standard, province-wide residential electricity bill for Ontario are discussed. The review was requested by the province's Minister of Energy in an effort to dispel growing confusion about the variations in customer billing practices used by the province's 90+ local distribution companies. Key recommendations and findings were as follows: (1)Consumer bill formats issued by local distribution companies should be more consumer-friendly, adhere to minimum design standards, adapt uniform terminology and common line charges; (2) charges on customer bills should be grouped into four standard line items, with full details available to customers: the four line items should be a basic service charge, a charge for delivering electricity to the customer, a charge for the electricity itself, and a separate charge for retiring the outstanding debt of the former Ontario Hydro; (3) bills should take advantage of opportunities for promoting province-wide energy conservation, such as encouraging the long-term use of interval meters, presenting historical consumption data on residential bills on a period-to-period basis, and education and communications initiatives. Details of the recommendations, including the calculation of the fixed and variable components of usage charges, an explanation of the concept of electricity system loss adjustments, a method for phasing in the recommendations, and the anticipated benefits to consumers are provided

Should providers be allowed to extra bill for uncovered services? Debate, resolution, and sequel in Japan.

Science.gov (United States)

Ikegami, Naoki

2006-12-01

Japan has managed to provide universal coverage at relatively low cost by containing prices and restricting the conditions for which services can be billed in the compulsory social health insurance (SHI) program. However, decline in Japan's economic growth ushered in new actors backed by the prime minister who proposed that the providers should be allowed to extra bill for services not covered by the SHI. In 2004 they took the strategy of drawing the attention of the public to areas where the rigidity of the current prohibition appeared to be unfair and ridiculous. They were opposed by the Ministry of Health, Labor, and Welfare and the Japan Medical Association, who strongly objected on the grounds of safety and equity. The compromise reached by the two ministers in charge led to a clarification of the services that are to be covered and of the process for extending coverage to new procedures and drugs. The prohibition on extra billing has remained essentially unchanged, but the momentum for deregulation has been lost. In 2005 an alternate proposal was made to contain SHI expenditures by introducing a global cap on health expenditures and increasing out-of-pocket payment. Although this proposal was not fully adopted, the gradual decline in SHI benefit levels could lead to a renewed move to allow extra billing.

Innovative Approach for IBS Vendor Selection Problem

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Omar Mohd Faizal

2016-01-01

Full Text Available Supply chain management in Industrialised Building System (IBS construction management has significantly determined the successful of company and project performance. Due to the wide variety of criteria and vendor available, the vendor selection process for a specific project needs is becoming more difficult. The need of decision aid for vendor selection in other areas is widely discussed in previous research. However, study on vendor selection for IBS project is largely neglected. Decision Support System (DSS is proposed for this purpose. Yet, most of the DSS models are impractical since they are complicated and difficult for a layman such as project managers to use. Research indicates that the rapid development of ICT has highly potential towards simple and effective DSS. Thus, this paper highlights the importance and research approach for vendor selection in IBS project management. The study is based on Design Science Research Methodology with combination of case studies. It is anticipates that this study will yield an effective value-for-money decision making platform to manage vendor selection process.

El estudio de la Fauna Ibérica

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Ramos Sánchez, María Ángeles

2007-10-01

Full Text Available Since the beginning in 1989, Fauna Ibérica has promoted coordinated research in Taxonomy bringing together more than 100 Spanish and non-Spanish experts. The programme supported by CSIC Presidency is lead by Museo Nacional de Ciencias Naturales. As a result, 30 Fauna Ibérica monographs has been published in addition to a year average of 50-60 scientific papers describing more than 50 new species per year. IBERFAUNA, the Data Bank of the Spanish Fauna, has been created including 38.000 out of the 61.000 species estimated to live in the Iberian Peninsula and Balearic Islands. This area is confirmed as one of the most biodiverse of the European Union with more than 50 % of the European species and more than 50 % of its endemics. Among future plans, a more stable organization is proposed in order to: maintaining dichotomy paper/digital publications, increasing interactivity among taxonomists and training, developing cyber-tools to facilitate public access to the information and increasing the strength of Fauna Ibérica through collaboration with other international initiatives and other areas of knowledge.Desde su inicio en 1989, Fauna Ibérica ha impulsado la investigación coordinada de más de 100 taxónomos españoles y extranjeros. El programa, apoyado por la Presidencia del CSIC, está dirigido por el Museo Nacional de Ciencias Naturales. Como resultado, se han publicado 30 monografías de la serie Fauna Ibérica, y un promedio anual de 50-60 artículos científicos que describen más de 50 nuevas especies por año. Se ha creado el Banco de Datos, IBERFAUNA, que cuenta ya con 38.000 de las aproximadamente 61.000 especies que habitan en la Península Ibérica y Baleares. Se confirma como una de las regiones más ricas en biodiversidad de la Unión Europea, con más del 50 % de las especies y más de un 50 % de sus endemismos. Entre los planes de futuro, se propone una estructura estable para Fauna Ibérica, que mantenga la dicotomía soporte

25 CFR 175.30 - Billing.

Science.gov (United States)

2010-04-01

... provided in the customer's special contract. (c) Service fee billing. The utility shall render service fee... 25 Indians 1 2010-04-01 2010-04-01 false Billing. 175.30 Section 175.30 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN ELECTRIC POWER UTILITIES Billing, Payments, and...

Key factors of successful JIT integration with IBS - An overview

Science.gov (United States)

Asri, Mohammad Azwanie Naim Mohammad; Nawi, Mohd Nasrun Mohd; Nadarajan, Santhirasegaran

2016-08-01

The Just-In-Time (JIT) philosophy has been used for many decades to increase productivity through waste elimination process. The purpose of this paper is to contribute to the knowledge by addressing the transportation and material delivery activities in Industrialized Building System (IBS) and integrating JIT to improve the performance of those activities. The literature review has been conducted through relevant database. It was found that there is a need for more holistic approach to be adopted to integrate JIT in IBS project. This paper discusses the key success factors for effective integration between JIT and IBS in the context of transportation and material delivery activities.

Badali recommends simplified bills

Energy Technology Data Exchange (ETDEWEB)

Anon

2003-04-01

A report on the variety of retail electricity bills across the province, authored by Salvatore Badali of Deloitte Consulting, was recently released by the Ontario Government. The report was commissioned by the Government to examine the underlying reasons for the significant format differences and the wide variation of fixed and variable charges among the approximately 95 local electricity distribution companies across the province. Regarding the appropriateness of the charges the report recommends common definitions for local distribution company (LDC) fixed and variable costs, and consideration of options for reducing LDC charges, mainly by consolidating the sector and sharing such services as customer billing, accounting and out sourcing operations. Seven recommendations deal with bill simplification. These include bills that are clear and easy to read and provide sufficient information for consumers to verify charges; promote energy conservation, e.g. by including historical information; allow comparisons between retail suppliers and distributors; accommodate revenue collection, marketing needs and other billing services. The report also recommends clearly defined and consistently used terminology for standardized line items, suggests ways to provide consumer information in a form useful for making energy conservation decisions, development of an LDC scorecard to enable stake holders to compare their own LDCs with LDCs around the province, creation of a conservation and bill calculation website, consideration of further use of shared services, and solutions to address the removal of line losses from invoices.

Badali recommends simplified bills

International Nuclear Information System (INIS)

Anon

2003-01-01

A report on the variety of retail electricity bills across the province, authored by Salvatore Badali of Deloitte Consulting, was recently released by the Ontario Government. The report was commissioned by the Government to examine the underlying reasons for the significant format differences and the wide variation of fixed and variable charges among the approximately 95 local electricity distribution companies across the province. Regarding the appropriateness of the charges the report recommends common definitions for local distribution company (LDC) fixed and variable costs, and consideration of options for reducing LDC charges, mainly by consolidating the sector and sharing such services as customer billing, accounting and out sourcing operations. Seven recommendations deal with bill simplification. These include bills that are clear and easy to read and provide sufficient information for consumers to verify charges; promote energy conservation, e.g. by including historical information; allow comparisons between retail suppliers and distributors; accommodate revenue collection, marketing needs and other billing services. The report also recommends clearly defined and consistently used terminology for standardized line items, suggests ways to provide consumer information in a form useful for making energy conservation decisions, development of an LDC scorecard to enable stake holders to compare their own LDCs with LDCs around the province, creation of a conservation and bill calculation website, consideration of further use of shared services, and solutions to address the removal of line losses from invoices

FRAGMENTATION ISSUE IN MALAYSIAN INDUSTRIALISED BUILDING SYSTEM (IBS PROJECTS

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MOHD NASRUN MOHD NAWI

2014-02-01

Full Text Available As a developing country, Malaysian is currently driving for implementing a new or modern construction method, the Industrialised Building System (IBS, as an alternative towards enhancing construction performance. Currently, most of the IBS project developments in Malaysia are still conducted by using the traditional construction process approach. This traditional construction process has been widely criticised for its fragmented approach to project delivery and its failure to form effective teams thus created a number of issues such as reworks, time delay, rising costs, lack of communication and coordination, and wastages. This paper through literature review aims to highlight this fragmentation issue and clarify how far it affects the process of IBS implementation. Suggestions on how an integrated approach in design and construction in order to minimise the fragmentation gaps will be concluded.

Influence of health-insurance access and hospital retention policies on childhood cancer treatment in Kenya.

Science.gov (United States)

Mostert, S; Njuguna, F; van de Ven, P M; Olbara, G; Kemps, L J P A; Musimbi, J; Strother, R M; Aluoch, L M; Skiles, J; Buziba, N G; Sitaresmi, M N; Vreeman, R C; Kaspers, G J L

2014-05-01

Kenyan national policies for public hospitals dictate that patients are retained on hospital wards until their hospital bills are paid, but this payment process differs for patients with or without access to National Hospital Insurance Fund (NHIF) at diagnosis. Whether these differences impact treatment outcomes has not been described. Our study explores whether childhood cancer treatment outcomes in Kenya are influenced by health-insurance status and hospital retention policies. This study combined retrospective review of medical records with an illustrative case report. We identified children diagnosed with malignancies at a large Kenyan academic hospital between 2007 and 2009, their treatment outcomes, and health-insurance status at diagnosis. Between 2007 and 2009, 222 children were diagnosed with malignancies. Among 180 patients with documented treatment outcome, 54% abandoned treatment, 22% had treatment-related death, 4% progressive/relapsed disease, and 19% event-free survival. Health-insurance status at diagnosis was recorded in 148 children: 23% had NHIF and 77% had no NHIF. For children whose families had NHIF compared with those who did not, the relative risk for treatment abandonment relative to event-free survival was significantly smaller (relative-risk ratio = 0.31, 95% CI = 0.12-0.81, P = 0.016). The case report illustrates difficulties that Kenyan families might face when their child is diagnosed with cancer, has no NHIF, and is retained in hospital. Children with NHIF at diagnosis had significantly lower chance of abandoning treatment and higher chance of survival. Childhood cancer treatment outcomes could be improved by interventions that prevent treatment abandonment and improve access to NHIF. Hospital retention of patients over unpaid medical bills must stop. © 2013 Wiley Periodicals, Inc.

Errors in energy bills

International Nuclear Information System (INIS)

Kop, L.

2001-01-01

On request, the Dutch Association for Energy, Environment and Water (VEMW) checks the energy bills for her customers. It appeared that in the year 2000 many small, but also big errors were discovered in the bills of 42 businesses

A unique set of SH3-SH3 interactions controls IB1 homodimerization

DEFF Research Database (Denmark)

Kristensen, Ole; Guenat, Sylvie; Dar, Imran

2006-01-01

Islet-brain 1 (IB1 or JIP-1) is a scaffold protein that interacts with components of the c-Jun N-terminal kinase (JNK) signal-transduction pathway. IB1 is expressed at high levels in neurons and in pancreatic beta-cells, where it controls expression of several insulin-secretory components...... reduces IB1-dependent basal JNK activity in 293T cells. Impaired dimerization also results in a reduction in glucose transporter type 2 expression and in glucose-dependent insulin secretion in pancreatic beta-cells. Taken together, these results indicate that IB1 homodimerization through its SH3 domain...

Nerve growth factor and diarrhea-predominant irritable bowel syndrome (IBS-D): a potential therapeutic target?

Science.gov (United States)

Xu, Xiao-juan; Liu, Liang; Yao, Shu-kun

2016-01-01

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS (IBS-D) is a major subtype of IBS, the predominant manifestations of which are abdominal pain and diarrhea. The pathogenesis of IBS-D remained unknown until recently. The effects of psychosocial stress, central hypervigilance, neuroendocrine abnormality, disturbed gastrointestinal motility, mucosal immune activation, intestinal barrier dysfunction, visceral hypersensitivity (VH), altered gut flora, and genetic susceptibility may be involved in its development. Recently, increased attention has been placed on the neural-immune-endocrine network mechanism in IBS-D, especially the role of various neuroendocrine mediators. As a member of the neurotrophin family, nerve growth factor (NGF) has diverse biological effects, and participates in the pathogenesis of many diseases. Basic studies have demonstrated that NGF is associated with inflammatory- and stress-related VH, as well as stress-related intestinal barrier dysfunction. The aim of this study is to summarize recent literature and discuss the role of NGF in the pathophysiology of IBS-D, especially in VH and intestinal barrier dysfunction, as well as its potential as a therapeutic target in IBS-D.

Los materiales hercínicos de la cordillera ibérica en el contexto del macizo ibérico

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Liñán, E.

1988-12-01

Full Text Available The discontinuity observed between the paleozoic outcrops of the Iberian Mountains and the ones of the Iberian Massif, has been the greatest incovenient to include those ones in a general Hercynian Iberian model. Two hypothesis have been proposed to the respect. One initial hypothesis postulates the inclusion of the Iberian Mountains paleozoic racks in the West Asturian-Leonese Zone (Lotze, 1961; Julivert et al., 1974. Other one postulates a double inelusion: the occidental part of the Iberian Chaines into the West Asturian-Leonese Zone and the oriental part of the Iberian Chaines into the Cantabrian Zona (Liñán, 1983. In this work new geological data are provided for the geological conexion between Cantabrian Zone and the oriental part of the Iberian Chains; they can be summarised in three points. One of them is referred to the paralellism between the Narcea and Paracuellos antiforms. Those antiforms are divided by a tectonic accident, wich separates different Precambrian sequences. Another point deals with the close relation of the stratigraphical sequences of the Paleozoic racks between the Cantabrian region and Iberian region at both sides of the Narcea and Paracuellos antiforms. the last point refers to the study of small outcrops located in the northwest of the Iberian Chains, that show a probably more similar geological structure to the Cantabrian Zone wich was defined as a fold and thrust belt.La falta de continuidad de los afloramientos paleozoicos de la Cordillera Ibérica con los del Macizo Ibérico han venido constituyendo un serio obstáculo para la inclusión de aquéllos dentro de un esquema general para el hercínico ibérico. Dos hipótesis han sido hasta ahora planteadas: su conexión con la Zona Asturoccidental-Leonesa, o su doble conexión con esta zona y con la zona Cantábrica. En este trabajo se aportan nuevos datos geológicos que son congruentes con la prolongación tanto de la Zona Cantábrica como de la Zona

Resistance to sulfur poisoning of Ni-based alloy with coinage (IB) metals

International Nuclear Information System (INIS)

Xu, Xiaopei; Zhang, Yanxing; Yang, Zongxian

2015-01-01

Highlights: • The effects of IB metal dopants on the S poisoning features of Ni are analyzed. • IB metal dopants can modify the surface electronic structure of Ni. • IB metal dopants can increase the S tolerance of Ni at an optimized concentration. • Au is a preferred dopant to increase the resistance to sulfur poisoning of Ni. - Abstract: The poisoning effects of S atom on the (1 0 0), (1 1 0) and (1 1 1) metal surfaces of pure Ni and Ni-based alloy with IB (coinage) metals (Cu, Ag, Au) are systematically studied. The effects of IB metal dopants on the S poisoning features are analyzed combining the density functional theory (DFT) results with thermodynamics data using the ab initio atomistic thermodynamic method. It is found that introducing IB doping metals into Ni surface can shift the d-band center downward from the Fermi level and weaken the adsorption of S on the (1 0 0) and (1 1 0) surfaces, and the S tolerance ability increases in the order of Ni, Cu/Ni, Ag/Ni and Au/Ni. Nevertheless, on the (1 1 1) surface, the S tolerance ability increases in the order of Ag/Ni (or Cu/Ni), Ni, and Au/Ni. When we increase the coverage of the IB metal dopants, we found that not only Au, but Cu and Ag can increase its S tolerance. We therefore propose that alloying can increase its S tolerance and alloying with Au would be a better way to increase the resistance to sulfur poisoning of the Ni anode as compared with the pure Ni and the Ag- or, Cu-doped Ni materials.

Nonsense mutation in the glycoprotein Ibα coding sequence associated with Bernard-Soulier syndrome

International Nuclear Information System (INIS)

Ware, J.; Russell, S.R.; Vicente, V.; Scharf, R.E.; Tomer, A.; McMillian, R.; Ruggeri, Z.M.

1990-01-01

Three distinct gene products, the α and β chains of glycoprotein (GP) Ib and GP IX, constitute the platelet membrane GP Ib-IX complex, a receptor for von Willebrand factor and thrombin involved in platelet adhesion and aggregation. Defective function of the GP Ib-IX complex is the hallmark of a rare congenital bleeding disorder of still undefined pathogenesis, the Bernard-Soulier syndrome. The authors have analyzed the molecular basis of the disease in one patient in whom immunoblotting of solubilized platelets demonstrated absence of normal GP Ibα but presence of a smaller immunoreactive species. The truncated polypeptide was also present, along with normal protein, in platelets from the patient's mother and two of his four children. Genetic characterization identified a nucleotide transition changing the Trp-343 codon (TGG) to a nonsense codon (TGA). Such a mutation explains the origin of the smaller GP Ibα, which by lacking half of the sequence on the carboxyl-terminal side, including the transmembrane domain, cannot be properly inserted in the platelet membrane. Both normal and mutant codons were found in the patient, suggesting that he is a compound heterozygote with a still unidentified defect in the other GP Ibα allele. Nonsense mutation and truncated GP Ibα polypeptide were found to cosegregate in four individuals through three generations and were associated with either Bernard-Soulier syndrome or carrier state phenotype. The molecular abnormality demonstrated in this family provides evidence that defective synthesis of GP Ibα alters the membrane expression of the GP Ib-IX complex and may be responsible for Bernard-Soulier syndrome

IB Offering Certificate for Careers

Science.gov (United States)

Robelen, Erik W.

2012-01-01

The International Baccalaureate (IB) organization, best known in the United States for its prestigious two-year diploma program for juniors and seniors, will enter new terrain this fall as it formally rolls out an initiative centered on a variety of career pathways that includes engineering, culinary arts, and automotive technology. The move comes…

Changes to the Employers' Use of Genetic Information and Non-discrimination for Health Insurance in the USA: Implications for Australians

Directory of Open Access Journals (Sweden)

Gemma A. Bilkey

2018-06-01

Full Text Available In the USA, a bill has been introduced to the senate that may jeopardize an individual's rights to privacy and non-discrimination. This piece examines the proposed Preserving Employee Wellness Programs Act (PEWPA, and implications this will have on the use of genetic information. The Act allows for employers to apply financial penalties for health insurance based on genetic information, which raises concerns as the capacity to interpret genetic results is limited by knowledge of the significance of both benign and pathogenic variants. In Australia, genetic information can only be used to determine life insurance, not to stratify health insurance, and any precedent set internationally should raise concerns of the potential for change on the horizon.

Message from the CERN Health Insurance Supervisory Board (CHISB)

CERN Multimedia

2004-01-01

Following a long series of discussions with the Administration of the La Tour Hospital, a tariff agreement has been concluded between the Hospital and the CERN Health Insurance Scheme. In the case of hospitalisations, this new agreement will apply to admissions on or after 1st September 2004 and will result, in particular, in the reintroduction of the third-party payer system. In the case of out-patient treatment, billing will be according to the Swiss medical tariff system TARMED and Uniqa will act as third-party guarantor. Further details will be published in the next issue of the CHISBull'. Tel.74484

The International Baccalaureate (IB programme: An international gateway to higher education and beyond

Directory of Open Access Journals (Sweden)

Susan E. Saxton

2014-09-01

Full Text Available The aim of this article is to present the International Baccalaureate (IB Programme and briefly outline its core components, followed by a review of what authoritative reports identify as skills for the future, esteemed by universities and the job market. There is a striking match between these skills and IB outcomes; thus, DP graduates perform well in higher education and add to the reputation of those institutions. After a review of the literature, the authors found the IB Diploma Programme has been studied in many countries by both consultants and educational agencies, and also by a wide array of universities themselves; however, there are fewer qualitative studies concerning the degree to which IB graduates display attitudes, values, and behaviours in line with the IB Learner Profile. This is why the authors stress the claims made are supported by examples of significant research, noting that there is a dearth of qualitative longitudinal studies to sufficiently substantiate the affective domain claims that currently rely more on anecdotal evidence. The authors conclude by pointing out more research is needed in order to substantiate anecdotal evidence regarding future employment success for IB Diploma Programme graduates.  DOI: 10.18870/hlrc.v4i3.123

48 CFR 942.704 - Billing rates.

Science.gov (United States)

2010-10-01

... ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 942.704 Billing rates. (b) When the contracting officer or auditor responsible for establishing billing rates, in accordance with 48 CFR 42.704, has not established... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Billing rates. 942.704...

Atomic Weapons Establishment Bill

International Nuclear Information System (INIS)

Clark, Alan; Dalyell, Tam; Haynes, Frank

1990-01-01

The Bill debated concerns the government's proposal for the future organisations of the atomic weapons establishment in the United Kingdom. The proposals arise from a full review carried out in 1989 and include points raised by the Select Committee on the Trident programme. Studies of productivity, pay and conditions, information systems and long term manufacturing strategy have been started to enable recommendations of the reorganisation of the establishments to be made. The details of the Bill were debated for just over two hours. The debate is reported verbatim. The main issues were over the principle of contractorisation, possible staff redundancies, conditions of employment, safety and security. The proposal that the Bill be read a second time was carried. (UK)

Effects of implementing electronic medical records on primary care billings and payments: a before-after study.

Science.gov (United States)

Jaakkimainen, R Liisa; Shultz, Susan E; Tu, Karen

2013-09-01

Several barriers to the adoption of electronic medical records (EMRs) by family physicians have been discussed, including the costs of implementation, impact on work flow and loss of productivity. We examined billings and payments received before and after implementation of EMRs among primary care physicians in the province of Ontario. We also examined billings and payments before and after switching from a fee-for-service to a capitation payment model, because EMR implementation coincided with primary care reform in the province. We used information from the Electronic Medical Record Administrative Data Linked Database (EMRALD) to conduct a retrospective before-after study. The EMRALD database includes EMR data extracted from 183 community-based family physicians in Ontario. We included EMRALD physicians who were eligible to bill the Ontario Health Insurance Plan at least 18 months before and after the date they started using EMRs and had completed a full 18-month period before Mar. 31, 2011, when the study stopped. The main outcome measures were physicians' monthly billings and payments for office visits and total annual payments received from all government sources. Two index dates were examined: the date physicians started using EMRs and were in a stable payment model (n = 64) and the date physicians switched from a fee-for-service to a capitation payment model (n = 42). Monthly billings and payments for office visits did not decrease after the implementation of EMRs. The overall weighted mean annual payment from all government sources increased by 27.7% after the start of EMRs among EMRALD physicians; an increase was also observed among all other primary care physicians in Ontario, but it was not as great (14.4%). There was a decline in monthly billings and payments for office visits after physicians changed payment models, but an increase in their overall annual government payments. Implementation of EMRs by primary care physicians did not result in decreased

Effects of implementing electronic medical records on primary care billings and payments: a before–after study

Science.gov (United States)

Shultz, Susan E.; Tu, Karen

2013-01-01

Background Several barriers to the adoption of electronic medical records (EMRs) by family physicians have been discussed, including the costs of implementation, impact on work flow and loss of productivity. We examined billings and payments received before and after implementation of EMRs among primary care physicians in the province of Ontario. We also examined billings and payments before and after switching from a fee-for-service to a capitation payment model, because EMR implementation coincided with primary care reform in the province. Methods We used information from the Electronic Medical Record Administrative Data Linked Database (EMRALD) to conduct a retrospective before–after study. The EMRALD database includes EMR data extracted from 183 community-based family physicians in Ontario. We included EMRALD physicians who were eligible to bill the Ontario Health Insurance Plan at least 18 months before and after the date they started using EMRs and had completed a full 18-month period before Mar. 31, 2011, when the study stopped. The main outcome measures were physicians’ monthly billings and payments for office visits and total annual payments received from all government sources. Two index dates were examined: the date physicians started using EMRs and were in a stable payment model (n = 64) and the date physicians switched from a fee-for-service to a capitation payment model (n = 42). Results Monthly billings and payments for office visits did not decrease after the implementation of EMRs. The overall weighted mean annual payment from all government sources increased by 27.7% after the start of EMRs among EMRALD physicians; an increase was also observed among all other primary care physicians in Ontario, but it was not as great (14.4%). There was a decline in monthly billings and payments for office visits after physicians changed payment models, but an increase in their overall annual government payments. Interpretation Implementation of EMRs by

Atomic Weapons Establishment Bill [Money

International Nuclear Information System (INIS)

Bennett, A.F.; Cryer, Bob; Carlisle, Kenneth; Dean, Paul.

1990-01-01

The debate concerns the authorisation of payment of the money required to reorganise the atomic weapons establishment in the United Kingdom provided for in the Atomic Weapons Establishment Bill in progress through Parliament. In the Bill the contractorisation of the establishment is recommended and some sort of Government owned company operated scheme set up. The debate lasted about half an hour and is reported verbatim. The issues raised concerned the actual sums likely to be incurred in the formation of a Company to carry out the designated activities of the Bill. These are connected with the research, development, production or maintenance of nuclear devices and the premises needed. The government spokesman suggested the sums required to support the Bill would not be large and the resolution was agreed to without a vote. (UK)

Enhanced accumulation of carotenoids in sweetpotato plants overexpressing IbOr-Ins gene in purple-fleshed sweetpotato cultivar.

Science.gov (United States)

Park, Sung-Chul; Kim, Sun Ha; Park, Seyeon; Lee, Hyeong-Un; Lee, Joon Seol; Park, Woo Sung; Ahn, Mi-Jeong; Kim, Yun-Hee; Jeong, Jae Cheol; Lee, Haeng-Soon; Kwak, Sang-Soo

2015-01-01

Sweetpotato [Ipomoea batatas (L.) Lam] is an important root crop that produces low molecular weight antioxidants such as carotenoids and anthocyanin. The sweetpotato orange (IbOr) protein is involved in the accumulation of carotenoids. To increase the levels of carotenoids in the storage roots of sweetpotato, we generated transgenic sweetpotato plants overexpressing IbOr-Ins under the control of the cauliflower mosaic virus (CaMV) 35S promoter in an anthocyanin-rich purple-fleshed cultivar (referred to as IbOr plants). IbOr plants exhibited increased carotenoid levels (up to 7-fold) in their storage roots compared to wild type (WT) plants, as revealed by HPLC analysis. The carotenoid contents of IbOr plants were positively correlated with IbOr transcript levels. The levels of zeaxanthin were ∼ 12 times elevated in IbOr plants, whereas β-carotene increased ∼ 1.75 times higher than those of WT. Quantitative RT-PCR analysis revealed that most carotenoid biosynthetic pathway genes were up-regulated in the IbOr plants, including PDS, ZDS, LCY-β, CHY-β, ZEP and Pftf, whereas LCY-ɛ was down-regulated. Interestingly, CCD1, CCD4 and NCED, which are related to the degradation of carotenoids, were also up-regulated in the IbOr plants. Anthocyanin contents and transcription levels of associated biosynthetic genes seemed to be altered in the IbOr plants. The yields of storage roots and aerial parts of IbOr plants and WT plants were not significantly different under field cultivation. Taken together, these results indicate that overexpression of IbOr-Ins can increase the carotenoid contents of sweetpotato storage roots. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Purification, crystallization and preliminary X-ray analysis of Enterococcus faecium aminoglycoside-2′′-phosphotransferase-Ib [APH(2′′)-Ib

International Nuclear Information System (INIS)

Walanj, Rupa; Young, Paul; Baker, Heather M.; Baker, Edward N.; Metcalf, Peter; Chow, Joseph W.; Lerner, Stephen; Vakulenko, Sergei; Smith, Clyde A.

2005-01-01

APH(2′′)-Ib is an enzyme responsible for high-level gentamicin resistance in E. faecium isolates. Native crystals of this enzyme have been prepared and preliminary X-ray diffraction experiments have been undertaken. Bacterial resistance to the aminoglycoside antibiotics is primarily the result of deactivation of the drugs. Three families of enzymes are responsible for this activity, with one such family being the aminoglycoside phosphotransferases (APHs). The gene encoding one of these enzymes, APH(2′′)-Ib, has been cloned and the protein (comprising 299 amino-acid residues) expressed in Escherichia coli, purified and crystallized in the presence of 16%(w/v) PEG 3350 and gentamicin. The crystals belong to the monoclinic space group P2 1 , with approximate unit-cell parameters a = 79.7, b = 58.8, c = 81.4 Å, β = 98.4°, and preliminary X-ray diffraction analysis is consistent with the presence of two molecules in the asymmetric unit. Synchrotron diffraction data to approximately 2.65 Å resolution were collected from a native APH(2′′)-Ib crystal at beamline BL9-2 at SSRL (Stanford, CA, USA). Selenium-substituted crystals have also been produced and structure determination is proceeding

Overcoming ICT Barriers in IBS Management Process in Malaysia Construction Industry

Directory of Open Access Journals (Sweden)

Soon Ern Peniel Ang

2017-01-01

Full Text Available As the result of government’s initiative and future outlook in uprising the awareness towards the implementation of sustainable elements in construction industries, the Industrialized Building System (IBS is one of the approaches that had been introduced as an alternative to conventional building method and produce the new strategy of reducing the waste of materials in construction. The IBS approach is actively promoted through several strategies and incentives as an alternative to conventional building methods. Extensive uptakes of modern Information Communication Technology (ICT applications are able to support the different IBS processes for effective production. However, it is argued that ICT uptake at the organizational level needs to be regularly improved. Thus, this paper fulfills the need to identify the critical barriers to ICT employment and highlighting the ICT drivers in enhancing the IBS management process. Critical barriers and drivers to ICT uptake were identified through questionnaire survey with industry stakeholders and were analyzed using mean index and critical t-value with the use of SPSS software. The critical drivers are top management support and commitment and improving the availability of the technologies. The critical drivers which were identified are significant in ensuring the enhancement of ICT implementation. Hence, any system in place should avoid the highest ranked barriers or seek to alleviate their impact by focusing on the identified drivers in order to enhance implementation of ICT in IBS process management.

Translation and validation of a Japanese version of the irritable bowel syndrome-quality of life measure (IBS-QOL-J

Directory of Open Access Journals (Sweden)

Hongo Michio

2007-03-01

Full Text Available Abstract Aims To compare quality of life (QOL for patients with irritable bowel syndrome (IBS between the U.S. and Japan, it is indispensable to develop common instruments. The IBS-QOL, which is widely used in Western countries, was translated into Japanese as there has been a lack of Japanese disease-specific QOL measures for IBS. Methods The original 34 items of the IBS-QOL were translated from English into Japanese through two independent forward translations, resolution, back translation, and resolution of differences. Forty nine patients who had GI symptoms but did not have any organic diseases (including 30 IBS patients diagnosed by Rome II criteria were recruited from Tohoku University Hospital in Sendai, Japan and completed a Japanese version of the IBS-QOL (IBS-QOL-J concomitant with a Japanese version of the IBS severity index (IBSSI-J twice within 7–14 days. Results The IBS-QOL-J demonstrated high internal consistency (Cronbach's alpha; 0.96 and high reproducibility (intraclass correlation coefficient; 0.92, p Conclusion The IBS-QOL-J is a reliable instrument to assess the disease-specific QOL for IBS. Considering cross-cultural comparison, this measure is likely to be a valuable tool to investigate the QOL in Japanese patients with IBS.

Improving the stability of alpha-conotoxin AuIB through N-to-C cyclization

DEFF Research Database (Denmark)

Armishaw, Christopher J; Jensen, Anders A; Balle, Lena D

2011-01-01

Modification of alpha-conotoxin frameworks through cyclization via an oligopeptide linker has previously been shown as an effective strategy for improving in vivo stability. We have extended this strategy by investigating cyclic analogs of alpha-conotoxin AuIB, a selective alpha3beta4 nicotinic a......-AuIB. As such, the cAuIB-2 globular isomer could constitute a useful probe for studying the role of the alpha3beta4 nicotinic acetylcholine receptor in a range of in vivo experimental paradigms....

Molecular Characterization and Growth Association of Two Apolipoprotein A-Ib Genes in Common Carp (Cyprinus carpio).

Science.gov (United States)

Wang, Xinhua; Yu, Xiaomu; Tong, Jingou

2016-09-16

Apolipoprotein A-I (ApoA-I) is functionally involved in the transportation and metabolism of lipids in vertebrates. In this study, two isoforms of apoA-Ib in common carp (Cyprinus carpio L.) were characterized. Sequence comparison and phylogenetic analysis showed that C. carpio ApoA-Ib is relatively conserved within cyprinid fishes. During embryonic development, C. carpio apoA-Ib was first expressed at the stage of multi-cells, and the highest mRNA level was observed at the stage of optic vesicle. A ubiquitous expression pattern was detected in various tissues with extreme predominance in the liver. Significantly different expression levels were observed between light and heavy body weight groups and also in the compensatory growth test. Seventeen and eight single-nucleotide polymorphisms (SNPs) were identified in matured mRNA of the C. carpio apoA-Ib.1 and apoA-Ib.2, respectively. Two of these SNPs (apoA-Ib.2-g.183A>T and apoA-Ib.2-g.1753C>T) were significantly associated with body weight and body length in two populations of common carp. These results indicate that apoA-Ib may play an important role in the modulation of growth and development in common carp.

Health insurance and care-seeking behaviours of female migrants in Accra, Ghana.

Science.gov (United States)

Lattof, Samantha R

2018-05-01

People working in Ghana's informal sector have low rates of enrolment in the publicly funded National Health Insurance Scheme. Informal sector workers, including migrant girls and women from northern Ghana working as head porters (kayayei), report challenges obtaining insurance and seeking formal health care. This article analyses how health insurance status affects kayayei migrants' care-seeking behaviours. This mixed-methods study involved surveying 625 migrants using respondent-driven sampling and conducting in-depth interviews with a sub-sample of 48 migrants. Analyses explore health status and health seeking behaviours for recent illness/injury. Binary logistic regression modelled the effects of selected independent variables on whether or not a recently ill/injured participant (n = 239) sought health care. Although recently ill/injured participants (38.4%) desired health care, less than half (43.5%) sought care. Financial barriers overwhelmingly limit kayayei migrants from seeking health care, preventing them from registering with the National Health Insurance Scheme, renewing their expired health insurance policies, or taking time away from work. Both insured and uninsured migrants did not seek formal health services due to the unpredictable nature of out-of-pocket expenses. Catastrophic and impoverishing medical expenses also drove participants' migration in search of work to repay loans and hospital bills. Health insurance can help minimize these expenditures, but only 17.4% of currently insured participants (58.2%) reported holding a valid health insurance card in Accra. The others lost their cards or forgot them when migrating. Access to formal health care in Accra remains largely inaccessible to kayayei migrants who suffer from greater illness/injury than the general female population in Accra and who are hindered in their ability to receive insurance exemptions. With internal migration on the rise in many settings, health systems must recognize the

La Inscripción Ibérica en escritura jonia, Serreta IX.

OpenAIRE

Silgo Gauche, Luís

1997-01-01

S’estudía una nova inscripció sobre làmina de plom, localitzada casualment en l’àrea del poblat ibèric de la Serreta (Alcoi, Cocentaina, Penàguila), en l’escriptura del qual es van emprar caracters greco-ibèrics.

Contributions of type II and Ib/c supernovae to Galactic chemical evolution

International Nuclear Information System (INIS)

Sahijpal Sandeep

2014-01-01

Type II and Ib/c supernovae (SNe II and Ib/c) have made major stellar nucleosynthetic contributions to the inventories of stable nuclides during chemical evolution of the Galaxy. A case study is performed here with the help of recently developed numerical simulations of Galactic chemical evolution in the solar neighborhood to understand the contributions of SNe II and Ib/c by comparing the stellar nucleosynthetic yields obtained by two leading groups in this field. These stellar nucleosynthetic yields differ in terms of their treatment of stellar evolution and nucleosynthesis. The formulation describing Galactic chemical evolution is developed with the recently revised solar metallicity of ∼0.014. Furthermore, the recent nucleosynthetic yields of stellar models based on the revised solar metallicity are also used. The analysis suggests that it could be difficult to explain, in a self-consistent manner, the various features associated with the elemental evolutionary trends over Galactic timescales by any single adopted stellar nucleosynthetic model that incorporates SNe II and Ib/c

Measuring IBS patient reported outcomes with an abdominal pain numeric rating scale: results from the proof cohort

Science.gov (United States)

SPIEGEL, B.; BOLUS, R.; HARRIS, L. A.; LUCAK, S.; NALIBOFF, B.; ESRAILIAN, E.; CHEY, W. D.; LEMBO, A.; KARSAN, H.; TILLISCH, K.; TALLEY, J.; MAYER, E.; CHANG, L.

2009-01-01

Background Controversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in the non-IBS pain literature. The FDA has proposed using the NRS in IBS. Aim To test the psychometrics of an abdominal pain NRS in IBS. Methods We analyzed data from a longitudinal cohort of Rome III IBS subjects. At entry, subjects completed a 10-point NRS, bowel symptoms, IBS severity measurements (IBSSS, FBDSI), health related quality of life indices (IBS-QOL, EQ5D), and the worker productivity activity index (WPAI). We repeated assessments at 3 months along with a response scale to calculate the minimal clinically important difference (MCID). Results There were 277 subjects (82% women; age=42±15) at baseline and 90 at 3 months. The NRS correlated cross-sectionally with IBSSS (r=0.60; p<0.0011), FBDSI (r=0.49; p<0.0001), IBS-QOL (r=0.43; p<0.0001), EQ5D (r=0.48; p<0.0001), presenteeism (r=0.39; p<0.0001), absenteeism (r=0.17; p=0.04), and distension (r=0.46; p<0.0001), but not stool frequency or form. The MCID was 2.2 points, correlating with a 29.5% reduction over time. Conclusions An abdominal pain NRS exhibits excellent validity and can be readily interpreted with an MCID in patients with IBS. These data support the use of the NRS in IBS clinical trials. PMID:19751360

Electricity Bill [Part 1

International Nuclear Information System (INIS)

Parkinson, C.; Hogg, N.; Salmond, A.

1988-01-01

The paper presents the first part of the Parliamentary debate on the second reading of the Electricity Bill, House of Commons, London 1988. The Bill sets out the government's proposals for the restructuring and privatisation of the electricity supply industry throughout Great Britain. Customers and suppliers, choice for the consumer, competition promotion, security of supply, nuclear power stations, and cost, are all discussed. (U.K.)

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case-control study in primary care

OpenAIRE

Grodzinsky, Ewa; Walter, Susanna; Viktorsson, Lisa; Carlsson, Ann-Kristin; Jones, Michael P.; Olsen Faresjö, Ashild

2015-01-01

Background Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder,that affects approximately 10% of the general population and the majority are diagnosed  in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to  investigate the psychosocial constructs of self-esteem and sense of...

Microbiota, gastrointestinal infections, low-grade inflammation, and antibiotic therapy in irritable bowel syndrome (IBS: an evidence-based review

Directory of Open Access Journals (Sweden)

Max Schmulson

2014-04-01

Conclusions: Further studies are required to determine the nature of the gut microbiota in IBS and the differences in low-grade inflammation between PI-IBS and non PI-IBS. Rifaximin has shown itself to be an effective treatment for IBS, regardless of prior factors.

RISK CORRIDORS AND REINSURANCE IN HEALTH INSURANCE MARKETPLACES: Insurance for Insurers

OpenAIRE

LAYTON, TIMOTHY J.; MCGUIRE, THOMAS G.; SINAIKO, ANNA D.

2016-01-01

In order to encourage entry and lower prices, most regulated markets for health insurance include policies that seek to reduce the uncertainty faced by insurers. In addition to risk adjustment of premiums paid to plans, the Health Insurance Marketplaces established by the Affordable Care Act implement reinsurance and risk corridors. Reinsurance limits insurer costs associated with specific individuals, while risk corridors protect against aggregate losses. Both tighten the insurer's distribut...

The role of stress in IBS symptom severity

Directory of Open Access Journals (Sweden)

Sanda Pletikosic

2016-04-01

Full Text Available Irritable bowel syndrome is regarded as a biopsychosocial disorder, the result of a complex combination of predisposing, precipitating and perpetuating factors. Personality traits, affective status and stress are some of the relevant factors contributing to lower quality of life and symptom exacerbation in IBS patients. In order to examine the role of stress in IBS symptom exacerbation, the aims of this study were to explore the relationship of daily stressful events and symptom severity in a prospective manner and to explore the roles of neuroticism, anxiety, depression and stress in the vicious circle of symptom perpetuation. A total of 49 patients with IBS reported their symptom severity and daily stressful events intensity each day for 14 consecutive days. They also completed the Big five personality inventory, the Beck Depression Inventory and the State-trait anxiety inventory. Cross-correlation analyses were performed on the time series data for daily stress and symptom severity for each participant separately. Four different patterns of relationships were found in different subgroups of participants: positive cross-correlations of symptom severity and stress intensity on the same day; higher symptom severity on days following stressful days; lower symptom severity on days following stressful days; and lower stress intensity on days following severe symptoms. Using average scores for daily stress and symptom severity, as well as scores for neuroticism, anxiety and depression, we performed a path analysis to test a model of symptom exacerbation. It showed that, on the group level, average stress intensity predicts average symptom severity. Neuroticism and anxiety were not significant predictors of symptom severity, while depression showed a marginally significant relationship with symptom severity, mediated by stress intensity. In conclusion, depression and daily stress seem to be important contributors to the vicious circle of IBS symptom

Politics and Pedagogy: Discursive Constructions in the IB "Theory of Knowledge--Guide"

Science.gov (United States)

Smith, Nigel V.; Morgan, Mandy

2010-01-01

The International Baccalaureate (IB) curriculum is increasingly popular in both national and international secondary education settings. The "Theory of knowledge" (TOK) course is cast as the prime example of the international globalised values the IB Diploma represents. This article argues that such a positioning is contested within the TOK…

Billing for outpatient transplant pharmacy services.

Science.gov (United States)

Maldonado, Angela Q; Seiger, Todd C; Urann, Christina L; McCleary, Jo Ann; Goroski, Angela L; Ojogho, Okechukwu N

2012-01-15

The economic impact of out-patient pharmacy services in a transplant program was evaluated. Full-time kidney transplant pharmacy services were implemented at Providence Sacred Heart Medical Center (PSHMC) in the fall of 2008, with two pharmacists combining hours to provide one full-time-equivalent position. At PSHMC, posttransplantation patients are seen three times per week. The number of patient visits with pharmacists for 2010 was compared with the total number of patient visits. The face-to-face time spent with the patient was translated to a level of billing that was associated with a set reimbursement schedule. For each patient encounter in which a pharmacist was involved, the incremental difference between the nursing and pharmacy levels of billing was examined, as were the levels most often billed by pharmacists. The difference in billing levels between pharmacists and nurses for the same patient encounter was also evaluated. Overall, pharmacist visits accounted for 208 (22%) of the 994 out-patient kidney transplant visits in 2010, with pharmacists billing at a higher level of acuity compared with nursing for the same patient encounter 48% of the time. This translated to an approximate increase of $100 per patient visit. For the one-year study period, pharmacists utilizing facility- fee billing increased out-patient reimbursement by approximately $10,000. By utilizing outpatient facility-fee billing for pharmacy services, the transplant program at PSHMC increased reimbursement in the outpatient setting.

Crop insurance: Risks and models of insurance

Directory of Open Access Journals (Sweden)

Čolović Vladimir

2014-01-01

Full Text Available The issue of crop protection is very important because of a variety of risks that could cause difficult consequences. One type of risk protection is insurance. The author in the paper states various models of insurance in some EU countries and the systems of subsidizing of insurance premiums by state. The author also gives a picture of crop insurance in the U.S., noting that in this country pays great attention to this matter. As for crop insurance in Serbia, it is not at a high level. The main problem with crop insurance is not only the risks but also the way of protection through insurance. The basic question that arises not only in the EU is the question is who will insure and protect crops. There are three possibilities: insurance companies under state control, insurance companies that are public-private partnerships or private insurance companies on a purely commercial basis.

Insurance against climate change and flood risk: Insurability and decision processes of insurers

Science.gov (United States)

Hung, Hung-Chih; Hung, Jia-Yi

2016-04-01

1. Background Major portions of the Asia-Pacific region is facing escalating exposure and vulnerability to climate change and flood-related extremes. This highlights an arduous challenge for public agencies to improve existing risk management strategies. Conventionally, governmental funding was majorly responsible and accountable for disaster loss compensation in the developing countries in Asia, such as Taiwan. This is often criticized as an ineffective and inefficient measure of dealing with flood risk. Flood insurance is one option within the toolkit of risk-sharing arrangement and adaptation strategy to flood risk. However, there are numerous potential barriers for insurance companies to cover flood damage, which would cause the flood risk is regarded as uninsurable. This study thus aims to examine attitudes within the insurers about the viability of flood insurance, the decision-making processes of pricing flood insurance and their determinants, as well as to examine potential solutions to encourage flood insurance. 2. Methods and data Using expected-utility theory, an insurance agent-based decision-making model was developed to examine the insurers' attitudes towards the insurability of flood risk, and to scrutinize the factors that influence their decisions on flood insurance premium-setting. This model particularly focuses on how insurers price insurance when they face either uncertainty or ambiguity about the probability and loss of a particular flood event occurring. This study considers the factors that are expected to affect insures' decisions on underwriting and pricing insurance are their risk perception, attitudes towards flood insurance, governmental measures (e.g., land-use planning, building codes, risk communication), expected probabilities and losses of devastating flooding events, as well as insurance companies' attributes. To elicit insurers' utilities about premium-setting for insurance coverage, the 'certainty equivalent,' 'probability

Critical Success Factors for Lean Thinking in the Application of Industrialised Building System (IBS)

Science.gov (United States)

Yunus, Riduan; Noor, Siti Rahimah Mohd; Halid Abdullah, Abd; Nagapan, Sasitharan; Hamid, Abdul Rahim Abdul; Tajudin, Saiful Azhar Ahmad; Rohani Mat Jusof, Siti

2017-08-01

Productivity in the manufacturing process of building components can be increased by optimising each advantage that is available in each activity. Identification of critical success factors (CSFs) for lean thinking in the Industrialised Building System (IBS) will be able to minimise cost and reduce time needed to complete a project. The focus of lean thinking in construction is on the production process and the client’s requirement. In developing countries such as Malaysia, the integration of lean thinking in IBS applications is still low and there is a shortage of comprehensive strategies to integrate lean thinking. As key stakeholders, feedback from contractors, manufacturers, developers and the local authority will be able to help the identification of CSFs in integrating lean thinking in IBS applications. The data was collected through a questionnaire survey and analysed quantitatively. There are 31 CSFs for lean thinking in IBS which have been identified in this study. A conceptual model was developed to assist researchers in investigating the influences of CSFs for lean thinking in IBS applications. This study will assist construction players to improvise their manufacturing process in the implementation of IBS to eliminate unnecessary activities and focus instead on significant processes without generating physical and non-physical waste.

A Preliminary Review on Economies of Scale (EOS Towards Industrialized Building System (IBS Manufacturer

Directory of Open Access Journals (Sweden)

Tajul Ariffin Syazwana

2017-01-01

Full Text Available Industrialized Building System (IBS is a potential technology to improve productivity of construction industry. Controlled production and minimum generation of construction waste are some of the benefits that can be achieved by replacing conventional construction with IBS. In business, IBS is giving a huge opportunity for manufacturer and supplier to expand their business while contributing to construction development. However, bad strategies will put the company in high risk due to higher initial capital for machines and equipment. Therefore, strategic planning for company’s growth, profit maximization, and enhancement of productivity is undeniable to ensure the success of business in construction industry. This preliminary paper is exploring associated factors that affect Economy of Scale (EOS and their relationships in catalyzing the IBS manufacturer especially precast concrete as the scope of study to continue their business in the construction industry. Thus, a framework of EOS is proposed to assist IBS manufacturers to ensure their company’s growth and stability, competitiveness in term of monopoly or an oligopoly, increasing productivity, leading constant returns to scale, and finally increasing the firm’s efficiency. The refined EOS’s conceptual framework is an important turning point to support the development of decision making tools for IBS manufacturer towards their stability and survival in this highly competitive industry.

The communication in industrialised building system (IBS) construction project: Virtual environment

Science.gov (United States)

Pozin, Mohd Affendi Ahmad; Nawi, Mohd Nasrun Mohd

2017-10-01

Large portion of numbers team organization in the IBS construction sector is known are being fragmented. That is contributed from a segregation of construction activity thus create team working in virtually. Virtual team are the nature when teams are working in distributed area, across culture and time. Therefore, teams can be respond to the task without relocating to the site project and settle down a problem through information and communication technology (ICT). The emergence of virtual team are carry out by advancements in communication technologies as a medium to improve project team communication in project delivery process on IBS construction. Based on literature review from previous study and data collected from interviewing, this paper aim to identified communication challenges among project team members according to current project development practices in IBS construction project. Hence, in attempt to develop effective communication through the advantages of virtual team approach for IBS construction project. In order to ensure the data is gathered comprehensively and accurately, the data was collected from project managers by using semi structured interview method. It was found that virtual team approach could be enable competitive challenges on complexity in the construction project management process.

Chinese nuclear insurance and Chinese nuclear insurance pool

International Nuclear Information System (INIS)

Gong Zhiqi

2000-01-01

Chinese Nuclear Insurance Started with Daya Bay Nuclear Power Station, PICC issued the insurance policy. Nuclear insurance cooperation between Chinese and international pool's organizations was set up in 1989. In 1996, the Chinese Nuclear Insurance Pool was prepared. The Chinese Nuclear Insurance Pool was approved by The Chinese Insurance Regulatory Committee in May of 1999. The principal aim is to centralize maximum the insurance capacity for nuclear insurance from local individual insurers and to strengthen the reinsurance relations with international insurance pools so as to provide the high quality insurance service for Chinese nuclear industry. The Member Company of Chinese Nuclear Pool and its roles are introduced in this article

The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy in ION SOLCA, Guayaquil Ecuador from November 1 to October 2002

International Nuclear Information System (INIS)

Gamboa, Eugenia; Falquez, Roberto

2003-01-01

To determine if the additional vaginal cuff irradiation is necessary or not in patients with cervix cancer, stages IB 1- IB 2, that has been treated previously with radical hysterectomies and pelvic radiotherapy, to get better local control and global survival versus presence of complications. We studied 54 patients from Radiation Oncology Department of ION SOLCA Guayaquil Ecuador, with cervix cancer stages IB1 - IB2, that have been treated with surgery plus pelvic radiotherapy plus or not brachytherapy. They have been divides into two arms, group one included surgery plus Rx T (radiotherapy) plus BxT (Brachytherapy), and group two included those patients with surgery plus external RxT alone. We studied, aged, histologic type, surgery type, doses and techniques of teletherapy and brachytherapy and we analyzed the presence of complications. Conclusions: The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy is not useful to get better local control and global survival in some patients carefully chosen without desfavorable factors, because this therapy represent and increase in the complication. (The author)

Integrated Baseline System (IBS) Version 2.0: Models guide

Energy Technology Data Exchange (ETDEWEB)

1994-03-01

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool being developed under the direction of the US Army Nuclear and Chemical Agency. This Models Guide summarizes the IBS use of several computer models for predicting the results of emergency situations. These include models for predicting dispersion/doses of airborne contaminants, traffic evacuation, explosion effects, heat radiation from a fire, and siren sound transmission. The guide references additional technical documentation on the models when such documentation is available from other sources. The audience for this manual is chiefly emergency management planners and analysts, but also data managers and system managers.

Rendimientos del colágeno, poliornitinas (tipos: IB, IIB y IC) y colágeno mas poliornitina IB, como substratos para el cultivo de ganglios ciliares disociados de embrión de pollo

OpenAIRE

Bustos Ruiz, M.; Alcaín Tejada, F.J.; Padilla-Alvarez, F.

1981-01-01

Dissociated ciliary ganglia of 8 days embryos were cultured in heart conditioned medium, employing differents substrata types: collagen, po¬lyornithines (types: IB,IIB and IC) and collagen plus polyornithine IB. The results from neuron survival (with and without prolongations) and non neuronal cells it obtained graphically. The polyornithines mollecular weights are discussed respect inductor factors binding for conditioned medium. The type IB is better than others types (IIB y IC), but collag...

Clinical laboratory billing: superfluous requirements without justification?

Science.gov (United States)

Stadler, Stephen

2004-01-01

Congress occasionally passes new laws that affect how clinical laboratories handle test orders from physicians and, subsequently, process the billing for tests. Once a bill is signed into law, it is forwarded to administrative agencies, which draft regulations and administrative procedures, under which the intentions of Congress are carried out. In the case of laboratory test ordering and billing, the Centers for Medicare and Medicaid Services (CMS) has the greatest influence over how these regulations and procedures are defined. Unfortunately, in many cases, billing rules have been promulgated in ways that create the need for hospitals and commercial laboratories to expend huge sums of money to bill within the confines of the administrative rules; cause clinical laboratories to suffer from omissions and mistakes of other parties who are part of the patient care process but are not accountable for the billing information they provide to laboratories; and, frankly, in some respects, simply defy common sense.

Purification, crystallization and preliminary X-ray analysis of Enterococcus faecium aminoglycoside-2′′-phosphotransferase-Ib [APH(2′′)-Ib

Energy Technology Data Exchange (ETDEWEB)

Walanj, Rupa; Young, Paul; Baker, Heather M.; Baker, Edward N.; Metcalf, Peter [Laboratory of Structural Biology, School of Biological Sciences, University of Auckland, Auckland (New Zealand); Chow, Joseph W.; Lerner, Stephen [Division of Infectious Diseases, Wayne State University School of Medicine and VA Medical Center, Detroit, Michigan 48201 (United States); Vakulenko, Sergei [Department of Chemistry and Biochemistry, University of Notre Dame, Notre Dame, IN 46556 (United States); Smith, Clyde A., E-mail: csmith@slac.stanford.edu [Stanford Synchrotron Radiation Laboratory, Stanford University, Menlo Park, CA 94025 (United States); Laboratory of Structural Biology, School of Biological Sciences, University of Auckland, Auckland (New Zealand)

2005-04-01

APH(2′′)-Ib is an enzyme responsible for high-level gentamicin resistance in E. faecium isolates. Native crystals of this enzyme have been prepared and preliminary X-ray diffraction experiments have been undertaken. Bacterial resistance to the aminoglycoside antibiotics is primarily the result of deactivation of the drugs. Three families of enzymes are responsible for this activity, with one such family being the aminoglycoside phosphotransferases (APHs). The gene encoding one of these enzymes, APH(2′′)-Ib, has been cloned and the protein (comprising 299 amino-acid residues) expressed in Escherichia coli, purified and crystallized in the presence of 16%(w/v) PEG 3350 and gentamicin. The crystals belong to the monoclinic space group P2{sub 1}, with approximate unit-cell parameters a = 79.7, b = 58.8, c = 81.4 Å, β = 98.4°, and preliminary X-ray diffraction analysis is consistent with the presence of two molecules in the asymmetric unit. Synchrotron diffraction data to approximately 2.65 Å resolution were collected from a native APH(2′′)-Ib crystal at beamline BL9-2 at SSRL (Stanford, CA, USA). Selenium-substituted crystals have also been produced and structure determination is proceeding.

The Significance of Coordination for Industrialised Building System (IBS) Precast Concrete in Construction Industry

OpenAIRE

Fitri Othman Mohd Khairul; Wan Muhammad Wan Mohd Nurdden; Abd Hadi Nurulhudaya; Azman Mohd Azrai

2017-01-01

IBS precast concrete is construction system which is meant to improve the conventional construction process. However IBS precast concrete projects are suffering from serious problems such as cost overrun, delays and less quality of the end product. The absence of coordination is perceived as the reason for this issue. The purpose of this paper is to review the significance of coordination for IBS precast concrete in the construction industry. It if found that the fragmentation which occurs in...

Advantages and Setbacks of Industrialized Building System (IBS) Implementation: A Case Study in Sarawak

OpenAIRE

Sing Sing Wong; Ling Kung Lau

2015-01-01

Industrialized Building System (IBS) is an innovative technique adopted to increase the efficiency, quality and productivity of projects. However, these advantages are proven mainly for projects located in urban areas only. IBS is not a common practice for projects located in rural areas. Although there were studies about IBS in Malaysia about its advantages and setbacks, these studies were focusing on projects located in urban areas located in West Malaysia only. Hence, this paper aids to cl...

How a new 'public plan' could affect hospitals' finances and private insurance premiums.

Science.gov (United States)

Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

2009-01-01

Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial.

Science.gov (United States)

McIntosh, Keith; Reed, David E; Schneider, Theresa; Dang, Frances; Keshteli, Ammar H; De Palma, Giada; Madsen, Karen; Bercik, Premysl; Vanner, Stephen

2017-07-01

To gain mechanistic insights, we compared effects of low fermentable oligosaccharides, disaccharides and monosaccharides and polyols (FODMAP) and high FODMAP diets on symptoms, the metabolome and the microbiome of patients with IBS. We performed a controlled, single blind study of patients with IBS (Rome III criteria) randomised to a low (n=20) or high (n=20) FODMAP diet for 3 weeks. Symptoms were assessed using the IBS symptom severity scoring (IBS-SSS). The metabolome was evaluated using the lactulose breath test (LBT) and metabolic profiling in urine using mass spectrometry. Stool microbiota composition was analysed by 16S rRNA gene profiling. Thirty-seven patients (19 low FODMAP; 18 high FODMAP) completed the 3-week diet. The IBS-SSS was reduced in the low FODMAP diet group (pmetabolome. In subsets of patients, FODMAPs modulate histamine levels and the microbiota, both of which could alter symptoms. NCT01829932. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

Science.gov (United States)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

Streptococcus sanguinis Class Ib Ribonucleotide Reductase

Science.gov (United States)

Makhlynets, Olga; Boal, Amie K.; Rhodes, DeLacy V.; Kitten, Todd; Rosenzweig, Amy C.; Stubbe, JoAnne

2014-01-01

Streptococcus sanguinis is a causative agent of infective endocarditis. Deletion of SsaB, a manganese transporter, drastically reduces S. sanguinis virulence. Many pathogenic organisms require class Ib ribonucleotide reductase (RNR) to catalyze the conversion of nucleotides to deoxynucleotides under aerobic conditions, and recent studies demonstrate that this enzyme uses a dimanganese-tyrosyl radical (MnIII2-Y•) cofactor in vivo. The proteins required for S. sanguinis ribonucleotide reduction (NrdE and NrdF, α and β subunits of RNR; NrdH and TrxR, a glutaredoxin-like thioredoxin and a thioredoxin reductase; and NrdI, a flavodoxin essential for assembly of the RNR metallo-cofactor) have been identified and characterized. Apo-NrdF with FeII and O2 can self-assemble a diferric-tyrosyl radical (FeIII2-Y•) cofactor (1.2 Y•/β2) and with the help of NrdI can assemble a MnIII2-Y• cofactor (0.9 Y•/β2). The activity of RNR with its endogenous reductants, NrdH and TrxR, is 5,000 and 1,500 units/mg for the Mn- and Fe-NrdFs (Fe-loaded NrdF), respectively. X-ray structures of S. sanguinis NrdIox and MnII2-NrdF are reported and provide a possible rationale for the weak affinity (2.9 μm) between them. These streptococcal proteins form a structurally distinct subclass relative to other Ib proteins with unique features likely important in cluster assembly, including a long and negatively charged loop near the NrdI flavin and a bulky residue (Thr) at a constriction in the oxidant channel to the NrdI interface. These studies set the stage for identifying the active form of S. sanguinis class Ib RNR in an animal model for infective endocarditis and establishing whether the manganese requirement for pathogenesis is associated with RNR. PMID:24381172

46 CFR 9.16 - Billing for services.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Billing for services. 9.16 Section 9.16 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC EXTRA COMPENSATION FOR OVERTIME SERVICES § 9.16 Billing for services. Overtime services shall be billed to the steamship companies...

Topoisomerase IB of Deinococcus radiodurans resolves guanine ...

Indian Academy of Sciences (India)

2015-11-28

Nov 28, 2015 ... All the oligonucleotides men- tioned here were ... further reactions with DraTopoIB were carried out at 37°C ... of G4 DNA moves faster than unfolded and intermolecular .... for its action on intramolecular G4 DNA structure was.

14 CFR 1215.115 - Payment and billing.

Science.gov (United States)

2010-01-01

... is applicable toward TDRSS operational services. (b) The procedure for billing and payment of... billings as the actual service time is tabulated. Amounts due to the user will be credited to the next... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Payment and billing. 1215.115 Section 1215...

The economic impact of the insured patients with severe chronic and acute illnesses: a qualitative approach

Directory of Open Access Journals (Sweden)

Budi Aji

2014-10-01

Full Text Available Background: Little research has focused on the economic hardship among the insured with severe illnesses and high treatment costs, in particular, the consequence of poorer insurance coverage for high-cost illnesses. Therefore, we presented the case for identifying the experiences of insured patients with severe chronic and acute illnesses. This study identified a qualitative understanding of the economic impact of severe chronic and acute illnesses and household strategies to deal with high treatment costs. Design: Interviews were conducted with 19 insured households of three different health insurance programs with a family member that had been hospitalized for severe chronic or acute illnesses in either Banyumas or Margono Sukarjo hospitals in Banyumas, Central Java, Indonesia. A thematic analysis was applied to guide the interpretation of the data. Results: Insured households with a family member that had been hospitalized for severe chronic and acute illnesses were greatly affected by the high treatment costs. Four major issues emerged from this qualitative study: insured patients are still burdened with high out-of-pocket payments, households adopt various strategies to cope with the high cost of treatments, households experience financial hardships, and positive and negative perceptions of the insured regarding their health insurance coverage for acute and chronic illnesses. Conclusions: Askes and Jamsostek patients faced financial burdens from high cost sharing for hospital amenities, non-covered drugs, and treatments and other indirect costs. Meanwhile, Jamkesmas beneficiaries faced no financial burden for related medical services but were rather burdened with indirect costs for the carers. Households relied on internal resources to cover hospital bills as the first strategy, which included the mobilization of savings, sale of assets, and borrowing of money. External support was tapped secondarily and included financial support from

SYMPOSIUM REPORT: An Evidence-Based Approach to IBS and CIC: Applying New Advances to Daily Practice

Science.gov (United States)

Chey, William D.

2017-01-01

Many nonpharmacologic and pharmacologic therapies are available to manage irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC). The American College of Gastroenterology (ACG) regularly publishes reviews on IBS and CIC therapies. The most recent of these reviews was published by the ACG Task Force on the Management of Functional Bowel Disorders in 2014. The key objective of this review was to evaluate the efficacy of therapies for IBS or CIC compared with placebo or no treatment in randomized controlled trials. Evidence-based approaches to managing diarrhea-predominant IBS include dietary measures, such as a diet low in gluten and fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs); loperamide; antispasmodics; peppermint oil; probiotics; tricyclic antidepressants; alosetron; eluxadoline, and rifaximin. Evidence-based approaches to managing constipation-predominant IBS and CIC include fiber, stimulant laxatives, polyethylene glycol, selective serotonin reuptake inhibitors, lubiprostone, and guanylate cyclase agonists. With the growing evidence base for IBS and CIC therapies, it has become increasingly important for clinicians to assess the quality of evidence and understand how to apply it to the care of individual patients. PMID:28729815

The sweet potato IbMYB1 gene as a potential visible marker for sweet potato intragenic vector system.

Science.gov (United States)

Kim, Cha Young; Ahn, Young Ock; Kim, Sun Ha; Kim, Yun-Hee; Lee, Haeng-Soon; Catanach, Andrew S; Jacobs, Jeanne M E; Conner, Anthony J; Kwak, Sang-Soo

2010-07-01

MYB transcription factors play important roles in transcriptional regulation of many secondary metabolites including anthocyanins. We cloned the R2R3-MYB type IbMYB1 complementary DNAs from the purple-fleshed sweet potato (Ipomoea batatas L. cv Sinzami) and investigated the expression patterns of IbMYB1 gene with IbMYB1a and IbMYB1b splice variants in leaf and root tissues of various sweet potato cultivars by reverse transcription-polymerase chain reaction. The transcripts of IbMYB1 were predominantly expressed in the purple-fleshed storage roots and they were also detectable in the leaf tissues accumulating anthocyanin pigments. In addition, transcript levels of IbMYB1 gene were up-regulated by treatment with methyl jasmonate or salicylic acid in leaf and root tissues of cv. White Star. To set up the intragenic vector system in sweet potato, we first evaluated the utilization of the IbMYB1 gene as a visible selectable marker. The IbMYB1a was transiently expressed in tobacco leaves under the control of a constitutive cauliflower mosaic virus 35S promoter, a root-specific and sucrose-inducible sporamin promoter, and an oxidative stress-inducible sweet potato anionic peroxidase2 promoter. We also showed that overexpression of IbMYB1a induced massive anthocyanin pigmentation in tobacco leaves and up-regulated the transcript levels of the structural genes in anthocyanin biosynthetic pathway. Furthermore, high-performance liquid chromatography analysis revealed that the expression of IbMYB1a led to production of cyanidin as a major core molecule of anthocyanidins in tobacco leaves. These results suggest that the IbMYB1 gene can be applicable to a visible marker for sweet potato transformation with intragenic vectors, as well as the production of anthocyanin as important nutritive value in other plant species.

Reform of the Buy-and-Bill System for Outpatient Chemotherapy Care Is Inevitable: Perspectives from an Economist, a Realpolitik, and an Oncologist.

Science.gov (United States)

Polite, Blase; Conti, Rena M; Ward, Jeffery C

2015-01-01

Treating patients with cancer with infused or injected oncolytics is a core component of outpatient oncology practice. Currently, practices purchase drugs and then bill insurers, colloquially called "buy and bill." Reimbursement for these drugs is the largest source of gross revenue for oncology practices, and as the prices of cancer drugs have grown over time, these purchases have had significant impact on the financial health of practices and pose a risk that jeopardizes the ability of many practices to operate and provide patient care. Medicare Part B spending on drugs is under political scrutiny because of federal spending pressures, and the margin between buy and bill, lowered to 6% by the Medicare Modernization Act and further decreased to 4.3% by sequestration, is a convenient and popular target of budgetary discussions and proposals, scored to save billions of dollars over 10-year budget windows for each percentage-point reduction. Alternatives to the buy-and-bill system have been proposed to include invoice pricing, least costly alternative reimbursement, bundling of drugs into episode-of-care payments, shifting Part B drugs to the Medicare Part D benefit, and revision of the failed Competitive Acquisition Program. This article brings the perspectives of policy makers, health care economists, and providers together to discuss this major challenge in oncology payment reform.

The ties that bind: perceived social support, stress, and IBS in severely affected patients.

Science.gov (United States)

Lackner, J M; Brasel, A M; Quigley, B M; Keefer, L; Krasner, S S; Powell, C; Katz, L A; Sitrin, M D

2010-08-01

This study assessed the association between social support and the severity of irritable bowel syndrome (IBS) symptoms in a sample of severely affected IBS patients recruited to an NIH-funded clinical trial. In addition, we examined if the effects of social support on IBS pain are mediated through the effects on stress. Subjects were 105 Rome II diagnosed IBS patients (F = 85%) who completed seven questionnaires which were collected as part of a pretreatment baseline assessment. Partial correlations were conducted to clarify the relationships between social support and clinically relevant variables with baseline levels of psychopathology, holding constant number of comorbid medical diseases, age, gender, marital status, ethnicity, and education. Analyses indicated that social support was inversely related to IBS symptom severity. Social support was positively related with less severe pain. A similar pattern of data was found for perceived stress but not quality of life impairment. Regression analyses examined if the effects of social support on pain are mediated by stress. The effects of social support on bodily pain were mediated by stress such that the greater the social support the less stress and the less pain. This effect did not hold for symptom severity, quality of life, or psychological distress. This study links the perceived adequacy of social support to the global severity of symptoms of IBS and its cardinal symptom (pain). It also suggests that the mechanism by which social support alleviates pain is through a reduction in stress levels.

The Significance of Coordination for Industrialised Building System (IBS Precast Concrete in Construction Industry

Directory of Open Access Journals (Sweden)

Fitri Othman Mohd Khairul

2017-01-01

Full Text Available IBS precast concrete is construction system which is meant to improve the conventional construction process. However IBS precast concrete projects are suffering from serious problems such as cost overrun, delays and less quality of the end product. The absence of coordination is perceived as the reason for this issue. The purpose of this paper is to review the significance of coordination for IBS precast concrete in the construction industry. It if found that the fragmentation which occurs in the construction industry requires continuity of coordination due to the construction activities are intertwined in nature. Coordination is designated to assist stakeholders in completing and complementing each other with the paramount focus of achieving the objective. Proper coordination is required in delivering the desired construction product at the ideal time, cost and quality. As for the findings, the significance of coordination for IBS precast concrete can be seen through the precast concrete construction phases which consist of planning; design; manufacturing; transportation and installation/construction. These phases are meant to complement construction process with the purpose to reduce issues of fragmentation and enhance IBS precast concrete project delivery.

Critical ICT-Inhibiting Factors on IBS Production Management Processes in the Malaysia Construction Industry

Science.gov (United States)

Ern, Peniel Ang Soon; Kasim, Narimah; Hamid, Zuhairi Abd; Chen, Goh Kai

2017-10-01

Industrialized Building System (IBS) is one of the approaches that had been introduced as an alternative to conventional building method where it becomes the new strategy of enhancing the sustainable construction in current industries while spearheading a huge advancement of benefits with green constructions into the existing industries. The IBS approach is actively promoted through several strategies and incentives as an alternative to conventional building methods. Extensive uptakes of modern Information Communication Technology (ICT) applications are able to support the different IBS processes for effective production. However, it is argued that ICT uptake at the organisational level is still in its infancy. This raises the importance to identify critical inhibitors which are inhibing the effective uptake of ICT in the IBS production management process. Critical inhibitors to ICT uptake were identified through questionnaire survey with the IBS industry stakeholders. The mean index and critical t-values are generated with the use of the quantitative tool, Statistical Package for Social Sciences (SPSS). The top ten priority ranked inhibitors reflect the Cost, People and Process elements to ICT uptake. High costs in acquiring the technologies and resistance to change were some main concerns from the findings.

Klinefelter's Syndrome with Seizure, Pseudohypoparathyroidism Type Ib and Multiple Endocrine Dysfunctions

Directory of Open Access Journals (Sweden)

Chwen-Yi Yang

2005-12-01

Full Text Available Klinefelter's syndrome is rarely associated with hypocalcemia, especially pseudohypoparathyroidism (PHP type Ib. We describe a case of Klinefelter's syndrome associated with seizure, PHP type Ib and multiple endocrine dysfunctions. A 19-year-old Taiwanese male was admitted due to seizures with loss of consciousness. He had been diagnosed with Klinefelter's syndrome with seizure disorder and hypocalcemia 3 months previously. Physical examination revealed eunuchoidism but no osteodystrophy, while laboratory data revealed severe hypocalcemia, hyperphosphatemia, and elevated parathyroid hormone. Chromosomal study showed 47, XXY. Osteoporosis was found on chest and abdominal radiography. Dense calcification in the cerebrum and cerebellum was shown on brain computed tomography and magnetic resonance imaging. Elevation of the patient's serum calcium level was noted after vitamin D and calcium carbonate supplements were given. Klinefelter's syndrome is rarely associated with PHP type Ib; our patient's hypocalcemia improved after long-term aggressive treatment.

The problems of private health insurance in Chile: Looking for a solution to a history of inefficiency and inequity

Directory of Open Access Journals (Sweden)

Camilo Cid

2011-12-01

Full Text Available The concept of health insurance is of vital importance for health policy. Beneficiaries are able to share the risk arising from health expenses, and are ensured access to health care provisions whenever necessary. The need to share an individual’s risk to become ill is the direct consequence of the uncertainty that surrounds the health sector. Chilean health insurance companies are able to reach financial balance (the state-owned insurer or profits (privately-owned insurers by setting a premium rate. Information flow tends to be asymmetric and one of the shortcomings of this system is that the private health insurance companies have better information, which leads to risk selection. A form of regulation would be to set a premium rate proportional to income thus incentivizing contributions in accordance with income (independent of risk and pool efficiency if the whole population is included. A natural solution that would be functional to the current system is the creation of a single pool together with a broad community premium rate to finance the fund. The article analyses the feasibility of a single fund, its requisites, and the health plan that the Chilean government is proposing in its bill to reform the private health insurance sector.

How the Change in IBS Criteria From Rome III to Rome IV Impacts on Clinical Characteristics and Key Pathophysiological Factors.

Science.gov (United States)

Aziz, Imran; Törnblom, Hans; Palsson, Olafur S; Whitehead, William E; Simrén, Magnus

2018-06-08

The diagnostic criteria for irritable bowel syndrome (IBS) have recently been updated from Rome III to Rome IV. Whereas in Rome III a diagnosis of IBS entailed chronic abdominal pain or discomfort at least 3 days per month, in Rome IV the term discomfort has been removed and the frequency of abdominal pain increased to at least 1 day per week. We examined how this change in IBS criteria impacts on clinical characteristics and pathophysiological factors. A total of 542 Swedish subjects with Rome III IBS completed a baseline questionnaire enquiring for the number of abdominal pain days in the last 10 days; this was subsequently used as a surrogate marker to identify Rome IV IBS, in that (a) those with 0 or 1 day of pain were classed as Rome IV-negative, and (b) those with ≥2 days of pain were classed as Rome IV-positive. Comparisons were made between Rome IV-positive and -negative IBS groups for demographics, IBS subtype, gastrointestinal and psychological symptoms, somatisation, fatigue, disease-specific quality of life, rectal sensitivity, and oro-anal transit time. Overall, 85% of Rome III IBS patients fulfilled the Rome IV criteria for IBS, but 15% did not. Rome IV-positive subjects were significantly more likely to be female, have poorer quality of life, greater pain severity, bloating, somatisation, fatigue, and rectal sensitivity than Rome IV-negative subjects. There were no differences in severity of anxiety or depression, IBS subtypes, bowel habit dissatisfaction, or oro-anal transit time. Finally, increasing number of pain days correlated positively with symptoms and visceral hypersensitivity. Most Rome III-positive IBS patients seeking healthcare fulfil the Rome IV IBS criteria. They constitute a more severe group than those who lose their IBS diagnosis.

24 CFR 266.602 - Mortgage insurance premium: Insured advances.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium: Insured... Contract Rights and Obligations Mortgage Insurance Premiums § 266.602 Mortgage insurance premium: Insured.... On each anniversary of the initial closing, the HFA shall pay an interim mortgage insurance premium...

An Investigation of Telecom Mobile Data Billing Plans

Directory of Open Access Journals (Sweden)

Yi-Bing Lin

2016-08-01

Full Text Available In the recent years, mobile operators have provided many billing alternatives such as limited and unlimited billing plans, and shared and non-shared data plans for the users with different needs. A non-shared data plan is designed for a single user with a limited monthly data allowance. On the other hand, the monthly data allowance of a shared data plan is shared by a group of users with multiple devices. The mobile operators often conduct the primary price study to compare their billing plans, which shows the relationship between the prices of the billing plans against the fixed amounts of data usage. Although the primary price study can easily and quickly draw the conclusions, it only provides rough billing plan suggestions. In reality, the amounts of data usage are not fixed, and therefore should be measured from commercial mobile networks to reflect the user behaviors on data usage. This paper proposes an analytical approach by using the measured data of Chunghwa Telecom Co., Ltd. (CHT, the largest telecommunications company in Taiwan, to derive the expected payments of various billing plans. The results of the analytical model are more accurate than those of the primary price study, and therefore provide better suggestions for billing plan selection. Other mobile operators can easily use our model to analyze the billing alternatives with their measured data.

46 CFR 296.40 - Billing procedures.

Science.gov (United States)

2010-10-01

... OPERATORS MARITIME SECURITY PROGRAM (MSP) Billing and Payment Procedures § 296.40 Billing procedures. Submission of voucher. For contractors operating under more than one MSP Operating Agreement, the contractor may submit a single monthly voucher applicable to all its MSP Operating Agreements. Each voucher...

Development of a Rhizoctonia solani AG1-IB Specific Gene Model Enables Comparative Genome Analyses between Phytopathogenic R. solani AG1-IA, AG1-IB, AG3 and AG8 Isolates.

Directory of Open Access Journals (Sweden)

Daniel Wibberg

Full Text Available Rhizoctonia solani, a soil-born plant pathogenic basidiomycetous fungus, affects various economically important agricultural and horticultural crops. The draft genome sequence for the R. solani AG1-IB isolate 7/3/14 as well as a corresponding transcriptome dataset (Expressed Sequence Tags--ESTs were established previously. Development of a specific R. solani AG1-IB gene model based on GMAP transcript mapping within the eukaryotic gene prediction platform AUGUSTUS allowed detection of new genes and provided insights into the gene structure of this fungus. In total, 12,616 genes were recognized in the genome of the AG1-IB isolate. Analysis of predicted genes by means of different bioinformatics tools revealed new genes whose products potentially are involved in degradation of plant cell wall components, melanin formation and synthesis of secondary metabolites. Comparative genome analyses between members of different R. solani anastomosis groups, namely AG1-IA, AG3 and AG8 and the newly annotated R. solani AG1-IB genome were performed within the comparative genomics platform EDGAR. It appeared that only 21 to 28% of all genes encoded in the draft genomes of the different strains were identified as core genes. Based on Average Nucleotide Identity (ANI and Average Amino-acid Identity (AAI analyses, considerable sequence differences between isolates representing different anastomosis groups were identified. However, R. solani isolates form a distinct cluster in relation to other fungi of the phylum Basidiomycota. The isolate representing AG1-IB encodes significant more genes featuring predictable functions in secondary metabolite production compared to other completely sequenced R. solani strains. The newly established R. solani AG1-IB 7/3/14 gene layout now provides a reliable basis for post-genomics studies.

BUSINESS STRATEGY OF LARGE CONTRACTORS IN ADOPTING INDUSTRIALISED BUILDING SYSTEM (IBS: THE MALAYSIAN CASE

Directory of Open Access Journals (Sweden)

FRANKY AMBON

2012-12-01

Full Text Available Industrialised Building System (IBS is the term coined by the government and industry in Malaysia to represent the construction industry and the application of prefabrication method in building construction. The purpose of this exploratory research paper is to highlight business strategy being pursued by large Malaysian contractors in adopting IBS. The paper uses case study as research method. The analysis is based primarily on cross-case analysis and pattern matching technique. The paper observes contractors which involved in IBS are part of larger holding companies in a corporate set-up include design and manufacturing subsidiaries. The companies positioned themselves as one-stop total solution provider for IBS and offer a wider range of services from design, production, and installation to clients. To become competitive and able to create total solution, contractors need to establish cluster and consortium of integrated project team by creating a partnership when and where it is needed. A vendor development programme modelled along the lines of the development of automotive industry should also be established. Future empirical studies should extensively examine these areas, especially the development of business model for contractors. The availability of this model could help to accelerate the uptake of IBS among contractors.

48 CFR 42.704 - Billing rates.

Science.gov (United States)

2010-10-01

... officer (or cognizant Federal agency official) or auditor responsible under 42.705 for establishing the... contracting officer (or cognizant Federal agency official) or auditor shall establish billing rates on the... officer (or cognizant Federal agency official) or auditor should ensure that the billing rates are as...

Flood risk and insurance loss potential in the Thames Gateway

Science.gov (United States)

Eldridge, J.; Horn, D.

2009-04-01

The Thames Gateway, currently Europe's largest regeneration project, is an area of redevelopment located in the South East of England, with Government plans to create up to 160,000 new homes and 180,000 new jobs by 2016. Although the new development is intended to contribute £12bn annually to the economy, the potential flood risk is high, with much of the area situated on Thames tidal floodplain and vulnerable to both storm surges and peak river flows. This poses significant hazard to those inhabiting the area and has raised concern amongst the UK insurance industry, who would be liable for significant financial claims if a large flood event were to occur, particularly with respect to the number of new homes and businesses being built in flood risk areas. Flood risk and the potential damage to both lives and assets in vulnerable areas have gained substantial recognition, in light of recent flooding events, from both governmental agencies and in the public's awareness of flood hazard. This has resulted in a change in UK policy with planning policy for flood risk (PPS25, Planning Policy Statement 25) adopting a more strategic approach to development, as well as a new Flooding and Water Bill which is due for consultation in 2009. The Government and the Association of British Insurers, who represent the UK insurance industry, have also recently changed their Statement of Principles which guides provision of flood insurance in the future. This PhD research project aims to quantify flood risk in the Thames Gateway area with a view to evaluating the insurance loss potential under different insurance and planning scenarios. Using current sources of inundation extent, and incorporating varying insurance penetration rates and degrees of adoption of planning policy and guidance, it focuses on estimating flood risk under these different scenarios. This presentation introduces the development of the project and the theory and methodology which will be used to address the

Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.

Science.gov (United States)

Wheeler, Stephanie B; Kuo, Tzy-Mey; Meyer, Anne Marie; Martens, Christa E; Hassmiller Lich, Kristen M; Tangka, Florence K L; Richardson, Lisa C; Hall, Ingrid J; Smith, Judith Lee; Mayorga, Maria E; Brown, Paul; Crutchfield, Trisha M; Pignone, Michael P

2017-06-01

Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p testing, 42% received colonoscopy, whereas 58% received FOBT/FIT, with significant regional variation. In multivariable models, females with private insurance had lower odds of colonoscopy than males (OR = 0.43; p < 0.05). People living 10-15 miles away from endoscopy facilities also had lower odds of colonoscopy than those living within 5 miles (OR = 0.91; p < 0.05). Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

Towards Integrated Team Practice: A Case of Malaysian Industrialised Building System (IBS Construction Projects

Directory of Open Access Journals (Sweden)

Mohd Nawi Mohd Nasrun

2014-01-01

Full Text Available Problems associated with fragmentation in the traditional construction process, such as isolation of professionals, lack of co-ordination between design and construction, and the sequential manner of its processes, has impacted on construction performance leading to a lack of integration, wastage, low productivity and efficiency. Integrated team practice is perceived as paramount. Unfortunately, there has a limitation of study focus on the dimension of fully integrated team especially for Malaysian Industrialised Building System (IBS projects. Accordingly, this research paper explores and identifies the dimension of fully integrated team from the traditional approach and conduct a validation process for implementing it in Malaysian IBS projects. The research presented uses interviews case study to obtain qualitative data. It was found that the dimension of fully integrated team from the traditional construction process could apply to the Malaysian IBS projects. Suggestions on how an integrated team practice in IBS design and construction process in order to minimise the fragmentation gaps will be concluded.

Travel Tips Help IBS Sufferers Enjoy Their Vacations

Science.gov (United States)

... can feel more in control when traveling." IFFGD's travel tips include: Allow enough time in the morning to get to the airport ... Heartache 2004-0929 Norton Honored 2004-0525 IBS Travel Tips ... Real World 2001-1119 Heartburn or Heart Attack Commentary ...

42 CFR 408.82 - Conditions for group billing.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Conditions for group billing. 408.82 Section 408.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE... for group billing. CMS agrees to a group billing arrangement only if the following conditions are met...

iB1350 no.3. Passive double confinement and SA population dose evaluation for the iB1350

International Nuclear Information System (INIS)

Sato, Takashi; Matsumoto, Keiji; Hosomi, Kenji; Iwasaki, Ryuji

2017-01-01

iB1350 stands for an innovative, intelligent and inexpensive BWR 1350. It is the first Generation III.7 reactor after the Fukushima Daiichi accident. The iB1350 uses the Mark W containment and the in-containment filtered venting system (IFVS). The Mark W containment is made of reinforced concrete and has double cylinder FP barriers. There are also IC/iPCCS pools, a fuel pool and a dryer separator (DS) pool on the top slab of the containment. These pools work as water seal for FP leakage through the top slab. Most FP such as CsI are scrubbed in the pools. The containment head is also submerged in the reactor well pool. The pool water works as shielding for radiation from the reactor core during normal operation and water seal for FP scrubbing during a severe accident. The base mat concrete is covered with the S/P and the core catcher that is also submerged with corium flooding water during an accident. Therefore, the Mark W containment has passive double confinement barriers for FP. Moreover, the IFVS works as in-containment filtered venting system that scrubs FP from the wet well (WW) and the dry well (DW). The filtered venting tank is arranged in the outer well (OW) of the Mark W containment. Even noble gases and organic iodine going through the filtered venting system are still confined inside the containment and never released directly to the environment. The IFVS uses the innovative passive containment cooling system (iPCCS) as the pre-stage heat removal system. The iPCCS has a normal open suction line from the WW. Therefore, FP are scrubbed in the S/P at first and then vented into the filtered venting tank. After the DW suction line of the iPCCS is opened all the steam is cooled and condensed in the heat exchanger. Most FP are trapped in the condensate and returned into the WW through the condensate return line of the iPCCS. Therefore, the Mark W containment has excellent FP double confinement barriers and the in-containment filtered venting system that enable

France's energy bill in 2007

International Nuclear Information System (INIS)

2008-01-01

This article comments the slight decrease of the French energy bill in 2007 and its evolution since 1970, as well as the energy price fluctuations during 2007. While noticing the importance of the dollar fall, the authors discuss the evolution of oil product prices and its different indicators (crude oil annual average quotation, Brent annual average quotation, and imported oil annual average price), the evolution of natural gas prices, of coal prices, of electricity prices. The global decrease of energy imports is then discussed, including quantities of imported crude oil from various origins, refined products, gas from various origins as well, solid mineral fuels. The balance between exports and imports is commented as a whole, and with some particular countries, enabling an assessment of energy independence. The bill evolution for oil and for gas is briefly discussed, and the global value is assessed with respect to the French GDP or as an amount of work days for French inhabitants. Several graphs and tables are given, gathering several data which have been discussed: energy trade (imports, exports, and bill), comparison of bill with other economic aggregates, average prices of imported energy expressed in dollars and in euros, average price of imported crude oil, etc

Reading and Calculating Billing Through Mobile Devices

Directory of Open Access Journals (Sweden)

Pilar Alexandra Moreno

2013-06-01

Full Text Available This article broadly describes the analysis, design and development of the system utilitarian, called “Reading and billing calculation site through mobile devices.” The application is oriented Public Services Companies, first water services, to perform part of the billing process “in place” through phones or any mobile devices compatible with Android. Will enable you to take readings of service consumption, recording new gauging, online update and control the information for users and turnover. This technology is considered as such one site billing method as through Internet is connected with the database of the company, sending and receiving date information, which makes the calculation of the billing for the reading period, bringing benefits to the client and the service generating company.

Optimum amount of an insurance sum in life insurance

Directory of Open Access Journals (Sweden)

Janez Balkovec

2001-01-01

Full Text Available Personal insurance represents one of the sources of personal social security as a category of personal property. How to get a proper life insurance is a frequently asked question. When insuring material objects (car, house..., the problem is usually not in the amount of the taken insurance. With life insurance (abstract goods, problems as such occur. In this paper, we wish to present a model that, according to the financial situation and the anticipated future, makes it possible to calculate the optimum insurance sum in life insurance.

9 CFR 590.130 - Basis of billing plants.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Basis of billing plants. 590.130... of Service § 590.130 Basis of billing plants. Overtime and/or holiday services shall be billed to the official plant on the basis of each 15 minutes of overtime and/or holiday service performed by each...

Insuring against Health Shocks: Health Insurance and Household Choices

OpenAIRE

Liu, Kai

2015-01-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investme...

Managing water utility financial risks through third-party index insurance contracts

Science.gov (United States)

Zeff, Harrison B.; Characklis, Gregory W.

2013-08-01

As developing new supply capacity has become increasingly expensive and difficult to permit (i.e., regulatory approval), utilities have become more reliant on temporary demand management programs, such as outdoor water use restrictions, for ensuring reliability during drought. However, a significant fraction of water utility income is often derived from the volumetric sale of water, and such restrictions can lead to substantial revenue losses. Given that many utilities set prices at levels commensurate with recovering costs, these revenue losses can leave them financially vulnerable to budgetary shortfalls. This work explores approaches for mitigating drought-related revenue losses through the use of third-party financial insurance contracts based on streamflow indices. Two different types of contracts are developed, and their efficacy is compared against two more traditional forms of financial hedging used by water utilities: Drought surcharges and contingency funds (i.e., self-insurance). Strategies involving each of these approaches, as well as their use in combination, are applied under conditions facing the water utility serving Durham, North Carolina. A multireservoir model provides information on the scale and timing of droughts, and the financial effects of these events are simulated using detailed data derived from utility billing records. Results suggest that third-party index insurance contracts, either independently or in combination with more traditional hedging tools, can provide an effective means of reducing a utility's financial vulnerability to drought.

Defense bill: Earmarking as usual

Science.gov (United States)

Earmarked funds in the $268 billion defense appropriations bill for fiscal year 1991 stirred congressional debate in late October. Senator Sam Nunn (D-Ga.), chairman of the Senate Armed Services Committee, charged that the defense bill contains questionable projects totaling tens of millions of dollars. AGU opposes legislative earmarking of money for particular institutions, maintaining that the practice prevents the best use of federal funding by circumventing competitive review. Nunn noted on the Senate floor that the appropriations bill provided specific funds for cited institutions—contravening a federal law promoting competition. “ If these programs have merit, they will succeed in a fair and competent review in competition,” Nunn said. “If no other institution in the country is able to compete, there should be no fear whatever of competition… But no one else in the world is allowed to compete to work on these projects.”

Premium Forecasting of an Insurance Company: Automobile Insurance

OpenAIRE

Fouladvand, M. Ebrahim; Darooneh, Amir H.

2002-01-01

We present an analytical study of an insurance company. We model the company's performance on a statistical basis and evaluate the predicted annual income of the company in terms of insurance parameters namely the premium, total number of the insured, average loss claims etc. We restrict ourselves to a single insurance class the so-called automobile insurance. We show the existence a crossover premium p_c below which the company is loss-making. Above p_c, we also give detailed statistical ana...

Performance improvement planning : developing effective billing and collection practices

OpenAIRE

anonymous

2008-01-01

Effective billing and collection systems are a critical component for ensuring the viability of a service provider. Improving billing and collection activities has an immediate impact on the revenue streams of a service provider that can, in turn, help the service provider in improving services. However, while effective billing and collection practices depend on many internal factors (including customer databases, the extent of metered and unmetered service provision, tariff and billing struc...

Insuring against health shocks: Health insurance and household choices.

Science.gov (United States)

Liu, Kai

2016-03-01

This paper provides empirical evidence on the role of public health insurance in mitigating adverse outcomes associated with health shocks. Exploiting the rollout of a universal health insurance program in rural China, I find that total household income and consumption are fully insured against health shocks even without access to health insurance. Household labor supply is an important insurance mechanism against health shocks. Access to health insurance helps households to maintain investment in children's human capital during negative health shocks, which suggests that one benefit of health insurance could arise from reducing the use of costly smoothing mechanisms. Copyright © 2016 Elsevier B.V. All rights reserved.

Defining the key-parameters of insurance product in Islamic insurance

Directory of Open Access Journals (Sweden)

Galim Zaribzyanovich Vakhitov

2015-06-01

Full Text Available Objective to define the range of actuarial calculations in Islamic insurance to study the main differences of the traditional and Islamic insurance to define what changes in calculations entail the above differences. Methods mathematical modeling probabilistic analysis of insurance risks adaptation of methods of actuarial mathematics to the principles of Islamic insurance. Results the mathematical form of the takafulfund models is presented the distribution is analyzed of a random variable of the resulting insurance fund or the insurance company balance in a particular fixed insurance portfolio. Scientific novelty calculation are presented of the optimal tariff rate in takaful. Islamic insurance is an innovative area of insurance industry. Actuarial calculations that meet the Sharia rules are still being developed. The authors set the new tasks of actuarial calculations including the specified changes in the calculation of the optimal tariff rate imposed by the Islamic insurance principles. Practical value the results obtained can be used in the actuarial calculations of the Islamic insurance companies. nbsp

Effects of gut-directed hypnotherapy on IBS in different clinical settings-results from two randomized, controlled trials.

Science.gov (United States)

Lindfors, Perjohan; Unge, Peter; Arvidsson, Patrik; Nyhlin, Henry; Björnsson, Einar; Abrahamsson, Hasse; Simrén, Magnus

2012-02-01

Gut-directed hypnotherapy has been found to be effective in irritable bowel syndrome (IBS). However, randomized, controlled studies are rare and few have been performed outside highly specialized research centers. The objective of this study was to study the effect of gut-directed hypnotherapy in IBS in different clinical settings outside the traditional research units. The study population included IBS patients refractory to standard management. In study 1, patients were randomized to receive gut-directed hypnotherapy (12 sessions, 1 h/week) in psychology private practices or supportive therapy, whereas patients were randomized to receive gut-directed hypnotherapy in a small county hospital or to serve as waiting list controls in study 2. Gastrointestinal symptom severity and quality of life were evaluated at baseline, at 3 months follow-up and after 1 year. We randomized 138 IBS patients refractory to standard management, 90 in study 1 and 48 in study 2. In both the studies, IBS-related symptoms were improved at 3 months in the gut-directed hypnotherapy groups (Phypnotherapy group than in the control group (Phypnotherapy is an effective treatment alternative for patients with refractory IBS, but the effectiveness is lower when the therapy is given outside the highly specialized research centers.

Exploring health insurance services in Sudan from the perspectives of insurers.

Science.gov (United States)

Salim, Anas Mustafa Ahmed; Hamed, Fatima Hashim Mahmoud

2018-01-01

It has been 20 years since the introduction of health insurance in Sudan. This study was the first one that explored health insurance services in Sudan from the perspectives of the insurers. This was a qualitative, exploratory, interview study. The sampling frame was the list of Social Health Insurance and Private Health Insurance institutions in Sudan. Participants were selected from the four Social Health Insurance institutions and from five Private Health Insurance companies. The study was conducted in January and February 2017. In-depth individual interviews were conducted with a convenient sample of key executives from the different health insurers. Ideas and themes were identified and analysed using thematic analysis. The result showed that universal coverage was not achieved despite long time presence of Social Health Insurance and Private Health Insurance in Sudan. All participants described their services as comprehensive. All participants have good perception of the quality of the services they provide, although none of them investigated customer satisfaction. The main challenges facing Social Health Insurance are achieving universal coverage, ensuring sustainability and recruitment of the informal sector and self-employed population. Consumers' affordability of the premiums is the main obstacle for Private Health Insurance, while rising healthcare cost due to economic inflation is a challenge facing both Social Health Insurance and Private Health Insurance. In spite of the presence of Social Health Insurance and Private Health Insurance in Sudan, the country is still far from achieving universal coverage. Moreover, the sustainability of health insurance is questionable. The main reasons include low governmental financial resources and lack of affordability by beneficiaries especially for Private Health Insurance. This necessitates finding solutions to improve them or trying other types of health insurance. The quality of services provided by Social

Genetic recombination and Cryptosporidium hominis virulent subtype IbA10G2.

Science.gov (United States)

Li, Na; Xiao, Lihua; Cama, Vitaliano A; Ortega, Ynes; Gilman, Robert H; Guo, Meijin; Feng, Yaoyu

2013-10-01

Little is known about the emergence and spread of virulent subtypes of Cryptosporidium hominis, the predominant species responsible for human cryptosporidiosis. We conducted sequence analyses of 32 genetic loci of 53 C. hominis specimens isolated from a longitudinally followed cohort of children living in a small community. We identified by linkage disequilibrium and recombination analyses only limited genetic recombination, which occurred exclusively within the 60-kDa glycoprotein gene subtype IbA10G2, a predominant subtype for outbreaks in industrialized nations and a virulent subtype in the study community. Intensive transmission of virulent subtype IbA10G2 in the study area might have resulted in genetic recombination with other subtypes. Moreover, we identified selection for IbA10G2 at a 129-kb region around the 60-kDa glycoprotein gene in chromosome 6. These findings improve our understanding of the origin and evolution of C. hominis subtypes and the spread of virulent subtypes.

Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34

Directory of Open Access Journals (Sweden)

Nasrine Masaeli

2013-01-01

Full Text Available Background: Quality of life (QOL improvement is the main objective of treating patients with irritable bowel syndrome (IBS. This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. Materials and Methods: Two hundred and forty patients with IBS (based on gastroenterologists′ diagnosis according to ROM III criteria were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36 and IBS severity index (IBSSI questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach′s alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS software, version 18. Results: Total reliability of the questionnaire was reported by using Cronbach′s alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in −0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. Conclusion: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

An integrated billing application to streamline clinician workflow.

Science.gov (United States)

Vawdrey, David K; Walsh, Colin; Stetson, Peter D

2014-01-01

Between 2008 and 2010, our academic medical center transitioned to electronic provider documentation using a commercial electronic health record system. For attending physicians, one of the most frustrating aspects of this experience was the system's failure to support their existing electronic billing workflow. Because of poor system integration, it was difficult to verify the supporting documentation for each bill and impractical to track whether billable notes had corresponding charges. We developed and deployed in 2011 an integrated billing application called "iCharge" that streamlines clinicians' documentation and billing workflow, and simultaneously populates the inpatient problem list using billing diagnosis codes. Each month, over 550 physicians use iCharge to submit approximately 23,000 professional service charges for over 4,200 patients. On average, about 2.5 new problems are added to each patient's problem list. This paper describes the challenges and benefits of workflow integration across disparate applications and presents an example of innovative software development within a commercial EHR framework.

24 CFR 266.600 - Mortgage insurance premium: Insurance upon completion.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Mortgage insurance premium... MULTIFAMILY PROJECT LOANS Contract Rights and Obligations Mortgage Insurance Premiums § 266.600 Mortgage insurance premium: Insurance upon completion. (a) Initial premium. For projects insured upon completion, on...

Detergent-Resistant Membrane Microdomains Facilitate Ib Oligomer Formation and Biological Activity of Clostridium perfringens Iota-Toxin

National Research Council Canada - National Science Library

Hale, Martha

2004-01-01

...) were extracted with cold Triton X-100. Western blotting revealed that Ib oligomers localized in DRMs extracted from Vero, but not MRC-5, cells while monomeric Ib was detected in the detergent-soluble fractions of both cell types...

Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly.

Science.gov (United States)

Zhang, Anwen; Nikoloski, Zlatko; Mossialos, Elias

2017-10-01

China's recent healthcare reforms aim to provide fair and affordable health services for its huge population. In this paper, we investigate the association between China's health insurance and out-of-pocket (OOP) healthcare expenditure. We further explore the heterogeneity in this association. Using data of 32,387 middle-aged and elderly individuals drawn from the 2011 and 2013 waves of China Health and Retirement Longitudinal Study (CHARLS), we report five findings. First, having health insurance increases the likelihood of utilizing healthcare and reduces inpatient OOP expenditure. Second, healthcare benefits are distributed unevenly: while low- and medium-income individuals are the main beneficiaries with reduced OOP expenditure, those faced with very high medical bills are still at risk, owing to limited and shallow coverage in certain aspects. Third, rural migrants hardly benefit from having health insurance, suggesting that institutional barriers are still in place. Fourth, health insurance does not increase patient visits to primary care facilities; hospitals are still the main provider of healthcare. Nonetheless, there is some evidence that patients shift from higher-tier to lower-tier hospitals. Last, OOP spending on pharmaceuticals is reduced for inpatient care but not for outpatient care, suggesting that people rely on inpatient care to obtain reimbursable drugs, putting further pressure on the already overcrowded hospitals. Our findings suggest that China's health insurance system has been effective in boosting healthcare utilization and lowering OOP hospitalization expenditure, but there still remain challenges due to the less generous rural scheme, shallow outpatient care coverage, lack of insurance portability, and an underdeveloped primary healthcare system. Copyright © 2017 Elsevier Ltd. All rights reserved.

Expression of the sweetpotato R2R3-type IbMYB1a gene induces anthocyanin accumulation in Arabidopsis.

Science.gov (United States)

Chu, Hyosub; Jeong, Jae Cheol; Kim, Wook-Jin; Chung, Dong Min; Jeon, Hyo Kon; Ahn, Young Ock; Kim, Sun Ha; Lee, Haeng-Soon; Kwak, Sang-Soo; Kim, Cha Young

2013-06-01

R2R3-type MYB transcription factors (TFs) play important roles in transcriptional regulation of anthocyanins. The R2R3-type IbMYB1 is known to be a key regulator of anthocyanin biosynthesis in the storage roots of sweetpotato. We previously showed that transient expression of IbMYB1a led to anthocyanin pigmentation in tobacco leaves. In this article, we generated transgenic Arabidopsis plants expressing the IbMYB1a gene under the control of CaMV 35S promoter, and the sweetpotato SPO and SWPA2 promoters. Overexpression of IbMYBa in transgenic Arabidopsis produced strong anthocyanin pigmentation in seedlings and generated a deep purple color in leaves, stems and seeds. Reverse transcription-polymerase chain reaction analysis showed that IbMYB1a expression induced upregulation of several structural genes in the anthocyanin biosynthetic pathway, including 4CL, CHI, F3'H, DFR, AGT, AAT and GST. Furthermore, overexpression of IbMYB1a led to enhanced expression of the AtTT8 (bHLH) and PAP1/AtMYB75 genes. high-performance liquid chromatography analysis revealed that IbMYB1a expression led to the production of cyanidin as a major core molecule of anthocyanidins in Arabidopsis, as occurs in the purple leaves of sweetpotato (cv. Sinzami). This result shows that the IbMYB1a TF is sufficient to induce anthocyanin accumulation in seedlings, leaves, stems and seeds of Arabidopsis plants. Copyright © Physiologia Plantarum 2012.

The development of application for billing of services

OpenAIRE

Šinko, Žiga

2013-01-01

Diploma is a description of a programming solution for preparing billing invoices of Mikrocop services. Developed system can easily manage billing invoices specifications for all customers and set schedules for generating invoices. These settings are than used by the service module generating invoices on schedule. Generated invoices can be seen and managed with help of Windows Reporting Services technology. First chapter describes services billing in general. Second chapter shortly de...

THE BILL OF EXCHANGE AS A MEANS OF PAYMENT AND SECURITY

Directory of Open Access Journals (Sweden)

Vojo Belovski

2016-07-01

Full Text Available The bill of exchange is a kind of paper in order that its holder shall entitle the debtor named in the document to pay a certain amount of payments. The bill of exchange represents a means of payment and an instrument of providing the payment. It is an unconditional order given by the drawer to the drawee to pay a certain amount to the payee listed on the bill of exchange. The bill of exchange is generally a paper on the orders but it can be issued as value paper to a name. It is such promissory notes where the issuer becomes a clause not by order. The bill of exchange though it appears as a means of payment and an instrument for securing the payment it also appears as a means of international payment, because the bill of exchange can become a modern instrument of crediting and payment. With the development of the credit market and the bill of exchange becomes a means for the drawer and the drawee. This means that instead of the bill of exchange to be paid after the expiry of a certain deadline for submission of the bill of exchange the holder may sell or discount, or to pay before the deadline for submission. With this the bill of exchange becomes a toll for discount. Based on this we can conclude that the bill of exchange has the following roles: -bill of exchange serves as a means of credit; -bill of exchange serves as means of payment; -bill of exchange serves as a means for discount by.

Breast Cancer Risk Estimation and Personal Insurance: A Qualitative Study Presenting Perspectives from Canadian Patients and Decision Makers

Directory of Open Access Journals (Sweden)

Gratien Dalpé

2017-09-01

Full Text Available Genetic stratification approaches in personalized medicine may considerably improve our ability to predict breast cancer risk for women at higher risk of developing breast cancer. Notwithstanding these advantages, concerns have been raised about the use of the genetic information derived in these processes, outside of the research and medical health care settings, by third parties such as insurers. Indeed, insurance applicants are asked to consent to insurers accessing their medical information (implicitly including genetic to verify or determine their insurability level, or eligibility to certain insurance products. This use of genetic information may result in the differential treatment of individuals based on their genetic information, which could lead to higher premium, exclusionary clauses or even the denial of coverage. This phenomenon has been commonly referred to as “Genetic Discrimination” (GD. In the Canadian context, where federal Bill S-201, An Act to prohibit and prevent genetic discrimination, has recently been enacted but may be subject to constitutional challenges, information about potential risks to insurability may raise issues in the clinical context. We conducted a survey with women in Quebec who have never been diagnosed with breast cancer to document their perspectives. We complemented the research with data from 14 semi-structured interviews with decision-makers in Quebec to discuss institutional issues raised by the use of genetic information by insurers. Our results provide findings on five main issues: (1 the reluctance to undergo genetic screening test due to insurability concerns, (2 insurers' interest in genetic information, (3 the duty to disclose genetic information to insurers, (4 the disclosure of potential impacts on insurability before genetic testing, and (5 the status of genetic information compared to other health data. Overall, both groups of participants (the women surveyed and the decision

TRPA1 is functionally expressed primarily by IB4-binding, non-peptidergic mouse and rat sensory neurons.

Directory of Open Access Journals (Sweden)

Marie E Barabas

Full Text Available Subpopulations of somatosensory neurons are characterized by functional properties and expression of receptor proteins and surface markers. CGRP expression and IB4-binding are commonly used to define peptidergic and non-peptidergic subpopulations. TRPA1 is a polymodal, plasma membrane ion channel that contributes to mechanical and cold hypersensitivity during tissue injury, making it a key target for pain therapeutics. Some studies have shown that TRPA1 is predominantly expressed by peptidergic sensory neurons, but others indicate that TRPA1 is expressed extensively within non-peptidergic, IB4-binding neurons. We used FURA-2 calcium imaging to define the functional distribution of TRPA1 among peptidergic and non-peptidergic adult mouse (C57BL/6J DRG neurons. Approximately 80% of all small-diameter (<27 µm neurons from lumbar 1-6 DRGs that responded to TRPA1 agonists allyl isothiocyanate (AITC; 79% or cinnamaldehyde (84% were IB4-positive. Retrograde labeling via plantar hind paw injection of WGA-Alexafluor594 showed similarly that most (81% cutaneous neurons responding to TRPA1 agonists were IB4-positive. Additionally, we cultured DRG neurons from a novel CGRP-GFP mouse where GFP expression is driven by the CGRPα promoter, enabling identification of CGRP-expressing live neurons. Interestingly, 78% of TRPA1-responsive neurons were CGRP-negative. Co-labeling with IB4 revealed that the majority (66% of TRPA1 agonist responders were IB4-positive but CGRP-negative. Among TRPA1-null DRGs, few small neurons (2-4% responded to either TRPA1 agonist, indicating that both cinnamaldehyde and AITC specifically target TRPA1. Additionally, few large neurons (≥27 µm diameter responded to AITC (6% or cinnamaldehyde (4%, confirming that most large-diameter somata lack functional TRPA1. Comparison of mouse and rat DRGs showed that the majority of TRPA1-responsive neurons in both species were IB4-positive. Together, these data demonstrate that TRPA1 is

TRPA1 Is Functionally Expressed Primarily by IB4-Binding, Non-Peptidergic Mouse and Rat Sensory Neurons

Science.gov (United States)

Stucky, Cheryl L.

2012-01-01

Subpopulations of somatosensory neurons are characterized by functional properties and expression of receptor proteins and surface markers. CGRP expression and IB4-binding are commonly used to define peptidergic and non-peptidergic subpopulations. TRPA1 is a polymodal, plasma membrane ion channel that contributes to mechanical and cold hypersensitivity during tissue injury, making it a key target for pain therapeutics. Some studies have shown that TRPA1 is predominantly expressed by peptidergic sensory neurons, but others indicate that TRPA1 is expressed extensively within non-peptidergic, IB4-binding neurons. We used FURA-2 calcium imaging to define the functional distribution of TRPA1 among peptidergic and non-peptidergic adult mouse (C57BL/6J) DRG neurons. Approximately 80% of all small-diameter (neurons from lumbar 1–6 DRGs that responded to TRPA1 agonists allyl isothiocyanate (AITC; 79%) or cinnamaldehyde (84%) were IB4-positive. Retrograde labeling via plantar hind paw injection of WGA-Alexafluor594 showed similarly that most (81%) cutaneous neurons responding to TRPA1 agonists were IB4-positive. Additionally, we cultured DRG neurons from a novel CGRP-GFP mouse where GFP expression is driven by the CGRPα promoter, enabling identification of CGRP-expressing live neurons. Interestingly, 78% of TRPA1-responsive neurons were CGRP-negative. Co-labeling with IB4 revealed that the majority (66%) of TRPA1 agonist responders were IB4-positive but CGRP-negative. Among TRPA1-null DRGs, few small neurons (2–4%) responded to either TRPA1 agonist, indicating that both cinnamaldehyde and AITC specifically target TRPA1. Additionally, few large neurons (≥27 µm diameter) responded to AITC (6%) or cinnamaldehyde (4%), confirming that most large-diameter somata lack functional TRPA1. Comparison of mouse and rat DRGs showed that the majority of TRPA1-responsive neurons in both species were IB4-positive. Together, these data demonstrate that TRPA1 is functionally expressed

Learning Negotiation Policies Using IB3 and Bayesian Networks

Science.gov (United States)

Nalepa, Gislaine M.; Ávila, Bráulio C.; Enembreck, Fabrício; Scalabrin, Edson E.

This paper presents an intelligent offer policy in a negotiation environment, in which each agent involved learns the preferences of its opponent in order to improve its own performance. Each agent must also be able to detect drifts in the opponent's preferences so as to quickly adjust itself to their new offer policy. For this purpose, two simple learning techniques were first evaluated: (i) based on instances (IB3) and (ii) based on Bayesian Networks. Additionally, as its known that in theory group learning produces better results than individual/single learning, the efficiency of IB3 and Bayesian classifier groups were also analyzed. Finally, each decision model was evaluated in moments of concept drift, being the drift gradual, moderate or abrupt. Results showed that both groups of classifiers were able to effectively detect drifts in the opponent's preferences.

47 CFR 76.981 - Negative option billing.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Negative option billing. 76.981 Section 76.981 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Rate Regulation § 76.981 Negative option billing. (a) A cable operator...

76 FR 77442 - Mutual Insurance Holding Company Treated as Insurance Company

Science.gov (United States)

2011-12-13

... insurance industry traces its roots back to England, where, in 1696, the first mutual fire insurer was... FEDERAL DEPOSIT INSURANCE CORPORATION 12 CFR Part 380 RIN 3064-AD89 Mutual Insurance Holding Company Treated as Insurance Company AGENCY: Federal Deposit Insurance Corporation (FDIC). ACTION: Notice...

Billing third party payers for vaccines: state and local health department perspectives.

Science.gov (United States)

Quintanilla, Carlos; Duncan, Lorraine; Luther, Lydia

2009-01-01

The cost of adequately immunizing a child has risen steadily with recommendations of new, more expensive vaccines. The Vaccines for Children (VFC) program, a federal entitlement, has continued to fund all recommended vaccines for eligible children. The one other federal vaccine-funding source, Section 317 of the Public Health Service Act, has not kept pace with rising vaccine costs. For local health departments to immunize children not eligible for VFC, but whose families are underinsured or otherwise unable to pay for vaccines, state immunization programs have often relied on Section 317 funds. Recognizing this funding challenge and having learned that children covered by health insurance were being immunized in public clinics with publicly supplied vaccines, the Oregon Immunization Program (OIP) launched a project to expand billing of health plans by local health departments for vaccines administered to covered persons. This has resulted in significant savings of Section 317 funds, allowing the Oregon program to provide more vaccines for high-need persons.

Reduced responses of submucous neurons from irritable bowel syndrome patients to a cocktail containing histamine, serotonin, TNFα and tryptase (IBS-cocktail

Directory of Open Access Journals (Sweden)

Daniela eOstertag

2015-12-01

Full Text Available Background & Aims:Malfunctions of enteric neurons are believed to play an important role in the pathophysiology of irritable bowel syndrome (IBS. Our aim was to investigate whether neuronal activity in biopsies from IBS patients is altered in comparison to healthy controls (HC.Methods:Activity of human submucous neurons in response to electrical nerve stimulation and local application of nicotine or a mixture of histamine, serotonin, tryptase and TNF-α (IBS-cocktail was recorded in biopsies from 17 HC and 35 IBS patients with the calcium-sensitive-dye Fluo-4 AM. The concentrations of the mediators resembeled those found in biopsy supernatants or blood. Neuronal activity in guinea-pig submucous neurons was studied with the voltage-sensitive-dye di-8-ANEPPS. Results:Activity in submucous ganglia in response to nicotine or electrical nerve stimulation was not different between HC and IBS patients (P=0.097 or P=0.448. However, the neuronal response after application of the IBS-cocktail was significantly decreased (P=0.039 independent of whether diarrhea (n=12, constipation (n=5 or bloating (n=5 was the predominant symptom. In agreement with this we found that responses of submucous ganglia conditioned by overnight incubation with IBS mucosal biopsy supernatant to spritz application of this supernatant was significantly reduced (P=0.019 when compared to incubation with HC supernatant.Conclusion:We demonstrated for the first time reduced neuronal responses in mucosal IBS biopsies to an IBS mediator cocktail. While excitability to classical stimuli of enteric neurons was comparable to HC, the activation by the IBS-cocktail was decreased. This was very likely due to desensitization to mediators constantly released by mucosal and immune cells in the gut wall of IBS patients.

The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

OpenAIRE

Helme, T

1991-01-01

In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983.

A new method using insert-based systems (IBS) to improve cell behavior study on flexible and rigid biomaterials.

Science.gov (United States)

Grenade, Charlotte; Moniotte, Nicolas; Rompen, Eric; Vanheusden, Alain; Mainjot, Amélie; De Pauw-Gillet, Marie-Claire

2016-12-01

In vitro studies about biomaterials biological properties are essential screening tests. Yet cell cultures encounter difficulties related to cell retention on material surface or to the observation of both faces of permeable materials. The objective of the present study was to develop a reliable in vitro method to study cell behavior on rigid and flexible/permeable biomaterials elaborating two specific insert-based systems (IBS-R and IBS-F respectively). IBS-R was designed as a specific cylindrical polytetrafluoroethylene (PTFE) system to evaluate attachment, proliferation and morphology of human gingival fibroblasts (HGFs) on grade V titanium and lithium disilicate glass-ceramic discs characteristics of dental prostheses. The number of cells, their covering on discs and their morphology were determined from MTS assays and microscopic fluorescent images after 24, 48 and 72 h. IBS-F was developed as a two components system to study HGFs behavior on guided bone regeneration polyester membranes. The viability and the membrane barrier effect were evaluated by metabolic MTS assays and by scanning electron microscopy. IBS-R and IBS-F were shown to promote (1) easy and rapid handling; (2) cell retention on biomaterial surface; (3) accurate evaluation of the cellular proliferation, spreading and viability; (4) use of non-toxic material. Moreover IBS-F allowed the study of the cell migration through degradable membranes, with an access to both faces of the biomaterial and to the bottom of culture wells for medium changing.

The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS).

Science.gov (United States)

Kanuri, N; Cassell, B; Bruce, S E; White, K S; Gott, B M; Gyawali, C P; Sayuk, G S

2016-10-01

Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on gastrointestinal (GI) symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity has not been studied. Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12), and HRQOL (SF-36). Current GI symptom severity and bother were assessed using 10-cm Visual Analog Scales. 272 ROME-defined IBS (47.6 ± 0.9 years, 81% female) and 246 non-FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood. Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances. © 2016 John Wiley & Sons Ltd.

Invasive cervical carcinoma (stage IB-IIB): assessment with MR imaging

International Nuclear Information System (INIS)

Sironi, S.; Del Maschio, A.; Belloni, C.; Taccagni, L.

1990-01-01

In patients with cervical carcinoma the selection of the optimal therapy depends on the precise preoperative assessment of the extent of disease. Currently, decisions regarding the management of these patients are made on the basis of clinical (FIGO) staging that has 50% mean error rate. To investigate the value of MR imaging in staging patients with invasive cervical cancer, we performed 25 MR examinations on 23 patients with histologic diagnosis of cervical cancer. All patients were clinically considered as having stage IB or IIB disease and underwent radical hysterectomy, providing specimens for pathologic correlation. The overall accuracy of MR imaging in staging cervical carcinoma (stage IB-IIB) was 78.1%. MR imaging seems to be the most reliable preoperative modality for staging invasive cervical cancer

The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

Science.gov (United States)

Helme, T

1991-01-01

In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983. PMID:2033626

The consumer pays the energy bill

International Nuclear Information System (INIS)

Meulmeester, P.; Haffner, R.C.G.

2005-01-01

The liberalization of the energy market for small-scale consumers in the Netherlands coincides with a period in which consumers have to pay high energy bills. However, the cause of this is not the liberalization, but the high oil prices and raised taxes. In this article an overview is given of the total energy bill n the Netherlands, its components and the first effects of the liberalization process [nl

Deposit Insurance Coverage, Credibility of Non-insurance, and Banking Crises

DEFF Research Database (Denmark)

Angkinand, Apanard; Wihlborg, Clas

2005-01-01

level require analyses of institutional factors affecting the credibility of non-insurance. In particular, the implementation of effective distress resolution procedures for banks would allow governments to reduce explicit deposit insurance coverage and, thereby, to strengthen market discipline......The ambiguity in existing empirical work with respect to effects of deposit insurance schemes on banks' risk-taking can be resolved if it is recognized that absence of deposit insurance is rarely credible and that the credibility of non-insurance can be enhanced by explicit deposit insurance...... schemes. We show that under reasonable conditions for effects on risk-taking of creditor protection in banking, and for effects on credibility of non-insurance of explicit coverage of deposit insurance schemes, there exists a partial level of coverage that maximizes market discipline and minimizes moral...

Insurance premiums and insurance coverage of near-poor children.

Science.gov (United States)

Hadley, Jack; Reschovsky, James D; Cunningham, Peter; Kenney, Genevieve; Dubay, Lisa

States increasingly are using premiums for near-poor children in their public insurance programs (Medicaid/SCHIP) to limit private insurance crowd-out and constrain program costs. Using national data from four rounds of the Community Tracking Study Household Surveys spanning the seven years from 1996 to 2003, this study estimates a multinomial logistic regression model examining how public and private insurance premiums affect insurance coverage outcomes (Medicaid/SCHIP coverage, private coverage, and no coverage). Higher public premiums are significantly associated with a lower probability of public coverage and higher probabilities of private coverage and uninsurance; higher private premiums are significantly related to a lower probability of private coverage and higher probabilities of public coverage and uninsurance. The results imply that uninsurance rates will rise if both public and private premiums increase, and suggest that states that impose or increase public insurance premiums for near-poor children will succeed in discouraging crowd-out of private insurance, but at the expense of higher rates of uninsurance. Sustained increases in private insurance premiums will continue to create enrollment pressures on state insurance programs for children.

Public submissions on the Uganda national biotechnology and biosafety bill, 2012 reveal consensus for Uganda legislators to pass the bill

Directory of Open Access Journals (Sweden)

Clet Wandui Masiga

2015-10-01

Full Text Available The Cartagena Protocol on Biosafety to the Convention on Biological Diversity is an internationally binding instrument addressing issues of biosafety. Biosafety refers to the need to protect human health and the environment from the possible adverse effects of the products of modern biotechnology. Accordingly all countries to the convention are required to put in place regulatory mechanisms to enhance the safety of biotechnology in the context of the Convention’s overall goal of reducing all potential threats to biological diversity, while taking into account the risks to human health. Therefore each country party to the convention has its own procedures to enact laws to guide the safe use of biotechnology. In Uganda the process involves the drafting of the bill by the first parliamentary counsel, approval by cabinet, first reading at the parliament, committal to the responsible parliamentary sessional committee, tabling of the bill for public hearing, consultations, and final approval. In Uganda, the Committee on Science and Technology is responsible for the Biosafety Bill. In March 2013, the Committee tabled the bill for public hearing and submissions from public institutions. There were comments supporting the passage of the Bill and comments in objection.The reasons for objection are mainly due to precaution, speculation, lack of knowledge about biotechnology and biosafety, and alleged influence from biosafety entrepreneurs. This article reviews these public views, revealing controversy and possible consensus to pass the bill.

Nuclear insurance

International Nuclear Information System (INIS)

Anon.

1992-01-01

The yearbook contains among others the figures of the nuclear insurance line. According to these these the DKVG (German nuclear power plant insurance association) has 102 member insurance companies all registered in the Federal Republic of Germany. By using reinsurance capacities of the other pools at present property insurance amounts to 1.5 billion DM and liability insurance to 200 million DM. In 1991 the damage charges on account of DKV amounted to 3.1 (1990 : 4.3) million DM. From these 0.6 million DM are apportioned to payments and 2.5 million DM to reserves. One large damage would cost a maximum gross sum of 2.2 billion DM property and liability insurance; on account of DKVG 750 million DM. (orig./HSCH) [de

Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women.

Science.gov (United States)

Mykletun, Arnstein; Jacka, Felice; Williams, Lana; Pasco, Julie; Henry, Margaret; Nicholson, Geoffrey C; Kotowicz, Mark A; Berk, Michael

2010-08-05

Irritable bowel syndrome (IBS) is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Data were derived from a population-based epidemiological study (n = 1077). Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP) and the General Health Questionnaire (GHQ-12). Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Current IBS (n = 69, 6.4%) was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60). Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12) followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.

Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS. An epidemiological population based study of women

Directory of Open Access Journals (Sweden)

Mykletun Arnstein

2010-08-01

Full Text Available Abstract Background Irritable bowel syndrome (IBS is commonly regarded as a functional disorder, and is hypothesized to be associated with anxiety and depression. This evidence mainly rests on population-based studies utilising self-report screening instruments for psychopathology. Other studies applying structured clinical interviews are generally based on small clinical samples, which are vulnerable to biases. The extant evidence base for an association between IBS and psychopathology is hence not conclusive. The aim of this study was therefore to re-examine the hypothesis using population-based data and psychiatric morbidity established with a structured clinical interview. Methods Data were derived from a population-based epidemiological study (n = 1077. Anxiety and mood disorders were established using the Structured Clinical Interview for DSM-IV-TR (SCID-I/NP and the General Health Questionnaire (GHQ-12. Current and lifetime IBS was self-reported. Hypertension and diabetes were employed as comparison groups as they are expected to be unrelated to mental health. Results Current IBS (n = 69, 6.4% was associated with an increased likelihood of current mood and/or anxiety disorders (OR = 2.62, 95%CI 1.49 - 4.60. Half the population reporting a lifetime IBS diagnosis also had a lifetime mood or anxiety disorder. Exploratory analyses demonstrated an increased prevalence of IBS across most common anxiety and mood disorders, the exception being bipolar disorder. The association with IBS and symptoms load (GHQ-12 followed a curved dose response pattern. In contrast, hypertension and diabetes were consistently unrelated to psychiatric morbidity. Conclusions IBS is significantly associated with anxiety and mood disorders. This study provides indicative evidence for IBS as a disorder with a psychosomatic aspect.

[Synthesis of exo-β-glucosaminidase BY FUNGUS Penicillium sp. IB-37-2].

Science.gov (United States)

Aktuganov, G E; Galimzyanova, N F; Teregulova, G A; Melentjev, A I

2016-01-01

A new strain Penicillium sp. IB-37-2, which actively hydrolyzes chitosan (SD ∼80–85%) but possesses low activity against colloidal chitin, was isolated. The fungus was observed to have a high level chitosanase biosynthesis (1.5–3.0 U/mL) during submerged cultivation at 28°C, with a pH of 3.5–7.0 and 220 rpm in nutrient media containing chitosan or chitin from shells of crabs. Purification of the chitosanase enzyme complex from Penicillium sp. IB-37-2 by ultrafiltration and hydrophobic chromatography, followed by denaturing electrophoresis, revealed two predominant proteins with molecular weights of 89 and 41 kDa. The purified enzyme complex demonstrated maximal activity (maximal rate of hydrolysis of dissolved chitosan) and stability at 50–55°C and a pH of 3.5–4.0. The enzyme preparation also hydrolyzed laminarin, β-(1,3)-(1,4)-glycan, and colloidal chitin. Exohydrolysis of chitosan by the preparation isolated from Penicillium sp. IB-37-2 resulted in the formation of single product, D-glucosamine.

Al-Shāṭibīs sufismekritik:

DEFF Research Database (Denmark)

Riexinger, Martin Thomas

2016-01-01

The faqīh (Islamic legal scholar) al-Shāṭibī (d. 1388) from Granada is primarily known for his innovative approach within the field of legal theory (uṣūl al-fiqh). However, he dedicated much attention to the criticism of sufism. But like other Islamic scholars who opposed Sufism he did...

Ilmumised ja mediteerimised / Bill Viola ; interv. Harry Liivrand

Index Scriptorium Estoniae

Viola, Bill

1998-01-01

Bill Viola videoretrospektiiv Stedelijk Museumis, Rijksmuseumis, New Metropolises jm. Amsterdamis 29. novembrini. H. Liivrand Bill Violast ja tema loomingust. B. Viola oma videokunstist praegu ja 25 aastat tagasi, mil tema alustas, mõjutustest loomingule.

42 CFR 71.11 - Bills of health.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Bills of health. 71.11 Section 71.11 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING FOREIGN QUARANTINE Measures at Foreign Ports § 71.11 Bills of health. A carrier at any foreign port clearing or...

16 CFR 308.7 - Billing and collection for pay-per-call services.

Science.gov (United States)

2010-01-01

... responsibility for receiving and responding to billing error complaints or inquiries. (2) Billing error means any... or other toll free telephone number. (v) The failure to reflect properly on a billing statement a... billing error complaint or inquiry. (6) Telephone-billed purchase means any purchase that is completed...

BK polyomavirus genotypes Ia and Ib1 exhibit different biological properties in renal transplant recipients.

Science.gov (United States)

Varella, Rafael B; Zalona, Ana Carolina J; Diaz, Nuria C; Zalis, Mariano G; Santoro-Lopes, Guilherme

2018-01-02

BK polyomavirus (BKV) is an opportunist agent associated with nephropathy (BKVAN) in 1-10% of kidney transplant recipients. BKV is classified into genotypes or subgroups according to minor nucleotidic variations with unknown biological implications. Studies assessing the possible association between genotypes and the risk of BKVAN in kidney transplant patients have presented conflicting results. In these studies, genotype Ia, which is highly prevalent in Brazil, was less frequently found and, thus, comparative data on the biological properties of this genotype are lacking. In this study, BKV Ia and Ib1 genotypes were compared according to their viral load, genetic evolution (VP1 and NCCR) - in a cohort of renal transplant recipients. The patients infected with Ia (13/23; 56.5%) genotype exhibited higher viral loads in urine [>1.4 log over Ib1 (10/23; 43.5%); p=0.025]. In addition, genotype Ia was associated with diverse mutations at VP1 loops and sites under positive selection outside loops, which were totally absent in Ib1. Although the number of viremic patients was similar, the three patients who had BK nephropathy (BKVAN) were infected with Ia genotype. NCCR architecture (ww or rr) were not distinctive between Ia and Ib1 genotypes. Ia genotype, which is rare in other published BKV cohorts, presented some diverse biological properties in transplanted recipients in comparison to Ib1. Copyright © 2017 Elsevier B.V. All rights reserved.

Differential protective effects of immune lymphoid cells against transplanted line Ib leukemia and immune polioencephalomyelitis

International Nuclear Information System (INIS)

Duffey, P.S.; Lukasewycz, O.A.; Olson, D.S.; Murphy, W.H.

1978-01-01

The capacity of immune cells obtained from the major lymphoid compartments to protect C58 mice from transplanted line Ib leukemia, and from an age-dependent autoimmune CNS disease (immune polioencephalomyelitis = IPE) elicited by immunizing old C58 mice with inactivated Ib cells was quantified. Cells used for comparative adoptive protection tests were harvested from the major lymphoid compartments 14 to 15 days after young C58 mice were immunized with inactivated Ib cell preparations. Regression curves were plotted from survival data and the log 10 PD 50 values were determined. Immune spleen (ISC) and peritoneal cells (IPEC) were significantly more protective against transplanted Ib cells than immune lymph node (ILNC), thymic (ITC), and marrow cells (IMC). In contrast, IPEC and IMC were not protective against IPE and ITC were only marginally protective. ILNC afforded significant protection to transplantable leukemia but were only marginally protective to IPE. When ISC were treated with anti-thy 1.2 serum and complement, protection against transplanted leukemia and IPE was reduced > 99%. When donors of immune lymphoid cells were treated with 12.5 mg of cortisone acetate daily for 2 days before lymphoid cells were harvested, protection against transplanted Ib cells by ISC was reduced by approximately 90% whereas protection against IPE was totally eliminated. Considered together, these results indicate that the protective mechanisms to transplantable leukemia and IPE differ significantly in the same indicator mouse strain

Atomic Energy Authority Bill

International Nuclear Information System (INIS)

Gray, J.H.N.; Stoddart, D.L.; Sinclair, R.M.; Ezra, D.

1985-01-01

The House, in Committee, discussed the following matters in relation to the Atomic Energy Authority Bill; financing; trading; personnel conditions of employment; public relations; organization; research programmes; fuels; energy sources; information dissemination. (U.K.)

A new method using insert-based systems (IBS) to improve cell behavior study on flexible and rigid biomaterials

OpenAIRE

Grenade, Charlotte; Moniotte, Nicolas; Rompen, Eric; Vanheusden, Alain; Mainjot, Amélie; De Pauw-Gillet, Marie-Claire

2016-01-01

In vitro studies about biomaterials biological properties are essential screening tests. Yet cell cultures encounter difficulties related to cell retention on material surface or to the observation of both faces of permeable materials. The objective of the present study was to develop a reliable in vitro method to study cell behavior on rigid and flexible/permeable biomaterials elaborating two specific insert-based systems (IBS-R and IBS-F respectively). IBS-R was designed as a specific cylin...

Electricity Bill [second reading

International Nuclear Information System (INIS)

Hooper, G.; Williams, C.C.P.; Ezra, D.

1989-01-01

The Parliamentary Under-Secretary at the Department of Energy introduced the second reading of the Electricity Bill which provides for the restructuring and privatisation of the electricity supply industry throughout Great Britain. Three features at the heart of the Government's proposals are mentioned - first that the proposals will promote competition in electricity generation and supply of electricity so there will be a downward pressure on costs and prices, second is a new deal for customers and third is the security of electricity supply which will be ensured by the diversity of suppliers. The benefits of the scheme are outlined and then specific details of the Bill are considered. The debate which followed lasted six hours and is reported verbatim. The issues raised included environmental effects, efficiency, energy conservation, research and development and investment. (UK)

Insurance crisis

International Nuclear Information System (INIS)

Williams, P.L.

1996-01-01

The article discusses the effects of financing and technology advances on the availability of insurance for independent power producers operating gas turbines. Combined cycle units which require new materials and processes make it difficult to assess risk. Insurers are denying coverage, or raising prices and deductibles. Many lenders, however, are requiring insurance prior to financing. Some solutions proposed include information sharing by industry participants and insurers and increased risk acceptance by plant owners/operators

Draft Surrogacy (Regulation Bill 2016: Rhetoric or Surrogate-centric?

Directory of Open Access Journals (Sweden)

Rituparna Bhattacharyya

2016-11-01

Full Text Available Chaired by honourable Prime Minister, Mr. Narendra Damodar Modi, the Union Cabinet on 24 August 2016 introduced and approved the draft bill on Assisted Reproductive Technologies (ART in India, known popularly as the Surrogacy (Regulation Bill, 2016. The bill aims at regulating the ever-proliferating unregulated surrogacy industry interalia banning commercial surrogacy services for single parents, homosexuals, cohabiting partners in addition to foreigners and overseas citizens of India. The key aim of this commentary is to make a nuanced examination of the draft bill aimed at gaining a deeper understanding of the practice of surrogacy and address gaps (if any that require interventions.

The Effects of Bill 4330/2004 on Union Relations

Directory of Open Access Journals (Sweden)

Felipe Prata Mendes

2016-10-01

Full Text Available This work aims to analyze in which way the bill 4330/2004 affects the union representativeness of outsourced workers. In order to accomplish the settled purpose, it is necessary firstly to frame the outsourcing phenomena in the context of the evolution of capitalism. In relation to the main problem of the work, it’s necessary to investigate if the bill 4330/2004 implies an offense to the union representativeness of outsourced workers. The conclusions obtained show that bill 4330/2004 compounds the representativeness trouble, since this bill proposes the agglutination of workers pertained to very different realities, what stunts the collective protection of interests.

Comparison groups on bills: Automated, personalized energy information

Energy Technology Data Exchange (ETDEWEB)

Iyer, Maithili; Kempton, Willett; Payne, Christopher

2006-07-01

A program called ``Innovative Billing?? has been developed to provide individualized energy information for a mass audience?the entireresidential customer base of an electric or gas utility. Customers receive a graph on the bill that compares that customer?s consumption with othersimilar customers for the same month. The program aims to stimulate customers to make ef?ciency improvements. To group as many as severalmillion customers into small ``comparison groups??, an automated method must be developed drawing solely from the data available to the utility.This paper develops and applies methods to compare the quality of resulting comparison groups.A data base of 114,000 customers from a utility billing system was used to evaluate Innovative Billing comparison groups, comparing fouralternative criteria: house characteristics (?oor area, housing type, and heating fuel); street; meter read route; billing cycle. Also, customers wereinterviewed to see what forms of comparison graphs made most sense and led to fewest errors of interpretation. We ?nd that good qualitycomparison groups result from using street name, meter book, or multiple house characteristics. Other criteria we tested, such as entire cycle, entiremeter book, or single house characteristics such as ?oor area, resulted in poor quality comparison groups. This analysis provides a basis forchoosing comparison groups based on extensive user testing and statistical analysis. The result is a practical set of guidelines that can be used toimplement realistic, inexpensive innovative billing for the entire customer base of an electric or gas utility.

The Maternity Benefit (Amendment Bill, 2016: A Critical Analysis

Directory of Open Access Journals (Sweden)

Suman Singh

2016-11-01

Full Text Available On 11 August 2016, amending the Maternity Benefit Act, 1961, the new bill, The Maternity Benefit (Amendment Bill, 2016 was introduced and passed in the Rajya Sabha (or Council of States, the upper house of the Parliament of India. Central aim of this article is to critically review the amendments to the bill regarding geographies of maternity leave and its associated facilities.

Platelet apoptosis by cld-induced glycoportein Ibα clustering

DEFF Research Database (Denmark)

van der Wal, Dianne E; Du, V X; Lo, KS

2010-01-01

Summary Background:  Cold-storage of platelets followed by rewarming induces changes in Glycoprotein (GP) Ibα-distribution indicative of receptor clustering and initiates thromboxane A2-formation. GPIbα is associated with 14-3-3 proteins, which contribute to GPIbα-signaling and in nucleated cells...

40 CFR 81.88 - Billings Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... Quality Control Regions § 81.88 Billings Intrastate Air Quality Control Region. The Metropolitan Billings Intrastate Air Quality Control Region (Montana) has been renamed the Billings Intrastate Air Quality Control... to by Montana authorities as follows: Sec. 481.168Great Falls Intrastate Air Quality Control Region...

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Directory of Open Access Journals (Sweden)

Yijie Li

2017-01-01

Conclusion: These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation, cell growth, apoptosis, stress granule formation, immune activation, loss of epithelial cell integrity, and visceral hypersensitivity.

Mitigation Index Insurance for Developing Countries: Insure the Loss or Insure the Signal?

OpenAIRE

Li, Yiting; Miranda, Mario J.

2015-01-01

Conventional agricultural index insurance indemnifies based on the observed value of a specified variable, such as rainfall, that is correlated with agricultural production losses. Typically, indemnities are paid to the policyholder after the losses have been experienced. This paper explores alternate timing for index insurance payouts. In particular, we explore the potential benefits of what we call “mitigation index insurance” in which the payouts of the insurance contract arrive before los...

Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

OpenAIRE

Nicole Maestas; Kathleen J. Mullen; Alexander Strand

2014-01-01

As health insurance becomes available outside of the employment relationship as a result of the Affordable Care Act (ACA), the cost of applying for Social Security Disability Insurance (SSDI)–potentially going without health insurance coverage during a waiting period totaling 29 months from disability onset–will decline for many people with employer-sponsored health insurance. At the same time, the value of SSDI and Supplemental Security Income (SSI) participation will decline for individuals...

MiR-144 Increases Intestinal Permeability in IBS-D Rats by Targeting OCLN and ZO1

Directory of Open Access Journals (Sweden)

Qiuke Hou

2017-12-01

Full Text Available Background/Aims: Irritable bowel syndrome with diarrhoea (IBS-D is a chronic, functional bowel disorder characterized by abdominal pain or diarrhoea and altered bowel habits, which correlate with intestinal hyperpermeability. MicroRNAs (miRNAs are involved in regulating intestinal permeability in IBS-D. However, the role of miRNAs in regulating intestinal permeability and protecting the epithelial barrier remains unclear. Our goals were to (i identify differential expression of miRNAs and their targets in the distal colon of IBS-D rats; (ii verify in vitro whether occludin (OCLN and zonula occludens 1 (ZO1/TJP1 were direct targets of miR-144 and were down-regulated in IBS-D rats; and (iii determine whether down-regulation of miR-144 in vitro could reverse the pathological hallmarks of intestinal hyperpermeability via targeting OCLN and ZO1. Methods: The IBS-D rat model was established using 4% acetic acid and evaluated by haematoxylin-eosin (HE staining. The distal colon was obtained in order to perform miRNA microarray analysis and to isolate and culture colonic epithelial cells. When differential expression of miRNA was found, the results were verified by qRT-PCR, and the target genes were further explored by bioinformatics analysis. Correlation analyses were carried out to compare the expression of miRNA and target genes. Then, mutants, miRNA mimics and inhibitors of the target genes were constructed and transfected to colonic epithelial cells. qRT-PCR, western blotting, enzyme-linked immunosorbent assays (ELISAs and dual-luciferase assays were used to investigate the expression of miR-144 and OCLN, ZO1 in IBS-D rats. Results: There were 8 up-regulated and 18 down-regulated miRNAs identified in the IBS-D rat model. Of these, miR-144 was markedly up-regulated and resulted in the down-regulation of OCLN and ZO1 expression. Overexpression of miR-144 by transfection of miR-144 precursor markedly inhibited the expression of OCLN and ZO1. Further

Pediatric Hospitalist Comanagement Survey of Clinical and Billing Practices.

Science.gov (United States)

O'Connor, Katherine M; Zipes, David G; Schaffzin, Joshua K; Rosenberg, Rebecca

2017-10-01

Surgical comanagement is an increasingly common practice in pediatric hospital medicine. Information about the structure and financing of such care is limited. The aim of the researchers for this study was to investigate pediatric hospitalist surgical comanagement models and to assess pediatric hospitalist familiarity with and patterns of billing for surgical patients. We conducted a cross-sectional cohort web-based survey of pediatric hospitalists using the American Academy of Pediatrics' Section on Hospital Medicine listserv. In our study ( N = 133), we found wide variation in our cohort in surgical patient practice management, including program structure, individual billing practices, and knowledge regarding billing practices. Even for pediatric hospitalists with comanagement service agreements between surgeons and pediatric hospitalists, there was no increased awareness or knowledge about reimbursement or billing for surgical patients. This global lack of knowledge in our small but diverse sample suggests that billing resources and training for pediatric hospitalists practicing comanagement of surgical patients are needed. Copyright © 2017 by the American Academy of Pediatrics.

Atomic Energy Authority Bill (Lords)

Energy Technology Data Exchange (ETDEWEB)

Eadie, A.; Goodlad, A.; Fisher, M.; Griffiths, P.; Coombs, S.

1986-01-30

The discussions of one of the standing committees of the House of Lords on the Atomic Energy Authority Bill are reported verbatim. Clauses 6, 9 and new clauses 3, 2 and 4 were discussed. The amendments to the clauses were put and debated. The safety requirements of the nuclear industry and the money necessary for these are discussed. At the end of the debate on each clause (and amendments if any), the decision of the House as to its agreement or otherwise is recorded. It was agreed that the Bill, as amended by the committee, should be reported to the (full) House of Lords. The debate lasted 1 3/4 hours.

EVALUATION OF LOW URINARY TRACT SYMPTOMS AND ERECTILE FUNCTION IN MEN WITH IRRITABLE BOWEL SYNDROME(IBS

Directory of Open Access Journals (Sweden)

Dogan Atilgan

2014-06-01

Conclusion: IBS, is a major health problem with serious psychosocial side effects and significantly reduces patients quality of life. LUTS and ED may be seen frequently in patients with IBS. Therefore, during menagement of these patients multydiciplinary assesment should be kept in mind. [J Contemp Med 2014; 4(2.000: 64-68

Probabilistic Insurance

NARCIS (Netherlands)

Wakker, P.P.; Thaler, R.H.; Tversky, A.

1997-01-01

Probabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in premium to compensate for a 1% default risk. These observations cannot be

Probabilistic Insurance

NARCIS (Netherlands)

P.P. Wakker (Peter); R.H. Thaler (Richard); A. Tversky (Amos)

1997-01-01

textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these

Health Insurance Basics

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

47 CFR 64.2401 - Truth-in-Billing Requirements.

Science.gov (United States)

2010-10-01

... 64.2401 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... provider. (3) The telephone bill must clearly and conspicuously identify any change in service provider... content so that customers can accurately assess that the services for which they are billed correspond to...

Who'll pay the electricity bill?

International Nuclear Information System (INIS)

Roche, P.

1989-01-01

Nuclear power will be protected from the vagaries of the free market by requiring the 12 privatised distribution companies to take around 15-20% of their power from non-fossil (i.e. nuclear) sources. The Electricity Bill also requires producers of fossil-fuelled electricity to charge a compulsory levy which will be used to finance the non-fossil quota. The extra cost of generating electricity by nuclear means compared with the alternatives will be recouped via the 'levy' after the new PWRs have come into operation. Producers of power which is neither nuclear nor fossil will not be required to make this levy, so renewable energies may gain a small competitive advantage. The financial implications of privatisation have not been fully clarified, especially regarding nuclear power with its associated expenses of radioactive waste disposal and decommissioning. Energy efficiency may be encouraged by the Bill, but competition may not result from the Bill. (author)

Federal Deposit Insurance Corporation (FDIC) Insured Banks

Data.gov (United States)

Department of Homeland Security — The Summary of Deposits (SOD) is the annual survey of branch office deposits for all FDIC-insured institutions including insured U.S. branches of foreign banks. Data...

Motivational Factors on Adopting Modular Coordination Concept in Industrialized Building System (IBS

Directory of Open Access Journals (Sweden)

Yunus Riduan

2016-01-01

Full Text Available Modular coordination (MC is recognized as a tool towards rationalization and industrialization. The implementation of MC concept in the design stage may improve the constructability and construction time. However, the implementation of MC in Industrialized Building System (IBS implementation is still low compare to other developed countries such as the United Kingdom, Sweden and Japan. This paper examined the interrelationship between motivational factors of stakeholders in adopting MC concept using Interpretative Structural Modeling (ISM. Questionnaire survey was engaged in this study to identify significant motivational factors. Then, semi-structure interviews were used to collect qualitative data. ISM was adopted to build relationship between factors and develop an initial model to promote the adoption of MC in IBS construction. Seven (7 significant motivational factors were identified in this research namely 1 ‘stakeholder’s commitment’, 2 ‘reduce site disruption’, 3 ‘increase productivity’, 4 ‘high skilled workers’, 5 ‘site sustainability (environment, economy and social benefits’ 6 ‘standardization’ and 7 ‘enabling ‘open building’ concept’. The result using Matrice d’Impacts Croises Multiplication Applique an Clasment (MICMAC shows that there are three factors can be categorized as Independent / Driving Factors namely ‘stakeholder’s commitment’, ‘standardization’ and ‘enabling “open building” concept’. These factors should be explored in details to enhance the adoption of IBS in Malaysia. The findings provide a very good platform for a further research in formulating an efficient solution to promote MC concept adoption among the stakeholders. This scenario will improve the deliverables of IBS construction and eliminate negative perception in its implementation.

A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D.

Science.gov (United States)

Eswaran, Shanti L; Chey, William D; Han-Markey, Theresa; Ball, Sarah; Jackson, Kenya

2016-12-01

There has been an increasing interest in the role of fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) in irritable bowel syndrome (IBS). We report results from the first randomized controlled trial of the low FODMAP diet in US adults with IBS and diarrhea (IBS-D). The objectives were to compare the efficacy of the low FODMAP diet vs. a diet based upon modified National Institute for Health and Care Excellence guidelines (mNICE) on overall and individual symptoms in IBS-D patients. This was a single-center, randomized-controlled trial of adult patients with IBS-D (Rome III) which compared 2 diet interventions. After a 2-week screening period, eligible patients were randomized to a low FODMAP or mNICE diet for 4 weeks. The primary end point was the proportion of patients reporting adequate relief of IBS-D symptoms ≥50% of intervention weeks 3-4. Secondary outcomes included a composite end point which required response in both abdominal pain (≥30% reduction in mean daily pain score compared with baseline) and stool consistency (decrease in mean daily Bristol Stool Form of ≥1 compared with baseline), abdominal pain and stool consistency responders, and other key individual IBS symptoms assessed using daily questionnaires. After screening, 92 subjects (65 women, median age 42.6 years) were randomized. Eighty-four patients completed the study (45 low FODMAP, 39 mNICE). Baseline demographics, symptom severity, and nutrient intake were similar between groups. Fifty-two percent of the low FODMAP vs. 41% of the mNICE group reported adequate relief of their IBS-D symptoms (P=0.31). Though there was no significant difference in the proportion of composite end point responders (P=0.13), the low FODMAP diet resulted in a higher proportion of abdominal pain responders compared with the mNICE group (51% vs. 23%, P=0.008). Compared with baseline scores, the low FODMAP diet led to greater reductions in average daily scores of abdominal pain, bloating

75 FR 15603 - Common Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions

Science.gov (United States)

2010-03-30

... to: (1) Theft; or (2) Inability to market the avocados for any reason other than actual physical... Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions AGENCY: Federal Crop Insurance... Common Crop Insurance Regulations; Florida Avocado Crop Insurance Provisions to convert the Florida...

Algorithms to identify colonic ischemia, complications of constipation and irritable bowel syndrome in medical claims data: development and validation.

Science.gov (United States)

Sands, Bruce E; Duh, Mei-Sheng; Cali, Clorinda; Ajene, Anuli; Bohn, Rhonda L; Miller, David; Cole, J Alexander; Cook, Suzanne F; Walker, Alexander M

2006-01-01

A challenge in the use of insurance claims databases for epidemiologic research is accurate identification and verification of medical conditions. This report describes the development and validation of claims-based algorithms to identify colonic ischemia, hospitalized complications of constipation, and irritable bowel syndrome (IBS). From the research claims databases of a large healthcare company, we selected at random 120 potential cases of IBS and 59 potential cases each of colonic ischemia and hospitalized complications of constipation. We sought the written medical records and were able to abstract 107, 57, and 51 records, respectively. We established a 'true' case status for each subject by applying standard clinical criteria to the available chart data. Comparing the insurance claims histories to the assigned case status, we iteratively developed, tested, and refined claims-based algorithms that would capture the diagnoses obtained from the medical records. We set goals of high specificity for colonic ischemia and hospitalized complications of constipation, and high sensitivity for IBS. The resulting algorithms substantially improved on the accuracy achievable from a naïve acceptance of the diagnostic codes attached to insurance claims. The specificities for colonic ischemia and serious complications of constipation were 87.2 and 92.7%, respectively, and the sensitivity for IBS was 98.9%. U.S. commercial insurance claims data appear to be usable for the study of colonic ischemia, IBS, and serious complications of constipation. (c) 2005 John Wiley & Sons, Ltd.

Understanding Your Water Bill

Science.gov (United States)

An easy to way to understand individual water use is to look at your water bill—not just the amount due, but how much water you used. Pull out your water bill and follow our steps to learn more about it.

76 FR 71276 - Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions

Science.gov (United States)

2011-11-17

...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Revenue Crop Insurance Provisions AGENCY... Corporation (FCIC) proposes to amend the Common Crop Insurance Regulations, Pecan Revenue Crop Insurance... Regulations (7 CFR part 457) by revising Sec. 457.167 Pecan Revenue Crop Insurance Provisions, to be effective...

Marketer consolidated billing : realizing the value of customer relationships

Energy Technology Data Exchange (ETDEWEB)

Schiratti, A. [Sunoco, Toronto, ON (Canada)

2001-07-01

This presentation focused on timely issues regarding marketer consolidated billing (MCB). MCB allows energy marketers to directly bill customers for both gas and electric commodities and distribution services. MCB is mandated by the Ontario Energy Board (OEB) in the electricity sector through the Retail Settlements Task Force and is proposed by the OEB in the Gas Distributor Access Rule. The main topics discussed in this paper were the new relationship under MCB, benefits for customers and challenges for marketers. The major obstacles for a successful MCB model were also proposed. The new MCB approach strengthens the relationship between the marketer and the customer. The MCB will allow both electricity and natural gas customers to choose marketers who bill for both delivery and gas on one bill.

Marketer consolidated billing : realizing the value of customer relationships

International Nuclear Information System (INIS)

Schiratti, A.

2001-01-01

This presentation focused on timely issues regarding marketer consolidated billing (MCB). MCB allows energy marketers to directly bill customers for both gas and electric commodities and distribution services. MCB is mandated by the Ontario Energy Board (OEB) in the electricity sector through the Retail Settlements Task Force and is proposed by the OEB in the Gas Distributor Access Rule. The main topics discussed in this paper were the new relationship under MCB, benefits for customers and challenges for marketers. The major obstacles for a successful MCB model were also proposed. The new MCB approach strengthens the relationship between the marketer and the customer. The MCB will allow both electricity and natural gas customers to choose marketers who bill for both delivery and gas on one bill

Heat loss may explain bill size differences between birds occupying different habitats.

Directory of Open Access Journals (Sweden)

Russell Greenberg

Full Text Available Research on variation in bill morphology has focused on the role of diet. Bills have other functions, however, including a role in heat and water balance. The role of the bill in heat loss may be particularly important in birds where water is limiting. Song sparrows localized in coastal dunes and salt marsh edge (Melospiza melodia atlantica are similar in size to, but have bills with a 17% greater surface area than, those that live in mesic habitats (M. m. melodia, a pattern shared with other coastal sparrows. We tested the hypotheses that sparrows can use their bills to dissipate "dry" heat, and that heat loss from the bill is higher in M. m. atlantica than M. m. melodia, which would indicate a role of heat loss and water conservation in selection for bill size.Bill, tarsus, and body surface temperatures were measured using thermal imaging of sparrows exposed to temperatures from 15-37°C and combined with surface area and physical modeling to estimate the contribution of each body part to total heat loss. Song sparrow bills averaged 5-10°C hotter than ambient. The bill of M. m atlantica dissipated up to 33% more heat and 38% greater proportion of total heat than that of M. m. melodia. This could potentially reduce water loss requirements by approximately 7.7%.This >30% higher heat loss in the bill of M. m. atlantica is independent of evaporative water loss and thus could play an important role in the water balance of sparrows occupying the hot and exposed dune/salt marsh environments during the summer. Heat loss capacity and water conservation could play an important role in the selection for bill size differences between bird populations and should be considered along with trophic adaptations when studying variation in bill size.

An Enterprise Model for Real-Time Inter-domain Billing of Services

OpenAIRE

Le, V.M.; van Beijnum, Bernhard J.F.; Nieuwenhuis, Lambertus Johannes Maria; Huitema, G.B.

2008-01-01

The technological developments in networking solutions, information and communication services create the basis for the provisioning of complex, realtime services. This paper addresses the charging and billing of such advanced services. Advanced services will be composed of services provided by various 3rd party providers residing in different domains. Hence, charging and billing of advanced services requires a billing system capable of composing charging and billing information from provider...

Myasthenia gravis in a patient affected by glycogen storage disease type Ib: a further manifestation of an increased risk for autoimmune disorders?

Science.gov (United States)

Melis, D; Balivo, F; Della Casa, R; Romano, A; Taurisano, R; Capaldo, B; Riccardi, G; Monsurrò, M R; Parenti, G; Andria, G

2008-12-01

Glycogen storage disease type Ib (GSD Ib, OMIM 232220) is an inborn disorder of glucose metabolism, caused by mutations in the G6PT gene, encoding a glucose 6-phosphate transporter (G6PT). GSD Ib is mainly associated with fasting hypoglycaemia and hepatomegaly. Most GSD Ib patients also show neutropenia and neutrophil dysfunction and therefore are at risk of developing severe infections and inflammatory bowel disease (IBD). An increased risk for autoimmune disorders, such as thyroid autoimmunity and Crohn-like disease, has also been demonstrated, but no systematic study on the prevalence of autoimmune disorders in GSD Ib patients has ever been performed. We describe a 25-year-old patient affected by GSD Ib who developed 'seronegative' myasthenia gravis (MG), presenting with bilateral eyelid ptosis, diplopia, dysarthria, severe dysphagia, dyspnoea and fatigue. The repetitive stimulation of peripheral nerves test showed signs of exhaustion of neuromuscular transmission, particularly evident in the cranial area. Even in the absence of identifiable anti-acetylcholine receptor antibodies, seronegative MG is considered an autoimmune disorder and may be related to the disturbed immune function observed in GSD Ib patients.

Variable billing for services: new fiscal direction for nursing.

Science.gov (United States)

Higgerson, N J; Van Slyck, A

1982-06-01

The advantages of variable billing for nursing care that: It identifies revenue nursing cost centers. It facilitates systematic control of revenue and expenses, improving budget planning and management. It generates a tremendous amount of data that can be used in administrative planning and decision making. It is more equitable than past billing practices for the patient, the third-party payer, and the hospital, making it a public relations asset. The disadvantages of variable billing are that: Charges at one hospital are not easily compared with those at another. The mix of patients at varying classification levels has a significant effect on revenue, thus increasing the possibility of lower revenue. More accountability and in some cases more work is required of nursing administrators. In this article, the practical application of variable billing in acute care settings has been discussed. It is hoped that the information provided here will stimulate nursing administrators to assess the feasibility of implementing varible billing for nursing services as a fiscal practice in their own institutions.

Human-Centered Design Bill of Rights for Educators.

Science.gov (United States)

Sugar, William A.

This paper presents a potential solution to encourage technology adoption and integration within schools by proposing a human-centered technology "bill of rights" for educators. The intention of this bill of rights it to influence educators' beliefs towards technology and to enable educators to confront with confidence the seemingly…

Investigation of the feasibility of elective irradiation to neck level Ib using intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma: a retrospective analysis

International Nuclear Information System (INIS)

Zhang, Fan; Cheng, Yi-Kan; Li, Wen-Fei; Guo, Rui; Chen, Lei; Sun, Ying; Mao, Yan-Ping; Zhou, Guan-Qun; Liu, Xu; Liu, Li-Zhi; Lin, Ai-Hua; Tang, Ling-Long; Ma, Jun

2015-01-01

To assess the feasibility of elective neck irradiation to level Ib in nasopharyngeal carcinoma (NPC) using intensity-modulated radiation therapy (IMRT). We retrospectively analyzed 1438 patients with newly-diagnosed, non-metastatic and biopsy-proven NPC treated with IMRT. Greatest dimension of level IIa LNs (DLN-IIa) ≥ 20 mm and/or level IIa LNs with extracapsular spread (ES), oropharynx involvement and positive bilateral cervical lymph nodes (CLNs) were independently significantly associated with metastasis to level Ib LN at diagnosis. No recurrence at level Ib was observed in the 904 patients without these characteristics (median follow-up, 38.7 months; range, 1.3–57.8 months), these patients were classified as low risk. Level Ib irradiation was not an independent risk factor for locoregional failure-free survival, distant failure-free survival, failure-free survival or overall survival in low risk patients. The frequency of grade ≥ 2 subjective xerostomia at 12 months after radiotherapy was not significantly different between low risk patients who received level Ib-sparing, unilateral level Ib-covering or bilateral level Ib-covering IMRT. Level Ib-sparing IMRT should be safe and feasible for patients without a DLN-IIa ≥ 20 mm and/or level IIa LNs with ES, positive bilateral CLNs or oropharynx involvement at diagnosis. Further investigations based on specific criteria for dose constraints for the submandibular glands are warranted to confirm the benefit of elective level Ib irradiation

THE NIGERIA DATA PROTECTION BILL: APPRAISAL, ISSUES, AND CHALLENGES

Directory of Open Access Journals (Sweden)

Abubakar Sanni Aliyu

2016-02-01

Full Text Available Nigeria has absolutely no privacy and personal information laws. This lacuna is even more material in an internet world where information published on the web is open to a global audience. It is in this regard that the Data Protection Bill was sponsored by Hon. Yakubu Dogara, member of the Federal House of Representatives, representing Bogoro/Dass/Tafawa Balewa Bauchi State, Nigeria. This paper has two key aims, firstly to find out the major issues address by the proposed Data Protection Bill 2010, secondly, to determine the significance and the challenges of the Bill to Nigeria environment. The study utilized secondary source of data from the Data Protection Bill, 2010 and other documentary sources for analysis. The study finds out that the Bill protect parties in regard to publication of market survey details and information, ensure that unauthorised processing of personal information is reduce, and use of personal data and information without the prior consent of the data is subjected to scrutiny. The paper recommends that the Federal Government of Nigeria and the policy makers should hasten the process of passing the Bill into law in order to strengthen the activities of ecommerce in Nigeria through the following benefits: Improved customer relations; Improved ability to market lawfully; Improved data quality; Improved data security among others.

Do self-insurance and disability insurance prevent consumption loss on disability?

OpenAIRE

Steffan G. Ball; Hamish W. Low

2009-01-01

In this paper we show the extent to which public insurance and self-insurance mitigate the cost of health shocks that limit the ability to work. We use consumption data from the UK to estimate the insurance provided by the government disability programme and account for the effectiveness of alternative self-insurance mechanisms. Individuals with a work-limiting health condition, but in receipt of disability insurance, have 7 percent lower consumption than those without such a condition. Self-...

42 CFR 408.84 - Billing and payment procedures.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Billing and payment procedures. 408.84 Section 408.84 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Billing and payment procedures. (a) Initial premium notice. (1) CMS or its agent always sends the initial...

INSURANCE MARKET. GENERAL CONSIDERATIONS OF INSURANCES IN ROMANIA

Directory of Open Access Journals (Sweden)

MARINEL NEDELUŢ

2013-10-01

Full Text Available Insurance is a contract made by a company or society, or by the state, to provide a guarantee for loss, damage, illness, death etc in return for regular payments. In other words it is a means by which one pays a relatively small known cost for protection against an uncertain and much larger cost. Still, this contract (insurance policy makes it possible for the insured to cover only losses that are measurable in terms of money and caused strictly by hazardous events, independent from own doing. If no such events should happen, the benefits won’t exist in a tangible, material form, but will take the shape of security against ruin. Since the insurance industry has developed more during the last decade due to the powerful players that have entered the market, the services provided by the insurance companies, and not only their products have evolved a lot in order to meet the requirements of the consumers, and to make them familiar with this type of investments. Therefore all the means of advertising became essential in this process of implementation and familiarization with this area of activity: mass-media advertising, insurance brokerage companies, the internet are all parts of this process.

Bill Barbour : mõned ideed kasvavatele firmadele / Bill Barbour ; interv. Taivo Paju

Index Scriptorium Estoniae

Barbour, Bill

2005-01-01

Suurbritannia üks kogenumaid ärikonsultante firmade ärikasvumudelist, mis aitab ettevõttel järgmisesse etappi üle minna. Mida peaks ettevõtja enne äri alustamist läbi mõtlema ning millised eesmärgid ja ülesanded enda jaoks paika panema. Lisad: Bill Barbour; Universaalne kriisimudel

THE CERN HEALTH INSURANCE SCHEME AND THE EURO

CERN Document Server

Human Resources Division

2002-01-01

Since 1 January 2002, the euro is the common currency of 12 European countries and some 300 million people. Of course, such a change has some consequences on our Health Insurance Scheme. As you know, when filling in the medical expenses claim form, you are required to indicate a currency code, i.e. the currency in which you have incurred medical expenses. You may have noticed that the euro is not yet on the list of currencies which appear on the bottom left of the existing form. This will be changed very soon, once the stock of existing forms has been used up. Until then, please note that the currency code for the euro is 002 (easy to remember since the code for the Swiss franc is 001). If you forget this code, don't worry! Just indicate «euro» next to the amount of your medical bill, or simply use the euro symbol!

A Measure of Suffering in relation to Anxiety and Quality of Life in IBS Patients: Preliminary Results

Directory of Open Access Journals (Sweden)

Sanda Pletikosić Tončić

2017-01-01

Full Text Available Irritable bowel syndrome (IBS is a chronic gastrointestinal (GI disorder with a severe impact on quality of life (QoL. We explored the relationship of a visual measure of suffering, the PRISM-RII, with quality of life (QoL and anxiety measures in IBS patients. Participants were 44 IBS patients who completed several questionnaires and kept a symptom diary for two weeks. The measures used were PRISM-RII (self-illness separation (SIS; illness perception measure (IPM; IBS-36 (IBS health related QoL; SF-36 (physical and mental health related QoL; State-Trait Anxiety Inventory (STAI-T; Visceral Sensitivity Index (VSI; GI-specific anxiety; and a symptom diary. SIS was negatively correlated to VSI, while IPM was negatively correlated to SIS and the physical component of SF-36 and positively to VSI and symptom severity. We found significant differences between participants who perceive their illness as small and those who perceive it as medium in SIS, symptom severity, VSI, and the mental component of SF-36. Participants, who perceived their illness as small, represented their illness as more distant, showed lower average symptom severity, and had lower GI-specific anxiety and higher QoL. The results indicate that IPM and SIS can be useful in discriminating patients with more prominent psychological difficulties and QoL impairment.

Life Insurance Contribution, Insurance Development and Economic Growth in China

Directory of Open Access Journals (Sweden)

Wang Ying

2017-07-01

Full Text Available Under L-type economy, remodelling the growth power in the medium and long term is essential. The insurance industry during the 13th Five-year Plan period has been given a heavy expectation on promoting economic quality and upgrading economic efficiency, so it will try to accelerate its innovation and development process which serves national needs, market demand and people's requirements. Referring to the previous researches of Solow and Zhang and measuring Capital Stock and Total Factor Productivity independently, the paper analyses the inherent correlation between insurance (including life insurance and non-life insurance and economic growth, reveals the contribution law of the insurance development in economic growth in the short and long term from both economic scale and quality respectively. It also shows enlightenments on policy decision for insurance industry, thus helps economic stability under the downturn periods.

INSURANCE INTERMEDIARIES

Directory of Open Access Journals (Sweden)

Andreea Stoican

2013-11-01

Full Text Available The actual Civil code regulates for the first time in the Romanian legislation the intermediation contract, until its entering into force existing multiple situations that lent themselves to this legal operation, but did not benefit of such particular legal rules. Yet, the case law has shown that the situations that arise in the activity of the legal or natural persons are much more complex, this leading, in time, to the reglementation of such particular rules. Such a case is that found in the matter of insurance contracts, the position of the insurance intermediaries being regulated especially by Law no. 32/2000, according to which they represent the natural or legal persons authorized in the conditions of the above mentioned legal document, that perform intermediation activities in the insurance field, in exchange of a remuneration, as well as the intermediaries from the EU member states that perform such an activity on the Romanian territory, in accordance with the freedom in performing services. Therefore, the present paper aims to analyze the conclusion of such insurance contracts and to underline the particular position of the insurance brokers, having the following structure: 1 Introduction; 2 The reglementation of the intermediation contract/brokerage agreement in the Romanian Law; 3 The importance of the intermediaries in the insurance contracts; 4 The conclusion of the insurance contracts; 5 Conclusions.

MARKETING OF INSURANCE PRODUCTS BY THE NATIONAL INSURANCE COMPANY LIMITED, RAJAPALAYAM

OpenAIRE

Dr. H. Christy Cynthia; Dr. T. Jebasheela; V. Maheswari

2017-01-01

Insurance is a way of reducing uncertainty of occurrence of an event. Insurance is an investment. Its basic purpose is to derive plans to counteract the financial consequences of unfavorable events. Insurance is a social device for eliminating or reducing the cost to society to certain types of risks. Insurance is essentially a co-operative endeavor. It is the function of the insurance to protect the few against the heavy financial impact of anticipated misfortunes by spreading losses among m...

Nereididae (Annelida, Polychaeta colectados en las campañas “Fauna II, III, IV” (Proyecto “Fauna Ibérica” y catálogo de las especies conocidas para el ámbito ibérico

Directory of Open Access Journals (Sweden)

Núñez, Jorge

2002-06-01

Full Text Available A check-list of 19 polychaetes species belonging to the family Nereididae is made, from the material collected during the Cruises “Fauna Ibérica II, III and IV”. Of these, data on the sampling stations are given. As a result of the identification of nereidid specimens, three new records for the Iberian Peninsula were found, Ceratonereis vittata Langerhans, 1884, Neanthes rubicunda (Ehlers, 1864 and Nereis perivisceralis Claparède, 1864. An updated catalogue is also presented, with the 36 nereidid species known for the Iberian Peninsula.

Se confecciona una lista de 19 especies de poliquetos pertenecientes a la familia Nereididae, a partir del material colectado en las campañas oceanográficas “Fauna Ibérica II, III y IV”. De éstas, se aportan datos sobre las estaciones de muestreo. De todo el material identificado son nuevas citas para la Península Ibérica tres especies: Ceratonereis vittata Langerhans, 1884, Neanthes rubicunda (Ehlers, 1864 y Nereis perivisceralis Claparède, 1864. También se aporta un catálogo actualizado de los neréididos conocidos para la Península Ibérica compuesto por 36 especies.

[Occupational health services as the insurance product and insurance economic instruments].

Science.gov (United States)

Rydlewska-Liszkowska, Izabela

2014-01-01

One of the most controversial issues in restructuring the Polish health insurance system is the implementation of private voluntary insurance and creation within it a new insurance product known as occupational health services (OHS). In this article some opportunities and dilemmas likely to be faced by providers and employers/employees, when contracting with insurance institutions, are considered as a contribution to the discussion on private insurance in Poland. The basic question is how private insurance institutions could influence the promotion of different preventive activities at the company level by motivating both OHS providers and employers. The descriptive qualitative method has been applied in the analysis of legal acts, scientific publications selected according to keywords (Pubmed), documents and expert evaluations and research project results. Taking into account the experiences of European countries, described in publications, international experts' opinions and results of research projects the solution proposed in Poland could be possible under the following several prerequisites: inclusion of a full scope of occupational health services into the insurance product, constant supervision of occupational medicine professionals, monitoring of the health care quality and the relations between private insurers and OHS provider and implementation of the economic incentives scheme to ensure an adequate position of OHS providers on the market. The proposed reconstruction of the health insurance system, comprising undoubtedly positive elements, may entail some threats in the area of health, organization and economy. Private voluntary health insurance implementation requires precisely defined solutions concerning the scope of insurance product, motivation scheme and information system.

BUSINESS PROCESS MANAGEMENT IN INSURANCE CASE OF JADRANSKO INSURANCE COMPANY

OpenAIRE

Sanja Coric; Danijel Bara

2014-01-01

Selling insurance products in conditions of today’s modern technological solutions is faced with numerous challenges. Business processes in insurance as well as the results of these business processes are the real interface to policyholders. Modeling and analysis of business process in insurance ensure organizations to focus on the customer and increase the efficiency and quality of work. Managing critical business processes in every single organization, likewise in insurance is a key factor ...

Willingness to join and pay for the newly proposed social health insurance among teachers in Wolaita Sodo Town, South Ethiopia.

Science.gov (United States)

Agago, Tesfamichael Alaro; Woldie, Mirkuzie; Ololo, Shimeles

2014-07-01

Cost-sharing between beneficiaries and governments is critical to achieve universal health care coverage. To address this, Ethiopia is currently introducing Social Health Insurance. However, there has been limited evidence on willingness to join the newly proposed insurance scheme in the country. The purpose of this study is to assess willingness to join and pay for the scheme among teachers in Wolaita Sodo Town government educational institutions, South Ethiopia. A cross-sectional study was conducted from February 5 to March 10, 2012 on 335 teachers. Stratified simple random sampling technique was used and data were collected using structured interviewer administered questionnaire. Binary and multiple logistic regressions were used to estimate the crude and adjusted odds ratios for willingness to pay. Three hundred twenty-eight teachers participated in the study with response rate of 98%. About 55% of the teachers had never heard of any type of health insurance scheme. However, 74.4% of them were willing to pay for the suggested insurance scheme. About 47% of those who were willing to pay agreed to contribute greater than or equal to 4% of their monthly salaries. Willingness to pay was more likely among those who had heard about health insurance, had previous history of inability to pay for medical bills and achieved higher educational status. The majority of the teachers were willing to join social health insurance; however, adequate awareness creation and discussion should be made with all employees at various levels for the successful implementation of the scheme.

Reports of "satisfactory relief" by IBS patients receiving usual medical care are confounded by baseline symptom severity and do not accurately reflect symptom improvement.

Science.gov (United States)

Whitehead, William E; Palsson, Olafur S; Levy, Rona L; Feld, Andrew D; VonKorff, Michael; Turner, Marsha

2006-05-01

Treatment trials for irritable bowel syndrome (IBS) usually define a responder as a patient who reports satisfactory relief or adequate relief of symptoms at the end of the trial. However, these measures have not been adequately validated. (1) Compare a binary satisfactory relief measure to alternative ways of defining a treatment responder. (2) Determine whether baseline IBS symptom severity or psychological distress influence the sensitivity of these outcome measures. A total of 350 patients (81% females, average age 50 yr) who had a medical diagnosis of IBS and satisfied Rome II criteria, were recruited from Group Health Cooperative of Puget Sound. At baseline the Irritable Bowel Severity Scale (IBSS) was used to assess symptom severity and to classify patients as mild, moderate, or severe. Psychological distress and IBS-specific quality of life (IBS-QOL) were also assessed. After 6 months treatment with standard medical care, IBSS and IBS-QOL were reassessed, and patients were asked whether they had experienced satisfactory relief and whether they were somewhat or markedly better. Initial severity of IBS significantly affected the proportion who reported satisfactory relief (mild, 72%; moderate, 53%; severe, 44%) and the proportion who were somewhat or markedly better (mild, 62%; moderate, 44%; severe, 38%), but did not affect the proportion with a 50% reduction in symptoms (mild, 26%; moderate, 25%; severe, 23%). Although mild patients were the most likely to report satisfactory relief, they showed no average decrease in symptom severity or improvement in IBS-QOL. Conversely, severe patients, who were the least likely to report satisfactory relief, had the largest reductions in IBS symptom severity and the largest improvements in IBS-QOL. Psychological distress had no significant effect on the responder rate after adjusting for IBS symptom severity. These data from a descriptive study suggest that satisfactory relief is confounded with initial IBS symptom

Bill Maurer

Directory of Open Access Journals (Sweden)

Lauren Tooker

2014-10-01

Full Text Available Professor Bill Maurer is a renowned cultural anthropologist who conducts research on law, property, money and finance, focusing on the technological infrastructures and social relations of exchange and payment. Professor Maurer graduated from Stanford University in 1994 with a PhD in Anthropology. He moved to UC Irvine in 1996 as Assistant Professor, going on to become Chair of UC Irvine’s Department of Anthropology (2005-2011 and Associate Dean for Research and Graduate Studies in the Social Sciences (2011-2013. In July 2013 he assumed his current role as Dean of UC Irvine’s School of Social Sciences. Professor Maurer has published on topics ranging from offshore financial services to mobile phone-enabled money transfers, Islamic finance, alternative currencies, and the future of money. He is founding director of the Institute for Money, Technology and Financial Inclusion, funded by the Bill and Melinda Gates Foundation, and was the founding co-director of the Intel Science and Technology Center in Social Computing. He is the editor of six collections, as well as the author of Recharting the Caribbean: Land, Law and Citizenship in the British Virgin Islands (1997, Pious Property: Islamic Mortgages in the United States (2006, and Mutual Life, Limited: Islamic Banking, Alternative Currencies, Lateral Reason (2005. The latter received the Victor Turner Prize in 2005. Professor Maurer visited the University of Warwick in September 2014 under the auspices of Warwick’s Global Governance GRP.

The formation method of the feature space for the identification of fatigued bills

Science.gov (United States)

Kang, Dongshik; Oshiro, Ayumu; Ozawa, Kenji; Mitsui, Ikugo

2014-10-01

Fatigued bills make a trouble such as the paper jam in a bill handling machine. In the discrimination of fatigued bills using an acoustic signal, the variation of an observed bill sound is considered to be one of causes in misclassification. Therefore a technique has demanded in order to make the classification of fatigued bills more efficient. In this paper, we proposed the algorithm that extracted feature quantity of bill sound from acoustic signal using the frequency difference, and carried out discrimination experiment of fatigued bill money by Support Vector Machine(SVM). The feature quantity of frequency difference can represent the frequency components of an acoustic signal is varied by the fatigued degree of bill money. The generalization performance of SVM does not depend on the size of dimensions of the feature space, even in a high dimensional feature space such as bill-acoustic signals. Furthermore, SVM can induce an optimal classifier which considers the combination of features by the virtue of polynomial kernel functions.

47 CFR 64.1201 - Restrictions on billing name and address disclosure.

Science.gov (United States)

2010-10-01

... interstate telecommunications services. (3) The term authorized billing agent means a third party hired by a telecommunications service provider to perform billing and collection services for the telecommunications service... billing name and address information to any party other than a telecommunications service provider or an...

Evidence Suggesting that Ivory-billed Woodpeckers (Campephilus principalis Exist in Florida

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Daniel J. Mennill

2006-12-01

Full Text Available The Ivory-billed Woodpecker (Campephilus principalis disappeared from the forests of southeastern North America in the early 20th Century and for more than 50 years has been widely considered extinct. On 21 May 2005, we detected a bird that we identified as an Ivory-billed Woodpecker in the mature swamp forest along the Choctawhatchee River in the panhandle of Florida. During a subsequent year of research, members of our small search team observed birds that we identified as Ivory-billed Woodpeckers on 14 occasions. We heard sounds that matched descriptions of Ivory-billed Woodpecker acoustic signals on 41 occasions. We recorded 99 putative double knocks and 210 putative kent calls. We located cavities in the size range reported for Ivory-billed Woodpeckers and larger than those of Pileated Woodpeckers (Dryocopus pileatus that have been reported in the literature or that we measured in Alabama. We documented unique foraging signs consistent with the feeding behavior of Ivory-billed Woodpeckers. Our evidence suggests that Ivory-billed Woodpeckers may be present in the forests along the Choctawhatchee River and warrants an expanded search of this bottomland forest habitat.

Neuroimmune interactions at different intestinal sites are related to abdominal pain symptoms in children with IBS.

Science.gov (United States)

Di Nardo, G; Barbara, G; Cucchiara, S; Cremon, C; Shulman, R J; Isoldi, S; Zecchi, L; Drago, L; Oliva, S; Saulle, R; Barbaro, M R; Stronati, L

2014-02-01

Neuroimmune interactions and inflammation have been proposed as factors involved in sensory-motor dysfunction and symptom generation in adult irritable bowel syndrome (IBS) patients. In children with IBS and healthy controls, we measured ileocolonic mast cell infiltration and fecal calprotectin and evaluated the relationships between these parameters and abdominal pain symptoms and stooling pattern. Irritable bowel syndrome patients diagnosed according to Pediatric Rome III criteria and healthy controls kept a 2-week pain/stooling diary. Ileocolonic mucosal mast cells (MC) and MC in close proximity to nerve fibers (MC-NF) were identified immunohistochemically and quantified. Fecal calprotectin concentration was measured. 21 IBS patients and 10 controls were enrolled. The MC-NF count was significantly higher in the ileum (p = 0.01), right colon (p = 0.04), and left colon (p Abdominal pain intensity score correlated with ileal MC count (r(s) = 0.47, p = 0.030) and right colon MC-NF count (r(s) = 0.52, p = 0.015). In addition, children with IBS with >3 abdominal pain episodes/week had greater ileal (p = 0.002) and right colonic (p = 0.01) MC counts and greater ileal (p = 0.05) and right colonic (p = 0.016) MC-NF counts than children with less frequent pain. No relationship was found between MC and MC-NF and fecal calprotectin or stooling pattern. Mast cells-nerve fibers counts are increased in the ileocolonic mucosa of children with IBS. Mast cells and MC-NF counts are related to the intensity and frequency of abdominal pain. © 2013 John Wiley & Sons Ltd.

Phenotyping of subjects for large scale studies on patients with IBS

NARCIS (Netherlands)

Boeckxstaens, G. E.; Drug, V.; Dumitrascu, D.; Farmer, A. D.; Hammer, J.; Hausken, T.; Niesler, B.; Pohl, D.; Pojskic, L.; Polster, A.; Simren, M.; Goebel-Stengel, M.; van Oudenhove, L.; Vassallo, M.; Wensaas, K.-A.; Aziz, Q.; Houghton, L. A.

2016-01-01

Background Irritable bowel syndrome (IBS) is a complex condition with multiple factors contributing to its aetiology and pathophysiology. Aetiologically these include genetics, life-time events and environment, and physiologically, changes in motility, central processing, visceral sensitivity,

7 CFR 91.42 - Billing.

Science.gov (United States)

2010-01-01

... of the month. The applicant will be billed by the National Finance Center (NFC) using the Foundation... voluntary laboratory services and other services were rendered at a particular Science and Technology...

Insurance of nuclear risk

International Nuclear Information System (INIS)

Lacroix, M.

1976-01-01

Insurance for large nuclear installations covers mainly four types of risk: third party liability which in accordance with the nuclear conventions, is borne by a nuclear operator following an incident occurring in his installation or during transport of nuclear substances; material damage to the installation itself, which precisely is not covered by third party liability insurance; machinery breakdown, i.e. accidental damage or interruption of operation. Only the first category must be insured. In view of the magnitude of the risk, nuclear insurance resorts to co-insurance and reinsurance techniques which results in a special organisation of the nuclear insurance market, based on national nuclear insurance pools and on the Standing Committee on Atomic Risk of the European Insurance Committee. Conferences of the chairmen of nuclear insurance pools are convened regularly at a worldwide level. (NEA) [fr

Decoding incident-to and provider-based billing: ensuring payment and avoiding liability.

Science.gov (United States)

Hofstra, Patricia S; Hart, Elinor L

2012-01-01

In this increasingly complex world of Medicare reimbursement, physicians must constantly review their billing practices to ensure compliance with all Medicare requirements. "Incident-to" billing and provider-based billing are two areas that present unique challenges for providers, especially those practicing in hospital-owned practices such as hospital outpatient departments. Both incident-to and provider-based billing limit providers' abilities to bill for and receive reimbursement in those practice settings. The Office of Inspector General's 2012 Work Plan Report identified both incident-to billing and place-of-service errors as two of the many areas for investigation and compliance efforts in 2012. This article focuses on identifying the unique point-of-service challenges presented by physicians practicing in hospital outpatient departments or hospital-owned clinics.

Acid rain: What the final bill looks like

International Nuclear Information System (INIS)

Burkhardt, D.A.

1990-01-01

This article examines the possible financial impacts of the 1990 amendments to the Clean Air Act. Topics include an overview of the bill, impact on utility companies, and implications for utility investors. The author feels the bill has important implications for investors who own utility stocks, particularly the stocks of coal-burning utilities in the Midwest and Appalachia

STRATEGI PEMASARAN TERHADAP PENJUALAN PRODUK TABUNGAN IB HASANAH DI PT. BANK NEGARA INDONESIA SYARIAH KANTOR CABANG JAKARTA BARAT

Directory of Open Access Journals (Sweden)

Raden Ajeng Entaresmen

2017-02-01

Full Text Available BNI Syariah branch office in West Jakarta has one of funding products that Savings iB Hasanah useful for pure investment vehicles Shariah compliance, where customers can make deposits and withdrawals of cash very easily. In marketing this product, BNI Syariah use 2 pattern to implement a marketing strategy that intensification patterns for customers who already have a product BNI Syariah and extension patterns for prospective customers at other banks that have not used that product at BNI Syariah. Besides, in general BNI Syariah has some marketing strategies that include 9P is Process, People, Product, Price, Place, Promotion, Partners, Presentation, and Passion. Employees who are experts in marketing their products to barriers such as the lack of make Savings iB Hasanah customers, how to services and lack of staff was quick to respond, competition between conventional banks and Islamic banks BNI Syariah office supplies in some areas. Keywords : Marketing strategy, Savings iB Hasanah, Product marketing barriers savings iB Hasanah

THE MODEL OF INTERACTION BETWEEN INSURANCE INTERMEDIARIES AND INSURANCE COMPANIES IN THE ASSURANCE OF SUSTAINABLE DEVELOPMENT OF THE INSURANCE MARKET

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Nataliia Kudriavska

2017-11-01

Full Text Available The purpose of this paper is the investigation of the model of interaction between insurance intermediaries and insurance companies in the assurance of sustainable development of the insurance market. The methodology is based on the new studies and books. It is underlined the importance of potency and effectiveness of this model, its influence on the insurance market stability. It is analysed the European experience and specific of Ukrainian insurance market. The main ways for improving its model and ways of its practical realization are characterized. Results. The problems that exist in the broker market in general are connected with an ineffective state policy. In particular, we can say about the absence of many laws, acts, resolutions, which explain what a broker have to do in case of different problems with insurance companies, another brokers and clients. At the same time, the problem of distrust to national brokers exists. It provokes a decline of the demand for their services and so on. However, it is possible to solve these problems. Practical implications. For this, it is necessary to do some acts. The first one is to implement resolutions that regulate relationships between insurance brokers and insurance companies, clearly regulate the model of its interaction. This model affects the stability of the insurance market in general. The second is to find methods of solving problems of the increase in insurance culture of the population (for example, by the way of advertisement. The third one is to solve problems connected with the appearance of foreign brokers in the insurance market of Ukraine. Actually, the Ukrainian market of insurance brokers is not developed enough. That is why it needs big changes and reforms. Value/originality. Among alternatives of the strategic development of insurance, the method of quick liberalization and gradual development is distinguished. According to the liberal way, it is possible to transfer to the

The billing process at a teaching hospital specialized in cardiology and pulmonology

Directory of Open Access Journals (Sweden)

Gabriela Favaro Faria Guerrer

2014-09-01

Full Text Available The objective of this exploratory study was to describe and map out the billing process in a public tertiary-level university hospital specialized in cardiology and pulmonology. In the period between May and June of 2012, we identified and documented the steps in the process validated by the professionals involved in the hospital bill audit service. We found that during billing pre-analysis, auditors make corrections to justify the billing of procedures and to avoid unwarranted billing and loss of revenue. Mapping out the process allowed us to propose strategies to minimize the time for presenting bills to payment sources. By bringing visibility to this process, which is fundamental for the economic-financial balance of the studied hospital, we bring such knowledge to the public domain. Thus, it is accessible to other health organizations that wish to increment their revenue and reduce divergences between patient charts and the patient’s hospital bill. doi: 10.5216/ree.v16i3.23487.

41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

77 FR 25349 - Mutual Insurance Holding Company Treated as Insurance Company

Science.gov (United States)

2012-04-30

..., the first mutual fire insurer was established. The first American mutual insurance company, the Philadelphia Contributionship for the Insurance of Houses from Loss by Fire, was founded in 1752.\\3\\ \\3\\ The...

China's Insurance Regulatory Reform, Corporate Governance Behavior and Insurers' Governance Effectiveness.

Science.gov (United States)

Li, Huicong; Zhang, Hongliang; Tsai, Sang-Bing; Qiu, Aichao

2017-10-17

External regulation is an important mechanism to improve corporate behavior in emerging markets. China's insurance governance regulation, which began to supervise and guide insurance corporate governance behavior in 2006, has experienced a complex process of reform. This study tested our hypotheses with a sample of 85 firms during 2010-2011, which was obtained by providing a questionnaire to all of China's shareholding insurance companies. The empirical study results generally show that China's insurance governance effectiveness has significantly improved through strict regulation. Insurance corporate governance can improve business acumen and risk-control ability, but no significant evidence was found to prove its influence on profitability, as a result of focusing less attention on governance than on management. State ownership is associated with higher corporate governance effectiveness than non-state ownership. Listed companies tend to outperform non-listed firms, and life insurance corporate governance is more effective than that of property insurers. This study not only contributes to the comprehensive understanding of corporate governance effectiveness but also to the literature by highlighting the effect of corporate governance regulation in China's insurance industry and other emerging economies of the financial sector.

Colm Tóibín and Post-Nationalist Ireland: Redefining Family Through Alterity

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José Carregal-Romero

2012-03-01

Full Text Available In nationalist Ireland, definitions of family have traditionally followed a hetero-normative and sexist pattern whereby husbands and wives fulfilled deeply unequal roles. Moreover, the notion of family has been too often idealized as a site of peace and unconditional love, its members being united by unbreakable bonds of mutual affection. In Colm Tóibín’s fiction, “traditional” families tend to be dysfunctional and the relations between their members become strained because of emotional distance, regrets and distrust. However, Tóibín’s protagonists do find their sense of home and domesticity outside the traditional parameters of family. In this regard, this paper intends to analyze the manner in which Tóibín de-stabilizes canonical definitions through his revisionist agenda and his inscription of alternative forms of family. In order to shed light on these points, I shall refer to his novels The South (1990, The Heather Blazing (1992, The Blackwater Lightship (1999 and his short stories “A Long Winter” (Mothers and Sons, 2006, “Two Women” and “The Street” (The Empty Family, 2010.

Bill project on a new organisation of the electricity market

International Nuclear Information System (INIS)

2010-01-01

A first text discusses the motivations of this bill project: to guarantee French supply security, to contribute to France economical competitiveness, to protect the environment, to give everybody access to energy, and to comply with the European energy market. It also comments the bill project content, the objectives aimed at through the different bill articles. These articles settle a regulated access to electricity and a regulatory frame for pricing, define provider responsibilities, deal with installation dismantling expenses. This presentation is followed by the bill text and by the report of an impact study of the implementation of a regulated access to electricity, of a capacity obligation, and of the evolution of regulated selling prices

Insurance Salespeople's Attitudes towards Collusion: The Case of Taiwan’s Car Insurance Industry

OpenAIRE

Lu-Ming Tseng; Wen-Pin Su

2014-01-01

Insurance researchers believe that the increase in insurance fraud may be associated with the unethical decisions made by some insurance salespeople. However, to date, research that has empirically investigated the link between insurance salespeople and collusion is scant. Using the car insurance industry in Taiwan as an example, this paper explores the impact of the opportunity to obtain the fraudulent claim and that of the size of actual loss on car insurance salespeople's attitudes towards...

Revisión de epigrafía Ibérica turolense

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Ignacio SIMÓN CORNAGO

2012-07-01

Full Text Available El objetivo de este artículo es revisar varias inscripciones ibéricas procedentes de tres yacimientos de la provincia de Teruel: un grafito grabado sobre un adobe de San Antonio de Calaceite, recuperado en las excavaciones de Juan Cabré y que se conserva en el Museo Arqueológico de Barcelona; una posible inscripción bilingüe de Azaila, incisa sobre un pequeño canto rodado, actualmente perdido y que presenta una notable similitud con otro descubierto en La Moleta dels Frares (Castellón; y, finalmente, dos estelas de La Iglesuela del Cid, reutilizadas como material de construcción en la ermita de Nuestra Señora del Cid, donde también se conservan una tercera inscripción ibérica y un conjunto de epígrafes latinos.

Fatigue Level Estimation of Bill Based on Acoustic Signal Feature by Supervised SOM

Science.gov (United States)

Teranishi, Masaru; Omatu, Sigeru; Kosaka, Toshihisa

Fatigued bills have harmful influence on daily operation of Automated Teller Machine(ATM). To make the fatigued bills classification more efficient, development of an automatic fatigued bill classification method is desired. We propose a new method to estimate bending rigidity of bill from acoustic signal feature of banking machines. The estimated bending rigidities are used as continuous fatigue level for classification of fatigued bill. By using the supervised Self-Organizing Map(supervised SOM), we estimate the bending rigidity from only the acoustic energy pattern effectively. The experimental result with real bill samples shows the effectiveness of the proposed method.

Ways of implementation of fatf recommendations on combating criminal incomes at bills market

Directory of Open Access Journals (Sweden)

Анатолій Іванович Гулей

2015-05-01

Full Text Available In this article the measures directed on counteraction to laundering of criminal incomes are considered about the financial transaction with using bills of exchange and promissory notes. A study and analysis of the development process of bills of exchange and promissory notes in different countries of the world, the nature of bills as payment document, securities, commercial and bank credit, and process of immobilization of bills. Also, the problems of the legal framework relating to bill circulation in Ukraine are investigated and some recommendations for reduce the risks of bill circulation are given

Patients Bill of Rights Data

Data.gov (United States)

U.S. Department of Health & Human Services — Reducing Costs, Protecting Consumers - The Affordable Care Act on the One Year Anniversary of the Patients Bill of Rights For too long, too many hard working...

78 FR 56583 - Deposit Insurance Regulations; Definition of Insured Deposit

Science.gov (United States)

2013-09-13

... as a potential global deposit insurer, preserve confidence in the FDIC deposit insurance system, and... the United States.\\2\\ The FDIC generally pays out deposit insurance on the next business day after a... since 2001 and total approximately $1 trillion today. In many cases, these branches do not engage in...

Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.

Science.gov (United States)

Douven, Rudy C H M; Schut, Frederik T

2011-03-01

In this paper we examine the pricing behaviour of nonprofit health insurers in the Dutch social health insurance market. Since for-profit insurers were not allowed in this market, potential spillover effects from the presence of for-profit insurers on the behaviour of nonprofit insurers were absent. Using a panel data set for all health insurers operating in the Dutch social health insurance market over the period 1996-2004, we estimate a premium model to determine which factors explain the price setting behaviour of nonprofit health insurers. We find that financial stability rather than profit maximisation offers the best explanation for health plan pricing behaviour. In the presence of weak price competition, health insurers did not set premiums to maximize profits. Nevertheless, our findings suggest that regulations on financial reserves are needed to restrict premiums. Copyright © 2011 Elsevier B.V. All rights reserved.

Value-Based Billing in a 3G IP Services Environment

OpenAIRE

Ryan, Conor; Donnelly, William; de Leastar, Eamonn; Cloney, James

2002-01-01

The proliferation of IP-based services has resulted in a paradigm shift away from traditional flat-rat, single service billing to content and usage based billing for composed service sets. The Information Societies Technology (IST) FORM project has prototyped an accounting and billing solution for IP-based telecommunications services. A key element of the solution is the IPDR Network Data Management - Usage specification. This paper presents the FORM development of a federated accounting and ...

Probabilistic insurance

OpenAIRE

Wakker, P.P.; Thaler, R.H.; Tversky, A.

1997-01-01

textabstractProbabilistic insurance is an insurance policy involving a small probability that the consumer will not be reimbursed. Survey data suggest that people dislike probabilistic insurance and demand more than a 20% reduction in the premium to compensate for a 1% default risk. While these preferences are intuitively appealing they are difficult to reconcile with expected utility theory. Under highly plausible assumptions about the utility function, willingness to pay for probabilistic i...

Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis.

Science.gov (United States)

Chakiath, Rosemary J; Siddall, Philip J; Kellow, John E; Hush, Julia M; Jones, Mike P; Marcuzzi, Anna; Wrigley, Paul J

2015-12-10

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. While abdominal pain is a dominant symptom of IBS, many sufferers also report widespread hypersensitivity and present with other chronic pain conditions. The presence of widespread hypersensitivity and extra-intestinal pain conditions suggests central nervous dysfunction. While central nervous system dysfunction may involve the spinal cord (central sensitisation) and brain, this review will focus on one brain mechanism, descending pain modulation. We will conduct a comprehensive search for the articles indexed in the databases Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Cochrane Central Register of Controlled Trial (CENTRAL) from their inception to August 2015, that report on any aspect of descending pain modulation in irritable bowel syndrome. Two independent reviewers will screen studies for eligibility, assess risk of bias and extract relevant data. Results will be tabulated and, if possible, a meta-analysis will be carried out. The systematic review outlined in this protocol aims to summarise current knowledge regarding descending pain modulation in IBS. PROSPERO CRD42015024284.

Audit and account billing process in a private general hospital: a case study

Directory of Open Access Journals (Sweden)

Raquel Silva Bicalho Zunta

2017-12-01

Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

S.1225: a Bill to amend the Atomic Energy Act of 1954. Introduced in the Senate of the United States, Ninety-Ninth Congress, First Session, May 24, 1985

International Nuclear Information System (INIS)

1985-01-01

The Price-Anderson Act Amendments Act of 1985 (S.1225) amends the Atomic Energy Act of 1954 by incorporating past experiences and new developments into a fair and efficient system for compensating the public when there is an accident involving nuclear materials. Licensees under the Nuclear Regulatory Commission must carry liability insurance only to the extent that private sources can provide, although large nuclear power plants can combine financial protection from a variety of self-insurance and external sources. The bill describes a retrospective rating plan for allocating premiums and procedures for deferring premiums. There are provisions for compensation in the event of liabilities incurred during periods of storage, transfer, or disposal of spent nuclear fuel. No more than $100 million will be available in the compensation for incidents outside the US. If enacted, the indemnification period extends from August 30, 1954 to August 1, 2012

A review on the current issues and barriers of Industrialised Building System (IBS) adoption in Malaysia’s construction industry

Science.gov (United States)

Amin, M. A. Mohd; Abas, N. H.; Shahidan, S.; Rahmat, M. H.; Suhaini, N. A.; Nagapan, S.; Rahim, R. Abdul

2017-11-01

Malaysia considers the construction industry as one of the main contributors to its Gross Domestic Product (GDP). However, there are some unresolved issues arising from the ongoing and widespread adoption of the conventional method of construction such as the resultant fragmentation of the industry itself; delays in production and delivery time of unnecessary wastages and lack of sustainability practice. Malaysian Government has been continuously encouraging the industry to use, partly or if not wholly, the Industrialized Building System (IBS), which is considered to be an important part of sustainable construction initiative. IBS was introduced to Malaysia as the solution to issues related to dependencies of foreign workers, raising demand for affordable accommodations and improving image, quality and productivity of construction industry. However, the IBS adoption in Malaysia remains low. This paper presents the review of the current issues and barriers of IBS adoption in Malaysian construction industry.

Women's Health Insurance Coverage

Science.gov (United States)

... Women's Health Policy Women’s Health Insurance Coverage Women’s Health Insurance Coverage Published: Oct 31, 2017 Facebook Twitter LinkedIn ... that many women continue to face. Sources of Health Insurance Coverage Employer-Sponsored Insurance: Approximately 57.9 million ...

Refusal to pay electricity bill is illegal

International Nuclear Information System (INIS)

Hermann, H.P.

1979-01-01

Pursuant to a judgement passed by the Lower Court of Hamburg, the author discusses probable legal arguments justifying the refusal to pay one's electricity bill, the so-called electricity bill boycott. Following an analysis of the power supply contract and of the content and the limits of the fundamental right of freedom of conscience, as well as of the concept of free enterprise and of the legal effect of licenses under the nuclear law, his point of view stated in the article is to agree with the decision of the court saying that the operation of a nuclear power plant licensed under the nuclear law does not mean an infringement of the right of freedom of conscience. It can further not be accepted to let people refuse to pay their electricity bill by referring to the right of freedom of speech, by alleging conduct against public policy on the part of the public utilities, or by referring to the right of opposition. (HSCH) [de

Portable XRF and principal component analysis for bill characterization in forensic science

International Nuclear Information System (INIS)

Appoloni, C.R.; Melquiades, F.L.

2014-01-01

Several modern techniques have been applied to prevent counterfeiting of money bills. The objective of this study was to demonstrate the potential of Portable X-ray Fluorescence (PXRF) technique and the multivariate analysis method of Principal Component Analysis (PCA) for classification of bills in order to use it in forensic science. Bills of Dollar, Euro and Real (Brazilian currency) were measured directly at different colored regions, without any previous preparation. Spectra interpretation allowed the identification of Ca, Ti, Fe, Cu, Sr, Y, Zr and Pb. PCA analysis separated the bills in three groups and subgroups among Brazilian currency. In conclusion, the samples were classified according to its origin identifying the elements responsible for differentiation and basic pigment composition. PXRF allied to multivariate discriminate methods is a promising technique for rapid and no destructive identification of false bills in forensic science. - Highlights: • The paper is about a direct method for bills discrimination by EDXRF and principal component analysis. • The bills are analyzed directly, without sample preparation and non destructively. • The results demonstrates that the methodology is feasible and could be applied in forensic science for identification of origin and false banknotes. • The novelty is that portable EDXRF is very fast and efficient for bills characterization

Boundary-Layer Control: In Memory of Bill Reynolds

Science.gov (United States)

Kim, John

2004-11-01

Professor Bill Reynolds (1933-2004) inspired many students and colleagues with his never-ending curiosity and thought-provoking ideas. Bill's relentless energy, together with his hallmark can-do character and do-it-yourself attitude, led to many seminal contributions to mechanical engineering in general, and fluid mechanics in particular. He has left a lasting impact on many of us, especially for those who had the privilege of working closely with him. Some of my current work on boundary-layer control, the use of neural networks in particular, were inspired by many discussions with Bill. He was among the first to see the potential of control-theoretic approaches for flow control, which has become the main thrust of my current research. Without his continued encouragement, I would not have been deeply involved in this line of research; and perhaps, we would not have seen the current flurry of research activities in applying modern control theories to flow control. In memory of Bill Reynolds, who himself has contributed much to flow control, an analysis of boundary-layer control from a linear system perspective will be presented.

Liberty through limits: The bill of rights as limited government provisions

Directory of Open Access Journals (Sweden)

Patrick M. Garry

2013-04-01

Full Text Available Under the modern view, individual autonomy has become the primary if not exclusive focus of the Bill of Rights. But the Bill of Rights came about not because of a desire to preserve individual autonomy, nor to insulate the individual from the democratic community. The impetus for the Bill of Rights arose from the same set of concerns that motivated the original Constitution. These concerns involved creating the appropriate structures so as to keep the new central government in check. The Bill of Rights sought to further ensure that the federal government would have limited power and operate in a limited role. Not only does this limited government model coincide with the original intent underlying the Bill of Rights, but it also provides for a more objective and manageable application. Under an individual autonomy view of the Bill of Rights, courts must define the ingredients necessary for such autonomy. However, this endeavor is fraught with ambiguity, and courts must constantly pit the individual against democratic society. But under the limited government model, the judicial role is more objective. Instead of trying to define an ambiguous individual autonomy, courts simply need to focus on whether a particular right is needed so as to maintain limited government. In addition, the limited government model does not put the Bill of Rights in conflict with democratic society. Instead, it just uses the Bill of Rights to maintain a check on government, just as the original Constitution seeks to do.

An electricity billing model | Adetona | Journal of Applied Science ...

African Journals Online (AJOL)

Linear regression analysis has been employed to develop a model for predicting accurately the electricity billing for commercial consumers in Ogun State (Nigeria) at faster rate. The electricity billing model was implement-ed, executed and tested using embedded MATLAB function blocks. The correlations between the ...

CURRENT CHANGES ON INSURANCE MARKET

Directory of Open Access Journals (Sweden)

Madalina Giorgiana MANGRA

2016-12-01

Full Text Available The offer of insurance products is about the requirements and needs of the consumer who must always have information regarding: the type of insurance risk covered and the excluded risks, the sum insured, the payment of premiums and their duration. The accurate information of customer requires, from the commencement of contract and throughout its duration, that he or she is aware of the obligations throughout the contractual period. Most of the Romanians are turning their attention to one of the insurance companies found in the top 10 in 2016, supervised by F.S.A. (Financial Supervision Authority, preferring to have a policy of mandatory household and goods insurance, auto liability or life insurance, but are also interested in travel health insurance when going abroad, private health insurance or private pension insurance. Romanians' reluctance regarding the conclusion of an insurance comes from their distrust in insurance companies (see the situations of companies like Astra Insurance, Carpatica Insurance etc., their personal financial situation and the fear that they will not receive protection if the risk is covered but the insured sum is insufficient

Accounting, Charging and Billing for Dynamic Service Composition Chains

Science.gov (United States)

Rumph, F. J.; Kruithof, G. H.; Huitema, G. B.

Services delivered to an end user can be composed of numerous subservices and form chains of composed services. These service composition chains traditionally consist of a static set of business entities. However, in order to increase business agility, dynamic service composition chains can be used by leveraging techniques of service publishing and discovery, and consist of more short-lived relations between the various business entities. This chapter focuses on issues concerning accounting, charging and billing of such dynamic service composition chains. In this type of service delivery, several traditional settlement models are not applicable since existing architectures lack support of automated negotiation of settlement parameters. Examples of such parameters are what the service consumer will be charged for and how much, how and when the consumer will be billed. In this chapter, the requirements that have to be fulfilled with respect to accounting, charging and billing in dynamic service composition chains are explored. Based on these requirements, a framework architecture for accounting charging and billing is described.

SERVICE QUALITY MEASUREMENT AND DEMAND FOR INSURANCE: AN EMPIRICAL STUDY FROM NIGERIAN INSURANCE INDUSTRY

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Abass, OlufemiAdebowale

2016-11-01

Full Text Available Insurance provides financial protection to the insured, though; its acceptance by Nigerian insuring public is still low. This can sharply be traced to low awareness of insurance service. More importantly, quality of service to the few who embraced it had been low. Therefore, insuring public perceives insurance service as defective because customers’ expectations are not met. The objective of this research is to find out whether application of service quality measurement will drive demand for insurance products. Hypothesis was tested to find out whether SERVQUAL measurement is not significantly related to demand for insurance products in Nigeria. The study adopts descriptive research design; hypothesis was tested using regression analysis. The study reveals that there is a significant relationship between application of SERVQUAL measurement and demand for insurance. It is recommended that insurance companies operating in Nigeria should adopt SERVQUAL measurement which will further increase customer retention and loyalty.

Tobacco company campaign contributions and congressional support of the cigar bill

Directory of Open Access Journals (Sweden)

Robbins RA

2016-11-01

Full Text Available Although it is widely held that campaign contributions influence support for legislation, the impact of contributions is unclear. Despite lack of a tobacco growing or manufacturing constituency, many members of Congress (MOC in the Southwest support the pro-tobacco Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2015 (HR 662/S 441, aka the "Cigar Bill". The association between campaign contributions from tobacco companies (2006-16 with cosponsor for the Cigar Bill were examined. There was a highly significant correlation with 92% of Southwest MOC who cosponsored the Cigar Bill having received campaign contributions. In contrast, 31% of those who did not cosponsoring the bill had received tobacco company campaign contributions (p<0.001 by Fisher's Exact Test. These data demonstrates a highly significant correlation between campaign contributions and legislative support for the "Cigar Bill".

42 CFR 424.540 - Deactivation of Medicare billing privileges.

Science.gov (United States)

2010-10-01

... change in practice location, a change of any managing employee, and a change in billing services. A... 42 Public Health 3 2010-10-01 2010-10-01 false Deactivation of Medicare billing privileges. 424.540 Section 424.540 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

19 CFR 142.14 - Delinquent payment of Customs bills.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Delinquent payment of Customs bills. 142.14 Section 142.14 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... of Customs bills. The following procedure shall be followed if an importer is substantially or...

19 CFR 142.26 - Delinquent payment of Customs bills.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Delinquent payment of Customs bills. 142.26 Section 142.26 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY... Delinquent payment of Customs bills. The following procedures shall be followed if an importer is...

In vitro activity and in vivo animal model efficacy of IB-367 alone and in combination with imipenem and colistin against Gram-negative bacteria.

Science.gov (United States)

Simonetti, Oriana; Cirioni, Oscar; Ghiselli, Roberto; Orlando, Fiorenza; Silvestri, Carmela; Mazzocato, Susanna; Kamysz, Wojciech; Kamysz, Elzbieta; Provinciali, Mauro; Giacometti, Andrea; Guerrieri, Mario; Offidani, Annamaria

2014-05-01

The aim of our study was to evaluate the in vitro activity of IB-367 and its bactericidal effect for Pseudomonas aeruginosa and Escherichia coli, associated to a synergic study to test the antibiotic combinations between the peptide and colistin or imipenem. Minimum inhibitory concentrations (MICs), the minimum bactericidal concentrations (MBCs), the synergy test and killing study were carried out to evaluate the IB-367 activity. In the in vivo model, a wound was incised through the panniculus carnosus of BALB/c mice, and then inoculated with 5 × 107 colony-forming units of P. aeruginosa and E. coli. For each strain, the study included an infected or not infected group that did not receive any treatment, and five contaminated groups treated with local IB- 367, intraperitoneal imipenem, intraperitoneal colistin, topical IB-367 local plus intraperitoneal imipenem or intraperitoneal colistin. All isolates were inhibited by IB-367 at concentrations of 4-64 mg/l. Killing by IB-367 was shown to be very rapid: its activity on all Gram-negative bacteria was completed within a 40 min exposure period at a concentration of 2 × MIC/l. Synergy was demonstrated when IB-367 was combined with colistin or imipenem. In in vivo studies, the groups treated with topical IB-367 and intraperitoneal colistin showed the best results in terms of bacterial load inhibition either for Pseudomonas or for E. coli. The good in vitro activity and in vivo efficacy, as well as, the synergic interactions with antibiotics suggest that IB-367 is a promising candidate for potential application in the treatment of wound Gram-negative infections. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of breath testing with fructose and high fructose corn syrups in health and IBS.

Science.gov (United States)

Skoog, S M; Bharucha, A E; Zinsmeister, A R

2008-05-01

Although incomplete fructose absorption has been implicated to cause gastrointestinal symptoms, foods containing high fructose corn syrup (HFCS) contain glucose. Glucose increases fructose absorption in healthy subjects. Our hypothesis was that fructose intolerance is less prevalent after HFCS consumption compared to fructose alone in healthy subjects and irritable bowel syndrome (IBS). Breath hydrogen levels and gastrointestinal symptoms were assessed after 40 g of fructose (12% solution) prepared either in water or as HFCS, administered in double-blind randomized order on 2 days in 20 healthy subjects and 30 patients with IBS. Gastrointestinal symptoms were recorded on 100-mm Visual Analogue Scales. Breath hydrogen excretion was more frequently abnormal (P fructose (68%) than HFCS (26%) in controls and patients. Fructose intolerance (i.e. abnormal breath test and symptoms) was more prevalent after fructose than HFCS in healthy subjects (25% vs. 0%, P = 0.002) and patients (40% vs. 7%, P = 0.062). Scores for several symptoms (e.g. bloating r = 0.35) were correlated (P fructose but not HFCS; in the fructose group, this association did not differ between healthy subjects and patients. Symptoms were not significantly different after fructose compared to HFCS. Fructose intolerance is more prevalent with fructose alone than with HFCS in health and in IBS. The prevalence of fructose intolerance is not significantly different between health and IBS. Current methods for identifying fructose intolerance should be modified to more closely reproduce fructose ingestion in daily life.

an assessment of billing electricity consumers via analogue meters

African Journals Online (AJOL)

DR. AMINU

an online system and window driven and can be used for the purpose of e- billing (Advalorem, 2009). ... Source: Billing Operation Unit, Customer Services Department KED Plc, (2002). Kilowatt hour is equal to the amount of energy ..... but reaction of the respondent confirmed the conclusion of poor consumers' response to ...

78 FR 33690 - Common Crop Insurance Regulations; Pecan Crop Insurance Provisions; Correction

Science.gov (United States)

2013-06-05

...-0008] RIN 0563-AC35 Common Crop Insurance Regulations; Pecan Crop Insurance Provisions; Correction... FR 13454-13460). The regulation pertains to the insurance of Pecans. DATES: Effective Date: June 5...: [[Page 33691

Health Insurance

Science.gov (United States)

Health insurance helps protect you from high medical care costs. It is a contract between you and your ... Many people in the United States get a health insurance policy through their employers. In most cases, the ...

Health insurance basic actuarial models

CERN Document Server

Pitacco, Ermanno

2014-01-01

Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

Hackers ring up big phone bills for hospitals.

Science.gov (United States)

Gardner, E

1992-11-02

A big telephone bill--possibly in six figures--can be a painful way for a hospital to find out its phone system isn't secure. When unusually large long-distance bills start to show up, chances are a professional telephone hacker has broken in. According to experts, one in 15 businesses has been victimized by long-distance toll fraud, and loss estimates range from $900 million to $4 billion a year.

Short Stories, Novels and Spain. An Interview With Colm Tóibín

Directory of Open Access Journals (Sweden)

José-Francisco Fernández Sánchez

2009-03-01

Full Text Available Colm Tóibín (Enniscorthy, 1955 is the author of five novels, The South (1990, The Heather Blazing (1992, The Story of the Night (1996, The Blackwater Lightship(1999 and The Master (2004. This last novel won the IMPAC Dublin Literary Award, the Los Angeles Times Novel of the Year, the Prix du Meilleur Livre Etranger for the best foreign novel published in 2005 in France, and it was shortlisted for the Man Booker Prize. Colm Tóibín has a long career in journalism and was the editor of the magazine Magill from 1982 to 1985. He is also the author of several non-fiction books, including Homage to Barcelona (1990 and The Sign of the Cross: Travels in Catholic Europe (1994. He edited The Penguin Book of Irish Fiction (1999 and has recently published his first book of short stories,Mothers and Sons (2006. Colm Tóibín attended the 10th International Conference on the Short Story in English, held at University College Cork on 19-21 June 2008, where this interview took place.

Insuring Care: Paperwork, Insurance Rules, and Clinical Labor at a U.S. Transgender Clinic.

Science.gov (United States)

van Eijk, Marieke

2017-12-01

What is a clinician to do when people needing medical care do not have access to consistent or sufficient health insurance coverage and cannot pay for care privately? Analyzing ethnographically how clinicians at a university-based transgender clinic in the United States responded to this challenge, I examine the U.S. health insurance system, insurance paperwork, and administrative procedures that shape transgender care delivery. To buffer the impact of the system's failure to provide sufficient health insurance coverage for transgender care, clinicians blended administrative routines with psychological therapy, counseled people's minds and finances, and leveraged the prestige of their clinic in attempts to create space for gender nonconforming embodiments in gender conservative insurance policies. My analysis demonstrates that in a market-based health insurance system with multiple payers and gender binary insurance rules, health care may be unaffordable, or remain financially challenging, even for transgender people with health insurance. Moreover, insurance carriers' "reliance" on clinicians' insurance-related labor is problematic as it exacerbates existing insurance barriers to the accessibility and affordability of transgender care and obscures the workings of a financial payment model that prioritizes economic expediency over gender nonconforming health.

How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?

Science.gov (United States)

Trish, Erin E; Herring, Bradley J

2015-07-01

The US health insurance industry is highly concentrated, and health insurance premiums are high and rising rapidly. Policymakers have focused on the possible link between the two, leading to ACA provisions to increase insurer competition. However, while market power may enable insurers to include higher profit margins in their premiums, it may also result in stronger bargaining leverage with hospitals to negotiate lower payment rates to partially offset these higher premiums. We empirically examine the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. We exploit a unique feature of employer-sponsored insurance, in which self-insured employers purchase only administrative services from managed care organizations, to disentangle these different effects on insurer concentration by constructing one concentration measure representing fully-insured plans' transactions with employers and the other concentration measure representing insurers' bargaining with hospitals. As expected, we find that premiums are indeed higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration. Copyright © 2015 Elsevier B.V. All rights reserved.

76 FR 20298 - Insurer Reporting Requirements; List of Insurers; Required To File Reports

Science.gov (United States)

2011-04-12

... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... more vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than...

75 FR 34966 - Insurer Reporting Requirements; List of Insurers Required To File Reports

Science.gov (United States)

2010-06-21

... vehicle insurers that are required to file reports on their motor vehicle theft loss experiences. An... the agency. Each insurer's report includes information about thefts and recoveries of motor vehicles... vehicles not covered by theft insurance policies issued by insurers of motor vehicles, other than any...

41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

Bill Gates eyes healthcare market.

Science.gov (United States)

Dunbar, C

1995-02-01

The entrepreneurial spirit is still top in Bill Gates' mind as he look toward healthcare and other growth industries. Microsoft's CEO has not intention of going the way of other large technology companies that became obsolete before they could compete today.

Maximizing collections from patient services billing.

Science.gov (United States)

Orenstein, Gil C; Kaye, Alan David; Fox, Charles J; Urman, Richard D

2014-01-01

The field of medical billing and collections continues to evolve along with current developments in U.S. healthcare reform. Although there has been a significant shift of payment responsibility from third-party payers to patients, many practices are not equipped to handle this change. As patients' financial obligations increase, the physician's ability to collect from patients will become increasingly important. Inability to collect bills receivable can adversely affect the revenue cycle of the practice. Solutions include improvement of the point-of-service collection processes, properly trained office staff, written financial policies, and the use of technology to facilitate online payments. Patients should fully understand their financial responsibilities and options available to them for payment of services rendered.

Utopian dream: a new farm bill.

Science.gov (United States)

Nestle, Marion

2012-01-01

In the fall of 2011, I taught a graduate food studies course at New York University devoted to the farm bill, a massive and massively opaque piece of legislation passed most recently in 2008 and up for renewal in 2012. The farm bill supports farmers, of course, but also specifies how the United States deals with such matters as conservation, forestry, energy policy, organic food production, international food aid, and domestic food assistance. My students came from programs in nutrition, food studies, public health, public policy, and law, all united in the belief that a smaller scale, more regionalized, and more sustainable food system would be healthier for people and the planet.

49 CFR Appendix A to Part 1035 - Uniform Straight Bill of Lading

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Uniform Straight Bill of Lading A Appendix A to Part 1035 Transportation Other Regulations Relating to Transportation (Continued) SURFACE... Appendix A to Part 1035—Uniform Straight Bill of Lading Uniform Straight Bill of Lading Original—Not...

Differential protective effects of immune lymphoid cells against transplanted line Ib leukemia and immune polioencephalomyelitis. [X radiation, mice

Energy Technology Data Exchange (ETDEWEB)

Duffey, P.S.; Lukasewycz, O.A.; Olson, D.S.; Murphy, W.H.

1978-12-01

The capacity of immune cells obtained from the major lymphoid compartments to protect C58 mice from transplanted line Ib leukemia, and from an age-dependent autoimmune CNS disease (immune polioencephalomyelitis = IPE) elicited by immunizing old C58 mice with inactivated Ib cells was quantified. Cells used for comparative adoptive protection tests were harvested from the major lymphoid compartments 14 to 15 days after young C58 mice were immunized with inactivated Ib cell preparations. Regression curves were plotted from survival data and the log/sub 10/PD/sub 50/ values were determined. Immune spleen (ISC) and peritoneal cells (IPEC) were significantly more protective against transplanted Ib cells than immune lymph node (ILNC), thymic (ITC), and marrow cells (IMC). In contrast, IPEC and IMC were not protective against IPE and ITC were only marginally protective. ILNC afforded significant protection to transplantable leukemia but were only marginally protective to IPE. When ISC were treated with anti-thy 1.2 serum and complement, protection against transplanted leukemia and IPE was reduced > 99%. When donors of immune lymphoid cells were treated with 12.5 mg of cortisone acetate daily for 2 days before lymphoid cells were harvested, protection against transplanted Ib cells by ISC was reduced by approximately 90% whereas protection against IPE was totally eliminated. Considered together, these results indicate that the protective mechanisms to transplantable leukemia and IPE differ significantly in the same indicator mouse strain.

[Abdominal spasms, meteorism, diarrhea: fructose intolerance, lactose intolerance or IBS?].

Science.gov (United States)

Litschauer-Poursadrollah, Margaritha; El-Sayad, Sabine; Wantke, Felix; Fellinger, Christina; Jarisch, Reinhart

2012-12-01

Meteorism, abdominal spasms, diarrhea, casually obstipation, flatulence and nausea are symptoms of fructose malabsorption (FIT) and/or lactose intolerance (LIT), but are also symptoms of irritable bowel syndrome (IBS). Therefore these diseases should be considered primarily in patients with digestive complaints. For diagnosis an H(2)-breath test is used.In 1,935 patients (526 m, 1,409 f) a fructose intolerance test and in 1,739 patients (518 m,1,221 f) a lactose intolerance test was done.FIT is found more frequently than LIT (57 versus 52 % in adults (p intolerance (HIT). Headache (ca. 10 %), fatigue (ca. 5 %) and dizziness (ca. 3 %) may occur after the test, irrespective whether the test was positive or negative.In more than 2/3 of patients a diet reduced in fructose or lactose may lead to improvement or remission of these metabolic disorders. IBS, which is often correlated with FIT (183/221 patients = 83 %), can be improved by relevant but also not relevant diets indicating that irritable bowel disease seems to be caused primarily by psychological disorders.

41 CFR 109-40.5003 - Commercial bills of lading.

Science.gov (United States)

2010-07-01

... shipments for the account of DOE shall include the following statement on all commercial bills of lading: This shipment is for the account of the U.S. Government which will assume the freight charges and is... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Commercial bills of...

Public Insurance and Equality

DEFF Research Database (Denmark)

Landes, Xavier; Néron, Pierre-Yves

2015-01-01

Heath (among other political theorists) considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved in the provision of specific insurance (primarily......Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph...... surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked...

Clinical and Microbiological Effect of a Multispecies Probiotic Supplementation in Celiac Patients With Persistent IBS-type Symptoms: A Randomized, Double-Blind, Placebo-controlled, Multicenter Trial.

Science.gov (United States)

Francavilla, Ruggiero; Piccolo, Maria; Francavilla, Antonio; Polimeno, Lorenzo; Semeraro, Francesco; Cristofori, Fernanda; Castellaneta, Stefania; Barone, Michele; Indrio, Flavia; Gobbetti, Marco; De Angelis, Maria

2018-04-23

The goals of this study were to evaluate the efficacy and safety of a probiotic mixture in patients with celiac disease (CD) with irritable bowel syndrome (IBS)-type symptoms despite a strict gluten-free diet (GFD). About 30% of patients with CD adherent to a GFD suffer from IBS-type symptoms; a possible cause resides in the imbalances of the intestinal microbiota in CD. Probiotics may represent a potential treatment. CD patients with IBS-type symptoms entered a prospective, double-blind, randomized placebo-controlled study. A 6-week treatment period was preceded by a 2-week run-in and followed by a 6-week follow-up phase. Clinical data were monitored throughout the study by validated questionnaires: IBS Severity Scoring System (IBS-SSS); Gastrointestinal Symptom Rating Scale (GSRS); Bristol Stool Form Scale (BSFS); and IBS Quality of Life Questionnaire (IBS-QOL). The fecal microbiota were assayed using plate counts and 16S rRNA gene-based analysis. In total, 109 patients were randomized to probiotics (n=54) or placebo (n=55). IBS-SSS and GSRS decreased significantly in probiotics, as compared with placebo [(-15.9%±14.8% vs. 8.2%±25.9%; Psymptoms, in CD patients on strict GFD, and is associated with a modification of gut microbiota, characterized by an increase of bifidobacteria.

[Using a multicomponent functional food in IBS patients with constipation a comparative controlled study].

Science.gov (United States)

Pilipenko, V I; Teplyuk, D A; Shakhovskaya, A K; Isakov, V A; Vorobyova, V M; Vorobyova, I S; Sarkisyan, V A; Kochetkova, A A; Mikheeva, G A; Yudina, A V

2016-01-01

Irritable bowel syndrome (IBS) is highly prevalent functional gastrointestinal disorder associated with decrease in quality of life and a high social cost. Diet is one of several therapeutic options in IBS treatment; therefore the development and clinical evaluation of innovative functional food for IBS patients are actual. Instant drink containing 4 g inulin, 4 mg menthol and 2 mg of pyridoxine (in daily dose) has been evaluated. 49 patients 18-68 (41.5±16.5) years old fulfilling the Rome III criteria for IBS-C were randomly assigned into two groups: one received standard diet plus two drinks per day for 2 weeks and control group received standard diet. Response to therapy was recorded daily using Likert scale of abdominal pain, bloating and feeling of incomplete bowel emptying, frequency of bowel movement, Bristol stool scale, and quality of life was assessed by IBSQoL questionnaire before and after the treatment. The consumption of the drink with inulin and menthol contributed to a significant positive effect on the stool parameters (from 0.91±0.73 to 1.12±0.45 bowel movements per day in stool frequency, p=0.05, from 2.68±1.63 to 3.43±1.27 index Bristol scale, p=0.05), reduced the severity of abdominal pain (from 1.78±0.58 to 1.47?0.61 Likert scale points, p=0.05), bloating (from 2.22±0.83 to 1.53±0.71 points ofLikertscale,p= 0.01) and a sense of incomplete bowelemptying (from 2.22 ± 0.88 to 1.61± 0.81 points of Likert scale, p=0.001), as well as increased the quality of life (from 75.3± 12.0 to 83.3±6.7%, p=0.05), but a significant part of patients (10 of 25) complained the appearance of heartburn after the start of the treatment. In conclusion, the consumption of the functional drink containing inulin, menthol and pyridoxine is associated with improve in stool parameters, abdominal pain, Bristol scale index and increase in quality of life in patients with IBS-C, but produce noticeable heartburn. Changes in functional drink composition are needed to

9 CFR 381.39 - Basis of billing for overtime and holiday services.

Science.gov (United States)

2010-01-01

... holiday services. 381.39 Section 381.39 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE... Inspection; Overtime and Holiday Service; Billing Establishments § 381.39 Basis of billing for overtime and holiday services. (a) Each recipient of overtime or holiday inspection service, or both, shall be billed...

Effects on gastrointestinal transit and antroduodenojejunal manometry after gut-directed hypnotherapy in irritable bowel syndrome (IBS).

Science.gov (United States)

Lindfors, Perjohan; Törnblom, Hans; Sadik, Riadh; Björnsson, Einar S; Abrahamsson, Hasse; Simrén, Magnus

2012-12-01

Gut-directed hypnotherapy is an effective treatment in irritable bowel syndrome (IBS) but little is known about the mechanisms of action. In this study we aimed to investigate the effects on gastrointestinal motility when treating IBS with gut-directed hypnotherapy. We randomized 90 patients with IBS, refractory to standard management to receive gut-directed hypnotherapy 1 h/week for 12 weeks or supportive treatment for the same time period. Eighty-one subjects (40 hypnotherapy, 41 controls) could be evaluated by one or more of the following investigations, both before and after the intervention: gastric emptying time, small bowel transit time, colonic transit time, and antroduodenojejunal manometry. No significant differences in gastric emptying time, small bowel transit time, or colonic transit time was found when comparing the baseline and post-intervention measurements in the hypnotherapy group or in the control group. The same was true concerning the results of the antroduodenojejunal manometry. However, there was a numerical trend toward a higher number of migrating motor complexes at manometry and an accelerated gastric emptying time after hypnotherapy that did not reach statistical significance. In this study, we were not able to find evidence for long-standing effects on gastrointestinal motility as a mediator of the effects on IBS when treating the condition with gut-directed hypnotherapy. Further research to understand the mechanism of action is needed.

Vaccine financing and billing in practices serving adult patients: A follow-up survey.

Science.gov (United States)

Lindley, Megan C; Hurley, Laura P; Beaty, Brenda L; Allison, Mandy A; Crane, Lori A; Brtnikova, Michaela; Snow, Megan; Bridges, Carolyn B; Kempe, Allison

2018-02-14

Financial concerns are often cited by physicians as a barrier to administering routinely recommended vaccines to adults. The purpose of this study was to assess perceived payments and profit from administering recommended adult vaccines and vaccine purchasing practices among general internal medicine (GIM) and family medicine (FM) practices in the United States. We conducted an interviewer-administered survey from January-June 2014 of practices stratified by specialty (FM or GIM), affiliation (standalone or ≥ 2 practice sites), and level of financial decision-making (independent or larger system level) in FM and GIM practices that responded to a previous survey on adult vaccine financing and provided contact information for follow-up. Practice personnel identified as knowledgeable about vaccine financing and billing responded to questions about payments relative to vaccine purchase price and payment for vaccine administration, perceived profit on vaccination, claim denial, and utilization of various purchasing strategies for private vaccine stocks. Survey items on payment and perceived profit were assessed for various public and private payer types. Descriptive statistics were calculated and responses compared by physician specialty, practice affiliation, and level of financial decision-making. Of 242 practices approached, 43% (n = 104) completed the survey. Reported payment levels and perceived profit varied by payer type. Only for preferred provider organizations did a plurality of respondents report profiting on adult vaccination services. Over half of respondents reported losing money vaccinating adult Medicaid beneficiaries. One-quarter to one-third of respondents reported not knowing about Medicare Part D payment levels for vaccine purchase and vaccine administration, respectively. Few respondents reported negotiating with manufacturers or insurance plans on vaccine purchase prices or payments for vaccination. Practices vaccinating adults may

Bradley vs. Gore: how media covered proposals for health insurance reform in the context of the 2000 presidential campaign.

Science.gov (United States)

Mebane, Felicia

2003-01-01

This study examines how often national media reported key aspects of Senator Bill Bradley's and Vice President Al Gore's proposals for health insurance reform during the 2000 Democratic primary campaign. The results show that news media reported on Bradley's plan and major features of his plan significantly more often than Gore's. Additionally, few reports contained explicit comparisons that explained which plan would have covered more people or cost more. Public health and media professionals need to work together to improve the quality of information the public depends on to develop views about and support for the uninsured.

Current job situation of the alumni from IBS Groningen -2017

NARCIS (Netherlands)

Liefers, Jan

2017-01-01

Our main question is: what is the current job situation of the alumni from IBS Groningen? The sub questions are: •How many students graduated in the various years? •What are the most popular jobs? •Where do alumni work and what is the career path? •What is their highest degree? •What companies

Farmers Insures Success

Science.gov (United States)

Freifeld, Lorri

2012-01-01

Farmers Insurance claims the No. 2 spot on the Training Top 125 with a forward-thinking training strategy linked to its primary mission: FarmersFuture 2020. It's not surprising an insurance company would have an insurance policy for the future. But Farmers takes that strategy one step further, setting its sights on 2020 with a far-reaching plan to…

76 FR 41138 - Insurer Reporting Requirements; List of Insurers Required To File Reports

Science.gov (United States)

2011-07-13

... passenger motor vehicle insurers that are required to file reports on their motor vehicle theft loss... information about thefts and recoveries of motor vehicles, the rating rules used by the insurer to establish... companies with a fleet of 20 or more vehicles not covered by theft insurance policies issued by insurers of...

Trino IB ameliorates the oxidative stress of cryptorchidism in the rat ...

African Journals Online (AJOL)

The study examined the effect of Trino IB, a mixture of oleuropein and -lipoic acid, on the plasma concentration of g-glutamyl transpeptidase (GGT), malondialdehyde (MDA), sperm count and apoptotic degeneration of testicular germ cells in experimentally induced cryptorchidism in adult male rats. Oral administration of ...

Sum Insured Determination for Cereal, Citrus and Vineyards in the Spanish Agricultural Insurance System

Science.gov (United States)

Lozano, C.; Tarquis, A. M.; Gómez-Barona, J. A.

2012-04-01

In general, insurance is a form of risk management used to hedge against a contingent loss. The conventional definition is the equitable transfer of a risk of loss from one entity to another in exchange for a premium or a guaranteed and quantifiable small loss to prevent a large and possibly devastating loss being agricultural insurance a special line of property insurance. Agriculture insurance, as actually are designed in the Spanish scenario, were established in 1978. At the macroeconomic insurance studies scale, it is necessary to know a basic element for the insurance actuarial components: sum insured. When a new risk assessment has to be evaluated in the insurance framework, it is essential to determinate venture capital in the total Spanish agriculture. In this study, three different crops (cereal, citrus and vineyards) cases are showed to determinate sum insured as they are representative of the cases found in the Spanish agriculture. Crop sum insured is calculated by the product of crop surface, unit surface production and crop price insured. In the cereal case, winter as spring cereal sowing, represents the highest Spanish crop surface, above to 6 millions of hectares (ha). Meanwhile, the four citrus species (oranges, mandarins, lemons and grapefruits) occupied an extension just over 275.000 ha. On the other hand, vineyard target to wine process shows almost one million of ha in Spain. A new method has been applied to estimate crop sum insured in these three cases. Under the maximum economic impact assumption, the maximum market price has been used to insurance each species. Depending on crop and reliability of the data base available, the insured area or insured production has been used in this estimation. When for a certain crop varieties or type of varieties show different insurance prices a geometric average was used as average insurance price for that particular crop. One extreme difficult case was vineyards, where differentiate prices based on

′Belonging without Belonging′: Colm Tóibín′s Dialogue with the Past

DEFF Research Database (Denmark)

Bøss, Michael

2005-01-01

It is argued that Tóibín is not the typical 'revisionist' intellectual that some have made him into, but a humanist and a sort of in-between, making a virtue of his own ambivalences towards notions of tradition, community and nationhood. The essay makes an analysis of these ambivalences with refe......It is argued that Tóibín is not the typical 'revisionist' intellectual that some have made him into, but a humanist and a sort of in-between, making a virtue of his own ambivalences towards notions of tradition, community and nationhood. The essay makes an analysis of these ambivalences...

Lymphangiogenesis in cervical cancer evaluated by expression of the VEGF-C gene in clinical stage IB-IIIB

Directory of Open Access Journals (Sweden)

Magdalena Franc

2015-02-01

Full Text Available Introduction : The aim of the present study was to evaluate the profile of VEGF-C gene expression in particular stages of cervical cancer (IB-IIIB and to estimate the correlation between VEGF-C mRNA quantity profile and clinical stage. Material and methods : Material for molecular analysis consisted of cervical cancer tissue specimens collected from 38 women (10, 15, 13 cases were classified as IB, IIB and IIIB, respectively. The control group was composed of normal cervical tissues collected from 10 women who underwent hysterectomy for non-oncological reasons. The number of VEGF-C mRNA copies in particular groups was estimated by the reverse transcription quantitative polymerase chain reaction (RT-qPCR method. Results: In the control group the average number of mRNA copies was 134 ± 36 (median: 106, in a group with stage IB it was 16 077 ± 7090 (median: 580, for stage IIB – 35 019 ± 8945 (median: 40 870. The highest number of mRNA VEGF-C copies was derived in a group of patients with cervical cancer of stage IIIB. The average quantity was 56 155 ± 12 470, whereas median 55 981. A statistically significantly higher level of VEGF-C gene expression was disclosed in cervical cancer specimens with stage IIB and IIIB than in the control group. In stage IIIB, the VEGF-C gene expression was significantly higher than in specimens derived from individuals in stage IB. Conclusions : In squamous cell carcinoma of the uterine cervix of stage IB-IIIB genes involved in lymphangio­genesis, especially VEGF-C , are expressed, which expression increases as the clinical stage of cervical cancer is higher.

32 CFR 220.11 - Special rules for automobile liability insurance and no-fault automobile insurance.

Science.gov (United States)

2010-07-01

... and no-fault automobile insurance. 220.11 Section 220.11 National Defense Department of Defense... insurance and no-fault automobile insurance. (a) Active duty members covered. In addition to Uniformed.... 1095 and this part. (c) Exclusion of automobile liability insurance and no-fault automobile insurance...

Alternative health insurance schemes

DEFF Research Database (Denmark)

Keiding, Hans; Hansen, Bodil O.

2002-01-01

In this paper, we present a simple model of health insurance with asymmetric information, where we compare two alternative ways of organizing the insurance market. Either as a competitive insurance market, where some risks remain uninsured, or as a compulsory scheme, where however, the level...... competitive insurance; this situation turns out to be at least as good as either of the alternatives...

78 FR 52780 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2013-08-26

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 85 (as of June 2013) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

77 FR 36566 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Science.gov (United States)

2012-06-19

...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of FY... Assistance/Subsidy Arrangement (Arrangement), 82 (as of April, 2012) private sector property insurers sell... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies...

Insurance: Accounting, Regulation, Actuarial Science

OpenAIRE

Alain Tosetti; Thomas Behar; Michel Fromenteau; Stéphane Ménart

2001-01-01

We shall be examining the following topics: (i) basic frameworks for accounting and for statutory insurance rules; and (ii) actuarial principles of insurance; for both life and nonlife (i.e. casualty and property) insurance.Section 1 introduces insurance terminology, regarding what an operation must include in order to be an insurance operation (the legal, statistical, financial or economic aspects), and introduces the accounting and regulation frameworks and the two actuarial models of insur...

Risk Management in Insurance Companies

OpenAIRE

Yang, Xufeng

2006-01-01

Insurance is the uncertain business in uncertain society. Today, insures face more complex and difficult risks. Efficient risk management mechanisms are essential for the insurers. The paper is set out initially to explore UK insurance companies risk management and risk disclosure by examining companies annual report after all the listed insurance companies are required to disclose risk information in their annual report, which seeks to reflect the recent development in UK insurance companies...

INTEGRAL FIELD SPECTROSCOPY OF SUPERNOVA EXPLOSION SITES: CONSTRAINING THE MASS AND METALLICITY OF THE PROGENITORS. I. TYPE Ib AND Ic SUPERNOVAE

Energy Technology Data Exchange (ETDEWEB)

Kuncarayakti, Hanindyo; Maeda, Keiichi [Kavli Institute for the Physics and Mathematics of the Universe (WPI), Todai Institutes for Advanced Study, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8583 (Japan); Doi, Mamoru; Morokuma, Tomoki; Hashiba, Yasuhito [Institute of Astronomy, Graduate School of Science, The University of Tokyo, 2-21-1 Osawa, Mitaka, Tokyo 181-0015 (Japan); Aldering, Greg [Physics Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720 (United States); Arimoto, Nobuo [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-0015 (Japan); Pereira, Rui [CNRS/IN2P3, Institut de Physique Nucleaire de Lyon, 4 Rue Enrico Fermi, F-69622 Villeurbanne Cedex (France); Usuda, Tomonori, E-mail: hanindyo.kuncarayakti@ipmu.jp [Subaru Telescope, National Astronomical Observatory of Japan, 650 North A' ohoku Place, Hilo, HI 96720 (United States)

2013-08-01

Integral field spectroscopy of 11 Type Ib/Ic supernova (SN Ib/Ic) explosion sites in nearby galaxies has been obtained using UH88/SNIFS and Gemini-N/GMOS. The use of integral field spectroscopy enables us to obtain both spatial and spectral information about the explosion site, enabling the identification of the parent stellar population of the SN progenitor star. The spectrum of the parent population provides metallicity determination via strong-line method and age estimation obtained via comparison with simple stellar population models. We adopt this information as the metallicity and age of the SN progenitor, under the assumption that it was coeval with the parent stellar population. The age of the star corresponds to its lifetime, which in turn gives the estimate of its initial mass. With this method we were able to determine both the metallicity and initial (zero-age main sequence) mass of the progenitor stars of SNe Ib and Ic. We found that on average SN Ic explosion sites are more metal-rich and younger than SN Ib sites. The initial mass of the progenitors derived from parent stellar population age suggests that SN Ic has more massive progenitors than SN Ib. In addition, we also found indication that some of our SN progenitors are less massive than {approx}25 M{sub Sun }, indicating that they may have been stars in a close binary system that have lost their outer envelope via binary interactions to produce SNe Ib/Ic, instead of single Wolf-Rayet stars. These findings support the current suggestions that both binary and single progenitor channels are in effect in producing SNe Ib/Ic. This work also demonstrates the power of integral field spectroscopy in investigating SN environments and active star-forming regions.

Jamaica National Net-Billing Pilot Program Evaluation

Energy Technology Data Exchange (ETDEWEB)

Doris, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States); Stout, Sherry [National Renewable Energy Lab. (NREL), Golden, CO (United States); Peterson, Kimberly [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-12-18

This technical report discusses the effectiveness of the Jamaica Public Service Company Limited Net-Billing Pilot Program. The National Renewable Energy Laboratory (NREL) collected and analyzed data from a wide range of stakeholders, conducted in-country research, and compared program elements to common interconnection practices to form programmatic recommendations for the Jamaica context. NREL finds that the net-billing pilot program has successfully contributed to the support of the emerging solar market in Jamaica with the interconnection of 80 systems under the program for a total of 1.38 megawatts (MW) at the time of original analysis.

Marketing in life insurance

Directory of Open Access Journals (Sweden)

Njegomir Vladimir

2006-01-01

Full Text Available Insurance industry has traditionally been oriented on sale of its products i.e. at the stage which from the aspect of marketing theory can be characterized as sales phase, phase which proceeds the marketing orientation. However, faced with numerous challenges of modern business environment such as globalization, deregulation and sophisticated information technology insurance companies must change their way of doing business. Competition is becoming fierce as insurance companies are faced with competition not only from insurance industry but also from other competitors, such as banks, that are in position to offer product substitutes for life insurance products. In this new environment information about customers and their education are becoming critical factors. Insurance companies must know their customers what influences their demand for life insurance, what is the amount of their income, what is inflation rate, their expenditures on other goods i.e. opportunity costs, etc. Those are factors that force insurance companies to concentrate more on present and potential buyers and their needs and force them to give their best to satisfy those needs in a way that will produce delighted customers.

The Gut-Brain Axis and the Microbiome: Clues to Pathophysiology and Opportunities for Novel Management Strategies in Irritable Bowel Syndrome (IBS

Directory of Open Access Journals (Sweden)

Eamonn M.M. Quigley

2018-01-01

Full Text Available Irritable bowel syndrome (IBS is one of the most common of all medical disorders worldwide and, while for some it represents no more than a nuisance, for others it imposes significant negative impacts on daily life and activities. IBS is a heterogeneous disorder and may well have a number of causes which may lie anywhere from the external environment to the contents of the gut lumen and from the enteric neuromuscular apparatus and the gut immune system to the central nervous system. Consequently, the paradigm of the gut-brain axis, which includes the participation of these various factors, has proven a useful model to assist clinicians and patients alike in understanding the genesis of symptoms in IBS. Now, given the widespread interest in the gut microbiome in health and disease, in general, reports of disordered enteric bacterial communities in IBS, and experimental data to indicate that components of the gut microbiota can influence brain morphology and function, as well as behavior and cognition, this concept has been extended to encompass the microbiota-gut-brain axis. The implications of this novel concept to the assessment and management of IBS will be explored in this review.

Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands.

Science.gov (United States)

Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria

2017-10-01

Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.

Serbian insurance market: Select issues

Directory of Open Access Journals (Sweden)

Obadović Mirjana M.

2010-01-01

Full Text Available Every day insurance companies face a number of risks arising from the insurance industry itself, as well as risks arising from insurance company operations. In this constant fight against risks insurance companies use different models and methods that help them better understand, have a more comprehensive view of, and develop greater tolerance towards risks, in order to reduce their exposure to these risks. The model presented in this paper has been developed for implementation in insurance risk management directly related to insurance company risk, i.e. it is a model that can reliably determine the manner and intensity with which deviations in the initial insurance risk assessment affect insurance company operations, in the form of changes in operational risks and consequently in insurance companies’ business strategies. Additionally we present the implementation of the model in the Serbian market for the period 2005-2010.

The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

Science.gov (United States)

Kelly, B D

2015-03-01

Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.

The Dynamics of Market Insurance, Insurable Assets, and Wealth Accumulation

OpenAIRE

Koeniger, Winfried

2002-01-01

We analyze dynamic interactions between market insurance, the stock of insurable assets and liquid wealth accumulation in a model with non-durable and durable consumption. The stock of the durable is exposed to risk against which households can insure. Since the model does not have a closed form solution we first provide an analytical approximation for the case in which households own abundant liquid wealth. It turns out that precautionary motives still matter because of fluctuations of the p...

Insurance dictionary

International Nuclear Information System (INIS)

Mueller-Lutz, H.L.

1984-01-01

Special technical terms used in the world of insurance can hardly be found in general dictionaries. This is a gap which the 'Insurance dictionary' now presented is designed to fill. In view of its supplementary function, the number of terms covered is limited to 1200. To make this dictionary especially convenient for ready reference, only the most commonly used translations are given for each key word in any of the four languages. This dictionary is subdivided into four parts, each containing the translation of the selected terms in the three other languages. To further facilitate the use of the booklet, paper of different colours was used for the printing of the German, English, French and Greek sections. The present volume was developed from a Swedish insurance dictionary (Fickordbok Foersaekring), published in 1967, which - with Swedish as the key language- offers English, French and German translations of the basic insurance terms. (orig./HP) [de

Towards an inter-domain billing system to support dynamic service provisioning

OpenAIRE

Le, V.M.

2009-01-01

Today, billing is a big challenge for service providers. With a growing number of rich services such as music, mobile TV, Video-on-Demand and eHealth delivered to the mass market, service providers are missing business opportunities because current billing solutions are not fully capable. In particular, the delivery of on-the-fly composite services, composed of many service components provided by different service providers causes many complexities. This book proposes a billing system that de...

Missed surgical intensive care unit billing: potential financial impact of 24/7 faculty presence.

Science.gov (United States)

Hendershot, Kimberly M; Bollins, John P; Armen, Scott B; Thomas, Yalaunda M; Steinberg, Steven M; Cook, Charles H

2009-07-01

To efficiently capture evaluation and management (E&M) and procedural billing in our surgical intensive care unit (SICU), we have developed an electronic billing system that links to the electronic medical record (EMR). In this system, only notes electronically signed and coded by an attending generate billing charges. We hypothesized that capture of missed billing during nighttime and weekends might be sufficient to subsidize 24/7 in-house attending coverage. A retrospective chart EMR review was performed of the EMRs for all SICU patients during a 2-month period. Note type, date, time, attending signature, and coding were analyzed. Notes without attending signature, diagnosis, or current procedural terminology (CPT) code were considered incomplete and identified as "missed billing." Four hundred and forty-three patients had 465 admissions generating 2,896 notes. Overall, 76% of notes were signed and coded by an attending and billed. Incomplete (not billed) notes represented an overall missed billing opportunity of $159,138 for the 2-month time period (approximately $954,000 annually). Unbilled E&M encounters during weekdays totaled $54,758, whereas unbilled E&M and procedures from weeknights and weekends totaled $88,408 ($44,566 and $43,842, respectively). Missed billing after-hours thus represents approximately $530K annually, extrapolating to approximately $220K in collections from our payer mix. Surprisingly, missed E&M and procedural billing during weekdays totaled $70,730 (approximately $425K billing, approximately $170K collections annually), and typically represented patients seen, but transferred from the SICU before attending documentation was completed. Capture of nighttime and weekend ICU collections alone may be insufficient to add faculty or incentivize in-house coverage, but could certainly complement other in-house derived revenues to such ends. In addition, missed daytime billing in busy modern ICUs can be substantial, and use of an EMR to identify

Education in medical billing benefits both neurology trainees and academic departments.

Science.gov (United States)

Waugh, Jeff L

2014-11-11

The objective of residency training is to produce physicians who can function independently within their chosen subspecialty and practice environment. Skills in the business of medicine, such as clinical billing, are widely applicable in academic and private practices but are not commonly addressed during formal medical education. Residency and fellowship training include limited exposure to medical billing, but our academic department's performance of these skills was inadequate: in 56% of trainee-generated outpatient notes, documentation was insufficient to sustain the chosen billing level. We developed a curriculum to improve the accuracy of documentation and coding and introduced practice changes to address our largest sources of error. In parallel, we developed tools that increased the speed and efficiency of documentation. Over 15 months, we progressively eliminated note devaluation, increased the mean level billed by trainees to nearly match that of attending physicians, and increased outpatient revenue by $34,313/trainee/year. Our experience suggests that inclusion of billing education topics into the formal medical curriculum benefits both academic medical centers and trainees. © 2014 American Academy of Neurology.

Long‐Term Monitoring of a Geosynthetic Reinforced Soil Integrated Bridge System (GRS‐IBS)

Science.gov (United States)

2017-11-01

The geosynthetic reinforced soil integrated bridge system (GRS-IBS) is an innovative alternative to conventional bridge technology that utilizes closely spaced layers of geosynthetic reinforcement and compacted granular fill material to provide direc...

Financial considerations insurance and coverage issues in intestinal transplantation.

Science.gov (United States)

Chaney, Michael

2004-12-01

To increase healthcare workers' knowledge of reimbursement concerns. Chronological survey of transplants reimbursed at the University of Nebraska Medical Center from December 1997 to October 2003, which include accounts of 30 patients who received intestine transplants. Gross billed hospital charges for the past 30 transplantations ranged from dollars 112094 to dollars 667597. Length of stay ranged from 18 to 119 days. Charges include organ procurement fees. All 30 intestine transplants were reimbursed by third-party healthcare coverage; combination of coverage; and/or patient and family payments, which resulted in adherence to financial guidelines prearranged by the hospital. Financial guidelines are usually cost plus a percentage. Thirteen transplantations occurred after April 2001, when Medicare made a national coverage decision to reimburse this form of transplantation. Since then, obtaining surgical authorization and reimbursement is easier. Most insurance companies and state public health agencies accept intestinal transplantations as a form of treatment. Researching transplant coverage before evaluation is essential to be compensated adequately. Financial guidelines will secure the fiscal success of the program. Educating patients to insurance and entitlements may reduce the out-of-pocket cost to patients. Transplant financial coordinators coordinate these efforts for the facility. The best coverage option for the patient and transplant programs is a combination of commercial healthcare coverage, secondary entitlement program, and fund-raising. With length of stay ranging up to 119 days and a lifetime of posttransplant outpatient follow-up care, it is beneficial for the facility to also have a fundraising program to assist patients.

The insurance of nuclear installations

International Nuclear Information System (INIS)

Francis, H.W.

1977-01-01

A brief account is given of the development of nuclear insurance. The subject is dealt with under the following headings: the need for nuclear insurance, nuclear insurance pools, international co-operation, nuclear installations which may be insured, international conventions relating to the liability of operators of nuclear installations, classes of nuclear insurance, nuclear reactor hazards and their assessment, future developments. (U.K.)

Regulated Medicare Advantage And Marketplace Individual Health Insurance Markets Rely On Insurer Competition.

Science.gov (United States)

Frank, Richard G; McGuire, Thomas G

2017-09-01

Two important individual health insurance markets-Medicare Advantage and the Marketplaces-are tightly regulated but rely on competition among insurers to supply and price health insurance products. Many local health insurance markets have little competition, which increases prices to consumers. Furthermore, both markets are highly subsidized in ways that can exacerbate the impact of market power-that is, the ability to set price above cost-on health insurance prices. Policy makers need to foster robust competition in both sectors and avoid designing subsidies that make the market-power problem worse. Project HOPE—The People-to-People Health Foundation, Inc.

Group Life Insurance

CERN Multimedia

2013-01-01

The CERN Administration would like to remind you that staff members and fellows have the possibility to take out a life insurance contract on favourable terms through a Group Life Insurance.   This insurance is provided by the company Helvetia and is available to you on a voluntary basis. The premium, which varies depending on the age and gender of the person insured, is calculated on the basis of the amount of the death benefit chosen by the staff member/fellow and can be purchased in slices of 10,000 CHF.    The contract normally ends at the retirement age (65/67 years) or when the staff member/fellow leaves the Organization. The premium is deducted monthly from the payroll.   Upon retirement, the staff member can opt to maintain his membership under certain conditions.   More information about Group Life Insurance can be found at: Regulations (in French) Table of premiums The Pension Fund Benefit Service &...

Nuclear insurance fire risk

International Nuclear Information System (INIS)

Dressler, E.G.

2001-01-01

Nuclear facilities operate under the constant risk that radioactive materials could be accidentally released off-site and cause injuries to people or damages to the property of others. Management of this nuclear risk, therefore, is very important to nuclear operators, financial stakeholders and the general public. Operators of these facilities normally retain a portion of this risk and transfer the remainder to others through an insurance mechanism. Since the nuclear loss exposure could be very high, insurers usually assess their risk first-hand by sending insurance engineers to conduct a nuclear insurance inspection. Because a serious fire can greatly increase the probability of an off-site release of radiation, fire safety should be included in the nuclear insurance inspection. This paper reviews essential elements of a facility's fire safety program as a key factor in underwriting nuclear third-party liability insurance. (author)

Adjuvant Chemotherapy Improves the Probability of Freedom From Recurrence in Patients With Resected Stage IB Lung Adenocarcinoma.

Science.gov (United States)

Hung, Jung-Jyh; Wu, Yu-Chung; Chou, Teh-Ying; Jeng, Wen-Juei; Yeh, Yi-Chen; Hsu, Wen-Hu

2016-04-01

The benefit of adjuvant chemotherapy remains controversial for patients with stage IB non-small-cell lung cancer (NSCLC). This study investigated the effect of adjuvant chemotherapy and the predictors of benefit from adjuvant chemotherapy in patients with stage IB lung adenocarcinoma. A total of 243 patients with completely resected pathologic stage IB lung adenocarcinoma were included in the study. Predictors of the benefits of improved overall survival (OS) or probability of freedom from recurrence (FFR) from platinum-based adjuvant chemotherapy in patients with resected stage IB lung adenocarcinoma were investigated. Among the 243 patients, 70 (28.8%) had received platinum-based doublet adjuvant chemotherapy. A micropapillary/solid-predominant pattern (versus an acinar/papillary-predominant pattern) was a significantly worse prognostic factor for probability of FFR (p = 0.033). Although adjuvant chemotherapy (versus surgical intervention alone) was not a significant prognostic factor for OS (p = 0.303), it was a significant prognostic factor for a better probability of FFR (p = 0.029) on multivariate analysis. In propensity-score-matched pairs, there was no significant difference in OS between patients who received adjuvant chemotherapy and those who did not (p = 0.386). Patients who received adjuvant chemotherapy had a significantly better probability of FFR than those who did not (p = 0.043). For patients with a predominantly micropapillary/solid pattern, adjuvant chemotherapy (p = 0.033) was a significant prognostic factor for a better probability of FFR on multivariate analysis. Adjuvant chemotherapy is a favorable prognostic factor for the probability of FFR in patients with stage IB lung adenocarcinoma, particularly in those with a micropapillary/solid-predominant pattern. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Risks and nuclear insurance

International Nuclear Information System (INIS)

Debaets, M.; Springett, G.D.; Luotonen, K.; Virole, J.

1988-01-01

When analysing the nuclear insurance market, three elements must be taken into account: the nuclear operator's liability is regulated by national laws and/or international Conventions, such operators pay large premiums to insure their nuclear installations against property damage and finally, the nuclear insurance market is made up of pools and is mainly a monopoly. This report describes the different types of insurance coverage, the system governing nuclear third party liability under the Paris Convention and the Brussels Supplementary Convention and several national laws in that field. The last part of the report deals with liability and insurance aspects of international transport of nuclear materials [fr

46 CFR 308.403 - Insured amounts.

Science.gov (United States)

2010-10-01

... total amount of war risk insurance obtainable from companies authorized to do an insurance business in a... MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS WAR RISK INSURANCE War Risk Builder's Risk Insurance § 308.403 Insured amounts. (a) Prelaunching period. The amount insured during...

Measuring public understanding on Tenaga Nasional Berhad (TNB) electricity bills using ordered probit model

Science.gov (United States)

Zainudin, WNRA; Ramli, NA

2017-09-01

In 2016, Tenaga Nasional Berhad (TNB) had introduced an upgrade in its Billing and Customer Relationship Management (BCRM) as part of its long-term initiative to provide its customers with greater access to billing information. This includes information on real and suggested power consumption by the customers and further details in their billing charges. This information is useful to help TNB customers to gain better understanding on their electricity usage patterns and items involved in their billing charges. Up to date, there are not many studies done to measure public understanding on current electricity bills and whether this understanding could contribute towards positive impacts. The purpose of this paper is to measure public understanding on current TNB electricity bills and whether their satisfaction towards energy-related services, electricity utility services, and their awareness on the amount of electricity consumed by various appliances and equipment in their home could improve this understanding on the electricity bills. Both qualitative and quantitative research methods are used to achieve these objectives. A total of 160 respondents from local universities in Malaysia participated in a survey used to collect relevant information. Using Ordered Probit model, this paper finds respondents that are highly satisfied with the electricity utility services tend to understand their electricity bills better. The electric utility services include management of electricity bills and the information obtained from utility or non-utility supplier to help consumers manage their energy usage or bills. Based on the results, this paper concludes that the probability to understand the components in the monthly electricity bill increases as respondents are more satisfied with their electric utility services and are more capable to value the energy-related services.

THE IMPACT OF COOPERATION BETWEEN INSURERS AND BANKS ON THE DEVELOPMENT OF THE INSURANCE SYSTEM

Directory of Open Access Journals (Sweden)

Nataliya Prikazyuk

2017-11-01

Full Text Available The article highlights how the cooperation of insurance companies and banks affects the insurance system. Defined the concept of bancassurance, provided a brief description of the main bancassurance models in the context of their impact on the insurance system. Defined the main benefits and risks that accompany cooperation of insurance companies and banks within different models of association. It is noted that despite the generally accepted benefits of cooperation between insurers and banks, financial intermediaries’ unions often carry significant risks. Benefits from the cooperation of insurance companies and banks are disclosed with operational, marketing and financial aspects. The purpose of the article is to study the forms of cooperation between financial intermediaries and their impact on the insurance system. Methodology. The study is based on theoretical methods to study this problem. The theoretical and methodological basis of the study is works of scientists on the models of cooperation between insurers and banks. The dialectical method of cognition as well as such methods as logical generalization, structural and systematic analysis are used to study the methodological foundations of banks’ impact on the insurance companies and insurance system. Results. Banking activity has a significant impact on the insurance system. This impact is noticeable at the micro-level: insurers and banks can be clients of each other as well as they can sign cooperation agreements. A significant positive impact of the bancassurance on the activities of both financial institutions within the synergy that appears during their cooperation is highlighted in the article. Respectively, the insurance company and the bank are experiencing the benefits of cooperation along with savings on fixed, variable costs and obtaining additional profits; simplifying and optimization of the process of collecting and processing information; savings on advertising and

Acute pain management efficiency improves with point-of-care handheld electronic billing system.

Science.gov (United States)

Fahy, Brenda G

2009-02-01

Technology advances continue to impact patient care and physician workflow. To enable more efficient performance of billing activities, a point-of-care (POC) handheld computer technology replaced a paper-based system on an acute pain management service. Using a handheld personal digital assistant (PDA) and software from MDeverywhere (MDe, MDeverywhere, Long Island, NY), we performed a 1-yr prospective observational study of an anesthesiology acute pain management service billings and collections. Seventeen anesthesiologists providing billable acute pain services were trained and entered their charges on a PDA. Twelve months of data, just before electronic implementation (pre-elec), were compared to a 12-m period after implementation (post-elec). The total charges were 4883 for 890 patients pre-elec and 5368 for 1128 patients post-elec. With adoption of handheld billing, the charge lag days decreased from 29.3 to 7.0 (P billing using PDAs to replace a paper-based billing system improved the collection rate and decreased the number of charge lag days with a positive return on investment. The handheld PDA billing system provided POC support for physicians during their daily clinical (e.g., patient locations, rounding lists) and billing activities, improving workflow.

Effectiveness of postoperative radiation therapy in stage IB cervical cancer with residual disease

International Nuclear Information System (INIS)

Herman, J.; Perez-Tamayo, C.; Komaki, R.U.; Terada, K.; Roberts, J.A.; Morley, G.W.; Greenberg, M.; Mattingly, R.; Hopkins, M.

1987-01-01

Twenty-one patients with stage IB cervical cancer were treated with radical hysterectomy, pelvic lymph node dissection, and pelvic radiation therapy to approximately 5,090 rad. Patients were divided into two groups: group I, nine patients with involved parametria or positive margins at surgery; group II, 12 patients with metastatic pelvic lymph nodes. Patients in group I had an actuarial survival of 40% at 5 years and 20% at 10 years; patients in group II had an actuarial survival of 67% at 5 and 10 years (.01 < P < .05). The overall actuarial survival was 55% at 5 years and 43% at 10 years. Thus, patients with stage IB disease and involved parametrium or surgical margins do poorly. Alternative forms of therapy should be considered when this disease picture is clinically suspected preoperatively

Using the skin protective lotion IB1 as a substitute for chemical protective gloves.

Science.gov (United States)

Ophir, Nimrod; Milk, Nadav; Mayer, Talia; Ravfogel, Shaul; Yavnai, Nirit; Eisenkraft, Arik; Kadar, Tamar; Kassirer, Michael; Rosman, Yossi

2016-10-01

We aimed to evaluate the performance of medical personnel in using the IB1 topical protective lotion on their hands and wrists together with standard disposable medical gloves, compared to standard-issued medical chemical protective gloves. This randomized cross-over study included 144 medical personnel. Primary endpoints were time-to-completion of autoinjection; success rate, number of attempts, and time-to-achieve successful endotracheal intubation; time-to-achieve satisfactory tube fixation; time-to-draw and inject the content of an ampoule; and the total time-to-perform all medical procedures. Secondary endpoints included the subjective assessment of convenience to perform these four procedures with each protective measure. Mean time was significantly shorter using IB1 compared to chemical protective gloves for tube fixation, ampoule drawing, and the total time-to-perform all procedures (58.6±22.7 seconds vs. 71.7±29.7; 31.5±21.8 vs. 38.2±19.4; 137.4±56.1 vs. 162.5±63.6, respectively; Pgloves (Pgloves significantly shorten the time-to-perform medical procedures requiring fine motor dexterities and is subjectively more convenient than chemical protective gloves. IB1 should be considered as an appropriate alternative for medical teams in a chemical event. Copyright © 2016 Elsevier Inc. All rights reserved.

Current issues in billing and coding in interventional pain medicine.

Science.gov (United States)

Manchikanti, L

2000-10-01

Interventional pain management is a dynamic field with changes occurring on a daily basis, not only with technology but also with regulations that have a substantial financial impact on practices. Regulations are imposed not only by the federal government and other regulatory agencies, and also by a multitude of other payors, state governments and medical boards. Documentation of medical necessity with coding that correlates with multiple components of the patient's medical record, operative report, and billing statement is extremely important. Numerous changes which have occurred in the practice of interventional pain management in the new millennium continue to impact the financial viability of interventional pain practices along with patient access to these services. Thus, while complying with regulations of billing, coding and proper, effective, and ethical practice of pain management, it is also essential for physicians to understand financial aspects and the impact of various practice patterns. This article provides guidelines which are meant to provide practical considerations for billing and coding of interventional techniques in the management of chronic pain based on the current state of the art and science of interventional pain management. Hence, these guidelines do not constitute inflexible treatment, coding, billing or documentation recommendations. It is expected that a provider will establish a plan of care on a case-by-case basis taking into account an individual patient's medical condition, personal needs, and preferences, along with physician's experience and in a similar manner, billing and coding practices will be developed. Based on an individual patient's needs, treatment, billing and coding, different from what is outlined here is not only warranted but essential.

Portable XRF and principal component analysis for bill characterization in forensic science.

Science.gov (United States)

Appoloni, C R; Melquiades, F L

2014-02-01

Several modern techniques have been applied to prevent counterfeiting of money bills. The objective of this study was to demonstrate the potential of Portable X-ray Fluorescence (PXRF) technique and the multivariate analysis method of Principal Component Analysis (PCA) for classification of bills in order to use it in forensic science. Bills of Dollar, Euro and Real (Brazilian currency) were measured directly at different colored regions, without any previous preparation. Spectra interpretation allowed the identification of Ca, Ti, Fe, Cu, Sr, Y, Zr and Pb. PCA analysis separated the bills in three groups and subgroups among Brazilian currency. In conclusion, the samples were classified according to its origin identifying the elements responsible for differentiation and basic pigment composition. PXRF allied to multivariate discriminate methods is a promising technique for rapid and no destructive identification of false bills in forensic science. Copyright © 2013 Elsevier Ltd. All rights reserved.

Utility Bill Insert for Wastewater Services

Science.gov (United States)

Intended for use by wastewater and water supply utilities, one side of the utility bill insert has information for customers that discharge to sanitary sewer systems; the other side is for customers with septic systems.

How to Bill Your Computer Services.

Science.gov (United States)

Dooskin, Herbert P.

1981-01-01

A computer facility billing procedure should be designed so that the full costs of a computer center operation are equitably charged to the users. Design criteria, costing methods, and management's role are discussed. (Author/MLF)

Counseling as an Insured Benefit: Perspectives from the Insurance Industry

Science.gov (United States)

Fulton, Wallace C.

1974-01-01

Article discusses the feasibility of marriage counseling as an insurance benefit in the future. It is suggested that the physician be used as a marriage counselor in that insurance companies will pay for medical services. (EK)

Limits on same-day billing in Medicaid hinders integration of behavioral health into the medical home model.