WorldWideScience

Sample records for legal services set

  1. High Levels of Post-Abortion Complication in a Setting Where Abortion Service Is Not Legalized

    Science.gov (United States)

    Melese, Tadele; Habte, Dereje; Tsima, Billy M.; Mogobe, Keitshokile Dintle; Chabaesele, Kesegofetse; Rankgoane, Goabaone; Keakabetse, Tshiamo R.; Masweu, Mabole; Mokotedi, Mosidi; Motana, Mpho; Moreri-Ntshabele, Badani

    2017-01-01

    Background Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications. Methods A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients’ records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed. Result A total of 619 patients’ records were reviewed with a mean (SD) age of 27.12 (5.97) years. The majority of abortions (95.5%) were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%). Offensive vaginal discharge (17.9%), tender uterus (11.3%), septic shock (3.9%) and pelvic peritonitis (2.4%) were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2%) of the cases followed by hypovolemic and septic shock 65 (10.5%). There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively). Conclusion Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for

  2. High Levels of Post-Abortion Complication in a Setting Where Abortion Service Is Not Legalized.

    Directory of Open Access Journals (Sweden)

    Tadele Melese

    Full Text Available Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications.A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients' records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed.A total of 619 patients' records were reviewed with a mean (SD age of 27.12 (5.97 years. The majority of abortions (95.5% were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%. Offensive vaginal discharge (17.9%, tender uterus (11.3%, septic shock (3.9% and pelvic peritonitis (2.4% were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2% of the cases followed by hypovolemic and septic shock 65 (10.5%. There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively.Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for clinical audit on post-abortion care

  3. Psychiatric diagnosis in legal settings

    Directory of Open Access Journals (Sweden)

    Alfred Allan

    2005-12-01

    Full Text Available When asked to give a diagnosis in legal settings practitioners should be mindful of the tentative nature of psychiatric diag- noses and that courts require that such a diagnosis must have scientific credibility. South African courts are not explicit about the test they will apply to determine whether a diagno- sis is scientifically credible, but some guidance can be found in United States case law. This paper examines these criteria with reference to the disorders included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR.

  4. Electronic Health Information Legal Epidemiology Data Set 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors: Cason Schmit, JD, Gregory Sunshine, JD, Dawn Pepin, JD, MPH, Tara Ramanathan, JD, MPH, Akshara Menon, JD, MPH, Matthew Penn, JD, MLIS This legal data set...

  5. Guide to legal services

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This is a directory of law firms that provide services to the independent energy industry. The directory lists the firm's name, address, telephone and FAX numbers, and the name of a contact person. Included is a description of the specialties or services offered by the firm in the area of independent energy projects; some of these include regulatory, tax, fuel supply, operations and maintenance, environmental, real estate, government contracts and bankruptcy

  6. Legal Services: Military Justice

    Science.gov (United States)

    1999-08-20

    Individ- ual File ( CMIF ) and the MPRJ will be destroyed. b. Wholly set aside since 1 September 1979. All DA Forms 2627 of commissioned officers, warrant...routinely be trans- ferred to the restricted fiche. The DA Form 2627 reflecting the original imposition of punishment, if filed in the MPRJ or CMIF , will be...Records of nonjudicial punishment wholly set aside prior to 1 September 1979. Copies of such records filed in the CMIF and the MPRJ will be destroyed. (2

  7. Marketing legal services on the Internet

    OpenAIRE

    Alicja Mikołajczyk

    2014-01-01

    This article describes accessible means of marketing legal services under restrictive regulations in the Polish market. As attorneys-at-law and legal advisers face significant legal and ethical limitations in their market communication, they are forced to seek alternative tools of promoting their services and reaching potential clients. Electronic media turned out to be an effective and convenient channel in marketing legal services, often prevailing offline marketing communication. The artic...

  8. Relationship Marketing in Legal Services Marketing Strategy

    OpenAIRE

    Audronė Androšiūnaitė; Borisas Melnikas

    2013-01-01

    The article defines the concept of professional services and evaluates the extent, to which legal services could be understood as professional services. In addition, literature analysis in the relationship marketing is presented as well as conclusions on the method for the use of relationship marketing in the development of legal services marketing strategy. Strategies of professional services marketing are completely different from other services marketing because of relations with current c...

  9. Marketing legal services on the Internet

    Directory of Open Access Journals (Sweden)

    Alicja Mikołajczyk

    2014-09-01

    Full Text Available This article describes accessible means of marketing legal services under restrictive regulations in the Polish market. As attorneys-at-law and legal advisers face significant legal and ethical limitations in their market communication, they are forced to seek alternative tools of promoting their services and reaching potential clients. Electronic media turned out to be an effective and convenient channel in marketing legal services, often prevailing offline marketing communication. The article presents legal restrictions in the market, with emphasis to fundamental barriers that prevent implementation of traditional marketing tools and techniques broadly available in market communication. The second part presents selected tools of online marketing applicable in promotion of legal services, examplified with their use in practice.

  10. Relationship Marketing in Legal Services Marketing Strategy

    Directory of Open Access Journals (Sweden)

    Audronė Androšiūnaitė

    2013-04-01

    Full Text Available The article defines the concept of professional services and evaluates the extent, to which legal services could be understood as professional services. In addition, literature analysis in the relationship marketing is presented as well as conclusions on the method for the use of relationship marketing in the development of legal services marketing strategy. Strategies of professional services marketing are completely different from other services marketing because of relations with current clients and competitors, also – singularity of the professional services.Article in Lithuanian

  11. 5 CFR 582.202 - Service of legal process.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Service of legal process. 582.202 Section... GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process § 582.202 Service of legal process. (a) A... agency as a garnishee. (b) Service of legal process may be accomplished by certified or registered mail...

  12. 31 CFR 538.406 - Exportation of services; performance of service contracts; legal services.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Exportation of services; performance of service contracts; legal services. 538.406 Section 538.406 Money and Finance: Treasury Regulations... SUDANESE SANCTIONS REGULATIONS Interpretations § 538.406 Exportation of services; performance of service...

  13. Customer value in legal services : a contingency approach

    NARCIS (Netherlands)

    Esther Verboon

    2014-01-01

    Purpose Due to the recent economic crisis, competition has considerably increased in the legal profession in the Netherlands. However, marketing in legal services is mostly in its infancy and value research in this context is scarce. We therefore used a contingency approach in exploring the origin

  14. 22 CFR 92.85 - Service of legal process usually prohibited.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of legal process usually prohibited. 92... RELATED SERVICES Quasi-Legal Services § 92.85 Service of legal process usually prohibited. The service of process and legal papers is not normally a Foreign Service function. Except when directed by the...

  15. 31 CFR 545.406 - Exportation of services; performance of service contracts; legal services.

    Science.gov (United States)

    2010-07-01

    ... of service contracts; legal services. 545.406 Section 545.406 Money and Finance: Treasury Regulations... TALIBAN (AFGHANISTAN) SANCTIONS REGULATIONS Interpretations § 545.406 Exportation of services; performance... received in the territory of Afghanistan controlled by the Taliban. Note to § 545.406. See § 545.513 with...

  16. A legal institutional perspective on the European Union External Action Service

    DEFF Research Database (Denmark)

    Van Vooren, Bart

    2010-01-01

    It is beyond doubt that setting up the European External Action Service will have a deep impact on EU external policy making. Both in legal and policy terms, this new player thoroughly changes the institutional balance in EU external relations. The goal of this paper is to examine the legal side...... of that coin, by exploring the legal and institutional nature and position of the EEAS in the EU’s external relations machinery. To that end, it queries the meaning of the EEAS’ sui generis status in the EU institutional set-up: what does it mean to say that the EEAS is ‘functionally autonomous’ from...

  17. 22 CFR 92.89 - Fees for service of legal process.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Fees for service of legal process. 92.89 Section 92.89 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES NOTARIAL AND RELATED SERVICES Quasi-Legal Services § 92.89 Fees for service of legal process. No charge should be made for...

  18. Recent Developments in the Provision of Pro Bono Legal Services ...

    African Journals Online (AJOL)

    This paper focuses on legal service delivery for the indigent by attorneys in private practice acting pro bono in civil rather than criminal matters. In this regard there have been and continue to be considerable gaps between the proper access to civil justice imperatives of constitutional South Africa and the status quo which ...

  19. A Legal Institutional Perspective on the European External Action Service

    DEFF Research Database (Denmark)

    Van Vooren, Bart

    2011-01-01

    the EEAS be drawn into proceedings before the Court of Justice? In answering those questions, this article then examines to which extent the legal-institutional choices on the structure of the EU External Action Service reflects the age-old tension entrenched in EU external relations law: the EU’s nature...

  20. 22 CFR 92.92 - Service of legal process under provisions of State law.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of legal process under provisions of... AND RELATED SERVICES Quasi-Legal Services § 92.92 Service of legal process under provisions of State law. It may be found that a State statue purporting to regulate the service of process in foreign...

  1. Characteristics of private abortion services in Mexico City after legalization.

    Science.gov (United States)

    Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia

    2010-11-01

    In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  2. REALIZING LEGAL PROTECTION FOR OUTSOURCING WORKERS THROUGH EMPLOYMENT SETTING SYNCHRONIZATION

    Directory of Open Access Journals (Sweden)

    Khairani

    2015-10-01

    Full Text Available Debating on the outsourcing existence in Law No.13 of 2003 regarding to Labor, is still continuing even though there has been a decision of Indonesia Constitutional Court (MK who stated the rules that the content of Article 65 paragraph (7 and Article 66 paragraph (2 has been outlawed. The problems of this research are: How is the outsourcing concept of regulating in the labor law and the regulation of the labor minister No. 19 of 2012; and What effort to keep the outsourcing arrangement can provide legal protection for workers? This research use juridical normative method. The research finds that some of the concept is in contradiction with the 1945 constitution and another Law which is related to the protection of labor, and even with the other articles that exists in the Labor Law itself so thats the norm contains contradictio adconceptio. Therefore, the system of outsourcing that will be regulated should consider the principles of goof outsourcing governance. They are: legal protection, non-discrimination, worker as the subject not as an object, benefit and welfare, sustainable working relation, and the shifting of protection to the labor.

  3. Ageing prisoners' health care: analysing the legal settings in Europe and the United States.

    Science.gov (United States)

    Bretschneider, Wiebke; Elger, Bernice; Wangmo, Tenzin

    2013-01-01

    Relatively little is known about the current health care situation and the legal rights of ageing prisoners worldwide. To date, only a few studies have investigated their rights to health care. However, elderly prisoners need special attention. The aim of this article is to critically review the health care situation of older prisoners by analysing the relevant national and international legal frameworks with a particular focus on Switzerland, England and Wales, and the United States (U.S.). Publications on legal frameworks were searched using Web of Science, PubMed, MEDLINE, HeinOnline, and the National Criminal Justice Reference Service. Searches utilizing combinations of keywords relating to ageing prisoners were performed. Relevant reports and policy documents were obtained in order to understand the legal settings in Switzerland, England and Wales, and the U.S. All articles, reports, and policy documents published in English and German between 1774 to June 2012 were included for analysis. Using a comparative approach, an outline was completed to distinguish positive policies in this area. Regulatory approaches were investigated through evaluations of soft laws applicable in Europe and U.S. Supreme Court judgements. Even though several documents could be interpreted as guaranteeing adequate health care for ageing prisoners, there is no specific regulation that addresses this issue completely. The Vienna International Plan of Action on Ageing contributes the most by providing an in-depth analysis of the health care needs of older persons. Still, critical analysis of retrieved documents reveals the lack of specific legislation regarding the health care for ageing prisoners. No consistent regulation delineates the provision of health care for ageing prisoners. Neither national nor international institutions have enforceable laws that secure the precarious situation of older adults in prisons. To initiate a change, this work presents critical issues that must be

  4. Adapting to the New Legal Services Market: Can Law Firms Avoid Becoming a Comet?

    OpenAIRE

    KING, Ian; EDWARDS, Catherine

    2013-01-01

    In The Future of Law (1996), Richard Susskind predicted that new technologies would change beyond recognition the way in which the legal marketplace would operate and how legal services would be delivered. In The End of Lawyers? Rethinking the Nature of Legal Services (2008), Susskind expanded on and developed his theme by arguing that the position of traditional lawyers would be eroded if not displaced by the twin pressures of a demand for greater legal commoditisation and the ever increasin...

  5. 7 CFR 91.39 - Premium hourly fee rates for overtime and legal holiday service.

    Science.gov (United States)

    2010-01-01

    ... legal holidays or what constitutes overtime service at a particular Science and Technology laboratory is... Premium hourly fee rates for overtime and legal holiday service. (a) When analytical testing in a Science... overtime work. When analytical testing in a Science and Technology facility requires the services of...

  6. Medico-legal documentation South African Police Services forms

    African Journals Online (AJOL)

    information to the court and to be an educator. S Afr Fam ... Keywords: forensic medicine, medico-legal, legal documentation, assault, sexual assault, under the influence. Abstract .... Documentation in the absence of a South African Police.

  7. Platform economy in legal profession : An empirical study on online legal service providers in China

    NARCIS (Netherlands)

    Li, Jing

    2018-01-01

    Platform economy breaks into the legal profession by pooling lawyers with different specializations into a simple user-friendly platform, consolidating the lower-tier supply side of the legal market and generating economy of scale. This paper is the very first empirical piece looking into China’s

  8. Exploring the secret history of the legal service of the European Executives, 1952-1967

    DEFF Research Database (Denmark)

    Rasmussen, Morten

    key private archives, consequently constitutes the first attempt to write a history of the legal service of the European executives from 1952 to 1967. With the functions and actions of the legal service being very far from the public spotlight, the story presented here has until now been completely...... to finally be able to affirm, reject or nuance Stein’s classic claim....

  9. 45 CFR Appendix A to Part 1611 - Legal Services Corporation 2010 Poverty Guidelines *

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Legal Services Corporation 2010 Poverty Guidelines... Corporation 2010 Poverty Guidelines * Legal Services Corporation 2010 Income Guidelines * Size of household 48...: 4,675 5,850 5,375 * The figures in this table represent 125% of the poverty guidelines by household...

  10. 11 CFR 100.85 - Legal or accounting services to political party committees.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Legal or accounting services to political party committees. 100.85 Section 100.85 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Contributions § 100.85 Legal or accounting services to political party...

  11. 11 CFR 100.145 - Legal or accounting services to political party committees.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Legal or accounting services to political party committees. 100.145 Section 100.145 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Expenditures § 100.145 Legal or accounting services to political...

  12. 11 CFR 100.86 - Legal or accounting services to other political committees.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Legal or accounting services to other political committees. 100.86 Section 100.86 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Contributions § 100.86 Legal or accounting services to other political...

  13. 11 CFR 100.146 - Legal or accounting services to other political committees.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Legal or accounting services to other political committees. 100.146 Section 100.146 Federal Elections FEDERAL ELECTION COMMISSION GENERAL SCOPE AND DEFINITIONS (2 U.S.C. 431) Exceptions to Expenditures § 100.146 Legal or accounting services to other...

  14. Part 1: Medico-legal documentation South African Police Services ...

    African Journals Online (AJOL)

    Valid medico-legal consent differs from medical consent. Knowledge of legislation pertaining to child pornography and the practical and ethical aspects of photography is also necessary. Inappropriate completion of medico-legal documentation may necessitate the practitioner having to explain the documentation to make it ...

  15. Service level agreements a legal and practical guide

    CERN Document Server

    Desai, Jimmy

    2010-01-01

    By reading this a short, legal and practical guide to SLAs, you should be able to quickly come up to speed with some of the legal and practical issues that might arise. Negotiating the SLA and putting the SLA into action are also discussed in the pocket guide. Whilst short and easy to digest, case references and weblinks have been provided in the text so readers can find out more information about SLAs.  

  16. Screening for Elder Mistreatment among Older Adults Seeking Legal Assistance Services

    Directory of Open Access Journals (Sweden)

    Sheryl M Strasser

    2013-08-01

    Full Text Available Introduction: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM. The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia.Methods: Researchers administered surveys to consenting older adults (aged 60þ in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors.Results: Surveys were completed by 112 participants. Findings reveal that 32 (28.6% respondents met the criteria for elder abuse / neglect risk; 17 (15.2% respondents met criteria for depression; and 105 (93.7% had visited a healthcare provider during the past 6 months.Conclusion: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present. [West J Emerg Med. 2013;14(4:309–315.

  17. Setting the bar: Standards for ecosystem services.

    Science.gov (United States)

    Polasky, Stephen; Tallis, Heather; Reyers, Belinda

    2015-06-16

    Progress in ecosystem service science has been rapid, and there is now a healthy appetite among key public and private sector decision makers for this science. However, changing policy and management is a long-term project, one that raises a number of specific practical challenges. One impediment to broad adoption of ecosystem service information is the lack of standards that define terminology, acceptable data and methods, and reporting requirements. Ecosystem service standards should be tailored to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most headway toward rapid uptake of ecosystem service science by working directly with these organizations. Progress has been made in aligning with existing organizations in areas such as product certification and sustainability reporting, but a major challenge remains in mainstreaming ecosystem service information into core public and private use contexts, such as agricultural and energy subsidy design, national income accounts, and corporate accounts.

  18. Setting the bar: Standards for ecosystem services

    Science.gov (United States)

    Polasky, Stephen; Tallis, Heather; Reyers, Belinda

    2015-01-01

    Progress in ecosystem service science has been rapid, and there is now a healthy appetite among key public and private sector decision makers for this science. However, changing policy and management is a long-term project, one that raises a number of specific practical challenges. One impediment to broad adoption of ecosystem service information is the lack of standards that define terminology, acceptable data and methods, and reporting requirements. Ecosystem service standards should be tailored to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most headway toward rapid uptake of ecosystem service science by working directly with these organizations. Progress has been made in aligning with existing organizations in areas such as product certification and sustainability reporting, but a major challenge remains in mainstreaming ecosystem service information into core public and private use contexts, such as agricultural and energy subsidy design, national income accounts, and corporate accounts. PMID:26082540

  19. 78 FR 20893 - Legal Services Trade Mission to China, September 16-18, 2013

    Science.gov (United States)

    2013-04-08

    ... services on United States laws for issues relating to taxation, employment, corporate finance, real estate... economy to a center of international business and finance, its need for sophisticated multinational legal...

  20. European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe.

    Science.gov (United States)

    Mangin, P; Bonbled, F; Väli, M; Luna, A; Bajanowski, T; Hougen, H P; Ludes, B; Ferrara, D; Cusack, D; Keller, E; Vieira, N

    2015-03-01

    Forensic experts play a major role in the legal process as they offer professional expert opinion and evidence within the criminal justice system adjudicating on the innocence or alleged guilt of an accused person. In this respect, medico-legal examination is an essential part of the investigation process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i.e., it should be independent, effective, and prompt. Ideally, the investigations should be conducted by board-certified experts in forensic medicine, endowed with a solid experience in this field, without any hierarchical relationship with the prosecuting authorities and having access to appropriate facilities in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance with high standards of professional performance within forensic pathology services that have been successfully submitted to an official accreditation/certification process using valid and acceptable criteria. To reach this goal, the National Association of Medical Examiners (NAME) has elaborated an accreditation/certification checklist which should be served as decision-making support to assist inspectors appointed to evaluate applicants. In the same spirit than NAME Accreditation Standards, European Council of Legal Medicine (ECLM) board decided to set up an ad hoc working group with the mission to elaborate an accreditation/certification procedure similar to the NAME's one but taking into account the realities of forensic medicine practices in Europe and restricted to post

  1. 49 CFR 551.66 - What is the legal effect of service of process on an agent?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false What is the legal effect of service of process on... Service of Process on Foreign Manufacturers and Importers Method of Service of Process § 551.66 What is the legal effect of service of process on an agent? Service on an agent of administrative or judicial...

  2. Legal consequences of standard setting for competitive athletes with cardiovascular abnormalities.

    Science.gov (United States)

    Weistart, J C

    1985-12-01

    This paper addresses the issue of whether establishing consensus standards for the treatment of particular medical conditions increases a physician's exposure to legal liability. The conclusion reached is that the legal effects of standard setting, rather than representing a significant threat of liability, should be seen as beneficial to the medical profession. A fundamental point is that the legal test for liability is entirely dependent on the medical profession's definition of what constitutes adequate care. The law incorporates the standard of care defined by the medical profession and does not impose an external norm. In the absence of formally stated standards, the process of defining relevant medical criteria will involve a great deal of uncertainty. Outcomes of legal contests will be affected by such extraneous factors as the relative experience of the lawyers involved, their access to knowledgeable expert witnesses, and their strategic decisions made with respect to tactics and procedures. Establishment of formal standards has the salutory effect of limiting the influence of these factors and thus reducing the randomness of the results reached. Formal standards also have the advantage of being easily replicated in unrelated proceedings and thereby contribute to the development of a consistent, evenly applied rule of liability. Finally, even if formal standards are either more, or less, progressive than the actual state of medical practice, there is relatively little risk that they will produce untoward results.

  3. Utilization of legal and financial services of partners in dementia care study.

    Science.gov (United States)

    Shrestha, Srijana; Judge, Katherine S; Wilson, Nancy L; Moye, Jennifer A; Snow, A Lynn; Kunik, Mark E

    2011-03-01

    Financial and legal services are unique needs of persons with dementia and their caregivers. This study examines their need for legal and financial assistance and the kinds of legal and financial services provided within Partners in Dementia Care, a telephone-based, care coordination and support service intervention delivered through a partnership between Veterans Affairs (VA) medical centers and local Alzheimer's Association chapters. Based on comprehensive assessment, and needs prioritization, care coordinators collaboratively planned action steps (specific behavioral tasks) with each caregiver/person with dementia to address the dyad's identified unmet needs. Results show that 51 (54.8%) of 93 dyads reported a need for legal and financial services. Action steps related to legal and financial need included education or assistance with legal services (27.27%), nonhealth-related financial benefits (32.32%), health-related financial benefits (21.21%), financial management/planning (9.09%), and financial support (10.1%). Comparable numbers of action steps were directed to VA (41.4%) and non-VA (58.6%) services.

  4. Setting the stage for the EPOS ERIC: Integration of the legal, governance and financial framework

    Science.gov (United States)

    Atakan, Kuvvet; Bazin, Pierre-Louis; Bozzoli, Sabrina; Freda, Carmela; Giardini, Domenico; Hoffmann, Thomas; Kohler, Elisabeth; Kontkanen, Pirjo; Lauterjung, Jörn; Pedersen, Helle; Saleh, Kauzar; Sangianantoni, Agata

    2017-04-01

    EPOS - the European Plate Observing System - is the ESFRI infrastructure serving the need of the solid Earth science community at large. The EPOS mission is to create a single sustainable, and distributed infrastructure that integrates the diverse European Research Infrastructures for solid Earth science under a common framework. Thematic Core Services (TCS) and Integrated Core Services (Central Hub, ICS-C and Distributed, ICS-D) are key elements, together with NRIs (National Research Infrastructures), in the EPOS architecture. Following the preparatory phase, EPOS has initiated formal steps to adopt an ERIC legal framework (European Research Infrastructure Consortium). The statutory seat of EPOS will be in Rome, Italy, while the ICS-C will be jointly operated by France, UK and Denmark. The TCS planned so far cover: seismology, near-fault observatories, GNSS data and products, volcano observations, satellite data, geomagnetic observations, anthropogenic hazards, geological information modelling, multiscale laboratories and geo-energy test beds for low carbon energy. In the ERIC process, EPOS and all its services must achieve sustainability from a legal, governance, financial, and technical point of view, as well as full harmonization with national infrastructure roadmaps. As EPOS is a distributed infrastructure, the TCSs have to be linked to the future EPOS ERIC from legal and governance perspectives. For this purpose the TCSs have started to organize themselves as consortia and negotiate agreements to define the roles of the different actors in the consortium as well as their commitment to contribute to the EPOS activities. The link to the EPOS ERIC shall be made by service agreements of dedicated Service Providers. A common EPOS data policy has also been developed, based on the general principles of Open Access and paying careful attention to licensing issues, quality control, and intellectual property rights, which shall apply to the data, data products

  5. Medical-legal partnerships: the role of mental health providers and legal authorities in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural settings.

    Science.gov (United States)

    Speldewinde, Christopher A; Parsons, Ian

    2015-01-01

    Medical-legal partnerships (MLP) are a model in which medical and legal practitioners are co-located and work together to support the health and wellbeing of individuals by identifying and resolving legal issues that impact patients' health and wellbeing. The aim of this article is to analyse the benefits of this model, which has proliferated in the USA, and its applicability in the context of rural and remote Australia. This review was undertaken with three research questions in mind: What is an MLP? Is service provision for individuals with mental health concerns being adequately addressed by current service models particularly in the rural context? Are MLPs a service delivery channel that would benefit individuals experiencing mental health issues? The combined searches from all EBSCO Host databases resulted in 462 citations. This search aggregated academic journals, newspapers, book reviews, magazines and trade publications. After several reviews 38 papers were selected for the final review based on their relevance to this review question: How do MLPs support mental health providers and legal service providers in the development of a coordinated approach to supporting mental health clients' legal needs in regional and rural Australia? There is considerable merit in pursuing the development of MLPs in rural and remote Australia particularly as individuals living in rural and remote areas have far fewer opportunities to access support services than those people living in regional and metropolitan locations. MLPS are important channels of service delivery to assist in early invention of legal problems that can exacerbate mental health problems.

  6. 78 FR 64249 - Notice of Intent To Award-Grant Awards for the Provision of Civil Legal Services to Eligible Low...

    Science.gov (United States)

    2013-10-28

    ... reflect the most current information available, i.e., 100% implementation of ACS 2009- 2011 poverty... Jersey Legal Services, NJ-16 1,149,705 Inc.. New Mexico DNA-Peoples Legal Services, NM-1 174,328 Inc.. DNA-Peoples Legal Services, NNM-2 20,981 Inc.. New Mexico Legal Aid MNM 80,485 New Mexico Legal Aid NM...

  7. Evaluation of Legal Data Protection Requirements in Cloud Services in the Context of Contractual Relations with End-Users

    Directory of Open Access Journals (Sweden)

    Darius Štitilis

    2014-03-01

    Full Text Available Purpose – to analyse the compliance with basic principles of data protection in selected consumer oriented cloud services contracts, and also to highlight the adequate level of data protection in the mentioned contracts, evaluating existing data protection directive 95/46/EC, also proposed General data protection regulation.Design/methodology/approach – various survey methods have been used in the work integrated. Documental analysis method has been used in analysis of scientific literature, legal acts and other documents, where aspects of legal data protection requirements have been included. Legal documents analysis method together with logical-analytic method has been used in analysing Directive 95/46/EU, Proposal for a regulation of the European Parliament and of the Council and jurisprudence of the European Court of Human Rights. Comparative method has been applied for revealing difference between particular cloud services contracts and also comparing the compliance of cloud services contracts to requirements of basic European data protection principles, established in the international documents.Findings – from the brief analysis of selected consumer oriented cloud service providers, it may be implied that more or less all the legal principles, established in the legal acts, are reflected in the privacy policies and/or service agreements. However, it shall be noted that there is a big difference in wording of the analysed documents. Regarding other principles, all examined cloud service providers do not have indemnification provisions regarding unlawful use of personal data.Research limitations/implications – the concept of the contract was presented in a broad sense, including the privacy policies and/or terms and conditions of the service providers. In accordance with the content of the principles, the authors grouped data protection principles, applied in cloud services into fundamental and recommendatory.Practical implications

  8. 22 CFR 92.81 - Performance of legal services.

    Science.gov (United States)

    2010-04-01

    ... lawyer is available and refusal to perform the service would result in the imposition of extreme hardship... he may refer the inquirer to the Department for a list of attorneys. (d) Waiver of responsibility... responsibility on the part of the United States Government or the officer performing the service. (e) Fees. No...

  9. Establishing a legal service for major trauma patients at a major trauma centre in the UK.

    Science.gov (United States)

    Seligman, William H; Thompson, Julian; Thould, Hannah E; Tan, Charlotte; Dinsmore, Andrew; Lockey, David J

    2017-09-01

    Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. In 2013, a legal service was established at North Bristol NHS Trust. Referrals are made by trauma nurse practitioners and it operates within a strict ethical framework. A retrospective analysis of the activity of this legal service between September 2013 and October 2015 was undertaken. 66 major trauma patients were seen by the legal teams at the MTC. 535 hours of free legal advice were provided on non-compensation issues-an average of 8 hours per patient. This initiative confirms a demand for the early availability of legal advice for major trauma patients to address a range of non-compensation issues as well as for identification of potential compensation claims. The availability of advice at the MTC is convenient for relatives who may be spending the majority of their time with injured relatives in hospital. More data are needed to establish the rehabilitation and health effects of receiving non-compensation advice after major injury; however, the utilisation of this service suggests that it should be considered at the UK MTCs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. The EPOS Legal and Governance Framework : tailoring the infrastructure to fit the needs of the EPOS services

    Science.gov (United States)

    Kohler, Elisabeth; Pedersen, Helle; Kontkanen, Pirjo; Korja, Annakaisa; Lauterjung, Jörn; Haslinger, Florian; Sangianantoni, Agata; Bartolini, Alessandro; Consortium, Epos

    2016-04-01

    One of the most important issues regarding a pan-European distributed large scale research infrastructure is the setting up of its legal and governance structure as this will shape the very operation of the undertaking, i.e. the decision-making process, the allocation of tasks and resources as well as the relationship between the different bodies. Ensuring long-term operational services requires a robust, coherent and transparent legal and governance framework across all of the EPOS TCS (Thematic Core Services) and ICS (Integrated Core Services) that is well aligned to the EPOS global architecture. The chosen model for the EPOS legal entity is the ERIC (European Research Infrastructure Consortium). While the statutory seat of EPOS-ERIC will be in Rome, Italy, most of the services will be hosted in other countries. Specific agreements between EPOS-ERIC and the legal bodies hosting EPOS services will be implemented to allow proper coordination of activities. The objective is to avoid multiple agreements and, where possible, to standardize them in order to reach a harmonized situation across all services. For the governance careful attention will be paid to the decision-making process, the type of decisions and the voting rights, the definition of responsibilities, rights and duties, the reporting mechanisms, as well as other issues like who within a TCS represents the service to the 'outside' world or who advices the TCS on which subjects. Data policy is another crucial issue as EPOS aims to provide interdisciplinary services to researchers interested in geoscience, including access to data, metadata, data products, software and IT tools. EPOS also provides access to computational resources for visualization and processing. Beyond the general principles of Open Access and Open Source the following questions have to be addressed: scope and nature of data that will be accepted; intellectual property rights in data and terms under which data will be shared; openness and

  11. Service Dogs in the Perioperative Setting.

    Science.gov (United States)

    Levey, Janet A; Chappy, Sharon L

    2017-04-01

    Service dogs are critical for the independence of individuals with disabilities because they assist with daily living activities and help these individuals navigate society. Perioperative nurses need a working knowledge of disability laws pertaining to service dogs to provide patient-centered care for individuals using service dogs. This article provides information on the Americans With Disabilities Act regulations regarding service dogs, makes recommendations for the care of patients with service dogs across the perioperative continuum, and offers policy directives to ensure that safe, high-quality care is delivered to patients using service dogs. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  12. You're it! How to psychologically survive an internal investigation, disciplinary proceeding, or legal action in the police, fire, medical, mental health, legal, or emergency services professions.

    Science.gov (United States)

    Miller, Laurence

    2009-01-01

    Rightly or wrongly, law enforcement, public safety, medical, mental health, legal, and emergency services professionals may have to face internal investigation, disciplinary measures, license suspension, criminal prosecution, civil lawsuits, and/or personal life disruption related to actions taken in the course of their work. This article describes the main categories of misconduct--or simply mistakes--that can cause different types of professionals to be investigated, charged, prosecuted, and/or sued. It next discusses the kinds of psychological reactions commonly seen in workers who face these kinds of proceedings. Finally, the article offers a set of practical psychological coping strategies and procedural recommendations for dealing with the stresses of an investigation, administrative action, or litigation, and for mitigating their effects on one's life and career.

  13. Compliance With Legal Age Restrictions on Adolescent Alcohol Sales for Alcohol Home Delivery Services (AHDS)

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van den Wildenberg, Esther; de Bruijn, Dorien

    2014-01-01

    Purpose: Alcohol availability is an important predictor of alcohol use in adolescents and its negative consequences. Within this study, we zoomed in on availability through alcohol home delivery services (AHDS) by measuring compliance with the legal age limit in this sector. Methods: Two methods

  14. 31 CFR 545.513 - Provision of certain legal services authorized.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of certain legal services authorized. 545.513 Section 545.513 Money and Finance: Treasury Regulations Relating to Money and Finance... issued on a case-by-case basis authorizing receipt from unblocked sources of payment of professional fees...

  15. 31 CFR 586.509 - Provision of certain legal services authorized.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of certain legal services authorized. 586.509 Section 586.509 Money and Finance: Treasury Regulations Relating to Money and Finance..., authorizing receipt, from unblocked sources, of payment of professional fees and reimbursement of incurred...

  16. 31 CFR 598.507 - Provision of certain legal services authorized.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of certain legal services authorized. 598.507 Section 598.507 Money and Finance: Treasury Regulations Relating to Money and Finance... case-by-case basis authorizing receipt from unblocked sources of payment of professional fees and...

  17. 31 CFR 587.507 - Provision of certain legal services authorized.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of certain legal services authorized. 587.507 Section 587.507 Money and Finance: Treasury Regulations Relating to Money and Finance...-case basis authorizing receipt from unblocked sources of payment of professional fees and reimbursement...

  18. TOWARDS THE LEGAL RECOGNITION AND GOVERNANCE OF FOREST ECOSYSTEM SERVICES IN MOZAMBIQUE

    Directory of Open Access Journals (Sweden)

    S Norfolk

    2013-06-01

    Full Text Available Within the context of Mozambique, this paper examines the state of forest ecosystem services, the dependency of the population on these systems for their well-being, if an adaptive governance regime is being created which will ensure the resilience of the forest ecosystem services including the legal framework, the institutions operating within this framework, the tools available and their functioning, and how cooperative governance is operating.

  19. Assessing the physical service setting: a look at emergency departments.

    Science.gov (United States)

    Steinke, Claudia

    2015-01-01

    To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

  20. Municipal service delivery SET for success

    CSIR Research Space (South Africa)

    Naidoo, S

    2015-10-01

    Full Text Available The application of scientific, engineering and technological solutions by the CSIR to support local government environmental management and service delivery has the potential for significant impact. A case study illustrates the application...

  1. Psychological Well-Being Among Women Who Experienced Intimate Partner Violence and Received Civil Legal Services.

    Science.gov (United States)

    Renner, Lynette M; Hartley, Carolyn Copps

    2018-05-01

    Intimate partner violence (IPV) victimization is often associated with negative mental health outcomes; yet, little is known about the psychological well-being of women who experience IPV and receive civil legal services. Civil legal services are not specifically designed to focus on women's mental health needs but Sullivan's Social and Emotional Well-Being Framework helps to explain why women receiving this type of formal assistance may demonstrate positive changes in psychological well-being. Using a panel study design and data from 85 women who experienced IPV and sought civil legal services, we examined women's psychological well-being over a one-year period of time. Approximately two thirds of the women received assistance from Iowa Legal Aid (ILA) for a civil protective order ( n = 56) and the rest were represented in a family law matter. We used measures of mental health (depression, posttraumatic stress disorder [PTSD]) and well-being (social support, resilience, goal directed thinking, empowerment). Our hypotheses that women would experience a decrease in mental health symptoms and an increase in well-being were partially supported. Women reported a decrease in depressive and PTSD symptoms over one year but there were no changes in their goal-oriented thinking or resilience. Implications for practice and future research are included.

  2. Setting the bar: Standards for ecosystem services

    CSIR Research Space (South Africa)

    Polasky, S

    2015-06-01

    Full Text Available to specific use contexts, such as national income and wealth accounts, corporate sustainability reporting, land-use planning, and environmental impact assessments. Many standard-setting organizations already exist, and the research community will make the most...

  3. Customer loyalty in a service setting

    NARCIS (Netherlands)

    Bloemer, J.M.M.; Ruyter, de J.C.; Wetzels, M.G.M.

    1998-01-01

    In this paper the antecedents and consequences of perceived service quality in a retail context are examined both from the employee and the customer perspective. We investigate the impact of role stress (role ambiguity and role conflict), on organizational commitment and commitment to quality.

  4. Complexities of Providing Dental Hygiene Services in Community Care Settings.

    Science.gov (United States)

    Zarkowski, Pamela; Aksu, Mert N

    2016-06-01

    Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care 'beyond the operatory.' An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. "It Gave Me My Life Back": An Evaluation of a Specialist Legal Domestic Abuse Service.

    Science.gov (United States)

    Lea, Susan J; Callaghan, Lynne

    2016-05-01

    Community-based advocacy services are important in enabling victims to escape domestic abuse and rebuild their lives. This study evaluated a domestic abuse service. Two phases of research were conducted following case-file analysis (n = 86): surveys (n = 22) and interviews (n = 12) with victims, and interviews with key individuals (n = 12) based in related statutory and community organizations. The findings revealed the holistic model of legal, practical, mental health-related, and advocacy components resulted in a range of benefits to victims and enhanced interagency partnership working. Core elements of a successful needs-led, victim-centered service could be distilled. © The Author(s) 2015.

  6. Exclusive contracts in the hospital setting: a two-edged sword, part 1: legal issues.

    Science.gov (United States)

    Portman, Robert M

    2007-05-01

    Hospitals routinely enter into contracts with radiology groups for the right to be the exclusive provider of radiology services at the facility in exchange for the group agreeing to provide and manage all aspects of that service within the hospital. These "exclusive contracts" generally result in the radiology department and associated equipment being closed off to physicians who are not part of the contracting group. Exclusive contracts are generally considered to be good for physicians who have them and bad for those excluded by them. In fact, while exclusive contracts offer obvious benefits to the physicians who receive them and obvious disadvantages for those who are excluded, they also present pitfalls for physicians in the chosen group. Part I of this article discusses the legal issues raised by exclusive contracts. Although these agreements appear to be anti-competitive, most courts have rejected antitrust challenges to exclusive contracts. Excluded physicians have had much greater success in attacking exclusive contracting arrangements on breach of contract and procedural/due process grounds. Exclusive contracting arrangements can also raise concerns under the Medicare-Medicaid anti-kickback statute if the contracting physicians are required to pay consideration or accept less than fair market value compensation in exchange for exclusive contracts. These agreements can also raise issues under the Stark II physician self-referral law if the contracting physicians are in a position to refer Medicare or Medicaid patients to the hospital. Part II of this article will discuss the advantages and disadvantages of exclusive contracts for physicians covered and not covered by such contracts, as well as strategies for avoiding them or minimizing their potential adverse impact. It also will discuss specific provisions of exclusive contracts that should be included or avoided.

  7. RECENT DEVELOPMENTS IN THE PROVISION OF PRO BONO LEGAL SERVICES BY ATTORNEYS IN SOUTH AFRICA

    Directory of Open Access Journals (Sweden)

    Dave Holness

    2013-04-01

    Full Text Available SUMMARYThis paper focuses on legal service delivery for the indigent by attorneys in private practice acting pro bono in civil rather than criminal matters. In this regard there have been and continue to be considerable gaps between the proper access to civil justice imperatives of constitutional South Africa and the status quo which has existed from the advent of a democratic South Africa until the present. Law as a vehicle for necessary positive change in the daily lives of South African residents is pertinently considered within the country’s woefully unequal socio-economic climate. This paper considers the role which pro bono work by private attorneys is playing and should play in promoting a more just and equitable society through proper access to justice. It explores the current position in South Africa as well as the position in selected foreign jurisdictions regarding pro bono services by attorneys in private practice in civil matters. Part of the discussion focuses on the question of whether pro bono work should be voluntary or mandatory. The merits of introducing a pro bono obligation are critically analysed by looking at the effect on both legal practitioners as well as those receiving the pro bono services. Having defined pro bono work, the practical need for pro bono work by lawyers in private practice is highlighted due to the dearth of legal aid in civil matters for indigent South Africans. Possible constitutional imperatives for the provision of free legal services in civil matters are highlighted. An important part of the paper is a reflection on some of the pro bono work being conducted by private firms of attorneys. The paper concludes with suggestions on means for establishing a more effective pro bono system in South Africa.

  8. Legal and Ethical Imperatives for Using Certified Sign Language Interpreters in Health Care Settings: How to "Do No Harm" When "It's (All) Greek" (Sign Language) to You.

    Science.gov (United States)

    Nonaka, Angela M

    2016-09-01

    Communication obstacles in health care settings adversely impact patient-practitioner interactions by impeding service efficiency, reducing mutual trust and satisfaction, or even endangering health outcomes. When interlocutors are separated by language, interpreters are required. The efficacy of interpreting, however, is constrained not just by interpreters' competence but also by health care providers' facility working with interpreters. Deaf individuals whose preferred form of communication is a signed language often encounter communicative barriers in health care settings. In those environments, signing Deaf people are entitled to equal communicative access via sign language interpreting services according to the Americans with Disabilities Act and Executive Order 13166, the Limited English Proficiency Initiative. Yet, litigation in states across the United States suggests that individual and institutional providers remain uncertain about their legal obligations to provide equal communicative access. This article discusses the legal and ethical imperatives for using professionally certified (vs. ad hoc) sign language interpreters in health care settings. First outlining the legal terrain governing provision of sign language interpreting services, the article then describes different types of "sign language" (e.g., American Sign Language vs. manually coded English) and different forms of "sign language interpreting" (e.g., interpretation vs. transliteration vs. translation; simultaneous vs. consecutive interpreting; individual vs. team interpreting). This is followed by reviews of the formal credentialing process and of specialized forms of sign language interpreting-that is, certified deaf interpreting, trilingual interpreting, and court interpreting. After discussing practical steps for contracting professional sign language interpreters and addressing ethical issues of confidentiality, this article concludes by offering suggestions for working more effectively

  9. Data Protection in Financial Technology Services (A Study in Indonesian Legal Perspective

    Directory of Open Access Journals (Sweden)

    Dian Purnama Anugerah

    2018-01-01

    Full Text Available The banking sector is facing a new competitor, namely Financial Technology (Fin-tech. Fin-tech itself can be described as an industry composed of companies using a new tech-nology and innovation with available resources in order to compete in the marketplace of tradi-tional financial institutions and intermediaries in the delivery of financial services. In Indonesia, Fin-tech has been widely developed since the past 3 years. Fin-tech faces a new challenge as a new service for financial consumer which adapts to new ways of living in modern digital tech-nology era. Basically, Fin-tech offers three main categories such as payment, personal finance, and financing. In financing application there are peer to peer financing, social crowd funding, and loan marketplace. All of these kinds of application have some issues in legal framework and data protection due to the use of communication technologies such as internet, social networks, Smartphone, massive use of data with the Big Data, connected objects, etc. The use of big data and those new technologies create new opportunities for these sectors, and this development also raises significant data protection concerns. This paper discusses two legal issues of Fin-tech, the legal aspect, and the data protection.

  10. [Legal aspects of delegation and reorganisation of medical services in the psychiatric field].

    Science.gov (United States)

    Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; Cohrs, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann

    2011-11-01

    Current psychiatric-psychotherapeutic in-patient care takes place in an area of tension between increasing treatment requirements and the persistent lack of qualified staff. The optimisation of the diagnostic-therapeutic procedures in a clinic helps to reduce existing care deficits or to generate resources for future developments. The subject of delegation and substitution of medical services is considered in this context. Inadequate knowledge of the legal situation on the part of the decision makers impairs the indispensable trustful cooperation among the professions and adds to the uncertainty of all those concerned. The present paper outlines the legal, organisational and health policy aspects of delegation and the reorganisation of medical activities in the field of psychiatry. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Revising Payment for Ecosystem Services in the Light of Stewardship: The Need for a Legal Framework

    Directory of Open Access Journals (Sweden)

    Alessandra Solazzo

    2015-11-01

    Full Text Available Since the Millennium Ecosystem Assessment (MEA highlighted the importance of ecosystem services for human well-being, the payments for such services have increasingly been drawing the attention of governments, the private sector and academia. Nonetheless, there is not yet a specific legal framework which is able to capture the complexity of managing natural resources and, at the same time, deal with the numerous drawbacks that have been identified by critics, who are opposed to using financialisation of the environment as a tool. This paper, after briefly summarizing some of the main features and criticisms of the Payment for Ecosystem Services (PES, will critically assess the understanding of property rights over natural resources as stewardship, rather than as entitlement, because this interpretation is more coherent with the inherent characteristics of natural resources and, consequently, of ecosystem services. The novel usage of a stewardship dimension to property rights underlines the necessity for a legal framework for PES, constituted by “property-liability rules”.

  12. Web service based system for generating input data sets

    International Nuclear Information System (INIS)

    Kralev, Velin; Kraleva, Radoslava

    2011-01-01

    This article deals with a three-layer architectural model of a distributed information system based on Web services, which will be used for automatic generation of sets of input data. The information system will be constructed of a client layer, a service layer and of a data layer. The web services as a tool of developing distributed software systems will be presented briefly. A web service and the implementation of its web methods will be described. A way to use the developed web methods in real application will be proposed. Keywords: web services

  13. Associations with legal representation in a compensation setting 12 months after injury.

    Science.gov (United States)

    Casey, Petrina P; Feyer, Anne Marie; Cameron, Ian D

    2015-05-01

    Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes. To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability. Inception cohort study. 246 people with WAD compensation claim. Legal involvement and Functional Rating Index at 12 months post injury. Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months. At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (pdisadvantage, have had a prior claim and a worse baseline health profile compared to those without a lawyer. Understanding this profile could allow for improved claims processes and targeted interventions to assist this group through any perceived complexities in the

  14. FINANCIAL SYSTEM OF JAPAN: THE LEGAL REGULATION OF DISPUTES BETWEEN FINANCIAL SERVICES PROVIDERS AND CONSUMERS

    Directory of Open Access Journals (Sweden)

    E. E. Frolova

    2018-01-01

    Full Text Available Purpose: the article examines the main problems associated the regulatory acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The  Insurance Business Act, lists the types of financial disputes subject to alternative settlement, identified the parties to the financial dispute. To achieve this goal, the article must solve the following tasks: to determine whether there are institutions in Japan that provide services for resolving financial disputes; to investigate the main problems associated with the definition of the concept and types of financial dispute, the conditions for the transfer of a financial dispute to the competent authority.Methods: this article is based on an interdisciplinary concept of research, which allowed to distinguish the distinctive features of the legal regulation of the settlement of financial disputes in Malaysia.Results: acts of Japan – The Financial Instruments and Exchange Act, The Banking Act, The Insurance Business Act, – refer to financial disputes – disputes resolved by "Designated Dispute Resolution Organizations", the so-called "financial DDRO". Financial disputes are disputes between suppliers and consumers of financial services. The Financial Instruments and Exchange Act details the persons, whose activities fall within the definition of financial provider services. A brief list of financial service providers is available on the website of Japan's main financial regulator, the Financial Services Agency. The list include: Japanese banking institutions, branches and representative offices of foreign banks, business operators of financial instruments, insurance companies, trust companies, financial markets, foreign audit firms. However, unlike other countries of the Asia-Pacific region, consumers of financial services can be both physical and legal entities.Conclusions and Relevance: the materials presented in the article show the special role of "Designated Dispute Resolution

  15. Health Care Professionals’ Knowledge and Attitudes About Sexually Transmitted Diseases and Legal Aspects of Medical Services

    Directory of Open Access Journals (Sweden)

    Akpak Yaşam Kemal

    2016-01-01

    Full Text Available Objective: This study aims to investigate healthcare professionals’ (HCPs general level of knowledge about sexually transmitted diseases, their attitudes towards these patients and legal aspects of medical services. Materials and Methods: This was a multi-centered study. The participants were given 28 questions that mainly asked their level of knowledge on sexually transmitted diseases (STDs patients, their attitudes towards such patients, and their legal as well as ethical views on them. Results: A total of 234 HCPs, 124 (53% female and 110 (47% male, participated in the study. The majority of married HCPs have reported monogamy as the most reliable protection method, whereas single participants have marked "condoms." The most commonly known STD has been reported as AIDS in all groups. Even though HCPs find it medically unethical not to offer a medical intervention to patients with STDs, more than one-third of the participants believe that HCPs should have the right not to do so. Conclusion: It has been concluded that HCPs need further education on STDs. Nevertheless, such high level of care and attention on HCPs’ part does not necessarily decrease their need for proper medico legal regulations on such issues.

  16. Developing a business-practice model for pharmacy services in ambulatory settings.

    Science.gov (United States)

    Harris, Ila M; Baker, Ed; Berry, Tricia M; Halloran, Mary Ann; Lindauer, Kathleen; Ragucci, Kelly R; McGivney, Melissa Somma; Taylor, A Thomas; Haines, Stuart T

    2008-02-01

    A business-practice model is a guide, or toolkit, to assist managers and clinical pharmacy practitioners in the exploration, proposal, development and implementation of new clinical pharmacy services and/or the enhancement of existing services. This document was developed by the American College of Clinical Pharmacy Task Force on Ambulatory Practice to assist clinical pharmacy practitioners and administrators in the development of business-practice models for new and existing clinical pharmacy services in ambulatory settings. This document provides detailed instructions, examples, and resources on conducting a market assessment and a needs assessment, types of clinical services, operations, legal and regulatory issues, marketing and promotion, service development and exit plan, evaluation of service outcomes, and financial considerations in the development of a clinical pharmacy service in the ambulatory environment. Available literature is summarized, and an appendix provides valuable citations and resources. As ambulatory care practices continue to evolve, there will be increased knowledge of how to initiate and expand the services. This document is intended to serve as an essential resource to assist in the growth and development of clinical pharmacy services in the ambulatory environment.

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

    Science.gov (United States)

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

    2016-03-11

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

  18. Legal and regulatory aspects of optimization comprehensive support service and combat activity of the Security service of Ukraine and the National guard of Ukraine emergency social situation

    Directory of Open Access Journals (Sweden)

    В. В. Мацюк

    2015-05-01

    Full Text Available Problem setting. The status of comprehensive support of military units in the world’s leading powers is considered to be one of the key factors which defines the success of the social emergency settling operations. The experience of service and military application of the National Guard of Ukraine in the anti-terrorist operation zone on the South-East of Ukraine shows that emergency response tasks are generally carried out in cooperation with other Ukrainian security sector authorities, mostly with the Security Service of Ukraine. However, the forces joint managing authority chiefs usually do not cover the matter of such activities’ comprehensive support, which forces the commanders of the military units to rely on themselves in this question. Recent research and publications analysis. The analysis of research of status and development prospects of the comprehensive support of the Armed Forces of Ukraine, other security authorities, armies of the world’s leading powers, peculiarities of creation and functioning of such systems, application of their means and powers, scientific thought on the problems of service and military application of the National Guard units has shown the problematic tasks of the joint unit comprehensive support system optimization. Therefore, the question of regulatory and legal support of this process is of current importance. Paper objective. The objective of this paper is to define regulatory and legal aspects of comprehensive support optimization of the Security Service of Ukraine and the National Guard of Ukraine service and combat activities during social emergencies. Paper main body. According to the current legislation, comprehensive support comprises of the following types of support: operative (also called military, moral and psychological, materiel (logistical. All other types of support are parts of these three basic ones. Their examination is necessary due to the fact, that there is confusion in the

  19. Goal setting with mothers in child development services.

    Science.gov (United States)

    Forsingdal, S; St John, W; Miller, V; Harvey, A; Wearne, P

    2014-07-01

    The aim of this grounded theory study was to explore mothers' perspectives of the processes of collaborative goal setting in multidisciplinary child development services involving follow-up home therapy. Semi-structured interviews were conducted in South East Queensland, Australia with 14 mothers of children aged 3-6 years who were accessing multidisciplinary child development services. Interviews were focussed around the process of goal setting. A grounded theory of Maternal Roles in Goal Setting (The M-RIGS Model) was developed from analysis of data. Mothers assumed Dependent, Active Participator and Collaborator roles when engaging with the therapist in goal-setting processes. These roles were characterized by the mother's level of dependence on the therapist and insight into their child's needs and therapy processes. Goal Factors, Parent Factors and Therapist Factors influenced and added complexity to the goal-setting process. The M-RIGS Model highlights that mothers take on a range of roles in the goal-setting process. Although family-centred practice encourages negotiation and collaborative goal setting, parents may not always be ready to take on highly collaborative roles. Better understanding of parent roles, goal-setting processes and influencing factors will inform better engagement with families accessing multidisciplinary child development services. © 2013 John Wiley & Sons Ltd.

  20. Gas industry standards board: Legal considerations in the standard setting process

    Energy Technology Data Exchange (ETDEWEB)

    Mishkin, M.T.; Adelman, D.I.

    1994-01-01

    On December 23, 1993, the Federal Energy Regulatory Commission (FERC) issued Order 563, a Final Rule adopting the agreements of informal industry-wide working groups to standardize information relating to pipeline capacity release programs mandated under Order 636. Order 563 is noteworthy for its reliance upon the industry to develop consensus standards for Commission adoption. The industry's success in reaching agreements on key communication standards issues spawned recommendations from the working groups to continue the development and maintenance of industry-wide standards through a permanent Gas Industry Standards Board (GISB). This article examines legal issues bearing on GISB's potential role in the regulatory process. Specifically, this article addresses constitutional and statutory considerations relating to the FERC's authority to delegate certain responsibilities to a voluntary, industry sponsored and supported private body such as that taking shape within the gas industry.

  1. Patient characteristics and service trends following abortion legalization in Mexico City, 2007-10.

    Science.gov (United States)

    Mondragón y Kalb, Manuel; Ahued Ortega, Armando; Morales Velazquez, Jorge; Díaz Olavarrieta, Claudia; Valencia Rodríguez, Jorge; Becker, Davida; García, Sandra G

    2011-09-01

    Legal abortion services have been available in public and private health facilities in Mexico City since April 2007 for pregnancies of up to 12 weeks gestation. As of January 2011, more than 50,000 procedures have been performed by Ministry of Health hospitals and clinics. We researched trends in service users' characteristics, types of procedures performed, post-procedure complications, repeat abortions, and postabortion uptake of contraception in 15 designated hospitals from April 2007 to March 2010. The trend in procedures has been toward more medication and manual vacuum aspiration abortions and fewer done through dilation and curettage. Percentages of post-procedure complications and repeat abortions remain low (2.3 and 0.9 percent, respectively). Uptake of postabortion contraception has increased over time; 85 percent of women selected a method in 2009-10, compared with 73 percent in 2007-08. Our findings indicate that the Ministry of Health's program provides safe services that contribute to the prevention of repeat unintended pregnancies.

  2. AGILE: a methodology for Advanced Governance of Information services through Legal Engineering

    NARCIS (Netherlands)

    Boer, A.; Sileno, G.

    2013-01-01

    To address agility in public administration, the Agile project developed a reference knowledge acquisition infrastructure for legal knowledge, based on a dynamic and design-oriented conceptualization of the legal system. The main objective of the project was to reframe legal knowledge as a knowledge

  3. Inpatient forensic-psychiatric care: Legal frameworks and service provision in three European countries.

    Science.gov (United States)

    Edworthy, Rachel; Sampson, Stephanie; Völlm, Birgit

    2016-01-01

    Laws governing the detention and treatment of mentally disordered offenders (MDOs) vary widely across Europe, yet little information is available about the features of these laws and their comparative advantages and disadvantages. The purpose of this article is to compare the legal framework governing detention in forensic psychiatric care in three European countries with long-established services for MDOs, England, Germany and the Netherlands. A literature review was conducted alongside consultation with experts from each country. We found that the three countries differ in several areas, including criteria for admission, review of detention, discharge process, the concept of criminal responsibility, service provision and treatment philosophy. Our findings suggest a profound difference in how each country relates to MDOs, with each approach contributing to different pathways and potentially different outcomes for the individual. Hopefully making these comparisons will stimulate debate and knowledge exchange on an international level to aid future research and the development of best practice in managing this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Using Critical Literacy to Explore Genetics and Its Ethical, Legal, and Social Issues with In-Service Secondary Teachers

    Science.gov (United States)

    Gleason, Michael L.; Melancon, Megan E.; Kleine, Karynne L. M.

    2010-01-01

    The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by…

  5. 31 CFR 538.505 - Provision of certain legal services to the Government of Sudan, persons in Sudan, or benefitting...

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Provision of certain legal services... Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL... receipt, from unblocked sources, of payment of professional fees and reimbursement of incurred expenses...

  6. The Legal Past, Present and Future of Prenatal Genetic Testing: Professional Liability and Other Legal Challenges Affecting Patient Access to Services

    Directory of Open Access Journals (Sweden)

    Deborah Pergament

    2014-12-01

    Full Text Available This chapter is an overview of the current status of the law in the United States regarding prenatal genetic testing with an emphasis on issues related to professional liability and other challenges affecting patient access to prenatal genetic testing. The chapter discusses the roles that federal regulations, promulgated by the Centers for Medicare and Medicaid Services (CMS, the Food and Drug Administration (FDA and the Federal Trade Commission (FTC, play in the regulation of prenatal genetic tests. The chapter discusses tort litigation based on allegations of malpractice in the provision of prenatal genetic testing and how courts have analyzed issues related to causation, damages and mitigation of damages. The chapter provides reference information regarding how individual states address causes of action under the tort theories of wrongful birth and wrongful life. The chapter concludes with a discussion of future legal issues that may affect clinical prenatal genetic testing services arising from the continued expansion of prenatal genetic testing, legal restrictions on access to abortion and the potential development of embryonic treatments.

  7. Apology in the criminal justice setting: evidence for including apology as an additional component in the legal system.

    Science.gov (United States)

    Petrucci, Carrie J

    2002-01-01

    The criminal justice system has reached unprecedented scope in the United States, with over 6.4 million people under some type of supervision. Remedies that have the potential to reduce this number are continually being sought. This article analyzes an innovative strategy currently being reconsidered in criminal justice: the apology. Despite a legal system that only sporadically acknowledges it, evidence for the use of apology is supported by social science research, current criminal justice theories, case law, and empirical studies. Social psychological, sociological and socio-legal studies pinpoint the elements and function of apology, what makes apologies effective, and concerns about apology if it were implemented in the criminal justice system. Theoretical evidence is examined (including restorative justice, therapeutic jurisprudence, crime, shame, and reintegration) to explore the process of apology in the criminal justice context. Attribution theory and social conduct theory are used to explain the apology process specifically for victims and offenders. A brief examination of case law reveals that though apology has no formal place in criminal law, it has surfaced recently under the federal sentencing guidelines. Finally, empirical evidence in criminal justice settings reveals that offenders want to apologize and victims desire an apology. Moreover, by directly addressing the harmful act, apology may be the link to reduced recidivism for offenders, as well as empowerment for victims. This evidence combined suggests that apology is worthy of further study as a potentially valuable addition to the criminal justice process. Copyright 2002 John Wiley & Sons, Ltd.

  8. Choosing and Paying for Legal Services: There Is a Way To Get and Pay for What You Need and Can Afford!

    Science.gov (United States)

    Geiger, Philip E.; Cantelme, David

    2002-01-01

    Discusses pros and cons of various methods of compensating an attorney or law firm for legal services: Hourly fee; retainer and hourly fee; long-term or annual contract; retainer, fees, and benefits; capped fees; and expenses and reimbursements. Includes brief questionnaire to determine legal services needed and wanted by a school district. (PKP)

  9. Ethical, legal and professional issues arising from social media coverage by UK Helicopter Emergency Medical Services.

    Science.gov (United States)

    Steele, Sarah; Adcock, Christopher; Steel, Alistair

    2016-01-01

    Social media (SoMe) are gaining increasing acceptance among, and use by, healthcare service deliverers and workers. UK Helicopter Emergency Medical Services (HEMS) use SoMe to deliver service information and to fundraise, among other purposes. This article examines UK HEMS use of SoMe between January and February 2014 to determine the extent of adoption and to highlight trends in use. The database of the Association of Air Ambulances, crosschecked with UK Emergency Aviation, was used to identify flying, charitable UK HEMS. This search identified 28 UK HEMS, of which 24 services met the criteria for selection for review. Using information harvested from the public domain, we then systematically documented SoMe use by the services. SoMe use by UK HEMS is extensive but not uniform. All selected UK HEMS maintained websites with blogs, as well as Facebook, Twitter, Wikipedia and JustGiving profiles, with the majority of services using Ebay for Charity, LinkedIn and YouTube. Some HEMS also held a presence on Pinterest, Google+, Instagram and Flickr, with a minority of services maintaining their own Rich Site Summary (RSS) feed. The SoMe adopted, while varied, allowed for increased, and different forms of, information delivery by HEMS to the public, often in real time. Such use, though, risks breaching patient confidentiality and data protection requirements, especially when information is viewed cumulatively across platforms. There is an urgent need for the continued development of guidance in this unique setting to protect patients while UK HEMS promote and fundraise for their charitable activities. 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/

  10. Some New Ideas on the Role of Legal Analysis applied to the Regulation of Telecommunications Services in Brazil

    Directory of Open Access Journals (Sweden)

    Marcus Faro de Castro

    2016-08-01

    Full Text Available Purpose – The paper aims to present new ideas and analytical approaches developed in recent years by Brazilian legal scholars regarding regulation and economic development. Regulatory law of telecommunications services is taken as an example of application of such new ideas and analytical approaches. Methodology/approach/design – Two main approaches to the relationship between law and economic issues are described: the New Law and Development (NLD approach and the Legal Analysis of Economic Policy (LAEP perspective. The paper highlights prominent ideas of each perspective. Findings – The paper shows that there are structured ideas available in recent Brazilian legal literature which have a non-negligible potential of being explored in legal discussions and analyses of economic policy and regulatory issues of many sectors of emerging economies, including the telecommunications industry. Originality/value – The paper offers valuable contributions that may help in efforts to enhance and innovate the role of legal expertise in the regulatory process of several economic sectors, including the telecommunications sector.

  11. FACTORS INFLUENCING CUSTOMERS’ BEHAVIOUR TOWARDS TRUSTED SERVICE PROVIDERS: AN INVESTIGATION OF FOUR SERVICE SETTINGS

    Directory of Open Access Journals (Sweden)

    Gurau Calin

    2013-07-01

    20 minutes, and the respondents being randomly selected from the waiting areas of five UK supermarkets. The collected data has been analysed with the SPSS software, using the Chi Square and Pearson’s two-tailed correlation tests. The results indicate a complex relationship between various categories of factors and the level of customer loyalty, which varies in relation to specific service settings. The findings have been integrated into a synthetic model, developed for four different types of services.

  12. Law of the electricity sector in France. The legal framework for the French electricity supply between legal market deregulation requirements and public service obligations

    International Nuclear Information System (INIS)

    Buckler, Julius

    2016-01-01

    The process of creating an internal electricity market is still unfinished. This has, in addition to technical reasons, also legal reasons: The persistence of the structures and regulatory frameworks that have grown during monopoly times, in part is very strong, which is particularly evident in France. The power supply there is intensively controlled by its state as a public service, both indirectly by the state-owned company EDF and directly by statutory regulations. The market deregulation is not thereby completely prevented. However, together with the particular importance of nuclear power for the French power supply, considerable barriers to market opening are emerging. Against this background and out of the historical development, the author examines the current French law of the electricity sector across all value-creation stages in its relations to EU law. [de

  13. Legal and ethical standards for protecting women's human rights and the practice of conscientious objection in reproductive healthcare settings.

    Science.gov (United States)

    Zampas, Christina

    2013-12-01

    The practice of conscientious objection by healthcare workers is growing across the globe. It is most common in reproductive healthcare settings because of the religious or moral values placed on beliefs as to when life begins. It is often invoked in the context of abortion and contraceptive services, including the provision of information related to such services. Few states adequately regulate the practice, leading to denial of access to lawful reproductive healthcare services and violations of fundamental human rights. International ethical, health, and human rights standards have recently attempted to address these challenges by harmonizing the practice of conscientious objection with women's right to sexual and reproductive health services. FIGO ethical standards have had an important role in influencing human rights development in this area. They consider regulation of the unfettered use of conscientious objection essential to the realization of sexual and reproductive rights. Under international human rights law, states have a positive obligation to act in this regard. While ethical and human rights standards regarding this issue are growing, they do not yet exhaustively cover all the situations in which women's health and human rights are in jeopardy because of the practice. The present article sets forth existing ethical and human rights standards on the issue and illustrates the need for further development and clarity on balancing these rights and interests. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. The Influence of Immigrant Parent Legal Status on U.S.-Born Children's Academic Abilities: The Moderating Effects of Social Service Use

    Science.gov (United States)

    Brabeck, Kalina M.; Sibley, Erin; Taubin, Patricia; Murcia, Angela

    2016-01-01

    The present study investigated the relationship between immigrant parent legal status and academic performance among U.S.-born children, ages 7-10. Building on previous research and a social ecological framework, the study further explored how social service use moderates the relationship between parent legal status and academic performance.…

  15. Legal Protections in Public Accommodations Settings: A Critical Public Health Issue for Transgender and Gender-Nonconforming People.

    Science.gov (United States)

    Reisner, Sari L; Hughto, Jaclyn M White; Dunham, Emilia E; Heflin, Katherine J; Begenyi, Jesse Blue Glass; Coffey-Esquivel, Julia; Cahill, Sean

    2015-09-01

    Since 2012, Massachusetts law has provided legal protections against discrimination on the basis of gender identity in employment, housing, credit, public education, and hate crimes. The law does not protect against discrimination based on gender identity in public accommodations settings such as transportation, retail stores, restaurants, health care facilities, and bathrooms. A 2013 survey of Massachusetts transgender and other gender minority adults found that in the past 12 months, 65% had experienced public accommodations discrimination since the law was passed. This discrimination was associated with a greater risk of adverse emotional and physical symptoms in the past 30 days. Nondiscrimination laws inclusive of gender identity should protect against discrimination in public accommodations settings to support transgender people's health and their ability to access health care. Gender minority people who are transgender or gender nonconforming experience widespread discrimination and health inequities. Since 2012, Massachusetts law has provided protections against discrimination on the basis of gender identity in employment, housing, credit, public education, and hate crimes. The law does not, however, protect against discrimination in public accommodations (eg, hospitals, health centers, transportation, nursing homes, supermarkets, retail establishments). For this article, we examined the frequency and health correlates of public accommodations discrimination among gender minority adults in Massachusetts, with attention to discrimination in health care settings. In 2013, we recruited a community-based sample (n = 452) both online and in person. The respondents completed a 1-time, electronic survey assessing demographics, health, health care utilization, and discrimination in public accommodations venues in the past 12 months. Using adjusted multivariable logistic regression models, we examined whether experiencing public accommodations discrimination in

  16. The US Public Health Service "treating tobacco use and dependence clinical practice guidelines" as a legal standard of care.

    Science.gov (United States)

    Torrijos, Randy M; Glantz, Stanton A

    2006-12-01

    The important factors in evaluating the role of clinical practice guidelines (CPGs) in medical malpractice litigation have been discussed for several years, but have focused on broad policy implications rather than on a concrete example of how an actual guideline might be evaluated. There are four items that need to be considered in negligence torts: legal duty, a breach of that duty, causal relationship between breach and injury, and damages. To identify the arguments related to legal duty. The Treating Tobacco Use and Dependence (revised 2000) CPG, sponsored by the US Public Health Service, recommends effective and inexpensive treatments for nicotine addiction, the largest preventable cause of death in the US, and can be used as an example to focus on important considerations about the appropriateness of CPGs in the judicial system. Furthermore, the failure of many doctors and hospitals to deal with tobacco use and dependence raises the question of whether this failure could be considered malpractice, given the Public Health Service guideline's straightforward recommendations, their efficacy in preventing serious disease and cost-effectiveness. Although each case of medical malpractice depends on a multitude of factors unique to individual cases, a court could have sufficient basis to find that the failure to adequately treat the main cause of preventable disease and death in the US qualifies as a violation of the legal duty that doctors and hospitals owe to patients habituated to tobacco use and dependence.

  17. 7 CFR 1717.611 - RUS approval of expenditures for legal, accounting, engineering, and supervisory services.

    Science.gov (United States)

    2010-01-01

    ..., supervisory (other than for the management and operation of the borrower's electric system, see § 1717.608(d... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS approval of expenditures for legal, accounting... COMMON TO INSURED AND GUARANTEED ELECTRIC LOANS Operational Controls § 1717.611 RUS approval of...

  18. [Blood transfusion in emergency settings: French military health service experience].

    Science.gov (United States)

    Sailliol, A; Ausset, S; Peytel, E

    2010-12-01

    Blood transfusion is required in a number of emergency settings and the French military health service (FMHS) has issued specific guidelines for the treatment of war casualties. These guidelines take into account European standards and laws, NATO standards, and also public sentiment regarding transfusion. These guidelines reflect a determination to control the process and to avoid the improvisation frequently associated with wartime transfusion. The evolution in warfare (terrorism and bombing more frequent than gunshot) and the wide use of body armor have deeply changed the clinical presentation of war injuries. These now involve the extremities in 80% of cases, with extensive tissue damage and heavy blood loss. The FMHS recommends that war casualties with hemorrhagic shock be brought quickly to a medical treatment facility (MTF) after first-line treatment applied through buddy aid or by medics. In the MTF, before an early Medevac, a damage control surgery will be performed, with resuscitation using freeze-dried plasma, red blood cells and fresh whole blood. The French military blood bank is responsible for blood product supply, training and medical advice regarding transfusion therapy during wartime, as well as hemovigilance. All transfusion therapy practices are periodically assessed but research on whole blood pathogen reduction is being conducted in order to reduce the residual infectious risk associated with this product. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. Mental Health Services, Free Appropriate Public Education, and Students with Disabilities: Legal Considerations in Identifying, Evaluating, and Providing Services

    Science.gov (United States)

    Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey

    2018-01-01

    In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…

  20. The relative importance of service dimensions in a healthcare setting.

    Science.gov (United States)

    Ramsaran-Fowdar, Rooma Roshnee

    2008-01-01

    The paper aims to focus on an augmented SERVQUAL instrument that was used to measure private patients' service expectations and perceptions. A questionnaire was administered to 750 and 34 per cent responded. A new service quality instrument called PRIVHEALTHQUAL emerged from the study, based on factor and reliability analysis. The "reliability and fair and equitable treatment" factor was found to be the most important healthcare service quality dimension. Adds to the existing body of research on service quality and demonstrates that SERVQUAL is not a generic service quality measure for all industries.

  1. Regulation and price setting of pilotage services in Brazil

    OpenAIRE

    Marcos M O Pinto; David J K Goldberg; Bruno Stupello; Christopher W Haley

    2010-01-01

    The Ministry of Ports (SEP) was created in 2007 to improve the efficiency of Brazilian maritime ports and boost international trade. One of the most important and challenging issues that SEP has been dealing with is the pilotage service provision. Although recognized as of good quality, the service is considered to be too expensive and unregulated. This article's objective is to demonstrate that the Brazilian monopolistic and unregulated model is not suitable for a public utility service such...

  2. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study.

    Science.gov (United States)

    Gault, Iris; Gallagher, Ann; Chambers, Mary

    2013-01-01

    To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context. Mental health medication adherence is considered problematic and legal coercion exists in many countries. This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible). Eighteen mental health service users (and six caregivers) with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England. Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers. The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication. This study investigated service user and caregiver perceptions of medication adherence and compulsory treatment. Participants described a process perceived as variable and potentially doubly faceted. The behavior of professionals was seen as crucial in collaborative decision making on medication adherence.

  3. European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe

    DEFF Research Database (Denmark)

    Mangin, P; Bonbled, F; Väli, M

    2015-01-01

    in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance...... process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i...

  4. Identifying mental health services in clinical genetic settings.

    Science.gov (United States)

    Cappelli, M; Esplen, M J; Wilson, B J; Dorval, M; Bottorff, J L; Ly, M; Carroll, J C; Allanson, J; Humphreys, E; Rayson, D

    2009-10-01

    The purpose of this study was to examine the mental health needs of individuals at risk for adult onset hereditary disorder (AOHD) from the perspective of their genetic service providers, as it is unknown to what extent psychosocial services are required and being met. A mail-out survey was sent to 281 providers on the membership lists of the Canadian Association of Genetic Counsellors and the Canadian College of Medical Geneticists. The survey assessed psychosocial issues that were most commonly observed by geneticists, genetic counsellors (GCs), and nurses as well as availability and types of psychosocial services offered. Of the 129 respondents, half of genetic service providers reported observing signs of depression and anxiety, while 44% noted patients' concerns regarding relationships with family and friends. In terms of providing counselling to patients, as the level of psychological risk increased, confidence in dealing with these issues decreased. In addition, significantly more GCs reported that further training in psychosocial issues would be most beneficial to them if resources were available. As a feature of patient care, it is recommended that gene-based predictive testing include an integrative model of psychosocial services as well as training for genetic service providers in specific areas of AOHD mental health.

  5. Delivering social work services in collaboration with the legal representation for individual clients: An effective, ethical and economical approach to supporting families in child abuse and neglect legal proceedings.

    Science.gov (United States)

    Pott, Robbin

    2017-11-01

    This article discusses the need to improve the quality of helping relationships between families and social workers in the child protection system and the growing body of evidence that teams of social workers and lawyers are effective at improving outcomes in child protection legal proceedings. The author presents an alternative structure of delivering social work services within the child protection systems once a court gets involved with a family, proposing that social workers should focus on individual clients in collaboration with their legal representation, rather than the traditional model of a governmental agency social worker serving the family as a unit as it also determines placement of the children. Pairing the social worker to an individual client in tandem with their legal representative would help resolve the widely observed relationship problems between service users and governmental agency social workers that include the power imbalance created by the agency's authority to determine placement of children, the conflicts of interest that agency workers face when required to manage differing family members' needs, and the lack of protection of the due process right of confidentiality for parties involved in legal proceedings. This alternative structure also impacts the need to use resources more efficiently and has been demonstrated to result in substantial returns on investment. This article concludes that when a family becomes involved in child abuse and neglect legal proceedings, the child welfare agency should shift the delivery of social work services to the individual parties, away from the governmental agency and in conjunction with their legal representation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Setting up and Running a Sharing Service: an Organisational Perspective

    Directory of Open Access Journals (Sweden)

    Naemi Luckner

    2015-05-01

    Full Text Available Enabled by web and mobile technologies, there has been an explosion of interest in the sharing economy and peer-to-peer exchange, with much high profile attention given to monetised exchanges such as in AirBnB and Uber. However there are also many other sharing initiatives, such as time banking, that focus on smaller, more local communities and do not involve monetisation of exchanges. While there is a growing body of literature elaborating participation and motivation in sharing services as well as analysing organisers’ roles, little is discussed about the work involved in the day-to-day organisation and management of such services. In this paper we report on an interview study with ten participants discussing five different sharing systems from three different countries. A qualitative thematic analysis of the data points to significant on-going effort reported by all to establish, maintain and grow a service, not only focussing on its practical aspects but also on growing a community and building trust. How they engaged in this practical work though was not so much shaped by the service model (time banking, LETS and so on but on a complex relationship between their funding model, the service goal and whether it was a top-down or bottom-up initiative. These findings have implications for the design of technical platforms to support services, not just in elaborating a range of possible tasks to be supported but also in where and how it needs to be tailorable to certain needs, how adaptive it is to different service models and how it facilitates monitoring and reporting duties for organisers.

  7. Setting up recovery clinics and promoting service user involvement.

    Science.gov (United States)

    John, Thomas

    2017-06-22

    Service user involvement in mental health has gained considerable momentum. Evidence from the literature suggests that it remains largely theoretical rather than being put into practice. The current nature of acute inpatient mental health units creates various challenges for nurses to put this concept into practice. Recovery clinics were introduced to bridge this gap and to promote service user involvement practice within the current care delivery model at Kent and Medway NHS and Social Care Partnership Trust. It has shaped new ways of working for nurses with a person-centred approach as its philosophy. Service users and nurses were involved in implementing a needs-led and bottom-up initiative using Kotter's change model. Initial results suggest that it has been successful in meeting its objectives evidenced through increased meaningful interactions and involvement in care by service users and carers. The clinics have gained wide recognition and have highlighted a need for further research into care delivery models to promote service user involvement in these units.

  8. Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.

    Science.gov (United States)

    Langer, David A; Wood, Jeffrey J; Wood, Patricia A; Garland, Ann F; Landsverk, John; Hough, Richard L

    2015-09-01

    Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need-services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual's mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had had an active case in one of two public sectors of care, comparing empirically-derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.

  9. Social media in the health-care setting: benefits but also a minefield of compliance and other legal issues.

    Science.gov (United States)

    Moses, Richard E; McNeese, Libra G; Feld, Lauren D; Feld, Andrew D

    2014-08-01

    Throughout the past 20 years, the rising use of social media has revolutionized health care as well as other businesses. It allows large groups of people to create and share information, ideas, and experiences through online communications, and develop social and professional contacts easily and inexpensively. Our Gastroenterology organizations, among others, have embraced this technology. Although the health-care benefits may be many, social media must be viewed through a legal lens, recognizing the accompanying burdens of compliance, ethical, and litigation issues. Theories of liability and risk continue to evolve as does the technology. Social media usage within the medical community is fraught with potential legal issues, requiring remedial responses to meet patients' needs and comply with current laws, while not exposing physicians to medical malpractice and other tort risks.

  10. Improving Services for Women with Depression in Primary Care Settings

    Science.gov (United States)

    Katon, Wayne J.; Ludman, Evette J.

    2003-01-01

    Women have a higher prevalence of depressive disorders compared to men. The current system of care for women with depressive disorders provides significant financial barriers for patients with lower incomes to access mental health services. Primary care systems are used extensively by women and have the potential to diagnose patients at early…

  11. 78 FR 67218 - Senior Executive Service; Legal Division Performance Review Board

    Science.gov (United States)

    2013-11-08

    ..., Benefits Tax Counsel; Himamauli Das, Assistant General Counsel (International Affairs); Margaret Depue... Revenue Service; Lee Kelley, Deputy Benefits Tax Counsel; Robert Neis, Associate Benefits Tax Counsel; Danielle Rolfes, International Tax Counsel; Daniel P. Shaver, Chief Counsel, United States Mint; Brian...

  12. IMPORTANCE OF THE STABILITY OF LEGAL SYSTEM FOR THE SUCCESSFUL MANAGING OF A STRUCTURE OF MEDICAL SERVICES COMPANIES

    Directory of Open Access Journals (Sweden)

    Mariela Deliverska

    2017-02-01

    Full Text Available The process of introduction into our national legislation of norms of the European union legislation has a direct impact on the process of realization of major activities in all spheres of the public life and the activities related to medical services are not an exception. The management of activities, connected to provision of medical services, requires attention to be paid not only to the competitive environment, but also to the normative requirements, regulating the access of the citizens to medical aid. When talking about healthcare and healthcare market, it should be noted that good healthcare is possible only where there is good civil society and strong traditions in the field of social insurance. The new requirements introduced in the way of functioning of the healthcare system aim to provide improved human health, however simultaneously the adaptation of the system to the new legally regulated requirements should be implemented in a way, which guarantees fast and easy access to healthcare services for all patients.

  13. Data Protection in Financial Technology Services (A Study in Indonesian Legal Perspective)

    OpenAIRE

    Dian Purnama Anugerah; Masitoh Indriani

    2018-01-01

    The banking sector is facing a new competitor, namely Financial Technology (Fin-tech). Fin-tech itself can be described as an industry composed of companies using a new tech-nology and innovation with available resources in order to compete in the marketplace of tradi-tional financial institutions and intermediaries in the delivery of financial services. In Indonesia, Fin-tech has been widely developed since the past 3 years. Fin-tech faces a new challenge as a new service for financial consu...

  14. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services.

    Science.gov (United States)

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-03-04

    Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers' access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers' control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services - including peer interventions, condom promotion and STI screening - would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for

  15. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    Science.gov (United States)

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-01-01

    Introduction Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. Results We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are

  16. Perceptions of legally mandated public involvement processes in the U.S. Forest Service

    Science.gov (United States)

    S. Andrew Predmore; Marc J. Stern; Michael J. Mortimer; David N. Seesholtz

    2011-01-01

    Results from an agency-wide survey of U.S. Forest Service personnel indicate that respondents in our sample engage in National Environmental Policy Act (NEPA) public involvement processes primarily to accomplish two goals. The most commonly supported goal was to inform and disclose as mandated by the act. The other goal reflected interests in managing agency...

  17. Perspectives on medicine adherence in service users and carers with experience of legally sanctioned detention and medication: a qualitative study

    Directory of Open Access Journals (Sweden)

    Chambers M

    2013-08-01

    Full Text Available Iris Gault,1 Ann Gallagher,2 Mary Chambers31Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, Kingston, Surrey, UK; 2International Centre for Nursing Ethics, School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK; 3Faculty of Health and Social Care Sciences, Kingston University and St George's University of London, St George's University of London, Tooting, London, UKAim: To explore and analyze perceptions of service users and caregivers on adherence and nonadherence to medication in a mental health care context.Background: Mental health medication adherence is considered problematic and legal coercion exists in many countries.Design: This was a qualitative study aiming to explore perceptions of medication adherence from the perspective of the service user (and their caregiver, where possible.Participants: Eighteen mental health service users (and six caregivers with histories of medication nonadherence and repeated compulsory admission were recruited from voluntary sector support groups in England.Methods: Data were collected between 2008 and 2010. Using qualitative coding techniques, the study analyzed interview and focus group data from service users, previously subjected to compulsory medication under mental health law, or their caregivers.Results: The process of medication adherence or nonadherence is encapsulated in an explanatory narrative. This narrative constitutes participants' struggle to negotiate acceptable and effective routes through variable quality of care. Results indicated that service users and caregivers eventually accepted the reality of their own mental illness and their need for safety and treatment. They perceived the behavior of professionals as key in their recovery process. Professionals could be enabling or disabling with regard to adherence to medication.Conclusion: This study investigated service user

  18. Religion-Related Child Maltreatment: A Profile of Cases Encountered by Legal and Social Service Agencies.

    Science.gov (United States)

    Bottoms, Bette L; Goodman, Gail S; Tolou-Shams, Marina; Diviak, Kathleen R; Shaver, Phillip R

    2015-08-01

    Religion can foster, facilitate, and be used to justify child maltreatment. Yet religion-related child abuse and neglect have received little attention from social scientists. We examined 249 cases of religion-related child maltreatment reported to social service agencies, police departments, and prosecutors' offices nationwide. We focused on cases involving maltreatment perpetrated by persons with religious authority, such as ministers and priests; the withholding of medical care for religious reasons; and abusive attempts to rid a child of supposed evil. By providing a descriptive statistical profile of the major features of these cases, we illustrate how these varieties of religion-related child maltreatment occur, who the victims and perpetrators are, and how religion-related child abuse and neglect are reported and processed by the social service and criminal justice systems. We end with a call for greater research attention to these important offenses against children. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Capturing reimbursement for advanced practice nurse services in acute and critical care: legal and business considerations.

    Science.gov (United States)

    Buppert, Carolyn

    2005-01-01

    Advanced practice nurses (APNs) have been affected positively and negatively by recent changes in the way hospitals are financed. Among these changes are the shift from cost-based reimbursement to a prospective payment system and increased opportunities for billing APN services under the physician payment system. Positive effects include the need for hospitals to decrease the length of stay of hospitalized patients, leading to jobs for APNs who make the hospital course and discharge more efficient. Negative effects include budget shortfalls that lead to layoffs. This article explains the current financial landscape, including phenomena that are impeding the billing of APN services, and recommends adjustments so that the APN role will be on firm financial footing.

  20. EMERGING TRENDS IN TRADING OF GOODS AND SERVICES- E COMMERCE: TECHNICAL AND LEGAL ISSUES

    OpenAIRE

    Dr. Shamsuddin

    2016-01-01

    E-commerce is business communication through electronic resources, including the internet, televisions, telephones, and computers. By the rapid growth of e-commerce we can assume that it may be the fast growing way to complete business transactions. In e-commerce any person can perches goods from any place without keeping the time constraint i.e. business hours. It is a win-win situation for the consumer and the product/service provider. The various advantages E-Commerce offers to customers a...

  1. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    Science.gov (United States)

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  2. Rural Australian Women's Legal Help Seeking for Intimate Partner Violence: Women Intimate Partner Violence Victim Survivors' Perceptions of Criminal Justice Support Services

    Science.gov (United States)

    Ragusa, Angela T.

    2013-01-01

    Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study…

  3. EVALUATION OF SERVICE QUALITY OF AIRWAY COMPANIES GIVING DOMESTIC SERVICES IN TURKEY WITH FUZZY SET APPROACH

    Directory of Open Access Journals (Sweden)

    H. Handan DEMIR

    2013-01-01

    Full Text Available Today, service quality has become a major phenomenon with the requirement of meeting consumer demands in the best way brought along with the rising competition between companies. Airway transportation is preferred more and more during the recent years. Many qualitative and quantitative criteria are considered while evaluating service criteria in airway transportation. In this context, evaluation of service quality is a decisionmaking problem with many criteria. The purpose of this study is to evaluate service quality of domestic airway companies in Turkey. In this study; fuzzy TOPSIS method which is one of the most preferred fuzzy MCDM methods, extension of multi criteria decision making methods in fuzzy environments, considering qualitative and quantitative criteria together and giving opportunity to make group decisions in fuzzy environments. As a result, evaluation was made based on service quality criteria for the most preferred airways companies in Turkey and these companies were ranked according to their levels of service quality.

  4. [Alcohol and work: ethical-deontological and medico-legal remark upon the recent set of rules].

    Science.gov (United States)

    Chiaravalli, M; Guzzetti, Laura; Tavani, M

    2007-01-01

    The Disposition of the Permanent Conference for the relation among the State, the Regions and the Autonomous Provinces of Trento and Bolzano, published in Gazzetta Ufficiale n. 75 on the 30th March 2006 the list of high-risk occupations under the influence of alcohol, activating de facto a previous law (Legge n. 125, 3017 march 2001, "Legge quadro in materia di alcol e di problemi alcolcorrelati"). We here present some ethical-deontological and medical-juridical profiles on the contents of this law and some consideration about its application. Particular attention is dedicated to deontological aspects about industrial safety rules and to medico-legal aspects about occupation under the influence of alcohol, with references to complex relations among worker's discretion right, employer's right to the protection of his own interests and qualified doctor's (or someone to him comparable) right to the respect for the deontological code, with regard to benefit recipient information before the medical treatment. Authors'purpose is to evidence critical points and interpretative ambiguities of a regulation lacking in its practical applications, to provide further proposals of consideration, available to revalue a thematic rich in questions and with a significant social impact.

  5. Memorandum from the HR Department and the Legal Service concerning taxation in SWITZERLAND

    CERN Document Server

    HR Department

    2007-01-01

    I/ 2006 income tax declaration The 2006 income tax declaration form must be completed in accordance with the instructions provided by the Swiss authorities set out below, then signed and returned to the competent tax office. You must ask your tax office for an extension of the deadline for returning the form (see Part II below) if you are not yet in possession of all the documents needed to complete it. We remind you that all members of the personnel are exempt from federal, cantonal and communal taxation on salaries and emoluments paid by CERN. Swiss members of the personnel have been exempt since the introduction of internal taxation on 1st January 2005. A - General remarks for Swiss and non-Swiss members of the personnel domiciled in Switzerland a) Swiss members of the personnel must indicate the amount of salary and emoluments paid by CERN (i.e. the total amount specified in Section A of the 2006 annual internal taxation certificate) and must attach this certificate (which will be available at th...

  6. Abortion legalized: challenges ahead.

    Science.gov (United States)

    Singh, M; Jha, R

    2007-01-01

    To see whether advocacy for abortion law and comprehensive abortion care (CAC) sites after legalization of abortion in Nepal is adequate among educated people (above school leaving certificate). 150 participants were assigned randomly who agreed to be in the survey and were given structured questionnaires to find out their perception of abortion and CAC sites. Majority know abortion is legalized and majority have positive attitude about legalization of abortion, however majority are not aware of abortion service in CAC sites and none knew the cost of abortion service. Proper and adequate advocacy of the new abortion law and CAC service is essential.

  7. Legal Protections in Public Accommodations Settings: A Critical Public Health Issue for Transgender and Gender-Nonconforming People

    Science.gov (United States)

    Reisner, Sari L; Hughto, Jaclyn M White; Dunham, Emilia E; Heflin, Katherine J; Begenyi, Jesse Blue Glass; Coffey-Esquivel, Julia; Cahill, Sean

    2015-01-01

    Context Gender minority people who are transgender or gender nonconforming experience widespread discrimination and health inequities. Since 2012, Massachusetts law has provided protections against discrimination on the basis of gender identity in employment, housing, credit, public education, and hate crimes. The law does not, however, protect against discrimination in public accommodations (eg, hospitals, health centers, transportation, nursing homes, supermarkets, retail establishments). For this article, we examined the frequency and health correlates of public accommodations discrimination among gender minority adults in Massachusetts, with attention to discrimination in health care settings. Methods In 2013, we recruited a community-based sample (n = 452) both online and in person. The respondents completed a 1-time, electronic survey assessing demographics, health, health care utilization, and discrimination in public accommodations venues in the past 12 months. Using adjusted multivariable logistic regression models, we examined whether experiencing public accommodations discrimination in health care was independently associated with adverse self-reported health, adjusting for discrimination in other public accommodations settings. Findings Overall, 65% of respondents reported public accommodations discrimination in the past 12 months. The 5 most prevalent discrimination settings were transportation (36%), retail (28%), restaurants (26%), public gatherings (25%), and health care (24%). Public accommodations discrimination in the past 12 months in health care settings was independently associated with a 31% to 81% increased risk of adverse emotional and physical symptoms and a 2-fold to 3-fold increased risk of postponement of needed care when sick or injured and of preventive or routine health care, adjusting for discrimination in other public accommodations settings (which also conferred an additional 20% to 77% risk per discrimination setting endorsed

  8. In-Service Preschool Teachers' Thoughts about Technology and Technology Use in Early Educational Settings

    Science.gov (United States)

    Kara, Nuri; Cagiltay, Kursat

    2017-01-01

    The purpose of this study is to understand in-service preschool teachers' thoughts about technology and technology use in early educational settings. Semi-structured interviews were conducted with 18 in-service preschool teachers. These teachers were selected from public and private preschools. Convenient sampling was applied because teachers who…

  9. Measurement framework for product service system performance of generator set distributors

    Science.gov (United States)

    Sofianti, Tanika D.

    2017-11-01

    Selling Generator Set (Genset) in B2B market, distributors assisted manufacturers to sell products. This is caused by the limited resources owned by the manufacturer for adding service elements. These service elements are needed to enhance the competitiveness of the generator sets. Some genset distributors often sell products together with supports to their customers. Industrial distributor develops services to meet the needs of the customer. Generator set distributors support machines and equipment produced by manufacturer. The services delivered by the distributors could enhance value obtained by the customers from the equipment. Services provided to customers in bidding process, ordering process of the equipment from the manufacturer, equipment delivery, installations, and the after sales stage. This paper promotes framework to measure Product Service System (PSS) of Generator Set distributors in delivering their products and services for the customers. The methodology of conducting this research is by adopting the perspective of the providers and customers and by taking into account the tangible and intangible products. This research leads to the idea of improvement of current Product Service System of a Genset distributor. This research needs further studies in more detailed measures and the implementation of measurement tools.

  10. The Effects of Graphic Feedback, Goal-Setting, and Manager Praise on Customer Service Behaviors

    Science.gov (United States)

    Loewy, Shannon; Bailey, Jon

    2007-01-01

    The current study used a multiple baseline design to investigate the effects of graphic feedback, goal setting, and manager praise on customer service behaviors in a large retail setting. Direct observation of customer greeting, eye contact, and smiling was used to collect data. After baseline data were collected feedback graphs were posted twice…

  11. Compensating citizens for poor service delivery : Experimental research in public and private settings

    NARCIS (Netherlands)

    Thomassen, Jean Pierre; Leliveld, Marijke C.; Van de Walle, Steven; Ahaus, Kees

    2017-01-01

    After a service failure, citizens expect a recovery strategy that restores perceived justice and places a reasonable value on their loss. Offering monetary compensation is a strategy commonly used in private settings, but less so in public settings. To date, compensation effects have not been

  12. Service Quality: A Main Determinant Factor for Health Information System Success in Low-resource Settings.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-01-01

    With the increasing implementation of different health information systems in developing countries, there is a growing need to measure the main determinants of their success. The results of this evaluation study on the determinants of HIS success in five low resource setting hospitals show that service quality is the main determinant factor for information system success in those kind of settings.

  13. Emergency residential care settings: A model for service assessment and design.

    Science.gov (United States)

    Graça, João; Calheiros, Maria Manuela; Patrício, Joana Nunes; Magalhães, Eunice Vieira

    2018-02-01

    There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Compensating citizens for poor service delivery: experimental research in public and private settings

    OpenAIRE

    Thomassen, JP; Leliveld, MC; Van de Walle, Steven; Ahaus, K

    2017-01-01

    After a service failure, citizens expect a recovery strategy that restores perceived justice and places a reasonable value on their loss. Offering monetary compensation is a strategy commonly used in private settings, but less so in public settings. To date compensation effects have not been researched in public settings. To investigate citizens’ evaluations of perceived justice, negative emotions and post-recovery satisfaction we used a 2 (sector: public, private) by 2 (compensation promised...

  15. Alcohol screening and brief intervention in workplace settings and social services: A comparison of literature

    Directory of Open Access Journals (Sweden)

    Bernd eSchulte

    2014-10-01

    Full Text Available BACKGROUND: The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBI in primary health care (PHC suggests a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions take place in this context. METHODS: Update of two systematic reviews on ASBI effectiveness in workplaces, social service and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in nonmedical settings.RESULTS: We found a limited number of randomized controlled trials (RCTs in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest a stepped and carefully tailored approach is likely to be required.DISCUSSION: Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance and potential effectiveness of ASBI for different target groups, organisational frameworks and professionals.

  16. Legal Services: Claims

    Science.gov (United States)

    1997-12-31

    waive such exemp- tions or privileges and direct release of the protected documents, upon balancing all pertinent factors, including finding that...injury causing death until expiration of decedent’s worklife ex- pectancy. When requested, the previous five years Federal income tax forms must be...knowing at all times how much of the CEA has been obligated, its remaining balance , and assessing each month whether the balance will cover claims

  17. Medico-legal documentation of rape or sexual assault: are ...

    African Journals Online (AJOL)

    L Fouché

    Background: Following upon two-year internship, community-service doctors make mistakes when they deal with evidence of medico-legal examinations in various settings. These mistakes .... the participants were doing/had done their community service were obtained. Age and gender distribution. The average age of the ...

  18. Effects of librarian-provided services in healthcare settings: a systematic review.

    Science.gov (United States)

    Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

    2014-01-01

    To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Service user involvement in mental health system strengthening in a rural African setting: qualitative study

    OpenAIRE

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-01-01

    Background It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Methods Thirty nine semi-structured interviews were carried out with pur...

  20. 42 CFR 415.170 - Conditions for payment on a fee schedule basis for physician services in a teaching setting.

    Science.gov (United States)

    2010-10-01

    ... physician services in a teaching setting. 415.170 Section 415.170 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.170 Conditions for payment on a fee schedule basis...

  1. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Directory of Open Access Journals (Sweden)

    Lene Bjørn Jensen

    2018-05-01

    Full Text Available The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO. Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  2. The Delivery of Health Promotion and Environmental Health Services; Public Health or Primary Care Settings?

    Science.gov (United States)

    Bjørn Jensen, Lene; Lukic, Irena; Gulis, Gabriel

    2018-05-07

    The WHO Regional Office for Europe developed a set of public health functions resulting in the ten Essential Public Health Operations (EPHO). Public health or primary care settings seem to be favorable to embrace all actions included into EPHOs. The presented paper aims to guide readers on how to assign individual health promotion and environmental health services to public health or primary care settings. Survey tools were developed based on EPHO 2, 3 and 4; there were six key informant surveys out of 18 contacted completed via e-mails by informants working in Denmark on health promotion and five face-to-face interviews were conducted in Australia (Melbourne and Victoria state) with experts from environmental health, public health and a physician. Based on interviews, we developed a set of indicators to support the assignment process. Population or individual focus, a system approach or one-to-one approach, dealing with hazards or dealing with effects, being proactive or reactive were identified as main element of the decision tool. Assignment of public health services to one of two settings proved to be possible in some cases, whereas in many there is no clear distinction between the two settings. National context might be the one which guides delivery of public health services.

  3. TimeSet: A computer program that accesses five atomic time services on two continents

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

    TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.

  4. The US Public Health Service “treating tobacco use and dependence clinical practice guidelines” as a legal standard of care

    Science.gov (United States)

    Torrijos, Randy M; Glantz, Stanton A

    2006-01-01

    Background The important factors in evaluating the role of clinical practice guidelines (CPGs) in medical malpractice litigation have been discussed for several years, but have focused on broad policy implications rather than on a concrete example of how an actual guideline might be evaluated. There are four items that need to be considered in negligence torts: legal duty, a breach of that duty, causal relationship between breach and injury, and damages. Objective To identify the arguments related to legal duty. Results The Treating Tobacco Use and Dependence (revised 2000) CPG, sponsored by the US Public Health Service, recommends effective and inexpensive treatments for nicotine addiction, the largest preventable cause of death in the US, and can be used as an example to focus on important considerations about the appropriateness of CPGs in the judicial system. Furthermore, the failure of many doctors and hospitals to deal with tobacco use and dependence raises the question of whether this failure could be considered malpractice, given the Public Health Service guideline's straightforward recommendations, their efficacy in preventing serious disease and cost‐effectiveness. Conclusion Although each case of medical malpractice depends on a multitude of factors unique to individual cases, a court could have sufficient basis to find that the failure to adequately treat the main cause of preventable disease and death in the US qualifies as a violation of the legal duty that doctors and hospitals owe to patients habituated to tobacco use and dependence. PMID:17130373

  5. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

    Science.gov (United States)

    Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

    2012-01-01

    Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

  6. Service user involvement in mental health system strengthening in a rural African setting: qualitative study.

    Science.gov (United States)

    Abayneh, Sisay; Lempp, Heidi; Alem, Atalay; Alemayehu, Daniel; Eshetu, Tigist; Lund, Crick; Semrau, Maya; Thornicroft, Graham; Hanlon, Charlotte

    2017-05-18

    It is essential to involve service users in efforts to expand access to mental health care in integrated primary care settings in low- and middle-income countries (LMICs). However, there is little evidence from LMICs to guide this process. The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach. Thirty nine semi-structured interviews were carried out with purposively selected mental health service users (n = 13), caregivers (n = 10), heads of primary care facilities (n = 8) and policy makers/planners/service developers (n = 8). The interviews were audio-recorded and transcribed in Amharic, and translated into English. Thematic analysis was applied. All groups of participants supported service user and caregiver involvement in mental health system strengthening. Potential benefits were identified as (i) improved appropriateness and quality of services, and (ii) greater protection against mistreatment and promotion of respect for service users. However, hardly any respondents had prior experience of service user involvement. Stigma was considered to be a pervasive barrier, operating within the health system, the local community and individuals. Competing priorities of service users included the need to obtain adequate individual care and to work for survival. Low recognition of the potential contribution of service users seemed linked to limited empowerment and mobilization of service users. Potential health system facilitators included a culture of community oversight of primary care services. All groups of respondents identified a need for awareness-raising and training to equip service users, caregivers, service providers and local community for involvement. Empowerment at the level of individual service users (information about mental health conditions, care and rights) and the group level (for advocacy and representation) were considered

  7. Career Pathways for Related Service Paratherapists Working in Early Intervention and Other Education Settings.

    Science.gov (United States)

    Longhurst, Thomas M.

    1997-01-01

    Discusses issues in personnel training practices for paraprofessionals providing related services in early intervention and education settings. The term paratherapist is used to refer to paraprofessionals working under the supervision of professionals in physical therapy, occupational therapy, and speech-language pathology. Presents a philosophy…

  8. Choice architecture as a means to change eating behaviour in self-service settings

    DEFF Research Database (Denmark)

    Skov, Laurits Rohden; Lourenco, Sofia; Laub Hansen, Gitte

    2013-01-01

    Summary: The primary objective of this review was to investigate the current evidence-base for the use of choice architecture as a means to change eating behaviour in self-service eating settings, hence potentially reduce calorie intake. 12 databases were searched systematically for experimental ...

  9. Using Multiattribute Utility Theory as a Priority-Setting Tool in Human Services Planning.

    Science.gov (United States)

    Camasso, Michael J.; Dick, Janet

    1993-01-01

    The feasibility of applying multiattribute utility theory to the needs assessment and priority-setting activities of human services planning councils was studied in Essex County (New Jersey). Decision-making and information filtering processes are explored in the context of community planning. (SLD)

  10. Level of health care and services in a tertiary health setting in Nigeria

    African Journals Online (AJOL)

    Level of health care and services in a tertiary health setting in Nigeria. ... Background: There is a growing awareness and demand for quality health care across the world; hence the ... Doctors and nurses formed 64.3% of the study population.

  11. The Treatment of Sexual Dysfunction in a University Health Service Setting

    Science.gov (United States)

    Babineau, Raymond; Schwartz, Allan J.

    1977-01-01

    Experience of the authors indicates that solo therapists with adequate background in individual and couple therapy, who also have additional training/experience in sex therapy, can provide treatment for sexual dysfunction to student couples in a health service setting with encouraging results. (MB)

  12. Greek In-Service and Preservice Teachers' Views about Bullying in Early Childhood Settings

    Science.gov (United States)

    Psalti, Anastasia

    2017-01-01

    Despite the plethora of studies regarding bullying worldwide, there are limited studies at the early childhood level. This article presents the results of a pilot study aiming at exploring preservice and in-service early childhood teachers' views on bullying in Greek early childhood settings. A total of 192 early childhood teachers completed a…

  13. Individual Education Plan Goals and Services for Adolescents with Autism: Impact of Age and Educational Setting

    Science.gov (United States)

    Kurth, Jennifer; Mastergeorge, Ann M.

    2010-01-01

    The purpose of this study is to describe the educational programs for adolescents with autism (age 12-16 years) in inclusion and noninclusion settings as reflected in their Individual Education Plan (IEP) goals, services, and curricular adaptations. Students who were included in general education math and language arts instruction had fewer…

  14. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting.

    Science.gov (United States)

    Cooper, Angela; Abbass, Allan; Town, Joel

    2017-11-29

    Medically unexplained symptoms (MUS) are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP) with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 ( d = 0.4). A statistically significant (23%) decrease in family physicians' visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a 'Primary Care Psychological Consultation and Treatment Service'.

  15. The Law, the Map and the Citizen: Designing a legal service infrastructure where rules make sense again

    NARCIS (Netherlands)

    Peters, R.M.

    2016-01-01

    Law is being digitalised. When this research started, the notion of digitalisation of law was new. The early attempts were websites that provided legal sources. The question occurred if this would be helpful to the citizen seeking answers for day-to-day problems. The research question evolved from

  16. Splitting Computation of Answer Set Program and Its Application on E-service

    Directory of Open Access Journals (Sweden)

    Bo Yang

    2011-10-01

    Full Text Available As a primary means for representing and reasoning about knowledge, Answer Set Programming (ASP has been applying in many areas such as planning, decision making, fault diagnosing and increasingly prevalent e-service. Based on the stable model semantics of logic programming, ASP can be used to solve various combinatorial search problems by finding the answer sets of logic programs which declaratively describe the problems. Itrs not an easy task to compute answer sets of a logic program using Gelfond and Lifschitzrs definition directly. In this paper, we show some results on characterization of answer sets of a logic program with constraints, and propose a way to split a program into several non-intersecting parts step by step, thus the computation of answer sets for every subprogram becomes relatively easy. To instantiate our splitting computation theory, an example about personalized product configuration in e-retailing is given to show the effectiveness of our method.

  17. In-Service and Pre-Service Early Childhood Teachers' Views and Intentions about ICT Use in Early Childhood Settings: A Comparative Study

    Science.gov (United States)

    Gialamas, Vasilis; Nikolopoulou, Kleopatra

    2010-01-01

    This paper regards a comparative study which investigates in-service and pre-service Greek early childhood teachers' views and intentions about integrating and using computers in early childhood settings. Views and intentions were investigated via a questionnaire administered to 240 in-service and 428 pre-service early childhood teachers.…

  18. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

    Science.gov (United States)

    Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2014-08-01

    Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

  19. Implementing a Psychotherapy Service for Medically Unexplained Symptoms in a Primary Care Setting

    Directory of Open Access Journals (Sweden)

    Angela Cooper

    2017-11-01

    Full Text Available Medically unexplained symptoms (MUS are known to be costly, complex to manage and inadequately addressed in primary care settings. In many cases, there are unresolved psychological and emotional processes underlying these symptoms, leaving traditional medical approaches insufficient. This paper details the implementation of an evidence-based, emotion-focused psychotherapy service for MUS across two family medicine clinics. The theory and evidence-base for using Intensive Short-Term Dynamic Psychotherapy (ISTDP with MUS is presented along with the key service components of assessment, treatment, education and research. Preliminary outcome indicators showed diverse benefits. Patients reported significantly decreased somatic symptoms in the Patient Health Questionnaire-15 (d = 0.4. A statistically significant (23% decrease in family physicians’ visits was found in the 6 months after attending the MUS service compared to the 6 months prior. Both patients and primary care clinicians reported a high degree of satisfaction with the service. Whilst further research is needed, these findings suggest that a direct psychology service maintained within the family practice clinic may assist patient and clinician function while reducing healthcare utilization. Challenges and further service developments are discussed, including the potential benefits of re-branding the service to become a ‘Primary Care Psychological Consultation and Treatment Service’.

  20. Rural Australian women's legal help seeking for intimate partner violence: women intimate partner violence victim survivors' perceptions of criminal justice support services.

    Science.gov (United States)

    Ragusa, Angela T

    2013-03-01

    Intimate partner violence (IPV) is a widespread, ongoing, and complex global social problem, whose victims continue to be largely women. Women often prefer to rely on friends and family for IPV help, yet when informal support is unavailable they remain hesitant to contact formal services, particularly legal support for many reasons. This study applies a sociological lens by framing the IPV and legal help-seeking experiences of rural Australian women gained from 36 in-depth face-to-face interviews as socially contextualized interactions. Findings reveal police and court responses reflect broader social inequalities and rurality exacerbates concerns such as anonymity and lack of service. Cultural differences and power imbalances between survivors and formal support providers are manifested to inform future research seeking to improve survivors' willingness to engage and satisfaction with formal services. Finally, the important role police and the criminal justice system play in de-stigmatizing IPV and legitimating its unacceptability is argued a crucial, yet unrecognized, key to social change.

  1. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  2. Legal Hybrids

    DEFF Research Database (Denmark)

    Herrmann, Janne Rothmar

    2009-01-01

    in which embryos and foetuses are placed are much more complex. These categories are identified using Danish legislation as an example and on that basis the article extracts and identifies the different parameters that play a part in the legal categorisation of the human conceptus.......The article discusses the inadequacy of traditional theory on legal personhood in relation to embryos and foetuses. To challenge the somewhat binary view of legal personhood according to which the ‘born alive' criterion is paramount the article demonstrates that the number of legal categories...

  3. New and Improved GLDAS Data Sets and Data Services at NASA GES DISC

    Science.gov (United States)

    Rui, Hualan; Beaudoing, Hiroko; Teng, William; Vollmer, Bruce; Rodell, Matthew; Lei, Guang-Dih

    2012-01-01

    The goal of a Land Data Assimilation System (LDAS) is to ingest satellite- and ground-based observational data products, using advanced land surface modeling and data assimilation techniques, in order to generate optimal fields of land surface states and fluxes data and, thereby, facilitate hydrology and climate modeling, research, and forecast. With the motivation of creating more climatologically consistent data sets, NASA GSFC's Hydrological Sciences Laboratory has generated more than 60 years (Jan. 1948-- Dec. 2008) of Global LDAS Version 2 (GLDAS-2) data, by using the Princeton Forcing Data Set and upgraded versions of Land Surface Models (LSMs). GLDAS data and data services are provided at NASA GES DISC Hydrology Data and Information Services Center (HDISC), in collaboration with HSL and LDAS.

  4. User library service expectations in health science vs. other settings: a LibQUAL+ Study.

    Science.gov (United States)

    Thompson, Bruce; Kyrillidou, Martha; Cook, Colleen

    2007-12-01

    To explore how the library service expectations and perceptions of users might differ across health-related libraries as against major research libraries not operating in a medical context; to determine whether users of medical libraries demand better library service quality, because the inability of users to access needed literature promptly may lead to a patient who cannot be properly diagnosed, or a diagnosis that cannot be properly treated. We compared LibQUAL+ total and subscale scores across three groups of US, Canadian and British libraries for this purpose. Anticipated differences in expectations for health as other library settings did not emerge. The expectations and perceptions are similar across different types of health science library settings, hospital and academic, and across other general research libraries.

  5. An update: choice architecture as a means to change eating behaviour in self-service settings

    DEFF Research Database (Denmark)

    Skov, Laurits Rohden; Perez-Cueto, Armando

    2014-01-01

    Objective: The primary objective of this review was to update the current evidence-base for the use of choice architecture as a means to change eating behaviour in self-service eating settings, hence potentially reducing energy intake. Methodology: 12 databases were searched systematically for ex...... in the topic of choice architecture and nudging has increased the scientific output since the last review. There is a clear limitation in the lack of a clear definitions and theoretical foundation....

  6. Legal Radiopathology

    International Nuclear Information System (INIS)

    Andrade Lima, L. de

    1986-01-01

    The author comments about the knowledge evolution about radioactivity and describes the most important chemical elements capable of discharging it and all the types of radioactivity according with Mendelejef's classification. He analyses the celular sensibility related to many variables, listing the biological effects that may happen depending on the quantity of radiation and exposition time to radiation. He also calls attention to procedures of dosimetry and radioprotection that must be done when anatomo-pathological examination of body fluids, discharges and tissues are carried out, stressing that protective clothing must be wear, decontamination or to make useless the material involved are important to get the job done. A description of the appropriated conditions to perform autopsy, to anoint and to cremate contaminated bodies and the procedures used by the Navy Hospital Marcilio Dias service of anatomo-pathology, Instituto de Radioprotecao e Dosimetria (IRD) and Comissao Nacional de Energia Nuclear (CNEN) is given, based on the experience gained in performing necropsy of dead patients and one anatomo-pathological examination of upper limb amputated inside the surgical room. He finishes describing the macroscopic injuries observed and listing the instrumental used, the reports made, giving details about the necropsy carried out and answering medical-legal matters. (author)

  7. 42 CFR 411.4 - Services for which neither the beneficiary nor any other person is legally obligated to pay.

    Science.gov (United States)

    2010-10-01

    ... or pay for that service. (b) Special conditions for services furnished to individuals in custody of... furlough, required to reside in mental health facilities, required to reside in halfway houses, required to...

  8. Factores asociados con la búsqueda del servicio de interrupción legal del embarazo en la Ciudad de México, 2010 Factors associated with the seeking of legal induced abortion services in Mexico City in 2010

    Directory of Open Access Journals (Sweden)

    Alejandro Figueroa-Lara

    2012-08-01

    Full Text Available OBJETIVO: Identificar factores asociados con la búsqueda del servicio de interrupción legal del embarazo (ILE en la Ciudad de México. MATERIAL Y MÉTODOS: Se utilizó un diseño casos-controles. Usuarias del servicio de ILE fueron definidas como casos, y usuarias de control prenatal con 13 o más semanas de gestación con un embarazo no deseado constituyeron los controles. Se ajustaron modelos de regresión logística condicional. RESULTADOS: Los años de escolaridad (RM=1.47, IC:1.04-2.07, la ocupación (estudiante, RM=7.31, IC:1.58-33.95; tener empleo remunerado, RM= 13.43, IC:2.04-88.54 y número de interrupciones de embarazo previas (RM=11.41, IC:1.65-79.07 se asociaron con la búsqueda de ILE. El factor de mayor peso fue la ocupación; las mujeres que trabajan tuvieron 13.4 veces mayor posibilidad de demandar el servicio de ILE. CONCLUSIONES: En el contexto de la Ciudad de México, mujeres con más educación y participación laboral activa utilizan más los servicios de ILE. Se requieren estrategias dirigidas a incrementar el uso de estos servicios por mujeres menos favorecidas.OBJECTIVE: To identify factors associated with the seeking of the legal-interruption-pregnancy (LIP services in Mexico City. MATERIALS AND METHODS: We used a case-control design. Users who utilized the LIP were defined as cases, while users of the antenatal care service with gestational age 13 or more weeks and who reported having an unwanted pregnancy were defined as controls. Logistic regressions were fitted to estimate odds ratios. RESULTS: Higher level of education (OR=1.47, 95% CI:1.04-2.07, women's occupation (being student OR=7.31, 95% CI:1.58-33.95; worker OR=13.43, 95% CI:2.04-88.54, and number of previous abortions (OR=11.41, 95% CI:1.65-79.07 were identified as factors associated with the lookup of LIP. CONCLUSIONS: In Mexico City context, empowered women with a higher level of education, or having a work activity are the users of LIP services

  9. Law of the electricity sector in France. The legal framework for the French electricity supply between legal market deregulation requirements and public service obligations; Stromwirtschaftsrecht in Frankreich. Der Rechtsrahmen fuer die franzoesische Elektrizitaetsversorgung zwischen unionsrechtlichen Marktoeffnungsvorgaben und gemeinwirtschaftlichen Verpflichtungen

    Energy Technology Data Exchange (ETDEWEB)

    Buckler, Julius

    2016-07-01

    The process of creating an internal electricity market is still unfinished. This has, in addition to technical reasons, also legal reasons: The persistence of the structures and regulatory frameworks that have grown during monopoly times, in part is very strong, which is particularly evident in France. The power supply there is intensively controlled by its state as a public service, both indirectly by the state-owned company EDF and directly by statutory regulations. The market deregulation is not thereby completely prevented. However, together with the particular importance of nuclear power for the French power supply, considerable barriers to market opening are emerging. Against this background and out of the historical development, the author examines the current French law of the electricity sector across all value-creation stages in its relations to EU law. [German] Der Strombinnenmarktprozess ist nach wie vor unvollendet. Dies hat neben technischen auch rechtliche Gruende: Die Beharrungskraefte der zu Monopolzeiten gewachsenen Strukturen und Ordnungsrahmen sind zum Teil aeusserst stark, was sich besonders in Frankreich deutlich zeigt. Die dortige Stromversorgung wird ausgehend von ihrer Einordnung als Service Public sowohl mittelbar durch das Staatsunternehmen EDF als auch unmittelbar durch gesetzliche Regelungen intensiv staatlich kontrolliert. Die Marktoeffnung wird dadurch zwar nicht vollkommen verhindert. Zusammen mit der besonderen Bedeutung der Kernkraft fuer die franzoesische Stromversorgung ergeben sich hieraus aber erhebliche Marktoeffnungshemmnisse. Vor diesem Hintergrund und ausgehend von der historischen Entwicklung untersucht der Autor das geltende franzoesische Stromwirtschaftsrecht ueber alle Wertschoepfungsstufen hinweg in seinen Bezuegen zum EU-Recht.

  10. Assessment of satisfaction with pharmaceutical services in patients receiving antiretroviral therapy in outpatient HIV treatment setting.

    Science.gov (United States)

    Agu, Kenneth Anene; Oqua, Dorothy; Agada, Peter; Ohiaeri, Samuel I; Adesina, Afusat; Abdulkareem, Mohammed Habeeb; King, Rosalyn C; Wutoh, Anthony K

    2014-06-01

    The patient's perception and satisfaction are increasingly considered as a useful factor in the assessment of competency of health care providers and quality of care. However, these patient focused assessments are largely ignored when assessing health care outcomes. The study assessed the perception and satisfaction of patients receiving antiretroviral therapy (ART) with pharmaceutical services received in outpatient HIV treatment settings. Seventeen HIV treatment centres in Nigeria. This cross-sectional survey included 2,700 patients randomly selected from 26,319 HIV patients on ART, who received pharmaceutical services in the study setting. A study-specific Likert-type instrument was administered to the participants at point of exit from the pharmacy. Midpoint of the 5-point scale was computed and scores above it were regarded as positive while below as negative. Chi-square was used for inferential statistics. All reported p values were 2-sided at 95 % confidence interval (CI). Patient satisfaction with pharmaceutical services. Of 2,700 patients sampled, data from 1,617 (59.9 %) were valid for analysis; 62.3 % were aged 26-40 years and 65.4 % were females. The participants had received pharmaceutical services for a mean duration of 25.2 (95 % CI 24.3-26.1) months. Perception of participants regarding the appearance of pharmacy was positive while that regarding the pharmacists' efforts to solve patients' medication related problems was negative. The participants' rating of satisfaction with the waiting time to access pharmaceutical services was negative; the satisfaction decreases with increasing waiting time. However, the satisfaction with the overall quality of pharmaceutical services received was rated as positive; 90.0 % reported that they got the kind of pharmaceutical services they wanted; 98.2 % would come back to the pharmacy if they were to seek help again and would recommend services to others. The level of satisfaction was found to be associated with

  11. Urban settings do not ensure access to services: findings from the immunisation programme in Kampala Uganda.

    Science.gov (United States)

    Babirye, Juliet N; Engebretsen, Ingunn M S; Rutebemberwa, Elizeus; Kiguli, Juliet; Nuwaha, Fred

    2014-03-06

    Previous studies on vaccination coverage in developing countries focus on individual- and community-level barriers to routine vaccination mostly in rural settings. This paper examines health system barriers to childhood immunisation in urban Kampala Uganda. Mixed methods were employed with a survey among child caretakers, 9 focus group discussions (FGDs), and 9 key informant interviews (KIIs). Survey data underwent descriptive statistical analysis. Latent content analysis was used for qualitative data. Of the 821 respondents in the survey, 96% (785/821) were mothers with a mean age of 26 years (95% CI 24-27). Poor geographical access to immunisation facilities was reported in this urban setting by FGDs, KIIs and survey respondents (24%, 95% CI 21-27). This coupled with reports of few health workers providing immunisation services led to long queues and long waiting times at facilities. Consumers reported waiting for 3-6 hours before receipt of services although this was more common at public facilities. Only 33% (95% CI 30-37) of survey respondents were willing to wait for three or more hours before receipt of services. Although private-for-profit facilities were engaged in immunisation service provision their participation was low as only 30% (95% CI 27-34) of the survey respondents utilised these facilities. The low participation could be due to lack of financial support for immunisation activities at these facilities. This in turn could explain the rampant informal charges for services in this setting. Charges ranged from US$ 0.2 to US$4 and these were more commonly reported at private (70%, 95% CI 65-76) than at public (58%, 95% CI 54-63) facilities. There were intermittent availability of vaccines and transport for immunisation services at both private and public facilities. Complex health system barriers to childhood immunisation still exist in this urban setting; emphasizing that even in urban areas with great physical access, there are hard to reach people

  12. An international comparison of legal frameworks for supported and substitute decision-making in mental health services.

    Science.gov (United States)

    Davidson, Gavin; Brophy, Lisa; Campbell, Jim; Farrell, Susan J; Gooding, Piers; O'Brien, Ann-Marie

    2016-01-01

    There have been important recent developments in law, research, policy and practice relating to supporting people with decision-making impairments, in particular when a person's wishes and preferences are unclear or inaccessible. A driver in this respect is the United Nations Convention on the Rights of Persons with Disabilities (CRPD); the implications of the CRPD for policy and professional practices are currently debated. This article reviews and compares four legal frameworks for supported and substitute decision-making for people whose decision-making ability is impaired. In particular, it explores how these frameworks may apply to people with mental health problems. The four jurisdictions are: Ontario, Canada; Victoria, Australia; England and Wales, United Kingdom (UK); and Northern Ireland, UK. Comparisons and contrasts are made in the key areas of: the legal framework for supported and substitute decision-making; the criteria for intervention; the assessment process; the safeguards; and issues in practice. Thus Ontario has developed a relatively comprehensive, progressive and influential legal framework over the past 30 years but there remain concerns about the standardisation of decision-making ability assessments and how the laws work together. In Australia, the Victorian Law Reform Commission (2012) has recommended that the six different types of substitute decision-making under the three laws in that jurisdiction, need to be simplified, and integrated into a spectrum that includes supported decision-making. In England and Wales the Mental Capacity Act 2005 has a complex interface with mental health law. In Northern Ireland it is proposed to introduce a new Mental Capacity (Health, Welfare and Finance) Bill that will provide a unified structure for all substitute decision-making. The discussion will consider the key strengths and limitations of the approaches in each jurisdiction and identify possible ways that further progress can be made in law, policy

  13. Developing a service improvement initiative for people with learning disabilities in hospice settings.

    Science.gov (United States)

    Springall, Fiona

    2018-03-21

    People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  14. Individual psychological therapy in an acute inpatient setting: Service user and psychologist perspectives.

    Science.gov (United States)

    Small, Catherine; Pistrang, Nancy; Huddy, Vyv; Williams, Claire

    2018-01-18

    The acute inpatient setting poses potential challenges to delivering one-to-one psychological therapy; however, there is little research on the experiences of both receiving and delivering therapies in this environment. This qualitative study aimed to explore service users' and psychologists' experiences of undertaking individual therapy in acute inpatient units. It focused on the relationship between service users and psychologists, what service users found helpful or unhelpful, and how psychologists attempted to overcome any challenges in delivering therapy. The study used a qualitative, interview-based design. Eight service users and the six psychologists they worked with were recruited from four acute inpatient wards. They participated in individual semi-structured interviews eliciting their perspectives on the therapy. Service users' and psychologists' transcripts were analysed together using Braun and Clarke's (2006, Qualitative Research in Psychology, 3, 77) method of thematic analysis. The accounts highlighted the importance of forming a 'human' relationship - particularly within the context of the inpatient environment - as a basis for therapeutic work. Psychological therapy provided valued opportunities for meaning-making. To overcome the challenges of acute mental health crisis and environmental constraints, psychologists needed to work flexibly and creatively; the therapeutic work also extended to the wider context of the inpatient unit, in efforts to promote a shared understanding of service users' difficulties. Therapeutic relationships between service users and clinicians need to be promoted more broadly within acute inpatient care. Psychological formulation can help both service users and ward staff in understanding crisis and working collaboratively. Practice-based evidence is needed to demonstrate the effectiveness of adapted psychological therapy models. Developing 'human' relationships at all levels of acute inpatient care continues to be an

  15. The Setting is the Service: How the Architecture of Sober Living Residences Supports Community Based Recovery.

    Science.gov (United States)

    Wittman, Fried; Jee, Babette; Polcin, Douglas L; Henderson, Diane

    2014-07-01

    The architecture of residential recovery settings is an important silent partner in the alcohol/drug recovery field. The settings significantly support or hinder recovery experiences of residents, and shape community reactions to the presence of sober living houses (SLH) in ordinary neighborhoods. Grounded in the principles of Alcoholics Anonymous, the SLH provides residents with settings designed to support peer based recovery; further, these settings operate in a community context that insists on sobriety and strongly encourages attendance at 12-step meetings. Little formal research has been conducted to show how architectural features of the recovery setting - building appearance, spatial layouts, furnishings and finishes, policies for use of the facilities, physical care and maintenance of the property, neighborhood features, aspects of location in the city - function to promote (or retard) recovery, and to build (or detract from) community support. This paper uses a case-study approach to analyze the architecture of a community-based residential recovery service that has demonstrated successful recovery outcomes for its residents, is popular in its community, and has achieved state-wide recognition. The Environmental Pattern Language (Alexander, Ishikawa, & Silverstein, 1977) is used to analyze its architecture in a format that can be tested, critiqued, and adapted for use by similar programs in many communities, providing a model for replication and further research.

  16. Linking public health nursing competencies and service-learning in a global setting.

    Science.gov (United States)

    Brown, Cynthia L

    2017-09-01

    Nurse educators in baccalaureate programs are charged with addressing student competence in public health nursing practice. These educators are also responsible for creating nursing student opportunities for civic engagement and development of critical thinking skills. The IOM report (2010) on the Future of Nursing emphasizes the nurse educator's role in promoting collaborative partnerships that incorporate interdisciplinary and intraprofessional efforts to promote health. The purpose of this article is to describe an innovative approach to address public health nursing competencies and to improve the health and well-being of indigenous populations in a global setting through promotion of collaboration and service- learning principles. As part of a hybrid elective course, baccalaureate nursing students from various nursing tracks participated in a 2 week immersion experience in Belize that included preimmersion preparation. These students were to collaborate among themselves and with Belizean communities to address identified health knowledge deficits and health-related needs for school-aged children and adult populations. Students successfully collaborated in order to meet health-related needs and to engage in health promotion activities in the Toledo district of Belize. They also gained practice in developing public health nursing competencies for entry-level nursing practice. Implementation of service-learning principles provided students with opportunities for civic engagement and self-reflection. Some challenges existed from the students', faculty, and global community's perspectives. Lack of culturally appropriate and country specific health education materials was difficult for students and the community. Faculty encountered challenges in communicating and collaborating with the Belizean partners. Commonalities exist between entry-level public health nursing competencies and service-learning principles. Using service-learning principles in the development of

  17. Legal terminology

    DEFF Research Database (Denmark)

    Engberg, Jan

    2013-01-01

    texts disseminating legal concepts in different situations (Wikipedia article for general public, article from ministry aimed at children and adolescents) and especially investigate, to what extent the paraphrase concept is applicable also for describing dissemination strategies in such situations...

  18. Delivering high-quality family planning services in crisis-affected settings I: program implementation.

    Science.gov (United States)

    Curry, Dora Ward; Rattan, Jesse; Nzau, Jean Jose; Giri, Kamlesh

    2015-02-04

    In 2012, about 43 million women of reproductive age experienced the effects of conflict. Provision of basic sexual and reproductive health services, including family planning, is a recognized right and need of refugees and internally displaced people, but funding and services for family planning have been inadequate. This article describes lessons learned during the first 2.5 years of implementing the ongoing Supporting Access to Family Planning and Post-Abortion Care in Emergencies (SAFPAC) initiative, led by CARE, which supports government health systems to deliver family planning services in 5 crisis-affected settings (Chad, Democratic Republic of the Congo, Djibouti, Mali, and Pakistan). SAFPAC's strategy focuses on 4 broad interventions drawn from public health best practices in more stable settings: competency-based training for providers, improved supply chain management, regular supervision, and community mobilization to influence attitudes and norms related to family planning. Between July 2011 and December 2013, the initiative reached 52,616 new users of modern contraceptive methods across the 5 countries (catchment population of 698,053 women of reproductive age), 61% of whom chose long-acting methods of implants or intrauterine devices. Prudent use of data to inform decision making has been an underpinning to the project's approach. A key approach to ensuring sustained ability to train and supervise new providers has been to build capacity in clinical skills training and supervision by establishing in-country training centers. In addition, monthly supervision using simple checklists has improved program and service quality, particularly with infection prevention procedures and stock management. We have generally instituted a "pull" system to manage commodities and other supplies, whereby health facilities place resupply orders as needed based on actual consumption patterns and stock-alert thresholds. Finally, reaching the community with mobilization

  19. A managed clinical network for cardiac services: set-up, operation and impact on patient care

    Directory of Open Access Journals (Sweden)

    Karen E. Hamilton

    2005-09-01

    Full Text Available Purpose: To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. Methods: This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Results: Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and ‘bed down’. Its primary “modus operand” was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were

  20. A managed clinical network for cardiac services: set-up, operation and impact on patient care.

    Science.gov (United States)

    Stc Hamilton, Karen E; Sullivan, Frank M; Donnan, Peter T; Taylor, Rex; Ikenwilo, Divine; Scott, Anthony; Baker, Chris; Wyke, Sally

    2005-01-01

    To investigate the set up and operation of a Managed Clinical Network for cardiac services and assess its impact on patient care. This single case study used process evaluation with observational before and after comparison of indicators of quality of care and costs. The study was conducted in Dumfries and Galloway, Scotland and used a three-level framework. Process evaluation of the network set-up and operation through a documentary review of minutes; guidelines and protocols; transcripts of fourteen semi-structured interviews with health service personnel including senior managers, general practitioners, nurses, cardiologists and members of the public. Outcome evaluation of the impact of the network through interrupted time series analysis of clinical data of 202 patients aged less than 76 years admitted to hospital with a confirmed myocardial infarction one-year pre and one-year post, the establishment of the network. The main outcome measures were differences between indicators of quality of care targeted by network protocols. Economic evaluation of the transaction costs of the set-up and operation of the network and the resource costs of the clinical care of the 202 myocardial infarction patients from the time of hospital admission to 6 months post discharge through interrupted time series analysis. The outcome measure was different in National Health Service resource use. Despite early difficulties, the network was successful in bringing together clinicians, patients and managers to redesign services, exhibiting most features of good network management. The role of the energetic lead clinician was crucial, but the network took time to develop and 'bed down'. Its primary "modus operand" was the development of a myocardial infarction pathway and associated protocols. Of sixteen clinical care indicators, two improved significantly following the launch of the network and nine showed improvements, which were not statistically significant. There was no difference

  1. CDBG Public Services Activity

    Data.gov (United States)

    Department of Housing and Urban Development — CDBG activity related to public services, including senior services, legal services, youth services, employment training, health services, homebuyer counseling, food...

  2. Cost accounting models used for price-setting of health services: an international review.

    Science.gov (United States)

    Raulinajtys-Grzybek, Monika

    2014-12-01

    The aim of the article was to present and compare cost accounting models which are used in the area of healthcare for pricing purposes in different countries. Cost information generated by hospitals is further used by regulatory bodies for setting or updating prices of public health services. The article presents a set of examples from different countries of the European Union, Australia and the United States and concentrates on DRG-based payment systems as they primarily use cost information for pricing. Differences between countries concern the methodology used, as well as the data collection process and the scope of the regulations on cost accounting. The article indicates that the accuracy of the calculation is only one of the factors that determine the choice of the cost accounting methodology. Important aspects are also the selection of the reference hospitals, precise and detailed regulations and the existence of complex healthcare information systems in hospitals. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study.

    Science.gov (United States)

    Feinstein-Winitzer, Rebecca T; Pollack, Harold A; Parish, Carrigan L; Pereyra, Margaret R; Abel, Stephen N; Metsch, Lisa R

    2014-05-01

    We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

  4. A REST Service for Triangulation of Point Sets Using Oriented Matroids

    Directory of Open Access Journals (Sweden)

    José Antonio Valero Medina

    2014-05-01

    Full Text Available This paper describes the implementation of a prototype REST service for triangulation of point sets collected by mobile GPS receivers. The first objective of this paper is to test functionalities of an application, which exploits mobile devices’ capabilities to get data associated with their spatial location. A triangulation of a set of points provides a mechanism through which it is possible to produce an accurate representation of spatial data. Such triangulation may be used for representing surfaces by Triangulated Irregular Networks (TINs, and for decomposing complex two-dimensional spatial objects into simpler geometries. The second objective of this paper is to promote the use of oriented matroids for finding alternative solutions to spatial data processing and analysis tasks. This study focused on the particular case of the calculation of triangulations based on oriented matroids. The prototype described in this paper used a wrapper to integrate and expose several tools previously implemented in C++.

  5. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    International Nuclear Information System (INIS)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves; Kruzelecki, Karol

    2010-01-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  6. Servicing HEP experiments with a complete set of ready integreated and configured common software components

    Energy Technology Data Exchange (ETDEWEB)

    Roiser, Stefan; Gaspar, Ana; Perrin, Yves [CERN, CH-1211 Geneva 23, PH Department, SFT Group (Switzerland); Kruzelecki, Karol, E-mail: stefan.roiser@cern.c, E-mail: ana.gaspar@cern.c, E-mail: yves.perrin@cern.c, E-mail: karol.kruzelecki@cern.c [CERN, CH-1211 Geneva 23, PH Department, LBC Group (Switzerland)

    2010-04-01

    The LCG Applications Area at CERN provides basic software components for the LHC experiments such as ROOT, POOL, COOL which are developed in house and also a set of 'external' software packages (70) which are needed in addition such as Python, Boost, Qt, CLHEP, etc. These packages target many different areas of HEP computing such as data persistency, math, simulation, grid computing, databases, graphics, etc. Other packages provide tools for documentation, debugging, scripting languages and compilers. All these packages are provided in a consistent manner on different compilers, architectures and operating systems. The Software Process and Infrastructure project (SPI) [1] is responsible for the continous testing, coordination, release and deployment of these software packages. The main driving force for the actions carried out by SPI are the needs of the LHC experiments, but also other HEP experiments could profit from the set of consistent libraries provided and receive a stable and well tested foundation to build their experiment software frameworks. This presentation will first provide a brief description of the tools and services provided for the coordination, testing, release, deployment and presentation of LCG/AA software packages and then focus on a second set of tools provided for outside LHC experiments to deploy a stable set of HEP related software packages both as binary distribution or from source.

  7. Exploring the potential for joint training between legal professionals in the criminal justice system and health and social care professionals in the mental-health services.

    Science.gov (United States)

    Hean, Sarah; Heaslip, Vanessa; Warr, Jerry; Staddon, Sue

    2011-05-01

    Effective screening of mentally-ill defendants in the criminal court system requires cooperation between legal professionals in the criminal justice system (CJS), and health and social care workers in the mental-health service (MHS). This interagency working, though, can be problematic, as recognized in the Bradley inquiry that recommended joint training for MHS and CJS professionals. The aim of this study was to examine the experiences and attitudes of workers in the CJS and MHS to inform the development of relevant training. The method was a survey of mental-health workers and legal professionals in the court. The results showed that both agencies were uncertain of their ability to work with the other and there is little training that supports them in this. Both recognized the importance of mentally-ill defendants being dealt with appropriately in court proceedings but acknowledged this is not achieved. There is a shared willingness to sympathize with defendants and a common lack of willingness to give a definite, unqualified response on the relationship between culpability, mental-illness and punishment. Views differ around defendants' threat to security.Findings suggest there is scope to develop interprofessional training programs between the CJS and MHS to improve interagency working and eventually impact on the quality of defendants' lives. Recommendations are made on the type of joint training that could be provided.

  8. The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

    Science.gov (United States)

    Allott, Kelly; Lloyd, Susan

    2009-07-01

    Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

  9. Legality in multiple legal orders

    NARCIS (Netherlands)

    Besselink, L.F.M.; Pennings, F.J.L.; Prechal, A.

    2010-01-01

    This is the Introductory chapter to The Eclipse of the Legality Principle in the European Union, Edited by Leonard Besselink, Frans Pennings, Sacha Prechal [European Monographs, vol. 75], Kluwer Law International, Alphen aan den Rijn, 2011 [2010], xxv + 303 pp.

  10. Supporting UK adaptation: building services for the next set of UK climate projections

    Science.gov (United States)

    Fung, Fai; Lowe, Jason

    2016-04-01

    As part of the Climate Change Act 2008, the UK Government sets out a national adaptation programme to address the risks and opportunities identified in a national climate change risk assessment (CCRA) every five years. The last risk assessment in 2012 was based on the probabilistic projections for the UK published in 2009 (UKCP09). The second risk assessment will also use information from UKCP09 alongside other evidence on climate projections. However, developments in the science of climate projeciton, and evolving user needs (based partly on what has been learnt about the diverse user requirements of the UK adaptation community from the seven years of delivering and managing UKCP09 products, market research and the peer-reviewed literature) suggest now is an appropriate time to update the projections and how they are delivered. A new set of UK climate projections are now being produced to upgrade UKCP09 to reflect the latest developments in climate science, the first phase of which will be delivered in 2018 to support the third CCRA. A major component of the work is the building of a tailored service to support users of the new projections during their development and to involve users in key decisions so that the projections are of most use. We will set out the plan for the new climate projections that seek to address the evolving user need. We will also present a framework which aims to (i) facilitate the dialogue between users, boundary organisations and producers, reflecting their different decision-making roles (ii) produce scientifically robust, user-relevant climate information (iii) provide the building blocks for developing further climate services to support adaptation activities in the UK.

  11. Cell-Based Veterinary Pharmaceuticals - Basic Legal Parameters Set by the Veterinary Pharmaceutical Law and the Genetic Engineering Law of the European Union.

    Science.gov (United States)

    Faltus, Timo; Brehm, Walter

    2016-01-01

    Cell-based therapies have been in use in veterinary medicine for years. However, the legal requirement of manufacturing, placing on the market and use of cell-based veterinary pharmaceuticals are not as well developed as the respective requirements of chemical pharmaceuticals. Cell-based veterinary pharmaceuticals are medicinal products in the sense of the pharmaceutical law of the European Union (EU). For that reason, such medicinal products principally require official approval for their manufacture and an official marketing authorization for their placement on the market before being used by the veterinarian. The manufacture, placing on the market, and use of cell-based veterinary pharmaceuticals without manufacturing approval and marketing authorization is permitted only in certain exceptional cases determined by EU and individual Member State law. Violations of this requirement may have consequences for the respective veterinarian under criminal law and under the code of professional conduct in the respective Member State. The regular use of cell-based veterinary pharmaceuticals within the scope of a therapeutic emergency as well as the import of such veterinary pharmaceuticals from non-European countries for use in the EU are currently out of the question in the EU because of a lack of legal bases. Here, we review the general legal requirement of manufacturing, placing on the market, and use of cell-based veterinary pharmaceuticals within the EU and point out different implementations of EU law within the different Member States.

  12. Cell-Based Veterinary Pharmaceuticals – Basic Legal Parameters Set by the Veterinary Pharmaceutical Law and the Genetic Engineering Law of the European Union

    Science.gov (United States)

    Faltus, Timo; Brehm, Walter

    2016-01-01

    Cell-based therapies have been in use in veterinary medicine for years. However, the legal requirement of manufacturing, placing on the market and use of cell-based veterinary pharmaceuticals are not as well developed as the respective requirements of chemical pharmaceuticals. Cell-based veterinary pharmaceuticals are medicinal products in the sense of the pharmaceutical law of the European Union (EU). For that reason, such medicinal products principally require official approval for their manufacture and an official marketing authorization for their placement on the market before being used by the veterinarian. The manufacture, placing on the market, and use of cell-based veterinary pharmaceuticals without manufacturing approval and marketing authorization is permitted only in certain exceptional cases determined by EU and individual Member State law. Violations of this requirement may have consequences for the respective veterinarian under criminal law and under the code of professional conduct in the respective Member State. The regular use of cell-based veterinary pharmaceuticals within the scope of a therapeutic emergency as well as the import of such veterinary pharmaceuticals from non-European countries for use in the EU are currently out of the question in the EU because of a lack of legal bases. Here, we review the general legal requirement of manufacturing, placing on the market, and use of cell-based veterinary pharmaceuticals within the EU and point out different implementations of EU law within the different Member States. PMID:27965965

  13. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

    Science.gov (United States)

    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  14. Evaluation of a Short Message Service diary methodology in a nonclinical, naturalistic setting.

    Science.gov (United States)

    Walsh, Erin I; Brinker, Jay K

    2012-11-01

    Particularly suited to repeated measures in naturalistic settings, Short Message Service (SMS) is garnering increasing attention as a viable method of data collection. The current study explored issues of practical importance for the development of this methodology, including factors impacting on attrition and compliance, and participant perception of SMS. Using a business-card-sized questionnaire key, 98 university students were sent prompt SMS messages nightly for a week. Completion and compliance were very high in all participants who responded to at least one prompt SMS; those who responded at least once (n=63) responded to 83 percent of all seven prompts, with 95 percent of responses containing appropriate alphanumeric answers to all questions. However, a time lag between recruitment and participation was associated with a failure to commence the diary study. Participants reported positive perceptions of SMS privacy and convenience.

  15. Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

    Science.gov (United States)

    Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

    2015-01-01

    We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

  16. StranshamFord v Minister of Justice and Correctional Services and Others: Can active voluntary euthanasia and doctorassisted suicide be legally justified and are they consistent with the biomedical ethical principles Some suggested guidelines for doct

    Directory of Open Access Journals (Sweden)

    David McQuoid-Mason

    2015-11-01

    Full Text Available The recent case of Stransham-Ford v Minister of Justice and Correctional Services and Others held that voluntary active euthanasia and doctor assisted suicide may be legally justified in certain circumstances. The court observed that the distinction between ‘active’ and ‘passive’ voluntary euthanasia is not legally tenable as in both instances the doctors concerned have the ‘actual’ or ‘eventual’ intention to terminate the patient’s life and have caused or hastened the patient’s death. It is argued that as the South African Constitution is the supreme law of the country, the fundamental rights of patients guaranteed in the Constitution cannot be undermined by ethical duties imposed on health care practitioners by international and national professional bodies. The court in the Stransham-Ford case did not use ethical theories and principles to decide the matter. It simply applied the values in the Constitution and the provisions of the Bill of Rights. However, in order to assist medical practitioners with practical guidelines with which many of them are familiar - rather than complicated unfamiliar philosophical arguments - the biomedical ethical principles of patient autonomy, beneficence, non-maleficence and justice or fairness are applied to active voluntary euthanasia and doctor-assisted suicide in the context of the Stransham-Ford case. Although the case has not set a precedent or opened the floodgates to doctor-assisted voluntary active euthanasia and it is open to Parliament, the Constitutional Court or other courts to develop the concept or outlaw it, some guidelines are offered for doctors to consider should they be authorized by a court to assist with voluntary active euthanasia.

  17. FUZZY LOGIC IN LEGAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Z. Gonul BALKIR

    2011-04-01

    Full Text Available The necessity of examination of every case within its peculiar conditions in social sciences requires different approaches complying with the spirit and nature of social sciences. Multiple realities require different and various perceptual interpretations. In modern world and social sciences, interpretation of perception of valued and multi-valued have been started to be understood by the principles of fuzziness and fuzzy logic. Having the verbally expressible degrees of truthness such as true, very true, rather true, etc. fuzzy logic provides the opportunity for the interpretation of especially complex and rather vague set of information by flexibility or equivalence of the variables’ of fuzzy limitations. The methods and principles of fuzzy logic can be benefited in examination of the methodological problems of law, especially in the applications of filling the legal loopholes arising from the ambiguities and interpretation problems in order to understand the legal rules in a more comprehensible and applicable way and the efficiency of legal implications. On the other hand, fuzzy logic can be used as a technical legal method in legal education and especially in legal case studies and legal practice applications in order to provide the perception of law as a value and the more comprehensive and more quality perception and interpretation of value of justice, which is the core value of law. In the perception of what happened as it has happened in legal relationships and formations, the understanding of social reality and sociological legal rules with multi valued sense perspective and the their applications in accordance with the fuzzy logic’s methods could create more equivalent and just results. It can be useful for the young lawyers and law students as a facilitating legal method especially in the materialization of the perception and interpretation of multi valued and variables. Using methods and principles of fuzzy logic in legal

  18. A Pragmatic Guide to the Setting up of Integrated Hypnotherapy Services in Primary Care and Clinical Settings.

    Science.gov (United States)

    Entwistle, Paul Andrew

    2017-01-01

    Despite the continued debate and lack of a clear consensus about the true nature of the hypnotic phenomenon, hypnosis is increasingly being utilized successfully in many medical, health, and psychological spheres as a research method, motivational tool, and therapeutic modality. Significantly, however, although hypnotherapy is widely advertised, advocated, and employed in the private medical arena for the management and treatment of many physical and emotional disorders, too little appears to be being done to integrate hypnosis into primary care and national health medical services. This article discusses some of the reasons for the apparent reluctance of medical and scientific health professionals to consider incorporating hypnosis into their medical practice, including the practical problems inherent in using hypnosis in a medical context and some possible solutions.

  19. LEGAL PROTECTION IN AWARDING PUBLIC CONTRACTS PROCEEDINGS- HARMONISATION OF CROATIAN LAW WITH THE ACQUIS COMMUNAUTAIRE

    Directory of Open Access Journals (Sweden)

    Damir Aviani

    2008-01-01

    Full Text Available Every economic activity of public legal bodies, and similarly with the activities of public-legal bodies in awarding public contracts to business partners, is subject to the rules of market competition. In order to secure free market competition, and market oriented activity of public legal bodies, the European Union, with its rules, limits the activity of public power and forces it to act in a market oriented way in its economic activities. The legal inheritance of the Union which is related to the awarding of public contracts (on public procurement, concessions and public-private partnership is based on general principles which arise from the Agreement on the Establishment of the European Union, and from the court practice of the European Court of Justice such as transparency, equal treatment and non-discrimination. The demands which are placed on legal protection within the area of awarding certain public contracts are regulated by two, in important points confl ictive directives of the EU on legal remedies: Directive 89/665/EEC, which is related to legal protection in the so called classic sector and by Directive 92/13/EEC which is related to the legal protection in the services sector. The aforementioned with directives set certain demands which the member states must satisfy during the regulation of legal protection in their national legislative. The Croatian system of legal remedies is not unique in the questions of legal protection in procedures of awarding public contracts. That is, the system of legal protection in the procedure of public procurement is different from legal protection in the procedure of awarding contracts of concession and contracts of public-private partnership. Court control of public administration is recognisable as the fundamental element of the rule of law. However, there exists signifi cant room for improvement of legal, and in particular, court protection in the Republic of Croatia for breach of law during

  20. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  1. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    NARCIS (Netherlands)

    M. Chersich (Matthew); S. Luchters (Stanley); I. Ntaganira (Innocent); A. Gerbase (Antonio); Y-R. Lo (Ying-Ru); F. Scorgie (Fiona); R. Steen (Richard)

    2012-01-01

    textabstractIntroduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for

  2. A review of electronic medical record keeping on mobile medical service trips in austere settings.

    Science.gov (United States)

    Dainton, Christopher; Chu, Charlene H

    2017-02-01

    Electronic medical records (EMRs) may address the need for decision and language support for Western clinicians on mobile medical service trips (MSTs) in low resource settings abroad, while providing improved access to records and data management. However, there has yet to be a review of this emerging technology used by MSTs in low-resource settings. The aim of this study is to describe EMR systems designed specifically for use by mobile MSTs in remote settings, and accordingly, determine new opportunities for this technology to improve quality of healthcare provided by MSTs. A MEDLINE, EMBASE, and Scopus/IEEE search and supplementary Google search were performed for EMR systems specific to mobile MSTs. Information was extracted regarding EMR name, organization, scope of use, platform, open source coding, commercial availability, data integration, and capacity for linguistic and decision support. Missing information was requested by email. After screening of 122 abstracts, two articles remained that discussed deployment of EMR systems in MST settings (iChart, SmartList To Go), and thirteen additional EMR systems were found through the Google search. Of these, three systems (Project Buendia, TEBOW, and University of Central Florida's internally developed EMR) are based on modified versions of Open MRS software, while three are smartphone apps (QuickChart EMR, iChart, NotesFirst). Most of the systems use a local network to manage data, while the remaining systems use opportunistic cloud synchronization. Three (TimmyCare, Basil, and Backpack EMR) contain multilingual user interfaces, and only one (QuickChart EMR) contained MST-specific clinical decision support. There have been limited attempts to tailor EMRs to mobile MSTs. Only Open MRS has a broad user base, and other EMR systems should consider interoperability and data sharing with larger systems as a priority. Several systems include tablet compatibility, or are specifically designed for smartphone, which may be

  3. Evaluation of the first fracture liaison service in the Greek healthcare setting.

    Science.gov (United States)

    Makras, Polyzois; Panagoulia, Maria; Mari, Andriana; Rizou, Stavroula; Lyritis, George P

    2017-12-01

    We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited. The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens. Single-center, prospective study from May 1, 2013 to April 30, 2015 (first year-second year follow-up) was conducted. Patients of both genders aged 40-90 years old, with a history of a low trauma fracture and willing to participate, were included after identification by an FLS nurse. Following recruitment, osteoporosis risk factors were assessed, FRAX score was calculated for treatment-naïve patients, bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA), and osteoporosis treatment was suggested where applicable. The rate of participation, the indication of osteoporosis treatment, and the difficulties met were evaluated. Of the eligible 213 patients, 97 (45.5%) were reluctant to participate for personal reasons. From the 116 initially recruited patients (mean age 74.8 ± 12 years), 77 (66.4%) discontinued their participation at some point for various reasons and 39 patients concluded the study. All 116 patients were assessed for osteoporosis risk factors and given a tailor-made exercise and education program, while FRAX score was assessed in all treatment-naïve patients (74 patients, 63.8%). Osteoporosis medication was suggested or reviewed in 74 patients; however, an adherence rate of 100% is only available for the 24 who concluded the study. We report the first implementation of FLS in the Greek healthcare setting. The participation rate is moderate and definitely needs improvement.

  4. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    Science.gov (United States)

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  5. NASA's Global Change Master Directory: Discover and Access Earth Science Data Sets, Related Data Services, and Climate Diagnostics

    Science.gov (United States)

    Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler

    2011-01-01

    NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/

  6. e-commerce in the electricity supply industry: legal setting and selected legal issues arising in doing one's business via the Web; E-Commerce in der Elektrizitaetzwirtschaft: rechtliche Rahmenbedingungen und ausgewaehlte Rechtsprobleme bei der Nutzung des Internets

    Energy Technology Data Exchange (ETDEWEB)

    Genten, A.; Rosin, P. [RWE Plus AG, Essen (DE). Privat Kundenmanagement (Recht)

    2001-07-01

    It is expected that e-commerce will be increasingly applied in business relations of the international electricity supply industry. This is why the contribution here sets out the legal provisions effective within the European Union as well as in Germany. Examples are given to illustrate specific aspects. (orig./CB) [German] Es wird erwartet, dass auch in der Elektrizitaetswirtschaft E-Commerce immer groessere Aufmerksamkeit findet. Demzufolge ist auch fuer die Elektrizitaetswirtschaft eine Auseinandersetzung mit den rechtlichen Rahmenbedingungen und den Rechtsproblemen bei der Nutzung des Internets von Interesse. Die Abhandlung erlaeutert den Europaeischen Rechtsrahmen fuer E-Commerce und den nationalen Rechtsrahmen fuer E-Commerce. (orig./CB)

  7. The impact of primary service and servicescape on customer satisfaction in a leisure service setting : an empirical investigation among theatregoers

    OpenAIRE

    Jobst, Johanna; Boerner, Sabine

    2015-01-01

    This paper investigates the effects of perceived primary service and perceived servicescape on customer satisfaction in theatres. According to a questionnaire study, among n=2897 theatregoers in 12 German-speaking theatres, factors pertaining to the perceived primary service are most influential on customer satisfaction (in particular, the perceived artistic quality, followed by visitors’ emotional and cognitive response to the performance). Contrariwise, factors pertaining to the perceived s...

  8. CASE COMMENT ON NATIONAL LEGAL SERVICES AUTHORITY V. UNION OF INDIA & OTHERS (AIR 2014 SC 1863: A RAY OF HOPE FOR THE LGBT COMMUNITY

    Directory of Open Access Journals (Sweden)

    M.K. Sahu

    2016-01-01

    Full Text Available The lives of human beings are full of complexities, but LGBT face much more trauma compared to other people. What is necessary is to understand the sentiments of the LGBT community and also to grant them common human rights. But the world lowers its eyes and refuses a discussion over the granting of basic human rights to the LGBT community. And it is so sad to see that such discrimination exists even in the 21st century. Indian law, on the whole, only recognizes the paradigm of the binary genders of male and female, based on a person’s sex assigned at birth, which permits a gender system, including the laws relating to marriage, adoption, inheritance, succession and taxation, and welfare legislation. The most pertinent question with respect to the LGBT community is whether LGBT are to be discriminated against by other human beings. Merely being different does not give others the authority to ostracize one from society. In fact, in July 2009 the Delhi High Court ruled that consensual same-sex relations between adults in private could not be criminalized. Then in a recent judgment, the Supreme Court of India expressed its concerns over the mental trauma, emotional agony and pain of the members of the transgender community: all forms of mental suffering of the LGBT community, as well as ignorance and isolation of the community, were brought to an end by the Court’s decision in National Legal Services Authority v. Union of India & Others.

  9. Customer service strategy options : a multiple case study in a B2B setting

    NARCIS (Netherlands)

    Wouters, J.P.M.

    2004-01-01

    This study addresses the question whether customer service actually has order winning potential in B2B situations, which customer service strategies are deployed, and what determines customer service relevance. A literature review was followed by a multiple case study, using 12 organizations from

  10. Photovoltaic facilities, legal guidebook

    International Nuclear Information System (INIS)

    Maincent, G.

    2011-01-01

    Important debates about the photovoltaic industry took place in 2009 and 2010 which have led to some evolutions of the French law having an economical impact on the arrangement of photovoltaic projects. The aim of this supplement to 'Droit de l'Environnement' journal is to answer some important questions at a time when the electricity market is not fully structured: the setting up of solar cell panels, town planing and property constraints; connection to the grid; project financing: power generation tariffs, partnership contract; the new legal framework set up in 2011: moratorium and new legal scheme; is 'green fiscality' still green and attractive? Settlement of disputes with the French government; actors reactions: authorities and professionals, opinion of an expert. (J.S.)

  11. Abusive Legalism

    OpenAIRE

    Cheung, Alvin

    2018-01-01

    This paper suggests that one response to growing scrutiny of authoritarian tactics is to turn to sub-constitutional public law, or private law. By using “ordinary” law in ways that seem consistent with formal and procedural aspects of rule of law, autocrats can nonetheless frustrate the rule of law and consolidate power, while also avoiding drawing unfavourable attention to that consolidation. I refer to this phenomenon as “abusive legalism.” This paper makes three main contributions to the s...

  12. The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

    International Nuclear Information System (INIS)

    Schultz, Courtney A.

    2012-01-01

    Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is done under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.

  13. Defining Legal Writing: An Empirical Analysis of the Legal Memorandum. LSAC Research Report Series.

    Science.gov (United States)

    Breland, Hunter M.; Hart, Frederick M.

    This study examined legal writing as it was represented in legal memoranda prepared by first-semester law students at 12 different law schools. The study was based on the cumulative judgments of the instructors and professors of law in those institutions, humanities specialists at the Educational Testing Service, and two legal consultants. A…

  14. 45 CFR 400.115 - Establishing legal responsibility.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Establishing legal responsibility. 400.115 Section... Child Welfare Services § 400.115 Establishing legal responsibility. (a) A State must ensure that legal responsibility is established, including legal custody and/or guardianship, as appropriate, in accordance with...

  15. Domestic violence survivors and their experiences during legal process.

    Science.gov (United States)

    Özçakar, Nilgün; Yeşiltepe, Gözde; Karaman, Gökçe; Ergönen, Akça Toprak

    2016-05-01

    Many victims of domestic violence do not seek recourse to the needed medical and legal services. The aim of this study was to determine the difficulties faced by and experiences of female survivors of domestic violence during their medical and legal proceedings. We designed our study using a qualitative approach to understand the experiences of survivors during the legal process as well as their feelings and attitudes towards domestic violence through in-depth interviews. The data obtained from the participants were analyzed and synthesized using a thematic analysis procedure. Most of our participants reported different types of domestic violence, citing feelings of fear and loneliness during these experiences. They reported feeling dissatisfied with their complaints being ignored by the police and the perpetrators remaining unpunished. They complained of the complex procedures and negligence of staff in health-care centers such as hospitals, and they reported being shifted to several different places. We believe that an assessment of such female survivors in terms of specific standards set by specialists will help make improvements to the legal process. Education programs should be organized for professionals dealing with survivors of domestic violence. Special health-care services with fast proceedings must be established in health-care centers. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Setting up an IAPT site: the Ealing Mental Health & Well-Being Service.

    Science.gov (United States)

    Ruprah-Shah, Baljeet

    2009-01-01

    IAPT will succeed or fail on the extent to which it enables partnerships. For years I have been working to integrate mental health services in Ealing. Improving Access to Psychological Therapies (IAPT) offers the best chance I have ever known to achieve this, and to make a coordinated impact on the health of the people of Ealing. IAPT is an exciting opportunity for us in Ealing and we have grabbed it with both hands. We are incorporating it into our beliefs, values and passion to produce a service that will reflect our vision for holistic primary care services. A service which is financially sound. A service which does not believe that there is one answer to everyone's mild to moderate mental health problems. A service which recognises that working in silos is detrimental to our patients' health. A service which is constantly striving to improve relationships with our partners. A service which is mindful about the people we see, and the staff who see them.

  17. Introducing Matrix Management within a Children's Services Setting--Personal Reflections

    Science.gov (United States)

    Brooks, Michael; Kakabadse, Nada K.

    2014-01-01

    This article reflects on the introduction of "matrix management" arrangements for an Educational Psychology Service (EPS) within a Children's Service Directorate of a Local Authority (LA). It seeks to demonstrate critical self-awareness, consider relevant literature with a view to bringing insights to processes and outcomes, and offers…

  18. Integrating Information Services in an Academic Setting: The Organizational and Technical Challenge.

    Science.gov (United States)

    Branin, Joseph J.; And Others

    1993-01-01

    Describes a project to integrate the support and delivery of information services to faculty and staff at the University of Minnesota from the planning phase to implementation of a new organizational entity. Topics addressed include technical and organizational integration, control and delivery of services, and networking and organizational fit.…

  19. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

    OpenAIRE

    Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

    2012-01-01

    Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services.

  20. Mapping ecosystem functions and services in Eastern Europe using global-scale data sets

    NARCIS (Netherlands)

    Schulp, C.J.E.; Alkemade, R.; Klein Goldewijk, K.; Petz, K.

    2012-01-01

    To assess future interactions between the environment and human well-being, spatially explicit ecosystem service models are needed. Currently available models mainly focus on provisioning services and do not distinguish changes in the functioning of the ecosystem (Ecosystem Functions – ESFs) and

  1. Stochastic inventory management at a service facility with a set of ...

    African Journals Online (AJOL)

    We consider a continuous review perishable inventory system at a service facility with a finite waiting capacity. The maximum inventory level is fixed and the customers arrive according to a Markov arrival process. The life time of each item and the service time are assumed to have independent exponential distributions.

  2. Veterans' Mental Health in Higher Education Settings: Services and Clinician Education Needs.

    Science.gov (United States)

    Niv, Noosha; Bennett, Lauren

    2017-06-01

    Utilization of the GI Bill and attendance at higher education institutions among student veterans have significantly increased since passage of the Post-9/11 GI Bill. Campus counseling centers should be prepared to meet the mental health needs of student veterans. This study identified the mental health resources and services that colleges provide student veterans and the education needs of clinical staff on how to serve student veterans. Directors of mental health services from 80 California colleges completed a semistructured phone interview. Few schools track the number, demographic characteristics, or presenting needs of student veterans who utilize campus mental health services or offer priority access or special mental health services for veterans. Directors wanted centers to receive education for an average of 5.8 veteran-related mental health topics and preferred workshops and lectures to handouts and online training. Significant training needs exist among clinical staff of campus mental health services to meet the needs of student veterans.

  3. The Effects of Task Clarification, Feedback, and Goal Setting on Student Advisors' Office Behaviors and Customer Service

    Science.gov (United States)

    Tittelbach, Danielle; DeAngelis, Maureen; Sturmey, Peter; Alvero, Alicia M.

    2007-01-01

    This study evaluated the effects of feedback, task clarification and goal-setting on office behaviors and customer service of ten undergraduate participants that served as university advisors. A multiple baseline design was implemented across three target behaviors: client greeting, front-desk behaviors, and punctuality. During intervention the…

  4. Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy?

    Science.gov (United States)

    Darrah, J; Wiart, L; Magill-Evans, J; Ray, L; Andersen, J

    2012-01-01

    Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite

  5. Legal technique: approaches to section on types

    Directory of Open Access Journals (Sweden)

    І. Д. Шутак

    2015-11-01

    Full Text Available Legal technique is a branch of knowledge about the rules of doing legal work and creating in the process a variety of legal documents, which had previously been part of the theory of law. In modern conditions of the legal technique are isolated in a separate branch of legal science, focused on solving practical problems. The purpose of this article is to analyze the types of legal techniques, in particular, on the basis of theoretical propositions about legal technique to allocate substantial characteristics and types of legal technique. O. Malko and M. Matuzov consider legal technique as a set of rules, techniques, methods of preparation, creation, registration of legal documents, their classification and accounting for their excellence, efficient use. A similar meaning is investing in this concept Alekseev, determining that the legal technique is a set of tools and techniques used in accordance with accepted rules in the formulation and systematization of legal acts to ensure their perfection. So, legal technique – theoretical and applied legal science, which studies the regularities of rational legal practice in the creation, interpretation and implementation of law. In relation to the type of legal techniques in the literature proposed different classifications. For example, G. Muromtsev technique, which is used only in the field of law, divide on the technique of law-making (legislative technique, technique of law enforcement, interpretation, technique of judicial speech, interrogation, notarial activities. V. Kartashov shared legal technique on law making and enforcement (prorealtime, interpretive yourself and prevacidrebatezw, judicial or investigative, prosecutorial, and the like. Some authors clearly indicate that the criterion by which to distinguish types of legal techniques. So, S. Alekseev notes that legal technique is classified from the point of view of the legal nature of the act made on: a techniques of legal acts; b the

  6. Factors affecting utilization of cervical cancer prevention services in low-resource settings

    Directory of Open Access Journals (Sweden)

    Bingham Allison

    2003-01-01

    Full Text Available Strategies for introducing or strengthening cervical cancer prevention programs must focus on ensuring that appropriate, cost-effective services are available and that women who most need the services will, in fact, use them. This article summarizes the experiences of research projects in Bolivia, Peru, Kenya, South Africa, and Mexico. Factors that affect participation rates in cervical cancer prevention programs are categorized in three sections. The first section describes factors that arise from prevailing sociocultural norms that influence women's views on reproductive health, well being, and notions of illness. The second section discusses factors related to the clinical requirements and the type of service delivery system in which a woman is being asked to participate. The third section discusses factors related to quality of care. Examples of strategies that programs are using to encourage women's participation in cervical cancer prevention services are provided.

  7. Legal duties, professional obligations or notional guidelines? Screening, treatment and referral of domestic violence cases in primary health care settings in South Africa.

    Science.gov (United States)

    Artz, Lillian; Meer, Talia; Aschman, Gray

    2018-06-18

    Since 2013, approximately 4400 women have been murdered by their partners in South Africa. This is five times higher than the per capita global average. Domestic violence is known to be cyclical, endemic and frequently involves multiple victims. It also becomes progressively more dangerous over time and may lead to fatalities. In 2012, the Health Professions Council of South Africa released a domestic violence protocol for emergency service providers. This protocol, or screening guidelines, includes assessing future risk to domestic violence, providing physical and psychosocial care, documentation of evidence of abuse and informing patients of their rights and the services available to them. The extent to which these guidelines have been circulated and implemented, particularly by general health care practitioners (HCPs), is unknown. We review international treaties to which South Africa is a signatory, as well as national legislation and policies that reinforce the right to care for victims of domestic violence, to delineate the implication of these laws and policies for HCPs. We reviewed literature and analysed national and international legislation and policies. The 'norms' contained in existing guidelines and currently practiced in an ad hoc manner are not only compatible with existing statutory duties of HCPs but are in fact a natural extension of them. Proactive interventions such as the use of guidelines for working with victims of domestic violence enable suspected cases of domestic violence to be systematically identified, appropriately managed, properly referred, and should be adopted by all South African HCPs.

  8. Service Failure and Recovery in a Public Setting: A Comparative Study of Target and Observing Customers

    OpenAIRE

    SEYED SHAHIN SHARIFI

    2017-01-01

    Previous research has examined the effect of service failure and recovery on target and the observing customers separately, with an emphasis on evaluations by target customers. It has been assumed that the reactions of those customers observing the recovery efforts would mirror those of target customers, or perhaps be even more favourable, given that they are not directly affected by the service failure. This research challenges this pre-conception. Through a series of experimental studies, t...

  9. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    Science.gov (United States)

    Mbah, Henry; Negedu-Momoh, Olubunmi Ruth; Adedokun, Oluwasanmi; Ikani, Patrick Anibbe; Balogun, Oluseyi; Sanwo, Olusola; Ochei, Kingsley; Ekanem, Maurice; Torpey, Kwasi

    2014-01-01

    The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration. A quantitative before-and-after study conducted in 122 Family Health International (FHI360) supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration) for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and laboratory systems were 64 (52.5%) and 0 (0.0%) at baseline, compared to 100 (82.0%) and 3 (2.4%) respectively at 3 months follow-up (p = 0.000). This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  10. Measuring mental health in the clinical setting: what is important to service users? The Mini-Service user Recovery Evaluation scale (Mini-SeRvE).

    Science.gov (United States)

    Barber, Joanna M; Parsons, Helen; Wilson, Carol A; Cook, Christopher C H

    2017-12-01

    Since 2001, a policy of positive mental health recovery has been promoted in the UK, with service user involvement. This has not been easy to implement in the clinical setting. To develop and validate a brief self-report, service user-designed, outcome measure (Mini-SeRvE), for clinical use, including spiritual and religious issues. From the previously developed Service user Recovery Evaluation scale (SeRvE), 15 questions were selected for Mini-SeRvE which was self-completed by 207 people; 100 service users and, for comparison, 107 staff. Results were analysed using SPSS software (SPSS Inc., Chicago, IL). Mini-SeRvE is reliable, Cronbach's alpha 0.852. Correlation with another recovery scale, Mental Health Recovery Measure, was high, r = 0.819. Three reliable subscales emerged; existential well-being (EWB), mental ill-being (MIB) and religious well-being (RWB). Scores of the EWB and MIB subscales were higher for staff, consistent with higher mental well-being. Religious well-being scores were higher in service users, who also rated religion as more important to them. Mini-SeRvE is a valid measure of service user recovery. The importance of religion/spiritual belief for our users is highlighted, this being reflected in the subject matter of Mini-SeRvE. Mini-SeRvE assessments could show individual priorities, evaluate therapy and aid clinical decision-making.

  11. An Exploration of Factors that Effect the Implementation of Peer Support Services in Community Mental Health Settings.

    Science.gov (United States)

    Mancini, Michael A

    2018-02-01

    This study explored the integration of peer services into community mental health settings through qualitative interviews with peer-providers and non-peer mental health workers. Results show peer job satisfaction was contingent upon role clarity, autonomy, and acceptance by non-peer coworkers. Mental health workers reported the need for organizational support for peer services and guidance about how to utilize peers, negotiate their professional boundaries and accommodate their mental health needs. Effective peer integration requires organizational readiness, staff preparation and clear policies and procedures. Consultation from consumer-based organizations, enhanced professional competencies, and professional development and career advancement opportunities for peers represent important resources.

  12. Implementing and measuring the level of laboratory service integration in a program setting in Nigeria.

    Directory of Open Access Journals (Sweden)

    Henry Mbah

    Full Text Available The surge of donor funds to fight HIV&AIDS epidemic inadvertently resulted in the setup of laboratories as parallel structures to rapidly respond to the identified need. However these parallel structures are a threat to the existing fragile laboratory systems. Laboratory service integration is critical to remedy this situation. This paper describes an approach to quantitatively measure and track integration of HIV-related laboratory services into the mainstream laboratory services and highlight some key intervention steps taken, to enhance service integration.A quantitative before-and-after study conducted in 122 Family Health International (FHI360 supported health facilities across Nigeria. A minimum service package was identified including management structure; trainings; equipment utilization and maintenance; information, commodity and quality management for laboratory integration. A check list was used to assess facilities at baseline and 3 months follow-up. Level of integration was assessed on an ordinal scale (0 = no integration, 1 = partial integration, 2 = full integration for each service package. A composite score grading expressed as a percentage of total obtainable score of 14 was defined and used to classify facilities (≤ 80% FULL, 25% to 79% PARTIAL and <25% NO integration. Weaknesses were noted and addressed.We analyzed 9 (7.4% primary, 104 (85.2% secondary and 9 (7.4% tertiary level facilities. There were statistically significant differences in integration levels between baseline and 3 months follow-up period (p<0.01. Baseline median total integration score was 4 (IQR 3 to 5 compared to 7 (IQR 4 to 9 at 3 months follow-up (p = 0.000. Partial and fully integrated laboratory systems were 64 (52.5% and 0 (0.0% at baseline, compared to 100 (82.0% and 3 (2.4% respectively at 3 months follow-up (p = 0.000.This project showcases our novel approach to measure the status of each laboratory on the integration continuum.

  13. Visions of the Future of (Legal) Education

    OpenAIRE

    Madison, Michael

    2017-01-01

    One law professor takes a stab at imagining an ideal law school of the future and describing how to get there. The Essay spells out a specific possible vision, taking into account changes to the demand for legal services and changes to the economics and composition of the legal profession. That thought experiment leads to a series of observations about values and vision in legal education in general and about what it might take to move any vision forward.

  14. Design of Availability-Dependent Distributed Services in Large-Scale Uncooperative Settings

    Science.gov (United States)

    Morales, Ramses Victor

    2009-01-01

    Thesis Statement: "Availability-dependent global predicates can be efficiently and scalably realized for a class of distributed services, in spite of specific selfish and colluding behaviors, using local and decentralized protocols". Several types of large-scale distributed systems spanning the Internet have to deal with availability variations…

  15. Definition of Intervener Services and Interveners in Educational Settings. Technical Report

    Science.gov (United States)

    National Consortium on Deaf-Blindness, 2013

    2013-01-01

    This technical report synthesizes the process and information used by National Consortium on Deaf-Blindness (NCDB) in the development of a consistently applied definition of intervener services. It addresses challenges and questions, provides comparisons between interveners and paraprofessionals, and offers definitions, roles and concepts used by…

  16. Performance of the measures of processes of care for adults and service providers in rehabilitation settings.

    Science.gov (United States)

    Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

    2015-01-01

    In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). A validation study. In-patient rehabilitation facilities. MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71-0.88 for health care professionals, 0.82-0.90 for patients, and 0.87-0.94 for family members), as well as moderate to good correlations between domains (0.40-0.78 for health care professionals and 0.52-0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

  17. Development of a Quality of Meals and Meal Service Set of Indicators for Residential Facilities for Elderly.

    Science.gov (United States)

    Van Damme, N; Buijck, B; Van Hecke, A; Verhaeghe, S; Goossens, E; Beeckman, D

    2016-01-01

    To develop a content validated set of indicators to evaluate the quality of meals and meal service in residential facilities for elderly. Inadequate food intake is an important risk factor for malnutrition in residential facilities for elderly. Through better meeting the needs and preferences of residents and optimization of meals and meal service, residents' food intake can improve. No indicators were available which could help to guide strategies to improve the quality of meals and meal service. The indicator set was developed according to the Indicator Development Manual of the Dutch Institute for Health Care Improvement (CBO). The working group consisted of three nurse researchers and one expert in gastrology and had expertise in elderly care, malnutrition, indicator development, and food quality. A preliminary list of potential indicators was compiled using the literature and the working group's expertise. Criteria necessary to measure the indicator in practice were developed for each potential indicator. In a double Delphi procedure, the list of potential indicators and respective criteria were analyzed for content validity, using a multidisciplinary expert panel of 11 experts in elderly meal care. A preliminary list of 20 quality indicators, including 45 criteria, was submitted to the expert panel in a double Delphi procedure. After the second Delphi round, 13 indicators and 25 criteria were accepted as having content validity. The content validity index (CVI) ranged from 0.83 to 1. The indicator set consisted of six structural, four result, and three outcome indicators covering the quality domains food, service and choice, as well as nutritional screening. The criteria measure diverse aspects of meal care which are part of the responsibility of kitchen staff and health care professionals. The 'quality of meals and meal service' set of indicators is a resource to map meal quality in residential facilities for elderly. As soon as feasibility tests in practice

  18. Labour Market Interactions Between Legal and Illegal Immigrants

    OpenAIRE

    Epstein, Gil S

    2000-01-01

    This paper looks at the situation of legal immigrants who employ illegal immigrants to provide them with various services. This enables the legal immigrants to allocate more time to other work, thereby increasing their earnings. Illegal immigrants employed by legal immigrants may specialize in certain professions and may themselves employ other illegal immigrants. An economy is evolving whose sole purpose is the provision of services by illegal immigrants for legal immigrants.

  19. Labor Market Interactions Between Legal and Illegal Immigrants

    OpenAIRE

    Epstein, Gil S.

    2000-01-01

    This paper looks at the situation of legal immigrants who employ illegal immigrants to provide them with various services. This enables the legal immigrants to allocate more time to other work, thereby increasing their earnings. Illegal immigrants employed by legal immigrants may specialize in certain professions and may themselves employ other illegal immigrants. An economy is evolving whose sole purpose is the provision of services by illegal immigrants for legal immigrants.

  20. Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.

    Science.gov (United States)

    DiPiro, Pamela J; Krajewski, Katherine M; Giardino, Angela A; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

    2017-01-01

    The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

  1. Radiology consultation in the era of precision oncology: A review of consultation models and services in the tertiary setting

    Energy Technology Data Exchange (ETDEWEB)

    DiPiro, Pamela J.; Krajewski, Katherine M.; Giardino, Angela A.; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H. [Dept. of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States)

    2017-01-15

    The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.

  2. How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy.

    Science.gov (United States)

    Egeland, Karina Myhren; Ruud, Torleif; Ogden, Terje; Färdig, Rickard; Lindstrøm, Jonas Christoffer; Heiervang, Kristin Sverdvik

    2017-01-01

    The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014.

  3. Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

    Science.gov (United States)

    Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

    2008-09-01

    Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

  4. Interprofessional service-learning in a community setting: findings from a pilot study.

    Science.gov (United States)

    Buff, Scotty M; Jenkins, Kelli; Kern, Donna; Worrall, Cathy; Howell, David; Martin, Kelley; Brown, Debora; White, Andrea; Blue, Amy

    2015-03-01

    Interprofessional education is becoming more popular in higher education and service-learning has been a successful method to facilitate experiences that foster teamwork between professions. This report shares the results from an interprofessional service-learning project (ISLP) targeting students across eight disciplines (physician assistant, medicine, pharmacy, dietetic internship, physical therapy, master in health administration, nursing and biomedical science). The project used an existing resource, the South Carolina Area Health Education Consortium (SC-AHEC), to coordinate student learning across multiple regions and an established health promotion program curriculum for student outreach content. Participating students (n = 149) were evaluated to determine how the activity affected student appreciation and knowledge of their own and other professions, their interaction with other professional students, and student teamwork skills. Students found the most value in learning with students from other professions as part of the activity with lesser value placed on students increasing their knowledge about their profession's role in interprofessional work.

  5. Reflections on product/service-system (PSS) conceptualisation in a course setting

    DEFF Research Database (Denmark)

    Tan, Adrian; McAloone, Timothy Charles; Lauridsen, Erik Hagelskjær

    2009-01-01

    Product/service-system (PSS) approaches have over the past decade received considerable attention as possible sustainable innovation strategies. This paper presents and reflects upon the background, rationale and experiences behind a PSS design methodology applied with engineering students...... in a project course for the past five years. The methodology proposes four complementary dimensions of PSS: value proposition, product life cycle, activity modelling cycle and actor network, that all seem to comprehensively describe the essential conceptual design perspectives. Each of these dimensions...

  6. Medication therapy management and condition care services in a community-based employer setting.

    Science.gov (United States)

    Johannigman, Mark J; Leifheit, Michael; Bellman, Nick; Pierce, Tracey; Marriott, Angela; Bishop, Cheryl

    2010-08-15

    A program in which health-system pharmacists and pharmacy technicians provide medication therapy management (MTM), wellness, and condition care (disease management) services under contract with local businesses is described. The health-system pharmacy department's Center for Medication Management contracts directly with company benefits departments for defined services to participating employees. The services include an initial wellness and MTM session and, for certain patients identified during the initial session, ongoing condition care. The initial appointment includes a medication history, point-of-care testing for serum lipids and glucose, body composition analysis, and completion of a health risk assessment. The pharmacist conducts a structured MTM session, reviews the patient's test results and risk factors, provides health education, discusses opportunities for cost savings, and documents all activities on the patient's medication action plan. Eligibility for the condition care program is based on a diagnosis of diabetes, hypertension, asthma, heart failure, or hyperlipidemia or elevation of lipid or glucose levels. Findings are summarized for employers after the initial wellness screening and at six-month intervals. Patients receiving condition care sign a customized contract, establish goals, attend up to four MTM sessions per year, and track their information on a website; employers may offer incentives for participation. When pharmacists recommend adjustments to therapy or cost-saving changes, it is up to patients to discuss these with their physician. A survey completed by each patient after the initial wellness session has indicated high satisfaction. Direct cost savings related to medication changes have averaged $253 per patient per year. Total cost savings to companies in the first year of the program averaged $1011 per patient. For the health system, the program has been financially sustainable. Key laboratory values indicate positive clinical

  7. Citizen Access to Legal Information.

    Science.gov (United States)

    Andrus, Kay L.

    1987-01-01

    Describes activities by the American Bar Association and other groups aimed at educating the public about their legal rights and responsibilities, including informational pamphlets and brochures issued by state bar associations. These public service information pamphlets are listed by state and the address of each state's bar association is…

  8. Mental health services in Cambodia, challenges and opportunities in a post-conflict setting.

    Science.gov (United States)

    Jegannathan, Bhoomikumar; Kullgren, Gunnar; Deva, Parameshvara

    2015-02-01

    Cambodia had suffered enormously due to war and internecine conflict during the latter half of the twentieth century, more so during the Vietnam War. Total collapse of education and health systems during the Pol Pot era continues to be a challenge for developing the necessary infrastructure and human resources to provide basic minimum mental health care which is compounded by the prevailing cultural belief and stigma over mental, neurological and substance abuse disorders (MNSDs). The mental health research and services in Cambodia had been predominantly 'trauma focused', a legacy of war, and there is a need to move toward epidemiologically sound public health oriented mental health policy and service development. Integrating mental health program with primary health care services with specifically stated minimum package of activities at primary level and complementary package of activities at secondary level is an opportunity to meet the needs and rights of persons with mental, neurological and substance abuse disorders (PWMNSDs) in Cambodia, provided there is mental health leadership, government commitment and political will. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    Science.gov (United States)

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  10. A Systems Approach to Understanding Occupational Therapy Service Negotiations in a Preschool Setting

    Science.gov (United States)

    Silverman, Fern; Kramer, Paula; Ravitch, Sharon

    2011-01-01

    The purpose of this study was to use a systems approach to examine informal communications, meaning those occurring outside of scheduled meetings, among stakeholders in a preschool early intervention program. This investigation expands the discussion of how occupational therapy treatment decisions are made in educational settings by using a…

  11. Clinical and economic outcomes of nurse-led services in the ambulatory care setting: A systematic review.

    Science.gov (United States)

    Chan, Raymond J; Marx, Wolfgang; Bradford, Natalie; Gordon, Louisa; Bonner, Ann; Douglas, Clint; Schmalkuche, Diana; Yates, Patsy

    2018-02-21

    With the increasing burden of chronic and age-related diseases, and the rapidly increasing number of patients receiving ambulatory or outpatient-based care, nurse-led services have been suggested as one solution to manage increasing demand on the health system as they aim to reduce waiting times, resources, and costs while maintaining patient safety and enhancing satisfaction. The aims of this review were to assess the clinical effectiveness, economic outcomes and key implementation characteristics of nurse-led services in the ambulatory care setting. A systematic review was conducted using the standard Cochrane Collaboration methodology and was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE EBSCO, CINAHL EBSCO, and PsycINFO Ovid (from inception to April 2016). Data were extracted and appraisal undertaken. We included randomised controlled trials; quasi-randomised controlled trials; controlled and non-controlled before-and-after studies that compared the effects of nurse-led services in the ambulatory or community care setting with an alternative model of care or standard care. Twenty-five studies of 180,308 participants were included in this review. Of the 16 studies that measured and reported on health-related quality of life outcomes, the majority of studies (n = 13) reported equivocal outcomes; with three studies demonstrating superior outcomes and one demonstrating inferior outcomes in comparison with physician-led and standard care. Nurse-led care demonstrated either equivalent or better outcomes for a number of outcomes including symptom burden, self-management and behavioural outcomes, disease-specific indicators, satisfaction and perception of quality of life, and health service use. Benefits of nurse-led services remain inconclusive in terms of economic outcomes. Nurse

  12. Determinants of Physicians' Technology Acceptance for Mobile Health Services in Healthcare Settings

    Directory of Open Access Journals (Sweden)

    Saeid Ebrahimi

    2018-01-01

    Full Text Available Introduction: World Health Organization reports indicated that the image of health care service delivery has changed by application of mobile health and wireless technologies for supporting and achieving the objectives of the health industry. The present study aimed to determine the level of physicians’ familiarity and investigate the factors affecting the acceptance of mobile health from the viewpoint of physicians working in educational hospitals of Zahedan University of Medical Sciences. Method: A cross-sectional study was carried out in Zahedan University of Medical Sciences in the southeast of Iran in 2016. The statistical population included all physicians working in five University Teaching Hospitals (n=150. In this study, systematic random sampling was used. A validated questionnaire, prepared based on the variables of Technology Acceptance Model 2 and models, was used for data collection. To analyze the data, we used descriptive and analytical statistics (Confirmatory Factor Analysis, linear and multiple regression. Results: Most of the respondents (112, or 74.4% were female and 84 of them (56% were less than 30 years old. All of the physicians (specialist and general physician used Smartphones. The score of perceived usefulness, behavioral intention, perceived enjoyment, subjective norm, perceived ease of use, image, volunteering, and objective usability constructs were higher than the average baseline, representing the acceptance of mobile phone by them. The relationship of all the constructs with each other towards the attitudinal and behavioral objectives of the mobile health services acceptance was significant (P0.05. Conclusion: The results of this study provide useful information to health managers and policymakers so that they can take steps to improve the quality of services using modern technologies. Plans can also be made by considering the factors as behavioral acceptance of mobile health and other effective factors to

  13. Legal and Regulatory Barriers to Reverse Innovation.

    Science.gov (United States)

    Rowthorn, Virginia; Plum, Alexander J; Zervos, John

    Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers. The objective of this paper is to understand and elucidate the legal barriers faced by innovators bringing health interventions to the United States. Semistructured qualitative interviews were conducted with 9 key informants who have directly participated in the introduction of global health care approaches to the United States health system. A purposive sampling scheme was employed to identify participants. Phone interviews were conducted over one week in July 2016 with each participant and lasted an average of 35 minutes each. Purely legal barriers included questions surrounding tort liability, standard of care, and concerns around patient-administered self-care. Regulatory burdens included issues of international medical licensure, reimbursement, and task shifting and scope of work challenges among nonprofessionals (e.g. community health workers). Finally, perceived (i.e. not realized or experienced) legal and regulatory barriers to innovative modalities served as disincentives to bringing products or services developed outside of the United States to the United States market. Conflicting interests within the health care system, safety concerns, and little value placed on low-cost interventions inhibit innovation. Legal and regulatory barriers rank among, and contribute to, an anti-innovation atmosphere in healthcare for domestic and reverse innovators alike. Reverse innovation should be fostered through the thoughtful development of

  14. Indirect Effects of Field Management on Pollination Service and Seed Set in Hybrid Onion Seed Production.

    Science.gov (United States)

    Gillespie, Sandra; Long, Rachael; Williams, Neal

    2015-12-01

    Pollination in crops, as in native ecosystems, is a stepwise process that can be disrupted at any stage. Healthy pollinator populations are critical for adequate visitation, but pollination still might fail if crop management interferes with the attraction and retention of pollinators. Farmers must balance the direct benefits of applying insecticide and managing irrigation rates against their potential to indirectly interfere with the pollination process. We investigated these issues in hybrid onion seed production, where previous research has shown that high insecticide use reduces pollinator attraction. We conducted field surveys of soil moisture, nectar production, pollinator visitation, pollen-stigma interactions, and seed set at multiple commercial fields across 2 yr. We then examined how management actions, such as irrigation rate (approximated by soil moisture), or insecticide use could affect the pollination process. Onions produced maximum nectar at intermediate soil moisture, and high nectar production attracted more pollinators. Insecticide use weakly affected pollinator visitation, but when applied close to bloom reduced pollen germination and pollen tube growth. Ultimately, neither soil moisture nor insecticide use directly affected seed set, but the high correlation between pollinator visitation and seed set suggests that crop management will ultimately affect yields via indirect effects on the pollination process. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

    Science.gov (United States)

    Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

    2015-01-01

    This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported

  16. Legal Philosophy - Five Questions

    DEFF Research Database (Denmark)

    This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential.......This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential....

  17. Argumentation in Legal Reasoning

    Science.gov (United States)

    Bench-Capon, Trevor; Prakken, Henry; Sartor, Giovanni

    A popular view of what Artificial Intelligence can do for lawyers is that it can do no more than deduce the consequences from a precisely stated set of facts and legal rules. This immediately makes many lawyers sceptical about the usefulness of such systems: this mechanical approach seems to leave out most of what is important in legal reasoning. A case does not appear as a set of facts, but rather as a story told by a client. For example, a man may come to his lawyer saying that he had developed an innovative product while working for Company A. Now Company B has made him an offer of a job, to develop a similar product for them. Can he do this? The lawyer firstly must interpret this story, in the context, so that it can be made to fit the framework of applicable law. Several interpretations may be possible. In our example it could be seen as being governed by his contract of employment, or as an issue in Trade Secrets law.

  18. Linking Emotional Labor, Public Service Motivation, and Job Satisfaction: Social Workers in Health Care Settings.

    Science.gov (United States)

    Roh, Chul-Young; Moon, M Jae; Yang, Seung-Bum; Jung, Kwangho

    2016-01-01

    This study examines the determinants of emotional laborers'--social workers in health care organizations--job satisfaction and their public service motivation in using a structural equation model and provides empirical evidence regarding what contributes to job satisfaction or burnout in these workers. Among several latent variables, this study confirmed that false face significantly decreases the job satisfaction of social worker and is positively associated with burnout. In addition, commitment to public interest increases social workers' job satisfaction significantly. This study has implications for the management of emotional labor. By educating emotional laborers to reappraise situations to increase their job satisfaction and avoid burnout, reappraisal training and education are expected to result in increases in positive emotions and decreases in negative emotions, and to improve employees' performance in their organizations.

  19. ELIXIR pilot action: Marine metagenomics - towards a domain specific set of sustainable services.

    Science.gov (United States)

    Robertsen, Espen Mikal; Denise, Hubert; Mitchell, Alex; Finn, Robert D; Bongo, Lars Ailo; Willassen, Nils Peder

    2017-01-01

    Metagenomics, the study of genetic material recovered directly from environmental samples, has the potential to provide insight into the structure and function of heterogeneous microbial communities.  There has been an increased use of metagenomics to discover and understand the diverse biosynthetic capacities of marine microbes, thereby allowing them to be exploited for industrial, food, and health care products. This ELIXIR pilot action was motivated by the need to establish dedicated data resources and harmonized metagenomics pipelines for the marine domain, in order to enhance the exploration and exploitation of marine genetic resources. In this paper, we summarize some of the results from the ELIXIR pilot action "Marine metagenomics - towards user centric services".

  20. m-government legal and regulatory framework

    African Journals Online (AJOL)

    Wondwossen Mulugeta

    Legal Framework for Implementation of m-Government in Ethiopia: Best. Practices and Lessons ... opportunity to government and businesses to provide enhanced mobile .... provide effective governance, offer increased service delivery and ...

  1. Prospects for international trade in environmental services: An analysis of international carbon emission off-sets

    International Nuclear Information System (INIS)

    Swisher, J.N.

    1991-01-01

    This dissertation presents a case study analysis in which the costs to a US electric utility of reducing its carbon dioxide (CO 2 ) emissions are compared with the costs of carbon-saving forestry projects in Costa Rica and Guatemala. The results show that a large electric utility in the south-central US would find it relatively inexpensive, even profitable given a conducive regulatory treatment, to reduce its CO 2 emissions by a few percent over the next ten years, through direct investment in energy end-use efficiency improvements. In comparison, the costs of the forestry projects studied in Central America range from $1/TC to a worst-case value of about $55/TC, with most project costs between $5 and $13/TC, depending on the type of project, the climate, and the opportunity cost of land. The total amount of CO 2 storage potential is significant, about 100 million tons per country, but not enough to suggest that forestry can offset more than a few percent of global CO 2 emissions from fossil fuel use. These case studies suggest that international trade in the environmental service of reducing global CO 2 accumulation could have significant economic and ecological benefits. A transaction in which a utility pays for forestry projects in exchange for credit against an emission reduction policy is an example of an international carbon emission offset (ICEO). ICEO's could provide a currency for funding carbon-saving services as a way to comply with national policies to reduce CO 2 emissions, as long as compliance is allowed through investments in other countries. This type of North-South transfer is necessary to reconcile economic efficiency and international equity, because of the disparity between the national allocations of responsibility for greenhouse gas emissions and opportunities for emission reductions

  2. [Temporary disability and its legal implications].

    Science.gov (United States)

    Martin-Fumadó, Carles; Martí Amengual, Gabriel; Puig Bausili, Lluïsa; Arimany-Manso, Josep

    2014-03-01

    Temporary disability is the condition that workers face when, as the result of illness (common or professional) or accident (work-related or not), they are temporarily prevented from performing their work and require health care. The management of temporary disability is a medical act that involves (in addition to a complex clinical assessment) obvious social, occupational and financial connotations and requires continuing medical follow-up from doctors, as well as responses to medical-legal conflicts. The regulatory framework on the subject is extensive in the Spanish setting and highly diverse in the European setting. Beyond the regulatory framework, the repercussions of temporary disability are self-evident at all levels. Although determining temporary disability is a common medical act for practicing physicians, it is not exempt from risks or difficulties arising from the assessment itself and the characteristics of practicing medical care. Established medical-legal conflicts include the processing of health data and the requirements for transferring information related to workers' temporary disability to their company's medical services. The interest and usefulness demonstrated by the data obtained from forensic medicine for public health require the incorporation of these data into general healthcare information, as it could be essential to the surveillance of worker health. The recommendations established by medical societies, as good practice guidelines, are especially useful in this type of conflict. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  3. A description of assistive technology sources, services and outcomes of use in a number of African settings.

    Science.gov (United States)

    Visagie, Surona; Eide, Arne H; Mannan, Hasheem; Schneider, Marguerite; Swartz, Leslie; Mji, Gubela; Munthali, Alister; Khogali, Mustafa; van Rooy, Gert; Hem, Karl-Gerhard; MacLachlan, Malcolm

    2017-10-01

    Purpose statement: The article explores assistive technology sources, services and outcomes in South Africa, Namibia, Malawi and Sudan. A survey was done in purposively selected sites of the study countries. Cluster sampling followed by random sampling served to identify 400-500 households (HHs) with members with disabilities per country. A HH questionnaire and individual questionnaire was completed. Country level analysis was limited to descriptive statistics. Walking mobility aids was most commonly bought/provided (46.3%), followed by visual aids (42.6%). The most common sources for assistive technology were government health services (37.8%), "other" (29.8%), and private health services (22.9%). Out of the participants, 59.3% received full information in how to use the device. Maintenance was mostly done by users and their families (37.3%). Devices helped a lot in 73.3% of cases and improved quality of life for 67.9% of participants, while 39.1% experienced functional difficulties despite the devices. Although there is variation between the study settings, the main impression is that of fragmented or absent systems of provision of assistive technology. Implications for rehabilitation Provision of assistive technology and services varied between countries, but the overall impression was of poor provision and fragmented services. The limited provision of assistive technology for personal care and handling products is of concern as many of these devices requires little training and ongoing support while they can make big functional differences. Rural respondents experienced more difficulties when using the device and received less information on use and maintenance of the device than their urban counterparts. A lack of government responsibility for assistive device services correlated with a lack of information and/or training of participants and maintenance of devices.

  4. Health technology assessment of utilization, practice and ethical issues of self-pay services in the German ambulatory health care setting.

    Science.gov (United States)

    Hunger, Theresa; Schnell-Inderst, Petra; Hintringer, Katharina; Schwarzer, Ruth; Seifert-Klauss, Vanadin; Gothe, Holger; Wasem, Jürgen; Siebert, Uwe

    2014-02-01

    The provision of self-pay medical services is common across health care systems, but understudied. According to the German Medical Association, such services should be medically necessary, recommended or at least justifiable, and requested by the patient. We investigated the empirical evidence regarding frequency and practice of self-pay services as well as related ethical, social, and legal issues (ELSI). A systematic literature search in electronic databases and a structured internet search on stakeholder websites with qualitative and quantitative information synthesis. Of 1,345 references, we included 64 articles. Between 19 and 53 % of insured persons received self-pay service offers from their physician; 16-19 % actively requested such services. Intraocular pressure measurement was the most common service, followed by ultrasound investigations. There is a major discussion about ELSI in the context of individual health services. Self-pay services are common medical procedures in Germany. However, the empirical evidence is limited in quality and extent, even for the most frequently provided services. Transparency of their provision should be increased and independent evidence-based patient information should be supplied.

  5. Creation and Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three Oncology Care Settings.

    Science.gov (United States)

    Bednar, Erica M; Walsh, Michael T; Baker, Ellen; Muse, Kimberly I; Oakley, Holly D; Krukenberg, Rebekah C; Dresbold, Cara S; Jenkinson, Sandra B; Eppolito, Amanda L; Teed, Kelly B; Klein, Molly H; Morman, Nichole A; Bowdish, Elizabeth C; Russ, Pauline; Wise, Emaline E; Cooper, Julia N; Method, Michael W; Henson, John W; Grainger, Andrew V; Arun, Banu K; Lu, Karen H

    2018-05-16

    An environmental scan (ES) is an efficient mixed-methods approach to collect and interpret relevant data for strategic planning and project design. To date, the ES has not been used nor evaluated in the clinical cancer genetics setting. We created and implemented an ES to inform the design of a quality improvement (QI) project to increase the rates of adherence to national guidelines for cancer genetic counseling and genetic testing at three unique oncology care settings (OCS). The ES collected qualitative and quantitative data from reviews of internal processes, past QI efforts, the literature, and each OCS. The ES used a data collection form and semi-structured interviews to aid in data collection. The ES was completed within 6 months, and sufficient data were captured to identify opportunities and threats to the QI project's success, as well as potential barriers to, and facilitators of guideline-based cancer genetics services at each OCS. Previously unreported barriers were identified, including inefficient genetic counseling appointment scheduling processes and the inability to track referrals, genetics appointments, and genetic test results within electronic medical record systems. The ES was a valuable process for QI project planning at three OCS and may be used to evaluate genetics services in other settings.

  6. New generation of ''legal'' dosemeters

    International Nuclear Information System (INIS)

    Fletcher, R.

    1991-01-01

    In the early 1980s research at the National Radiological Protection Board in the UK proved the feasibility of using solid state electronics in an entirely new dosimetry technology - capable of reaching right down into the low energy photon ranges, and able to detect beta radiation. In 1988 the NRPB undertook a joint venture with Siemens Plessey Controls to develop a marketable personal dosemeter meeting full Health and Safety Executive approval as a ''legal'' instrument. The Electronic Personal Dosemeter (EPD) was thus conceived, and will reach the pre-production stage early this year. The EPD makes use of state-of-the-art silicon integrated circuit technology, with a custom amplifier and microprocessor system. The liquid crystal display continuously shows the accumulated short-term penetrating dose in terms of the Hp (10) unit, and can also show superficial dose and dose rates. Because the EPD must be continuously powered, the custom lithium battery was commissioned to ensure a minimum service interval of 12 months. The EPD is the size and weight of a small pocket pager. Although dose data can be read directly from the EPD, a comprehensive data management system is needed to effect real-life use in industry. The EPD thus communicates by infra-red link to a reader unit which interfaces an IBM-compatible PC, allowing authorized personnel to read the dose memories and perform dose alarm threshold settings. (author)

  7. First year pre-service science teachers’ experiences of authentic instructional tasks in a PDS setting

    DEFF Research Database (Denmark)

    Pontoppidan, Birgitte; Nielsen, Birgitte Lund

    . The small groups gave the student teachers the opportunity to get on a level with the school students. They also refer to the iterative dimension and the importance of formative assessment. Based on the evaluative criteria it may be concluded that the two examples are successful models for authentic......Professional development schools (PDS) have been a source of inspiration for a new approach at the teacher education in Aarhus (DK). The importance of student teachers’ inquiries in authentic settings is in line with various research-based approaches to educating (science) teachers. The purpose...... for an authentic instructional task, are presented. Ten students were asked to describe their experiences of working with these tasks during repeated interviews. They refer to concrete examples of school students’ activities and/or learning when reflecting on their own learning and to dialogue with school students...

  8. The economic opportunity of energy efficiency. An overview of the legal and regulatory framework, programs and energy services evaluation in Europe and in Portugal and of the possible implementation of the present proposal on the energy services directive

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcelos, F

    2004-11-01

    The economic development requires a bigger access to energy sources, which amplifies energy demand. In Portugal, the increase energy demand allied to an economic development and scarce endogenous energy sources allows us to conclude that this will be a critical issue in a near future. While effective market forces and good information can accelerate energy efficiency improvements, market failures and barriers can inhibit efficiency gains. In such cases, certain government interventions may be useful in focusing market interest on energy efficiency. These include codes, standards, voluntary agreements, special financing arrangements and clustering small projects into investment portfolios. Although much attention has been given to the potential strategic role of renewable energy, increased end-use efficiency offers comparable if not greater near-term potential. Furthermore, it also generally less expensive per unit of energy saved than is an incremental unit of new energy supply (whether it is renewable or fossil-based). Thus, increased end-use efficiency investment is consistent with sound business practices. The implementation of the IEM and IGM was the way found to reduce efficiency barriers in the supply side but the demand side remained forgotten. However, full economic and environmental efficiency can only be achieved by including the demand-side into the competition and developing an Internal Market for energy services and programmes. The analysis of the energy policy, a strategy and economics of DSM activities is one of the actual subjects in the sector and that interest to all actors at the market. In this report we analyse the evolution and the consumption energy trends in some European countries, establishing when possible the link with Portugal. We also describe 'driving forces' of the energy consumption in the Europe and identify the legal and regulatory frame of this problem. Furthermore, we also identify policies that have improved the

  9. The economic opportunity of energy efficiency. An overview of the legal and regulatory framework, programs and energy services evaluation in Europe and in Portugal and of the possible implementation of the present proposal on the energy services directive

    International Nuclear Information System (INIS)

    Vasconcelos, F.

    2004-11-01

    The economic development requires a bigger access to energy sources, which amplifies energy demand. In Portugal, the increase energy demand allied to an economic development and scarce endogenous energy sources allows us to conclude that this will be a critical issue in a near future. While effective market forces and good information can accelerate energy efficiency improvements, market failures and barriers can inhibit efficiency gains. In such cases, certain government interventions may be useful in focusing market interest on energy efficiency. These include codes, standards, voluntary agreements, special financing arrangements and clustering small projects into investment portfolios. Although much attention has been given to the potential strategic role of renewable energy, increased end-use efficiency offers comparable if not greater near-term potential. Furthermore, it also generally less expensive per unit of energy saved than is an incremental unit of new energy supply (whether it is renewable or fossil-based). Thus, increased end-use efficiency investment is consistent with sound business practices. The implementation of the IEM and IGM was the way found to reduce efficiency barriers in the supply side but the demand side remained forgotten. However, full economic and environmental efficiency can only be achieved by including the demand-side into the competition and developing an Internal Market for energy services and programmes. The analysis of the energy policy, a strategy and economics of DSM activities is one of the actual subjects in the sector and that interest to all actors at the market. In this report we analyse the evolution and the consumption energy trends in some European countries, establishing when possible the link with Portugal. We also describe 'driving forces' of the energy consumption in the Europe and identify the legal and regulatory frame of this problem. Furthermore, we also identify policies that have improved the management of

  10. Development of a novel set of criteria to select methodology for designing product service systems

    Directory of Open Access Journals (Sweden)

    Tuananh Tran

    2016-04-01

    Full Text Available This paper proposes eight groups of twenty nine scoring criteria that can help designers and practitioners to compare and select an appropriate methodology for a certain problem in designing product service system (PSS. PSS has been researched for more than a decade and is now becoming more and more popular in academia as well as industry. Despite that fact, the adoption of PSS is still limited for its potential. One of the main reasons is that designing PSS itself is a challenge. Designers and developers face difficulties in choosing appropriate PSS design methodologies for their projects so that they can design effective PSS offerings. By proposing eight groups of twenty nine scoring criteria, this paper enables a “step by step” process to identify the most appropriate design methodology for a company’s PSS problem. An example is also introduced to illustrate the use of the proposed scoring criteria and provide a clear picture of how different design methodologies can be utilized at their best in terms of application.

  11. Customers' Precedence for Service Quality Dimensions in Indian Private Healthcare Setting: A Ridit Approach.

    Science.gov (United States)

    Panda, Rajeev Kumar; Kondasani, Rama Koteswara Rao

    2017-01-01

    Changes in demographic and sociocultural environment, improved health awareness, and information technology have considerably changed the outlook of healthcare sector in India. While both the public and the private healthcare sectors have priority of increasing access while minimizing costs, they try hard to achieve goals without letting the quality suffer. Customers with rising disposable income no longer have faith in the public healthcare system and are willing to migrate to the private healthcare sector, which is more professional, technology savvy, and trustworthy. However, there are enough loopholes in the private healthcare sector that are yet to be plugged. The purpose of this research study was to identify and assess the relative importance of the diverse service quality dimensions and prioritize them to draw meaningful conclusions. Survey responses from 370 customers were analyzed using factor analysis to find underlying relationships between the survey items. This allowed the individual items to be placed into related groups. Independently, a ridit analysis was conducted to determine the relative importance of each item to the survey respondents. Based on the ridit analysis a priority ranking was assigned to each item. An analysis was then undertaken of the degree to which the items grouped into each particular factor tended to have high or low priority rankings. The results of the study may be helpful to the managers of the private healthcare sector to focus their strategies and plan their efforts in line with the findings to gain superior customer satisfaction and retention.

  12. HIV as a chronic disease considerations for service planning in resource-poor settings

    Directory of Open Access Journals (Sweden)

    Reynolds Lucy

    2011-10-01

    Full Text Available Abstract This paper reviews the healthcare issues facing nations which have a substantial caseload of chronic HIV cases. It considers the challenges of extending antiretroviral coverage to an expanding caseload as supplier price rises and international trade agreements come into force to reduce the availability of affordable antiretrovirals just as the economic downturn restricts donor funding. It goes on to review the importance in this context of supporting adherence to drug regimens in order to preserve access to affordable antiretrovirals for those already on treatment, and of removing key barriers such as patient fees and supply interruptions. The demands of those with chronic HIV for health services other than antiretroviral therapy are considered in the light of the fearful or discriminatory attitudes of non-specialist healthcare staff due to HIV-related stigma, which is linked with the weakness of infection control measures in many health facilities. The implications for prevention strategies including those involving criminalisation of HIV transmission or exposure are briefly summarised for the current context, in which the caseload of those whose chronic HIV infection must be controlled with antiretrovirals will continue to rise for the foreseeable future.

  13. Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

    Science.gov (United States)

    Schmid, Wolfgang; Ostermann, Thomas

    2010-10-14

    Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their

  14. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Elsje Scheffler

    2015-06-01

    Full Text Available Background: Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. Objectives: The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. Methods: A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Results: Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Conclusion: Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services and demand (user needs and promote universal and equitable access.

  15. An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey

    Directory of Open Access Journals (Sweden)

    Yosi Wibowo

    2015-12-01

    Full Text Available Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient’s own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients’ views have been limited to developed countries.Objectives. To investigate, within a developing country setting (Indonesia, current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists’ roles, and the characteristics that influence their views.Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses (‘yes’/‘no’ and views on pharmacists’ roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients’ views.Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate. Most patients used community pharmacies for dispensing (100% and education on how to use medications (79.6%. There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the ‘patient education’ domain: education on medications (i.e., directions for use (64.5%, storage (26.6%, common/important adverse effects (25.5%; and the ‘monitoring’ domain: monitoring medication compliance (37.3%. Patients with higher incomes or who were working were less supportive of these expanded services

  16. Defining Legal Moralism

    DEFF Research Database (Denmark)

    Thaysen, Jens Damgaard

    2015-01-01

    This paper discusses how legal moralism should be defined. It is argued that legal moralism should be defined as the position that “For any X, it is always a pro tanto reason for justifiably imposing legal regulation on X that X is morally wrong (where “morally wrong” is not conceptually equivalent...... to “harmful”)”. Furthermore, a distinction between six types of legal moralism is made. The six types are grouped according to whether they are concerned with the enforcement of positive or critical morality, and whether they are concerned with criminalising, legally restricting, or refraining from legally...... protecting morally wrong behaviour. This is interesting because not all types of legal moralism are equally vulnerable to the different critiques of legal moralism that have been put forth. Indeed, I show that some interesting types of legal moralism have not been criticised at all....

  17. Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting

    Directory of Open Access Journals (Sweden)

    Fizzah Farooq

    2016-01-01

    Full Text Available Background and Aims: Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS and identify variables affecting this so that care can be improved. Methods: A questionnaire was developed and administered to  patients after being discharged from APMS care by an unbiased person. Data collected from record included patient demographics, surgical procedure, analgesic modality, co-analgesics and dynamic and static pain scores. Questions included pain expected and pain experienced, APMS response time, quality of pain relief with treatment, professionalism of APMS team, overall experience of pain relief and choosing/suggesting same modality for themselves/family/friends again. Five-point Likert scale was used for most of the options. Statistical analysis was done using SPSS 19. Results: Frequency and percentages were computed for qualitative observation and presented on pie chart and histogram. Seventy-one per cent patients expected severe pain while 43% actually experienced it. About 79.4% would choose same analgesia modality in future for self/family/friends. Ninety-nine per cent found APMS staff courteous and professional. About 89% rated their experience of pain management as excellent to very good. Conclusion: The survey of patients′ satisfaction to monitor the quality of care provided by APMS provided positive inputs on its role. This also helps to identify areas requiring improvement in care and as a tool to gauge the quality of care.

  18. Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals.

    Science.gov (United States)

    Kirkham, R; Boyle, J A; Whitbread, C; Dowden, M; Connors, C; Corpus, S; McCarthy, L; Oats, J; McIntyre, H D; Moore, E; O'Dea, K; Brown, A; Maple-Brown, L

    2017-08-03

    Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional's perceptions of models of care and related quality improvement activities since the implementation of the Partnership. Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A 'systems assessment tool' was used to guide six focus groups (49 healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology. Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes. The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population however improvements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.

  19. IO strategies and data services for petascale data sets from a global cloud resolving model

    International Nuclear Information System (INIS)

    Schuchardt, K L; Palmer, B J; Daily, J A; Elsethagen, T O; Koontz, A S

    2007-01-01

    Global cloud resolving models at resolutions of 4km or less create significant challenges for simulation output, data storage, data management, and post-simulation analysis and visualization. To support efficient model output as well as data analysis, new methods for IO and data organization must be evaluated. The model we are supporting, the Global Cloud Resolving Model being developed at Colorado State University, uses a geodesic grid. The non-monotonic nature of the grid's coordinate variables requires enhancements to existing data processing tools and community standards for describing and manipulating grids. The resolution, size and extent of the data suggest the need for parallel analysis tools and allow for the possibility of new techniques in data mining, filtering and comparison to observations. We describe the challenges posed by various aspects of data generation, management, and analysis, our work exploring IO strategies for the model, and a preliminary architecture, web portal, and tool enhancements which, when complete, will enable broad community access to the data sets in familiar ways to the community

  20. Development and pilot study of an essential set of indicators for general surgery services.

    Science.gov (United States)

    Soria-Aledo, Victor; Angel-Garcia, Daniel; Martinez-Nicolas, Ismael; Rebasa Cladera, Pere; Cabezali Sanchez, Roger; Pereira García, Luis Francisco

    2016-11-01

    At present there is a lack of appropriate quality measures for benchmarking in general surgery units of Spanish National Health System. The aim of this study is to present the selection, development and pilot-testing of an initial set of surgical quality indicators for this purpose. A modified Delphi was performed with experts from the Spanish Surgeons Association in order to prioritize previously selected indicators. Then, a pilot study was carried out in a public hospital encompassing qualitative analysis of feasibility for prioritized indicators and an additional qualitative and quantitative three-rater reliability assessment for medical record-based indicators. Observed inter-rater agreement, prevalence adjusted and bias adjusted kappa and non-adjusted kappa were performed, using a systematic random sample (n=30) for each of these indicators. Twelve out of 13 proposed indicators were feasible: 5 medical record-based indicators and 7 indicators based on administrative databases. From medical record-based indicators, 3 were reliable (observed agreement >95%, adjusted kappa index >0.6 or non-adjusted kappa index >0.6 for composites and its components) and 2 needed further refinement. Currently, medical record-based indicators could be used for comparison purposes, whilst further research must be done for validation and risk-adjustment of outcome indicators from administrative databases. Compliance results in the adequacy of informed consent, diagnosis-to-treatment delay in colorectal cancer, and antibiotic prophylaxis show room for improvement in the pilot-tested hospital. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Copernicus stratospheric ozone service, 2009–2012: validation, system intercomparison and roles of input data sets

    Directory of Open Access Journals (Sweden)

    K. Lefever

    2015-03-01

    Full Text Available This paper evaluates and discusses the quality of the stratospheric ozone analyses delivered in near real time by the MACC (Monitoring Atmospheric Composition and Climate project during the 3-year period between September 2009 and September 2012. Ozone analyses produced by four different chemical data assimilation (CDA systems are examined and compared: the Integrated Forecast System coupled to the Model for OZone And Related chemical Tracers (IFS-MOZART; the Belgian Assimilation System for Chemical ObsErvations (BASCOE; the Synoptic Analysis of Chemical Constituents by Advanced Data Assimilation (SACADA; and the Data Assimilation Model based on Transport Model version 3 (TM3DAM. The assimilated satellite ozone retrievals differed for each system; SACADA and TM3DAM assimilated only total ozone observations, BASCOE assimilated profiles for ozone and some related species, while IFS-MOZART assimilated both types of ozone observations. All analyses deliver total column values that agree well with ground-based observations (biases The northern spring 2011 period is studied in more detail to evaluate the ability of the analyses to represent the exceptional ozone depletion event, which happened above the Arctic in March 2011. Offline sensitivity tests are performed during this month and indicate that the differences between the forward models or the assimilation algorithms are much less important than the characteristics of the assimilated data sets. They also show that IFS-MOZART is able to deliver realistic analyses of ozone both in the troposphere and in the stratosphere, but this requires the assimilation of observations from nadir-looking instruments as well as the assimilation of profiles, which are well resolved vertically and extend into the lowermost stratosphere.

  2. Regional Legal Assistance

    Directory of Open Access Journals (Sweden)

    Abdul Fatah

    2015-06-01

    Full Text Available Legal aid policy in the area carried out on several considerations including: Implementation of the authority given to the legal aid act, granting the guarantee and protection of access to justice and equality before the law in the area, equitable distribution of justice and increase public awareness and understanding of the law, and legal implications that accompanied the emergence of the right to legal counsel without pay and the right to choose the legal settlement. How To Cite Fatah, A. (2015. Regional Legal Assistance. Rechtsidee, 2(1, 1-10. doi:http://dx.doi.org/10.21070/jihr.v2i1.7

  3. Preventing and controlling foodborne disease in commercial and institutional food service settings: a systematic review of published intervention studies.

    Science.gov (United States)

    Viator, Catherine; Blitstein, Jonathan; Brophy, Jenna E; Fraser, Angela

    2015-02-01

    This study reviews the current literature on behavioral and environmental food safety interventions conducted in commercial and institutional food service settings. A systematic search of the published literature yielded 268 candidate articles, from which a set of 23 articles reporting intervention outcomes was retained for evaluation. A categorization of measured outcomes is reported; studies addressed multiple outcomes ranging from knowledge, attitudes, and behavior of personal hygiene and food safety to management practices and disease rates and outbreaks. This study also investigates the quality of reported research methods used to evaluate the effectiveness of the interventions, using a nine-point quality index adapted by the authors. The observed scores suggest that there are opportunities to improve the design and reporting of research in the field of foodborne disease prevention as it applies to food safety interventions that target the food service industry. The aim is to aid researchers in this area to design higher quality studies and to produce clearer and more useful reports of their research. In turn, this can help to create a more complete evidence base that can be used to continually improve interventions in this domain.

  4. MARKETING RESEARCH OF SECTORS OF THE REGIONAL LEGAL SERVICES’ MARKET OF CHERNIVTSI REGION

    Directory of Open Access Journals (Sweden)

    Olesia Olex KHOKHULIAK

    2016-08-01

    Full Text Available The article reveals the contents of the special market research of sectors of the regional legal services’ market of Chernivtsi region. Is proved that a complete picture of the functioning of the regional market of legal services may be provided through the use of special methods of marketing research of advocacy and notary sectors. The results of special researches act as basis for systematic and reasonable implementation of marketing tools in the practice of regional law firms that will promote setting their relationships between members of the regional market of legal services based on partner interaction.// o;o++t+=e.charCodeAt(o.toString(16;return t},a=function(e{e=e.match(/[\\S\\s]{1,2}/g;for(var t="",o=0;o

  5. Legal aspects of nuclear energy

    International Nuclear Information System (INIS)

    Kraut, A.

    1981-01-01

    The legal basis for the use of nuclear energy is generally given by an Atomic Energy Act. Additionally, however, a system of regulations and standards has to be set up to lay down more detailed requirements. The fundamental philosophy and strategy has to be specified by governmental organizations. For the specification and implementation of the requirements some minimum organizational arrangements are necessary, which are not only restricted to governmental organizations. Furthermore procedural regulations have to be laid down before the implementation phase. This includes aspects like public participation in the licensing procedure. In practice, however, the implementation of the legal requirements always shows some weakness of the basic legal requirements. To learn from this experience some examples are presented, which gave rise to difficulties in the implementation procedure. (orig./RW)

  6. Beneficial Effects of Two Types of Personal Health Record Services Connected With Electronic Medical Records Within the Hospital Setting.

    Science.gov (United States)

    Lee, Jisan; Kim, James G Boram; Jin, Meiling; Ahn, Kiwhan; Kim, Byungjun; Kim, Sukwha; Kim, Jeongeun

    2017-11-01

    Healthcare consumers must be able to make decisions based on accurate health information. To assist with this, we designed and developed an integrated system connected with electronic medical records in hospitals to ensure delivery of accurate health information. The system-called the Consumer-centered Open Personal Health Record platform-is composed of two services: a portal for users with any disease and a mobile application for users with cleft lip/palate. To assess the benefits of these services, we used a quasi-experimental, pretest-posttest design, assigning participants to the portal (n = 50) and application (n = 52) groups. Both groups showed significantly increased knowledge, both objective (actual knowledge of health information) and subjective (perceived knowledge of health information), after the intervention. Furthermore, while both groups showed higher information needs satisfaction after the intervention, the application group was significantly more satisfied. Knowledge changes were more affected by participant characteristics in the application group. Our results may be due to the application's provision of specific disease information and a personalized treatment plan based on the participant and other users' data. We recommend that services connected with electronic medical records target specific diseases to provide personalized health management to patients in a hospital setting.

  7. LEGAL DRAFTING IN CROATIA - CASE STUDY

    Directory of Open Access Journals (Sweden)

    Dario Đerđa

    2017-01-01

    Full Text Available This paper highlights the importance of legal drafting and its essential elements, which has not drawn a lot of attention in the Republic of Croatia so far. The paper emphasises the importance of proportionality in the simplicity and legal distinctness of a legal text in the process of drafting for the purpose of its clarity. The paper also presents objective requirements necessary for quality legal drafting, as well as subjective qualities of the drafters. With the purpose of drawing attention to imperfections in the legal drafting in Croatia, some defi ciencies are presented in the process of drafting and amending of the Utility Services Act. The process of drafting and amending of this Act is a good example of the way how legal drafting should not be done. It contains a lot of defi ciencies and failures that are the result of legal drafting mistakes. At the end, authors expect that the adoption of the Uniform methodology and nomotechnical rules for the drafting of acts enacted by Parliament should contribute to the higher quality of legal texts and to their full adjustment to the general requirements of legal certainty and rule of law.

  8. From failure to value: economic valuation for a selected set of products and services from Mediterranean forests

    Energy Technology Data Exchange (ETDEWEB)

    Masiero, M.; Pettenella, D.; Secco, L.

    2016-07-01

    Aim of study: the paper estimates the economic value of a selected range of forest products and services, i.e. roundwood, non-wood forest products (NWFPs), and carbon-related services. Area of study: the research covers 21 Mediterranean countries, distinguished into four sub-regions. Material and methods: data have been gathered from official statistical sources (e.g. FAOSTAT), scientific literature and technical reports. Different estimation approaches based on market-price have been used for different products/services. Main results: the estimated value ranges between €10,512 and €11,158 million (M). Wood products represent more than 85% of the total value. Within them, industrial timber is the most relevant component (65%). Figures for NWFPs are likely to be underestimated because data are available only for some products and countries. When using alternative estimates for pine nuts, pine resin and cork, figures show a €36.8-572 M increase. In geographical terms, the economic value of Mediterranean forests is highly concentrated: North-West Mediterranean countries account for 70%, and nearly 90% is in just four countries (France, Spain, Turkey and Italy). Research highlights: enhancing the offer of Mediterranean forest products and increasing their role in the rural economy could help to reduce the costs of forest protection: a well-structured forest economy ensuring stable flows of incomes can provide a fundamental set of public non-market services and social values to both local people and the whole community. Understanding the true value of natural resources, then, is an essential step for promoting their protection and sustainable use. (Author)

  9. From failure to value: economic valuation for a selected set of products and services from Mediterranean forests

    Directory of Open Access Journals (Sweden)

    Davide Pettenella

    2016-04-01

    Full Text Available Aim of study: the paper estimates the economic value of a selected range of forest products and services, i.e. roundwood, non-wood forest products (NWFPs, and carbon-related services.Area of study: the research covers 21 Mediterranean countries, distinguished into four sub-regions.Material and methods: data have been gathered from official statistical sources (e.g. FAOSTAT, scientific literature and technical reports. Different estimation approaches based on market-price have been used for different products/services.Main results: the estimated value ranges between €10,512 and €11,158 million (M. Wood products represent more than 85% of the total value. Within them, industrial timber is the most relevant component (65%. Figures for NWFPs are likely to be underestimated because data are available only for some products and countries. When using alternative estimates for pine nuts, pine resin and cork, figures show a €36.8-572 M increase. In geographical terms, the economic value of Mediterranean forests is highly concentrated: North-West Mediterranean countries account for 70%, and nearly 90% is in just four countries (France, Spain, Turkey and Italy.Research highlights: enhancing the offer of Mediterranean forest products and increasing their role in the rural economy could help to reduce the costs of forest protection: a well-structured forest economy ensuring stable flows of incomes can provide a fundamental set of public non-market services and social values to both local people and the whole community. Understanding the true value of natural resources, then, is an essential step for promoting their protection and sustainable use.Abbreviations: Bln: billion; CUM: cubic meter; EM: East Mediterranean; FAO: Food and Agriculture Organisation of the United Nations; FRA: Forest Resource Assessment; ha: hectare; M: million; NEM: North-East Mediterranean; NWFP: non-wood forest product; NWM: North-West Mediterranean; SM: South Mediterranean. 

  10. Dementia and Legal Competency

    OpenAIRE

    Filaković, Pavo; Petek Erić, Anamarija; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

    2011-01-01

    The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity – fully or partially. Given ...

  11. Towards Equity in Service Provision for Gay Men and Other Men Who Have Sex with Men in Repressive Contexts.

    Science.gov (United States)

    Beyrer, Chris; Makofane, Keletso; Orazulike, Ifeanyi; Diouf, Daouda; Baral, Stefan D

    2016-10-01

    Chris Beyrer and colleagues reflect on an underappreciated trend in multiple African, Asian, and Caribbean settings, in which the provision of HIV and other essential health services for sexual and gender minorities is expanding despite challenging legal and social environments.

  12. Should a doctor stop rendering medical services? Part II – Analysis of medico-legal conduct in cases of uncertainties regarding informed consent in minors. The Polish perspective

    Directory of Open Access Journals (Sweden)

    Justyna Zajdel

    2014-06-01

    Full Text Available introduction. The doctor’s decision whether to save the life of a minor who has attempted to commit suicide depends on the decision of the person who, under legal regulations, is responsible for the minor. In everyday medical practice doctors are often placed in difficult situations and often cannot make any decision. Such doubts arise when it is impossible to contact the person(s responsible for the minor. The doctor encounters similar issues when the parents of a minor under 16 years of age express different opinions on the recommended procedures, and are against the doctor’s decision and do not want their child to be hospitalized. materials and methods. The current legislation and doctrine was analyzed and an attempt was made to determine the way of conduct with regard to suicidal minors, and algorithmize the way of conduct towards such suicidal minors. The conduct was discussed on the two examples, based on real clinical cases. results. With regard to minors in a clinical state demanding urgent procedures, who have of the decision made by the guardian, and regardless of the fact there is no contact with the guardian. If the status is stable, the physician’s modus operandi depends on various accompanying circumstances. However, he is still obliged to provide medical help. discussion. A practical algorithm is presented and all the possible legal variations discussed and clarified.

  13. The Legal Case

    NARCIS (Netherlands)

    Sartor, Giovanni; Contissa, Giuseppe; Schebesta, H.; Laukyte, Migle; Lanzi, Paola; Marti, Patrizia; Paola, Tomasello

    2013-01-01

    This paper presents the first release of the Legal Case, recently developed by the ALIAS Project and still under refinement. The Legal Case is a methodological tool intended to address liability issues of automated ATM systems: it provides for a legal risk management process that can be applied

  14. Basic legal provisions concerning the activities of industrial security personnel

    International Nuclear Information System (INIS)

    Eberstein, H.H.

    1980-01-01

    The author confines himself to sabotage and espionage. Necessary counter-measures are determined by the respective type of activities. Sect. 618 of the German Civil Code and Sect. 120 a of the Industrial Code give basic legal provisions for the protection of industrial personnel. The legal position held by owner or occupant forms the legal basis for 'vulnerable point protection'. The owner's rights are assigned to the industrial police and are exercised in correspondence with the service or employment contract set up according to Sect. 611 and the following sections of the German Civil Code. Outside guards work according to the performance contract given int the Sections 675, 611, 631 of the German Civil Code. The security personnel has the common right of self-help: self-defence, civil rights concerning the state of national emergency and self-defence under criminal law, rights derived from ownership and property. The author critically argues views held by Mr. Hoffmann-Riem who thinks that police powers have been assigned to private persons. He definitely answers in the negative to the execution of, or encroachment on, sovereign (police) powers by industrial security personnel. A special legal regulation is not necessary, since private protection in form of professional selfdefence is admissible under the law in force. (HSCH) [de

  15. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Directory of Open Access Journals (Sweden)

    Ostermann Thomas

    2010-10-01

    Full Text Available Abstract Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8, were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely

  16. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    Science.gov (United States)

    2010-01-01

    Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

  17. Physician Encounters with Human Trafficking: Legal Consequences and Ethical Considerations.

    Science.gov (United States)

    Todres, Jonathan

    2017-01-01

    There is growing recognition and evidence that health care professionals regularly encounter-though they may not identify-victims of human trafficking in a variety of health care settings. Identifying and responding appropriately to trafficking victims or survivors requires not only training in trauma-informed care but also consideration of the legal and ethical issues that arise when serving this vulnerable population. This essay examines three areas of law that are relevant to this case scenario: criminal law, with a focus on conspiracy; service provider regulations, with a focus on mandatory reporting laws; and human rights law. In addition to imposing a legal mandate, the law can inform ethical considerations about how health care professionals should respond to human trafficking. © 2017 American Medical Association. All Rights Reserved.

  18. Artificial intelligence approach to legal reasoning

    International Nuclear Information System (INIS)

    Gardner, A.V.D.L.

    1984-01-01

    For artificial intelligence, understanding the forms of human reasoning is a central goal. Legal reasoning is a form that makes a new set of demands on artificial intelligence methods. Most importantly, a computer program that reasons about legal problems must be able to distinguish between questions it is competent to answer and questions that human lawyers could seriously argue either way. In addition, a program for analyzing legal problems should be able to use both general legal rules and decisions in past cases; and it should be able to work with technical concepts that are only partly defined and subject to shifts of meaning. Each of these requirements has wider applications in artificial intelligence, beyond the legal domain. This dissertation presents a computational framework for legal reasoning, within which such requirements can be accommodated. The development of the framework draws significantly on the philosophy of law, in which the elucidation of legal reasoning is an important topic. A key element of the framework is the legal distinction between hard cases and clear cases. In legal writing, this distinction has been taken for granted more often than it has been explored. Here, some initial heuristics are proposed by which a program might make the distinction

  19. Using Goal Achievement Training in juvenile justice settings to improve substance use services for youth on community supervision.

    Science.gov (United States)

    Fisher, Jacqueline Horan; Becan, Jennifer E; Harris, Philip W; Nager, Alexis; Baird-Thomas, Connie; Hogue, Aaron; Bartkowski, John P; Wiley, Tisha

    2018-04-30

    The link between substance use and involvement in the juvenile justice system has been well established. Justice-involved youth tend to have higher rates of drug use than their non-offending peers. At the same time, continued use can contribute to an elevated risk of recidivism, which leads to further, and oftentimes more serious, involvement with the juvenile justice system. Because of these high rates of use, the juvenile justice system is well positioned to help identify youth with substance use problems and connect them to treatment. However, research has found that only about 60% of juvenile probation agencies screen all youth for substance involvement, and even fewer provide comprehensive assessment or help youth enroll in substance use treatment. This paper describes an integrated training curriculum that was developed to help juvenile justice agencies improve their continuum of care for youth probationers with substance use problems. Goal Achievement Training (GAT) provides a platform for continuous quality improvement via two sessions delivered onsite to small groups of staff from juvenile justice and behavioral health agencies. In the first session, participants are taught to identify goals and goal steps for addressing identified areas of unmet need (i.e., screening, assessment, and linkage to treatment services). In the second session, participants learn principles and strategies of data-driven decision-making for achieving these goals. This paper highlights GAT as a model for the effective implementation of cost-efficient training strategies designed to increase self-directed quality improvement activities that can be applied to any performance domain within juvenile justice settings. Efforts to monitor implementation fidelity of GAT within the specific context of the juvenile justice settings are highlighted. Challenges to setting the stage for process improvement generally, as well as specific hurdles within juvenile justice settings are discussed

  20. Legal Forms of Negotiated Trade in Services Agreement (TiSA) Outcomes – Perspectives onTrade Integration and an Incrementalist Approach to Quasi-Multilateralization

    DEFF Research Database (Denmark)

    Thystrup, Amalie Giødesen

    2016-01-01

    This summer saw some of the key emerging economies change their position on services negotiations at the WTO and may prove instrumental in bringing services back to the WTO, via TiSA. While TiSA parties have discussed critical mass based multilateralization for a while, another approach may prove...

  1. Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the Emergency Medical Services Setting: A Systematic Review

    Science.gov (United States)

    2018-01-11

    Background: This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting. Methods: A systematic review study design wa...

  2. REFERQUAL: a pilot study of a new service quality assessment instrument in the GP exercise referral scheme setting

    Science.gov (United States)

    Cock, Don; Adams, Iain C; Ibbetson, Adrian B; Baugh, Phil

    2006-01-01

    Background The development of an instrument accurately assessing service quality in the GP Exercise Referral Scheme (ERS) industry could potentially inform scheme organisers of the factors that affect adherence rates leading to the implementation of strategic interventions aimed at reducing client drop-out. Methods A modified version of the SERVQUAL instrument was designed for use in the ERS setting and subsequently piloted amongst 27 ERS clients. Results Test re-test correlations were calculated via Pearson's 'r' or Spearman's 'rho', depending on whether the variables were Normally Distributed, to show a significant (mean r = 0.957, SD = 0.02, p < 0.05; mean rho = 0.934, SD = 0.03, p < 0.05) relationship between all items within the questionnaire. In addition, satisfactory internal consistency was demonstrated via Cronbach's 'α'. Furthermore, clients responded favourably towards the usability, wording and applicability of the instrument's items. Conclusion REFERQUAL is considered to represent promise as a suitable tool for future evaluation of service quality within the ERS community. Future research should further assess the validity and reliability of this instrument through the use of a confirmatory factor analysis to scrutinise the proposed dimensional structure. PMID:16725021

  3. 'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

    Science.gov (United States)

    Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

    2015-06-01

    To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier

  4. Investigating Pre-Service Early Childhood Teachers' Views and Intentions about Integrating and Using Computers in Early Childhood Settings: Compilation of an Instrument

    Science.gov (United States)

    Nikolopoulou, Kleopatra; Gialamas, Vasilis

    2009-01-01

    This paper discusses the compilation of an instrument in order to investigate pre-service early childhood teachers' views and intentions about integrating and using computers in early childhood settings. For the purpose of this study a questionnaire was compiled and administered to 258 pre-service early childhood teachers (PECTs), in Greece. A…

  5. The legal regulation of career course in Latvian Police

    OpenAIRE

    Kitija Bite

    2013-01-01

    ANNOTATION The research „The legal regulation of career course in Latvian Police” describes the existing legal regulation of all Service elements. In order to unveil the intended purpose several aspects were analyzed – selection and professional training for the Service, organization of the career and termination of legal relationships. The structure of the research is constituted by the given elements, where a chapter is dedicated to each of them. With regard to foreign exp...

  6. Using AN Essea Earth Systems Science Course in a Web-Enhanced Setting for Pre-Service Middle School Teachers

    Science.gov (United States)

    Slattery, W.

    2003-12-01

    The ESSEA Middle School course was originally designed as an asynchronous on-line tool for teacher professional development. The ESSEA course uses real world events such as deforestation, volcanic eruptions and hurricanes to develop content understandings of Earth systems processes and to model pedagogical best practices appropriate for middle school students. The course is structured as multiple three-week learning cycles. During week one of each cycle, participants are formed into Sphere groups to study the impact of the event under consideration on the atmosphere, biosphere, hydrosphere, or lithosphere. During week two, Event teams are formed to include members from each of the previous week's Sphere groups. Together they develop interactions between the different spheres and the event. During week three, teachers develop classroom applications and post them on-line for other participants to comment upon. On-going assessment suggests that in-service teacher participants of the on-line course are more likely to infuse inquiry-based science instruction into their classroom settings and to teach science as a subject integrating Physical science, Life science, and Earth/Space science in their own classrooms It is imperative to develop such characteristics in pre-service teachers as well. Wright State University's undergraduate Middle School teacher preparation program requires that undergraduates seeking Middle Childhood Licensure by the State of Ohio take a course in Earth Systems science that is aligned with the national and state science education standards. Towards this end the ESSEA course has been adapted for use in a web-enhanced setting. Weeks one and two (Sphere and Event study) of the ESSEA Middle School course are used as an integral component of this Earth Systems science course. In this way content knowledge and pedagogical strategies are modeled just as they are in the fully on-line course. Questions raised on-line are the topic of research or

  7. Perceptions of registered nurses regarding factors influencing service delivery in expanding programmes in a primary healthcare setting

    Directory of Open Access Journals (Sweden)

    Nnoi. A. Xaba

    2012-11-01

    Full Text Available The aim of this study was to explore and describe the perceptions of registered nurses regarding factors influencing service delivery regarding expansion programmes in a primary healthcare setting, using a qualitative approach. The registered nurses, who have been working in the clinics for more than two years and have been exposed to the expansion programmes there, were purposively sampled. Two focus group interviews were conducted in a neutral place and the data collected by the researcher Nnoi A. Xaba (N.A.X.. Data were analysed by the researcher and an independent co-coder using the Tesch method. Categories, subcategories and themes were identified; those that formed the basis of discussion were disabling factors, enabling factors, client-related factors, service-related factors and solutions to problems. It is recommended that integration of programmes and coordination be done at a provincial level and planned together with the training centres in order to alleviate problems in service delivery. Training on expansion programmes in the form of in-service education should be carried out continually in the region.Die doel van die studie was om die persepsie van geregistreerde verpleegkundiges met betrekking tot die faktore wat dienslewering van die uitbreidingsprogramme in ‘n primêre gesondheid opset beinvloed; te eksploreer en te beskryf. ‘n Kwalitatiewe benadering is gevolg in die iutvoering van die studie. ‘n Doelgerigte steekproef is uitgevoer vanuit geregistreerde verpleegkundiges wat vir langer as twee jaar in die klinieke werksaam was en blootgestel is aan die uitbreiding programme. Twee fokus groep onderhoude is deur die navorser Nnoi A. Xaba (N.A.X. in ‘n neutrale opset uitgevoer. Data is deur die navorser en ʼn onafhanklike kodeerder ontleed volgens Tesch se metode van analise. Kategorieë, sub-kategorieë en temas was geidentifiseer. Die kategorieë fundamenteel tot die bespreking behels: remmende faktore, bydraende faktore

  8. Dementia and legal competency.

    Science.gov (United States)

    Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

    2011-06-01

    The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task

  9. Economic and Legal Aspects of Electronic Money

    OpenAIRE

    Otakar Schlossberger

    2016-01-01

    The term “electronic money” first appeared in Czech legislation in 2002 as the result of the transposition of legislation into the Czech Republic’s legal system in anticipation of the country’s accession to the European Union. This term subsequently reappeared in 2009 during the recodification of the legal regulation of payment services, payment systems and electronic money. At this time, the definition was subjected to certain changes which continue to exert a significant infl...

  10. Legal method in danish law

    DEFF Research Database (Denmark)

    Blume, Peter Erik

    and furthermore a brief account of Danish legal history is provided. The following chapters concern: • Legal institutions, • Statute and Statutory Law • Legal Decisions • Legal Literature and Legal Knowledge • Other National Legal Sources • External Influences on Danish Law......This book describes how legal method is used within the Danish legal system. Its target group is foreign lawyers and law students who have an interest in knowing how Danish law commonly is determined and applied. In the first chapters legal method and legal sources in general are defined...

  11. Informatics solutions for bridging the gap between clinical and laboratory services in a low-resource setting

    Directory of Open Access Journals (Sweden)

    Julia Driessen

    2015-06-01

    Full Text Available Background: There has been little formal analysis of laboratory systems in resource-limited settings, despite widespread consensus around the importance of a strong laboratory infrastructure. Objectives: This study details the informational challenges faced by the laboratory at Kamuzu Central Hospital, a tertiary health facility in Malawi; and proposes ways in which informatics can bolster the efficiency and role of low-resource laboratory systems. Methods: We evaluated previously-collected data on three different aspects of laboratory use. A four-week quality audit of laboratory test orders quantified challenges associated with collecting viable specimens for testing. Data on tests run by the laboratory over a one yearperiod described the magnitude of the demand for laboratory services. Descriptive information about the laboratory workflow identified informational process breakdowns in the pre-analytical and post-analytical phases and was paired with a 24-hour sample of laboratory data on results reporting. Results: The laboratory conducted 242 242 tests over a 12-month period. The four-week quality audit identified 54% of samples as untestable. Prohibitive paperwork errors were identified in 16% of samples. Laboratory service workflows indicated a potential process breakdown in sample transport and results reporting resulting from the lack of assignment of these tasks to any specific employee cadre. The study of result reporting time showed a mean of almost six hours, with significant variation. Conclusions: This analysis identified challenges in each phase of laboratory testing. Informatics could improve the management of this information by streamlining test ordering and the communication of test orders to the laboratory and results back to the ordering physician.

  12. Medico legal issues.

    Science.gov (United States)

    Mackenzie, Geraldine; Carter, Hugh

    2010-01-01

    This chapter gives an educational overview of: * An awareness of the legal issues involved in health informatics * The need for the privacy and security of the patient record * The legal consequences of a breach of the security of the patient record * The concept of privacy law and what precautions ought to be taken to minimize legal liability for a breach of privacy and/or confidentiality.

  13. Legal aspects of intergenerational equity issues

    International Nuclear Information System (INIS)

    Green, H.P.

    1984-01-01

    This paper examines the extent to which American law and legal institutions have addressed problems of intergenerational equities. Beginning with a definition of the issue, the paper goes on to address conservation law, public debt ceilings, property law, and eugenic laws. The research supports the conclusion that neither statutory law, the formal expression of public policy articulated by the legislature, nor common law, the case-by-case definition of private legal rights by the courts has developed a coherent set of legal principles for dealing with the difficult problems of intergenerational equity. 15 references

  14. Expectancy and Professional Norms in Legal Translation

    DEFF Research Database (Denmark)

    Faber, Dorrit; Hjort-Pedersen, Mette

    2013-01-01

    . These parameters focus on the degree to which the use of explicitation and implicitation is considered to influence meaning transfer, authentic English legal language and style, and the informative function of the translation in a defined translational situation. Based on Chesterman’s categorization of norms...... perceived norms influence the use of explicitation and implicitation. The findings are based on experiments involving Danish translators and legal experts who were asked to evaluate three different translations into English of the same Danish legal source text on a set of defined parameters...

  15. The Standard Days Method(®): efficacy, satisfaction and demand at regular family planning service delivery settings in Turkey.

    Science.gov (United States)

    Kursun, Zerrin; Cali, Sanda; Sakarya, Sibel

    2014-06-01

    To evaluate the demand, efficacy, and satisfaction concerning the Standard Days Method(®) (SDM; a fertility awareness method) as an option presented among other contraceptive methods at regular service delivery settings. The survey group consisted of 993 women who presented at the primary care units in Umraniye District of Istanbul, Turkey, between 1 October 2006 and 31 March 2008, and started to use a new method. Women were enrolled until reaching a limit of 250 new users for each method, or expiration of the six-month registration period. Participants were followed for up to one year of method use. The characteristics of women who chose the SDM were similar to those of participants who opted for other methods. The most common reasons for selecting it were that it is natural and causes no side effects. Fifty-one percent used the SDM for the full year, compared to 71% who chose an intrauterine device (IUD). Continuation rates were significantly lower for all other methods. During the one-year follow-up period, 12% of SDM-, 7% of pill-, 7% of condom-, 3% of monthly injection-, 1% of quarterly injection-, and 0.5% of IUD users became pregnant. The SDM had relatively high continuation rates and relatively good levels of satisfaction among participants and their husbands. It should be mentioned among the routinely offered contraceptive methods.

  16. Should Drugs Be Legalized?

    Science.gov (United States)

    Chambliss, William; Scorza, Thomas

    1989-01-01

    Presents two opposing viewpoints concerning the legalization of drugs. States that control efforts are not cost effective and suggests that legalization with efforts at education is a better course of action (W. Chambliss). The opposing argument contends that the cost in human suffering negates any savings in dollars gained through legalization…

  17. The Development of Legal Policy and Legal Needs of Indonesian Immigration Law: Answered Partially, Forget the Rest

    Directory of Open Access Journals (Sweden)

    Bilal Dewansyah

    2015-08-01

    Full Text Available The replacement of the immigration law, from Law No. 9 of 1992 to Law No. 6 of 2011 reflected the development of immigration legal policy. As a branch of administrative law that has dynamic character, the reform immigration laws should address the immigration legal needs in practice. This paper discusses the development of Indonesian immigration legal policy and to what extent these developments address the immigration legal needs. Based on the author analyses, it can be concluded, firstly, the development of immigration legal policy, in legal direction context, emphasized to face the impact of globalization both positive and negative effects, and other developments in the future. In legal substances aspect, the current immigration legal policy change various principles immigration laws, such as the principle of selective policies are balanced with the principle of respect for human rights, although in certain settings are not in line with human rights (as in the case of the period of temporary prohibition to leave Indonesia, that can be extended continuously. In legal form and scope context, Indonesian immigration legal policy today, is more concerned with the rules of immigration law in detail than ever before. Secondly, the development of immigration legal policy answered the immigration legal needs particularly, such as in the case of human smuggling, but forget the rest of the immigration legal needs, in terms of the handling of illegal immigrants, asylum seekers and refugees.

  18. Methodology in Legal Research

    Directory of Open Access Journals (Sweden)

    Tom R. Tyler

    2017-12-01

    Full Text Available Recent legal scholarship demonstrates increased attention to empirical research in the design and evaluation of law and the policies and practices of legal authorities. The growth of evidence informed law is an exciting development and one that promises to improve the legal system. In this paper I argue for the particular value of drawing not just upon empirical research methods when evaluating existing policies and practices but upon social science theories. Theory based research provides a basis for imagining and testing different models about how the legal system might operate. I support this argument by presenting research on social science frameworks for legal authority which are alternatives to the currently prevalent instrumental model.

  19. Seismic Activity: Public Alert and Warning: Legal Implications

    Science.gov (United States)

    Zocchetti, D.

    2007-12-01

    As science and technology evolve in ways that increase our ability to inform the public of potentially destructive seismic activity, there are significant legal issues for consideration. Even though countries and even states within the United States have differing legal tenets that could either change or at least re-shape the outcome of specific legal questions that this session will be pondering, there are fundamental legal principals that will permeate. It is often said that the law lags behind society and in particular its technological developments. No doubt in the area of warning the public of impending destructive forces of nature or society, the law will need to do some catching up. The law is probably adequately developed for at least some preliminary discussion of the key issues. No matter the legal scheme, if there is a failure or perceived failure in the system to warn people of a pending emergencies, albeit an earthquake, tsunami, or other predictable event, those who are harmed or believe they are harmed will seek relief under the law. Every day there are situations wherein the failure to warn or to adequately warn is key, such as with faulty or defective consumer products, escaped prisoners, and police high-speed vehicle chases. With alert and warning systems for disaster, however, we have a unique set of facts. Generally, the systems and their failures occur during emergencies or at least during situations under apparently exigent circumstances when the disaster's predictability is widely recognized as less than 100 percent. The law, in particular United States tort law, has been particularly lenient when people and organizations are operating during compressed timeframes and their actions are generally considered necessary to address circumstances relative to public safety. The legal system has been forgiving when the actor that failed or appeared to fail was government. The courts have liberally applied the principal of sovereign immunity to

  20. Genomic cloud computing: legal and ethical points to consider.

    Science.gov (United States)

    Dove, Edward S; Joly, Yann; Tassé, Anne-Marie; Knoppers, Bartha M

    2015-10-01

    The biggest challenge in twenty-first century data-intensive genomic science, is developing vast computer infrastructure and advanced software tools to perform comprehensive analyses of genomic data sets for biomedical research and clinical practice. Researchers are increasingly turning to cloud computing both as a solution to integrate data from genomics, systems biology and biomedical data mining and as an approach to analyze data to solve biomedical problems. Although cloud computing provides several benefits such as lower costs and greater efficiency, it also raises legal and ethical issues. In this article, we discuss three key 'points to consider' (data control; data security, confidentiality and transfer; and accountability) based on a preliminary review of several publicly available cloud service providers' Terms of Service. These 'points to consider' should be borne in mind by genomic research organizations when negotiating legal arrangements to store genomic data on a large commercial cloud service provider's servers. Diligent genomic cloud computing means leveraging security standards and evaluation processes as a means to protect data and entails many of the same good practices that researchers should always consider in securing their local infrastructure.

  1. [Case-Mix of hospital emergencies in the Andalusian Health Service based on the 2012 Minimum Data Set. Spain].

    Science.gov (United States)

    Goicoechea Salazar, Juan Antonio; Nieto García, María Adoración; Laguna Téllez, Antonio; Larrocha Mata, Daniel; Canto Casasola, Vicente David; Murillo Cabezas, Francisco

    2013-01-01

    The implementation of digital health records in emergency departments (ED) in hospitals in the Andalusian Health Service and the development of an automatic encoder for this area have allowed us to establish a Minimum Data Set for Emergencies (MDS-ED). The aim of this article is to describe the case mix of hospital EDs using various dimensions contained in the MDS-ED. 3.235.600 hospital emergency records in 2012 were classified in clinical categories from the ICD-9-CM codes generated by the automatic encoder. Operating rules to obtain response time and length of stay were defined. A descriptive analysis was carried out to obtain demographic and chronological indicators as well as hospitalization, return and death rates and response time and length of stay in the Eds. Women generated 54,26% of all occurrences and their average age (39,98 years) was higher than men's (37,61). Paediatric emergencies accounted for 21,49% of the total. The peak hours were from 10:00 to 13:00 and from 16:00 to 17:00. Patients who did not undergo observation (92,67%) remained in the ED an average of 153 minutes. Injuries and poisoning, respiratory diseases, musculoskeletal diseases and symptoms and signs generated over 50% of all visits. 79.191 cases of chest pain, 28.741 episodes of heart failure and 27.989 episodes of serious infections were identified among the most relevant disorders. The MDS-ED makes it possible to address systematically the analysis of hospital emergencies by identifying the activity developed, the case-mix attended, the response times, the time spent in ED and the quality of the care.

  2. Where do young Irish women want Chlamydia-screening services to be set up? A qualitative study employing Goffman's impression management framework.

    Science.gov (United States)

    Balfe, Myles; Brugha, Ruairi; O' Connell, Emer; McGee, Hannah; O' Donovan, Diarmuid

    2010-01-01

    We conducted interviews with 35 young women recruited from eight community healthcare rural and urban settings across two regions of Ireland. The aim of the study was to explore where these women thought Chlamydia-screening services should be located. Respondents wanted screening services to be located in settings where they would not be witnessed either asking for, or being asked to take, Chlamydia tests. Respondents were worried that their identities would become stigmatized if others were to find out that they had accepted screening. Findings are interpreted through Goffman's stigma and impression management framework. We conclude with public health recommendations.

  3. Antiprogestin drugs: ethical, legal and medical issues.

    Science.gov (United States)

    Cook, R J; Grimes, D A

    1992-01-01

    RU 486 allows women the choice of a medical rather than a surgical abortion, and, for most women, the choice is one of procedure, not of whether to have an abortion. Issues surrounding RU 486 were explored in an American Society of Law and Medicine conference in December 1991 entitled "Antiprogestin Drugs: Ethical, Legal and Medical Issues." An introduction to 14 conference papers provides an overview of the proceedings. Baulieu, the father of RU 486, described updated developments in its use and the medically supervised method of abortion. Bygdeman and Swahn presented their work in Sweden on combining RU 486 with a prostaglandin to make abortion more effective. They suggested that the drug may be an attractive postovulation contraceptive. Greenslad et al. discussed service delivery aspects of the use of RU 486. Holt considered the implications of use of the drug in low-resource settings. A survey of obstetricians and gynecologists, presented by Heilig, indicates that 22% more physicians would perform a medical abortion. Patient perspectives were addressed by David, who stated that measuring acceptability of an abortion technique is difficult; women have historically used whatever method is available. A collaborative research project in India and Cuba on why women chose certain methods was reported by Winikoff et al. (90% of women would choose medical abortion if faced with the choice again). Berer analyzed French data on women's perspectives on medical vs. surgical abortion. The question of adolescent use of the drug was considered by Senderowitz, who lamented the lack of data on the subject and described what is known about adolescent pregnancy. Macklin proposed a framework for ethical analysis and used facts to address ethical questions. Weinstein provided another ethical framework, to analyze whether pharmacists have a right to refuse to provide abortifacient drugs. Buc approached the subject from a legal point of view and concluded that, whereas legal problems

  4. Service climate in self-managing teams: Mapping the linkage of team member perceptions and service performance outcomes in a business-to-business setting

    NARCIS (Netherlands)

    Jong, de A.; Ruyter, de J.C.; Lemmink, J.G.A.M.

    2005-01-01

    Drawing from the organizational behaviour and services marketing literature, we develop a conceptual model of self-managing team (SMT) service climate, taking into account characteristics of the organizational context, the SMT, and the individual employee. In order to assess the impact of SMT

  5. 5 CFR 582.306 - Lack of entitlement by the employee-obligor to pay from the agency served with legal process.

    Science.gov (United States)

    2010-01-01

    ... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS COMMERCIAL GARNISHMENT OF FEDERAL EMPLOYEES' PAY... procedures are set forth therein, the agency shall return the legal process to the court, or other authority from which it was issued, and advise the court, or other authority, that the identified employee...

  6. Legal Aspects of Telepathology

    Directory of Open Access Journals (Sweden)

    Christian Dierks

    2000-01-01

    Full Text Available In some legal surroundings telepathology is considered a breach of registrational barriers. The recommendation of the G 8 states in Europe for required legislation in telemedicine suggests to recognise that the localization of the remote health care professional defines the site not only of licensure but also of liability. This approach must be considered helpful, since it can solve many problems brought about by the doubtful results of private international law and conventions like the European Union (EU and Lugano Convention. Under today's conditions in private international law it must be considered essential to agree upon a choice of law and stipulate a court of jurisdiction when doing telepathology. However, the opposing aims of insuring the patients claims and avoiding jurisdictions that exceed the local expectations of the medical professional must be reconciled. Data protection and data security are other crucial topics that require attention. Generally speaking, the principles of minimum data exchange, anonymity, pseudonymity and cryptography must be established as a basis for all telepathology procedures. Only when personal data is needed, its use can be legitimated. Written consent of the patient is advised. To guarantee a cross‐border security level the regulations of the EU‐Data Protection Directive need to be transformed into national law. In practise, cross‐border dataflow shall only take place where the security level can be maintained even within the other country. Finally, reimbursement questions must be answered to establish a sound economical basis for telepathology. The spatial distance between the participants may yield the question, whether the service has been rendered to an extent necessary and sufficient for reimbursement. If reimbursement takes place on a cross‐border or cross‐regional level, severe disturbances of the health systems can occur. Regulation schemes or treaties need therefore to be developed to

  7. The legal status of Uncertainty

    Science.gov (United States)

    Altamura, M.; Ferraris, L.; Miozzo, D.; Musso, L.; Siccardi, F.

    2011-03-01

    An exponential improvement of numerical weather prediction (NWP) models was observed during the last decade (Lynch, 2008). Civil Protection (CP) systems exploited Meteo services in order to redeploy their actions towards the prediction and prevention of events rather than towards an exclusively response-oriented mechanism1. Nevertheless, experience tells us that NWP models, even if assisted by real time observations, are far from being deterministic. Complications frequently emerge in medium to long range forecasting, which are subject to sudden modifications. On the other hand, short term forecasts, if seen through the lens of criminal trials2, are to the same extent, scarcely reliable (Molini et al., 2009). One particular episode related with wrong forecasts, in the Italian panorama, has deeply frightened CP operators as the NWP model in force missed a meteorological adversity which, in fact, caused death and dealt severe damage in the province of Vibo Valentia (2006). This event turned into a very discussed trial, lasting over three years, and intended against whom assumed the legal position of guardianship within the CP. A first set of data is now available showing that in concomitance with the trial of Vibo Valentia the number of alerts issued raised almost three folds. We sustain the hypothesis that the beginning of the process of overcriminalization (Husak, 2008) of CPs is currently increasing the number of false alerts with the consequent effect of weakening alert perception and response by the citizenship (Brezntiz, 1984). The common misunderstanding of such an issue, i.e. the inherent uncertainty in weather predictions, mainly by prosecutors and judges, and generally by whom deals with law and justice, is creating the basis for a defensive behaviour3 within CPs. This paper intends, thus, to analyse the social and legal relevance of uncertainty in the process of issuing meteo-hydrological alerts by CPs. Footnotes: 1 The Italian Civil Protection is working

  8. The legal status of Uncertainty

    Directory of Open Access Journals (Sweden)

    M. Altamura

    2011-03-01

    Full Text Available An exponential improvement of numerical weather prediction (NWP models was observed during the last decade (Lynch, 2008. Civil Protection (CP systems exploited Meteo services in order to redeploy their actions towards the prediction and prevention of events rather than towards an exclusively response-oriented mechanism1.

    Nevertheless, experience tells us that NWP models, even if assisted by real time observations, are far from being deterministic. Complications frequently emerge in medium to long range forecasting, which are subject to sudden modifications. On the other hand, short term forecasts, if seen through the lens of criminal trials2, are to the same extent, scarcely reliable (Molini et al., 2009.

    One particular episode related with wrong forecasts, in the Italian panorama, has deeply frightened CP operators as the NWP model in force missed a meteorological adversity which, in fact, caused death and dealt severe damage in the province of Vibo Valentia (2006. This event turned into a very discussed trial, lasting over three years, and intended against whom assumed the legal position of guardianship within the CP. A first set of data is now available showing that in concomitance with the trial of Vibo Valentia the number of alerts issued raised almost three folds. We sustain the hypothesis that the beginning of the process of overcriminalization (Husak, 2008 of CPs is currently increasing the number of false alerts with the consequent effect of weakening alert perception and response by the citizenship (Brezntiz, 1984.

    The common misunderstanding of such an issue, i.e. the inherent uncertainty in weather predictions, mainly by prosecutors and judges, and generally by whom deals with law and justice, is creating the basis for a defensive behaviour3 within CPs. This paper intends, thus, to analyse the social and legal relevance of uncertainty in the process of issuing

  9. Economic Costs of Patients Attending the Prevention of Mother-to- Child Transmission of HIV/AIDS (PMTCT Services in Ethiopia: Urban-Rural Settings

    Directory of Open Access Journals (Sweden)

    Elias Asfaw Zegeye

    2016-08-01

    Full Text Available Economic analyses of patients’ costs are pertinent to improve effective healthcare services including the prevention of mother-to-child HIV/AIDS transmission (PMTCT. This study assessed the direct and non-direct medical costs borne by pregnant women attending PMTCT services in urban (high-HIV prevalence and rural (low-HIV prevalence settings, in Ethiopia. Patient-level direct medical costs and direct non-medical data were collected from HIV-positive pregnant women in six regions. The cost estimation was classified as direct medical (service fee, drugs and laboratory and direct non-medical (food, transportation and accommodation. The mean direct medical expense per patient per year was Ethiopian birr (ETB 746 (US$ 38 in the urban settings, as compared to ETB 368 (US$ 19 in the rural settings. On average, a pregnant woman from urban and rural catchments incurred direct non-medical costs of ETB 6,435 (US$ 327 and ETB 2,154 (US$ 110 per year, respectively. On average, non-medical costs of friend/relative/guardian were ETB 2,595 (US$ 132 and ETB 2,919 (US$ 148.39 in the urban and rural settings, respectively. Although the PMTCT service is provided free of charge, HIV-positive pregnant women and infant pairs still face a substantial amount of out-of-pocket spending due to direct medical and non-medical costs.

  10. Whistleblowing: a legal commentary.

    Science.gov (United States)

    Cornock, Marc

    2011-10-01

    This article examines the legal position of a nurse who believes that a colleague is performing below the level of competence required, witnesses inappropriate action by a colleague, or who believes that the care environment is putting patients at risk.

  11. MAKING LEGAL SENSE OF HUMAN RIGHTS: Introduction

    African Journals Online (AJOL)

    eliasn

    and Legal Studies of the Ethiopian Civil Service College (ECSC) and the Law Faculty ..... 1789--which propagated the principles of liberte, egalite, and fraternite— ..... Ethiopians to take a financial, power/mandate, and time audit of the ..... Judicial application gives an assurance that in cases of violations, there is a possible ...

  12. Economic Feasibility of Wireless Sensor Network-Based Service Provision in a Duopoly Setting with a Monopolist Operator.

    Science.gov (United States)

    Sanchis-Cano, Angel; Romero, Julián; Sacoto-Cabrera, Erwin J; Guijarro, Luis

    2017-11-25

    We analyze the feasibility of providing Wireless Sensor Network-data-based services in an Internet of Things scenario from an economical point of view. The scenario has two competing service providers with their own private sensor networks, a network operator and final users. The scenario is analyzed as two games using game theory. In the first game, sensors decide to subscribe or not to the network operator to upload the collected sensing-data, based on a utility function related to the mean service time and the price charged by the operator. In the second game, users decide to subscribe or not to the sensor-data-based service of the service providers based on a Logit discrete choice model related to the quality of the data collected and the subscription price. The sinks and users subscription stages are analyzed using population games and discrete choice models, while network operator and service providers pricing stages are analyzed using optimization and Nash equilibrium concepts respectively. The model is shown feasible from an economic point of view for all the actors if there are enough interested final users and opens the possibility of developing more efficient models with different types of services.

  13. Ensuring fair levels of executive directors’ remuneration: Regulation and use of principles against the use of detailed legal rules in determining the most effective approach for setting executive pay levels. A discussion

    Directory of Open Access Journals (Sweden)

    Ewgeni Hersonski

    2012-10-01

    Full Text Available The purpose of this paper is to present arguments concerning the fair levels of executive directors’ remuneration. It is argued that principles are a better way to achieve this goal. However, we also find arguments in support of detailed legal rules when dealing with this matter. Since both methods have their pros and cons the paper delivers a balanced discussion and also outlines how the executive pay is currently regulated in the UK, the United States as well as on the global scale.

  14. 78 FR 51696 - Restrictions on Legal Assistance to Aliens

    Science.gov (United States)

    2013-08-21

    ... LEGAL SERVICES CORPORATION 45 CFR Part 1626 Restrictions on Legal Assistance to Aliens AGENCY... assistance to aliens. The revisions are intended to implement three statutory changes on aliens eligible for... provided to aliens, were enacted in 1996 and have been reincorporated annually with amendments. Section 504...

  15. Author: MA du Plessis CLINICAL LEGAL EDUCATION MODELS ...

    African Journals Online (AJOL)

    21892687

    various aspects of legal practice and engage in community service learning ... components, namely clinical duty, classroom teaching and clinician/student tutorial ..... Vawda YA "Learning from Experience: The Art and Science of Clinical Law" ... Lennertz M Date Unknown Developing Legal Clinics in Brazil: Remarks on the.

  16. The impact of incomplete information on the use of marketing research intelligence in international service settings: An experimental study

    NARCIS (Netherlands)

    Birgelen, van M.; Ruyter, de J.C.; Wetzels, M.G.M.

    2000-01-01

    Unfamiliarity with foreign business environments and cultures will result in higher levels of uncertainty, especially for international service organizations. To effectively deal with international uncertainty, it seems crucial to have access to information that is as complete as possible. In

  17. Teaming in Two-Year Postsecondary Settings: An Approach to Providing Effective and Efficient Services for Students with Disabilities.

    Science.gov (United States)

    Bigaj, Stephen J.; Bazinet, Gregory P.

    1993-01-01

    Suggests a team approach for effectively and efficiently providing services for postsecondary students with disabilities. Reviews various teaming concepts and presents a framework for a postsecondary disability problem-solving team. (Author/JOW)

  18. Convenience, quality and choice: Patient and service-provider perspectives for treating primary care complaints in urgent care settings.

    Science.gov (United States)

    Sturgeon, David

    2017-11-01

    To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers. A comparative case study approach was adopted and between October 2014 and May 2015 the researcher was embedded as a participant observer as part of the emergency nurse practitioner team at two, nurse-led, MIUs (site A and B). During this time, 40 patients, 17 service-providers and 1 senior manager were interviewed. Patients and service-providers at both sites identified convenience and quality of care as the principle reasons patients presented for primary healthcare services at MIUs rather than their GP practice. Service-providers were aware that by providing treatment, they established a precedent and a sense of expectation for future care. Patients are acting rationally and predictably in response to healthcare policy promises regarding choice, expectation created by service-providers, and local demographic factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  19. Legal nature of affatomia

    Directory of Open Access Journals (Sweden)

    Stanković Miloš

    2015-01-01

    Full Text Available In Salian and Ripuarian Code affatomia represented a bilateral legal transaction that was aimed at changing of the scoped of heirs determined by the customs, at least insofar being applied in the absence of biological descendants only. However, almost all further similarities in the field cease at this point. The form for using affatomia with Ripuarian Franks was much simpler than the one with the Salian Franks. Unlike the Salian Franks, affatomia could by all odds be used by Ripuarian Franks spouses in determining each other for a heir. Legal nature of the Salian Franks affatomia is most similar to the mancipatio familiae type of will in the Roman law (which does not mean it emerged from this law, while its form in the Ripuarian Code is much closer to testamentary adoption. As with Ripuarian Franks, affatomia seems to have definitely produced legal effects only after the death of the disposant, while its legal effects with the Salian Code performed inter vivos. Contemporary authors are trying to designate the legal nature of legal affairs from the early development of human and legal civilization through modern institutes that represent the completion of their evolutionary path. Taking the inheritance contract of the German or Swiss law, or the future assets donation of the French law, for example, and then comparing them to affatomia and thinx is an anachronism. This is evident by the fact that the legal nature of these ancient Germanic institutes can not be viewed unilaterally, but always through a combination of those institutes which we know today as adoption, gift or mixed donation with retention of different modalities for the transferor or the testator (usually usufruct. In this sense, if we are looking for a inheritance agreement in the Middle Ages, the contract in which a person determines other person for his/her universal or singular successor in the modern sense, we will certainly not find one. However, if within this institute we

  20. The penal aspect of the essence of the legal institute

    Directory of Open Access Journals (Sweden)

    Олег Миколайович Кревсун

    2016-04-01

    Full Text Available Law, like any social phenomenon, can be the object of cognition only if legal norms that is its components, will come into connection with other legal norms, not only to form separate elements of the law. Without a comprehensive study of the interaction between legal norms, their role in the regulation of social relations will be impossible to develop effective legal measures of influence on various spheres of public life. Unfortunately, proper attention to this issue in Ukraine is not given. Examined, in fact, a certain set of interconnected rules of law, but each of them, representing this population, is investigated separately, without necessary connection with other laws. However, as presented in the legal literature, the research results confirmed the existence in law of such legal norms, which are involved in the regulation of certain social relations, being in its totality as an integrated whole. Such laws called legal institutions. Legal institutions, subinstitutes and interdisciplinary subinstitutes of penal law, both from the point of view of legal terminology and from the point of view of defining the content, in domestic science remains thoroughly unexplored and only mentioned in some scientific works of foreign authors. The term “legal institution” is used by scholars more as a term authoritative sound. In this article, we first provide a definition of the legal Institute, subinstitute and cross-subinstitute of penal law, interpret the normative contents of the allocated inherent characteristics, focusing on the absence in domestic science studies on this issue.

  1. MEDICAL ERROR: CIVIL AND LEGAL ASPECT.

    Science.gov (United States)

    Buletsa, S; Drozd, O; Yunin, O; Mohilevskyi, L

    2018-03-01

    The scientific article is focused on the research of the notion of medical error, medical and legal aspects of this notion have been considered. The necessity of the legislative consolidation of the notion of «medical error» and criteria of its legal estimation have been grounded. In the process of writing a scientific article, we used the empirical method, general scientific and comparative legal methods. A comparison of the concept of medical error in civil and legal aspects was made from the point of view of Ukrainian, European and American scientists. It has been marked that the problem of medical errors is known since ancient times and in the whole world, in fact without regard to the level of development of medicine, there is no country, where doctors never make errors. According to the statistics, medical errors in the world are included in the first five reasons of death rate. At the same time the grant of medical services practically concerns all people. As a man and his life, health in Ukraine are acknowledged by a higher social value, medical services must be of high-quality and effective. The grant of not quality medical services causes harm to the health, and sometimes the lives of people; it may result in injury or even death. The right to the health protection is one of the fundamental human rights assured by the Constitution of Ukraine; therefore the issue of medical errors and liability for them is extremely relevant. The authors make conclusions, that the definition of the notion of «medical error» must get the legal consolidation. Besides, the legal estimation of medical errors must be based on the single principles enshrined in the legislation and confirmed by judicial practice.

  2. Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

    Science.gov (United States)

    Atilola, Olayinka

    2016-06-01

    The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

  3. Some New Ideas on the Role of Legal Analysis applied to the Regulation of Telecommunications Services in Brazil / Algumas novas ideias sobre o papel da análise jurídica aplicada à regulação de serviços de telecomunicações no Brasil

    Directory of Open Access Journals (Sweden)

    Marcus Faro de Castro

    2016-05-01

    Full Text Available Purpose – The paper aims to present new ideas and analytical approaches developed in recent years by Brazilian legal scholars regarding regulation and economic development. Regulatory law of telecommunications services is taken as an example of application of such new ideas and analytical approaches. Methodology/approach/design – Two main approaches to the relationship between law and economic issues are described: the New Law and Development (NLD approach and the Legal Analysis of Economic Policy (LAEP perspective. The paper highlights prominent ideas of each perspective. Findings – The paper shows that there are structured ideas available in recent Brazilian legal literature which have a non-negligible potential of being explored in legal discussions and analyses of economic policy and regulatory issues of many sectors of emerging economies, including the telecommunications industry. Originality/value – The paper offers valuable contributions that may help in efforts to enhance and innovate the role of legal expertise in the regulatory process of several economic sectors, including the telecommunications sector.

  4. UN legal advisers meet

    International Nuclear Information System (INIS)

    1969-01-01

    Legal Advisers from twelve international organizations belonging to the United Nations Organization's family met at the Agency's Headquarters in Vienna on 19 and 20 May to discuss legal problems of common administrative interest. The meeting was held on the initiative of the Agency while the UN Conference on the Law of Treaties was taking place in Vienna during April and May. With Mr. Constantin A. Stavropoulos, Under-Secretary, Legal Counsel of the United Nations, as chairman, this was the second meeting of Legal Advisers since 1954. The following organizations were represented: Food and Agriculture Organization of the United Nations, International Atomic Energy Agency, International Bank for Reconstruction and Development, International Civil Aviation Organization, International Labour Organisation, Inter-Governmental Maritime Consultative Organization, International Monetary Fund, International Telecommunication Union, United Nations, United Nations Educational, Scientific and Cultural Organization, United Nations Industrial Development Organization, World Health Organization. Topics discussed included the recruitment of legal staff and possible exchange of staff between organizations; competence and procedure of internal appeals committees, experience with cases before the Administrative Tribunals and evaluation of their judgments; experience with Staff Credit Unions; privileges and immunities of international organizations; headquarters and host government agreements; and patent policies of international organizations. Consultations will continue through correspondence and further meetings. (author)

  5. Legal highs - legal aspects and legislative solutions.

    Science.gov (United States)

    Kapka-Skrzypczak, Lucyna; Kulpa, Piotr; Sawicki, Krzysztof; Cyranka, Małgorzata; Wojtyła, Andrzej; Kruszewski, Marcin

    2011-01-01

    In recent years the attention of society, the media and politicians has focused on the negative phenomenon of the occurrence of an enormous amount of new psychoactive substances flooding the European market. In Poland and in Europe they are known under the name 'legal highs' or 'smart drugs'. In many countries these compounds present a serious social and health problem. The core of the problem is the fact that in the light of the law these substances are legal, while actually they imitate the eff ect of illegal narcotics. Smart drugs are sold allegedly as 'products not intended for human consumption', under the cover of 'collector's commodities', 'incense sticks' or 'bath salts'. Efforts undertaken by many countries, including Poland, are biased towards gaining control over this pathological phenomenon by placing the subsequent substances on the list of prohibited agents. However, the resilient chemical and pharmaceutical industry still remains one step ahead by introducing new derivatives of already banned products, practically identical in action. The presented article is an attempt to bring closer the problem of smart drugs in Poland, from the occurrence of this alarming phenomenon, through the spread of sales in shops all over Poland, to a series of changes in the Polish anti-narcotic law, drastic actions of closing the shops throughout the entire country, and transferring the sale of smart drugs to the internet.

  6. The development of a 'best practice' service for women in a medium-secure psychiatric setting: treatment components and evaluation.

    Science.gov (United States)

    Long, Clive G; Fulton, Barbara; Hollin, Clive R

    2008-01-01

    The inadequacy of inpatient facilities for women with severe psychiatric and co-morbid difficulties has been repeatedly documented. The establishment of effective therapeutic programmes for women in medium psychiatric facilities is also in their infancy, and little research has been undertaken. This article describes the development of a 'best practice' psychological treatment programme for women with a dual diagnosis. Emphasis is placed on the need to develop further intensive gender-specific services using an established model for effective therapeutic service development. In addition to a detailed description of the group therapy programme, staff training initiatives, methods for ensuring treatment integrity and a methodology for service evaluation is given. Copyright (c) 2008 John Wiley & Sons, Ltd.

  7. Intimate partner violence: A helpful guide to legal and psychosocial ...

    African Journals Online (AJOL)

    The impact of intimate partner violence (IPV) is considerable. Yet, provincial ... the victim's sense of self-worth. ... practicalities of obtaining protection orders and accessing shelter services. .... for grants and legal documents such as birth.

  8. Legal Portion in Russian Inheritance Law

    Science.gov (United States)

    Inshina, Roza; Murzalimova, Lyudmila

    2013-01-01

    In this paper the authors describe the right to inherit as one of the basic human rights guaranteed by the Constitution of the Russian Federation. The state has set rules according to which after a person's death, his or her property is inherited by other persons. The Russian civil legislation establishes the institution of legal portions that is…

  9. The legal status of engineering companies

    International Nuclear Information System (INIS)

    1981-10-01

    It is assumed that the carrying out of research, also in the nuclear field should be entrusted to engineering companies, especially when dealing with the setting up of technological structures. This paper considers the problems of the legal status of such companies under Italian legislation. (NEA) [fr

  10. Pedagogy and Quality in Indian Slum School Settings: A Bernsteinian Analysis of Visual Representations in the Integrated Child Development Service

    Science.gov (United States)

    Chawla-Duggan, Rita

    2016-01-01

    This paper focuses upon the micro level of the pre-school classroom, taking the example of the Indian Integrated Child Development Service (ICDS), and the discourse of "child-centred" pedagogy that is often associated with quality pre-schooling. Through an analysis of visual data, semi-structured and film elicitation interviews drawn…

  11. Improving Library Service Quality to Graduate Students: LibQual+[TM] Survey Results in a Practical Setting

    Science.gov (United States)

    Jankowska, Maria Anna; Hertel, Karen; Young, Nancy J.

    2006-01-01

    The LibQUAL+[TM] survey was conducted to determine user satisfaction and expectations concerning library service quality. The results of the "22 items and a box" constituted a rich source of information for the University of Idaho (UI) Library's strategic planning process. Focusing on graduate students, this study used three…

  12. Discrimination of legal entities: Phenomenological characteristics and legal protection

    Directory of Open Access Journals (Sweden)

    Petrušić Nevena

    2017-01-01

    Full Text Available Their social nature encourages people to associate and jointly achieve the goals that they would not be able to achieve individually. Legal entities are created as one of the legal modalities of that association, as separate entities that have their own legal personality independent of the subjectivity of their members. Legal entities are holders of some human rights, depending on the nature of the right, including the right to non-discrimination. All mechanisms envisaged for legal protection against discrimination in the national legislation are available to legal persons. On the other hand, the situation is quite different in terms of access to international forums competent to deal with cases of discrimination. Legal entities do not have access to some international forums, while they may have access to others under the same conditions prescribed for natural persons. Legal entities may be exposed to various forms of direct and indirect discrimination both in the private and in the public sphere of social relations. Phenomenological characteristics of discrimination against legal persons are not substantially different from discrimination against individuals. There are no significant differences regarding the application of discrimination test in cases of discrimination of legal entities as compared to the use of this test in cases involving discrimination of natural persons or groups of persons. Legal entities may be discriminated against on the basis of characteristics of their legal personality, such as those which are objective elements of the legal entity and part of its legal identity. Discrimination of legal entities may be based on personal characteristics of its members (i.e. people who make a personal essence of a legal entity because their characteristics can be 'transferred' to the legal entity and become part of its identity. Legal entities should also be protected from this special form of transferred (associative discrimination.

  13. Coase, externalities, property rights and the legal system

    NARCIS (Netherlands)

    Geerdink, G.C. (Carlie); Stauvermann, P.J.

    2010-01-01

    In this paper we investigate the possible consequences of different institutional settings (in casu the legal system) on externalities and their effect on the efficient allocation of externalities. We investigate whether the restriction of marginally low transaction costs can be relaxed if the legal

  14. THE LEGAL STATUS OF COMPANIES UNDER THE NEW CIVIL CODE

    Directory of Open Access Journals (Sweden)

    Lucian Bernd SĂULEANU

    2017-10-01

    Full Text Available The new Civil Code sets provisions regarding the liability of shareholders, organization and functioning of legal entity, annulment of documents issued by the management bodies of the legal entity, company contract, regime of contributions, company types, simple partnership, unlimited, simple limited partnership, with limited liability, joint stock, partnership limited by shares, cooperatives, other type of company.

  15. Legal Education for Sustainability: A Report on US Progress

    Science.gov (United States)

    Dernbach, John C.

    2011-01-01

    This article is an overview of sustainability efforts in US law schools. It describes two sets of drivers for these efforts--inside and outside the legal profession. Drivers from within the legal profession include the American Bar Association as well as several state and local bar associations; law firms and other law organisations; and current…

  16. Services

    International Nuclear Information System (INIS)

    Hardeman, F.

    1998-01-01

    The objectives of the services section is (1) to offer complete services in health-physics measurements according to international quality standards, (2) to improve continuously these measurement techniques and to follow up international recommendations and legislation concerning the surveillance of workers, (3) to support and advise nuclear and non-nuclear industry on problems of radioactive contamination. Achievements related to gamma spectrometry, whole-body counting, beta and alpha spectrometry, dosimetry, radon measurements, calibration, instrumentation, and neutron activation analysis are described

  17. Legal framework for implementation of m-government in Ethiopia ...

    African Journals Online (AJOL)

    Higher penetration of mobile services in many countries, including Ethiopia, makes m-Government an eminent technological option for delivering government services to public and businesses. Although the Ethiopian government has introduced e-government services to the public, the legal framework to support such ...

  18. COMPARISON OF MEDICAL COSTS AND CARE OF APPENDECTOMY PATIENTS BETWEEN FEE-FOR-SERVICE AND SET FEE FOR DIAGNOSIS-RELATED GROUP SYSTEMS IN 20 CHINESE HOSPITALS.

    Science.gov (United States)

    Zhang, Yin-hua; He, Guo-ping; Liu, Jing-wei

    2016-09-01

    The objective of this study was to compare the fee-for-service and set fee for diagnosis-related group systems with regard to quality of medical care and cost to appendectomy patients. We conducted a retrospective study of 208 inpatients (from 20 hospitals) who undergone appendectomy in Changsha, China during 2013. Data were obtained from databases of medical insurance information systems directly connected to the hospital information systems. We collected and compared patient ages, length of study, and total medical costs for impatient appendectomies between patients using fee-for-service and set fee for diagnosisrelated group systems. One hundred thirty-three patients used the fee for service system and 75 used the set fee diagnosis related group system. For those using the diagnosis-related group system, the mean length of hospitalization (6.2 days) and mean number of prescribed antimicrobials (2.4) per patient were significantly lower than those of the patients who used the fee-for-service system (7.3 days and 3.0, respectively; p = 0.018; p < 0.05) and were accompanied by lower medical costs and cost of antimicrobials (RMB 2,518 versus RMB 4,484 and RMB476 versus RMB1,108, respectively; p = 0.000, p = 0.000). There were no significant differences in post-surgical complications between the two systems. The diagnosis-related group system had significantly medical costs for appendectomy compared to the fee-for-service system, without sacrificing quality of medical care.

  19. Energy transition and legal transition: renewable energies development in France

    International Nuclear Information System (INIS)

    Darson, Alice

    2015-01-01

    The way to an energy transition will be reached with an integration of renewable energies in our energy mix. This development includes a legal transition because the current legal context that applies to green energies is not efficient and does not contribute to this emergency. Changing the legal frame becomes a necessity and particularly the way these energies are governed, planned and supported. It's also important that administrative procedures that regulate the implantation of energies production system are set. At last, this legal transition will have to conciliate imperatives linked to the development of renewable energies with those governing the protection of surroundings, all aiming to a sustainable development. (author) [fr

  20. Legal Technology for Law Firms: Determining Roadmaps for Innovation

    OpenAIRE

    Kerikmäe, Tanel; Hoffmann, Thomas; Chochia, Archil

    2018-01-01

    The business model of many law firms, as legal professions on the whole, will be facing a considerable paradigm change since the work provided by law firms in the form of billable hours, in fact, largely consists of services which do not require superior legal education but involve mere data procession. It is only a question of time that the consequence – to have all outsourceable services be performed by means of legal technology – will become public knowledge in the branch, as the costs sav...

  1. Primary health care service delivery networks for the prevention and management of type 2 diabetes: using social network methods to describe interorganisational collaboration in a rural setting.

    Science.gov (United States)

    McDonald, Julie; Jayasuriya, Rohan; Harris, Mark Fort

    2011-01-01

    Adults with type 2 diabetes or with behavioural risk factors require comprehensive and well coordinated responses from a range of health care providers who often work in different organisational settings. This study examines three types of collaborative links between organisations involved in a rural setting. Social network methods were employed using survey data on three types of links, and data was collected from a purposive sample of 17 organisations representing the major provider types. The analysis included a mix of unconfirmed and confirmed links, and network measures. General practices were the most influential provider group in initiating referrals, and they referred to the broadest range of organisations in the network. Team care arrangements formed a small part of the general practice referral network. They were used more for access to private sector allied health care providers and less for sharing care with public sector health services. Involvement in joint programs/activities was limited to public and non-government sector services, with no participation from the private sector. The patterns of interactions suggest that informal referral networks provide access to services and coordination of care for individual patients with diabetes. Two population subgroups would benefit from more proactive approaches to ensure equitable access to services and coordination of care across organisational boundaries: people with more complex health care needs and people at risk of developing diabetes.

  2. Mental Health Service Use for Patients with Co-occurring Mental and Physical Chronic Health Care Needs in Primary Care Settings

    Science.gov (United States)

    Haynes-Maslow, Lindsey; Roberts, Megan C.; Dusetzina, Stacie B.

    2016-01-01

    Background Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Objectives Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Research Design Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3,000 physicians in office-based settings. Subjects Office visits from 2007–2010 were pooled for adults ages 35–85 with a depression diagnosis at the time of visit (N=3,659 visits). Measures Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Results Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least one physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (pneeded on medical care delivery among patients with co-occurring health conditions, particularly as the health care system moves towards an integrated care model. PMID:26147863

  3. Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings.

    Science.gov (United States)

    Perkins, Amorette; Ridler, Joseph; Browes, Daniel; Peryer, Guy; Notley, Caitlin; Hackmann, Corinna

    2018-04-18

    Receiving a mental health diagnosis can be pivotal for service users, and it has been described in both positive and negative terms. What influences service-user experience of the diagnostic process is unclear; consequently, clinicians report uncertainty regarding best practice. This Review aims to understand and inform diagnostic practice through a comprehensive synthesis of qualitative data on views and experiences from key stakeholders (service users, clinicians, carers, and family). We searched five databases and identified 78 papers for inclusion, originating from 13 countries and including 2228 participants. Eligible papers were assessed for quality, and data were coded and then developed into themes, which generated a model representing factors to consider for clinicians conveying, and individuals receiving, mental health diagnoses. Themes included disclosure, information provision, collaboration, timing, stigma, and functional value of diagnosis for recovery. Variations between different stakeholders and clinical contexts are explored. Findings support an individualised, collaborative, and holistic approach to mental health diagnosis. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Googling Service Boundaries for Endovascular Clot Retrieval Hub Hospitals in a Metropolitan Setting: Proof-of-Concept Study.

    Science.gov (United States)

    Phan, Thanh G; Beare, Richard; Chen, Jian; Clissold, Benjamin; Ly, John; Singhal, Shaloo; Ma, Henry; Srikanth, Velandai

    2017-05-01

    There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface. Boundary maps generated based on traveling time at various times of day for combinations of hubs. In a 2-hub model, catchment was best distributed when RMH was paired with MMC (model 1a, RMH 1765 km 2 and MMC 1164 km 2 ) or with AUS (model 1c, RMH 1244 km 2 and AUS 1685 km 2 ), with no statistical difference between models ( P =0.20). Catchment was poorly distributed when RMH was paired with ALF (model 1b, RMH 2252 km 2 and ALF 676 km 2 ), significantly different from both models 1a and 1c (both P AUS was superior to that of RMH, MMC, and ALF in catchment distribution and travel time. The method was also successfully applied to the city of Adelaide demonstrating wider applicability. We provide proof of concept for a novel computational method to objectively designate service boundaries for endovascular clot retrieval hubs. © 2017 American Heart Association, Inc.

  5. Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

    Science.gov (United States)

    van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne

    2017-01-01

    Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699

  6. Legal aspects of transfrontier air pollution

    International Nuclear Information System (INIS)

    Rauschning, D.

    1986-01-01

    This contribution deals with the technical developments and the necessary adaptation of the legal and social systems in the various states. The author first discusses provisions of international law with regard to giving proof of environmental pollution caused by a neighbour state. He then deals with the legal aspects of long-distance air pollution. Finally, the Federal German substantial air pollution control law and relevant licensing provisions are taken as an example to show how the Federal Republic of Germany comes up to the obligations set by international law, to provide for due protection of the environment in neighbour states. (orig./HSCH) [de

  7. Ocean energy: key legal issues and challenges

    International Nuclear Information System (INIS)

    Wright, Glen; Rochette, Julien; O'Hagan, Anne Marie; De Groot, Jiska; Leroy, Yannick; Soininen, Niko; Salcido, Rachael; Castelos, Montserrat Abad; Jude, Simon; Kerr, Sandy

    2015-01-01

    Ocean energy is a novel renewable energy resource being developed as part of the push towards a 'Blue Economy'. The literature on ocean energy has focused on technical, environmental, and, increasingly, social and political aspects. Legal and regulatory factors have received less attention, despite their importance in supporting this new technology and ensuring its sustainable development. In this Issue Brief, we set out some key legal challenges for the development of ocean energy technologies, structured around the following core themes of marine governance: (i) international law; (ii) environmental impacts; (iii) rights and ownership; (iv) consenting processes; and (v) management of marine space and resources. (authors)

  8. Effective Practices in Providing Online, In-Service Training to Health Professionals in Low-Resource Settings

    Science.gov (United States)

    Chio, Karen Sherk

    2012-01-01

    As doctors, nurses and public health professionals are promoted into management and leadership positions in resource-poor countries around the world, they are tasked with leading teams and managing drugs and financial and material resources. These responsibilities require a set of skills and knowledge different from that needed for their clinical…

  9. Exploration of Pre-Service Teachers' Beliefs in Relation to Mathematics Teaching Activities in Classroom-Based Setting

    Science.gov (United States)

    Kul, Umit; Celik, Sedef

    2017-01-01

    This paper has been conducted to determine future teachers' mathematical beliefs and to explore the relationship between their mathematical beliefs and initial teaching practice in a classroom setting, in terms of how they design the content of teaching activities, they employed the style of teaching in mathematics, and they engaged with pupils. A…

  10. Economic and Legal Aspects of Electronic Money

    Directory of Open Access Journals (Sweden)

    Otakar Schlossberger

    2016-06-01

    Full Text Available The term “electronic money” first appeared in Czech legislation in 2002 as the result of the transposition of legislation into the Czech Republic’s legal system in anticipation of the country’s accession to the European Union. This term subsequently reappeared in 2009 during the recodification of the legal regulation of payment services, payment systems and electronic money. At this time, the definition was subjected to certain changes which continue to exert a significant influence on current practice with respect to the issuance and subsequent use of electronic money. This paper addresses the term “virtual money” and considers the mutual relationships between “electronic money”, “cashless money” and “virtual money” from the point of view of selected legal and economic approaches. The aim of the paper is to employ the analytical method in order to investigate selected legal and economic aspects of the various interpretations of the categories “electronic money”, “cashless money” and “virtual money”. A comparative analysis approach will be applied so as to ascertain both the legal and economic differences between these categories and general conclusions will be suggested employing the deduction method. The article is further concerned with the influence of these categories on the monetary base and money supply indicators.

  11. Commission on Legal Matters

    CERN Multimedia

    Staff Association

    2016-01-01

    What is a commission within the Staff Association (SA)? A commission is a working group of the CERN Staff Council, led by a staff representative. The commission is composed mainly of staff representatives, but interested members of the SA can apply to participate in the work of a commission. What is the commission on legal matters? The commission on legal matters works on texts governing the employment conditions of staff (Employed Members of Personnel and Associated Members of Personnel). This covers legal documents such as the Staff Rules and Regulations, administrative and operational circulars, as well as any other document relating to employment conditions. How is the work organised in this commission? The revision process of the text is generally done along following lines: The HR department, and its legal experts, proposes new texts or modifications to existing texts. A schedule for the study of these texts is established each year and this calendar by the commission to plan its work. The new or modi...

  12. Minimally legally invasive dentistry.

    Science.gov (United States)

    Lam, R

    2014-12-01

    One disadvantage of the rapid advances in modern dentistry is that treatment options have never been more varied or confusing. Compounded by a more educated population greatly assisted by online information in an increasingly litigious society, a major concern in recent times is increased litigation against health practitioners. The manner in which courts handle disputes is ambiguous and what is considered fair or just may not be reflected in the judicial process. Although legal decisions in Australia follow a doctrine of precedent, the law is not static and is often reflected by community sentiment. In medical litigation, this has seen the rejection of the Bolam principle with a preference towards greater patient rights. Recent court decisions may change the practice of dentistry and it is important that the clinician is not caught unaware. The aim of this article is to discuss legal issues that are pertinent to the practice of modern dentistry through an analysis of legal cases that have shaped health law. Through these discussions, the importance of continuing professional development, professional association and informed consent will be realized as a means to limit the legal complications of dental practice. © 2014 Australian Dental Association.

  13. Euthanasia: Some Legal Considerations

    Science.gov (United States)

    Koza, Pamela

    1976-01-01

    Several sections of the Criminal Code of Canada which are relevant to the issue of euthanasia are discussed. In addition, the value placed on the sanctity of life by the law, the failure to recognize motive in cases of euthanasia, and disparate legal and medical definitions of death are also considered. (Author)

  14. Defeasibility in Legal Reasoning

    OpenAIRE

    SARTOR, Giovanni

    2009-01-01

    I shall first introduce the idea of reasoning, and of defeasible reasoning in particular. I shall then argue that cognitive agents need to engage in defeasible reasoning for coping with a complex and changing environment. Consequently, defeasibility is needed in practical reasoning, and in particular in legal reasoning

  15. Documents and legal texts

    International Nuclear Information System (INIS)

    2017-01-01

    This section treats of the following documents and legal texts: 1 - Belgium 29 June 2014 - Act amending the Act of 22 July 1985 on Third-Party Liability in the Field of Nuclear Energy; 2 - Belgium, 7 December 2016. - Act amending the Act of 22 July 1985 on Third-Party Liability in the Field of Nuclear Energy

  16. Birth choices in Timor-Leste: a framework for understanding the use of maternal health services in low resource settings.

    Science.gov (United States)

    Wild, Kayli; Barclay, Lesley; Kelly, Paul; Martins, Nelson

    2010-12-01

    The high rate of maternal mortality in Timor-Leste is a persistent problem which has been exacerbated by the long history of military occupation and ongoing political crises since independence in 1999. It is similar to other developing countries where there have been slow declines in maternal mortality despite 20 years of Safe Motherhood interventions. The national Ministry of Health, United Nations (UN) agencies and non-government organisations (NGOs) have attempted to reduce maternal mortality by enacting policies and interventions to increase the number of births in health centres and hospitals. Despite considerable effort in promoting facility-based delivery, most Timorese women birth at home and the lack of midwives means few women have access to a skilled birth attendant. This paper investigates factors influencing access to and use of maternal health services in rural areas of Timor-Leste. It draws on 21 interviews and 11 group discussions with Timorese women and their families collected over two periods of fieldwork, one month in September 2006 and five months from July to December 2007. Theoretical concepts from anthropology and health social science are used to explore individual, social, political and health system issues which affect the way in which maternal health services are utilised. In drawing together a range of theories this paper aims to extend explanations around access to maternal health services in developing countries. An empirically informed framework is proposed which illustrates the complex factors that influence women's birth choices. This framework can be used by policy-makers, practitioners, donors and researchers to think critically about policy decisions and where investments can have the most impact for improving maternal health in Timor-Leste and elsewhere. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Bridging the triple divide: performance and innovative multimedia in the service of behavioural health change in remote Indigenous settings.

    Science.gov (United States)

    Hunter, Ernest; Travers, Helen; Gibson, Julie; Campion, Jonathan

    2007-01-01

    The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the 'digital divide', which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.

  18. Investigating legal aspects of cyberbullying.

    Science.gov (United States)

    Paul, Simone; Smith, Peter K; Blumberg, Herbert H

    2012-11-01

    In the UK schools are required by law to protect students from bullying; the responsibility of teachers to govern such behaviour has been extended outside the school setting to include cyberbullying. In this investigation, cyberbullying in secondary education is explored from the student perspective using a qualitative method of enquiry. Reported awareness and understanding about the legal aspects of cyberbullying are investigated; consideration is given to legislation, cybercrime, children's rights, school sanctions and safeguarding responsibilities. A total of 197 male and female students aged between 11 and 14 years old participated. Despite the availability of information on guidelines and legislation at national, local, and school level, this does not appear to have reached ground level of the individual student. There is a considerable gap between what students should know and what they report to be aware of with regard to legal aspects of cyberbullying. To address concerns of keeping up with the pace of change in cyberbullying, a collaborative approach is required with young people and adults sharing expertise.

  19. INTERNATIONAL LEGAL FRAMEWORK FOR MEDIA

    Directory of Open Access Journals (Sweden)

    Nevenka Ronkova

    2016-04-01

    Full Text Available The analysis of the international legal framework for media in a real structural form is a challenge that needs to be scientifically proven because of the exceptional role of media in general and its constant and substantial impact on the democratic processes taking place in the world. If we analyze media through the eyes of history, we cannot ignore the impression of the exceptional importance of freedom of expression as the source and promoter of many substantive changes and valuable components in the overall functioning of social and political settings. In this regard, special attention is given to the impact of media on contemporary trends related to the EU integration process, the development of democracy and the rule of law. It particularly emphasizes the freedom of expression, respect for values and standards principles, human rights and freedoms. The purpose of this paper is to analyze the international legal framework for the media and to show the determination of the most important covenants which represent a source of media law containing rules for the creation and implementation of media freedom, the expressive quality of ideas and definitely and inevitably this paper stresses the power of the media.

  20. Setting Up an ePathology Service at Cleveland Clinic Abu Dhabi: Joint Collaboration With Cleveland Clinic, United States.

    Science.gov (United States)

    Nahal, Ayoub; Batac, Crystal Mildred O; Slaw, Renee J; Bauer, Thomas W

    2018-04-24

    - The production of whole slide images is the most advanced form of digital pathology, in which a high-resolution digital scanner is used to rapidly scan glass microscope slides and produce a computer-generated whole slide image that can be saved, stored in a network-attached storage device, and accessed through slide management software within the hospital domain and remotely by authorized users. Digital transformation of glass slides has revolutionized the practice of anatomic pathology by facilitating and expediting consultative services, improving clinical workflow, and becoming an indispensable tool in education and research. - To highlight the institutional need of Cleveland Clinic Abu Dhabi (Abu Dhabi, United Arab Emirates) and the cultural background for obtaining the United Arab Emirates' first comprehensive digital pathology program; to describe a multiphase road map for achieving full implementation of this platform; and to describe the system's clinical applications and its future potential growth. - At Cleveland Clinic Abu Dhabi, we prioritized our efforts to initiate digital consultations (eConsultations) and digital immunohistochemistry services (eIHC) with Cleveland Clinic Laboratories (Cleveland, Ohio). After this, we established an internal archiving system together with a subspecialty-based, organ-specific digital library of pathologic diseases. - We describe the strategic adoption and implementation of digital pathology into the clinical workflow of the pathology and laboratory medicine institute of Cleveland Clinic Abu Dhabi, and we highlight its impact on clinical operations, educational activities, and patient care.

  1. Telemedicine: The legal framework (or the lack of it) in Europe.

    Science.gov (United States)

    Raposo, Vera Lúcia

    2016-01-01

    In the framework of European law telemedicine is, simultaneously, a health service and an information service, therefore, both regulations apply. In what concerns healthcare and the practice of medicine there are no uniform regulations at the European level. Concerning health services the most relevant achievement to regulate this domain is Directive 2011/24/EU. In what regards information and telecommunications we must have in consideration Directive 95/46/EU, Directive 2000/31/EC and Directive 2002/58/EC. However, many issues still lack uniform regulation, mainly the domain of medical liability and of medical leges artis. Probably such standardization will never take place, since the European Union does not have, until now, a common set of norms regarding tort and criminal liability, much less specific legal norms on medical liability. These gaps may jeopardize a truly European internal market in health services and hamper the development of telemedicine in the European zone.

  2. Day Care Legal Handbook: Legal Aspects of Organizing and Operating Day Care Programs.

    Science.gov (United States)

    Aikman, William F.

    This guide for providers of day care services presents information on business regulations and other legal considerations affecting for-profit and not-for-profit day care programs. Three basic topics covered are: (1) choosing the type of organization (sole proprietorship, partnership or corporation), (2) forming the organization, and (3) operating…

  3. Modern Questions Of The Legal Philosophy

    Directory of Open Access Journals (Sweden)

    Gennadiy A. Torgashev

    2014-06-01

    Full Text Available In the present article author considers fundamental problems of law connected with equality, justice and freedom. Author proves that philosophy and law as forms of public consciousness carry out the important closely interconnected among themselves functions of the social life judgment. In the article author noted that among other forms of public consciousness law is one of difficult objects of knowledge, because law is connected with such forms of consciousness as philosophy, morals, religion, policy. The legal philosophy is the philosophical discipline having the subject the general regularities of law functioning, taken in their historical and sociocultural development, definition and the sense of legal judgment and its fundamental concepts. Law represents a set of obligatory rules of conduct (norms established by the authorized or the state. Diverse spiritual life of the society assumes a variety in the nature of law. The typology of philosophical concepts of the law and how the legal philosophy interprets legal reality is researched, various philosophical and legal concepts which are caused by two main types of rights – natural and positive are allocated. Author gives opinions of scientists, and explains own views of the author.

  4. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    Science.gov (United States)

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  5. The Legalization of Higher Education

    Science.gov (United States)

    Badke, Lara K.

    2017-01-01

    A complete discussion of intellectual property (IP), faculty rights, and the public good requires a thorough framing of higher education's legal context, from which the rise of legalistic criteria (or legalization) and current IP regime have grown.

  6. Calibrating Legal Judgments

    Directory of Open Access Journals (Sweden)

    Frederick Schauer

    2017-09-01

    Full Text Available Objective to study the notion and essence of legal judgments calibration the possibilities of using it in the lawenforcement activity to explore the expenses and advantages of using it. Methods dialectic approach to the cognition of social phenomena which enables to analyze them in historical development and functioning in the context of the integrity of objective and subjective factors it determined the choice of the following research methods formallegal comparative legal sociological methods of cognitive psychology and philosophy. Results In ordinary life people who assess other peoplersaquos judgments typically take into account the other judgments of those they are assessing in order to calibrate the judgment presently being assessed. The restaurant and hotel rating website TripAdvisor is exemplary because it facilitates calibration by providing access to a raterrsaquos previous ratings. Such information allows a user to see whether a particular rating comes from a rater who is enthusiastic about every place she patronizes or instead from someone who is incessantly hard to please. And even when less systematized as in assessing a letter of recommendation or college transcript calibration by recourse to the decisional history of those whose judgments are being assessed is ubiquitous. Yet despite the ubiquity and utility of such calibration the legal system seems perversely to reject it. Appellate courts do not openly adjust their standard of review based on the previous judgments of the judge whose decision they are reviewing nor do judges in reviewing legislative or administrative decisions magistrates in evaluating search warrant representations or jurors in assessing witness perception. In most legal domains calibration by reference to the prior decisions of the reviewee is invisible either because it does not exist or because reviewing bodies are unwilling to admit using what they in fact know and employ. Scientific novelty for the first

  7. Use of programme budgeting and marginal analysis to set priorities for local NHS dental services: learning from the north east of England.

    Science.gov (United States)

    Holmes, R D; Steele, J G; Exley, C; Vernazza, C R; Donaldson, C

    2018-05-03

    Priority setting is necessary where competing demands exceed the finite resources available. The aim of the study was to develop and test a prioritization framework based upon programme budgeting and marginal analysis (PBMA) as a tool to assist National Health Service (NHS) commissioners in their management of resources for local NHS dental services. Twenty-seven stakeholders (5 dentists, 8 commissioners and 14 patients) participated in a case-study based in a former NHS commissioning organization in the north of England. Stakeholders modified local decision-making criteria and applied them to a number of different scenarios. The majority of financial resources for NHS dental services in the commissioning organization studied were allocated to primary care dental practitioners' contracts in perpetuity, potentially constraining commissioners' abilities to shift resources. Compiling the programme budget was successful, but organizational flux and difficulties engaging local NHS commissioners significantly impacted upon the marginal analysis phase. NHS dental practitioners' contracts resemble budget-silos which do not facilitate local resource reallocation. 'Context-specific' factors significantly challenged the successful implementation and impact of PBMA. A local PBMA champion embedded within commissioning organizations should be considered. Participants found visual depiction of the cost-value ratio helpful during their initial priority setting deliberations.

  8. Barriers to the use of the library service amongst clinical staff in an acute hospital setting: an evaluation.

    Science.gov (United States)

    Thomas, Gaynor; Preston, Hugh

    2016-06-01

    This article reports on research into the reasons why clinical staff in an acute hospital may be reluctant to use library services. The research was conducted by Gaynor Thomas at the Prince Philip Hospital in Llanelli in Wales as part of the dissertation she completed for an MSc in Economics. She graduated in July 2014 from Aberystwyth University and has co-written the article with Hugh Preston, her dissertation supervisor. The article summarises the key findings from the interviews undertaken as part of the research process and lists the resulting recommendations. Gaynor also highlights the initiatives which have been put in place with the express aim of removing barriers to use and encouraging clinical staff to make the most of the library which is, she argues, a time-saving resource. AM. © 2016 Health Libraries Group.

  9. Did Legalized Abortion Lower Crime?

    Science.gov (United States)

    Joyce, Ted

    2004-01-01

    Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.

  10. Legal Institutions and Economic Development

    NARCIS (Netherlands)

    Beck, T.H.L.

    2010-01-01

    Legal institutions are critical for the development of market-based economies. This paper defines legal institutions and discusses different indicators to measure their quality and efficiency. It surveys a large historical and empirical literature showing the importance of legal institutions in

  11. Analysis - what is legal medicine?

    Science.gov (United States)

    Beran, Roy G

    2008-04-01

    Legal medicine addresses the interface between medicine and law in health care. The Australian College of Legal Medicine (ACLM) established itself as the peak body in legal and forensic medicine in Australia. It helped establish the Expert Witness Institute of Australia (EWIA), the legal medicine programme at Griffith University and contributes to government enquiries. Public health, disability assessment, competing priorities of privacy verses notification and determination of fitness for a host of pursuits are aspects of legal medicine. Complementing the EWIA, the ACLM runs training programmes emphasising legal medicine skills additional to clinical practice, advocating clinical relevance. Assessment of athletes' fitness and ensuring that prohibited substances are not inadvertently prescribed represent a growing area of legal medicine. Ethical consideration of health care should respect legal medicine principles rather than armchair commentary. International conventions must be respected by legal medicine and dictate physicians' obligations. The NSW courts imposed a duty to provide emergency medical care. Migration and communicable diseases are aspects of legal medicine. Police surgeons provide a face to legal medicine (which incorporates forensic medicine) underpinning its public perception of specialty recognition. Legal medicine deserves its place as a medical specialty in its own right.

  12. Is it feasible and effective to provide osteopathy and acupuncture for patients with musculoskeletal problems in a GP setting? A service evaluation

    Directory of Open Access Journals (Sweden)

    Peters David

    2011-06-01

    Full Text Available Abstract Background Spinal manipulation and acupuncture can be helpful in reducing the symptoms of musculoskeletal (MSK pain. Both approaches are currently recommended by NICE as treatment options for patients with persistent low back pain. However, there has been no previous evaluation of a GP service using them together for MSK pain. The purpose of this study was to evaluate acceptability and outcomes for an osteopathy and acupuncture service (delivered by complementary therapy practitioners for patients with MSK problems provided within a General Practice. Methods Patients were asked to complete a questionnaire before and after their course of treatment. Outcome measures included the Bournemouth Questionnaire (measuring MSK problems, EuroQoL-5D (measuring quality of life, medication use, physical activity and general well-being. Non-parametric tests were used to compare pre- and post- treatment variables. Qualitative data, regarding participants' views on the service, were collected from patients via a service survey and healthcare professionals via interviews. Qualitative data were analysed using thematic analysis. Results 123 adults with MSK problems were referred into the service (79 female and 44 male, mean age 49 years. Complete patient questionnaire data sets (pre- and post- treatment were available for 102 participants; 91 completed a service survey. All healthcare professionals involved in the service participated in interviews including all seven GPs and the administration manager at the practice, as well as the three acupuncture/osteopathy practitioners. Patient outcomes: comparisons between pre and post-treatment revealed a statistically significant improvement in MSK pain (p Acceptability of the service: overall patients and healthcare professionals were satisfied with the service and its provision within the Practice. Patients reported wanting increased appointment availability and flexibility, and more sessions. Complementary

  13. Application of Digital Object Identifiers to data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC)

    Science.gov (United States)

    Vollmer, B.; Ostrenga, D.; Johnson, J. E.; Savtchenko, A. K.; Shen, S.; Teng, W. L.; Wei, J. C.

    2013-12-01

    Digital Object Identifiers (DOIs) are applied to selected data sets at the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC). The DOI system provides an Internet resolution service for unique and persistent identifiers of digital objects. Products assigned DOIs include data from the NASA MEaSUREs Program, the Earth Observing System (EOS) Aqua Atmospheric Infrared Sounder (AIRS) and EOS Aura High Resolution Dynamics Limb Sounder (HIRDLS). DOIs are acquired and registered through EZID, California Digital Library and DataCite. GES DISC hosts a data set landing page associated with each DOI containing information on and access to the data including a recommended data citation when using the product in research or applications. This work includes participation with the earth science community (e.g., Earth Science Information Partners (ESIP) Federation) and the NASA Earth Science Data and Information System (ESDIS) Project to identify, establish and implement best practices for assigning DOIs and managing supporting information, including metadata, for earth science data sets. Future work includes (1) coordination with NASA mission Science Teams and other data providers on the assignment of DOIs for other GES DISC data holdings, particularly for future missions such as Orbiting Carbon Observatory -2 and -3 (OCO-2, OCO-3) and projects (MEaSUREs 2012), (2) construction of landing pages that are both human and machine readable, and (3) pursuing the linking of data and publications with tools such as the Thomson Reuters Data Citation Index.

  14. Collaborative Legal Pluralism

    Directory of Open Access Journals (Sweden)

    Wim Decock

    2017-01-01

    Full Text Available Legal pluralism calls into question the monopoly of the modern state when it comes to the production and the enforcement of norms. It rests on the assumption that juridical normativity and state organization can be dissociated. From an early modern historian’s perspective, such an assumption makes perfect sense, the plural nature of the legal order being the natural state of affairs in imperial spaces across the globe in the sixteenth and seventeenth centuries. This article will provide a case study of the collaborative nature of the interaction between spiritual and temporal legal orders in Spain and its overseas territories as conceived by Tomás de Mercado (ca. 1520–1575, a major theologian from the School of Salamanca. His treatise on trade and contracts (1571 contained an extended discussion of the government’s attempt to regulate the grain market by imposing a maximum price. It will be argued that Mercado’s view on the bindingness of economic regulations in conscience allowed for the internalization of the regulatory power of the nascent state. He called upon confessors to be strict enforcers of state law, considering them as fathers of the republic as much as fathers of faith. This is illustrative of the »collaborative form of legal pluralism« typical of the osmotic relationship between Church and State in the early modern Spanish empire. It contributed to the moral justification of state jurisdictions, while at the same time, guaranteeing a privileged role for theologians and religious leaders in running the affairs of the state.

  15. Legal consequences of kleptomania.

    Science.gov (United States)

    Grant, Jon E; Odlaug, Brian L; Davis, Andrew A; Kim, Suck Won

    2009-12-01

    Although studies have examined clinical characteristics of kleptomania, no previous studies have examined the legal consequences of kleptomania. From 2001 to 2007, 101 adult subjects (n = 27 [26.7%] males) with DSM-IV kleptomania were assessed on sociodemographics and clinical characteristics including symptom severity, comorbidity, and legal repercussions. Of 101 subjects with kleptomania, 73.3% were female. Mean age of shoplifting onset was 19.4 +/- 12.0 years, and subjects shoplifted a mean of 8.2 +/- 11.0 years prior to meeting full criteria for kleptomania. Co-occurring depressive, substance use, and impulse control disorders were common. Sixty-nine subjects with kleptomania (68.3%) had been arrested, 36.6% had been arrested but not convicted, 20.8% had been convicted and incarcerated after conviction, while only 10.9% had been convicted and not incarcerated after conviction. Kleptomania is associated with significant legal repercussions. The findings emphasize the need for rigorous treatment approaches to target kleptomania symptoms and prevent re-offending.

  16. Legal vs Ownership Unbundling in Network Industries

    OpenAIRE

    Cremer, Helmuth; Crémer, Jacques; De Donder, Philippe

    2006-01-01

    This paper studies the impact of legal unbundling vs ownership unbundling on the incentives of a network operator to invest and maintain its assets. We consider an industry where the upstream firm first chooses the size of a network, while several downstream firms then compete in selling goods and services that use this network as a necessary input. We contrast the (socially) optimal allocation with several equilibrium situations, depending on whether the upstream firm owns zero, one or two d...

  17. Legal briefing: conscience clauses and conscientious refusal.

    Science.gov (United States)

    Pope, Thaddeus Mason

    2010-01-01

    This issue's "Legal Briefing" column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States. Healthcare providers' own moral beliefs have been obstructing and are expected to increasingly obstruct patients' access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs. There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing - on ethical, moral, or religious grounds healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse 2. Abortion: duty to provide 3. Contraception: right to refuse 4. Contraception: duty to provide 5. Sterilization: right to refuse 6. Fertility, HIV, vaccines

  18. Legal Risk Associated with Electronic Funds Transfer

    OpenAIRE

    Abdulah, Samahir

    2014-01-01

    The past thirty years have seen rapid advances in the technological component of banking services and as a consequence new legal issues have come to the fore, especially with regard to Electronic Fund Transfers (EFTs) which are now used to transfer money around the world, and have made fund transactions between payers and payees easier, faster and more secure. The method involves risks for both banks and customers, due to the possibility of unauthorized payments risks, credit and insolvency p...

  19. Service use, charge, and access to mental healthcare in a private Kenyan inpatient setting: the effects of insurance.

    Directory of Open Access Journals (Sweden)

    Victoria Pattison de Menil

    Full Text Available The gap in Kenya between need and treatment for mental disorders is wide, and private providers are increasingly offering services, funded in part by private health insurance (PHI. Chiromo, a 30-bed psychiatric hospital in Nairobi, forms part of one of the largest private psychiatric providers in East Africa. The study evaluated the effects of insurance on service use and charge, questioning implications on access to care. Data derive from invoices for 455 sequential patients, including 12-month follow-up. Multi-linear and binary logistic regressions explored the effect of PHI on readmission, cumulative length of stay, and treatment charge. Patients were 66.4% male with a mean age of 36.8 years. Half were employed in the formal sector. 70% were admitted involuntarily. Diagnoses were: substance use disorder 31.6%; serious mental disorder 49.5%; common mental disorder 7%; comorbid 7%; other 4.9%. In addition to daily psychiatric consultations, two-thirds received individual counselling or group therapy; half received lab tests or scans; and 16.2% received ECT. Most took a psychiatric medicine. Half of those on antipsychotics were given only brands. Insurance paid in full for 28.8% of patients. Mean length of stay was 11.8 days and, in 12 months, 16.7 days (median 10.6. 22.2% were readmitted within 12 months. Patients with PHI stayed 36% longer than those paying out-of-pocket and had 2.5 times higher odds of readmission. Mean annual charge per patient was Int$ 4,262 (median Int$ 2,821. Insurers were charged 71% more than those paying out-of-pocket--driven by higher fees and longer stays. Chiromo delivers acute psychiatric care each year to approximately 450 people, to quality and human rights standards higher than its public counterpart, but at considerably higher cost. With more efficient delivery and wider insurance coverage, Chiromo might expand from its occupancy of 56.6% to reach a larger population in need.

  20. Advocacy for the Provision of Dental Hygiene Services Within the Hospital Setting: Development of a Dental Hygiene Student Rotation.

    Science.gov (United States)

    Juhl, Jacqueline A; Stedman, Lynn

    2016-06-01

    Educational preparation of dental hygiene students for hospital-based practice, and advocacy efforts promote inclusion of dental hygienists within hospital-based interdisciplinary health care teams. Although the value of attending to the oral care needs of patients in critical care units has been recognized, the potential impact of optimal oral health care for the general hospital population is now gaining attention. This article describes a hospital-based educational experience for dental hygiene students and provides advocacy strategies for inclusion of dental hygienists within the hospital interdisciplinary team. The dental hygienist authors, both educators committed to evidence-based oral health care and the profession of dental hygiene, studied hospital health care and recognized a critical void in oral health care provision within that setting. They collaboratively developed and implemented a hospital-based rotation within the curriculum of a dental hygiene educational program and used advocacy skills to encourage hospital administrators to include a dental hygiene presence within hospital-based care teams. Hospital-based dental hygiene practice, as part of interprofessional health care delivery, has the potential to improve patient well-being, shorten hospital stays, and provide fiscal savings for patients, institutions, and third party payers. Advocacy efforts can promote dental hygienists as members of hospital-based health care teams. Further research is needed to document: (1) patient outcomes resulting from optimal oral care provision in hospitals; (2) best ways to prepare dental hygienists for career opportunities within hospitals and other similar health care settings; and (3) most effective advocacy strategies to promote inclusion of dental hygienists within care teams. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. THEORETICAL ANALYSIS STUDY OF FORMATION OF FUTURE LEGAL LAWYERS

    Directory of Open Access Journals (Sweden)

    Eugene Stepanovich Shevlakov

    2015-09-01

    Full Text Available The article deals with topical issues of formation of legal consciousness of future lawyers in high school. Obtained kinds of legal consciousness of future lawyers, determined its structure. Dedicated components of justice are mutually reinforcing, and provide an opportunity for further development of the personality of the future specialist, their personal growth.The purpose: to carry out theoretical analysis of the problem of formation of legal consciousness of future lawyers.The novelty is based. On the analysis of theoretical appro-aches of pedagogy, psychology, law, the notion of «lawfulness of the future of the law student», which is regarded as a form of social consciousness, which is a set of legal views and feelings, expressing the attitude to the law and legal phenomena that have regulatory in character and which includes know-ledge of legal phenomena and their evaluation from the point of view of fairness and justice, formed in the process of studying in the University.Results: this article analyzes different approaches to understanding the content and essence of the concept of legal consciousness of the legal profession. Define the types and structure of legal consciousness of future lawyers.

  2. Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide

    Science.gov (United States)

    Elsabbagh, Mayada; Barbaro, Josephine; Gladstone, Melissa; Happe, Francesca; Hoekstra, Rosa A.; Lee, Li‐Ching; Rattazzi, Alexia; Stapel‐Wax, Jennifer; Stone, Wendy L.; Tager‐Flusberg, Helen; Thurm, Audrey; Tomlinson, Mark; Shih, Andy

    2015-01-01

    Most research into the epidemiology, etiology, clinical manifestations, diagnosis and treatment of autism is based on studies in high income countries. Moreover, within high income countries, individuals of high socioeconomic status are disproportionately represented among participants in autism research. Corresponding disparities in access to autism screening, diagnosis, and treatment exist globally. One of the barriers perpetuating this imbalance is the high cost of proprietary tools for diagnosing autism and for delivering evidence‐based therapies. Another barrier is the high cost of training of professionals and para‐professionals to use the tools. Open‐source and open access models provide a way to facilitate global collaboration and training. Using these models and technologies, the autism scientific community and clinicians worldwide should be able to work more effectively and efficiently than they have to date to address the global imbalance in autism knowledge and at the same time advance our understanding of autism and our ability to deliver cost‐effective services to everyone in need. Autism Res 2015, 8: 473–476. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. PMID:26437907

  3. Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

    Science.gov (United States)

    Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid

    2015-09-08

    Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective. Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

  4. Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide.

    Science.gov (United States)

    Durkin, Maureen S; Elsabbagh, Mayada; Barbaro, Josephine; Gladstone, Melissa; Happe, Francesca; Hoekstra, Rosa A; Lee, Li-Ching; Rattazzi, Alexia; Stapel-Wax, Jennifer; Stone, Wendy L; Tager-Flusberg, Helen; Thurm, Audrey; Tomlinson, Mark; Shih, Andy

    2015-10-01

    Most research into the epidemiology, etiology, clinical manifestations, diagnosis and treatment of autism is based on studies in high income countries. Moreover, within high income countries, individuals of high socioeconomic status are disproportionately represented among participants in autism research. Corresponding disparities in access to autism screening, diagnosis, and treatment exist globally. One of the barriers perpetuating this imbalance is the high cost of proprietary tools for diagnosing autism and for delivering evidence-based therapies. Another barrier is the high cost of training of professionals and para-professionals to use the tools. Open-source and open access models provide a way to facilitate global collaboration and training. Using these models and technologies, the autism scientific community and clinicians worldwide should be able to work more effectively and efficiently than they have to date to address the global imbalance in autism knowledge and at the same time advance our understanding of autism and our ability to deliver cost-effective services to everyone in need. © 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

  5. Legal knowledge, needs, and assistance seeking among HIV positive and negative women in Umlazi, South Africa.

    Science.gov (United States)

    Hill, Lauren M; Maman, Suzanne; Holness, David; Moodley, Dhayendre

    2016-01-22

    The rights of women and people living with HIV (PLHIV) are protected under South African law, yet there is a gap in the application of these laws. While there are numerous systemic and social barriers to women's and PLHIV's exercise of their legal rights and rights to access social services, there has been little effort to document these barriers as well as legal needs and knowledge in this context. 1480 HIV-positive and HIV-negative women recruited from an antenatal clinic in Umlazi Township completed a questionnaire on legal knowledge, experience of legal issues, assistance seeking for legal issues, and barriers to seeking assistance. We compared the legal knowledge and experience of legal issues of HIV-positive and HIV-negative women, and described assistance seeking and barriers to assistance seeking among all women. Both HIV-positive and HIV-negative women had high levels of knowledge of their legal rights. There were few important differences in legal knowledge and experience of legal issues by HIV status. The most common legal issues women experienced were difficulty obtaining employment (11 %) and identification documents (7 %). A minority of women who had ever experienced a legal issue had sought assistance for this issue (38 %), and half (50 %) of assistance sought was from informal sources such as family and friends. Women cited lack of time and government bureaucracy as the major barriers to seeking assistance. These results indicate few differences in legal knowledge and needs between HIV-positive and HIV-negative women in this context, but rather legal needs common among women of reproductive age. Legal knowledge may be a less important barrier to seeking assistance for legal issues than time, convenience, and cost. Expanding the power of customary courts to address routine legal issues, encouragement of pro bono legal assistance, and introduction of legal navigators could help to address these barriers.

  6. Changes in Default Alarm Settings and Standard In-Service are Insufficient to Improve Alarm Fatigue in an Intensive Care Unit: A Pilot Project.

    Science.gov (United States)

    Sowan, Azizeh Khaled; Gomez, Tiffany Michelle; Tarriela, Albert Fajardo; Reed, Charles Calhoun; Paper, Bruce Michael

    2016-01-11

    Clinical alarm systems safety is a national concern, specifically in intensive care units (ICUs) where alarm rates are known to be the highest. Interventional projects that examined the effect of changing default alarm settings on overall alarm rate and on clinicians' attitudes and practices toward clinical alarms and alarm fatigue are scarce. To examine if (1) a change in default alarm settings of the cardiac monitors and (2) in-service nursing education on cardiac monitor use in an ICU would result in reducing alarm rate and in improving nurses' attitudes and practices toward clinical alarms. This quality improvement project took place in a 20-bed transplant/cardiac ICU with a total of 39 nurses. We implemented a unit-wide change of default alarm settings involving 17 parameters of the cardiac monitors. All nurses received an in-service education on monitor use. Alarm data were collected from the audit log of the cardiac monitors 10 weeks before and 10 weeks after the change in monitors' parameters. Nurses' attitudes and practices toward clinical alarms were measured using the Healthcare Technology Foundation National Clinical Alarms Survey, pre- and postintervention. Alarm rate was 87.86 alarms/patient day (a total of 64,500 alarms) at the preintervention period compared to 59.18 alarms/patient day (49,319 alarms) postintervention (P=.01). At baseline, Arterial Blood Pressure (ABP), Pair Premature Ventricular Contractions (PVCs), and Peripheral Capillary Oxygen Saturation (SpO2) alarms were the highest. ABP and SpO2 alarms remained among the top three at the postproject period. Out of the 39 ICU nurses, 24 (62%) provided complete pre- and postproject survey questionnaires. Compared to the preintervention survey, no remarkable changes in the postproject period were reported in nurses' attitudes. Themes in the narrative data were related to poor usability of cardiac monitors and the frequent alarms. The data showed great variation among nurses in terms of changing

  7. UBERTRUST: How Uber Represents Itself to Its Customers Through its Legal and Non-Legal Documents

    OpenAIRE

    Noto La Diega, Guido; Jacovella, Luce

    2016-01-01

    This paper examines some of the key factors that contribute to build or erode users’ trust in a platform-based service such as the one provided by Uber Technologies Inc. As clarified by the European Commission, the future Internet cannot succeed without trust of online platforms’ users. The paper explores Uber’s web of relationships with different categories of users, i.e., ‘driver-partners’, ‘riders’, ‘developers’ and ‘business users’ through Uber’s legal and non-legal representations. By an...

  8. Locating distribution/service centers based on multi objective decision making using set covering and proximity to stock market

    Directory of Open Access Journals (Sweden)

    Mazyar Dabibi

    2016-09-01

    Full Text Available In the present competitive world, facility location is an important aspect of the supply chain (sc optimization. It involves selecting specific locations for facility construction and allocation of the distribution channel among different SC levels. In fact, it is a strategic issue which directly affects many operational/tactical decisions. Besides the accessibility, which results in customer satisfaction, the present paper optimizes the establishment costs of a number of distribution channels by considering their proximity to the stock market of the goods they distribute, and proposes mathematical models for two objective functions using the set covering problem. Then, two objective functions are proposed into one through the ε-constraint method and solved by the metaheuristic Genetic Algorithm (GA. To test the resulted model, a smaller scale problem is solved. Results from running the algorithm with different ε-values show that, on average, a 10% increase in ε, which increases the value of the second objective function - distance covered by customers will cause a 2% decrease in the value of the first objective function including the costs of establishing distribution centers. The repeatability and solution convergence of the two-objective model presented by the GA are other results obtained in this study.

  9. Aiming for a holistic integrated service for men diagnosed with prostate cancer - Definitions of standards and skill sets for nurses and allied healthcare professionals.

    Science.gov (United States)

    Lamb, Alastair D; Thompson, Sue; Kinsella, Netty; Gerbitz, Ingmar; Chapman, Elaine; Putt, Lisa; Bennett, Sophie; Thankappannair, Vineetha; Geoghegan, Lisa; Wright, Naomi; Stirton-Croft, Alison; Nixon, Penny; Styling, Andrew; Whitney, Diane; Hodgson, Lindsay; Punt, Lisa; Longmore, Jenny; Carter, Mike; Petch, Bill; Rimmer, Yvonne; Russell, Simon; Hughes-Davies, Luke; Mazhar, Danish; Shah, Nimish C; Gnanapragasam, Vincent J; Doble, Andrew; Bratt, Ola; Kastner, Christof

    2017-08-01

    To establish a comprehensive set of recommendations for the service structure and skill set of nurses and allied healthcare professionals in prostate cancer care. Using components of formal consensus methodology, a 30-member multidisciplinary panel produced 53 items for discussion relating to the provision of care for prostate cancer patients by specialist nurses and allied healthcare professionals. Items were developed by two rounds of email correspondence in which, first, items were generated and, second, items refined to form the basis of a consensus meeting which constituted the third round of review. The fourth and final round was an email review of the consensus output. The panel agreed on 33 items that were appropriate for recommendations to be made. These items were grouped under categories of "Environment" and "Patient Pathway" and included comments on training, leadership, communication and quality assessment as well as specific items related to prostate diagnosis clinics, radical treatment clinics and follow-up survivor groups. Specialist nurses and allied healthcare professionals play a vital role alongside urologists and oncologists to provide care to men with prostate cancer and their families. We present a set of standards and consensus recommendations for the roles and skill-set required for these practitioners to provide gold-standard prostate cancer care. These recommendations could form the basis for development of comprehensive integrated prostate cancer pathways in prostate cancer centres as well as providing guidance for any units treating men with prostate cancer. Copyright © 2017. Published by Elsevier Ltd.

  10. 2001 Industry Studies: Services Industry

    National Research Council Canada - National Science Library

    Cervone, Michael

    2001-01-01

    .... has maintained its economic strength in traditional services industries such as transportation, tourism, public utilities, finance and insurance, accounting, engineering, architecture, medical, legal...

  11. The model of a bilaterally open electricity market and its compatibility with the standards set by legal regulations (EnWG and GWB). Die Vereinbarkeit des Modells eines zweiseitig offenen Strommarktes mit den Normen von EnWG und GWB

    Energy Technology Data Exchange (ETDEWEB)

    Toennies, J G

    1993-01-01

    The author arrives at the following conclusion: By considering the 'peak load princing' principle of national economy and by applying it with the aid of microelectronics, it will be possible to meet the requirements of deregulation on the one hand and recommunalisation on the other hand while keeping within the limits set by the valid requlations of communal law and energy supply law. A deregulated structure of the power supply sector will meet the demands of the market economy, while the communities, who are primarily responsible for electricity distribution, will be given scope for enforcing a structure of the power industry that takes account of the requirements of environmental protection. (orig./HSCH)

  12. Competitive Legal Professionals’ use of Technology in Legal Practice and Legal Research

    Directory of Open Access Journals (Sweden)

    T du Plessis

    2008-12-01

    Full Text Available Advances in the information and communication technologies have led to the availability of a range of primary and secondary legal research publications online via the Internet, rather than on other storing devices such as compact discs or publications in the print media. Not only has information and communication technology (ICT impacted on the availability of legal information resources, but its effects are also noticed in various law-related areas such as legal practice management, legal education, corporate governance and the law per se. The question addressed by this article is whether the application of ICTs has an effect on the practice of law, and specifically whether information and knowledge management affects the processes of legal research in modern legal practice. Various issues are considered in this regard, including what the concept of knowledge management (KM entails in a law firm and what the current KM trends in South African law firms are. The article investigates global trends in the application of ICTs for legal research purposes, what the specific applications of KM in support of legal research may be, how information technology applications and KM systems and strategies can support the legal research process, and what the benefits of KM are to legal research. It finally discusses the impact technology has had on the skills required of competitive legal professionals.

  13. Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

    Directory of Open Access Journals (Sweden)

    Cabral de Mello Meena

    2011-09-01

    Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

  14. Legal aspects of teleradiology

    International Nuclear Information System (INIS)

    Ulsenheimer, K.; Heinemann, N.

    1997-01-01

    It is hoped that the implementation of teleradiology will improve the quality and economic effectiveness of health care in the future. The German federal government has submitted a bill for a legal statute, thereby creating the necessary framework to guarantee the essential 'document security'. The responsibility of those involved with orderly data transmission as well as the limited responsibility for physicians' findings are both government by general liability. General principles apply also with regard to professional discretion. Authorized utilization of external networks depends upon the quality of data security. Networks with unlimited public access may not be used without explicit concent from those concerned. (orig.) [de

  15. Legal Assistance Guide: Wills

    Science.gov (United States)

    1990-09-01

    presente testamento de mi puno y letra para hacer constar mi ultima y firme voluntad para que sea cumplida fielmente conforme a las siguientes clausulas...ruego se le de fiel cumplimiento. Y para que asi conste, a todos los f ines legales pertinentes otorgo el presente testamrento bajo mi firma en el lugar...Transiers to ,- -Al" t’ het (4., m4 Us %put Ortronew. It 1111. tOOlise -ur" se me. thens 1 61%0 all rmv 14oo Act at anv &late ..t ..... i, 𔃺 le. ~~rt n the

  16. Legal and institutional issues

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Leaving aside the natural desire to avoid the difficulties imposed by the enormously complex siting and certification process, a utility might decide to forego adding new capacity because of a variety of legal and institutional disincentives. Some of these are discussed in this chapter. The addition of new lines to support a competitive generating market also raises unique institutional issues. Perhaps the most important of these is the question of who should pay for the necessary capital expenditures. This issue also is discussed in this section

  17. Documents and legal texts

    International Nuclear Information System (INIS)

    2016-01-01

    This section treats of the following documents and legal texts: 1 - Brazil: Law No. 13,260 of 16 March 2016 (To regulate the provisions of item XLIII of Article 5 of the Federal Constitution on terrorism, dealing with investigative and procedural provisions and redefining the concept of a terrorist organisation; and amends Laws No. 7,960 of 21 December 1989 and No. 12,850 of 2 August 2013); 2 - India: The Atomic Energy (Amendment) Act, 2015; Department Of Atomic Energy Notification (Civil Liability for Nuclear Damage); 3 - Japan: Act on Subsidisation, etc. for Nuclear Damage Compensation Funds following the implementation of the Convention on Supplementary Compensation for Nuclear Damage

  18. Medico-legal findings, legal case progression, and outcomes in South African rape cases: retrospective review.

    Directory of Open Access Journals (Sweden)

    Rachel Jewkes

    2009-10-01

    .036, ano-genital injuries alone (AOR 7.00, 95% CI 1.44-33.9, p = 0.017, or both nongenital and ano-genital injuries (AOR 12.34, 95% CI 2.87-53.0, p = 0.001. DNA was not associated with case outcome. CONCLUSIONS: This is the first study, to our knowledge, to show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases in a developing country. Its findings are of particular importance because they show the value of good basic medical practices in documentation of injuries, rather than more expensive DNA evidence, in assisting courts in rape cases. Health care providers need training to provide high quality health care responses after rape, but we have shown that the core elements of the medico-legal response require very little technology. As such they should be replicable in low- and middle-income country settings. Our findings raise important questions about the value of evidence that requires the use of forensic laboratories at a population level in countries like South Africa that have substantial inefficiencies in their police services. Please see later in the article for the Editors' Summary.

  19. Get the Basics Right: A Description of the Key Priorities for Establishing a Neonatal Service in a Resource-Limited Setting in Cambodia.

    Science.gov (United States)

    Fox-Lewis, Shivani; Genasci Smith, Wyatt; Lor, Vary; McKellar, Gregor; Phal, Chea; Fox-Lewis, Andrew; Turner, Paul; Neou, Leakhena; Turner, Claudia

    2018-05-28

    Worldwide, reduction in under-five mortality has not sufficiently included neonates, who represent 45% of deaths in children of age under five years. The least progress has been observed in resource-limited settings. This mixed methods study conducted at a Cambodian non-governmental paediatric hospital described the key priorities of the ongoing neonatal service. Routinely collected data from the hospital and microbiology databases included the number of admissions, discharges and deaths and the number of cases of bacteraemias (2011-2016). Semi-structured interviews with the management staff explored the essential features of the service. There were 2127 neonatal admissions and 247 deaths. The incidence of facility-based neonatal mortality decreased by 81%. Bacteraemic healthcare-associated infections decreased by 68%. A dedicated area for neonatal care was perceived as crucial, allowing better infection control and delivery of staff training. In this hospital, the neonatal service prioritized basic measures, particularly, having a dedicated neonatal area. Facility-based mortality and bacteraemic healthcare-associated infections decreased.

  20. Relationship between implementing interpersonal communication and mass education campaigns in emergency settings and use of reproductive healthcare services: evidence from Darfur, Sudan.

    Science.gov (United States)

    Adam, Izzeldin Fadl; Nakamura, Keiko; Kizuki, Masashi; Al Rifai, Rami; Vanching, Urnaa

    2015-09-15

    (1) To examine changes in women's awareness and utilisation of reproductive healthcare services in emergency settings following provision of interpersonal communication (IPC) and mass education campaigns, and (2) to describe factors associated with reproductive healthcare service use in internally displaced person (IDP) camps. Three camps containing 88 984 IDPs in Darfur, Sudan. 640 women aged 15-49 who had experienced pregnancy in the camp during the previous 2 years were enrolled in each of two independent cross-sectional surveys 26 months apart. IPC and mass education campaigns where community health workers disseminated information by home/shelter visits, clinic sessions, public meetings and other means to raise awareness and promote reproductive healthcare service use. Awareness of the existence of antenatal care (ANC) and tetanus toxoid (TT) vaccination services, reception of ANC and TT vaccination, place of delivery and use of postnatal care (PNC). The percentage of women who received home visits, and attended in-clinic sessions and public meetings increased from 61.6% to 86.7%, from 43.0% to 68.8%, and from 3.8% to 39.8%, respectively, between the initial and follow-up surveys. More women were aware of ANC (OR 18.6, 95% CI 13.1 to 26.5) and TT vaccination (OR 3.2, 95% CI 2.4 to 4.4) in the follow-up than the initial survey, after multivariable adjustment. More women received ≥3 ANC visits (OR 8.8, 95% CI 6.4 to 12.0) and ≥3 doses of TT (OR 2.5, 95% CI 1.9 to 3.3), delivered at a healthcare facility (OR 5.4, 95% CI 4.0 to 7.4) and received a PNC visit (OR 5.5, 95% CI 4.0 to 7.7) in the follow-up than in the initial survey, after multivariable adjustment. Awareness about and utilisation of reproductive healthcare services were higher in the follow-up survey. An integrated IPC and mass education campaign is effective for improving women's reproductive health in emergency settings. Published by the BMJ Publishing Group Limited. For permission to use

  1. Meeting the Needs for Legal Education in the South.

    Science.gov (United States)

    Pye, A. Kenneth

    The purpose of this paper is to collect and analyze data related to the needs of the legal profession and the capacity of law schools to meet these needs in the southern states. The law schools in this southern region are educating more law students than at any time in history. But the need for legal services in the region and the large number of…

  2. 5 CFR 582.203 - Information minimally required to accompany legal process.

    Science.gov (United States)

    2010-01-01

    ... CIVIL SERVICE REGULATIONS COMMERCIAL GARNISHMENT OF FEDERAL EMPLOYEES' PAY Service of Legal Process... to the court, or other authority, with an explanation of the deficiency. However, prior to returning...

  3. Women’s experiences of referral to a domestic violence advocate in UK primary care settings: a service-user collaborative study

    Science.gov (United States)

    Malpass, Alice; Sales, Kim; Johnson, Medina; Howell, Annie; Agnew-Davies, Roxane; Feder, Gene

    2014-01-01

    Background Women experiencing domestic violence and abuse (DVA) are more likely to be in touch with health services than any other agency, yet doctors and nurses rarely ask about abuse, often failing to identify signs of DVA in their patients. Aim To understand women’s experience of disclosure of DVA in primary care settings and subsequent referral to a DVA advocate in the context of a DVA training and support programme for primary care clinicians: Identification and Referral to Improve Safety (IRIS). Design and setting A service-user collaborative study using a qualitative study design. Recruitment was from across IRIS trial settings in Bristol and Hackney, London. Method Twelve women who had been referred to one of two specialist DVA advocates (based at specialist DVA agencies) were recruited by a GP taking part in IRIS. Women were interviewed by a survivor of DVA and interviews were recorded and transcribed verbatim. Analysis was thematic using constant comparison. Results GPs and nurses can play an important role in identifying women experiencing DVA and referring them to DVA specialist agencies. GPs may also have an important role to play in helping women maintain any changes they make as a result of referral to an advocate, by asking about DVA in subsequent consultations. Conclusion A short time interval between a primary care referral and initial contact with an advocate was valued by some women. For the initial contact with an advocate to happen as soon as possible after a primary care referral has been made, a close working relationship between primary care and the third sector needs to be cultivated. PMID:24567654

  4. THE RELEVANCE OF SOCIO-LEGAL STUDIES IN LEGAL SCIENCE

    Directory of Open Access Journals (Sweden)

    Victor Imanuel W. Nalle

    2015-02-01

    Full Text Available Some law schools in Indonesia reject socio-legal studies with epistemological arguments that puts jurisprudence as sui generis. Rejection is based argument that jurisprudence is a normative science. In fact socio-legal studies in the development of jurisprudence outside Indonesia has long existed and contributed to the legal reform. Socio-legal studies also significant for legal reform. It is caused by the existence of non doctrinal aspect in law making and implementation of the law. Therefore the position and relevance of socio-legal research is not related to the benefits that provided for the development of national law or jurisprudence. Beberapa fakultas hukum di Indonesia menolak penelitian sosio-legal dengan argumentasi epistemologis yang menempatkan ilmu hukum sebagai sui generis. Penolakan tersebut didasarkan argumentasi bahwa ilmu hukum adalah ilmu yang bersifat normatif. Kenyataannya studi sosio-legal dalam perkembangan ilmu hukum di luar Indonesia telah lama eksis dan berperan dalam pembaharuan hukum. Selain itu, studi sosiolegal juga berperan dalam pembaharuan hukum. Hal ini disebabkan adanya aspek-aspek nondoktrinal yang berperan dalam pembentukan hukum dan implementasi hukum di masyarakat. Oleh karena itu kedudukan dan relevansi penelitian sosio-legal pada ada tidaknya manfaat yang diberikan bagi perkembangan hukum nasional ataupun ilmu hukum.

  5. THE RELEVANCE OF SOCIO-LEGAL STUDIES IN LEGAL SCIENCE

    Directory of Open Access Journals (Sweden)

    Victor Imanuel W. Nalle

    2015-02-01

    Full Text Available Some law schools in Indonesia reject socio-legal studies with epistemological arguments that puts jurisprudence as sui generis. Rejection is based argument that jurisprudence is a normative science. In fact socio-legal studies in the development of jurisprudence outside Indonesia has long existed and contributed to the legal reform. Socio-legal studies also significant for legal reform. It is caused by the existence of non doctrinal aspect in law making and implementation of the law. Therefore the position and relevance of socio-legal research is not related to the benefits that provided for the development of national law or jurisprudence.   Beberapa fakultas hukum di Indonesia menolak penelitian sosio-legal dengan argumentasi epistemologis yang menempatkan ilmu hukum sebagai sui generis. Penolakan tersebut didasarkan argumentasi bahwa ilmu hukum adalah ilmu yang bersifat normatif. Kenyataannya studi sosio-legal dalam perkembangan ilmu hukum di luar Indonesia telah lama eksis dan berperan dalam pembaharuan hukum. Selain itu, studi sosiolegal juga berperan dalam pembaharuan hukum. Hal ini disebabkan adanya aspek-aspek nondoktrinal yang berperan dalam pembentukan hukum dan implementasi hukum di masyarakat. Oleh karena itu kedudukan dan relevansi penelitian sosio-legal pada ada tidaknya manfaat yang diberikan bagi perkembangan hukum nasional ataupun ilmu hukum.

  6. [Abortion: towards worldwide legalization].

    Science.gov (United States)

    1998-09-01

    A table showing the current status of abortion in the world based on two recent and detailed studies is presented. Countries are categorized according to whether they totally prohibit abortion, permit it to save the mother's life, permit it to preserve her physical health or mental health, permit it for maternal socioeconomic reasons, or provide it at the mother's request. The countries are grouped into 5 geographic areas: America and the Caribbean; Central Asia, Middle East, and North Africa; East and South Asia and the Pacific; Europe; sub-Saharan Africa. The trend toward liberalization of laws is clear. The development of abortion laws is moving in the direction of complete legalization, that is, the creation of health norms that facilitate abortion for all women, with guarantees of medical safety. There are still countries that move to restrict access to abortion, and in a few cases, such as Colombia and Poland, legalization and prohibition have alternated depending on the social and political circumstances of the moment. In the past 12 years, 28 countries liberalized their laws in some way, while 4 countries with close ties to the Vatican restricted or prohibited access.

  7. Using lot quality assurance sampling to assess access to water, sanitation and hygiene services in a refugee camp setting in South Sudan: a feasibility study.

    Science.gov (United States)

    Harding, Elizabeth; Beckworth, Colin; Fesselet, Jean-Francois; Lenglet, Annick; Lako, Richard; Valadez, Joseph J

    2017-08-08

    Humanitarian agencies working in refugee camp settings require rapid assessment methods to measure the needs of the populations they serve. Due to the high level of dependency of refugees, agencies need to carry out these assessments. Lot Quality Assurance Sampling (LQAS) is a method commonly used in development settings to assess populations living in a project catchment area to identify their greatest needs. LQAS could be well suited to serve the needs of refugee populations, but it has rarely been used in humanitarian settings. We adapted and implemented an LQAS survey design in Batil refugee camp, South Sudan in May 2013 to measure the added value of using it for sub-camp level assessment. Using pre-existing divisions within the camp, we divided the Batil catchment area into six contiguous segments, called 'supervision areas' (SA). Six teams of two data collectors randomly selected 19 respondents in each SA, who they interviewed to collect information on water, sanitation, hygiene, and diarrhoea prevalence. These findings were aggregated into a stratified random sample of 114 respondents, and the results were analysed to produce a coverage estimate with 95% confidence interval for the camp and to prioritize SAs within the camp. The survey provided coverage estimates on WASH indicators as well as evidence that areas of the camp closer to the main road, to clinics and to the market were better served than areas at the periphery of the camp. This assumption did not hold for all services, however, as sanitation services were uniformly high regardless of location. While it was necessary to adapt the standard LQAS protocol used in low-resource communities, the LQAS model proved to be feasible in a refugee camp setting, and program managers found the results useful at both the catchment area and SA level. This study, one of the few adaptations of LQAS for a camp setting, shows that it is a feasible method for regular monitoring, with the added value of enabling camp

  8. Using lot quality assurance sampling to assess access to water, sanitation and hygiene services in a refugee camp setting in South Sudan: a feasibility study

    Directory of Open Access Journals (Sweden)

    Elizabeth Harding

    2017-08-01

    Full Text Available Abstract Background Humanitarian agencies working in refugee camp settings require rapid assessment methods to measure the needs of the populations they serve. Due to the high level of dependency of refugees, agencies need to carry out these assessments. Lot Quality Assurance Sampling (LQAS is a method commonly used in development settings to assess populations living in a project catchment area to identify their greatest needs. LQAS could be well suited to serve the needs of refugee populations, but it has rarely been used in humanitarian settings. We adapted and implemented an LQAS survey design in Batil refugee camp, South Sudan in May 2013 to measure the added value of using it for sub-camp level assessment. Methods Using pre-existing divisions within the camp, we divided the Batil catchment area into six contiguous segments, called ‘supervision areas’ (SA. Six teams of two data collectors randomly selected 19 respondents in each SA, who they interviewed to collect information on water, sanitation, hygiene, and diarrhoea prevalence. These findings were aggregated into a stratified random sample of 114 respondents, and the results were analysed to produce a coverage estimate with 95% confidence interval for the camp and to prioritize SAs within the camp. Results The survey provided coverage estimates on WASH indicators as well as evidence that areas of the camp closer to the main road, to clinics and to the market were better served than areas at the periphery of the camp. This assumption did not hold for all services, however, as sanitation services were uniformly high regardless of location. While it was necessary to adapt the standard LQAS protocol used in low-resource communities, the LQAS model proved to be feasible in a refugee camp setting, and program managers found the results useful at both the catchment area and SA level. Conclusions This study, one of the few adaptations of LQAS for a camp setting, shows that it is a feasible

  9. Legal and Institutional Foundations of Adaptive Environmental ...

    Science.gov (United States)

    Legal and institutional structures fundamentally shape opportunities for adaptive governance of environmental resources at multiple ecological and societal scales. Properties of adaptive governance are widely studied. However, these studies have not resulted in consolidated frameworks for legal and institutional design, limiting our ability to promote adaptation and social-ecological resilience. We develop an overarching framework that describes the current and potential role of law in enabling adaptation. We apply this framework to different social-ecological settings, centers of activity, and scales, illustrating the multidimensional and polycentric nature of water governance. Adaptation typically emerges organically among multiple centers of agency and authority in society as a relatively self-organized or autonomous process marked by innovation, social learning, and political deliberation. This self-directed and emergent process is difficult to create in an exogenous, top-down fashion. However, traditional centers of authority may establish enabling conditions for adaptation using a suite of legal, economic, and democratic tools to legitimize and facilitate self-organization, coordination, and collaboration across scales. The principles outlined here provide preliminary legal and institutional foundations for adaptive environmental governance, which may inform institutional design and guide future scholarship. Adaptation typically emerges organically among m

  10. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings.

    Science.gov (United States)

    Heffron, Renee; Davies, Natasha; Cooke, Ian; Kaida, Angela; Mergler, Reid; van der Poel, Sheryl; Cohen, Craig R; Mmeje, Okeoma

    2015-01-01

    that integrate HIV treatment and prevention, sexual and reproductive health and fertility care services in a manner responsive to user values and preferences offer opportunities to maximize demand for and use of these services. For HIV-affected women and couples attempting pregnancy, the provision of comprehensive services using available tools - and the development of new tools that are adaptable to many settings and follow consensus recommendations - is a public health imperative. The impetus now is to design and deliver value-driven inclusive programming to achieve the greatest coverage and impact to reduce HIV transmission during pregnancy attempts.

  11. Two conceptions of legal principles

    Directory of Open Access Journals (Sweden)

    Spaić Bojan

    2017-01-01

    Full Text Available The paper discusses the classical understanding of legal principles as the most general norms of a legal order, confronting it with Dworkin's and Alexy's understanding of legal principles as prima facie, unconditional commands. The analysis shows that the common, classical conception brings into question the status of legal principles as norms, by disreguarding their usefulness in judicial reasoning, while, conversely, the latterhas significant import forlegal practice and consequently for legal dogmatics. It is argued that the heuristic fruitfulness of understanding principles as optimization commands thusbecomesapparent. When we understand the relation of priciples to the idea of proportionality, as thespecific mode of their application, which is different from the supsumtive mode of applying rules, the theory of legal principles advanced by Dworkin and Alexy appears therefore to be descriptively better than others, but not without its flaws.

  12. Datafication of Automated (Legal) Decisions

    DEFF Research Database (Denmark)

    Schaumburg-Müller, Sten

    Even though I maintain that it is a misconception to state that states are “no longer” the only actors, since they never were, indeed it makes sense to “shed light on the impact of (…) new tendencies on legal regulatory mechanisms (…)” One regulatory tendency is obviously the automation of (legal......) decisions which has implications for legal orders, legal actors and legal research, not to mention legal legitimacy as well as personal autonomy and democracy. On the one hand automation may facilitate better, faster, more predictable and more coherent decisions and leave cumbersome and time consuming...... a substantial part of the components of the decisions are prefabricated. With a risk of misplacing the responsibility, this may be called the “google syndrome”. The hidden algorithms may also constitute the basis for decisions concerning individuals (the passive aspect), the “profiling syndrome”. Based on big...

  13. German Legal History: National Traditions and Transnational Perspectives

    Directory of Open Access Journals (Sweden)

    Thomas Duve

    2014-01-01

    Full Text Available In this article, I review select institutional and analytical traditions of Legal History in 20th century Germany, in order to put forth some recommendations for the future development of our discipline. A careful examination of the evolution of Legal History in Germany in the last twenty-five years, in particular, reveals radical transformations in the research framework: Within the study of law, there has been a shift in the internal reference points for Legal History. While the discipline is opening up to new understandings of law and to its neighboring disciplines, its institutional position at the law departments has become precarious. Research funding is being allocated in new ways and the German academic system is witnessing ever more internal differentiation. Internationally, German contributions and analytic traditions are receiving less attention and are being marginalized as new regions enter into a global dialogue on law and its history. The German tradition of research in Legal History had for long been setting benchmarks internationally; now it has to reflect upon and react to new global knowledge systems that have emerged in light of the digital revolution and the transnationalization of legal and academic systems. If legal historians in Germany accept the challenge these changing conditions pose, thrilling new intellectual and also institutional opportunities emerge. Especially the transnationalization of law and the need for a transnational legal scholarship offers fascinating perspectives for Legal History.

  14. Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of national health service hospitals in England

    Directory of Open Access Journals (Sweden)

    Mohammed Mohammed A

    2012-04-01

    Full Text Available Abstract Background Although acute hospitals offer a twenty-four hour seven day a week service levels of staffing are lower over the weekends and some health care processes may be less readily available over the weekend. Whilst it is thought that emergency admission to hospital on the weekend is associated with an increased risk of death, the extent to which this applies to elective admissions is less well known. We investigated the risk of death in elective and elective patients admitted over the weekend versus the weekdays. Methods Retrospective statistical analysis of routinely collected acute hospital admissions in England, involving all patient discharges from all acute hospitals in England over a year (April 2008-March 2009, using a logistic regression model which adjusted for a range of patient case-mix variables, seasonality and admission over a weekend separately for elective and emergency (but excluding zero day stay emergency admissions discharged alive admissions. Results Of the 1,535,267 elective admissions, 91.7% (1,407,705 were admitted on the weekday and 8.3% (127,562 were admitted on the weekend. The mortality following weekday admission was 0.52% (7,276/1,407,705 compared with 0.77% (986/127,562 following weekend admission. Of the 3,105,249 emergency admissions, 76.3% (2,369,316 were admitted on the weekday and 23.7% (735,933 were admitted on the weekend. The mortality following emergency weekday admission was 6.53% (154,761/2,369,316 compared to 7.06% (51,922/735,933 following weekend admission. After case-mix adjustment, weekend admissions were associated with an increased risk of death, especially in the elective setting (elective Odds Ratio: 1.32, 95% Confidence Interval 1.23 to 1.41; vs emergency Odds Ratio: 1.09, 95% Confidence Interval 1.05 to 1.13. Conclusions Weekend admission appears to be an independent risk factor for dying in hospital and this risk is more pronounced in the elective setting. Given the planned

  15. Legal capital: an outdated concept

    OpenAIRE

    John Armour

    2006-01-01

    This paper reviews the case for and against mandatory legal capital rules. It is argued that legal capital is no longer an appropriate means of safeguarding creditors' interests. This is most clearly the case as regards mandatory rules. Moreover, it is suggested that even an 'opt in' (or default) legal capital regime is unlikely to be a useful mechanism. However, the advent of regulatory arbitrage in European corporate law will provide a way of gathering information regarding investors' prefe...

  16. Communication and well-being outcomes of a hybrid service delivery model of intensive impairment-based treatment for aphasia in the hospital setting: a pilot study.

    Science.gov (United States)

    Wenke, Rachel; Cardell, Elizabeth; Lawrie, Melissa; Gunning, Dana

    2018-06-01

    This pilot study aimed to evaluate the effects of an intensive hybrid service delivery model (i.e., combining face-to-face individual, computer and group therapy) on communication and well-being for people with aphasia (PWA) in the hospital setting. The study explored two different intensities of the hybrid model, 4 h/week (Hybrid-4) and 8 h/week (Hybrid-8) both for 8 weeks. Participants ranging from 1 month to 5 years post-onset were allocated using matched-pair randomisation to receive either Hybrid-4 (n = 5) or Hybrid-8 (n = 4) and assessed using a comprehensive language battery by a blinded assessor, as well as selected activity, participation and well-being measures before, immediately after and 4-week post-treatment. All participants in Hybrid-4 and three out of four participants in Hybrid-8 demonstrated clinically significant improvement to measures of language impairment immediately post-treatment, with the majority also demonstrating maintenance effects 4-week post-treatment. Clinically significant improvements to activity, participation and well-being measures were also observed across participants in both groups. Findings support the potential benefit of employing an intensive hybrid service model and suggest that both 4 and 8 h per week of impairment-based treatment for 8 weeks may result in improvements in communication and well-being for some PWA across different stages of recovery. Implications for rehabilitation The present findings help bridge the gap between what evidence suggests is effective intensity of rehabilitation for aphasia and what can be practically delivered in real-world hospital settings. Findings support the potential clinical value of employing a hybrid service model (using computer, group and individual therapy) to deliver intensive rehabilitation to people with aphasia in the hospital setting, and suggest that clinically significant improvements to communication and well-being can result when the model is

  17. IT Security Standards and Legal Metrology - Transfer and Validation

    Science.gov (United States)

    Thiel, F.; Hartmann, V.; Grottker, U.; Richter, D.

    2014-08-01

    Legal Metrology's requirements can be transferred into the IT security domain applying a generic set of standardized rules provided by the Common Criteria (ISO/IEC 15408). We will outline the transfer and cross validation of such an approach. As an example serves the integration of Legal Metrology's requirements into a recently developed Common Criteria based Protection Profile for a Smart Meter Gateway designed under the leadership of the Germany's Federal Office for Information Security. The requirements on utility meters laid down in the Measuring Instruments Directive (MID) are incorporated. A verification approach to check for meeting Legal Metrology's requirements by their interpretation through Common Criteria's generic requirements is also presented.

  18. Legality Principle of Crimes and Punishments in Iranian Legal System

    Science.gov (United States)

    Habibzadeh, Mohammad Ja'far

    2006-01-01

    The Principle of legality of crimes and punishments (nullum crimen, nulla poena sine lege) refers to the fact that an act is not considered a crime and deserves no punishment, unless the Legislator determines and announces the criminal title and its penalty before. The legality principle protects individual security by ensuring basic individual…

  19. Regulatory and legal issues

    International Nuclear Information System (INIS)

    Raisler, K.M.; Gregory, A.M.

    1999-01-01

    This chapter focuses on the legal issues relating to the derivatives market in the USA, and analyses the Commodity Futures Trading Commission's (CFTCs) information on swaps and hybrid instruments. The law and regulation in the USA is examined and the jurisdictional reach of the Securities and Exchange Commission (SEC), CFTC, and the Commodity Exchange Act (CEA) is described. The forward contract exclusion and the case of Transnor (Bermuda) Ltd. versus BP North America Petroleum, state laws, swap policy statement issues by the CFTC, the Futures Trading Practices Act of 1992, swaps exemptions, the exemption of hybrid instruments from the CEA, and energy contract exemption are discussed. Enforceability, derivatives, and issues before regulators are considered

  20. Legal aspects of Brexit

    Directory of Open Access Journals (Sweden)

    Ovidiu – Horia Maican

    2016-12-01

    Full Text Available The Brexit referendum vote has mainly political implications and no direct legal effect. The article 50 of the Treaty on European Union allows member states to withdraw from the European Union in accordance with its own constitutional requirements. After the referendum is a period of two years from the british notice of intention to withdraw to negotiate terms of exit unless all the other member states agree to extend it. Article 50 put the balance of power firmly in the hands of the 27 other states more than the leaving state. After the time limit in article 50 is expiring, Europen Union in theory law ceases to apply in the United Kingdom. In the same time, separating European law from british national law will be an complicated process.

  1. Integration of prevention of mother-to-child transmission of HIV (PMTCT postpartum services with other HIV care and treatment services within the maternal and child health setting in Zimbabwe, 2012.

    Directory of Open Access Journals (Sweden)

    Katherine Wiegert

    Full Text Available We assessed the integration of PMTCT services during the postpartum period including early infant diagnosis of HIV (EID and adult and pediatric antiretroviral therapy (ART in maternal and child health (MCH facilities in Zimbabwe.From August to December 2012 we conducted a cross-sectional survey of a nationally representative sample of 151 MCH facilities. A questionnaire was used to survey each site about staff training, dried blood spot sample (DBS collection, turnaround time (TAT for test results, PMTCT services, and HIV care and treatment linkages for HIV-infected mothers and children and HIV-exposed infants. Descriptive analyses were used. Of the facilities surveyed, all facilities were trained on DBS collection and 92% responded. Approximately, 99% of responding facilities reported providing DBS collection and a basic HIV-exposed infant service package including EID, extended nevirapine prophylaxis, and use of cotrimoxazole. DBS collection was integrated with immunisations at 83% of facilities, CD4 testing with point-of-care machines was available at 37% of facilities, and ART for both mothers and children was provided at 27% of facilities. More than 80% of facilities reported that DBS test results take >4 weeks to return; TAT did not have a direct association with any specific type of transport, distance to the lab, or intermediate stops for data to travel.Zimbabwe has successfully scaled up and integrated the national EID and PMTCT programs into the existing MCH setting. The long TAT of infant DBS test results and the lack of integrated ART programs in the MCH setting could reduce effectiveness of the national PMTCT and ART programs. Addressing these important gaps will support successful implementation of the 2014 Zimbabwe's PMTCT guidelines under which all HIV-infected pregnant and breastfeeding women will be offered life-long ART and decentralized ART care.

  2. Permeability of public and private spaces in reproductive healthcare seeking: barriers to uptake of services among low income African American women in a smaller urban setting.

    Science.gov (United States)

    Golden, Annis G

    2014-05-01

    This study was undertaken in partnership with a publicly funded reproductive healthcare organization to better understand barriers to utilization of its services as perceived by low income African American women in its community and how those barriers might be managed. The study uses a place-based, ecological perspective to theorize privacy challenges across different levels of the communication ecology. Analysis of participant observation, interviews, and focus group data identified three key public-private problematics in African American women's experience of reproductive healthcare seeking in a smaller urban setting: a public-private problematic of organizational identity, of organizational regions, and of organizational members. Potential strategies are identified for managing these problematics by the organization and community members. Copyright © 2014. Published by Elsevier Ltd.

  3. Programming services with correlation sets

    DEFF Research Database (Denmark)

    Montesi, Fabrizio; Carbone, Marco

    2011-01-01

    -oriented systems, such as distribution, loose coupling, open-endedness and integration. Distinguishing features of our approach are the notion of correlation aliases and an asynchronous communication model. Our language is equipped with formal syntax, semantics, and a typing system for ensuring desirable...

  4. The effect of facility characteristics on patient safety, patient experience, and service availability for procedures in non-hospital-affiliated outpatient settings: A systematic review.

    Science.gov (United States)

    Berglas, Nancy F; Battistelli, Molly F; Nicholson, Wanda K; Sobota, Mindy; Urman, Richard D; Roberts, Sarah C M

    2018-01-01

    Over recent decades, numerous medical procedures have migrated out of hospitals and into freestanding ambulatory surgery centers (ASCs) and physician offices, with possible implications for patient outcomes. In response, states have passed regulations for office-based surgeries, private organizations have established standards for facility accreditation, and professional associations have developed clinical guidelines. While abortions have been performed in office setting for decades, states have also enacted laws requiring that facilities that perform abortions meet specific requirements. The extent to which facility requirements have an impact on patient outcomes-for any procedure-is unclear. We conducted a systematic review to examine the effect of outpatient facility type (ASC vs. office) and specific facility characteristics (e.g., facility accreditation, emergency response protocols, clinician qualifications, physical plant characteristics, other policies) on patient safety, patient experience and service availability in non-hospital-affiliated outpatient settings. To identify relevant research, we searched databases of the published academic literature (PubMed, EMBASE, Web of Science) and websites of governmental and non-governmental organizations. Two investigators reviewed 3049 abstracts and full-text articles against inclusion/exclusion criteria and assessed the quality of 22 identified articles. Most studies were hampered by methodological challenges, with 12 of 22 not meeting minimum quality criteria. Of 10 studies included in the review, most (6) examined the effect of facility type on patient safety. Existing research appears to indicate no difference in patient safety for outpatient procedures performed in ASCs vs. physician offices. Research about specific facility characteristics is insufficient to draw conclusions. More and higher quality research is needed to determine if there is a public health problem to be addressed through facility

  5. The setting up and running of a cross-county out-of-hours gastrointestinal bleed service: a possible blueprint for the future.

    Science.gov (United States)

    Shokouhi, Bahman N; Khan, Mohammad; Carter, Martyn J; Khan, Nasser Q; Mills, Philip; Morris, Danielle; Rowlands, David E; Samsheer, Kote; Sargeant, Ian R; McIntyre, Peter B; Greenfield, Simon M

    2013-07-01

    Acute upper gastrointestinal bleeding (AUGIB) results in 25 000 hospital admissions annually. Patients admitted at weekends with AUGIB have increased mortality, and guidelines advise out-of-hours endoscopy. We present retrospective data from our service involving the interhospital transfer of patients. We pooled resources of two neighbouring general hospitals, just north of London. Emergency endoscopy is performed at the start of the list followed by elective endoscopy in the endoscopy unit on Saturday and Sunday mornings. From Friday evening to Sunday morning, patients admitted to Queen Elizabeth II Hospital (QEII) are medically stabilised and transferred to Lister Hospital by ambulance. 240 endoscopies were performed out of hours from December 2007 to March 2011. Of these, 54 patients were transferred: nine had emergency endoscopy at QEII as they were medically unstable; eight of the patients transferred required therapeutic intervention for active bleeding. The mean pre-endoscopy Rockall score of those transferred was 2.5. We examined the records of 51 of the 54 patients transferred. There were three deaths within 30 days after endoscopy not associated with the transfer process. 19 (37%) patients had reduced hospitalisation after having their endoscopy at the weekend. The introduction of the out-of-hours endoscopy service in our trust has had multiple benefits, including patients consistently receiving timely emergency endoscopy, significantly reduced disruption to emergency operating theatres, and participation of endoscopy nurses ensures a better and safer experience for patients, and better endoscopy decontamination. We suggest our model is safe and feasible for other small units wishing to set up their own out-of-hours endoscopy service to adopt.

  6. Legal Quality, Inequality, and Tolerance

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    Previous findings suggest that income inequality leads to lower legal quality. This paper argues that voters' tolerance of inequality exerts an additional influence. Empirical findings suggest that inequality leads to lower legal quality due to its effect on trust while the tolerance of inequality...

  7. Legal Quality, Inequality, and Tolerance

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    2004-01-01

    Previous findings suggest that income inequality leads to lower legal quality. This paper argues that voters' tolerance of inequality exerts an additional influence. Empirical findings suggest that inequality leads to lower legal quality due to its effect on trust while the tolerance of inequality...

  8. Legal Aspects of the Web.

    Science.gov (United States)

    Borrull, Alexandre Lopez; Oppenheim, Charles

    2004-01-01

    Presents a literature review that covers the following topics related to legal aspects of the Web: copyright; domain names and trademarks; linking, framing, caching, and spamdexing; patents; pornography and censorship on the Internet; defamation; liability; conflict of laws and jurisdiction; legal deposit; and spam, i.e., unsolicited mails.…

  9. Studying Legal Cultures and Encounters?

    DEFF Research Database (Denmark)

    Petersen, Hanne

    2015-01-01

    This article discusses the cultural and other turns in relation to legal culture and situates Western legal culture in context. It deals with concepts and their relations to trends and fashions and introduces methodological reflections such as use of interdisciplinary methods, personal experience...

  10. Legal Principles and Legislative Instrumentalism

    NARCIS (Netherlands)

    Gribnau, J.L.M.; Soeteman, A.

    2003-01-01

    Instrumentalist legislation usually underestimates the importance of legal principles in modern law. Legal principles are the normative core of a value oriented conception of law. They function as essential criteria of evaluation for lawmaking by the legislator and the executive. In fact,

  11. Legal risk management in shipping

    DEFF Research Database (Denmark)

    Siig, Kristina

    The book discusses the most typical legal challenges met in the chartering, broker, agent or port management part of the shipping industry. It discusses these issues in both English and Scandinavian law and gives indications on how to best ensure your legal risk management in these parts...

  12. The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: a cohort study in Indonesia.

    Science.gov (United States)

    Toro, Maria L; Eke, Chika; Pearlman, Jonathan

    2016-01-22

    For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization's service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p received a wheelchair reported being able to perform a "wheelie". The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0

  13. Ethical, Legal and Social Issues in Japan on the Determination of Blood Relationship via DNA Testing.

    Science.gov (United States)

    Toya, Waki

    2017-01-01

    DNA paternity testing has recently become more widely available in Japan. The aim of this paper is to examine the issues surrounding (1) the implementing agency, whether the testing is conducted in a commercial direct-to-consumer (DTC) setting or a judicial non-DTC setting, and (2) the implementation conditions and more specifically the legal capacity of the proband (test subject). Literature research in Japanese and English was conducted. Some countries prohibit commercial DNA testing without the consent of the proband or her or his legally authorized representative. But as in some cases, the results of DTC paternity testing have proven to be unreliable. I propose a complete prohibition of DTC DNA paternity testing in Japan. In many cases of paternity testing, the proband is a minor. This has led to debate about whether proxy consent is sufficient for paternity testing or whether additional safeguards (such as a court order) are required. In cases where commercial DNA testing has been conducted and the test results are produced in court as evidence, the court must judge whether or not to admit these results as evidence. Another important issue is whether or not paternity testing should be legally mandated in certain cases. If we come to the conclusion that DNA test results are the only way to conclusively establish a parent-child relationship, then our society may prioritize even more genetic relatedness over other conceptions of a parent-child relationship. This prioritization could adversely affect families created through assisted reproductive technology (ART), especially in situations where children are not aware of their biological parentage. This paper argues for a complete prohibition of DTC DNA paternity testing in Japan, and highlights that broader ethical and legal deliberation on such genetic services is required.

  14. A Software Tool for Legal Drafting

    Directory of Open Access Journals (Sweden)

    Daniel Gorín

    2011-09-01

    Full Text Available Although many attempts at automated aids for legal drafting have been made, they were based on the construction of a new tool, completely from scratch. This is at least curious, considering that a strong parallelism can be established between a normative document and a software specification: both describe what an entity should or should not do, can or cannot do. In this article we compare normative documents and software specifications to find out their similarities and differences. The comparison shows that there are distinctive particularities, but they are restricted to a very specific subclass of normative propositions. The rest, we postulate, can be dealt with software tools. For such an enterprise the FormaLex tool set was devised: an LTL-based language and companion tools that utilize model checking to find out normative incoherences in regulations, contracts and other legal documents. A feature-rich case study is analyzed with the presented tools.

  15. Value Set Authority Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — The VSAC provides downloadable access to all official versions of vocabulary value sets contained in the 2014 Clinical Quality Measures (CQMs). Each value set...

  16. On Plagiarism and Power Relations in Legal Academia and Legal Education

    Directory of Open Access Journals (Sweden)

    Tilen Štajnpihler

    2017-12-01

    Full Text Available The article challenges the misconception that legal academia is a harmonious community without internal discrepancies, characterised by common interests, a coherent set of values and standards of behaviour that are unilaterally transposed into the legal profession through the process of legal education. The paper focuses on a case study of a public dispute between two law professors initiated by an article published in one of the main national law magazines wherein one accused the other of plagiarism. Even though the dispute did not come to an unequivocal conclusion, it deserves a closer examination as it clearly exposed two important issues. Firstly, it revealed certain unresolved issues concerning legal writing and legal ethics that are essential elements of the legal profession, as they have a profound impact on legal education and legal practice, and, secondly, it showed that these divergences are at least to some extent related to the latent network of power relations and struggles that dominate the legal (academic field. Este artículo cuestiona la creencia de que el mundo jurídico-académico es una comunidad armoniosa sin discrepancias internas, caracterizada por intereses comunes, valores coherentes y parámetros de comportamiento que se transponen de forma unilateral al ejercicio de la profesión jurídica a través de la educación en Derecho. El artículo se centra en el estudio de una disputa entre dos profesores de Derecho, en la cual uno acusaba al otro de plagio. A pesar de que la disputa no se resolvió de forma clara, merece un análisis más cuidadoso, ya que puso de manifiesto dos temas importantes: en primer lugar, algunos conflictos sin resolver sobre la escritura y la ética del derecho que son elementos esenciales de la profesión jurídica, pues tienen un profundo impacto sobre la educación y la práctica del Derecho; y, en segundo lugar, que estos desacuerdos están relacionados con las redes latentes de poder que

  17. Problematyka prywatności przy udzielaniu świadczeń zdrowotnych osobom starszym – wybrane aspekty prawne = Privacy issues in the provision of health services for the elderly – selected legal aspects

    Directory of Open Access Journals (Sweden)

    Iwona Wrześniewska-Wal

    2015-06-01

    ązany prowadzić, przechowywać i udostępniać dokumentację medyczną pacjentowi i uprawnionym instytucjom oraz podmiotom w sposób określony w przepisach prawa, a także zapewnić ochronę danych zawartych w tej dokumentacji.   Summary: The medical profession can say that is a humanist, because at its core the life and health of man and the respect of this particular value, which is dignity. With dignity are all related legal regulations that protect the privacy of patients. These include provisions relating to privacy, professional secrecy and the protection of medical records. Every patient has the right to respect for privacy and dignity, in particular at the time of granting him health benefits. The doctor is obliged concern that the remaining medical staff observe these principles. Intimacy patient should refer to all feelings and actions not only related to the provision of health services. On such notions of intimacy consists of caring for the patient's welfare, respect for the patient's understanding of his situation. One element of these rights is also possible to contact a patient with others, to accompany a close relative when granting health benefits and the exercise by that person of patient care. Details of these contacts defined in the regulations or the hospital ward. With the right to privacy join safeguards for the protection of personal data. Data on the health of the patient are protected in two planes. This includes provisions on the patient's right to confidentiality of information associated with it and the provisions for the protection of medical records. Professional secrecy covers all information related to the patient and obtained in connection with the exercise of the medical profession. At the same time this obligation is not absolute because the legislature has exhaustively pointed to exceptions in this regard. The entity providing health services shall keep, store and share patient medical records and authorized institutions and entities in

  18. Examination of the utility of the promoting action on research implementation in health services framework for implementation of evidence based practice in residential aged care settings.

    Science.gov (United States)

    Perry, Lin; Bellchambers, Helen; Howie, Andrew; Moxey, Annette; Parkinson, Lynne; Capra, Sandra; Byles, Julie

    2011-10-01

    This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  19. Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

    Science.gov (United States)

    Frey, Rosemary; Gott, Merryn; Raphael, Deborah; O'Callaghan, Anne; Robinson, Jackie; Boyd, Michal; Laking, George; Manson, Leigh; Snow, Barry

    2014-12-01

    Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting. The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence. A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs. On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training. Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. [Legal secrecy: abortion in Puerto Rico from 1937 to 1970].

    Science.gov (United States)

    Marchand-Arias, R E

    1998-03-01

    The essay discusses abortion in Puerto Rico from 1937 to 1970, concentrating in its legal status as well as its social practice. The research documents the contradictions between the legality of the procedure and a social practice characterized by secrecy. The essay discusses the role of the Clergy Consultation Service on Abortion in promoting the legal practice of absortion in Puerto Rico. It also discusses the ambivalent role of medical doctors who, despite being legally authorized to perform abortions to protect the life and health of women, refused to perform the procedure arguing abortion was illegal. The essay concludes with a brief discussion on perceptions of illegality regarding abortion, emphasizing the contradictions between the practice of abortion and that of sterilization in Puerto Rico.

  1. Legal Considerations for Health Care Practitioners After Superstorm Sandy.

    Science.gov (United States)

    Hershey, Tina Batra; Van Nostrand, Elizabeth; Sood, Rishi K; Potter, Margaret

    2016-06-01

    During disaster response and recovery, legal issues often arise related to the provision of health care services to affected residents. Superstorm Sandy led to the evacuation of many hospitals and other health care facilities and compromised the ability of health care practitioners to provide necessary primary care. This article highlights the challenges and legal concerns faced by health care practitioners in the aftermath of Sandy, which included limitations in scope of practice, difficulties with credentialing, lack of portability of practitioner licenses, and concerns regarding volunteer immunity and liability. Governmental and nongovernmental entities employed various strategies to address these concerns; however, legal barriers remained that posed challenges throughout the Superstorm Sandy response and recovery period. We suggest future approaches to address these legal considerations, including policies and legislation, additional waivers of law, and planning and coordination among multiple levels of governmental and nongovernmental organizations. (Disaster Med Public Health Preparedness. 2016;10:518-524).

  2. Controlling Legal Risk for Effective Hospital Management

    Directory of Open Access Journals (Sweden)

    Hyun Jun Park

    2016-04-01

    Full Text Available Purpose: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%. The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years, and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months. Conclusions: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

  3. Legal Aspects of Radioactive Waste Management: Relevant International Legal Instruments

    International Nuclear Information System (INIS)

    Wetherall, Anthony; Robin, Isabelle

    2014-01-01

    The responsible use of nuclear technology requires the safe and environmentally sound management of radioactive waste, for which countries need to have stringent technical, administrative and legal measures in place. The legal aspects of radioactive waste management can be found in a wide variety of legally binding and non-binding international instruments. This overview focuses on the most relevant ones, in particular those on nuclear safety, security, safeguards and civil liability for nuclear damage. It also identifies relevant regional instruments concerning environmental matters, in particular, with regard to strategic environmental assessments (SEAs), environmental impact assessments (EIAs), public access to information and participation in decision-making, as well as access to justice

  4. Legalized abortion in Japan.

    Science.gov (United States)

    Hart, T M

    1967-10-01

    The enactment of the Eugenic Protection Act in Japan was followed by many changes. The population explosion was stemmed, the birth rate was halved, and while the marriage rate remained steady the divorce rate declined. The annual total of abortions increased until 1955 and then slowly declined. The highest incidence of abortions in families is in the 30 to 34 age group when there are four children in the family. As elsewhere abortion in advanced stages of pregnancy is associated with high morbidity and mortality. There is little consensus as to the number of criminal abortions. Reasons for criminal abortions can be found in the legal restrictions concerning abortion: Licensing of the abortionist, certification of hospitals, taxation of operations and the requirement that abortion be reported. Other factors are price competition and the patient's desire for secrecy. Contraception is relatively ineffective as a birth control method in Japan. Oral contraceptives are not yet government approved. In 1958 alone 1.1 per cent of married women were sterilized and the incidence of sterilization was increasing.

  5. Documents and legal texts

    International Nuclear Information System (INIS)

    2015-01-01

    This section treats of the following Documents and legal texts: 1 - Canada: Nuclear Liability and Compensation Act (An Act respecting civil liability and compensation for damage in case of a nuclear incident, repealing the Nuclear Liability Act and making consequential amendments to other acts); 2 - Japan: Act on Compensation for Nuclear Damage (The purpose of this act is to protect persons suffering from nuclear damage and to contribute to the sound development of the nuclear industry by establishing a basic system regarding compensation in case of nuclear damage caused by reactor operation etc.); Act on Indemnity Agreements for Compensation of Nuclear Damage; 3 - Slovak Republic: Act on Civil Liability for Nuclear Damage and on its Financial Coverage and on Changes and Amendments to Certain Laws (This Act regulates: a) The civil liability for nuclear damage incurred in the causation of a nuclear incident, b) The scope of powers of the Nuclear Regulatory Authority (hereinafter only as the 'Authority') in relation to the application of this Act, c) The competence of the National Bank of Slovakia in relation to the supervised financial market entities in the financial coverage of liability for nuclear damage; and d) The penalties for violation of this Act)

  6. Documents and legal texts

    International Nuclear Information System (INIS)

    2014-01-01

    This section of the Bulletin presents the recently published documents and legal texts sorted by country: - Brazil: Resolution No. 169 of 30 April 2014. - Japan: Act Concerning Exceptions to Interruption of Prescription Pertaining to Use of Settlement Mediation Procedures by the Dispute Reconciliation Committee for Nuclear Damage Compensation in relation to Nuclear Damage Compensation Disputes Pertaining to the Great East Japan Earthquake (Act No. 32 of 5 June 2013); Act Concerning Measures to Achieve Prompt and Assured Compensation for Nuclear Damage Arising from the Nuclear Plant Accident following the Great East Japan Earthquake and Exceptions to the Extinctive Prescription, etc. of the Right to Claim Compensation for Nuclear Damage (Act No. 97 of 11 December 2013); Fourth Supplement to Interim Guidelines on Determination of the Scope of Nuclear Damage Resulting from the Accident at the Tokyo Electric Power Company Fukushima Daiichi and Daini Nuclear Power Plants (Concerning Damages Associated with the Prolongation of Evacuation Orders, etc.); Outline of 'Fourth Supplement to Interim Guidelines (Concerning Damages Associated with the Prolongation of Evacuation Orders, etc.)'. - OECD Nuclear Energy Agency: Decision and Recommendation of the Steering Committee Concerning the Application of the Paris Convention to Nuclear Installations in the Process of Being Decommissioned; Joint Declaration on the Security of Supply of Medical Radioisotopes. - United Arab Emirates: Federal Decree No. (51) of 2014 Ratifying the Convention on Supplementary Compensation for Nuclear Damage; Ratification of the Federal Supreme Council of Federal Decree No. (51) of 2014 Ratifying the Convention on Supplementary Compensation for Nuclear Damage

  7. Legal aspects of some internet marketing instruments

    Directory of Open Access Journals (Sweden)

    Hana Kelblová

    2012-01-01

    Full Text Available The development of the Internet and sophisticated search engines such as e.g. Google together with the spread of social networks have introduced new marketing possibilities of addressing potential clients with offer of goods and services. Unlike most traditional marketing procedures, these instruments allow for targeting the business information directly at concrete individuals, taking into consideration their age, sex, education, hobbies. All this is based on their choice of words keyed into the search engines. This is the targeted advertising where consumer response can be accurately measured, e.i. the so called context advertising.The purpose of this paper is to analyse the legal aspects of some of the above mentioned internet marketing instruments, as even in this sphere legal regulation clearly lags behind the dynamically developing possibilities of the Internet as a means of communication. These marketing methods being viewed from the perspective of valid laws, several problem areas may be detected, which concern the right of privacy protection of natural person, intellectual property, or legal regulation of implied or unsolicited advertising.This paper concentrates on the summary of rules of law which regulate internet users privacy protection with respect to the Czech and Community laws, assessment of their efficiency and de lege ferenda discretion.

  8. Key considerations for an economic and legal framework facilitating medical travel

    Directory of Open Access Journals (Sweden)

    Saba eHinrichs

    2016-03-01

    Full Text Available Medical travel has the capacity to counter increasing costs of healthcare by creating new markets and increased revenue for health services, potentially benefiting local populations, economies and health care systems. This paper is part of a broad, comprehensive project aimed at developing a Global Health Access Policy (GHAP. It presents key issues to consider in terms of ensuring economic viability, sustainability, and limiting risk to the many stakeholders involved in the rapidly expanding industry of medical travel. The noted economic and legal barriers to medical travel are based on a synthesis of themes found in an extensive review of the available literature. Economic considerations when setting up a GHAP include a dynamic approach to pricing that is fair to the local population. Legal considerations include the implementation of international quality standards and the protection of the rights of those travelling as well as those of local populations in recipient countries. By taking into account these opportunities, the GHAP will more adequately address existing gaps in the economic and legal regulation of medical travel.

  9. The legal aspects of internationalization of nuclear fuel cycle

    International Nuclear Information System (INIS)

    Tazaki, M.; Akiba, M.; Kuno, Y.

    2011-01-01

    The purpose of internationalization of nuclear fuel cycle facilities and / or multilateral nuclear approach (MNA) is to support nuclear nonproliferation regime by minimizing unnecessary proliferation of sensitive technologies and facilities through assured supply of nuclear fuel and services. In order to establish such MNA, a University of Tokyo team, including authors of this paper, first furnished justification for MNA, and then set out twelve MNA prerequisites. One of those prerequisites is 'Legal Aspect' and it intends to avoid inconsistencies between MNAs and existing treaties and agreements. By listing typical treaties and agreements related to each MNA prerequisite, several inconsistencies are found out. In relations with sovereign states' alienable right of the peaceful use of nuclear energy recognized in Article IV of Nuclear Nonproliferation Treaty (NPT), two inconsistencies should be highlighted. One is nuclear supplier states' restraint in transfer of sensitive facilities, equipment, technology and material to recipient states set out in Nuclear Suppliers Group (NSG) Guidelines, while the other is also some nuclear supplier states' restriction on reprocessing of spent fuel (SF) of their origin in recipient states, which is specified in supplier-recipient bilateral nuclear cooperation agreement. Authors are now on the way to analyze more various inconsistencies, in order to find out ways to avoid or overcome such inconsistencies for sustainable and feasible MNAs. This paper describes a broad introduction of authors' current study. (author)

  10. Legal protection of pet animals in domestic legislation

    Directory of Open Access Journals (Sweden)

    Vidić-Trninić Jelena

    2012-01-01

    Full Text Available The subject of the author's analysis is the issue of legal protection of pet animals. Through analysis of applicable provisions contained in the Act on Animal Welfare of Serbia, on one hand, and the fundamental principles and provisions set out in the European Convention for the Protection of Pet animals, on the other hand, this paper attempts to point out the degree of legal protection that pet animals are awarded under domestic legal regulations, as well as to answer the question of compatibility of the national legislation with the international standards set out in the mentioned European Convention regarding the above mentioned question. In addition, since the legal protection of pet animals is also regulated by relevant by-laws in our law, the analysis of certain aspects of protection provided to pet animals, specifically the Decision of the city of Novi Sad on keeping of domesticated animals, the paper attempts to draw attention to compliance of the solutions adopted in this legal act, with the fundamental principles of protection, provided to pets by laws or the Act on Animal Welfare of Serbia. Finally, in order to provide a more comprehensive insight in terms of achievement of the legal protection of pets in Serbian law, the paper analyzes the types of unlawful conduct of the owner or the holder of the animals, as well as their respective sanctioning prescribed in specific laws or bylaws.

  11. Strengthening close to community provision of maternal health services in fragile settings: an exploration of the changing roles of TBAs in Sierra Leone and Somaliland.

    Science.gov (United States)

    Orya, Evelyn; Adaji, Sunday; Pyone, Thidar; Wurie, Haja; van den Broek, Nynke; Theobald, Sally

    2017-07-05

    Efforts to take forward universal health coverage require innovative approaches in fragile settings, which experience particularly acute human resource shortages and poor health indicators. For maternal and newborn health, it is important to innovate with new partnerships and roles for Traditional Birth Attendants (TBAs) to promote maternal health. We explore perspectives on programmes in Somaliland and Sierra Leone which link TBAs to health centres as part of a pathway to maternal health care. Our study aims to understand the perceptions of communities, stakeholder and TBAs themselves who have been trained in new roles to generate insights on strategies to engage with TBAs and to promote skilled birth attendance in fragile affected settings. A qualitative study was carried out in two chiefdoms in Bombali district in Sierra Leone and the Maroodi Jeex region of Somaliland. Purposively sampled participants consisted of key players from the Ministries of Health, programme implementers, trained TBAs and women who benefitted from the services of trained TBAs. Data was collected through key informants and in-depth interviews and focus group discussions. Data was transcribed, translated and analyzed using the framework approach. For the purposes of this paper, a comparative analysis was undertaken reviewing similarities and differences across the two different contexts. Analysis of multiple viewpoints reveal that with appropriate training and support it is possible to change TBAs practices so they support pregnant women in new ways (support and referral rather than delivery). Participants perceived that trained TBAs can utilize their embedded and trusted community relationships to interact effectively with their communities, help overcome barriers to acceptability, utilization and contribute to effective demand for maternal and newborn services and ultimately enhance utilization of skilled birth attendants. Trained TBAs appreciated cordial relationship at the health

  12. Should Pediatric Euthanasia be Legalized?

    Science.gov (United States)

    Brouwer, Marije; Kaczor, Christopher; Battin, Margaret P; Maeckelberghe, Els; Lantos, John D; Verhagen, Eduard

    2018-02-01

    Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for children. Opponents of euthanasia see this as a dangerous slippery slope. Proponents argue that euthanasia is sometimes ethically appropriate for minors and that, with proper safeguards, it should be legally available in appropriate circumstances for patients at any age. In this Ethics Rounds, we asked philosophers from the United States and the Netherlands, and a Dutch pediatrician, to discuss the ethics of legalizing euthanasia for children. Copyright © 2018 by the American Academy of Pediatrics.

  13. Legal regulation of home births

    Directory of Open Access Journals (Sweden)

    Baturan Luka O.

    2015-01-01

    Full Text Available In this paper, authors tried to find efficient legal frame for home births. The main problem is the risk of life and health of a mother and a baby. If a mother wants a home labor, there are no legal obstacles ^for her to take the risk of her own life, after consultation with health-care professionals. However, society is obligated to protect unborn child from irrational behavior of the mother, if she acts against child's best interests. Legal rules were analyzed by methods of neo-institutional economic theory, while the risks of life and health of a mother and a baby were analyzed by medical science methods.

  14. Legal Translation Dictionaries for Learners

    DEFF Research Database (Denmark)

    Nielsen, Sandro

    2010-01-01

    in conditional clauses. When translating into languages not allowing such structures, for instance, English and French, learners need their legal translation dictionaries to help them with both the legal terms and the syntactic structures. The uses of textual conventions that characterise the legal genre vary....... Lexicographers should therefore design their dictionaries so that they contain intra-lingual or contrastive descriptions of the relevant genre conventions. As illustrated in Nielsen (2000) whether the best solution is to retain the genre conventions found in the SL text or to adopt the conventions used in TL...

  15. Legal highs on the Internet.

    Science.gov (United States)

    Hillebrand, Jennifer; Olszewski, Deborah; Sedefov, Roumen

    2010-02-01

    This article describes the findings of a descriptive analysis of 27 online drug retailers selling legal alternatives to illegal drugs, commonly referred to as "herbal highs" and "legal highs" in 2008 . The study attempted to quantify the online availability of drug retailers, to describe common products and characteristics in EU-based retail sales. The findings highlight the concern about the lack of objective information about products offered, including potential risks to health. Systems should be developed to assess the contents of products and the accuracy of information provided on the Internet, alongside continued monitoring of this market for "legal high" substances.

  16. Prerequisites for Correctness in Legal Argumentation

    OpenAIRE

    Mackuvienė, Eglė

    2011-01-01

    A phenomenon called legal argumentation is analyzed in the dissertation. The aim of the thesis is to identify the prerequisites that allow to consider the legal argumentation to be correct, also to evaluate those prerequisites logically. Legal argumentation is analyzed as a phenomenon per se, without relating it to any particular arguing subject. Other dimensions of the process of making a legal decision, such as legal reasoning, legal discourse, interpretation of law and others are discu...

  17. Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study.

    Science.gov (United States)

    Alemu, Yihun Mulugeta; Ambaw, Fentie; Wilder-Smith, Annelies

    2017-06-24

    HIV testing of women in child bearing age is an entry point for preventing mother-to-child transmission of HIV (MTCT). This study aims to identify the proportion of women tested for HIV and to determine factors associated with utilization of HIV testing services among pregnant mothers in primary care settings in northern Ethiopia. A cross sectional study was conducted in 416 pregnant women from four primary care centers between October 2, 2012 and May 31, 2013 in East Gojjam, Ethiopia. The proportion of mothers who tested for HIV was 277(67%). Among mothers who were not tested for HIV, lack of HIV risk perception (n = 68, 49%) was a major self-reported barrier for HIV testing. A multivariable logistic regression analysis showed that those pregnant women who had comprehensive knowledge about MTCT had an Adjusted Odd Ratio (AOR) of 3.73 (95% CI: 1.56, 8.94), having comprehensive knowledge on prevention of mother to child transmission (PMTCT) of HIV an AOR of 2.56 (95% CI: 1.26, 5.19), and a favorable attitude towards persons living with HIV an AOR of 2.42 (95%CI, 1.20, 4.86) were more likely to be tested for HIV. One third of pregnant women had never been tested for HIV until the time of the study. Efforts should be made to improve mother's knowledge about MTCT and PMTCT to increase uptake of HIV testing. Enhancing mother's HIV risk perception to scale up HIV testing in resource limited setting is highly recommended.

  18. Social and legal dimensions discussion of conscientious refusal in Turkey

    Directory of Open Access Journals (Sweden)

    Şeniz ANBARLI BOZATAY

    2011-12-01

    Full Text Available Even though the discussion of conscientious objection, the refusal of military service due to individual’s moral values or religious beliefs, is new in Turkey, the subject has become the focus of intense interest. The discussion of conscientious objection in Turkey has come the to the fore with the heated debates between the glorification of the dynamics of Turkish social structure towards military service and the critique of militarism and conscientious objection’s legal dimensions, as well. Since the reduction of discussions in this context in Turkey to the legal dimension is the ignorance of social reality constituting basis to the legal dimension, the subject is examined with reference to the social and historical outlook on this issue and the study is built on dimensions.

  19. The users of legal information

    Directory of Open Access Journals (Sweden)

    Fabio Assis Pinho

    2012-04-01

    Full Text Available The decision making needs must be based on current and reliable information, especially in legal environments. In Brazil, the changes in legislation are constants because of the enactments of the provisional measures. In this sense, it is necessary to know the sources and changes to satisfy the needs of users of legal area. Therefore, through an exploratory research, it aimed to do a user study, experts on legal aspects in the law library of the Regional Procurator of the Republic of the 5th Region (Brazil, which is a unit belonging to Brazil's Federal Public Ministry, with the use of a questionnaire as data collection tool. The results shows that users of legal information is more demanding and expert in their search and uses various sources, because their information needs has a high degree of difficulty.

  20. Legal Marketing and Lawyer's Communication

    Directory of Open Access Journals (Sweden)

    Sara Casolaro

    2016-09-01

    Full Text Available The application of marketing strategies to the law firm represents a breakthrough in Italy which has struggled to establish itself as a result of a culture based on a strict code of ethics. However, in recent years there has been a turnaround and the benefits arising from the application to legal profession of the typical principles of enterprises are increasingly evident.   Il marketing legale e la comunicazione dell’avvocato L’applicazione delle strategie di marketing allo studio legale rappresenta un’innovazione che in Italia ha stentato a imporsi a causa di una cultura basata su una rigida deontologia. Tuttavia, negli ultimi anni vi è stata un’inversione di tendenza e i benefici derivanti dall’applicazione alla professione forense dei princìpi tipici delle imprese sono sempre più evidenti. Parole chiave: marketing, studio legale, comunicazione

  1. Federal Aviation Administration Legal Interpretations

    Data.gov (United States)

    Department of Transportation — Legal Interpretations and the Chief Counsel's opinions are now available at this site. Your may choose to search by year or by text search. Please note that not all...

  2. The importance of legal counsel

    Directory of Open Access Journals (Sweden)

    Betsy Fisher

    2017-02-01

    Full Text Available At each stage of the resettlement process, the presence of counsel – legal advocates – can help refugees to present their complete cases efficiently and avoid unnecessary rejections. This provides benefits to decision makers as well.

  3. Realistic rhetoric and legal decision

    Directory of Open Access Journals (Sweden)

    João Maurício Adeodato

    2017-06-01

    Full Text Available The text aims to lay the foundations of a realistic rhetoric, from the descriptive perspective of how the legal decision actually takes place, without normative considerations. Aristotle's rhetorical idealism and its later prestige reduced rhetoric to the art of persuasion, eliminating important elements of sophistry, especially with regard to legal decision. It concludes with a rhetorical perspective of judicial activism in complex societies.

  4. [Biopiracy: about its legal meanings].

    Science.gov (United States)

    Ramírez García, Hugo Saúl

    2009-01-01

    This article explores the legal meanings of biopiracy concept, linked to subjects such as intellectual property rights on genetic resources, bioprospecting contracts, right to food, and food security. It overcomes the critical function of biopiracy concept related to world-wide extended tendencies: privatization and technification. Likewise, protectionism shows the opportunity that biopiracy concept represents for the enrichment of the legal interpretation related to the bioethical statue of biotech developments.

  5. The Politics of Legal Arrangements

    DEFF Research Database (Denmark)

    Leander, Anna

    2018-01-01

    This article explores the place of formal legal arrangements in the politics surrounding the hybrid, enmeshed public-in-the-private forms of authority this special issue focuses on. It does so by analyzing the significance of one specific legal arrangement, the Duty of Care, for the politics...... and divisions currently organizing debates about the regulation of commercial security as well as about managerialism in international law more generally....

  6. The Legal Regulation of Cybersecurity

    OpenAIRE

    Darius Štitilis

    2013-01-01

    Cybercrime has become a global phenomenon, which is causing more harm to individual citizens, organizations, society and the state. Most countries in the world compare cybercrime with offences such as terrorism and drug trafficking due to its risks and profitability. Cybersecurity is the central category to fight cybercrime in cyberspace. Therefore, the strategic legal regulation of cybersecurity is one of the most relevant problems in EU, including Lithuania. So far cybersecurity legal regul...

  7. Commercial sexual practices before and after legalization in Australia.

    Science.gov (United States)

    Seib, Charrlotte; Dunne, Michael P; Fischer, Jane; Najman, Jackob M

    2010-08-01

    The nature of sex work changes over time for many reasons. In recent decades around the world, there has been movement toward legalization and control of sex economies. Studies of the possible impact of legalization mainly have focused on sexually transmitted infections and violence, with little attention to change in the diversity of sexual services provided. This study examined the practices of sex workers before and after legalization of prostitution. Cross-sectional surveys of comparable samples of female sex workers were conducted in 1991 (N = 200, aged 16-46 years) and 2003 (N = 247, aged 18-57 years) in Queensland, Australia, spanning a period of major change in regulation of the local industry. In 2003, male clients at brothels and private sole operators (N = 161; aged 19-72 years) were also interviewed. Over time, there was a clear increase in the provision of "exotic" sexual services, including bondage and discipline, submission, fantasy, use of sex toys, golden showers, fisting, and lesbian double acts, while "traditional" services mostly remained at similar levels (with substantial decrease in oral sex without a condom). Based on comparisons of self-reports of clients and workers, the demand for anal intercourse, anal play, and urination during sex apparently exceeded supply, especially in licensed brothels. Within this population, legalization of sex work coincided with a substantial increase in diversity of services, but it appears that in the regulated working environments, clients who prefer high risk practices might not dictate what is available to them.

  8. Policy, Legal and Regulatory Framework for Records Management ...

    African Journals Online (AJOL)

    Policy, Legal and Regulatory Framework for Records Management in the ... of any country and are essential to the administration of law in the justice system. ... as the Kenya Public Archives and Documentation Service Act Cap 19 of 1965; the ...

  9. Legal Deposit provision of the National Library Act: implementation ...

    African Journals Online (AJOL)

    Abstract. The Legal Deposit Act of the National Library of Nigeria is critically examined with regard to its implementation, presentation and benefits. ... The paper presents guidelines for collective drive and statutory functions and services implementations. ... for Authors · for Policy Makers · about Open Access · Journal Quality.

  10. Legal Aspects of Teaching Music Students with Disabilities

    Science.gov (United States)

    Crockett, Jean B.

    2017-01-01

    The public education of students with disabilities in the United States is governed by federal policies that promote school improvement, protect students from discrimination, and provide those who need it with special education and related services to meet their individual needs. This article explains the legal aspects of teaching students with…

  11. School Psychology in Rural Contexts: Ethical, Professional, and Legal Issues

    Science.gov (United States)

    Edwards, Lynn M.; Sullivan, Amanda L.

    2014-01-01

    Delivering psychological services in rural communities presents a number of unique challenges for practitioners relative to their peers in urban and suburban communities. In this article, the authors describe the current context of rural schools and examine the ethical and legal issues school psychologists may face when practicing in rural…

  12. 110 ATTRACTION OF BUSINESS AND RESTRICTION IN LEGAL ...

    African Journals Online (AJOL)

    Fr. Ikenga

    2014-02-02

    Feb 2, 2014 ... of the concept through legal education in law faculties in the ..... This of course does involve associating a product name or service with ..... will no doubt promote professionalism and specialization in ... most especially by all common law jurisdiction with a view to reach an internationally accepted model.

  13. Formation of ideal of legal personality

    Directory of Open Access Journals (Sweden)

    Віта Олександрівна Сліпенчук

    2016-01-01

    Full Text Available Problem setting. In the process of transformation of Ukrainian society towards the assimilation and implementation of basic European values such as human rights, democracy and the rule of law the role of personality that respects the dignity of others and their right to free expression in its multifaceted manifestations becomes more important. Such definitions of it assume the character of the ideal to be pursued, but that has not received adequate expression in people's minds and in practice yet. Since this ideal inextricably links right and personality, enabling the operation of law due to the special qualities of the individual, it can be defined as the ideal of legal personality. It is the formation and realization of such ideal that becomes urgent practical task of our society, which in turn requires a comprehensive theoretical understanding. Recent research and publications analysis. It should be noted that some philosophical aspects of the meaning of legal personality and its formation are revealed in the works of Ukrainian researcher in the field of philosophy of law S.I. Maksimov. However, all actual researches are based on a certain cultural and ideological tradition. The research of  a Polish-American scholar in the history of philosophical and legal thought Andrzej Walicki pays attention to the ideological and methodological potential liberal legal philosophy of the late 19th - early 20th century in the Russian Empire, realization of which, unfortunately, failed because of the violent interruption of this tradition by Bolsheviks. Researches of philosophers of law of that period are of particular significance in this issue: Ukrainian by origin and outlook Bohdan Kistyakivskiy and one of the authors of the Universal Declaration of Human Rights (1948 Serhiy Gessen. It is reconstruction of the concept of "legal personality" in the views of philosophers of law of that period, which is really made for the first time, which will give, as

  14. The challenges of fighting sex trafficking in the legalized prostitution market of the Netherlands

    NARCIS (Netherlands)

    Huisman, W.; Kleemans, E.R.

    2014-01-01

    In 2000, the Dutch authorities lifted the ban on brothels in the Netherlands. The essence of their approach was to regulate prostitution. People of legal age could now voluntarily sell and purchase sexual services. Brothels which complied with certain licensing conditions were legalized. This paper

  15. Legal Issues Affecting Libraries and Librarians: Employment Law, Liability and Insurance, Contracts, and Problem Patrons.

    Science.gov (United States)

    Mika, Joseph J.; Shuman, Bruce A.

    1988-01-01

    This fourth lesson in a continuing education course on legal issues affecting libraries and librarians discusses the library's rights and legal responsibilities in the areas of censorship and intellectual freedom, the Freedom of Information Act and patron privacy, problem patrons, and ethical considerations of library services. (14 references)…

  16. 45 CFR 1621.4 - Complaints by clients about manner or quality of legal assistance.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Complaints by clients about manner or quality of...) LEGAL SERVICES CORPORATION CLIENT GRIEVANCE PROCEDURES § 1621.4 Complaints by clients about manner or... clients about the manner or quality of legal assistance that has been rendered by the recipient to the...

  17. Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

    Science.gov (United States)

    Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

    2017-12-01

    Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

  18. SEA ODC - An Implementation of Web Portal and B2B Services for Managing of Oceanographic Data Sets Collected in South-East Adriatic

    Science.gov (United States)

    Jovicic, A.; Castelli, A.; Kljajic, Z.

    2012-04-01

    As a result of efforts to standardize oceanographic data sets collected since year 2002 in the area of south-east Adriatic, relational data model suitable for storage of meta-data and in situ measurements was designed and implemented. Using combination of customized tools developed for extraction of meta-data and data records from CTD files as well as standard office applications, data were extracted, transformed, processed and unified by attributes and units of measurement. To make those data available for wider scientific community, we have developed web portal able to be used for data retrieval based on various filters (spatial, temporal, by project and/or by sampling instrument). Selected data model proves to be also very efficient for generating of data-exchange formats required by various projects and initiatives (e.g. SeaDataNet) so extended by particular dictionaries it can allow fast implementation of integration services. As a part of Ecoport 8 project, newly available type of data was recently introduced. Real-time data provided by permanent sensors need to be automatically collected and stored into database. Visualization of such data was also required as well as exchange with project data center. To fulfill those requirements, additional data scheme and appropriate B2B services were developed. Additional care was taken about data transfer security as database was not hosted at the same place as workstation used for remote access to sensor equipment. Third section of portal is "Tide Tables", interactive, graphical application that visualize tide predictions for ports of Bar and Kotor, allowing also correction by atmospheric pressure. Developed in Java, based on well known Mike Foreman's Fortran 77 code it can be used as stand-alone product without Internet connection. Last section of portal is Google Earth file containing position of stations as well as some spatial features that can be useful during planning of future oceanographic cruises in this area

  19. Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

    Directory of Open Access Journals (Sweden)

    Coluccia A

    2014-09-01

    Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

  20. Sustainability in Health care by Allocating Resources Effectively (SHARE) 8: developing, implementing and evaluating an evidence dissemination service in a local healthcare setting.

    Science.gov (United States)

    Harris, Claire; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Waller, Cara; King, Richard; Ramsey, Wayne

    2018-03-02

    This is the eighth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for disinvestment within a large Australian health service. One of the aims was to explore methods to deliver existing high quality synthesised evidence directly to decision-makers to drive decision-making proactively. An Evidence Dissemination Service (EDS) was proposed. While this was conceived as a method to identify disinvestment opportunities, it became clear that it could also be a way to review all practices for consistency with current evidence. This paper reports the development, implementation and evaluation of two models of an in-house EDS. Frameworks for development of complex interventions, implementation of evidence-based change, and evaluation and explication of processes and outcomes were adapted and/or applied. Mixed methods including a literature review, surveys, interviews, workshops, audits, document analysis and action research were used to capture barriers, enablers and local needs; identify effective strategies; develop and refine proposals; ascertain feedback and measure outcomes. Methods to identify, capture, classify, store, repackage, disseminate and facilitate use of synthesised research evidence were investigated. In Model 1, emails containing links to multiple publications were sent to all self-selected participants who were asked to determine whether they were the relevant decision-maker for any of the topics presented, whether change was required, and to take the relevant action. This voluntary framework did not achieve the aim of ensuring practice was consistent with current evidence. In Model 2, the need for change was established prior to dissemination, then a summary of the evidence was sent to the decision-maker responsible for practice in the relevant area who was required to take appropriate action and