WorldWideScience

Sample records for medical negligence coverage

  1. [Medical negligence].

    Science.gov (United States)

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  2. Medical negligence.

    OpenAIRE

    Rosen, M.

    1992-01-01

    The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular circumstances and that he acted with guilt and therefore can be blamed for the deed. This paper describes medical practitioner negligence and reviews relevant cases.

  3. Medical negligence

    African Journals Online (AJOL)

    Enrique

    19. SA JOURNAL OF RADIOLOGY • August 2004. Abstract. The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malprac- tice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the.

  4. Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective

    Directory of Open Access Journals (Sweden)

    M S Pandit

    2009-01-01

    Full Text Available A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment.

  5. Medical Negligence : An Overview

    Directory of Open Access Journals (Sweden)

    Bratin Kumar Dey

    2017-04-01

    Full Text Available Medical professionals are treated as next to God. They provide humanitarian services and gives solace to individuals suffering from various diseases and disorders. Due to their great service to humanity, the doctors and medical professionals are treated with reverence and since the ancient times the medical profession has been considered as a noble profession. However with the passage of time, there has been a change in the doctor - patient relationship. During the last few decades a number of incidents have come to light in which the patients have suffered due to the error and inadvertent conduct of doctors. Due to the increasing conflicts and legal disputes between the doctors and patients, most of the legal systems have developed various rules and principles to deal with such inadvertent behavior of doctors. This has led to the development of a new branch of jurisprudence, i.e. medical negligence. Hence, any negligence on part of the medical professional would be treated as either a tort of negligence or a deficiency in service under Consumer Protection Act, 1986. As the profession involves the idea of an occupation requiring purely intellectual skills or of manual skills controlled by the intellectual skill of the operator, it is distinctively different from an occupation, which is substantially production or sale or arrangement for the production or sale of commodities. Medicine is a highly complex domain. It is difficult for consumer laws to review medical negligence cases with flawless technical clarity and accuracy. Thus medical negligence is not purely a matter of consideration for judiciary but also the technical inputs of specialized experts in the field have substantial weightage while deciding the case of medical negligence against doctors. The present paper is devoted to introvert inspection of negligence in medical profession in the light of existing laws with more emphasis on the interpretation of consumer protection law by

  6. Medical negligence and the law.

    Science.gov (United States)

    Murthy, K K S R

    2007-01-01

    After the Consumer Protection Act, 1986, came into effect, a number of patients have filed cases against doctors. This article presents a summary of legal decisions related to medical negligence: what constitutes negligence in civil and criminal law, and what is required to prove it.

  7. Medical negligence: Indian legal perspective

    Directory of Open Access Journals (Sweden)

    Amit Agrawal

    2016-01-01

    Full Text Available A basic knowledge of how judicial forums deal with the cases relating to medical negligence is of absolute necessity for doctors. The need for such knowledge is more now than before in light of higher premium being placed by the Indian forums on the value of human life and suffering, and perhaps rightly so. Judicial forums, while seeking to identify delinquents and delinquency in the cases of medical negligence, actually aim at striking a careful balance between the autonomy of a doctor to make judgments and the rights of a patient to be dealt with fairly. In the process of adjudication, the judicial forums tend to give sufficient leeway to doctors and expressly recognize the complexity of the human body, inexactness of medical science, the inherent subjectivity of the process, genuine scope for error of judgment, and the importance of the autonomy of the doctors. The law does not prescribe the limits of high standards that can be adopted but only the minimum standard below which the patients cannot be dealt with. Judicial forums have also signaled an increased need of the doctors to engage with the patients during treatment, especially when the line of treatment is contested, has serious side effects and alternative treatments exist.

  8. Clinical errors and medical negligence.

    Science.gov (United States)

    Oyebode, Femi

    2013-01-01

    This paper discusses the definition, nature and origins of clinical errors including their prevention. The relationship between clinical errors and medical negligence is examined as are the characteristics of litigants and events that are the source of litigation. The pattern of malpractice claims in different specialties and settings is examined. Among hospitalized patients worldwide, 3-16% suffer injury as a result of medical intervention, the most common being the adverse effects of drugs. The frequency of adverse drug effects appears superficially to be higher in intensive care units and emergency departments but once rates have been corrected for volume of patients, comorbidity of conditions and number of drugs prescribed, the difference is not significant. It is concluded that probably no more than 1 in 7 adverse events in medicine result in a malpractice claim and the factors that predict that a patient will resort to litigation include a prior poor relationship with the clinician and the feeling that the patient is not being kept informed. Methods for preventing clinical errors are still in their infancy. The most promising include new technologies such as electronic prescribing systems, diagnostic and clinical decision-making aids and error-resistant systems. Copyright © 2013 S. Karger AG, Basel.

  9. Factual causation in medical negligence.

    Science.gov (United States)

    Manning, Joanna

    2007-12-01

    The conventional approach to causation in negligence is the "but for" test, decided on the balance of probabilities. Even when supplemented by the "material contribution" principle, satisfying the onus of proof of causation can be an insuperable obstacle for plaintiffs, particularly in medical cases. Yet, having found a breach of duty, a court's sympathies may gravitate toward the plaintiff at this point in the case. Accordingly, courts have sometimes accepted a relaxation of strict causation principles. The judicial devices are described: a special principle of causation in particular duties of care; a shifting burden of proof; "bridging the evidentiary gap" by drawing a robust inference of causation; treating a material increase in risk as sufficient proof of causation; and permitting causation to be established on the basis of the loss of a material chance of achieving a better outcome and discounting damages. In Accident Compensation Corp v Ambros [2007] NZCA 304 the New Zealand Court of Appeal recognised the need for a legal device to ameliorate the injustice sometimes caused by the strict rules of causation, and preferred the "inferential reasoning" approach favoured by the Canadian common law for use in the context of the accident compensation scheme. It is hoped that the New Zealand Supreme Court approves Ambros if the opportunity arises.

  10. Medical negligence--prevention and management.

    Science.gov (United States)

    Chao, T C

    1987-04-01

    The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

  11. Medical negligence- Meaning and Scope in India

    Directory of Open Access Journals (Sweden)

    L Kumar

    2011-03-01

    Full Text Available It is a principle recognized by our as well as by other legal systems that ignorance of the law is no excuse for violating it. The rule is also expressed in the form of a legal presumption that everyone knows the law. It is the duty of every man to know that part of it which concerns him. A doctor, in particular, is conclusively presumed to know the law, and is dealt with as if he did know it, because in general he can and ought to know it. In the matter of professional liability, the medical profession differs from other occupations for the reason that the former operates in spheres where success cannot be achieved in every case and very often success or failure depends upon factors beyond a medical man’s control. Due to the increasing awareness of the rights of a patient in present day society, a medical man has become more vulnerable to being sued by a litigation suit of any kind, civil or criminal. The basis of a medical negligence suit is still alien to the majority of the practicing doctors in our country. Hence, the present article aims at discussing the various aspects of negligence, like the meaning and types of negligence, and the concept of duty of care, degree of care, and standard. Keywords: degree of care, duty of care, medical negligence, standard of care.

  12. Medical negligence | Otto | SA Journal of Radiology

    African Journals Online (AJOL)

    The progress made in diagnostic and therapeutic medicine has resulted in an increase in the number of malpractice suits brought against medical practitioners. To constitute negligence it must be shown that the conduct of the accused did not measure up to the standard of care the law required of him in the particular ...

  13. Limits of negligent responsibility for medical malpractice

    Directory of Open Access Journals (Sweden)

    Marin Mrčela

    2017-01-01

    Full Text Available Criminal offence of medical malpractice is one of core medical criminal offences. Protected object is health of patients. Application of inadequate methods in health treatment can have severe consequences for patient’s health, even death. Croatian jurisprudence is familiar with such cases. However, Croatian literature until now did not deal with this sensitive area of criminal law. Scope and limits of responsibility for negligent form of medical malpractice can cause doubts in court’s practice when deciding about criminal liability. This paper is dedicated to this topic. After presentation of main characteristics of this criminal offence, the authors are making an effort to establish criteria for estimation of negligence in case of medical malpractice. They are testing their thesis on one very complicated case from recent Croatian jurisprudence.

  14. Medical negligence- meaning and scope in India.

    Science.gov (United States)

    Kumar, L; Bastia, B K

    2011-01-01

    It is a principle recognized by our as well as by other legal systems that ignorance of the law is no excuse for violating it. The rule is also expressed in the form of a legal presumption that everyone knows the law. It is the duty of every man to know that part of it which concerns him. A doctor, in particular, is conclusively presumed to know the law, and is dealt with as if he did know it, because in general he can and ought to know it. In the matter of professional liability, the medical profession differs from other occupations for the reason that the former operates in spheres where success cannot be achieved in every case and very often success or failure depends upon factors beyond a medical man's control. Due to the increasing awareness of the rights of a patient in present day society, a medical man has become more vulnerable to being sued by a litigation suit of any kind, civil or criminal. The basis of a medical negligence suit is still alien to the majority of the practicing doctors in our country. Hence, the present article aims at discussing the various aspects of negligence, like the meaning and types of negligence, and the concept of duty of care, degree of care, and standard of care, as considered by the law.

  15. Medical records and issues in negligence

    Directory of Open Access Journals (Sweden)

    Joseph Thomas

    2009-01-01

    Full Text Available It is very important for the treating doctor to properly document the management of a patient under his care. Medical record keeping has evolved into a science of itself. This will be the only way for the doctor to prove that the treatment was carried out properly. Moreover, it will also be of immense help in the scientific evaluation and review of patient management issues. Medical records form an important part of the management of a patient. It is important for the doctors and medical establishments to properly maintain the records of patients for two important reasons. The first one is that it will help them in the scientific evaluation of their patient profile, helping in analyzing the treatment results, and to plan treatment protocols. It also helps in planning governmental strategies for future medical care. But of equal importance in the present setting is in the issue of alleged medical negligence. The legal system relies mainly on documentary evidence in a situation where medical negligence is alleged by the patient or the relatives. In an accusation of negligence, this is very often the most important evidence deciding on the sentencing or acquittal of the doctor. With the increasing use of medical insurance for treatment, the insurance companies also require proper record keeping to prove the patient′s demand for medical expenses. Improper record keeping can result in declining medical claims. It is disheartening to note that inspite of knowing the importance of proper record keeping it is still in a nascent stage in India. It is wise to remember that "Poor records mean poor defense, no records mean no defense". Medical records include a variety of documentation of patient′s history, clinical findings, diagnostic test results, preoperative care, operation notes, post operative care, and daily notes of a patient′s progress and medications. A properly obtained consent will go a long way in proving that the procedures were

  16. [Medical negligence in surgery: 112 cases retrospective analysis].

    Science.gov (United States)

    Xiang, Jian; Chang, Lin; Wang, Xu; Zhang, Feng-Qin

    2013-06-01

    To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.

  17. Loss of chance in medical negligence.

    Science.gov (United States)

    Leslie, K; Bramley, D; Shulman, M; Kennedy, E

    2014-05-01

    Occasionally accidents and complications occur during anaesthesia and perioperative care that result in injury to the patient. Unfortunately, this is sometimes due to a breach in the anaesthetist's duty of care to the patient. Sometimes, rather than being the cause of immediate damage, the act or omission results in an alteration in the prognosis of the complaint or increased risk of complications related to the complaint. This avenue for a negligence action is known as 'loss of chance of a better outcome' and has been the subject of much legal argument in Australia in recent years. A recent High Court of Australia decision is widely seen as having 'closed the door' to, or at least made it difficult for the patient to succeed in, loss of chance cases. Many anaesthetists may not be familiar with the concept of 'loss of chance'. This review will explore the concept of loss of chance and the manner in which Australian courts have dealt with it before and after Tabet v Gett from the perspective of the anaesthetist.

  18. Medical negligence- Meaning and Scope in India

    OpenAIRE

    L Kumar; BK Bastia

    2011-01-01

    It is a principle recognized by our as well as by other legal systems that ignorance of the law is no excuse for violating it. The rule is also expressed in the form of a legal presumption that everyone knows the law. It is the duty of every man to know that part of it which concerns him. A doctor, in particular, is conclusively presumed to know the law, and is dealt with as if he did know it, because in general he can and ought to know it. In the matter of professional liability, the medical...

  19. Modern negligence law: Contribution of the medical cases.

    Science.gov (United States)

    Hodgson, John

    The law on medical negligence is part of the law of negligence generally. It has played a significant part in developing two key aspects of the law. There are special rules to determine the standard of care expected of experts when advising and solving problems, and medical cases have largely shaped the law. Although cases on causation may arise in any area, several of the key cases happen to be medical ones. They are particularly likely to assist where there are alternative causes, as it is often difficult to distinguish the effects of disease from those of inappropriate treatment.

  20. Medical negligence and res ipsa loquitur in South Africa | Patel ...

    African Journals Online (AJOL)

    The inter-relationship between Medicine and Law is most commonly brought to the fore by cases involving medical negligence. This relationship needs to protect all parties concerned based on the probability of reasonableness in terms of who performs the act as well as the patient affected by the act in question. The res ...

  1. Handling medical negligence: necessity of a proper system

    Directory of Open Access Journals (Sweden)

    Nuwadatta Subedi

    2017-12-01

    Full Text Available The issue of medical negligence has been catching attention of many people nowadays. With advancement of technology in medical field, many incurable diseases of past time can now be managed well at the cost of burdening expenditure. This   has resulted in obvious expectations to the patient and their families that any ailment can be cured from the medical procedures and therapies. When these expectations are not met in terms of complications or death of the near ones, people get frustrated and tend to allege health care providers against medically negligent.Negligence are of two types; civil negligence where the doctors are alleged to have lost simple degree of care and attention to the patients thereby causing damage whereas in criminal negligence, the doctors grossly deviate from the standard of care and competence or perform activities which are understood prima facie as a crime, for eg: performing criminal abortion, organ transplantation against the law etc.Whatever the type of negligence, there are legal measures to file complaint against the doctors who are alleged to have caused negligence. Gone are the days when people regarded doctors near to gods. Medical service also falls under the consumer protection act where the patients are the consumers and medical personnel, the service providers. The patients have rights to get quality medical service under this act. If the patients or their relatives are dissatisfied with the medical service rendered to them by the health care providers, they have the right to lodge complaint to the compensation committee of the district in which chief district officer (CDO is the chairman in each district. If there is an issue of criminal negligence, the complaint can also be filed in the concerned court.In some circumstances, when the patient develops complications or dies, the attendants accuse the doctors for the failure in treatment and protest in the hospital premises rather than opting the legal way

  2. Craniofacial Surgery and Adverse Outcomes: An Inquiry Into Medical Negligence.

    Science.gov (United States)

    Svider, Peter F; Eloy, Jean Anderson; Folbe, Adam J; Carron, Michael A; Zuliani, Giancarlo F; Shkoukani, Mahdi A

    2015-07-01

    This study aimed to evaluate factors contributing to medical negligence relevant to craniofacial surgery. Retrospective analysis of verdict and settlement reports on the Westlaw legal database for outcome, awards, physician defendants, and other specific factors raised in malpractice litigation. Of 42 verdicts and settlement reports included, 52.4% were resolved with either an out-of-court settlement or plaintiff verdict, with aggregate payments totaling $50.1M (in 2013 dollars). Median settlements and jury-awarded damages were $988,000 and $555,000, respectively. Payments in pediatric cases ($1.2M) were significantly higher. Plastic surgeons, oral surgeons, and otolaryngologists were the most commonly named defendants. The most common alleged factors included intraoperative negligence (69.0%), permanent deficits (54.8%), requiring additional surgery (52.4%), missed/delayed diagnosis of a complication (42.9%), disfigurement/scarring (28.6%), postoperative negligence (28.6%), and inadequate informed consent (20.6% of surgical cases). Failure to diagnose a fracture (19.0%) and cleft-reparative procedures (14.3%) were the most frequently litigated entities. Medical negligence related to craniofacial surgery involves plaintiffs in a wide age range as well as physician defendants in numerous specialties, and proceedings resolved with settlement and plaintiff verdict involve substantial payments. Cases with death, allegedly permanent injuries, and pediatric plaintiffs had significantly higher payments. © The Author(s) 2015.

  3. Negligence in securing informed consent and medical malpractice.

    Science.gov (United States)

    Perry, C

    1988-01-01

    The doctrine of informed consent requires that the patient must act voluntarily and in the light of adequate information in order to give legally valid consent to medical care. Different models have been developed by various courts to determine whether the informational requirement, what the physician must disclose to the patient about the potential risks of the proposed treatment, has been met under the tort theory of negligence. To prevail, the patient plaintiff must show that a particular jurisdiction's disclosure standard has been breached, that harm has resulted, and that the defendant physician's negligent failure to discuss certain risks was causally responsible for the patient's failure to withhold consent. Perry discusses possible problems of redundancy or inconsistency concerning the relationship between different models for disclosure and causality, and notes that these problems may have serious implications for patient autonomy.

  4. Medical negligence liability under the consumer protection act: A review of judicial perspective.

    Science.gov (United States)

    Joga Rao, S V

    2009-07-01

    It is important to know what constitutes medical negligence. A doctor owes certain duties to the patient who consults him for illness. A deficiency in this duty results in negligence. A basic knowledge of how medical negligence is adjudicated in the various judicial courts of India will help a doctor to practice his profession without undue worry about facing litigation for alleged medical negligence.

  5. Medical Mishap and Negligence: It happens in the Outpatients too

    LENUS (Irish Health Repository)

    Murphy, JFA

    2011-06-01

    When we consider medical negligence and clinical error we think of busy hospitals late at night and at week-ends. We think of crowded emergency medicine departments, complex surgery and the critically ill ICU patient. We think of prescribing errors in the administration of potent intravenous therapy. We think of high risk specialties such as obstetrics, anaesthesia and surgery. We are less likely to think of outpatients\\/ ambulatory care or a non-interventionist specialty as an important source of litigation. This is remiss on our part. Risks in this setting have gone relatively unnoticed. There 30 times more outpatients than inpatients annually. In the US there are 900 million outpatient visits compared with 30 million inpatients. It is not surprising that this quantum of patient-doctor interaction should also be a source of litigation claims. Furthermore it is likely to continue rising with the increased numbers of procedures now being undertaken at outpatients.

  6. [Between evidence and negligence: coverage and invisibilityof health topics in the Portuguese printed media].

    Science.gov (United States)

    Cavaca, Aline Guio; Vasconcellos-Silva, Paulo Roberto; Ferreira, Patrícia; Nunes, João Arriscado

    2015-11-01

    The scope of this study is to conduct an assessment of the media coverage and dissemination of health issues in Portugal in order to problematize the aspects of coverage and invisibility of health topics and establish the themes neglected in media coverage. To achieve this, the coverage on health issues in the Portuguese daily newspaper Público was compared with the epidemiological context regarding health priorities and the perceptions of key players on media dissemination and the themes that are relevant to the Portuguese population. The results showed that the recurrent health-associated themes do not deal with diseases per se, but with the politics and economics of health and medication. The themes neglected in media coverage identified in the Portuguese context include: communicable diseases, such as hepatitis and tuberculosis; issues related to mental health and suicide; and ailments and social consequences associated with the economic crisis that has beset Portugal recently. From the standpoint of the people interviewed, other neglected diseases include hemochromatosis and other rare diseases. In tandem with this, the study highlights the well covered media themes that revolve around the lives and activities of celebrities, which are exhaustively aired in the communication media in the country.

  7. Medical teams and the standard of care in negligence.

    Science.gov (United States)

    Sappideen, Carolyn

    2015-09-01

    Medical teams are essential to the delivery of modern, patient-centred health care in hospitals. A collective model of responsibility envisaged by team care is inconsistent with common law tort liability which focuses on the individual rather than the team. There is no basis upon which a team can be liable as a collective at common law. Nor does the common law'countenance liability for the conduct of other team members absent some form of agency, vicarious liability or non-delegable duty. Despite the barriers to the adoption of a team standard of care in negligence, there is scope for team factors to have a role in determining the standard of care so that being a team player is part and parcel of what it is to be a competent professional. If this is the case, the skill set, and the standard of care expected of the individual professional, includes skills based on team models of communication, cross-monitoring and trust.

  8. Medical negligence liability under the consumer protection act: A review of judicial perspective

    Directory of Open Access Journals (Sweden)

    S V Joga Rao

    2009-01-01

    Full Text Available It is important to know what constitutes medical negligence. A doctor owes certain duties to the patient who consults him for illness. A deficiency in this duty results in negligence. A basic knowledge of how medical negligence is adjudicated in the various judicial courts of India will help a doctor to practice his profession without undue worry about facing litigation for alleged medical negligence.

  9. The decline of judicial deference to medical opinion in medical negligence litigation in Malaysia.

    Science.gov (United States)

    Kassim, Puteri Nemie J

    2008-06-01

    The decision of the Federal Court of Malaysia in abandoning the Bolam principle in relation to doctor's duty to disclose risks has clearly marked the decline of judicial deference to medical opinion in medical negligence litigation in Malaysia. It is undeniable that the Bolam principle has acted as a gatekeeper to the number of claims against medical practitioners. This has always been seen as necessary to protect the society from unwanted effects of defensive medicine. However, will these changes contribute significantly to the growth of medical negligence cases in Malaysia? This article will trace the development of the Bolam principle in medical negligence litigation in Malaysia since 1965 and analyse the influence of selected Commonwealth cases on the development. The implications of the Federal Court ruling will also be discussed.

  10. ["The severe degree of negligence" and its application in the settle of medical malpractice].

    Science.gov (United States)

    Wang, You-Min; Zhang, Qin-Chu

    2006-04-01

    To found the quantifiable index of "The severe degree of negligence" in describing the general severity degree of medical malpractice or medical dispute. "The severe degree of negligence" can be calculated by the way of multiplying the coefficient of medical malpractice's grade by the coefficient of responsibility degree. There are 15 grades of "The severe degree of negligence" through calculation, from the severest degree of 1 to the lightest degree of 20. "The severe degree of negligence" can give an order of severe degree to different grade and different responsibility of medical malpractice. According to this order, the operation of medical malpractice and medical dispute settle will be easier and more rationality.

  11. Beyond the standard of care: a new model to judge medical negligence.

    Science.gov (United States)

    Brenner, Lawrence H; Brenner, Alison Tytell; Awerbuch, Eric J; Horwitz, Daniel

    2012-05-01

    The term "standard of care" has been used in law and medicine to determine whether medical care is negligent. However, the precise meaning of this concept is often unclear for both medical and legal professionals. Our purposes are to (1) examine the limitations of using standard of care as a measure of negligence, (2) propose the use of the legal concepts of justification and excuse in developing a new model of examining medical conduct, and (3) outline the framework of this model. We applied the principles of tort liability set forth in the clinical and legal literature to describe the difficulty in applying standard of care in medical negligence cases. Using the concepts of justification and excuse, we propose a judicial model that may promote fair and just jury verdicts in medical negligence cases. Contrary to conventional understanding, medical negligence is not simply nonconformity to norms. Two additional concepts of legal liability, ie, justification and excuse, must also be considered to properly judge medical conduct. Medical conduct is justified when the benefits outweigh the risks; the law sanctions the conduct and encourages future conduct under similar circumstances. Excuse, on the other hand, relieves a doctor of legal liability under specific circumstances even though his/her conduct was not justified. Standard of care is an inaccurate measure of medical negligence because it is premised on the faulty notion of conformity to norms. An alternative judicial model to determine medical negligence would (1) eliminate standard of care in medical malpractice law, (2) reframe the court instruction to jurors, and (3) establish an ongoing consensus committee on orthopaedic principles of negligence.

  12. The changing face of medical negligence law: from Bolam to Bolitho.

    Science.gov (United States)

    Sooriakumaran, Prasanna

    2008-06-01

    The Bolam test was the standard by which medical negligence cases were judged. However, recently, the Bolitho case has resulted in a shift away from Bolam, with significant effects for all future negligence suits. Doctors need to have a thorough understanding of these issues in order to practice successfully in the current litiginous climate.

  13. Closed medical negligence claims can drive patient safety and reduce litigation.

    Science.gov (United States)

    Pegalis, Steven E; Bal, B Sonny

    2012-05-01

    Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols. We searched for medical societies that have systematically examined closed medical negligence claims in their specialty to develop specific standards of physician conduct. We then searched the medical literature for published evidence of the efficacy, if any, related to the patient safety measures thus developed. Anesthesia and obstetric physician societies have successfully targeted costs and related concerns arising from medical malpractice lawsuits by using data from closed claims to develop patient safety and treatment guidelines. In both specialties, after institution of safety measures derived from closed medical negligence claims, the incidence and costs related to medical malpractice decreased and physician satisfaction improved. Tort reform, in the form of legislatively prescribed limits on damages arising from lawsuits, is not the only means of addressing the incidence and costs related to medical malpractice litigation. As the experience of anesthesia and obstetric physicians has demonstrated, safety guidelines derived from analyzing past medical malpractice litigation can achieve the same goals while also promoting patient safety.

  14. Medicolegal Investigation of Medical Negligence in India: A Report of Forensic Autopsy Case

    Directory of Open Access Journals (Sweden)

    Raktim Pratim Tamuli

    2016-01-01

    Full Text Available In general negligence means failure to take proper care over something and according to law negligence means breach of a duty of care which results in damage. Medical negligence is not very uncommon; every now and then cases of medical negligence are reported in the electronic media. Medical Negligence is doing something that one is not supposed to do, or failing to do something that one is supposed to do. Role of Forensic Pathologist in cases of Medical Negligence is always unquestionable. Forensic Pathologists need to explore and maintain a high degree of transparency between the doctors, patients and the law enforcing agencies. In the present case, a person was attacked by a wild animal and he fell down on a rough surface. Immediately he was rushed to a local hospital. The treating doctor stitched the external injury and allowed him to go home; he neither advised any investigation nor kept him under observation to rule out any internal injury. After 12 hours the victim succumbed to death. At autopsy a fractured skull with underlying subdural haemorrhage was noticed. Was not the treating doctor negligent in this case? Were the protocols followed? What should be the role of a Forensic Pathologist in such kind of cases?

  15. [Medical coverage of a road bicycle race].

    Science.gov (United States)

    Reifferscheid, Florian; Stuhr, Markus; Harding, Ulf; Schüler, Christine; Thoms, Jürgen; Püschel, Klaus; Kappus, Stefan

    2010-07-01

    Major sport events require adequate expertise and experience concerning medical coverage and support. Medical and ambulance services need to cover both participants and spectators. Likewise, residents at the venue need to be provided for. Concepts have to include the possibility of major incidents related to the event. Using the example of the Hamburg Cyclassics, a road bicycle race and major event for professional and amateur cyclists, this article describes the medical coverage, number of patients, types of injuries and emergencies. Objectives regarding the planning of future events and essential medical coverage are consequently discussed. (c) Georg Thieme Verlag Stuttgart-New York.

  16. Medical negligence. An overview of legal theory and neurosurgical practice: duty of care.

    Science.gov (United States)

    Todd, Nicholas V

    2014-04-01

    A working knowledge of the legal principles of medical negligence is helpful to neurosurgeons. It helps them to act in a "reasonable, responsible and logical" manner, that is a practice that is consistent with the surgical practice of their peers. This article will review and explain the relevant medical law in relation to duty of care with illustrative neurosurgical cases.

  17. Dental negligence.

    Science.gov (United States)

    Tay, C S

    2000-02-01

    Medical and dental errors and negligence are again in the spotlight in recent news report. Dead because of doctor's bad handwriting Prescribing drug overdoses Germ-infested soap pumps--infections in hospitals This articles explains dental negligence including dental duty of care and the standard of care expected of dentists in relation to the Bolam principle.

  18. Hindsight bias and outcome bias in the social construction of medical negligence: a review.

    Science.gov (United States)

    Hugh, Thomas B; Dekker, Sidney W A

    2009-05-01

    Medical negligence has been the subject of much public debate in recent decades. Although the steep increase in the frequency and size of claims against doctors at the end of the last century appears to have plateaued, in Australia at least, medical indemnity costs and consequences are still a matter of concern for doctors, medical defence organisations and governments in most developed countries. Imprecision in the legal definition of negligence opens the possibility that judgments of this issue at several levels may be subject to hindsight and outcome bias. Hindsight bias relates to the probability of an adverse event perceived by a retrospective observer ("I would have known it was going to happen"), while outcome bias is a largely subconscious cognitive distortion produced by the observer's knowledge of the adverse outcome. This review examines the relevant legal, medical, psychological and sociological literature on the operation of these pervasive and universal biases in the retrospective evaluation of adverse events. A finding of medical negligence is essentially an after-the-event social construction and is invariably affected by hindsight bias and knowledge of the adverse outcome. Such biases obviously pose a threat to the fairness of judgments. A number of debiasing strategies have been suggested but are relatively ineffective because of the universality and strength of these biases and the inherent difficulty of concealing from expert witnesses knowledge of the outcome. Education about the effect of the biases is therefore important for lawyers, medical expert witnesses and the judiciary.

  19. Medical negligence based on bad faith, breach of contract, or mental anguish.

    Science.gov (United States)

    Ficarra, B J

    1980-01-01

    Financial recovery owing to breach of contract is restricted to the pecuniary amount lost because of failure to perform on the stipulated contract. With the acquisition of newer knowledge, attorneys are now utilizing the weapon of contractual failure as applied to medical negligence. The impetus to this new weapon for the plaintiff has accrued because of the favorable verdicts rendered from positive decisions based upon bad faith.

  20. Abandoning the common law: medical negligence, genetic tests and wrongful life in the Australian High Court.

    Science.gov (United States)

    Faunce, Thomas; Jefferys, Susannah

    2007-05-01

    The Australian High Court recently found that the common law could allow parents to claim tortious damages when medical negligence was proven to have led to the birth of an unplanned, but healthy, baby (Cattanach v Melchior (2003) 215 CLR 1). In Harriton v Stephens (2006) 80 ALJR 791; [2006] HCA 15 and Waller v James; Waller v Hoolahan (2006) 80 ALJR 846; [2006] HCA 16 the High Court in a six-to-one decision (Kirby J dissenting) decided that no such claim could be made by a child when medical negligence in failing to order an in utero genetic test caused the child severe disability. In an era when almost all pregnancies will soon require patented fetal genetic tests as part of the professional standard of care, the High Court, by barring so-called "wrongful life" (better termed "wrongful suffering") claims, may have created a partial immunity from suit for their corporate manufacturers and the doctors who administer them. What lessons can be learnt from this case about how the Australian High Court is, or should be, approaching medical negligence cases and its role as guardian of the Australian common law?

  1. The High Court's lost chance in medical negligence: Tabet v Gett (2010) 240 CLR 537.

    Science.gov (United States)

    Faunce, Thomas; McEwan, Alexandra

    2010-12-01

    In 2010 the High Court of Australia in Tabet v Gett (2010) 240 CLR 537 determined an appeal in a medical negligence case concerning a six-year-old girl who had presented to a major paediatric hospital with symptoms over several weeks of headaches and vomiting after a recent history of chicken pox. The differential diagnosis was varicella, meningitis or encephalitis and two days later, after she deteriorated neurologically, she received a lumbar puncture. Three days later she suffered a seizure and irreversible brain damage. A CT scan performed at that point showed a brain tumour. As Australia does not have a no-fault system providing compensation to cover the long-term care required for such a condition, the girl (through her parents and lawyers) sued her treating physician. She alleged that, because a cerebral CT scan was not performed when clinically indicated after the diagnosis of meningitis or encephalitis and before the lumbar puncture, she had "lost the chance" to have her brain tumour treated before she sustained permanent brain damage. She succeeded at first instance, but lost on appeal. The High Court also rejected her claim, holding unanimously that there were no policy reasons to allow recovery of damages based on possible (less than 50%) "loss of a chance" of a better medical outcome. The court held that the law of torts in Australia required "all or nothing" proof that physical injury was caused or contributed to by a negligent party. The High Court, however, did not exclude loss of chance as forming the substance of a probable (greater than 50%) claim in medical negligence in some future case. In the meantime, patients injured in Australia as a result of possible medical negligence (particularly in the intractable difficult instances of late diagnosis) must face the injustice of the significant day-to-day care needs of victims being carried by family members and the taxpayer-funded public hospital system. The High Court in Tabet v Gett again provides

  2. Scrutinising the duty of care and standard of care in English medical negligence.

    Science.gov (United States)

    Gromek-Broc, Katarzyna

    2012-03-01

    The aim of this article is to discuss the difficulties that claimants encounter in civil law action in English medical negligence cases. It argues that the current legal framework, in particular in relation to the existence of the duty of care and the assessment of standard of care, is haphazard and flawed. It suggests that the law should provide the boundaries that would encompass a moral obligation to rescue and to treat. In conclusion it discusses some timid attempts to reform the law in order to facilitate redress and compensation.

  3. Aspects of coverage in medical DNA sequencing

    Directory of Open Access Journals (Sweden)

    Wilson Richard K

    2008-05-01

    Full Text Available Abstract Background DNA sequencing is now emerging as an important component in biomedical studies of diseases like cancer. Short-read, highly parallel sequencing instruments are expected to be used heavily for such projects, but many design specifications have yet to be conclusively established. Perhaps the most fundamental of these is the redundancy required to detect sequence variations, which bears directly upon genomic coverage and the consequent resolving power for discerning somatic mutations. Results We address the medical sequencing coverage problem via an extension of the standard mathematical theory of haploid coverage. The expected diploid multi-fold coverage, as well as its generalization for aneuploidy are derived and these expressions can be readily evaluated for any project. The resulting theory is used as a scaling law to calibrate performance to that of standard BAC sequencing at 8× to 10× redundancy, i.e. for expected coverages that exceed 99% of the unique sequence. A differential strategy is formalized for tumor/normal studies wherein tumor samples are sequenced more deeply than normal ones. In particular, both tumor alleles should be detected at least twice, while both normal alleles are detected at least once. Our theory predicts these requirements can be met for tumor and normal redundancies of approximately 26× and 21×, respectively. We explain why these values do not differ by a factor of 2, as might intuitively be expected. Future technology developments should prompt even deeper sequencing of tumors, but the 21× value for normal samples is essentially a constant. Conclusion Given the assumptions of standard coverage theory, our model gives pragmatic estimates for required redundancy. The differential strategy should be an efficient means of identifying potential somatic mutations for further study.

  4. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    Directory of Open Access Journals (Sweden)

    Meghana S Chandra

    2016-01-01

    Full Text Available In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul.

  5. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    Science.gov (United States)

    Chandra, Meghana S; Math, Suresh Bada

    2016-10-01

    In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul.

  6. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    Science.gov (United States)

    Chandra, Meghana S.; Math, Suresh Bada

    2016-01-01

    In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul. PMID:27891021

  7. Introduction to the Tort of Negligence as It Pertains to the Medical Office. Medical Law and Economics, Lesson Plan No. 3.

    Science.gov (United States)

    Young, Joan

    Designed as part of a 40-hour course in medical law and economics, this lesson plan was developed to enable students to: (1) define and give examples of the tort of negligence in the medical profession; (2) distinguish between and give examples of personal and professional negligence; (3) be able to identify, for a given situation, the three major…

  8. Effects of coverage gap reform on adherence to diabetes medications.

    Science.gov (United States)

    Zeng, Feng; Patel, Bimal V; Brunetti, Louis

    2013-04-01

    To investigate the impact of Part D coverage gap reform on diabetes medication adherence. Retrospective data analysis based on pharmacy claims data from a national pharmacy benefit manager. We used a difference-in-difference-indifference method to evaluate the impact of coverage gap reform on adherence to diabetes medications. Two cohorts (2010 and 2011) were constructed to represent the last year before Affordable Care Act (ACA) reform and the first year after reform, respectively. Each patient had 2 observations: 1 before and 1 after entering the coverage gap. Patients in each cohort were divided into groups based on type of gap coverage: no coverage, partial coverage (generics only), and full coverage. Following ACA reform, patients with no gap coverage and patients with partial gap coverage experienced substantial drops in copayments in the coverage gap in 2011. Their adherence to diabetes medications in the gap, measured by percentage of days covered, improved correspondingly (2.99 percentage points, 95% confidence interval [CI] 0.49-5.48, P = .019 for patients with no coverage; 6.46 percentage points, 95% CI 3.34-9.58, P gap in 2011. However, their adherence did not increase (-0.13 percentage point, P = .8011). In the first year of ACA coverage gap reform, copayments in the gap decreased substantially for all patients. Patients with no coverage and patients with partial coverage in the gap had better adherence in the gap in 2011.

  9. When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.

    Science.gov (United States)

    Heckert, Carina

    2016-12-01

    Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.

  10. [Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

    Science.gov (United States)

    Halidou Doudou, M; Manzo, M L; Guero, D

    2014-12-01

    In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. [Analysis of judicial sentences issued against traumatologists between 1995 and 2011 as regards medical negligence].

    Science.gov (United States)

    Cardoso-Cita, Z; Perea-Pérez, B; Albarrán-Juan, M E; Labajo-González, M E; López-Durán, L; Marco-Martínez, F; Santiago-Saéz, A

    2016-01-01

    Traumatology and Orthopaedic Surgery is one of the specialities with most complaints due to its scope and complexity. The aim of this study is to determine the characteristics of the complaints made against medical specialists in Traumatology, taking into account those variables that might have an influence both on the presenting of the complaint as well as on the resolving of the process. An analysis was performed on 303 legal judgments (1995-2011) collected in the health legal judgements archive of the Madrid School of Medicine, which is linked to the Westlaw Aranzadi data base. Civil jurisdiction was the most used. The specific processes with most complaints were bone-joint disorders followed by vascular-nerve problems and infections. The injury claimed against most was in the lower limb, particularly the knee. The most frequent general cause of complaint was surgical treatment error, followed by diagnostic error. There was lack of information in 14.9%. There was sentencing in 49.8% of the cases, with compensation mainly being less than 50,000 euros. Traumatology and Orthopaedic Surgery is a speciality prone to complaints due to malpractice. The number of sentences against traumatologists is high, but compensations are usually less than 50,000 euros. The main reason for sentencing is surgical treatment error; thus being the basic surgical procedure and where precautions should be maximised. The judgements due to lack of information are high, with adequate doctor-patient communication being essential as well as the correct completion of the informed consent. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Financial compensation for radiotherapy-related adverse events in a judicial system where proof of medical negligence is not required

    International Nuclear Information System (INIS)

    Nyandoto, Paul; Muhonen, Timo; Hakala, Tapani; Dombrowski, Mitchell P.; Joensuu, Heikki

    2001-01-01

    Purpose: To examine the frequency of adverse events related to radiation therapy that lead to financial compensation in a judicial system that is not based on litigation in court but on statutory insurance where proof of medical negligence is not required for obtaining compensation. Methods and Materials: In Finland, an injured patient does not sue through the courts, but submits an insurance claim to the Patient Insurance Association. Proof of medical negligence is not required for obtaining compensation. We reviewed all filed claims associated with radiotherapy presented to the Patient Insurance Association from May 1987 to January 1999. During this time period, 1,732,000 patient visits to radiation therapy units were made, and the estimated number of radiotherapy treatments was 86,600. The data collected included descriptions of the adverse events, examination of the radiation therapy procedures followed, assessment of the causal relation of the event to radiotherapy by the therapists involved and by independent reviewers, and the sums used for compensation. Results: Only 102 patients (about 0.1%) had filed a claim for financial compensation, and in 18 (0.02%) cases the claim led to compensation. The mean national annual expenditure used for compensation was $35,200, and the sums paid in single cases ranged from $310 to $287,430 (median, $1,970). The expenditure used for compensating adverse radiation events was about $4 per treated patient, which is about 0.3% of all radiation therapy costs. Conclusions: The frequency of radiation therapy injuries that are financially compensated can remain low in an insurance-based judicial system where no litigation or attorneys are involved

  13. 42 CFR 436.321 - Medically needy coverage of the blind.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medically needy coverage of the blind. 436.321... Optional Coverage of the Medically Needy § 436.321 Medically needy coverage of the blind. If the agency provides Medicaid to the medically needy, it may provide Medicaid to blind individuals who meet— (a) The...

  14. Negligence, genuine error, and litigation

    OpenAIRE

    Sohn DH

    2013-01-01

    David H SohnDepartment of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USAAbstract: Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort syst...

  15. 42 CFR 436.308 - Medically needy coverage of individuals under age 21.

    Science.gov (United States)

    2010-10-01

    ... THE VIRGIN ISLANDS Optional Coverage of the Medically Needy § 436.308 Medically needy coverage of... (b) of this section: (1) Who would not be covered under the mandatory medically needy group of... nursing facility services are provided under the plan to individuals within the age group selected under...

  16. From Bolam-Bolitho to Modified-Montgomery - A Paradigm Shift in the Legal Standard of Determining Medical Negligence in Singapore.

    Science.gov (United States)

    Neo, Han Yee

    2017-09-01

    In a recent landmark litigation, the Singapore Court of Appeal introduced a new legal standard for determining medical negligence with regards to information disclosure - the Modified-Montgomery test. This new test fundamentally shifts the legal position concerning the standard of care expected of a doctor when he dispenses medical advice. Previously, a doctor is expected to disclose what a "reasonable physician" would tell his patient. Now, a doctor must disclose "all material risks" that a "reasonable patient" would want to know under his unique circumstances. Patient-centred communication is no longer an aspirational ideal but has become a legal mandate. Manpower, administrative, logistic and medical educational reforms should start now, so as to support the average physician transit from the era of the Bolam-Bolitho, to that of the Modified-Montgomery.

  17. Ethico-legal aspects of hospital-based blood transfusion practice; implications of professional negligence to medical practitioners: a review

    OpenAIRE

    Orkuma J.A; Ayia O.N.

    2014-01-01

    Background: Blood transfusion is predominantly a hospital-based practice in many resourceconstrained economies like Nigeria, wherein the sourcing, storage, processing and clinical use of blood and blood products resides in the often financial and manpower constrained hospitals. Aim: To identify the ethical and legal issues related to hospital-based blood transfusion practice for medical practitioner. Methods: Relevant articles retrieved via PubMed/MEDLINE and Google scholar search...

  18. 42 CFR 416.45 - Condition for coverage-Medical staff.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Medical staff. 416.45....45 Condition for coverage—Medical staff. The medical staff of the ASC must be accountable to the governing body. (a) Standard: Membership and clinical privileges. Members of the medical staff must be...

  19. Negligence, genuine error, and litigation

    Directory of Open Access Journals (Sweden)

    Sohn DH

    2013-02-01

    Full Text Available David H SohnDepartment of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USAAbstract: Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system.Keywords: medical malpractice, tort reform, no fault compensation, alternative dispute resolution, system errors

  20. Health insurance coverage and its impact on medical cost: observations from the floating population in China.

    Directory of Open Access Journals (Sweden)

    Yinjun Zhao

    Full Text Available China has the world's largest floating (migrant population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population.A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost.82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost.For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost.

  1. Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China

    Science.gov (United States)

    Zhao, Yinjun; Kang, Bowei; Liu, Yawen; Li, Yichong; Shi, Guoqing; Shen, Tao; Jiang, Yong; Zhang, Mei; Zhou, Maigeng; Wang, Limin

    2014-01-01

    Background China has the world's largest floating (migrant) population, which has characteristics largely different from the rest of the population. Our goal is to study health insurance coverage and its impact on medical cost for this population. Methods A telephone survey was conducted in 2012. 644 subjects were surveyed. Univariate and multivariate analysis were conducted on insurance coverage and medical cost. Results 82.2% of the surveyed subjects were covered by basic insurance at hometowns with hukou or at residences. Subjects' characteristics including age, education, occupation, and presence of chronic diseases were associated with insurance coverage. After controlling for confounders, insurance coverage was not significantly associated with gross or out-of-pocket medical cost. Conclusion For the floating population, health insurance coverage needs to be improved. Policy interventions are needed so that health insurance can have a more effective protective effect on cost. PMID:25386914

  2. Professional negligence reconsidered

    OpenAIRE

    DeVries, Ubaldus R M Th

    1996-01-01

    This thesis examines the concept of professional negligence. In doing so, it aims to find the distinguishing factors that characterize professional negligence as against other types of negligence. It seeks to emphasize the functions, duties and activities of professional people, rather than any examination of their status. The thesis demonstrates that this concept is based on a "broadspectrum" duty of care with specific obligations, particular to professional conduct. ...

  3. Negligence, genuine error, and litigation

    Science.gov (United States)

    Sohn, David H

    2013-01-01

    Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system. PMID:23426783

  4. Negligence and Athletic Events.

    Science.gov (United States)

    Mawdsley, Ralph D.

    2001-01-01

    Although athletic events generate their share of negligence lawsuits, the relatively small number, compared with other education areas, suggests that defenses (like assumption or risk and contributory negligence) have a better fit in athletics. Implications of newer litigation trends involving coaches' misconduct and interpretation of state…

  5. Medicalization of global health 4: The universal health coverage campaign and the medicalization of global health.

    Science.gov (United States)

    Clark, Jocalyn

    2014-01-01

    Universal health coverage (UHC) has emerged as the leading and recommended overarching health goal on the post-2015 development agenda, and is promoted with fervour. UHC has the backing of major medical and health institutions, and is designed to provide patients with universal access to needed health services without financial hardship, but is also projected to have 'a transformative effect on poverty, hunger, and disease'. Multiple reports and resolutions support UHC and few offer critical analyses; but among these are concerns with imprecise definitions and the ability to implement UHC at the country level. A medicalization lens enriches these early critiques and identifies concerns that the UHC campaign contributes to the medicalization of global health. UHC conflates health with health care, thus assigning undue importance to (biomedical) health services and downgrading the social and structural determinants of health. There is poor evidence that UHC or health care alone improves population health outcomes, and in fact health care may worsen inequities. UHC is reductionistic because it focuses on preventative and curative actions delivered at the individual level, and ignores the social and political determinants of health and right to health that have been supported by decades of international work and commitments. UHC risks commodifying health care, which threatens the underlying principles of UHC of equity in access and of health care as a collective good.

  6. Medical Expenditures Associated With Diabetes Among Youth With Medicaid Coverage.

    Science.gov (United States)

    Shrestha, Sundar S; Zhang, Ping; Thompson, Theodore J; Gregg, Edward W; Albright, Ann; Imperatore, Giuseppina

    2017-07-01

    Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States. We analyzed data from 2008 to 2012 MarketScan multistate Medicaid database for 6502 youths with diagnosed diabetes and 6502 propensity score matched youths without diabetes, enrolled in fee-for-service payment plans. We stratified analysis by Medicaid eligibility criteria (poverty or disability). We used 2-part regression models to estimate diabetes-related excess medical expenditures, adjusted for age, sex, race/ethnicity, year of claims, depression status, asthma status, and interaction terms. For poverty-based Medicaid enrollees, estimated annual diabetes-related total medical expenditure was $9046 per person [$3681 (no diabetes) vs. $12,727 (diabetes); PMedicaid enrollees, the estimated annual diabetes-related total medical expenditure was $9944 per person ($14,149 vs. $24,093; PMedicaid programs are substantial, which is larger among those with disabilities than without disabilities. Identifying cost-effective ways of managing diabetes in this vulnerable segment of the youth population is needed.

  7. Innovative negligence rules

    NARCIS (Netherlands)

    Dari-Mattiacci, G.; Franzoni, L.A.

    2014-01-01

    Often, injurers or victims (or both) can adopt a new technology that reduces the social costs of accidents. When adoption costs are not verifiable in court, optimal adoption decisions cannot be induced by means of an appropriate determination of negligence. Hence the parties might either over- or

  8. Sources and Coverage of Medical News on Front Pages of US Newspapers

    Science.gov (United States)

    Lai, William Y. Y.; Lane, Trevor; Jones, Alison

    2009-01-01

    Background Medical news that appears on newspaper front pages is intended to reach a wide audience, but how this type of medical news is prepared and distributed has not been systematically researched. We thus quantified the level of visibility achieved by front-page medical stories in the United States and analyzed their news sources. Methodology Using the online resource Newseum, we investigated front-page newspaper coverage of four prominent medical stories, and a high-profile non-medical news story as a control, reported in the US in 2007. Two characteristics were quantified by two raters: which newspaper titles carried each target front-page story (interrater agreement, >96%; kappa, >0.92) and the news sources of each target story (interrater agreement, >94%; kappa, >0.91). National rankings of the top 200 US newspapers by audited circulation were used to quantify the extent of coverage as the proportion of the total circulation of ranked newspapers in Newseum. Findings In total, 1630 front pages were searched. Each medical story appeared on the front pages of 85 to 117 (67.5%–78.7%) ranked newspaper titles that had a cumulative daily circulation of 23.1 to 33.4 million, or 61.8% to 88.4% of all newspapers. In contrast, the non-medical story achieved front-page coverage in 152 (99.3%) newspaper titles with a total circulation of 41.0 million, or 99.8% of all newspapers. Front-page medical stories varied in their sources, but the Washington Post, Los Angeles Times, New York Times and the Associated Press together supplied 61.7% of the total coverage of target front-page medical stories. Conclusion Front-page coverage of medical news from different sources is more accurately revealed by analysis of circulation counts rather than of newspaper titles. Journals wishing to widen knowledge of research news and organizations with important health announcements should target at least the four dominant media organizations identified in this study. PMID:19724643

  9. Media coverage of medical journals: do the best articles make the news?

    Science.gov (United States)

    Selvaraj, Senthil; Borkar, Durga S; Prasad, Vinay

    2014-01-01

    News coverage of medical research is followed closely by many Americans and affects the practice of medicine and influence of scientific research. Prior work has examined the quality of media coverage, but no investigation has characterized the choice of stories covered in a controlled manner. We examined whether the media systematically covers stories of weaker study design. We compared study characteristics of 75 clinically-oriented journal articles that received coverage in the top five newspapers by circulation against 75 clinically-oriented journal articles that appeared in the top five medical journals by impact factor over a similar timespan. Subgroup analysis was performed to determine whether differences between investigations from both sources varied by study type (randomized controlled trial [RCT] or observational study). Investigations receiving coverage from newspapers were less likely to be RCTs (17% vs. 35%, p = 0.016) and more likely to be observational studies (75% vs. 47%, pstudied (median: 1034 vs. 1901, p = 0.14) or length of follow-up (median: 1.80 vs. 1.00 years, p = 0.22). In subgroup analysis, observational studies from the media used smaller sample sizes (median: 1984 vs. 21136, p = 0.029) and were more likely to be cross-sectional (71% vs. 31%, pstudies and less likely to cover RCTs than high impact journals. Additionally, when the media does cover observational studies, they select articles of inferior quality. Newspapers preferentially cover medical research with weaker methodology.

  10. Determining the dimensions of essential medical coverage required by military body armour plates utilising Computed Tomography.

    Science.gov (United States)

    Breeze, J; Lewis, E A; Fryer, R

    2016-09-01

    Military body armour is designed to prevent the penetration of ballistic projectiles into the most vulnerable structures within the thorax and abdomen. Currently the OSPREY and VIRTUS body armour systems issued to United Kingdom (UK) Armed Forces personnel are provided with a single size front and rear ceramic plate regardless of the individual's body dimensions. Currently limited information exists to determine whether these plates overprotect some members of the military population, and no method exists to accurately size plates to an individual. Computed Tomography (CT) scans of 120 male Caucasian UK Armed Forces personnel were analysed to measure the dimensions of internal thoraco-abdominal anatomical structures that had been defined as requiring essential medical coverage. The boundaries of these structures were related to three potential anthropometric landmarks on the skin surface and statistical analysis was undertaken to validate the results. The range of heights of each individual used in this study was comparable to previous anthropometric surveys, confirming that a representative sample had been used. The vertical dimension of essential medical coverage demonstrated good correlation to torso height (suprasternal notch to iliac crest) but not to stature (r(2)=0.53 versus 0.04). Horizontal coverage did not correlate to either measure of height. Surface landmarks utilised in this study were proven to be reliable surrogate markers for the boundaries of the underlying anatomical structures potentially requiring essential protection by a plate. Providing a range of plate sizes, particularly multiple heights, should optimise the medical coverage and thus effectiveness of body armour for UK Armed Forces personnel. The results of this work provide evidence that a single width of plate if chosen correctly will provide the essential medical coverage for the entire military population, whilst recognising that it still could overprotect the smallest individuals

  11. Relative fault and efficient negligence: Comparative negligence explained

    NARCIS (Netherlands)

    Dari-Mattiacci, G.; Hendriks, E.S.

    2013-01-01

    This paper shows that the rule of comparative negligence with relative fault - a sharing of the loss proportional to the parties’ relative departures from due care - induces the parties to an accident to be efficiently negligent. Comparative negligence is more efficient than simple or contributory

  12. Relative fault and efficient negligence: comparative negligence explained

    NARCIS (Netherlands)

    Dari-Mattiacci, G.; Hendriks, E.S.

    2010-01-01

    Comparative negligence poses a persisting puzzle in law & economics. Under standard assumptions, its performance is identical to other negligence rules, while its implementation is slightly more complex. If so, why is it the most common rule? In this paper, we advance a novel argument: comparative

  13. Negligence is negligence: implications for an egalitarian agenda [Blog

    OpenAIRE

    Priaulx, Nicolette

    2013-01-01

    This short paper explores the significance of the "constitutionalism of private law" through the lens of developments in the context of the tort of negligence. Drawing a distinction between legal egalitarianism and social egalitarianism, the author notes that in the former respect the greater convergence of human rights and private law might be regarded as a welcome development; in respect of social egalitarianism, however, the author argues that given the way that the tort of negligence oper...

  14. Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support

    OpenAIRE

    Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

    2017-01-01

    Background Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians? experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mech...

  15. Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

    Science.gov (United States)

    Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

    2004-05-12

    Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

  16. Influence of medical journal press releases on the quality of associated newspaper coverage: retrospective cohort study.

    Science.gov (United States)

    Schwartz, Lisa M; Woloshin, Steven; Andrews, Alice; Stukel, Therese A

    2012-01-27

    To determine whether the quality of press releases issued by medical journals can influence the quality of associated newspaper stories. Retrospective cohort study of medical journal press releases and associated news stories. We reviewed consecutive issues (going backwards from January 2009) of five major medical journals (Annals of Internal Medicine, BMJ, Journal of the National Cancer Institute, JAMA, and New England Journal of Medicine) to identify the first 100 original research articles with quantifiable outcomes and that had generated any newspaper coverage (unique stories ≥100 words long). We identified 759 associated newspaper stories using Lexis Nexis and Factiva searches, and 68 journal press releases using Eurekalert and journal website searches. Two independent research assistants assessed the quality of journal articles, press releases, and a stratified random sample of associated newspaper stories (n=343) by using a structured coding scheme for the presence of specific quality measures: basic study facts, quantification of the main result, harms, and limitations. Proportion of newspaper stories with specific quality measures (adjusted for whether the quality measure was present in the journal article's abstract or editor note). We recorded a median of three newspaper stories per journal article (range 1-72). Of 343 stories analysed, 71% reported on articles for which medical journals had issued press releases. 9% of stories quantified the main result with absolute risks when this information was not in the press release, 53% did so when it was in the press release (relative risk 6.0, 95% confidence interval 2.3 to 15.4), and 20% when no press release was issued (2.2, 0.83 to 6.1). 133 (39%) stories reported on research describing beneficial interventions. 24% mentioned harms (or specifically declared no harms) when harms were not mentioned in the press release, 68% when mentioned in the press release (2.8, 1.1 to 7.4), and 36% when no press release

  17. Evaluation of an educational program on deciphering heterogeneity for medical coverage decisions.

    Science.gov (United States)

    Warholak, Terri L; Hilgaertner, Jianhua W; Dean, Joni L; Taylor, Ann M; Hines, Lisa E; Hurwitz, Jason; Brown, Mary; Malone, Daniel C

    2014-06-01

    It is increasingly important for decision makers, such as medical and pharmacy managers (or pharmacy therapeutics committee members and staff), to understand the variation and diversity in treatment response as decisions shift from an individual patient perspective to optimizing care for populations of patients. To assess the effectiveness of an instructional program on heterogeneity designed for medical and pharmacy managers. A live educational program was offered to members of the Academy of Managed Care Pharmacy at the fall 2012 educational meeting and also to medical directors and managers attending a national payer roundtable meeting in October 2012. Participants completed a retrospective pretest-posttest assessment of their knowledge, attitudes, and self-efficacy immediately following the program. Participants were offered the opportunity to participate in a follow-up assessment 6 months later. Willing participants for the follow-up assessment were contacted via e-mail and telephone. Rasch rating scale models were used to compare pre- and postscores measuring participants' knowledge about and attitude towards heterogeneity. A total of 49 individuals completed the retrospective pretest-posttest assessment and agreed to be a part of the program evaluation. Fifty percent (n = 25) of participants had heard of the phrase "heterogeneity of treatment effect," and 36 (72%) were familiar with the phrase "individualized treatment effect" prior to the live program. Participants reported a significant improvement in knowledge of heterogeneity (P  less than  0.01) and attitudes about heterogeneity (P  less than  0.01) immediately after attending the program. At the time of the educational program, participants had either never considered heterogeneity (26%) or reported not knowing (28%) whether their organizations considered it when determining basic coverage. Participants were more likely to report "sometimes" considering heterogeneity for determining

  18. Medical negligence | Otto | SA Journal of Radiology

    African Journals Online (AJOL)

    SA Journal of Radiology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 2 (2004) >. Log in or Register to get access to full text downloads.

  19. The efficiency of the negligence rules

    OpenAIRE

    Nikolić, Ljubica; Mojašević, Aleksandar

    2012-01-01

    This study comparatively analizes economic effects of different negligence rules, contained in American law on the one hand, and Serbian law on the other. It is important to establish economic implications of the different negligence rules, based on the incentives for tortfeasor’s and victim’s precaution under the different negligence rules. Study of the efficiency of several different forms of negligence rules: simple negligence, negligence with a defense of contributory negligence, comparat...

  20. Negligent Rape and Reasonable Beliefs

    DEFF Research Database (Denmark)

    Hansen, Pelle Guldborg

    2008-01-01

    practice such defences are often acknowledged if the belief is reasonable by some general standard, even when this standard does not pertain to the rules currently governing the practice of intercourse in Denmark. As a result it has often been argued that the notion of negligent rape should be introduced...

  1. Development of coverage with evidence development for medical technologies in Switzerland from 1996 to 2012.

    Science.gov (United States)

    Brügger, Urs; Ruckstuhl, Andreas; Horisberger, Bruno; Gratwohl, Alois

    2014-07-01

    The aim of this study was to assess incidence, time frame, and outcome of "Coverage with Evidence Development" (CED) decisions in the Swiss Basic Health Insurance scheme. Analysis of all controversial medical technologies submitted to review by the Swiss Federal Office of Public Health (FOPH) from 1996 to 2012 with focus on decisions with constraints. Description of types of technology, type of initial decision, duration of evaluation period, final decision, and search for potential factors associated with changes over time. Forty-five (37.5 percent) of 120 controversial health technologies were classified as "yes, in evaluation, reimbursed" for a certain period of time and thirty-five (29.2 percent) as "no, in evaluation, not reimbursed" by the Federal Department of Home Affairs from 1996 to 2012. The rate of CED decisions ranged between zero and nine per year and was influenced by type of technology and calendar year. Forty-four of forty-five decisions were subject to further restrictions, to a "center or a specialist" (76 percent), "indications" (49 percent), "registry" (31 percent), or "other" (49 percent). The time to a final decision ranged from 1.5 to 11 years (median, 6 years). No factors associated with initial decision and final outcome could be identified. CED as a reality in Switzerland might have enabled patients to obtain access to promising technologies early in their life cycle. CED might have acted as a trigger to a successful implementation of a comprehensive national registry. The lack of qualitative data stresses the urgent need for evaluation of the HTA decisions and their impact on patient outcome and costs.

  2. Optimal Rules of Negligent Misrepresentation in Insurance Law

    DEFF Research Database (Denmark)

    Lando, Henrik

    This article analyzes rules for negligent misrepresentation in insurance contract law. Before contract signature, the applicant can be asked by the insurer to fill in a questionnaire concerning the risk, and may then omit or make untrue statements about facts. Such misrepresentation is considered...... negligent by the court when it is unclear the misrepresentation was due to a mistake or intentional. Rules of negligent misrepresentation differ significantly across jurisdictions. For example, the rule of common law allows the insurer to rescind the contract, whereas the German rule does not allow...... of these rules through an analysis of the degree to which the insured should be allowed to lower coverage in case of negligent misrepresentation. On the one hand, a strict rule renders it easier for an insurer to separate different types of risk without having to use other costly means of separation...

  3. Asymptotic density and effective negligibility

    Science.gov (United States)

    Astor, Eric P.

    In this thesis, we join the study of asymptotic computability, a project attempting to capture the idea that an algorithm might work correctly in all but a vanishing fraction of cases. In collaboration with Hirschfeldt and Jockusch, broadening the original investigation of Jockusch and Schupp, we introduce dense computation, the weakest notion of asymptotic computability (requiring only that the correct answer is produced on a set of density 1), and effective dense computation, where every computation halts with either the correct answer or (on a set of density 0) a symbol denoting uncertainty. A few results make more precise the relationship between these notions and work already done with Jockusch and Schupp's original definitions of coarse and generic computability. For all four types of asymptotic computation, including generic computation, we demonstrate that non-trivial upper cones have measure 0, building on recent work of Hirschfeldt, Jockusch, Kuyper, and Schupp in which they establish this for coarse computation. Their result transfers to yield a minimal pair for relative coarse computation; we generalize their method and extract a similar result for relative dense computation (and thus for its corresponding reducibility). However, all of these notions of near-computation treat a set as negligible iff it has asymptotic density 0. Noting that this definition is not computably invariant, this produces some failures of intuition and a break with standard expectations in computability theory. For instance, as shown by Hamkins and Miasnikov, the halting problem is (in some formulations) effectively densely computable, even in polynomial time---yet this result appears fragile, as indicated by Rybalov. In independent work, we respond to this by strengthening the approach of Jockusch and Schupp to avoid such phenomena; specifically, we introduce a new notion of intrinsic asymptotic density, invariant under computable permutation, with rich relations to both

  4. Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support.

    Science.gov (United States)

    Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

    2017-01-01

    Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge. Plausible reasoning mechanisms include inductive reasoning , which generalizes the commonalities among the data to induce new rules, and analogical reasoning , which is guided by data similarities to infer new facts. By further leveraging rich, biomedical Semantic Web ontologies to represent medical knowledge, both known and tentative, we increase the accuracy and expressivity of plausible reasoning, and cope with issues such as data heterogeneity, inconsistency and interoperability. In this paper, we present a Semantic Web-based, multi-strategy reasoning approach, which integrates deductive and plausible reasoning and exploits Semantic Web technology to solve complex clinical decision support queries. We evaluated our system using a real-world medical dataset of patients with hepatitis, from which we randomly removed different percentages of data (5%, 10%, 15%, and 20%) to reflect scenarios with increasing amounts of incomplete medical knowledge. To increase the reliability of the results, we generated 5 independent datasets for each percentage of missing values, which resulted in 20 experimental datasets (in addition to the original dataset). The results show that plausibly inferred knowledge extends the coverage of the knowledge base by, on average, 2%, 7%, 12%, and 16% for datasets with, respectively, 5%, 10%, 15

  5. Framing risks and benefits of medical tourism: a content analysis of medical tourism coverage in Korean American community newspapers.

    Science.gov (United States)

    Jun, Jungmi; Oh, Kyeung Mi

    2015-01-01

    This study examines Korean American community newspapers' representation of risks and benefits involved with medical tourism offered in Korea. Using framing theory, this research attempts to explain Korean Americans' highly positive perceptions and high willingness to use health and medical services in Korea through medical tourism rather than using such services in the United States. The result of content analyses indicated that Korean American community newspapers are rarely engaged in risk communication and lack sufficient information about potential risks of medical tourism while emphasizing diverse benefits. Korean ethnic media, as the primary source of health communication for Korean Americans, should provide more reliable health and medical information for the population's appropriate health management.

  6. Audience responses to television news coverage of medical advances: The mediating role of audience emotions and identification.

    Science.gov (United States)

    Hong, Hyehyun

    2015-08-01

    Exemplifying a real person in news stories has become a popular journalistic technique to describe an event or issue. With the frequent appearance of medical news reports in local television in recent years, this news presentation style is widely believed to help audiences better engage in and understand complex medical information and to influence their perceptions and judgments. In terms of television news coverage of medical advances, this study investigates how audiences respond to embedded human examples (mainly patients who experience benefits from the advances) and to overall news stories, and how such responses are related to their perception of portrayed medical advances. The experimental results indicate that news stories with a human example were more likely to intensify the audience's positive emotions than those without, which in turn influenced favorable perceptions of the described medical advance. In addition, the extent to which the audience identified with a human example (in particular, sympathy) mediated the relationship between the audience's involvement in the news story and its perception of the portrayed medical advance. © The Author(s) 2014.

  7. Contributory Negligence. Law and the School Principal

    Science.gov (United States)

    Walden, John C.

    1974-01-01

    One of the most frequently used legal defenses against the charge that a school employee or district has been negligent is contributory negligence. Contributory negligence means that the injured person failed to exercise the required standard of care for his own safety and, therefore, contributed to his own injury. (Author/WM)

  8. An Update on Negligence. A Legal Memorandum.

    Science.gov (United States)

    Gluckman, Ivan

    This newsletter defines common law negligence, discusses recent trends in common law negligence, cites litigation, and establishes guidelines to assist school administrators in the avoidance of such tort action. The success or failure of a negligence suit most commonly turns on one of three factors: duty, breach of that duty, and proximate cause…

  9. On the optimal scope of negligence

    NARCIS (Netherlands)

    Dari-Mattiacci, G.

    2005-01-01

    This article studies the optimal scope of negligence, considering which of the parties’ precautionary measures should be included in the determination of negligence and which instead should be omitted. The analysis shows that the optimal scope of negligence balances the gains derived from improved

  10. 46 CFR 5.29 - Negligence.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Negligence. 5.29 Section 5.29 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE INVESTIGATION REGULATIONS-PERSONNEL ACTION Definitions § 5.29 Negligence. Negligence is the commission of an act which a reasonable...

  11. 42 CFR 416.47 - Condition for coverage-Medical records.

    Science.gov (United States)

    2010-10-01

    ... accurate medical records to ensure adequate patient care. (a) Standard: Organization. The ASC must develop and maintain a system for the proper collection, storage, and use of patient records. (b) Standard...) Patient identification. (2) Significant medical history and results of physical examination. (3) Pre...

  12. The Medical Imaging & Technology Alliance conference on research endpoints appropriate for Medicare coverage of new PET radiopharmaceuticals.

    Science.gov (United States)

    Hillman, Bruce J; Frank, Richard A; Abraham, Brian C

    2013-09-01

    The outcomes of a 2011 Medical Imaging & Technology Alliance (MITA) conference helped shape considerations about what might be the most appropriate pathways for the regulatory and payment considerations of new PET radiopharmaceuticals. As follow-up to that conference, MITA convened a second conference of stakeholders to advise payers on what might be acceptable endpoints for clinical trials to support the coverage of novel PET agents. The conference involved experts on imaging and clinical research, providers of PET services, as well as representatives of interested medical societies, the PET industry, and the regulatory and payer communities. The principal outcome of their deliberations was that it was unrealistic to expect trials of new PET radiopharmaceuticals to directly demonstrate a health benefit. Rather, intermediate outcomes, such as a positive change in patient management, would be more efficient and appropriate.

  13. Discrepancies among Scopus, Web of Science, and PubMed coverage of funding information in medical journal articles.

    Science.gov (United States)

    Kokol, Peter; Vošner, Helena Blažun

    2018-01-01

    The overall aim of the present study was to compare the coverage of existing research funding information for articles indexed in Scopus, Web of Science, and PubMed databases. The numbers of articles with funding information published in 2015 were identified in the three selected databases and compared using bibliometric analysis of a sample of twenty-eight prestigious medical journals. Frequency analysis of the number of articles with funding information showed statistically significant differences between Scopus, Web of Science, and PubMed databases. The largest proportion of articles with funding information was found in Web of Science (29.0%), followed by PubMed (14.6%) and Scopus (7.7%). The results show that coverage of funding information differs significantly among Scopus, Web of Science, and PubMed databases in a sample of the same medical journals. Moreover, we found that, currently, funding data in PubMed is more difficult to obtain and analyze compared with that in the other two databases.

  14. Clinical negligence and duty of candour.

    Science.gov (United States)

    Shekar, Vinita; Singh, Mark; Shekar, Kishore; Brennan, Peter

    2011-12-01

    The Department of Health is considering imposing a legal duty of candour on health care providers to ensure that an apology and explanation are given to patients when errors occur during medical treatment. This aims to improve quality of care and reduce adverse events during medical treatment. We present the current system of clinical negligence and the future of medical ethics. We discuss relevant cases with regard to duty of candour, and highlight the existence of serious imbalances in which patients' rights and corresponding ethical duties of professionals predominate over the responsibilities of patients themselves. It is known that most adverse events arise because of multiple factors for which no individual should be blamed. To improve healthcare services there is a need for a system in which lessons can be learnt from mistakes, and services can be improved in the interest of patient safety, and for transparency in the broad principles on which the decisions are based within which clinical performance is supervised and monitored. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Media Coverage, Journal Press Releases and Editorials Associated with Randomized and Observational Studies in High-Impact Medical Journals: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Michael T M Wang

    Full Text Available Publication of clinical research findings in prominent journals influences health beliefs and medical practice, in part by engendering news coverage. Randomized controlled trials (RCTs should be most influential in guiding clinical practice. We determined whether study design of clinical research published in high-impact journals influences media coverage.We compared the incidence and amount of media coverage of RCTs with that of observational studies published in the top 7 medical journals between 1 January 2013 and 31 March 2013. We specifically assessed media coverage of the most rigorous RCTs, those with >1000 participants that reported 'hard' outcomes. There was no difference between RCTs and observational studies in coverage by major newspapers or news agencies, or in total number of news stories generated (all P>0.63. Large RCTs reporting 'hard' outcomes did not generate more news coverage than small RCTs that reported surrogate outcomes and observational studies (all P>0.32. RCTs were more likely than observational studies to attract a journal editorial (70% vs 46%, P = 0.003, but less likely to be the subject of a journal press release (17% vs 50%, P0.99, nor were they more likely to be the subject of a journal press release (14% vs 38%, P = 0.14.The design of clinical studies whose results are published in high-impact medical journals is not associated with the likelihood or amount of ensuing news coverage.

  16. 42 CFR 435.308 - Medically needy coverage of individuals under age 21.

    Science.gov (United States)

    2010-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS ELIGIBILITY IN THE STATES, DISTRICT OF.... (3) Individuals in nursing facilities when nursing facility services are provided under the plan to...

  17. Locating helicopter emergency medical service bases to optimise population coverage versus average response time

    NARCIS (Netherlands)

    Garner, A.A. (Alan A.); P.L. van den Berg (Pieter)

    2017-01-01

    textabstractBackground: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate

  18. Medical coverage of winter Nordic sports: an overview from the field.

    Science.gov (United States)

    Gaul, Lawrence W

    2010-01-01

    Traveling with sports teams requires flexibility and a wide range of knowledge, as well as problem-solving abilities. Dominating the medical types of problems in the Nordic sports are the respiratory illnesses, especially asthma and upper respiratory infections (URI). Additionally, the team physician must have an awareness of antidoping issues. This overview highlights many of the issues encountered traveling domestically as well as internationally with high-level Nordic teams. Helpful links are included to facilitate the care of all levels of athletes. Additionally, a few side issues such as altitude illness and minor trauma are mentioned.

  19. Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Padula, William V; Heru, Shiona; Campbell, Jonathan D

    2016-04-01

    Recently, the Massachusetts Group Insurance Commission (GIC) prioritized research on the implications of a clause expressly prohibiting the denial of health insurance coverage for transgender-related services. These medically necessary services include primary and preventive care as well as transitional therapy. To analyze the cost-effectiveness of insurance coverage for medically necessary transgender-related services. Markov model with 5- and 10-year time horizons from a U.S. societal perspective, discounted at 3% (USD 2013). Data on outcomes were abstracted from the 2011 National Transgender Discrimination Survey (NTDS). U.S. transgender population starting before transitional therapy. No health benefits compared to health insurance coverage for medically necessary services. This coverage can lead to hormone replacement therapy, sex reassignment surgery, or both. Cost per quality-adjusted life year (QALY) for successful transition or negative outcomes (e.g. HIV, depression, suicidality, drug abuse, mortality) dependent on insurance coverage or no health benefit at a willingness-to-pay threshold of $100,000/QALY. Budget impact interpreted as the U.S. per-member-per-month cost. Compared to no health benefits for transgender patients ($23,619; 6.49 QALYs), insurance coverage for medically necessary services came at a greater cost and effectiveness ($31,816; 7.37 QALYs), with an incremental cost-effectiveness ratio (ICER) of $9314/QALY. The budget impact of this coverage is approximately $0.016 per member per month. Although the cost for transitions is $10,000-22,000 and the cost of provider coverage is $2175/year, these additional expenses hold good value for reducing the risk of negative endpoints--HIV, depression, suicidality, and drug abuse. Results were robust to uncertainty. The probabilistic sensitivity analysis showed that provider coverage was cost-effective in 85% of simulations. Health insurance coverage for the U.S. transgender population is affordable

  20. Mandatory Rest Stops Improve Athlete Safety during Event Medical Coverage for Ultramarathons.

    Science.gov (United States)

    Joslin, Jeremy; Mularella, Joshua; Bail, Allison; Wojcik, Susan; Cooney, Derek R

    2016-02-01

    Provisions of medical direction and clinical services for ultramarathons require specific attention to heat illness. Heat stress can affect athlete performance negatively, and heat accumulation without acclimatization is associated with the development of exertional heat stroke (EHS). In order to potentially mitigate the risk of this safety concern, the Jungle Marathon (Para, Brazil) instituted mandatory rest periods during the first two days of this 7-day, staged, Brazilian ultramarathon. Race records were reviewed retrospectively to determine the number of runners that suffered an emergency medical complication related to heat stress and did not finish (DNF) the race. Review of records included three years before and three years after the institution of these mandatory rest periods. A total of 326 runners competed in the Jungle Marathon during the 2008-2013 period of study. During the pre-intervention years, a total of 46 athletes (21%) DNF the full race with 25 (54.3%) cases attributed to heat-related factors. During the post-intervention years, a total of 26 athletes (24.3%) DNF the full race with four (15.4%) cases attributed to heat-related factors. Mandatory rest stops during extreme running events in hot or tropical environments, like the Jungle Marathon, are likely to improve athlete safety and improve the heat acclimatization process.

  1. Educators' Negligence: What, Why, and Who's Responsible?

    Science.gov (United States)

    Dunklee, Dennis R.; Shoop, Robert J.

    1988-01-01

    The authors define negligence and cite specific examples where teachers were found accountable for their negligent actions related to their profession. They report results of an informal study of teacher knowledge of tort liability that indicate educators should be more knowledgeable about education law. Recommendations are included. (CH)

  2. Pricing of medical devices under coverage uncertainty--a modelling approach.

    Science.gov (United States)

    Girling, Alan J; Lilford, Richard J; Young, Terry P

    2012-12-01

    Product vendors and manufacturers are increasingly aware that purchasers of health care will fund new clinical treatments only if they are perceived to deliver value-for-money. This influences companies' internal commercial decisions, including the price they set for their products. Other things being equal, there is a price threshold, which is the maximum price at which the device will be funded and which, if its value were known, would play a central role in price determination. This paper examines the problem of pricing a medical device from the vendor's point of view in the presence of uncertainty about what the price threshold will be. A formal solution is obtained by maximising the expected value of the net revenue function, assuming a Bayesian prior distribution for the price threshold. A least admissible price is identified. The model can also be used as a tool for analysing proposed pricing policies when no formal prior specification of uncertainty is available. Copyright © 2011 John Wiley & Sons, Ltd.

  3. 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/

  4. Findings of negligence followed communication lapses in BC aneurysm case

    OpenAIRE

    Capen, K

    1997-01-01

    Negligence is sometimes established on the basis of lapses in communication and patient care management that, in hindsight, could have been avoided. A recent BC court case concerned a patient who died because of a ruptured aneurysm. A Supreme Court judge found that some of the physicians involved had failed in their duty to diagnose the patient's condition properly, or failed to communicate to one another significant signs of the patient's illness, and failed to refer him in time to the medic...

  5. 24/7 in-house intensivist coverage and fellowship education: a cross-sectional survey of academic medical centers in the United States.

    Science.gov (United States)

    Diaz-Guzman, Enrique; Colbert, Colleen Y; Mannino, David M; Davenport, Daniel L; Arroliga, Alejandro C

    2012-04-01

    The objectives of this study were to determine the current staffing models of practice and the frequency of 24/7 coverage in academic medical centers in the United States and to assess the perceptions of critical care trainees and program directors toward these models. A cross-sectional national survey was conducted using an Internet-based survey platform. The survey was distributed to fellows and program directors of 374 critical care training programs in US academic medical centers. We received 518 responses: 138 from program directors (PDs) (37% of 374 programs) and 380 fellow responses. Coverage by a board-certified or board-eligible intensivist physician 24/7 was reported by 33% of PD respondents and was more common among pediatric and surgical critical care programs. Mandatory in-house call for critical care trainees was reported by 48% of the PDs. Mandatory call was also more common among pediatric-critical care programs compared with the rest (P 24/7 coverage would be associated with better patient care in the ICU and improved education for the fellows, although 65% of them believed this model would have a negative impact on trainees' autonomy. Intensivist coverage 24/7 was not commonly used in US academic centers responding to our survey. Significant differences in coverage models among critical care medicine specialties appear to exist. Program director and trainee respondents believed that 24/7 coverage was associated with better outcomes and education but also expressed concerns about the impact of this model on fellows' autonomy.

  6. [Trends in the use of medical and dental services and associations with educational level and private health plan coverage in Brazil, 1998-2013].

    Science.gov (United States)

    Pilotto, Luciane Maria; Celeste, Roger Keller

    2018-03-29

    The public-private mix in the Brazilian health system favors double coverage of health services for individuals with private health plans and may aggravate inequities in the use of services. The aim of this study was to describe trends in the use of medical and dental services and associations with schooling and private health coverage. Data were obtained from a national household survey with representative samples in the years 1998, 2003, 2008, and 2013. The study described trends in the use of health services by adults, adjusted by private health coverage, years of schooling, sex, and age. There was an upward trend in the use of health services in adults without a private plan and among adults with a private plan the trend in use varied in a non-linear way. The medical service presented alternation in use over the years and the dental service showed a tendency to decline after 2003. It is necessary to monitor trends in private health coverage and the use of health services to assist government in regulating private plans and avoid increasing inequities among citizens in access to and use of health services.

  7. Sports physicians, ethics and antidoping governance: between assistance and negligence.

    Science.gov (United States)

    Dikic, Nenad; McNamee, Michael; Günter, Heinz; Markovic, Snezana Samardzic; Vajgic, Bojan

    2013-07-01

    Recent positive doping cases and a series of mistakes of medical doctors of the International Federation of Basketball have reopened the debate about the role of medical doctor in elite sport. This study shows that some sports physicians involved in recent positive doping cases are insufficiently aware of the nuances of doping regulations and, most importantly, of the list of prohibited substances. Moreover, several team doctors are shown to have exercised poor judgement in relation to these matters with the consequence that athletes are punished for doping offences on the basis of doctors' negligence. In such circumstances, athletes' rights are jeopardised by a failure of the duty of care that (sports) physicians owe their athlete patients. We argue that, with respect to the World Anti Doping Code, antidoping governance fails to define, with sufficient clarity, the role of medical doctors. There is a need for a new approach emphasising urgent educational and training of medical doctors in this domain, which should be considered prior to the revision of the next World Anti Doping Code in 2013 in order to better regulate doctor's conduct especially in relation to professional errors, whether negligent or intentional.

  8. The Vulnerable Subject of Negligence Law

    OpenAIRE

    Stychin, C.

    2012-01-01

    The approach taken by English courts to the duty of care question in negligence has been subject to harsh criticism in recent years. This article examines this fundamental issue in tort law, drawing upon Canadian and Australian jurisprudence by way of comparison. From this analysis, the concept of vulnerability is developed as a productive means of understanding the duty of care. Vulnerability is of increasing interest in legal and political theory and it is of particular relevance to the law...

  9. Clinical negligence and the need to keep professionally updated.

    Science.gov (United States)

    Tingle, John

    Nurses and doctors are under a legal duty to keep reasonably up to date; this is a fundamental aspect of their legal duty of care to their patients. A nurse or doctor could be negligent if a patient is harmed because of ignorance of well accepted and known published nursing and medical research findings. It is all a question of fact and degree and cases will turn on their own circumstances. There are a number of reported court cases which explore this issue and which contain useful guidance. These cases are discussed within the context of the new NHS and the Government's emphasis on health quality, and increasing healthcare litigation.

  10. 7 CFR 276.3 - Negligence or fraud.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Negligence or fraud. 276.3 Section 276.3 Agriculture... Negligence or fraud. (a) General. If FNS determines that there has been negligence or fraud on the part of..., pay to FNS a sum equal to the amount of coupons issued as a result of such negligence or fraud. (b...

  11. Safety Tips: Avoiding Negligence Suits in Chemistry Teaching.

    Science.gov (United States)

    Gerlovich, Jack A.

    1983-01-01

    Discusses various aspects related to negligence on the part of chemistry teachers. Areas addressed include negligence in tort law, avoiding negligence suits, proper instructions, proper supervision, equipment maintenance, and other considerations such as sovereign immunity, and contributory versus comparative negligence. (JN)

  12. Reporting by multiple employer welfare arrangements and certain other entities that offer or provide coverage for medical care to the employees of two or more employers. Final rule.

    Science.gov (United States)

    2003-04-09

    This document contains a final rule governing certain reporting requirements under Title I of the Employee Retirement Income Security Act of 1974 (ERISA) for multiple employer welfare arrangements (MEWAs) and certain other entities that offer or provide coverage for medical care to the employees of two or more employers. The final rule generally requires the administrator of a MEWA, and certain other entities, to file a form with the Secretary of Labor for the purpose of determining whether the requirements of certain recent health care laws are being met.

  13. Percent Coverage

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Percent Coverage is a spreadsheet that keeps track of and compares the number of vessels that have departed with and without observers to the numbers of vessels...

  14. Negligence: What Is It? How Can It Be Avoided?

    Science.gov (United States)

    Carpenter, Linda Jean; Acosta, R. Vivian

    1982-01-01

    The physical educator or athletic coach needs to be aware of negligence in relation to the possible athletic injuries of students. The four legal components of negligence--duty, breach, cause, and harm--are discussed. (JN)

  15. Negligent Hiring and Employer Liability in the Selection of Employees.

    Science.gov (United States)

    Howard, Sharon Swenson

    1988-01-01

    Reviews some theories of employer liability: (1) negligent hiring; (2) negligent entrustment; and (3) respondent superior. Applicable cases focusing on the investigation of prospective employees and the emerging constitutional implications are discussed. (MLF)

  16. 19 CFR 181.62 - Commercial samples of negligible value.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Commercial samples of negligible value. 181.62... Returned After Repair or Alteration § 181.62 Commercial samples of negligible value. (a) General. Commercial samples of negligible value imported from Canada or Mexico may qualify for duty-free entry under...

  17. Negligence and the legal standard of care: what is 'reasonable' conduct?

    Science.gov (United States)

    Miola, José

    Medical negligence has become a big issue for medical practitioners. Fear of the law, and of litigation, has led to claims of defensive medical practice among doctors and nurses. At the heart of this lies the legal definition of the standard of care, where the law seeks to determine when conduct is 'reasonable' (and thus not negligent), or 'unreasonable' (and thus a breach of the legal duty of care and potentially negligent). In this article the author clarifies what the law means by 'reasonableness' with respect to nurses, drawing on both the law and the NMC Code. Furthermore, the article shall demonstrate that the law is not something to be fearful of but, rather, demands a standard no higher than that of the NMC.

  18. Copayment and recommended strategies to mitigate its impacts on access to emergency medical services under universal health coverage: a case study from Thailand

    Directory of Open Access Journals (Sweden)

    Paibul Suriyawongpaisal

    2016-10-01

    Full Text Available Abstract Background Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. Methods Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review, we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001. Results The copayment poses a barrier of access to emergency care delivered by private hospitals despite the policy proclaiming free access and payment. The copayment differentially affects beneficiaries of the major 3 public-health insurance schemes hence inducing inequity of access. Conclusions We have identified 6 drivers of the copayment i.e., 1 perceived under payment, 2 unclear operational definitions of emergency conditions or 3 lack of criteria to justify inter-hospital transfer after the first 72 h of admission, 4 limited understanding by the service users of the policy-directed benefits, 5 weak regulatory mechanism as indicated by lack of information systems to trace private provider’s practices, and 6 ineffective arrangements for inter-hospital transfer. With demand-side perspectives, we addressed the reasons for bypassing gatekeepers or assigned local hospitals. These are the perception of inferior quality of care and age-related tendency to use emergency department, which indicate a deficit in the current healthcare systems under universal health coverage. Finally, we have discussed strategies to address these potential drivers of copayment and needs for further studies.

  19. Copayment and recommended strategies to mitigate its impacts on access to emergency medical services under universal health coverage: a case study from Thailand.

    Science.gov (United States)

    Suriyawongpaisal, Paibul; Aekplakorn, Wichai; Srithamrongsawat, Samrit; Srithongchai, Chaisit; Prasitsiriphon, Orawan; Tansirisithikul, Rassamee

    2016-10-21

    Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001. The copayment poses a barrier of access to emergency care delivered by private hospitals despite the policy proclaiming free access and payment. The copayment differentially affects beneficiaries of the major 3 public-health insurance schemes hence inducing inequity of access. We have identified 6 drivers of the copayment i.e., 1) perceived under payment, 2) unclear operational definitions of emergency conditions or 3) lack of criteria to justify inter-hospital transfer after the first 72 h of admission, 4) limited understanding by the service users of the policy-directed benefits, 5) weak regulatory mechanism as indicated by lack of information systems to trace private provider's practices, and 6) ineffective arrangements for inter-hospital transfer. With demand-side perspectives, we addressed the reasons for bypassing gatekeepers or assigned local hospitals. These are the perception of inferior quality of care and age-related tendency to use emergency department, which indicate a deficit in the current healthcare systems under universal health coverage. Finally, we have discussed strategies to address these potential drivers of copayment and needs for further studies.

  20. Systemic Negligence: Why It Is Morally Important for Developing World Bioethics.

    Science.gov (United States)

    Chakraborti, Chhanda

    2015-12-01

    In the context of clinical and non-clinical biomedical practices, negligence is usually understood as a lapse of a specific professional duty by a healthcare worker or by a medical facility. This paper tries to delineate systemic negligence as another kind of negligence in the context of health systems, particularly in developing countries, that needs to be recognized and addressed. Systemic negligence is not just a mere collection of stray incidences of medical errors and system failures in a health system, but is proposed in this paper as a more pervasive kind of neglect. Several non-medical factors, such as lack of social and political will, also contribute to it and hence is more difficult to address in a health system. This paper argues that recognizing systemic negligence and including it research agenda have special moral importance for researchers in developing world bioethics, public health ethics and for health activists in the developing world. For, it can be a potent health system barrier, and can seriously impair efforts to ensure patient safety, particularly in the weaker health systems. As it erodes accountability in a health system, addressing it is also important for the twin goals of ensuring patient safety and improving health system performance. Above all, it needs to be addressed because the tolerance of its persistence in a health system seems to undervalue health as a social good. © 2014 John Wiley & Sons Ltd.

  1. Immunization Coverage

    Science.gov (United States)

    ... room/fact-sheets/detail/immunization-coverage","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... Plan Global Health Observatory (GHO) data - Immunization More information on vaccines and immunization News 1 in 10 ...

  2. Functional coverages

    NARCIS (Netherlands)

    Donchyts, G.; Baart, F.; Jagers, H.R.A.; Van Dam, A.

    2011-01-01

    A new Application Programming Interface (API) is presented which simplifies working with geospatial coverages as well as many other data structures of a multi-dimensional nature. The main idea extends the Common Data Model (CDM) developed at the University Corporation for Atmospheric Research

  3. Rural-to-urban migration and its implication for new cooperative medical scheme coverage and utilization in China

    Directory of Open Access Journals (Sweden)

    Zhang Juying

    2011-06-01

    Full Text Available Abstract Background China has been experiencing the largest rural to urban migration in history. Rural-to-urban migrants are those who leave their hometown for another place in order to work or live without changing their hukou status, which is a household registration system in China, categorizing people as either rural residents or urban residents. Rural-to-urban migrants typically find better job opportunities in destination cities, and these pay higher salaries than available in their home regions. This has served to improve the enrollment rates in the New Cooperative Medical Scheme (NCMS of rural families, protecting households from falling into poverty due to diseases. However, current regulations stipulate that people who are registered in China's rural hukou can only participate in their local NCMS, which in turn poses barriers when migrants seek medical services in the health facilities of their destination cities. To examine this issue in greater depth, this study examined the associations between migration, economic status of rural households, and NCMS enrollment rate, as well as NCMS utilization of rural-to-urban migrants. Methods A multistage cluster sampling procedure was adopted. Our sample included 9,097 households and 36,720 individuals. Chi-square test and T-test were used to examine differences between the two populations of migrants and non-migrants based on age, gender, marriage status, and highest level of education. Ordinal logistic regression was used to examine the association between migration and household economic status. Binary logistic regression was used to examine the associations between household economic status, migration and enrollment in the NCMS. Results Migration was positively associated with improved household economic status. In households with no migrants, only 11.3% of the population was in the richest quintile, whereas the percentage was more than doubled in households with family members who migrated

  4. Preschoolers' Understanding of Lies and Innocent and Negligent Mistakes.

    Science.gov (United States)

    Siegal, Michael; Peterson, Candida C.

    1998-01-01

    Examined preschoolers' ability to distinguish innocent and negligent mistakes from lies. Found that, when asked to identify a mistake or lie about a food's contact with contaminants and identify a bystander's reaction, children distinguished mistakes from lies; they could also discriminate between lies and both negligent mistakes that generate…

  5. Children in Civil Law: The Tort of Negligence.

    Science.gov (United States)

    Sheehy, N. P.; Chapman, A. J.

    1984-01-01

    Examines judgments involving children under the tort of negligence, using All England Law Reports for 1939 to 1983 and some cases from other countries. Discusses "contributory negligence,""parental liability,""responsibility,""allurement," and "res-ipsa loquitur." Suggests more use of developmental…

  6. Chemistry, Courtrooms, and Common Sense. Part I: Negligence and Duty.

    Science.gov (United States)

    Gass, J. Ric

    1990-01-01

    Discussed are concepts involved in legal liability for laboratory accidents. The focus of this article is on negligence, duty, and responsibility issues. Highlighted are the basis of a lawsuit, negligent tort, duty and breech of duty, and cause and harm. Thirty-one cases are cited. (CW)

  7. Negligence--When Is the Principal Liable? A Legal Memorandum.

    Science.gov (United States)

    Stern, Ralph D., Ed.

    Negligence, a tort liability, is defined, discussed, and reviewed in relation to several court decisions involving school principals. The history of liability suits against school principals suggests that a reasonable, prudent principal can avoid legal problems. Ten guidelines are presented to assist principals in avoiding charges of negligence.…

  8. Negligence: What You Need To Know To Avoid Liability.

    Science.gov (United States)

    Russo, Charles J.; Fericks, Donald J.

    1996-01-01

    To help educators understand their legal responsibilities when supervising students, this article reviews the elements of negligence (duty, breach, injury, and causation) an injured party must prove to hold an educator or school system legally accountable. The article also reviews basic defenses to negligence: immunity, comparative/contributory…

  9. Pandemic influenza A/H1N1 vaccination coverage, adverse reactions, and reasons for vaccine refusal among medical students in Brazil

    Directory of Open Access Journals (Sweden)

    Eduardo Pernambuco de Souza

    2012-04-01

    Full Text Available The aim of this cross-sectional study was to determine, among medical students at a public university in Rio de Janeiro, Brazil, the acceptance of the pandemic influenza A/H1N1 vaccine during the 2010 mass immunization campaign and the vaccine safety in this group and, among unvaccinated students, the reasons for refusing vaccination. Of a total of 858 students, 678 (79% participated in the study. Vaccination coverage was 60.4% among students aged 20 to 39 years (an age group targeted for vaccination and 43.8% among those who did not belong to this age group. The most frequent adverse reactions to the vaccine were pain at the injection site (8.7% and fever (7.9%. There were no serious adverse reactions. Among students aged 20 to 39 years, the most common reasons for refusing the vaccine were "lack of time" (42.4%, "fear of adverse reactions" (41.9%, and "difficult access to the vaccine" (11.5%. Other reasons for vaccine refusal were "uncertainties about vaccine safety and efficacy" and "vaccination was not needed". To increase the acceptance of the influenza vaccine, a comprehensive immunization program should be offered to these students.

  10. Clinical negligence in hospitals in France and England.

    Science.gov (United States)

    Kelly, Michael J; de Bono Q C, John; Métayer, Patrice

    2015-12-01

    This article arose from the back-to-back presentations by Michael Kelly and Patrice Métayer to the Anglo-French Medical Society in 2013 on the French and English legal systems handling a case of alleged clinical negligence as it proceeds from complaint to settlement or judgment in the two jurisdictions. Both systems have a hospital-based first stage with various avenues being available for amicable resolution, the French version being more regulated and prescribed than the English one. In both jurisdictions fewer than 5% cases go down the criminal route. Before the court is involved, in England there is an elaborate lawyer-controlled phase involving negotiations between the two sides and their experts which is expensive but often leads to pre-trial settlement for significant sums of money. Medical experts are central to all of this. In England they are largely unregulated and entirely advisory in an open market, in France they are both regulated and supervised by judges, being placed on official lists. These experts take a major inquisitorial role in a Debate between the two sides, combining the functions of Single Joint Expert (SJE), arbiter and mentor. If agreement is not reached, a second Debate before a different Expert is arranged. In both countries fewer than 5% cases reach a court for a hearing before a judge. In England a trial is an elaborate lengthy, expensive adversarial contest where all of the issues are rehearsed in full with factual and expert evidence, whereas in France in a contested case the judge reviews the reports of the two Debates with the lawyers who were involved (and not the experts, factual witnesses or parties). © The Author(s) 2015.

  11. Negligent Hiring and Retaining of Sexually Abusive Teachers.

    Science.gov (United States)

    Regotti, Terri L.

    1992-01-01

    Explores negligent hiring, supervision, and retention of teachers who sexually abuse students. Examines the issue of defamation and suggests school policy that will work toward eradication of sexual abuse of students by teachers. (33 references) (MLF)

  12. On the Firing Line: Negligence in Physical Education

    Science.gov (United States)

    Drowatzky, John N.

    1977-01-01

    Discusses teachers' vulnerability to tort actions for negligence in physical education classes, and suggests guidelines for proper teacher behavior, based on analysis of court cases in various states. (JG)

  13. The high cost of clinical negligence litigation in the NHS.

    Science.gov (United States)

    Tingle, John

    2017-03-09

    John Tingle, Reader in Health Law at Nottingham Trent University, discusses a consultation document from the Department of Health on introducing fixed recoverable costs in lower-value clinical negligence claims.

  14. Malodorous consequences: what comprises negligence in anosmia litigation?

    Science.gov (United States)

    Svider, Peter F; Mauro, Andrew C; Eloy, Jean Anderson; Setzen, Michael; Carron, Michael A; Folbe, Adam J

    2014-03-01

    Our objectives were to evaluate factors raised in malpractice litigation in which plaintiffs alleged that physician negligence led to olfactory dysfunction. We analyzed publically available federal and court records using Westlaw, a widely used computerized legal database. Pertinent jury verdicts and settlements were comprehensively examined for alleged causes of malpractice (including procedures for iatrogenic causes), defendant specialty, patient demographics, and other factors raised in legal proceedings. Of 25 malpractice proceedings meeting inclusion criteria, 60.0% were resolved for the defendant, 12.0% were settled, and 28.0% had jury-awarded damages. Median payments were significant ($300,000 and $412,500 for settlements and awards, respectively). Otolaryngologists were the most frequently named defendants (68.0%), with the majority of iatrogenic cases (55.0%) related to rhinologic procedures. Associated medical events accompanying anosmia included dysgeusia, cerebrospinal fluid leaks, and meningitis. Other alleged factors included requiring additional surgery (80.0%), unnecessary procedures (47.4% of iatrogenic procedural cases), untimely diagnosis leading to anosmia (44.0%), inadequate informed consent (35.0%), dysgeusia (56.0%), and psychological sequelae (24.0%). Olfactory dysfunction can adversely affect quality of life and thus is a potential area for malpractice litigation. This is particularly true for iatrogenic causes of anosmia, especially following rhinologic procedures. Settlements and damages awarded were considerable, making an understanding of factors detailed in this analysis of paramount importance for the practicing otolaryngologist. This analysis reinforces the importance of explicitly including anosmia in a comprehensive informed consent process for any rhinologic procedure. © 2013 ARS-AAOA, LLC.

  15. Impact of around-the-clock in-house cardiology fellow coverage on door-to-balloon time in an academic medical center

    Directory of Open Access Journals (Sweden)

    Kohan LC

    2017-04-01

    Full Text Available Luke C Kohan,1,* Vijaiganesh Nagarajan,1,* Michael A Millard,2 Michael J Loguidice,2 Nancy M Fauber,1 Ellen C Keeley1 1Division of Cardiology, 2Department of Medicine, University of Virginia, Charlottesville, VA, USA * These authors contributed equally to this work Objectives: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI program. Background: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning. Methods: We performed a retrospective study assessing symptom onset to arrival, arterial access to first device, and door-to-balloon (D2B times, in consecutive STEMI patients presenting to our emergency department before and after initiation of the night float fellow system. Results: From 2009 to 2013, 208 STEMI patients presented to our emergency department and underwent primary percutaneous coronary intervention. There was no difference in symptom onset to arrival (150±102 minutes vs 154±122 minutes, p=0.758, arterial access to first device (12±8 minutes vs 11±7 minutes, p=0.230, or D2B times (50±32 minutes vs 52±34 minutes, p=0.681 during regular working hours. However, there was a significant decrease in D2B times seen during off-hours (72±33 minutes vs 49±15 minutes, p=0.007. There was no difference in in-hospital mortality (11% vs 8%, p=0.484 or need for intra-aortic balloon pump placement (7% vs 8%, p=0.793. Conclusion: In academic medical centers, in-house cardiology fellow coverage during off-hours may expedite care of STEMI patients. Keywords: door-to-balloon time, 24/7 in-house call, cardiology fellow

  16. Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010.

    Science.gov (United States)

    Mathew, Rajeev; Asimacopoulos, Eleni; Walker, David; Gutierrez, Tatiana; Valentine, Peter; Pitkin, Lisa

    2012-05-01

    We determined the characteristics of medical negligence claims following tonsillectomy. Claims relating to tonsillectomy between 1995 and 2010 were obtained from the National Health Service Litigation Authority database. The number of open and closed claims was determined, and data were analyzed for primary injury claimed, outcome of claim, and associated costs. Over 15 years, there were 40 claims of clinical negligence related to tonsillectomy, representing 7.7% of all claims in otolaryngology. There were 34 closed claims, of which 32 (94%) resulted in payment of damages. Postoperative bleeding was the most common injury, with delayed recognition and treatment of bleeding alleged in most cases. Nasopharyngeal regurgitation as a result of soft palate fistulas or excessive tissue resection was the next-commonest cause of a claim. The other injuries claimed included dentoalveolar injury, bums, tonsillar remnants, and temporomandibular joint dysfunction. Inadequate informed consent was claimed in 5 cases. Clinical negligence claims following tonsillectomy have a high success rate. Although postoperative bleeding is the most common cause of negligence claims, a significant proportion of claims are due to rare complications of surgery. Informed consent should be tailored to the individual patient and should include a discussion of common and serious complications.

  17. Radioactive wastes with negligible heat generation suitable for disposal

    International Nuclear Information System (INIS)

    Brennecke, P.; Schumacher, J.; Warnecke, E.

    1987-01-01

    It is planned to dispose of radioactive wastes with negligible heat generation in the Konrad repository. Preliminary waste acceptance requirements are derived taking the results of site-specific safety assessments as a basis. These requirements must be fulfilled by the waste packages on delivery. The waste amounts which are currently stored and those anticipated up to the year 2000 are discussed. The disposability of these waste packages in the Konrad repository was evaluated. This examination reveals that basically almost all radioactive wastes with negligible heat generation can be accepted. (orig.) [de

  18. Negligence and the communication of neonatal genetic information to parents.

    Science.gov (United States)

    Fay, Michael

    2012-01-01

    It is inevitable that neonatal genetic information will be communicated to parents and a potential for psychiatric injury exists where the communication is negligent. An important question in this regard is whether a health-care provider may owe a duty of care to parents when communicating accurate genetic information, or whether the courts might treat it as merely the receipt of distressing news, which hitherto attracts no liability in English Tort Law. The important role of genetic counselling in this context will likely be determinative in deciding whether communicating accurate genetic information is actionable because it arguably distinguishes the parent-physician relationship from that of messenger-recipient. If communication is accepted as being something more than the receipt of distressing news and is capable of causing 'shock', then parents will need to establish themselves as either primary or secondary victims if claims are to be reconciled with the Alcock paradigm. Claims by parents as secondary victims will be unlikely to succeed because the neonate does not fulfil the role of primary victim, although parents may be owed a duty as elevated primary victims as a result of the lack of an immediate victim. Elevating claimants to primary victim status is not without criticism and may serve to further complicate a difficult area of tort law. Alternatively, it may be open to parents to demonstrate that a duty exists subsequent to an assumption of responsibility, as the provision of genetic counselling during and after neonatal screening is indicative of health-care providers assuming responsibility for the parents' mental health. If parents are able to establish that a duty of care exists, then success of their claims will be determined by reference to breach and causation. The potential difficulties and solutions, particularly with regard to causation, are also briefly considered. It is suggested that breach will likely be determined by reference to a

  19. Medicare Coverage Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Coverage Database (MCD) contains all National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), local articles, and proposed NCD...

  20. Optimal Rules of Negligent Misrepresentation in Insurance Contract Law

    DEFF Research Database (Denmark)

    Lando, Henrik

    2016-01-01

    Rules of misrepresentation in insurance contract law differ widely between jurisdictions. When the insured has negligently misrepresented a fact prior to contracting, common law allows the insurer to rescind the contract if the misrepresentation was material, while civil law countries apply more...

  1. Maximum Permissible Concentrations and Negligible Concentrations for pesticides

    NARCIS (Netherlands)

    Crommentuijn T; Kalf DF; Polder MD; Posthumus R; Plassche EJ van de; CSR

    1997-01-01

    Maximum Permissible Concentrations (MPCs) and Negligible Concentrations (NCs) derived for a series of pesticides are presented in this report. These MPCs and NCs are used by the Ministry of Housing, Spatial Planning and the Environment (VROM) to set Environmental Quality Objectives. For some of the

  2. The professional standard of care in clinical negligence.

    Science.gov (United States)

    Tingle, John

    The general principle of law relating to breach of duty in the tort of negligence has been discussed during this series of articles. This article continues that discussion in relation to healthcare professionals such as nurses and doctors, and how the law affects their case. The issue of the expanded role of the nurse is also discussed.

  3. 42 CFR 435.350 - Coverage for certain aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain aliens. 435.350 Section 435... ISLANDS, AND AMERICAN SAMOA Optional Coverage of the Medically Needy § 435.350 Coverage for certain aliens... treatment of an emergency medical condition, as defined in § 440.255(c) of this chapter, to those aliens...

  4. [Risk factors associated with mother negligence in child care].

    Science.gov (United States)

    Vargas-Porras, Carolina; Villamizar-Carvajal, Beatriz; Ardila-Suárez, Edinson Fabian

    2016-01-01

    To determine the factors associated with the risk of negligence in child care during the first year of rearing in adolescent and adult mothers. This was cross-sectional correlation study with a non-probabilistic sample composed of 250 mothers during their first year of child rearing. The information was collected through the Parenting Inventory for Teenagers and Adults. 88 teenager mothers and 162 adult mothers participated in this study. In general low scores were found in all dimensions in both adolescent mothers group and adult mother group, which indicate the existence of deficiencies in the adequate maternal behavior and risk of negligent care to their children. In the group of teenage mothers there was an evident and significant correlation between the factors: maternal age and occupation dimension belief in punishment and occupation with inappropriate expectations dimension. The group of adult mothers showed significant correlation between: educational level with the dimensions of role reversal, belief in punishment and lack of empathy; socioeconomic dimension with the belief in punishment and age of the child with the lack of empathy dimension. Child rearing expectations of mothers show a high risk of negligence in child care. Therefore, nurses should promote the strengthening of the maternal role. Copyright © 2016. Published by Elsevier España, S.L.U.

  5. Women's Health Insurance Coverage

    Science.gov (United States)

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

  6. Compensating Injury to Autonomy in English Negligence Law: Inconsistent Recognition.

    Science.gov (United States)

    Keren-Paz, Tsachi

    2018-04-10

    Recently in Shaw v Kovac, the Court of Appeal seemed to have rejected a standalone injury to autonomy (ITA) as actionable in negligence, in an informed consent case. In this article, I argue that Shaw can be explained away, and that English law recognizes ITA as actionable in a series of cases, some of which-Bhamra, Tracey, and Yearworth-were not hitherto understood to do so. However, the under-theorization in the cases leads to inconsistencies. Like cases (Rees/Yearworth; Chester/Tracey) are not treated alike; ITA is misunderstood to be about 'religious offence' (Bhamra) and property loss (Yearworth) and worse still, the more serious type 2 ITA (Rees) gives rise to a weaker remedy (of exceptional nature aside) than the less serious type 1 injury (Chester). A better understanding of the different manifestations of ITA will lead to results which are both more consistent and more justified on the merit.

  7. Fixational eye movement: a negligible source of dynamic aberration.

    Science.gov (United States)

    Mecê, Pedro; Jarosz, Jessica; Conan, Jean-Marc; Petit, Cyril; Grieve, Kate; Paques, Michel; Meimon, Serge

    2018-02-01

    To evaluate the contribution of fixational eye movements to dynamic aberration, 50 healthy eyes were examined with an original custom-built Shack-Hartmann aberrometer, running at a temporal frequency of 236Hz, with 22 lenslets across a 5mm pupil, synchronized with a 236Hz pupil tracker. A comparison of the dynamic behavior of the first 21 Zernike modes (starting from defocus) with and without digital pupil stabilization, on a 3.4s sequence between blinks, showed that the contribution of fixational eye movements to dynamic aberration is negligible. Therefore we highlighted the fact that a pupil tracker coupled to an Adaptive Optics Ophthalmoscope is not essential to achieve diffraction-limited resolution.

  8. Management of radioactive wastes with negligible heat generation

    International Nuclear Information System (INIS)

    Alter, U.

    1990-01-01

    In the Federal Republic of Germany only one company is responsible for the management of radioactive wastes with negligible heat generations. This is the Company for Nuclear Service (GNS mbH). It was the intention of the competent authorities of the FRG to intensify state control during conditioning, intermediate storage and transport of low- and medium level radioactive waste. A guideline provides that the responsibility of the waste producers and of those concerned with conditioning, storage and transport of radioactive waste is assigned in the individual case and that the qualitative and quantitative registration of all waste streams will be ensured. An overview of the radioactive waste management within the last two years in the FRG is presented. (orig./DG)

  9. Longitudinal investigation into implicit stigma of epilepsy among Japanese medical students before and after mass media coverage of car accidents associated with people with epilepsy.

    Science.gov (United States)

    Nagamori, Chizuko; Hara, Keiko; Ohta, Katsuya; Akaza, Miho; Sumi, Yuki

    2017-08-01

    Public attitudes and stigma toward epilepsy may limit patient motivation for treatment and participation in social activities. Stigma research requiring individuals to report personal beliefs is useful but is subject to social desirability bias. Self-reporting methods often do not capture implicit attitudes; therefore, in this study, implicit stigma was measured using the implicit association test (IAT), which is a word sorting task to minimize this bias. Recently, in Japan, several serious car accidents caused by people with epilepsy (PWE) resulted in pedestrian fatalities. Traffic accidents involving PWE have been reported extensively and repeatedly in the media since 2011. The present study aimed to examine differences in implicit stigma toward epilepsy among medical students in 2010, 2013, and 2016. We recruited 41 medical students in 2010, 44 medical students in 2013 and 42 medical students in 2016. We investigated the strength of conceptual associations between the words "Epilepsy" or "Hypertension", and "Safety" or "Danger" in the IAT. The association between the words "Epilepsy" and "Danger" was stronger in 2013 compared with that in 2010; however, the association was weaker in 2016 compared with that in 2013. There was no significant difference between 2010 and 2016. The change in IAT results between 2010 and 2013 might be due to the traffic accident involving PWE in Japan. However, the result in 2016 might indicate that the implicit attitudes toward epilepsy were improved to the same level as those in 2010. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Your Medicare Coverage: Durable Medical Equipment (DME) Coverage

    Science.gov (United States)

    ... Glossary MyMedicare.gov Login Search Main Menu , collapsed Main Menu Sign Up / Change Plans Getting started with ... setup: setupNotifier, notify: notify }; lrNotifier.setup(); $("#menu-btn, li.toolbarmenu .toolbarmenu-a").click(function() { // var isExpanded = ' is ...

  11. Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China

    Science.gov (United States)

    Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

    2014-01-01

    Background The People’s Republic of China’s population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People’s Republic of China. Objective To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People’s Republic of China. Methods We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People’s Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. Results We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. Conclusion A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services. PMID:24855346

  12. Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People's Republic of China.

    Science.gov (United States)

    Zhang, Zhenyu; Wang, Jianbing; Jin, Mingjuan; Li, Mei; Zhou, Litao; Jing, Fangyuan; Chen, Kun

    2014-01-01

    The People's Republic of China's population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People's Republic of China. To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People's Republic of China. We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People's Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level. We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration. A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services.

  13. Can medical insurance coverage reduce disparities of income in elderly patients requiring long-term care? The case of the People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Zhang ZY

    2014-05-01

    Full Text Available Zhenyu Zhang,1 Jianbing Wang,1 Mingjuan Jin,1 Mei Li,1 Litao Zhou,2 Fangyuan Jing,1 Kun Chen1 1Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Zhejiang, People’s Republic of China; 2Quality Control Department, Zhejiang Hospital, Zhejiang, People’s Republic of China Background: The People’s Republic of China’s population is aging rapidly, partly because of the impact of the one-child policy and improvements in the health care system. Caring for bedridden seniors can be a challenge for many families in the People’s Republic of China.Objective: To identify the inequality of income among different age groups and social statuses, and evaluate the medical burden and health insurance compensation in the People’s Republic of China.Methods: We measured income inequality and insurance compensation levels among bedridden patients in Zhejiang province, People’s Republic of China. Factor analysis and Gini coefficients were used to evaluate degree of income inequality and insurance compensation level.Results: We found distinct regional disparities in Zhejiang province, including the aspects of income, expenses, and time. Gini coefficients of older adults with long-term care needs in urban and rural areas were 0.335 and 0.602, respectively. In all age groups, Gini coefficients increased after adjustment for medical expenditures, and the inequality persisted after insurance reimbursement was taken into consideration.Conclusion: A significant income disparity between rural and urban areas was observed. Inequality increased with age, and medical expenditure is a huge burden for older people with long-term care needs. Health insurance does not play an important role in reducing inequalities among patients who need long-term care services. Keywords: Gini coefficient, bedridden, long-term care, insurance

  14. Obesity in menopause – our negligence or an unfortunate inevitability?

    Directory of Open Access Journals (Sweden)

    Jarosław Kozakowski

    2017-06-01

    Full Text Available Numerous concerns about menopause exist among women, and fear of an increase in body weight is one of the most important of them. This paper presents an overview of current knowledge concerning the etiology of obesity related to menopause and about the mechanisms of its development, with particular regard to the hormonal changes that occur during this period of life. The role of estrogens in the regulation of energy balance and the effect of sex hormones on metabolism of adipose tissue and other organs are presented. The consequence of the sharp decline in the secretion of estrogens with subsequent relative hyperandrogenemia is briefly discussed. The main intention of this review is to clarify what is inevitable and what perhaps results from negligence and unhealthy lifestyles. In the last part of the paper the possibilities of counteracting the progress of adverse changes in body composition, by promoting beneficial lifestyle modifications and the use of hormonal substitution treatment, in cases where it is reasonable and possible, are described.

  15. Basics of elder law and legal liabilities of negligence and malpractice for physicians as they apply to individuals with disabilities.

    Science.gov (United States)

    Ullman, David; Zuller, Michael E

    2005-02-01

    This article provides information regarding the issues that physicians face when dealing with elderly patients with cognitive deficits. It includes a discussion of basic legal terms and concepts that medical personnel should understand, various difficulties encountered by patients and families in crisis situations, and how the legal system deals with these issues. It concludes with a general discussion of the legal liabilities of negligence and malpractice.

  16. Sideline coverage of youth football.

    Science.gov (United States)

    Rizzone, Katie; Diamond, Alex; Gregory, Andrew

    2013-01-01

    Youth football is a popular sport in the United States and has been for some time. There are currently more than 3 million participants in youth football leagues according to USA Football. While the number of participants and overall injuries may be higher in other sports, football has a higher rate of injuries. Most youth sporting events do not have medical personnel on the sidelines in event of an injury or emergency. Therefore it is necessary for youth sports coaches to undergo basic medical training in order to effectively act in these situations. In addition, an argument could be made that appropriate medical personnel should be on the sideline for collision sports at all levels, from youth to professional. This article will discuss issues pertinent to sideline coverage of youth football, including coaching education, sideline personnel, emergency action plans, age and size divisions, tackle versus flag football, and injury prevention.

  17. A report on 15 years of clinical negligence claims in rhinology.

    Science.gov (United States)

    Geyton, Thomas; Odutoye, Tunde; Mathew, Rajeev

    2014-01-01

    This study was designed to determine the characteristics of medical negligence claims in rhinology. In 2010-2011 the National Health Service (NHS) litigation bill surpassed 1 billion Great British Pounds (GBP; 1.52 billion U.S. dollars [US$]). Systematic analysis of malpractice complaints allows for the identification of errors and can thereby improve patient safety and reduce the burden of litigation claims on health services. Claims relating to ear, nose, and throat between 1995 and 2010 were obtained from the NHS Litigation Authority and were analyzed. The series contains 65 closed claims that resulted in payment totaling 3.1 million GBP (US$4.7 million). Fifty claims were related to surgical complications. Functional endoscopic sinus surgery and septoplasty were the procedures most commonly associated with successful claims. There were 11 cases of orbital injury including 6 cases of visual loss and 5 cases of diplopia. The most common cause of a claim was failure to recognize the complication or manage it appropriately. Lack of informed consent was claimed in eight cases. Other claims arose because of errors in outpatient procedures (two), diagnosis (six), delayed surgery (one), and errors in medical management (three). This is the first study to report the outcomes of negligence claims in rhinology in the United Kingdom. Claims in rhinology are associated with a high success rate. Steps that can be taken to reduce litigation include careful patient workup and ensuring adequate informed consent. Where there is a suspicion of orbital damage early recognition and intervention is needed to reduce long-term injury to the patient.

  18. 26 CFR 1.6662-3 - Negligence or disregard of rules or regulations.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Negligence or disregard of rules or regulations... Penalties § 1.6662-3 Negligence or disregard of rules or regulations. (a) In general. If any portion of an... Internal Revenue Code that is required to be shown on a return is attributable to negligence or disregard...

  19. Negligent Liability and the Foreseeability Factor: A Critical Issue for School Counselors.

    Science.gov (United States)

    Henderson, Donald H.

    1987-01-01

    Notes that negligent liability suits involving school counselors seem to be increasing. Cites cases, most of which involved defendant's alleged negligence emanating from failure to provide reasonable care to individuals who were later injured or killed. Emphasizes role of foreseeability in determining outcome of negligence cases. Indicates areas…

  20. Procedural protection of juvenile victims of negligence and abuse

    Directory of Open Access Journals (Sweden)

    Ilić Ivan

    2014-01-01

    Full Text Available Violence against children is often designated as the worst form of domestic violence, and violence in general. Such a conclusion is a result of multiple factors: children's age and vulnerability, the distinctive features in their physical and mental development which makes them inferior to adults, the kinship (blood relations] and emotional bonds between parents and children, etc. The positive trend in the evolution of the social response to violence against children is reflected in the effort to discover and prevent the abuse, to punish the offenders and to protect the child/victim from secondary victimization during the criminal proceedings. In the Republic of Serbia, the procedural measures governing the protection of juvenile victims/witnesses are set out in Part III of the Juvenile Justice Act (Act on the Juvenile Offenders and Criminal Law Protection of Minors]. However, it was soon evident that there was a need to provide a better legislative framework than the one envisaged in this Act, particularly in terms of ensuring a better protection of minors in the course of criminal proceedings involving children who are victims of abuse and neglect. For this purpose, in 2004, the legislator adopted the National Action Plan on Children in Adversity. This document envisaged the adoption of the General Protocol on the protection of children from abuse and negligence, as well as the adoption of subject-specific protocols which would further regulate the specific procedures for the protection of children-victims in particular social circumstances (health, education, justice] by different social institutions (police, social services]. In this paper, the author analyses the legal framework governing the procedural protection of juvenile victims in the course of criminal proceedings. In addition, the author also explores the statutory provisions (by-laws] adopted in order to establish specific standards and ensure a higher level of protection of

  1. Insurance Coverage Policies for Personalized Medicine

    Directory of Open Access Journals (Sweden)

    Andrew Hresko

    2012-10-01

    Full Text Available Adoption of personalized medicine in practice has been slow, in part due to the lack of evidence of clinical benefit provided by these technologies. Coverage by insurers is a critical step in achieving widespread adoption of personalized medicine. Insurers consider a variety of factors when formulating medical coverage policies for personalized medicine, including the overall strength of evidence for a test, availability of clinical guidelines and health technology assessments by independent organizations. In this study, we reviewed coverage policies of the largest U.S. insurers for genomic (disease-related and pharmacogenetic (PGx tests to determine the extent that these tests were covered and the evidence basis for the coverage decisions. We identified 41 coverage policies for 49 unique testing: 22 tests for disease diagnosis, prognosis and risk and 27 PGx tests. Fifty percent (or less of the tests reviewed were covered by insurers. Lack of evidence of clinical utility appears to be a major factor in decisions of non-coverage. The inclusion of PGx information in drug package inserts appears to be a common theme of PGx tests that are covered. This analysis highlights the variability of coverage determinations and factors considered, suggesting that the adoption of personal medicine will affected by numerous factors, but will continue to be slowed due to lack of demonstrated clinical benefit.

  2. Medical negligence. An overview of legal theory and neurosurgical practice: causation.

    Science.gov (United States)

    Todd, Nicholas V

    2014-06-01

    This article discusses the principles of the law in relation to legal causation as applied to neurosurgical practice. Causation is a causal link between a breach of duty of care and the final harm. The fundamental "but-for" test for causation will be discussed, together with Chester v Afshar modified causation, prospective and retrospective probabilities of harm, loss of a chance, causation following breach of duty of care by omission, breaking the chain of causation, material contribution and the law in relation to multiple defendants, with neurosurgical examples.

  3. Sports coaching and the law of negligence: implications for coaching practice

    OpenAIRE

    Partington, Neil

    2016-01-01

    The ordinary principles of the law of negligence are applicable in the context of sport, including claims brought against volunteer and professional coaches. Adopting the perspective of the coach, this article intends to raise awareness of the emerging intersection between the law of negligence and sports coaching, by utilising an interdisciplinary analysis designed to better safeguard and reassure coaches mindful of legal liability. Detailed scrutiny of two cases concerning alleged negligent...

  4. Understanding the legal duty of care in the course of negligence.

    Science.gov (United States)

    Tingle, John

    The first article in this series gave an introduction to clinical negligence (Vol 11(15): 1033-1035). This article begins with a discussion of the law of negligence within the context of the law generally. What must be established in order to bring a legal claim for compensation in negligence is also discussed along with the important concept of owing a legal duty of care. The duty of care concept is illustrated through two cases.

  5. 42 CFR 436.330 - Coverage for certain aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain aliens. 436.330 Section 436... Coverage of the Medically Needy § 436.330 Coverage for certain aliens. If an agency provides Medicaid to... condition, as defined in § 440.255(c) of this chapter to those aliens described in § 436.406(c) of this...

  6. Jacob Mathew v. State of Punjab, the judgment stipulates the guidelines to be followed before launching a prosecution against a doctor for negligence

    Directory of Open Access Journals (Sweden)

    Bhattaram Visweswara Subrahmanyam

    2013-01-01

    Full Text Available In a landmark judgment, the supreme court of India laid down guidelines in cases of alleged negligence against medical practitioners in India. It clearly stated that there is a need for protecting doctors from frivolous or unjust prosecution.

  7. Cannabis Use Has Negligible Effects Following Severe Traumatic Injury.

    Science.gov (United States)

    AbdelFattah, Kareem R; Edwards, Courtney R; Cripps, Michael W; Minshall, Christian T; Phelan, Herb A; Minei, Joseph P; Eastman, Alexander L

    Nearly half of all states have legalized medical marijuana or recreational-use marijuana. As more states move toward legalization, the effects on injured patients must be evaluated. This study sought to determine effects of cannabis positivity at the time of severe injury on hospital outcomes compared with individuals negative for illicit substances and those who were users of other illicit substances. A Level I trauma center performed a retrospective chart review covering subjects over a 2-year period with toxicology performed and an Injury Severity Score (ISS) of more than 16. These individuals were divided into the negative and positive toxicology groups, further divided into the marijuana-only, other drugs-only, and mixed-use groups. Differences in presenting characteristics, hospital length of stay, intensive care unit (ICU) stays, ventilator days, and death were compared. A total of 8,441 subjects presented during the study period; 2,134 (25%) of these had toxicology performed; 843 (40%) had an ISS of more than 16, with 347 having negative tests (NEG); 70 (8.3%) substance users tested positive only for marijuana (MO), 323 (38.3%) for other drugs-only, excluding marijuana (OD), and 103 (12.2%) subjects showed positivity for mixed-use (MU). The ISS was similar for all groups. No differences were identified in Glasgow Coma Scale (GCS), ventilator days, blood administration, or ICU/hospital length of stay when comparing the MO group with the NEG group. Significant differences occurred between the OD group and the NEG/MO/MU groups for GCS, ICU length of stay, and hospital charges. Cannabis users suffering from severe injury demonstrated no detrimental outcomes in this study compared with nondrug users.

  8. 42 CFR 435.139 - Coverage for certain aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain aliens. 435.139 Section 435... Aliens § 435.139 Coverage for certain aliens. The agency must provide services necessary for the treatment of an emergency medical condition, as defined in § 440.255(c) of this chapter, to those aliens...

  9. 7 CFR 1.51 - Claims based on negligence, wrongful act or omission.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Claims based on negligence, wrongful act or omission. 1.51 Section 1.51 Agriculture Office of the Secretary of Agriculture ADMINISTRATIVE REGULATIONS Claims § 1.51 Claims based on negligence, wrongful act or omission. (a) Authority of the Department...

  10. Delictual Negligence of Educators in Schools: The Confusing Influence of the "in loco parentis" Doctrine

    Science.gov (United States)

    Potgieter, Johan

    2004-01-01

    This article points out that the "in loco parentis" maxim is partly to blame for introducing the confusing "reasonable parent" doctrine as the test for delictual negligence of educators in the school context. It is argued that the standard of care exercised by parents over their children is not appropriate to determine the negligence of educators.…

  11. An Examination of Negligence, Assumption of Risk, and Risk Management in Outdoor Recreation.

    Science.gov (United States)

    Teague, Travis L.

    This paper stresses the outdoor recreation and education professionals should understand aspects of liability, negligence, and risk management. There are four elements that must be present if a person or organization is to be considered negligent: the presence of a legal duty of care, a breach of duty, proximate cause, and actual damages. When…

  12. Coverage Metrics for Model Checking

    Science.gov (United States)

    Penix, John; Visser, Willem; Norvig, Peter (Technical Monitor)

    2001-01-01

    When using model checking to verify programs in practice, it is not usually possible to achieve complete coverage of the system. In this position paper we describe ongoing research within the Automated Software Engineering group at NASA Ames on the use of test coverage metrics to measure partial coverage and provide heuristic guidance for program model checking. We are specifically interested in applying and developing coverage metrics for concurrent programs that might be used to support certification of next generation avionics software.

  13. An Examination of Contemporary Issues Relating to Medical Liability ...

    African Journals Online (AJOL)

    In Nigeria, cases of negligence are under-reported; consequently marginal compensations ... consent, the doctor retains the duty to do what is in the best interest of the patient. ... Keywords: Medical, liability, negligence, Bolam, standard of care ...

  14. Maximum permissible concentrations and negligible concentrations for antifouling substances. Irgarol 1051, dichlofluanid, ziram, chlorothalonil and TCMTB

    NARCIS (Netherlands)

    Wezel AP van; Vlaardingen P van; CSR

    2001-01-01

    This report presents maximum permissible concentrations and negligible concentrations that have been derived for various antifouling substances used as substitutes for TBT. Included here are Irgarol 1051, dichlofluanide, ziram, chlorothalonil and TCMTB.

  15. Unintended, but still blameworthy: the roles of awareness, desire, and anger in negligence, restitution, and punishment.

    Science.gov (United States)

    Laurent, Sean M; Nuñez, Narina L; Schweitzer, Kimberly A

    2016-11-01

    Two experiments (Experiment 1 N = 149, Experiment 2 N = 141) investigated how two mental states that underlie how perceivers reason about intentional action (awareness of action and desire for an outcome) influence blame and punishment for unintended (i.e., negligent) harms, and the role of anger in this process. Specifically, this research explores how the presence of awareness (of risk in acting, or simply of acting) and/or desire in an acting agent's mental states influences perceptions of negligence, judgements that the acting agent owes restitution to a victim, and the desire to punish the agent, mediated by anger. In both experiments, awareness and desire led to increased anger at the agent and increased perception of negligence. Anger mediated the effect of awareness and desire on negligence rather than negligence mediating the effect of mental states on anger. Anger also mediated punishment, and negligence mediated the effects of anger on restitution. We discuss how perceivers consider mental states such as awareness, desire, and knowledge when reasoning about blame and punishment for unintended harms, and the role of anger in this process.

  16. 29 CFR 825.106 - Joint employer coverage.

    Science.gov (United States)

    2010-07-01

    ... facts and circumstances. A PEO does not enter into a joint employment relationship with the employees of... Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Coverage Under the Family and Medical Leave Act § 825.106 Joint employer...

  17. [Analysis of the causes of cancer negligence and low survival in the patients with malignant neoplasms of ENT and oral cavity in the city of Moscow].

    Science.gov (United States)

    Sdvizhkov, A M; Kozhanov, L G; Shatskaia, N Kh; Belov, E N

    2014-01-01

    The objective of the present study was to elucidate the causes of late detection of malignant neoplasms of ENT and oral cavity and low survival of the patents with these tumours in Moscow. The secondary objective was to elaborate the organizational measures for reducing the level of negligence and mortality from these malignancies among the city population. It was shown that the main cause behind the negligence is the late application of the patients for the medical assistance. Next in importance are asymptomatic clinical course of the disease in the absence of the pathognomonic and early signs of malignant neoplasms, a combination of several pathologies, imperfection of medical knowledge, and the poor resolving power of the modern methods. It is emphasized that the lack of vigilance against cancer among the practicing health providers is one of the main causes of medical errors. A few ways to address the problem of negligence with respect to malignant neoplasms of ENT and oral cavity in Moscow are proposed.

  18. Establishing breach of the duty of care in the tort of negligence.

    Science.gov (United States)

    Tingle, John

    This article, the third in a series on clinical negligence, looks at the law surrounding breach of the duty of care in negligence. It shows some of the principles that judges and lawyers use in order to decide whether a person has broken his/her duty of care in the tort of negligence. It will be seen that the principles are contained in decided court cases, some of which are quite old but are still relevant today. The focus of this article is on the rule that courts, in deciding the issue of a breach of duty of care, would judge the defendant's conduct by the standard of what the hypothetical, 'reasonable person' would have done in the circumstances of the case.

  19. 32 CFR 536.128 - Effect of disciplinary action, voluntary restitution, or contributory negligence for claims under...

    Science.gov (United States)

    2010-07-01

    ... restitution, or contributory negligence for claims under the UCMJ. 536.128 Section 536.128 National Defense... action, voluntary restitution, or contributory negligence for claims under the UCMJ. (a) Disciplinary... claimant. (c) Contributory negligence. A claim otherwise cognizable and meritorious is payable whether or...

  20. Establishing breach of the duty of care in the tort of negligence: 2.

    Science.gov (United States)

    Tingle, John

    This article discusses the law surrounding breach of the duty of care in negligence. A mistake or error does not necessarily mean legal fault and negligence. Judges look at risks and benefits in determining what would have been the appropriate standard of care to be exercised in the circumstances and may decide that the defendant's conduct was reasonable. There are a number of interrelated factors which judges have to balance and these can be categorized as foreseeability of harm, magnitude of risk, burden of taking precautions, utility of the defendant's conduct and common practice.

  1. A SHOCKING REQUIREMENT IN THE LAW ON NEGLIGENCE LIABILITY FOR PSYCHIATRIC ILLNESS: LIVERPOOL WOMEN'S HOSPITAL NHS FOUNDATION TRUST V RONAYNE [2015] EWCA CIV 588.

    Science.gov (United States)

    Burrows, Andrew S; Burrows, John H

    2016-01-01

    The Ronayne case concerned a husband who suffered a psychiatric illness, described as an adjustment disorder, in seeing the condition of his wife who was the primary victim of admitted medical negligence. His claim for compensation, as a 'secondary victim', failed because he could not satisfy the legal requirement that there must be a sudden shocking event. This commentary criticises that requirement which appears to make no medical sense. © The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Negligent Liability Issues Involving Colleges and Students: Does an Ethic of Caring Heighten Institutional Liability?

    Science.gov (United States)

    Beckham, Joseph; Pearson, Douglas

    This paper--part of a collection of 54 papers from the 48th annual conference of the Education Law Association held in November 2002--addresses the question of how and to what extent institutions of higher learning could be held liable for negligence involving students. The paper is, mainly, a review of recent case law related to the liability of…

  3. A child's potential claim for negligent misdiagnosis: The case of H v ...

    African Journals Online (AJOL)

    South African law recognises a financial claim against a health provider for negligently failing to ... costs of now caring for a child who has serious health challenges or ... provider was liable against either the parent or the child and not to.

  4. The Influence of Negligence, Intention, and Outcome on Children's Moral Judgments

    Science.gov (United States)

    Nobes, Gavin; Panagiotaki, Georgia.; Pawson, Chris

    2009-01-01

    Piaget (1932) and subsequent researchers have reported that young children's moral judgments are based more on the outcomes of actions than on the agents' intentions. The current study investigated whether negligence might also influence these judgments and explain children's apparent focus on outcome. Children (3-8 years of age) and adults (N =…

  5. Student Injuries and Negligence: Lessons from the International Scene with Implications for Singapore's Educators

    Science.gov (United States)

    Teh, Kim

    2008-01-01

    Many jurisdictions are showing a trend of school-related negligence cases being taken to court. This article explores the legal principles applied by the courts in England, Australia, Canada, the United States, and New Zealand to ensure the safety of students in schools. As we look at the developments in these countries, we can see student injury…

  6. Negligence 10 Years after Gertz v. Welch. Journalism Monographs Number Ninety-Three.

    Science.gov (United States)

    Hopkins, W. Wat

    The implications and shortcomings of court rulings on negligence in libel laws are explored in this paper. The paper first discusses the particulars of the 1974 landmark "Gertz versus Robert Welch, Inc." United States Supreme Court case, in which the court ruled that private persons as well as public figures would be required to prove…

  7. Electromagnetic waves in a layer of hot plasma with negligible collisions

    International Nuclear Information System (INIS)

    Vacca, J.

    1975-01-01

    The propagation of electromagnetic waves in a plane plasma layer in a uniform magnetic field has been studied, following the hypothesis of immoble ions and negligible ion-electron interactions. Waves dependent on one spatial coordinate are considered and all the parameters of the problems are considered. The cases of perpendicular and parallel magnetic field are treated

  8. The School Counselors' Ideas on Features, Determinant and Intervention on Child Negligence and Abuse Cases

    Science.gov (United States)

    Usakli, Hakan

    2012-01-01

    It is sad to know that many of the child negligence and child abuse cases, which are being frequently encountered in the society today, still remains unknown. This perhaps is due to lack of information on the part of the administrators, school counselors and other related bodies in the management of such cases. In this study, 50 school counselors…

  9. How to model a negligible probability under the WTO sanitary and phytosanitary agreement?

    Science.gov (United States)

    Powell, Mark R

    2013-06-01

    Since the 1997 EC--Hormones decision, World Trade Organization (WTO) Dispute Settlement Panels have wrestled with the question of what constitutes a negligible risk under the Sanitary and Phytosanitary Agreement. More recently, the 2010 WTO Australia--Apples Panel focused considerable attention on the appropriate quantitative model for a negligible probability in a risk assessment. The 2006 Australian Import Risk Analysis for Apples from New Zealand translated narrative probability statements into quantitative ranges. The uncertainty about a "negligible" probability was characterized as a uniform distribution with a minimum value of zero and a maximum value of 10(-6) . The Australia - Apples Panel found that the use of this distribution would tend to overestimate the likelihood of "negligible" events and indicated that a triangular distribution with a most probable value of zero and a maximum value of 10⁻⁶ would correct the bias. The Panel observed that the midpoint of the uniform distribution is 5 × 10⁻⁷ but did not consider that the triangular distribution has an expected value of 3.3 × 10⁻⁷. Therefore, if this triangular distribution is the appropriate correction, the magnitude of the bias found by the Panel appears modest. The Panel's detailed critique of the Australian risk assessment, and the conclusions of the WTO Appellate Body about the materiality of flaws found by the Panel, may have important implications for the standard of review for risk assessments under the WTO SPS Agreement. © 2012 Society for Risk Analysis.

  10. Educational Malpractice: Breach of Statutory Duty and Affirmative Acts of Negligence by a School District.

    Science.gov (United States)

    Beckham, Joseph

    1979-01-01

    A cause of action for educational malpractice may well receive initial judicial recognition through successfully harmonizing allegations of breach of a statutory duty of care and acts of negligence of a type and magnitude that would distinguish a student-plaintiff's injuries from others for whose benefit the statutory duty was created. (Author)

  11. Negligência infantil a partir do Child Neglect Index aplicado no Brasil

    Directory of Open Access Journals (Sweden)

    Mara Silvia Pasian

    2015-03-01

    Full Text Available Este estudo objetivou descrever a utilização do Child Neglect Indexpara identificar casos de crianças negligenciadas por seus pais/cuidadores no contexto brasileiro. Após adaptação inicial à realidade sociocultural brasileira, o instrumento foi aplicado em três grupos de indivíduos, cada qual com 30 díades de crianças/pais, totalizando 90 díades (n=180, assim compostos: G1 (primeiro grupo = casos oficialmente notificados por negligência infantil; G2 (segundo grupo = casos suspeitos de negligência não notificados; G3 (terceiro grupo = casos sem suspeita de negligência ou outra forma de maus-tratos (grupo de comparação; além de um quarto grupo de professoras dessas crianças (n=11. Os resultados apontaram altos escores no índice de negligência em G1 e G2, e baixos escores em G3, sugerindo presença de indicadores de falta de supervisão parental referentes a cuidados com alimentação, vestimenta, higiene, saúde física, saúde mental e educação nos dois primeiros grupos avaliados, comparativamente às crianças sem suspeita de maus-tratos. Os atuais achados empíricos, embora preliminares em termos de adaptação do Child Neglect Index ao contexto do Brasil, foram promissores ao sinalizar potencial do instrumento como recurso para detecção/confirmação da negligência infantil, estimulando novas investigações e aprimoramento desse recurso técnico para favorecer adequada identificação e intervenção nesses casos.

  12. Aspectos orofaciais dos maus-tratos infantis e da negligência odontológica Orofacial aspects of childhood abuse and dental negligence

    Directory of Open Access Journals (Sweden)

    Andreza Cristina de Lima Targino Massoni

    2010-03-01

    Full Text Available O objetivo deste artigo foi identificar os principais aspectos orofaciais dos maus-tratos infantis e da negligência odontológica, contribuindo com a identificação destas vítimas no ambiente odontológico. Foi realizada uma pesquisa bibliográfica nas bases de dados Adolec, MEDLINE, LILACS e BBO. Utilizaram-se como descritores: maus-tratos infantis, manifestações bucais, odontólogos, papel (figurativo e responsabilidade legal. Verificou-se que os maus-tratos infantis acontecem em geral em domicílio e os ferimentos orofaciais decorrentes incluem trauma, queimaduras e lacerações dos tecidos duros e moles, marcas de mordida e hematomas em vários estágios de cura. Pode haver ferimentos que envolvem outras partes do corpo próximas à cavidade bucal, como hematoma periorbital e contusão nasal. Quanto ao abuso sexual, muitas vítimas não apresentam nenhum sinal físico associado; assim, indicadores comportamentais devem ser observados. A imediata identificação e o relato de maus-tratos infantis e da negligência odontológica pelo cirurgião-dentista são essenciais para a proteção das crianças, sendo fundamental uma maior atuação destes profissionais, através do registro e denúncia dos casos suspeitos às agências de proteção à criança.The aim of this paper was to identify the main oral and dental aspects of childhood abuse and dental neglect, contributing to the identification of these victims in a dental office. A bibliographic research was carried out, in ADOLEC, MEDLINE, LILACS and BBO databases. The following key words were used: child abuse, oral manifestations, dentists; role; liability, legal. It was verified that violence against children happens in general at home and the resulting orofacial injuries encompass: injuries, burns and lacerations on soft and hard tissues, bite marks and gradually-healed wounds. It can have wounds in other parts of the body next to the oral cavity, such as periorbital wound and nasal

  13. Effect of stone coverage on soil erosion

    Science.gov (United States)

    Jomaa, S.; Barry, D. A.; Heng, B. P.; Brovelli, A.; Sander, G. C.; Parlange, J.

    2010-12-01

    Soil surface coverage has a significant impact on water infiltration, runoff and soil erosion yields. In particular, surface stones protect the soils from raindrop detachment, they retard the overland flow therefore decreasing its sediment transport capacity, and they prevent surface sealing. Several physical and environmental factors control to what extent stones on the soil surface modify the erosion rates and the related hydrological response. Among the most important factors are the moisture content of the topsoil, stone size, emplacement, coverage density and soil texture. Owing to the different inter-related processes, there is ambiguity concerning the quantitative effect of stones, and process-based understanding is limited. Experiments were performed (i) to quantify how stone features affect sediment yields, (ii) to understand the local effect of isolated surface stones, that is, the changes of the soil particle size distribution in the vicinity of a stone and (iii) to determine how stones attenuate the development of surface sealing and in turn how this affects the local infiltration rate. A series of experiments using the EPFL 6-m × 2-m erosion flume were conducted at different rainfall intensities (28 and 74 mm h-1) and stone coverage (20 and 40%). The total sediment concentration, the concentration of the individual size classes and the flow discharge were measured. In order to analyze the measurements, the Hairsine and Rose (HR) erosion model was adapted to account for the shielding effect of the stone cover. This was done by suitably adjusting the parameters based on the area not covered by stones. It was found that the modified HR model predictions agreed well with the measured sediment concentrations especially for the long time behavior. Changes in the bulk density of the topsoil due to raindrop-induced compaction with and without stone protection revealed that the stones protect the upper soil surface against the structural seals resulting in

  14. Socio-economic inequality in oral healthcare coverage

    DEFF Research Database (Denmark)

    Hosseinpoor, A R; Itani, L; Petersen, P E

    2012-01-01

    wealth quintiles in each country, a wealth-based relative index of inequality was used to measure socio-economic inequality. The index was adjusted for sex, age, marital status, education, employment, overall health status, and urban/rural residence. Pro-rich inequality in oral healthcare coverage......The objective of this study was to assess socio-economic inequality in oral healthcare coverage among adults with expressed need living in 52 countries. Data on 60,332 adults aged 18 years or older were analyzed from 52 countries participating in the 2002-2004 World Health Survey. Oral healthcare...... coverage was defined as the proportion of individuals who received any medical care from a dentist or other oral health specialist during a period of 12 months prior to the survey, among those who expressed any mouth and/or teeth problems during that period. In addition to assessment of the coverage across...

  15. The market for precedent: shifting visions of the role of clinical negligence claims and trials.

    Science.gov (United States)

    Mulcahy, Linda

    2014-01-01

    This article considers the interface between the standard setting activity of the NHS Litigation Authority, and the courts and uses the clinical negligence action as a prism through which to examine it. It is suggested that despite its many disadvantages, the clinical negligence action remains an important safety valve when internal regulatory systems fail or are insufficiently transparent to gain full legitimacy. More specifically, it explores the ways in which attitudes about the usefulness of the data contained in claims against the NHS have changed in the aftermath of a number of high profile inquiries which have focused on issues of poor performance. The article concludes that while much greater use is now been made of the data contained in claims when setting standards, strategies for prompting judicial precedent as an alternative way of mobilising standard setting behaviour remain under developed. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Assuring Access to Affordable Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Under the Affordable Care Act, millions of uninsured Americans will gain access to affordable coverage through Affordable Insurance Exchanges and improvements in...

  17. Is The Legal Practice Course Training Future Solicitors to Avoid Professional Negligence?

    OpenAIRE

    Davies, Mark R

    1996-01-01

    In 1993 the Law Society for England and Wales introduced the Legal Practice Course as the final major taught and examined stafe of solicitors' training replacing the previous Law Socity Finals Course. In this article it is argued that many of the occurrences of solicitors negligence result not from a lack of legal knowledge but from poor working practices. The article considers whether the LPC meets the challenge of better preparing future solicitors for a modern and changing practice environ...

  18. Lymphoma Patients Treated without Anthracyclines Have Negligible Risk of Cardiotoxicity: A Nationwide Cohort Study

    DEFF Research Database (Denmark)

    bech, Joachim; Hansen, Steen Møller; Lund, Peter Enemark

    Abstract Objective: For more than two decades, CHOP (and later R-CHOP) has been the standard frontline treatment for diffuse large b-cell lymphoma (DLBCL). However, anthracycline-based chemotherapy regimens increase risk of cardiotoxicity with congestive heart failure (HF) being the best document....... Patients treated without anthracyclines had a negligible risk of HF supporting the safety of these regimens in patients considered at substantial risk of cardiotoxicity....

  19. The Development of the Concept of Contributory Negligence in English Common Law

    Directory of Open Access Journals (Sweden)

    Emanuel G.D. van Dongen

    2016-01-01

    Full Text Available The injured party’s own conduct which has contributed to the damage that he has suffered has been a bar to the recovery of damages for centuries in the common law tradition. This article describes and analyses the historical development, from the early modern period until the Law Reform (Contributory Negligence Act of 1945, of the way in which English common law dealt with cases in which the behaviour of the injured party contributed to the occurrence of his damage – nowadays called ‘contributory negligence’. Historically, contributory conduct was linked to the (broader question of causation. The way in which cases involving contributory negligence were dealt with slowly developed from a very strict rule, depriving the injured party of his action even in the presence of the slightest degree of negligence on his part  (leading to a so-called all-or-nothing approach, into a more lenient approach, in which attempts aimed at doing justice to the degree to which both parties contributed to the accident were made during the 19th century. Furthermore, juries regularly mitigated the damages they awarded, rather than applying the all-or-nothing rule. The idea of a partition of damages seems to have emerged in English common law around the end of the 19th century. In 1945, the possibility of a reduction, based on the respective degrees of the responsibility of the parties, was officially introduced with the Law Reform (Contributory Negligence Act, which is still in force today.

  20. Clinical negligence claims in pediatric surgery in England: pattern and trends.

    Science.gov (United States)

    Thyoka, Mandela

    2015-02-01

    We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

  1. [Negligent homicide caused by exhaust gas escaping from a manipulated chimney].

    Science.gov (United States)

    Wirth, Ingo; Varchmin-schultheiss, Karin; Schmeling, Andreas

    2011-01-01

    A chimney built and operated according to the instructions is supposed to ensure that the combustion gases coming from the fireplace can escape safely. If the operational reliability is impaired, this presents a risk of acute poisoning. The report deals with a negligently caused carbon monoxide poisoning of a married couple as a consequence of improper installation of a cover of the chimney opening. Various causes of fatal poisoning due to defective exhaust systems are discussed in connection with the presented case report.

  2. [Liability of pediatric nurses for professional negligence in Taiwan: a case study].

    Science.gov (United States)

    Huang, Hui-Man; Sun, Fan-Ko

    2014-04-01

    Liability attribution and professional negligence in pediatric nursing are topics that have been neglected in Taiwan. (1) Identify the definitions of related criminal activities in accordance with domestic criminal law; (2) Elucidate the facts and the dispute in a current case involving a pediatric nurse; (3) Elucidate the principle of 'no punishment without law'; (4) Explore the reasons why the pediatric nurse in the current case received a verdict of 'not guilty'. A literature review and case study approach were used to analyze a sentence reconsideration of the first instance No. 1 (2011) issued by the Taiwan high court, Kaohsiung branch court. The conditions for the scrutiny of criminal activity under Taiwan criminal law are statement of facts, illegality (justifiable cause), and liability (excuse). In this case, the pediatric nurse was accused of failing to prevent an infant from suffocation and of not discharging her obligations as a nurse. The pediatric nurse rebutted the charge of criminal negligence. The intervening behaviors of the pediatric nurse were found to be legal and not culpable. In this case, the High Court and Supreme Court made a final criminal judgment based on the presumption of innocence, and the pediatric nurse was pronounced innocent of the charge. This article intends to assist pediatric nurses understand their liabilities under Taiwan's criminal law. Pediatric nurses should gain a better understanding of the nature of liability for professional negligence in order to clarify how actions that may be illegal do not necessarily make nurses culpable.

  3. How the contractualist account of preconception negligence undermines prenatal reproductive autonomy.

    Science.gov (United States)

    Melanson, Glen

    2013-08-01

    Suppose a physician advises a woman to delay her planned pregnancy for a few months in order to significantly reduce the likelihood that her baby will suffer with Spina Bifida. If the woman chooses to ignore this advice and conceives soon after, I believe most people would consider it a matter of common sense that the child thus born is a victim of this woman's negligence, even if it is fortunate enough to not be burdened with Spina Bifida. This common sense judgement appeared to have been done in by the fact that the timing of conception can be identity-influencing, and so the child that is born only exists because of its mother's decision to ignore her physician's advice. However, recently, contemporary contractualist theories have been used to make sense of preconception negligence towards persons whose existence is a result of that same negligence. I will briefly discuss this interesting development and then show how this retrieval of the common sense judgement comes at a great cost to prenatal reproductive autonomy.

  4. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter

    2005-03-01

    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  5. Newspaper coverage of biobanks

    Directory of Open Access Journals (Sweden)

    Ubaka Ogbogu

    2014-07-01

    Full Text Available Background. Biobanks are an important research resource that provides researchers with biological samples, tools and data, but have also been associated with a range of ethical, legal and policy issues and concerns. Although there have been studies examining the views of different stakeholders, such as donors, researchers and the general public, the media portrayal of biobanks has been absent from this body of research. This study therefore examines how biobanking has been represented in major print newspapers from Australia, Canada, the United Kingdom and the United States to identify the issues and concerns surrounding biobanks that have featured most prominently in the print media discourse.Methods. Using Factiva, articles published in major broadsheet newspapers in Canada, the US, the UK, and Australia were identified using specified search terms. The final sample size consisted of 163 articles.Results. Majority of articles mentioned or discussed the benefits of biobanking, with medical research being the most prevalent benefit mentioned. Fewer articles discussed risks associated with biobanking. Researchers were the group of people most quoted in the articles, followed by biobank employees. Biobanking was portrayed as mostly neutral or positive, with few articles portraying biobanking in a negative manner.Conclusion. Reporting on biobanks in the print media heavily favours discussions of related benefits over risks. Members of the scientific research community appear to be a primary source of this positive tone. Under-reporting of risks and a downtrend in reporting on legal and regulatory issues suggests that the print media views such matters as less newsworthy than perceived benefits of biobanking.

  6. Hospital emergency on-call coverage: is there a doctor in the house?

    Science.gov (United States)

    O'Malley, Ann S; Draper, Debra A; Felland, Laurie E

    2007-11-01

    The nation's community hospitals face increasing problems obtaining emergency on-call coverage from specialist physicians, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. The diminished willingness of specialist physicians to provide on-call coverage is occurring as hospital emergency departments confront an ever-increasing demand for services. Factors influencing physician reluctance to provide on-call coverage include decreased dependence on hospital admitting privileges as more services shift to non-hospital settings; payment for emergency care, especially for uninsured patients; and medical liability concerns. Hospital strategies to secure on-call coverage include enforcing hospital medical staff bylaws that require physicians to take call, contracting with physicians to provide coverage, paying physicians stipends, and employing physicians. Nonetheless, many hospitals continue to struggle with inadequate on-call coverage, which threatens patients' timely access to high-quality emergency care and may raise health care costs.

  7. Assessing Requirements Quality through Requirements Coverage

    Science.gov (United States)

    Rajan, Ajitha; Heimdahl, Mats; Woodham, Kurt

    2008-01-01

    In model-based development, the development effort is centered around a formal description of the proposed software system the model. This model is derived from some high-level requirements describing the expected behavior of the software. For validation and verification purposes, this model can then be subjected to various types of analysis, for example, completeness and consistency analysis [6], model checking [3], theorem proving [1], and test-case generation [4, 7]. This development paradigm is making rapid inroads in certain industries, e.g., automotive, avionics, space applications, and medical technology. This shift towards model-based development naturally leads to changes in the verification and validation (V&V) process. The model validation problem determining that the model accurately captures the customer's high-level requirements has received little attention and the sufficiency of the validation activities has been largely determined through ad-hoc methods. Since the model serves as the central artifact, its correctness with respect to the users needs is absolutely crucial. In our investigation, we attempt to answer the following two questions with respect to validation (1) Are the requirements sufficiently defined for the system? and (2) How well does the model implement the behaviors specified by the requirements? The second question can be addressed using formal verification. Nevertheless, the size and complexity of many industrial systems make formal verification infeasible even if we have a formal model and formalized requirements. Thus, presently, there is no objective way of answering these two questions. To this end, we propose an approach based on testing that, when given a set of formal requirements, explores the relationship between requirements-based structural test-adequacy coverage and model-based structural test-adequacy coverage. The proposed technique uses requirements coverage metrics defined in [9] on formal high-level software

  8. 31 CFR 370.40 - Can I be held accountable if my negligence contributes to a forged signature?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Can I be held accountable if my negligence contributes to a forged signature? 370.40 Section 370.40 Money and Finance: Treasury Regulations... if my negligence contributes to a forged signature? (a) General. If your failure to exercise ordinary...

  9. Financial considerations insurance and coverage issues in intestinal transplantation.

    Science.gov (United States)

    Chaney, Michael

    2004-12-01

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

  10. Age distributions of Greenlandic dwarf shrubs support concept of negligible actuarial senescence

    DEFF Research Database (Denmark)

    Dahlgren, Johan; Rizzi, Silvia; Schweingruber, Fritz

    2016-01-01

    shrub species from 863 taproot samples collected in coastal east Greenland. Penalized composite link models (pclm) were used to fill gaps in the observed age ranges, caused by low species-specific sample sizes in relation to life span. Resulting distributions indicate that mortality patterns...... are independent of age. Actuarial senescence is thus negligible in these dwarf shrub populations. We suggest that smoothing techniques such as pclm enable consideration of noisy age data for determining age distributions. These distributions may, in turn, reveal age effects on demographic rates. Moreover, age...

  11. Asymmetric actuating structure generates negligible influence on the supporting base for high performance scanning probe microscopies

    Science.gov (United States)

    Yi Yan, Gang; Bin Liu, Yong; Hua Feng, Zhi

    2014-02-01

    An asymmetric actuating structure generating negligible influence on the supporting base for high performance scanning probe microscopies is proposed in this paper. The actuator structure consists of two piezostacks, one is used for actuating while the other is for counterbalancing. In contrast with balanced structure, the two piezostacks are installed at the same side of the supporting base. The effectiveness of the structure is proved by some experiments with the actuators fixed to the free end of a cantilever. Experimental results show that almost all of the vibration modes of the cantilever are suppressed effectively at a wide frequency range of 90 Hz-10 kHz.

  12. Mediating Trust in Terrorism Coverage

    DEFF Research Database (Denmark)

    Mogensen, Kirsten

    crisis. While the framework is presented in the context of television coverage of a terror-related crisis situation, it can equally be used in connection with all other forms of mediated trust. Key words: National crisis, risk communication, crisis management, television coverage, mediated trust.......Mass mediated risk communication can contribute to perceptions of threats and fear of “others” and/or to perceptions of trust in fellow citizens and society to overcome problems. This paper outlines a cross-disciplinary holistic framework for research in mediated trust building during an acute...

  13. Monitoring intervention coverage in the context of universal health coverage.

    Directory of Open Access Journals (Sweden)

    Ties Boerma

    2014-09-01

    Full Text Available Monitoring universal health coverage (UHC focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the

  14. An exploration of the effects of clinical negligence litigation on the practice of midwives in England: A phenomenological study.

    Science.gov (United States)

    Robertson, Judith H; Thomson, Ann M

    2016-02-01

    to explore how midwives׳ personal involvement in clinical negligence litigation affects their midwifery practice. descriptive phenomenological study using semi-structured interviews. in 2006-2007 in-depth interviews were conducted in participants׳ homes or at their place of work and focused on participants׳ experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. clinical practice affected was an increase in documentation, fear of practising outside clinical guidelines and electronic fetal monitoring of women at low obstetric risk; these changes were not widespread. Changes in practice were sometimes perceived negatively and sometimes positively. Forming a good relationship with childbearing women was judged to promote effective midwifery care but litigation had affected the ability of a minority of midwives to advocate for women if this relationship had not been established. Litigation could result in loss of confidence leading to self-doubt, isolation, increased readiness to seek medical assistance and avoidance of working in the labour ward, perceived as an area with a high risk of litigation. A blame culture in the NHS was perceived by several midwives. In contrast an open non-punitive culture resulted in midwives readily reporting mistakes to risk managers. Litigation lowered midwifery morale and damaged professional reputations, particularly when reported in the newspapers. Some midwives expressed thoughts of leaving midwifery or taking time off work because of litigation but only one was actively seeking other employment, another took sick leave and one had left midwifery and returned to nursing. litigation can have a negative effect on midwives׳ clinical practice and morale and fosters a culture of blame within the NHS. education regarding appropriate documentation, use or non-use of electronic fetal monitoring and the legal status of clinical

  15. Paving the road to negligence: the compensation for research-related injuries in Spain.

    Science.gov (United States)

    Ramiro Avilés, Miguel A

    2015-01-01

    The planned reform of the regulation of clinical trials in Spain has reopened the debate over how to regulate research-related injuries. Act 29/2006 and Royal Decree 223/2004 regulate the insurance of research-related injuries, and they include a general clause requiring mandatory insurance and imposing a no-fault compensation system; they also contain an exception clause enabling clinical trials to be carried out without insurance under some conditions, and an exclusion clause excluding compensation when there is no causal connection between injuries and a clinical trial. National legislation is under review, affecting the requirement of mandatory insurance and paving the road to a liability system based on negligence, which will affect the level of protection of the persons enrolled in clinical trials because it would not ensure compensation. Regulatory texts on individuals' participation as research subjects should include not only mandatory insurance, but also a no-fault compensation system for cases when voluntary research subjects are injured, irrespective of negligence.

  16. Using cohort change ratios to estimate life expectancy in populations with negligible migration: A new approach

    Directory of Open Access Journals (Sweden)

    David A. Swanson

    2012-07-01

    Full Text Available Census survival methods are the oldest and most widely applicable methods of estimating adult mortality, and for populations with negligible migration they can provide excellent results. The reason for this ubiquity is threefold: (1 their data requirements are minimal in that only two successive age distributions are needed; (2 the two successive age distributions are usually easily obtained from census counts; and (3 the method is straightforward in that it requires neither a great deal of judgment nor “data-fitting” techniques to implement. This ubiquity is in contrast to other methods, which require more data, as well as judgment and, often, data fitting. In this short note, the new approach we demonstrate is that life expectancy at birth can be computed by using census survival rates in combination with an identity whereby the radix of a life table is equal to 1 (l0 = 1.00. We point out that our suggested method is less involved than the existing approach. We compare estimates using our approach against other estimates, and find it works reasonably well. As well as some nuances and cautions, we discuss the benefits of using this approach to estimate life expectancy, including the ability to develop estimates of average remaining life at any age. We believe that the technique is worthy of consideration for use in estimating life expectancy in populations that experience negligible migration.

  17. Using cohort change ratios to estimate life expectancy in populations with negligible migration: A new approach

    Directory of Open Access Journals (Sweden)

    Lucky Tedrow

    2012-01-01

    Full Text Available Census survival methods are the oldest and most widely applicable methods of estimating adult mortality, and for populations with negligible migration they can provide excellent results. The reason for this ubiquity is threefold: (1 their data requirements are minimal in that only two successive age distributions are needed; (2 the two successive age distributions are usually easily obtained from census counts; and (3 the method is straightforward in that it requires neither a great deal of judgment nor “data-fitting” techniques to implement. This ubiquity is in contrast to other methods, which require more data, as well as judgment and, often, data fitting. In this short note, the new approach we demonstrate is that life expectancy at birth can be computed by using census survival rates in combination with an identity whereby the radix of a life table is equal to 1 (l0 = 1.00. We point out that our suggested method is less involved than the existing approach. We compare estimates using our approach against other estimates, and find it works reasonably well. As well as some nuances and cautions, we discuss the benefits of using this approach to estimate life expectancy, including the ability to develop estimates of average remaining life at any age. We believe that the technique is worthy of consideration for use in estimating life expectancy in populations that experience negligible migration.

  18. Armenian media coverage of science topics

    Science.gov (United States)

    Mkhitaryan, Marie

    2016-12-01

    The article discusses features and issues of Armenian media coverage on scientific topics and provides recommendations on how to promote scientific topics in media. The media is more interested in social or public reaction rather than in scientific information itself. Medical science has a large share of the global media coverage. It is followed by articles about environment, space, technology, physics and other areas. Armenian media mainly tends to focus on a scientific topic if at first sight it contains something revolutionary. Media primarily reviews whether that scientific study can affect the Armenian economy and only then decides to refer to it. Unfortunately, nowadays the perception of science is a little distorted in media. We can often see headlines of news where is mentioned that the scientist has made "an invention". Nowadays it is hard to see the border between a scientist and an inventor. In fact, the technological term "invention" attracts the media by making illusionary sensation and ensuring large audience. The report also addresses the "Gitamard" ("A science-man") special project started in 2016 in Mediamax that tells about scientists and their motivations.

  19. Terrorism and nuclear damage coverage

    International Nuclear Information System (INIS)

    Horbach, N. L. J. T.; Brown, O. F.; Vanden Borre, T.

    2004-01-01

    This paper deals with nuclear terrorism and the manner in which nuclear operators can insure themselves against it, based on the international nuclear liability conventions. It concludes that terrorism is currently not covered under the treaty exoneration provisions on 'war-like events' based on an analysis of the concept on 'terrorism' and travaux preparatoires. Consequently, operators remain liable for nuclear damage resulting from terrorist acts, for which mandatory insurance is applicable. Since nuclear insurance industry looks at excluding such insurance coverage from their policies in the near future, this article aims to suggest alternative means for insurance, in order to ensure adequate compensation for innocent victims. The September 11, 2001 attacks at the World Trade Center in New York City and the Pentagon in Washington, DC resulted in the largest loss in the history of insurance, inevitably leading to concerns about nuclear damage coverage, should future such assaults target a nuclear power plant or other nuclear installation. Since the attacks, some insurers have signalled their intentions to exclude coverage for terrorism from their nuclear liability and property insurance policies. Other insurers are maintaining coverage for terrorism, but are establishing aggregate limits or sublimits and are increasing premiums. Additional changes by insurers are likely to occur. Highlighted by the September 11th events, and most recently by those in Madrid on 11 March 2004, are questions about how to define acts of terrorism and the extent to which such are covered under the international nuclear liability conventions and various domestic nuclear liability laws. Of particular concern to insurers is the possibility of coordinated simultaneous attacks on multiple nuclear facilities. This paper provides a survey of the issues, and recommendations for future clarifications and coverage options.(author)

  20. Evaluation of the Defense Contract Audit Agency Audit Coverage of Tricare Contracts

    National Research Council Canada - National Science Library

    Brannin, Patricia

    2000-01-01

    Our objective was to evaluate the adequacy of the Defense Contract Audit Agency (DCAA) audit coverage of contracts for health care provided under TRICARE and the former Civilian Health Care and Medical Program of the Uniformed Services...

  1. Clearance of material with negligible levels of radioactivity based on the amended German radiation protection ordinance

    International Nuclear Information System (INIS)

    Schaller, G.; Bayer, A.

    2002-01-01

    For the first time the modalities for the clearance of relevant materials have been laid down in the amended Radiation Protection Ordinance in a comprehensive form. A distinction is made between unconditional clearance and cases of clearance in which disposal, recycling, and re-use is prescribed. The focus of attention in the case of unconditional clearance consists in special consideration of large volumes of building rubble and excavated soil. Material can only be released from supervision under the Atomic Energy Act, when the radiation-related risk, and correspondingly, also the dose from material issued with clearance, are at negligible levels. In order to facilitate the practical application of clearance, values have been derived on the basis of scenarios which cover all radiation exposures which can reasonably be considered. (orig.) [de

  2. Charging and coagulation of water aerosols with negligible addition of high-radioactive droplets

    International Nuclear Information System (INIS)

    Vasil'eva, N.L.; Sedova, G.L.; Chernyj, L.T.

    1994-01-01

    The mechanics of electrocoagulation of water aerosols with negligible admixture of high-radioactive droplets is considered. A corresponding mathematical model has been worked out which describes the processes of ionization, electrification and coagulation of radioactive aerosols. Numerical studies are carried out for a series of typical aerosols on the time dependence of ion concentrations, charge and pure droplet concentrations, as well as the charge and radius of radioactive droplets. It is shown that coagulation can give rise to the growth of droplet radius from 5-10 μm up to 30-40 μm for a 10 4 s period f time, and therefore it can play a considerable role in the development of aerosols with droplet radius up to 20 μm when gravitational coagulation is insignificant

  3. Hazard and precautionary measures in connection with negligent or wilful contamination

    International Nuclear Information System (INIS)

    Ahlfaenger, Rainer; Scheidegger, Roland

    2009-01-01

    Handling open radioactive substances requires extensive precautionary measures in order to avoid any danger. During the past 100 years many persons were injured or killed due to unintended external irradiation, contamination of the skin or uptake of radioactive substances. With the help of organisational measures with users of sources and with operators of radionuclide laboratories or nuclear installations numerous accidents can be avoided or their consequences can be mitigated. Also the government itself is challenged in order to register and secure radioactive sources and maintaining the national safeguard. Education of personnel handling radioactive substances plays an important role when it comes to precautionary measures. In combination with suitable technical equipment it is possible to obtain a high degree of protection against the hazard from negligent or wilful contamination. (orig.)

  4. Perturbed Newtonian description of the Lemaître model with non-negligible pressure

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Kazuhiro [Department of Physical Sciences, Hiroshima University, Higashi-hiroshima, Kagamiyama 1-3-1, 739-8526 (Japan); Marra, Valerio [Departamento de Física, Universidade Federal do Espírito Santo, Av. F. Ferrari, 514, 29075-910, Vitória, ES (Brazil); Mukhanov, Viatcheslav [Theoretical Physics, Ludwig Maxmillians University, Theresienstr. 37, 80333 Munich (Germany); Sasaki, Misao, E-mail: kazuhiro@hiroshima-u.ac.jp, E-mail: valerio.marra@me.com, E-mail: Viatcheslav.Mukhanov@physik.lmu.de, E-mail: misao@yukawa.kyoto-u.ac.jp [Yukawa Institute for Theoretical Physics, Kyoto University, Kitashirakawa-Oiwakecho, Sakyo-Ku, Kyoto 606-8502 (Japan)

    2016-03-01

    We study the validity of the Newtonian description of cosmological perturbations using the Lemaître model, an exact spherically symmetric solution of Einstein's equation. This problem has been investigated in the past for the case of a dust fluid. Here, we extend the previous analysis to the more general case of a fluid with non-negligible pressure, and, for the numerical examples, we consider the case of radiation (P=ρ/3). We find that, even when the density contrast has a nonlinear amplitude, the Newtonian description of the cosmological perturbations using the gravitational potential ψ and the curvature potential φ is valid as long as we consider sub-horizon inhomogeneities. However, the relation ψ+φ=O(φ{sup 2})—which holds for the case of a dust fluid—is not valid for a relativistic fluid, and an effective anisotropic stress is generated. This demonstrates the usefulness of the Lemaître model which allows us to study in an exact nonlinear fashion the onset of anisotropic stress in fluids with non-negligible pressure. We show that this happens when the characteristic scale of the inhomogeneity is smaller than the sound horizon and that the deviation is caused by the nonlinear effect of the fluid's fast motion. We also find that ψ+φ= [O(φ{sup 2}),O(c{sub s}{sup 2φ} δ)] for an inhomogeneity with density contrast δ whose characteristic scale is smaller than the sound horizon, unless w is close to −1, where w and c{sub s} are the equation of state parameter and the sound speed of the fluid, respectively. On the other hand, we expect ψ+φ=O(φ{sup 2}) to hold for an inhomogeneity whose characteristic scale is larger than the sound horizon, unless the amplitude of the inhomogeneity is large and w is close to −1.

  5. Perturbed Newtonian description of the Lemaître model with non-negligible pressure

    International Nuclear Information System (INIS)

    Yamamoto, Kazuhiro; Marra, Valerio; Mukhanov, Viatcheslav; Sasaki, Misao

    2016-01-01

    We study the validity of the Newtonian description of cosmological perturbations using the Lemaître model, an exact spherically symmetric solution of Einstein's equation. This problem has been investigated in the past for the case of a dust fluid. Here, we extend the previous analysis to the more general case of a fluid with non-negligible pressure, and, for the numerical examples, we consider the case of radiation (P=ρ/3). We find that, even when the density contrast has a nonlinear amplitude, the Newtonian description of the cosmological perturbations using the gravitational potential ψ and the curvature potential φ is valid as long as we consider sub-horizon inhomogeneities. However, the relation ψ+φ=O(φ 2 )—which holds for the case of a dust fluid—is not valid for a relativistic fluid, and an effective anisotropic stress is generated. This demonstrates the usefulness of the Lemaître model which allows us to study in an exact nonlinear fashion the onset of anisotropic stress in fluids with non-negligible pressure. We show that this happens when the characteristic scale of the inhomogeneity is smaller than the sound horizon and that the deviation is caused by the nonlinear effect of the fluid's fast motion. We also find that ψ+φ= [O(φ 2 ),O(c s 2φ  δ)] for an inhomogeneity with density contrast δ whose characteristic scale is smaller than the sound horizon, unless w is close to −1, where w and c s are the equation of state parameter and the sound speed of the fluid, respectively. On the other hand, we expect ψ+φ=O(φ 2 ) to hold for an inhomogeneity whose characteristic scale is larger than the sound horizon, unless the amplitude of the inhomogeneity is large and w is close to −1

  6. Smoking prevalence in Medicaid has been declining at a negligible rate.

    Directory of Open Access Journals (Sweden)

    Shu-Hong Zhu

    Full Text Available In recent decades the overall smoking prevalence in the US has fallen steadily. This study examines whether the same trend is seen in the Medicaid population.National Health Interview Survey (NHIS data from 17 consecutive annual surveys from 1997 to 2013 (combined N = 514,043 were used to compare smoking trends for 4 insurance groups: Medicaid, the Uninsured, Private Insurance, and Other Coverage. Rates of chronic disease and psychological distress were also compared.Adjusted smoking prevalence showed no detectable decline in the Medicaid population (from 33.8% in 1997 to 31.8% in 2013, trend test P = 0.13, while prevalence in the other insurance groups showed significant declines (38.6%-34.7% for the Uninsured, 21.3%-15.8% for Private Insurance, and 22.6%-16.8% for Other Coverage; all P's<0.005. Among individuals who have ever smoked, Medicaid recipients were less likely to have quit (38.8% than those in Private Insurance (62.3% or Other Coverage (69.8%; both P's<0.001. Smokers in Medicaid were more likely than those in Private Insurance and the Uninsured to have chronic disease (55.0% vs 37.3% and 32.4%, respectively; both P's<0.01. Smokers in Medicaid were also more likely to experience severe psychological distress (16.2% for Medicaid vs 3.2% for Private Insurance and 7.6% for the Uninsured; both P's<0.001.The high and relatively unchanging smoking prevalence in the Medicaid population, low quit ratio, and high rates of chronic disease and severe psychological distress highlight the need to focus on this population. A targeted and sustained campaign to help Medicaid recipients quit smoking is urgently needed.

  7. Root coverage with bridge flap

    Directory of Open Access Journals (Sweden)

    Pushpendra Kumar Verma

    2013-01-01

    Full Text Available Gingival recession in anterior teeth is a common concern due to esthetic reasons or root sensitivity. Gingival recession, especially in multiple anterior teeth, is of huge concern due to esthetic reasons. Various mucogingival surgeries are available for root coverage. This case report presents a new bridge flap technique, which allows the dentist not only to cover the previously denuded root surfaces but also to increase the zone of attached gingiva at a single step. In this case, a coronally advanced flap along with vestibular deepening technique was used as root coverage procedure for the treatment of multiple recession-type defect. Here, vestibular deepening technique is used to increase the width of the attached gingiva. The predictability of this procedure results in an esthetically healthy periodontium, along with gain in keratinized tissue and good patient′s acceptance.

  8. -Net Approach to Sensor -Coverage

    Directory of Open Access Journals (Sweden)

    Fusco Giordano

    2010-01-01

    Full Text Available Wireless sensors rely on battery power, and in many applications it is difficult or prohibitive to replace them. Hence, in order to prolongate the system's lifetime, some sensors can be kept inactive while others perform all the tasks. In this paper, we study the -coverage problem of activating the minimum number of sensors to ensure that every point in the area is covered by at least sensors. This ensures higher fault tolerance, robustness, and improves many operations, among which position detection and intrusion detection. The -coverage problem is trivially NP-complete, and hence we can only provide approximation algorithms. In this paper, we present an algorithm based on an extension of the classical -net technique. This method gives an -approximation, where is the number of sensors in an optimal solution. We do not make any particular assumption on the shape of the areas covered by each sensor, besides that they must be closed, connected, and without holes.

  9. [Quantification of acetabular coverage in normal adult].

    Science.gov (United States)

    Lin, R M; Yang, C Y; Yu, C Y; Yang, C R; Chang, G L; Chou, Y L

    1991-03-01

    Quantification of acetabular coverage is important and can be expressed by superimposition of cartilage tracings on the maximum cross-sectional area of the femoral head. A practical Autolisp program on PC AutoCAD has been developed by us to quantify the acetabular coverage through numerical expression of the images of computed tomography. Thirty adults (60 hips) with normal center-edge angle and acetabular index in plain X ray were randomly selected for serial drops. These slices were prepared with a fixed coordination and in continuous sections of 5 mm in thickness. The contours of the cartilage of each section were digitized into a PC computer and processed by AutoCAD programs to quantify and characterize the acetabular coverage of normal and dysplastic adult hips. We found that a total coverage ratio of greater than 80%, an anterior coverage ratio of greater than 75% and a posterior coverage ratio of greater than 80% can be categorized in a normal group. Polar edge distance is a good indicator for the evaluation of preoperative and postoperative coverage conditions. For standardization and evaluation of acetabular coverage, the most suitable parameters are the total coverage ratio, anterior coverage ratio, posterior coverage ratio and polar edge distance. However, medial coverage and lateral coverage ratios are indispensable in cases of dysplastic hip because variations between them are so great that acetabuloplasty may be impossible. This program can also be used to classify precisely the type of dysplastic hip.

  10. Social evaluation of intentional, truly accidental, and negligently accidental helpers and harmers by 10-month-old infants.

    Science.gov (United States)

    Woo, Brandon M; Steckler, Conor M; Le, Doan T; Hamlin, J Kiley

    2017-11-01

    Whereas adults largely base their evaluations of others' actions on others' intentions, a host of research in developmental psychology suggests that younger children privilege outcome over intention, leading them to condemn accidental harm. To date, this question has been examined only with children capable of language production. In the current studies, we utilized a non-linguistic puppet show paradigm to examine the evaluation of intentional and accidental acts of helping or harming in 10-month-old infants. In Experiment 1 (n=64), infants preferred intentional over accidental helpers but accidental over intentional harmers, suggestive that by this age infants incorporate information about others' intentions into their social evaluations. In Experiment 2 (n=64), infants did not distinguish "negligently" accidental from intentional helpers or harmers, suggestive that infants may find negligent accidents somewhat intentional. In Experiment 3 (n=64), we found that infants preferred truly accidental over negligently accidental harmers, but did not reliably distinguish negligently accidental from truly accidental helpers, consistent with past work with adults and children suggestive that humans are particularly sensitive to negligently accidental harm. Together, these results imply that infants engage in intention-based social evaluation of those who help and harm accidentally, so long as those accidents do not stem from negligence. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. [Coverage by health insurance or discount cards: a household survey in the coverage area of the Family Health Strategy].

    Science.gov (United States)

    Fontenelle, Leonardo Ferreira; Camargo, Maria Beatriz Junqueira de; Bertoldi, Andréa Dâmaso; Gonçalves, Helen; Maciel, Ethel Leonor Noia; Barros, Aluísio J D

    2017-10-26

    This study was designed to assess the reasons for health insurance coverage in a population covered by the Family Health Strategy in Brazil. We describe overall health insurance coverage and according to types, and analyze its association with health-related and socio-demographic characteristics. Among the 31.3% of persons (95%CI: 23.8-39.9) who reported "health insurance" coverage, 57.0% (95%CI: 45.2-68.0) were covered only by discount cards, which do not offer any kind of coverage for medical care, but only discounts in pharmacies, clinics, and hospitals. Both for health insurance and discount cards, the most frequently cited reasons for such coverage were "to be on the safe side" and "to receive better care". Both types of coverage were associated statistically with age (+65 vs. 15-24 years: adjusted odds ratios, aOR = 2.98, 95%CI: 1.28-6.90; and aOR = 3.67; 95%CI: 2.22-6.07, respectively) and socioeconomic status (additional standard deviation: aOR = 2.25, 95%CI: 1.62-3.14; and aOR = 1.96, 95%CI: 1.34-2.97). In addition, health insurance coverage was associated with schooling (aOR = 7.59, 95%CI: 4.44-13.00) for complete University Education and aOR = 3.74 (95%CI: 1.61-8.68) for complete Secondary Education, compared to less than complete Primary Education. Meanwhile, neither health insurance nor discount card was associated with health status or number of diagnosed diseases. In conclusion, studies that aim to assess private health insurance should be planned to distinguish between discount cards and formal health insurance.

  12. 29 CFR 95.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... § 95.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage...

  13. Assessing Measurement Error in Medicare Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — Assessing Measurement Error in Medicare Coverage From the National Health Interview Survey Using linked administrative data, to validate Medicare coverage estimates...

  14. 76 FR 7767 - Student Health Insurance Coverage

    Science.gov (United States)

    2011-02-11

    ... Student Health Insurance Coverage AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION... health insurance coverage under the Public Health Service Act and the Affordable Care Act. The proposed rule would define ``student health insurance [[Page 7768

  15. [The prevalence and influencing factors of abuse and negligence against elderly in rural areas of Anhui province].

    Science.gov (United States)

    Su, Pu-yu; Hao, Jia-hu; Xiong, Li-ming; Yu, Dan-dan; Cao, Yue-ting; Fang, Yun; Jiang, Xiu-ling; Qian, Qiao-xia; Tao, Fang-biao

    2011-02-01

    To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. 975 elderly over 60 years from 41 counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. In the last year, rates of common physical abuse, serious physical abuse, emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it. Low ability in managing daily activity of living was the risk factor causing serious physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. High prevalence on abuse and

  16. Dosimetric characteristics of PASSAG as a new polymer gel dosimeter with negligible toxicity

    Science.gov (United States)

    Farhood, Bagher; Abtahi, Seyed Mohammad Mahdi; Geraily, Ghazale; Ghorbani, Mehdi; Mahdavi, Seied Rabi; Zahmatkesh, Mohammad Hasan

    2018-06-01

    Despite many advantages of polymer gel dosimeters, their clinical use is only not realized now. Toxicity of polymer gel dosimeters can be considered as one of their main limitations for use in routine clinical applications. In the current study, a new polymer gel dosimeter is introduced with negligible toxicity. For this purpose, 2-Acrylamido-2-Methy-1-PropaneSulfonic acid (AMPS) sodium salt monomer was replaced instead of acrylamide monomer used in PAGAT gel dosimeter by using %6 T and %50 C to the gel formula and the new formulation is called PASSAG (Poly AMPS Sodium Salt and Gelatin) polymer gel dosimeter. The irradiation of gel dosimeters was carried out using a Co-60 therapy machine. MRI technique was used to quantify the dose responses of the PASSAG gel dosimeter. Then, the MRI responses (R2) of the gel dosimeter was analyzed at different dose values, post-irradiation times, and scanning temperatures. The results showed that the new gel formulation has a negligible toxicity and it is also eco-friendly. In addition, carcinogenicity and genetic toxicity tests are negative for the monomer used in PASSAG. The radiological properties of PASSAG gel dosimeter showed that this substance can be considered as a soft tissue/water equivalent material. Furthermore, dosimetric evaluation of the new polymer gel dosimeter revealed an excellent linear R2-dose response in the evaluated dose range (0-15 Gy). The R2-dose sensitivity and dose resolution of PASSAG gel dosimeter were 0.081 s-1Gy-1 (in 0-15 Gy dose range) and 1 Gy (in 0-10 Gy dose range), respectively. Moreover, it was shown that the R2-dose sensitivity and dose resolution of the new gel dosimeter improves over time after irradiation. It was also found that the R2 response of the PASSAG gel dosimeter has less dependency to the 18, 20, and 24 °C scanning temperature in comparison to that of room temperature (22 °C).

  17. 5 CFR 890.1106 - Coverage.

    Science.gov (United States)

    2010-01-01

    ... family member is an individual whose relationship to the enrollee meets the requirements of 5 U.S.C. 8901... EMPLOYEES HEALTH BENEFITS PROGRAM Temporary Continuation of Coverage § 890.1106 Coverage. (a) Type of enrollment. An individual who enrolls under this subpart may elect coverage for self alone or self and family...

  18. 40 CFR 51.356 - Vehicle coverage.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Vehicle coverage. 51.356 Section 51.356....356 Vehicle coverage. The performance standard for enhanced I/M programs assumes coverage of all 1968 and later model year light duty vehicles and light duty trucks up to 8,500 pounds GVWR, and includes...

  19. 29 CFR 801.3 - Coverage.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Coverage. 801.3 Section 801.3 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 General § 801.3 Coverage. (a) The coverage of the Act extends to “any...

  20. Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

    Science.gov (United States)

    Reis, Andreas A

    2016-06-07

    This article provides a commentary to Ole Norheim' s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). © 2016 by Kerman University of Medical Sciences.

  1. Counting the cost of negligence in neurosurgery: Lessons to be learned from 10 years of claims in the NHS.

    Science.gov (United States)

    Hamdan, Alhafidz; Strachan, Roger D; Nath, Fredrick; Coulter, Ian C

    2015-04-01

    Despite substantial progress in modernising neurosurgery, the specialty still tops the list of medico-legal claims. Understanding the factors associated with negligence claims is vital if we are to identify areas of underperformance and subsequently improve patient safety. Here we provide data on trends in neurosurgical negligence claims over a 10-year period in England. We used data provided by the National Health Service Litigation Authority to analyse negligence claims related to neurosurgery from the financial years 2002/2003 to 2011/2012. Using the abstracts provided, we extracted information pertaining to the underlying pathology, injury severity, nature of misadventure and claim value. Over the 10-year period, the annual number of claims increased significantly. In total, there were 794 negligence claims (range 50-117/year); of the 613 closed cases, 405 (66.1%) were successful. The total cost related to claims during the 10 years was £65.7 million, with a mean claim per successful case of £0.16 million (total damages, defence and claimant costs of £45.1, £6.36 and £14.3 million, respectively). Claims related to emergency cases were more costly compared to those of elective cases (£209,327 vs. £112,627; P=0.002). Spinal cases represented the most frequently litigated procedures (350; 44.1% of total), inadequate surgical performance the most common misadventure (231; 29.1%) and fatality the commonest injury implicated in claims (102; 12.8%). Negligence claims related to wrong-site surgery and cauda equina syndrome were frequently successful (26/26; 100% and 14/16; 87.5% of closed cases, respectively). In England, the number of neurosurgical negligence claims is increasing, the financial cost substantial, and the burden significant. Lessons to be learned from the study are of paramount importance to reduce future cases of negligence and improve patient care.

  2. Analysis of 11 years of clinical negligence claims in esophagogastric cancer in England.

    Science.gov (United States)

    Ratnasingham, K; Stroud, L; Knight, J; Preston, S R; Sultan, J

    2017-04-01

    In the National Health Service (NHS), clinical negligence claims and associated compensations are constantly rising. The aim of this study is to identify the size, trends, and causes of litigations claims in relation to esophagogastric (EG) cancer in the NHS. Data requests were submitted to the NHS Litigation Authority (NHSLA) for the period of January 2003 to December 2013. Data were reviewed, categorized clinically, and analyzed in terms of causes and costs behind claims. In this time period, there were 163 claims identified from the NHSLA database. Ninety-five (58.3%) claims were successful with a pay out of £6.25 million. An increasing overall claim frequency and success rate were found over the last few years. Majority of the claims were from gastric cancer 84 (88.4%). The commonest cause of complaint in successful claims was delay or failure in diagnosis (21.1%) and treatment (17.9%). There were only 10.5% successful intraoperative claims, of which 50% were due to unnecessary or additional procedures. The frequency and success rates of malpractice claims in EG cancer are rising. The failure or delay in diagnosing and treatment in EG malignancy are the common cause for successful litigation claims. The findings further reinforce the need to improve early diagnosis. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Language-related differential item functioning between English and German PROMIS Depression items is negligible.

    Science.gov (United States)

    Fischer, H Felix; Wahl, Inka; Nolte, Sandra; Liegl, Gregor; Brähler, Elmar; Löwe, Bernd; Rose, Matthias

    2017-12-01

    To investigate differential item functioning (DIF) of PROMIS Depression items between US and German samples we compared data from the US PROMIS calibration sample (n = 780), a German general population survey (n = 2,500) and a German clinical sample (n = 621). DIF was assessed in an ordinal logistic regression framework, with 0.02 as criterion for R 2 -change and 0.096 for Raju's non-compensatory DIF. Item parameters were initially fixed to the PROMIS Depression metric; we used plausible values to account for uncertainty in depression estimates. Only four items showed DIF. Accounting for DIF led to negligible effects for the full item bank as well as a post hoc simulated computer-adaptive test (German general population sample was considerably lower compared to the US reference value of 50. Overall, we found little evidence for language DIF between US and German samples, which could be addressed by either replacing the DIF items by items not showing DIF or by scoring the short form in German samples with the corrected item parameters reported. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Paleomagnetism of Cretaceous limestones from western Tarim basin suggests negligible latitudinal offset yet significant clockwise rotation

    Science.gov (United States)

    Tan, X.; Gilder, S.; Chen, Y.; Cogné, J. P.; Courtillot, V. E.; Cai, J.

    2017-12-01

    Large northward translation of central Asian crustal blocks has been reported from paleomagnetism of Cretaceous and Tertiary terrestrial sediments. This motion was initially taken as evidence of deformation occurred in the Asian interior as a result of indentation of the Indian Plate. However, because the amount of motion is far greater than geological observations, accuracy of the paleomagnetic record has become a controversial issue. To solve the problem, it has been shown that the latitudinal offset can be entirely attributed to inclination shallowing during deposition and compaction processes (Tan et al., 2003; Tauxe and Kent, 2004). On the other hand, coeval volcanic rocks from central Asia did record steeper paleomagnetic inclinations than terrestrial rocks (Gilder et al., 2003). To extend the effort of solving the controversy, we report paleomagnetic results of Cretaceous limestones from western Tarim basin. Our results show that the majority of our collections have been overprinted. Fortunately, a special type of limestones preserved stable characteristic remanence. Fold tests suggest a primary origin of the magnetization. Comparison of the paleomagnetic direction with the coeval expected direction from reference poles indicates a negligible amount of northward movement consistent with previous result of inclination correction based on magnetic fabrics, and a pattern of clockwise rotation symmetric with the style observed in the western flank of the Pamir ranges. Rock magnetic data will also be presented to support the accurate paleomagnetic record.

  5. Medicalization, markets and consumers.

    Science.gov (United States)

    Conrad, Peter; Leiter, Valerie

    2004-01-01

    This paper examines the impact of changes in the medical marketplace on medicalization in U.S. society. Using four cases (Viagra, Paxil, human growth hormone and in vitro fertilization), we focus on two aspects of the changing medical marketplace: the role of direct-to-consumer advertising of prescription drugs and the emergence of private medical markets. We demonstrate how consumers and pharmaceutical corporations contribute to medicalization, with physicians, insurance coverage, and changes in regulatory practices playing facilitating roles. In some cases, insurers attempt to counteract medicalization by restricting access. We distinguish mediated and private medical markets, each characterized by differing relationships with corporations, insurers, consumers, and physicians. In the changing medical environment, with medical markets as intervening factors, corporations and insurers are becoming more significant determinants in the medicalization process.

  6. Liposomalization of oxaliplatin induces skin accumulation of it, but negligible skin toxicity.

    Science.gov (United States)

    Nishida, Kentaro; Kashiwagi, Misaki; Shiba, Shunsuke; Muroki, Kiwamu; Ohishi, Akihiro; Doi, Yusuke; Ando, Hidenori; Ishida, Tatsuhiro; Nagasawa, Kazuki

    2017-12-15

    Liposomalization causes alteration of the pharmacokinetics of encapsulated drugs, and allows delivery to tumor tissues through passive targeting via an enhanced permeation and retention (EPR) effect. PEGylated liposomal doxorubicin (Doxil ® , Lipo-DXR), a representative liposomal drug, is well-known to reduce cardiotoxicity and increase the anti-tumor activity of DXR, but to induce the hand-foot syndrome (HFS) as a result of skin DXR accumulation, which is one of its severe adverse effects. We have developed a new liposomal preparation of oxaliplatin (l-OHP), an important anti-tumor drug for treatment of colorectal cancer, using PEGylated liposomes (Lipo-l-OHP), and showed that Lipo-l-OHP exhibits increased anti-tumor activity in tumor-bearing mice compared to the original preparation of l-OHP. However, whether Lipo-l-OHP causes HFS-like skin toxicity similar to Lipo-DXR remains to be determined. Administration of Lipo-l-OHP promoted accumulation of platinum in rat hind paws, however, it caused negligible morphological and histological alterations on the plantar surface of the paws. Administration of DiI-labeled empty PEGylated liposomes gave almost the same distribution profile of dyes into the dermis of hind paws with DXR as in the case of Lipo-DXR. Treatment with Lipo-l-OHP, Lipo-DXR, DiI-labeled empty PEGylated liposomes or empty PEGylated liposomes caused migration of CD68 + macrophages into the dermis of hind paws. These findings suggest that the skin toxicity on administration of liposomalized drugs is reflected in the proinflammatory characteristics of encapsulated drugs, and indicate that Lipo-l-OHP with a higher anti-cancer effect and no HFS may be an outstanding l-OHP preparation leading to an improved quality of life of cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Electron heating in the exhaust of magnetic reconnection with negligible guide field

    Science.gov (United States)

    Wang, Shan; Chen, Li-Jen; Bessho, Naoki; Kistler, Lynn M.; Shuster, Jason R.; Guo, Ruilong

    2016-03-01

    Electron heating in the magnetic reconnection exhaust is investigated with particle-in-cell simulations, space observations, and theoretical analysis. Spatial variations of the electron temperature (Te) and associated velocity distribution functions (VDFs) are examined and understood in terms of particle energization and randomization processes that vary with exhaust locations. Inside the electron diffusion region (EDR), the electron temperature parallel to the magnetic field (Te∥) exhibits a local minimum and the perpendicular temperature (Te⊥) shows a maximum at the current sheet midplane. In the intermediate exhaust downstream from the EDR and far from the magnetic field pileup region, Te⊥/Te∥ is close to unity and Te is approximately uniform, but the VDFs are structured: close to the midplane, VDFs are quasi-isotropic, whereas farther away from the midplane, VDFs exhibit field-aligned beams directed toward the midplane. In the far exhaust, Te generally increases toward the midplane and the pileup region, and the corresponding VDFs show counter-streaming beams. A distinct population with low v∥ and high v⊥ is prominent in the VDFs around the midplane. Test particle results show that the magnetic curvature near the midplane produces pitch angle scattering to generate quasi-isotropic distributions in the intermediate exhaust. In the far exhaust, electrons with initial high v∥ (v⊥) are accelerated mainly through curvature (gradient-B) drift opposite to the electric field, without significant pitch angle scattering. The VDF structures predicted by simulations are observed in magnetotail reconnection measurements, indicating that the energization mechanisms captured in the reported simulations are applicable to magnetotail reconnection with negligible guide field.

  8. Principles and applications of colorimetric solid-phase extraction with negligible depletion

    International Nuclear Information System (INIS)

    Dias, Neil C.; Porter, Marc D.; Fritz, James S.

    2006-01-01

    Colorimetric solid-phase extraction (C-SPE) is an integrated technique in which an analyte is selectively concentrated onto a disk and then quantitated by diffuse reflectance spectroscopy. This paper describes the results of an investigation that applies the concept of negligible depletion (ND) to C-SPE, representing the first application of ND concepts to solid-phase extractions. The approach relies on passing the minimal volume of sample through the disk required to reach an equilibrium in which the concentration of analyte in the sample entering and exiting the disk are equal. At this point, the amount of analyte extracted by the disk is proportional to the sample concentration but is independent of the sample volume passed through the disk. With this new method, called C-SPE/ND, the precise measurement of sample volume is no longer necessary. The work herein details the general principles of this new methodology, and validates its basic tenets in an investigation of the extraction of the organic dye methyl violet. The analytical capabilities of C-SPE/ND are then demonstrated by its application to measurements of iodine. Iodine is a biocide increasingly used as a simple and effective disinfectant for water in locations where municipal water treatment systems are potentially compromised. Thus, the ability to operate C-SPE in an ND mode notably enhances the broad-based utility of this methodology as a reliable and an easy-to-use analysis tool for water quality assessments. Since iodine is also the biocide used on NASAs Space Shuttle, C-SPE/ND has the potential to overcome problems associated with the removal of air bubbles entrapped in a water sample in the microgravity environment encountered in space exploration. Extensions of C-SPE/ND to facile determinations of other water quality parameters with respect to both earth- and space-based needs are briefly discussed

  9. Disparities in Private Health Insurance Coverage of Skilled Care

    Directory of Open Access Journals (Sweden)

    Stacey A. Tovino

    2017-10-01

    Full Text Available This article compares and contrasts public and private health insurance coverage of skilled medical rehabilitation, including cognitive rehabilitation, physical therapy, occupational therapy, speech-language pathology, and skilled nursing services (collectively, skilled care. As background, prior scholars writing in this area have focused on Medicare coverage of skilled care and have challenged coverage determinations limiting Medicare coverage to beneficiaries who are able to demonstrate improvement in their conditions within a specific period of time (the Improvement Standard. By and large, these scholars have applauded the settlement agreement approved on 24 January 2013, by the U.S. District Court for the District of Vermont in Jimmo v. Sebelius (Jimmo, as well as related motions, rulings, orders, government fact sheets, and Medicare program manual statements clarifying that Medicare covers skilled care that is necessary to prevent or slow a beneficiary’s deterioration or to maintain a beneficiary at his or her maximum practicable level of function even though no further improvement in the beneficiary’s condition is expected. Scholars who have focused on beneficiaries who have suffered severe brain injuries, in particular, have framed public insurance coverage of skilled brain rehabilitation as an important civil, disability, and educational right. Given that approximately two-thirds of Americans with health insurance are covered by private health insurance and that many private health plans continue to require their insureds to demonstrate improvement within a short period of time to obtain coverage of skilled care, scholarship assessing private health insurance coverage of skilled care is important but noticeably absent from the literature. This article responds to this gap by highlighting state benchmark plans’ and other private health plans’ continued use of the Improvement Standard in skilled care coverage decisions and

  10. [Using the concept of universal health coverage to promote the health system reform in China].

    Science.gov (United States)

    Hu, S L

    2016-11-06

    The paper is systematically explained the definition, contents of universal health coverage (UHC). Universal health coverage calls for all people to have access to quality health services they need without facing undue financial burden. The relationship between five main attributes, i.e., quality, efficiency, equity, accountability and resilience, and their 15 action plans has been explained. The nature of UHC is belonged to the State and government. The core function is commitment with equality. The whole-of-system method is used to promoting the health system reform. In China, the universal health coverage has been reached to the preliminary achievements, which include universal coverage of social medical insurance, basic medical services, basic public health services, and the provision of essential medicines. China has completed millennium development goals (MDG) and is being stepped to the sustainable development goals (SDG).

  11. Providing Universal Health Insurance Coverage in Nigeria.

    Science.gov (United States)

    Okebukola, Peter O; Brieger, William R

    2016-07-07

    Despite a stated goal of achieving universal coverage, the National Health Insurance Scheme of Nigeria had achieved only 4% coverage 12 years after it was launched. This study assessed the plans of the National Health Insurance Scheme to achieve universal health insurance coverage in Nigeria by 2015 and discusses the challenges facing the scheme in achieving insurance coverage. In-depth interviews from various levels of the health-care system in the country, including providers, were conducted. The results of the analysis suggest that challenges to extending coverage include the difficulty in convincing autonomous state governments to buy into the scheme and an inadequate health workforce that might not be able to meet increased demand. Recommendations for increasing the scheme's coverage include increasing decentralization and strengthening human resources for health in the service delivery systems. Strong political will is needed as a catalyst to achieving these goals. © The Author(s) 2016.

  12. The role of nano-perovskite in the negligible thorium release in seawater from Greek bauxite residue (red mud)

    DEFF Research Database (Denmark)

    Gkamaletsos, Platon; Godelitsas, Athanasios; Kasama, Takeshi

    2016-01-01

    -ICP-MS, using Mediterranean seawater from Greece, indicated significant release of V, depending on S/L ratio, and negligible release of Th at least after 12 months leaching. STEM-EDS/EELS & HR-STEM-HAADF study of the leached BR at the nanoscale revealed that the significant immobility of Th4+ is due to its...

  13. Evolution of E. coli on [U-13C] Glucose Reveals a Negligible Isotopic Influence on Metabolism and Physiology

    DEFF Research Database (Denmark)

    Sandberg, Troy E.; Long, Christopher P.; Gonzalez, Jacqueline E.

    2016-01-01

    13C-Metabolic flux analysis (13C-MFA) traditionally assumes that kinetic isotope effects from isotopically labeled compounds do not appreciably alter cellular growth or metabolism, despite indications that some biochemical reactions can be non-negligibly impacted. Here, populations of Escherichia...

  14. Coverage for Gender-Affirming Care: Making Health Insurance Work for Transgender Americans.

    Science.gov (United States)

    Padula, William V; Baker, Kellan

    2017-08-01

    Many transgender Americans continue to remain uninsured or are underinsured because of payers' refusal to cover medically necessary, gender-affirming healthcare services-such as hormone therapy, mental health counseling, and reconstructive surgeries. Coverage refusal results in higher costs and poor health outcomes among transgender people who cannot access gender-affirming care. Research into the value of health insurance coverage for gender-affirming care for transgender individuals shows that the health benefits far outweigh the costs of insuring transition procedures. Although the Affordable Care Act explicitly protects health insurance for transgender individuals, these laws are being threatened; therefore, this article reviews their importance to transgender-inclusive healthcare coverage.

  15. An insight into medical malpractice and litigation | Aimakhu ...

    African Journals Online (AJOL)

    Medical malpractice otherwise known as a breach of professional obligation and negligence of duty by medical practitioners has been identified as the major cause of emerging medical litigation in Nigeria. Medical personnel must be aware in their practice that patients are becoming more aware of their rights. The public ...

  16. Quantifying the impact of cross coverage on physician's workload and performance in radiation oncology.

    Science.gov (United States)

    Mosaly, Prithima R; Mazur, Lukasz M; Jones, Ellen L; Hoyle, Lesley; Zagar, Timothy; Chera, Bhishamjit S; Marks, Lawrence B

    2013-01-01

    To quantitatively assess the difference in workload and performance of radiation oncology physicians during radiation therapy treatment planning tasks under the conditions of "cross coverage" versus planning a patient with whom they were familiar. Eight physicians (3 experienced faculty physicians and 5 physician residents) performed 2 cases. The first case represented a "cross-coverage" scenario where the physicians had no prior information about the case to be planned. The second exposure represented a "regular-coverage" scenario where the physicians were familiar with the patient case to be planned. Each case involved 3 tasks to be completed systematically. Workload was assessed both subjectively (perceived) using National Aeronautics and Space Administration-Task Load Index (NASA-TLX), and objectively (physiological) throughout the task using eye data (via monitoring pupil size and blink rate). Performance of each task and the case was measured using completion time. Subjective willingness to approve or disapprove the generated plan was obtained after completion of the case only. Forty-eight perceived and 48 physiological workload assessments were obtained. Overall, results revealed a significant increase in perceived workload (high NASA-TLX score) and decrease in performance (longer completion time and reduced approval rate) during cross coverage. There were nonsignificant increases in pupil diameter and decreases in the blink rate during cross-coverage versus regular-coverage scenario. In both cross-coverage and regular-coverage scenarios the level of experience did not affect workload and performance. The cross-coverage scenario significantly increases perceived workload and degrades performance versus regular coverage. Hence, to improve patient safety, efforts must be made to develop policies, standard operating procedures, and usability improvements to electronic medical record and treatment planning systems for "easier" information processing to deal with

  17. Cervical cancer screening policies and coverage in Europe

    DEFF Research Database (Denmark)

    Anttila, Ahti; von Karsa, Lawrence; Aasmaa, Auni

    2009-01-01

    with education, training and communication among women, medical professionals and authorities are required, accordingly. The study indicates that, despite substantial efforts, the recommendations of the Council of the EU on organised population-based screening for cervical cancer are not yet fulfilled. Decision......The aim of the study was to compare current policy, organisation and coverage of cervical cancer screening programmes in the European Union (EU) member states with European and other international recommendations. According to the questionnaire-based survey, there are large variations in cervical...... cancer screening policies and inadequacies in the key organisational elements of the programme such as registration and monitoring required for quality-assurance and fail-safe mechanisms. Based on data from available screening registers, coverage of the screening test taken within the population...

  18. Understanding Medicare Prescription Drug Coverage

    Science.gov (United States)

    ... to know what your insurance company is paying…Health Insurance: Understanding What It CoversRead Article >>Insurance & BillsHealth Insurance: Understanding What It CoversYour insurance policy lists a package of medical benefits such as tests, drugs, and treatment services. These ...

  19. Coverage-based constraints for IMRT optimization

    Science.gov (United States)

    Mescher, H.; Ulrich, S.; Bangert, M.

    2017-09-01

    Radiation therapy treatment planning requires an incorporation of uncertainties in order to guarantee an adequate irradiation of the tumor volumes. In current clinical practice, uncertainties are accounted for implicitly with an expansion of the target volume according to generic margin recipes. Alternatively, it is possible to account for uncertainties by explicit minimization of objectives that describe worst-case treatment scenarios, the expectation value of the treatment or the coverage probability of the target volumes during treatment planning. In this note we show that approaches relying on objectives to induce a specific coverage of the clinical target volumes are inevitably sensitive to variation of the relative weighting of the objectives. To address this issue, we introduce coverage-based constraints for intensity-modulated radiation therapy (IMRT) treatment planning. Our implementation follows the concept of coverage-optimized planning that considers explicit error scenarios to calculate and optimize patient-specific probabilities q(\\hat{d}, \\hat{v}) of covering a specific target volume fraction \\hat{v} with a certain dose \\hat{d} . Using a constraint-based reformulation of coverage-based objectives we eliminate the trade-off between coverage and competing objectives during treatment planning. In-depth convergence tests including 324 treatment plan optimizations demonstrate the reliability of coverage-based constraints for varying levels of probability, dose and volume. General clinical applicability of coverage-based constraints is demonstrated for two cases. A sensitivity analysis regarding penalty variations within this planing study based on IMRT treatment planning using (1) coverage-based constraints, (2) coverage-based objectives, (3) probabilistic optimization, (4) robust optimization and (5) conventional margins illustrates the potential benefit of coverage-based constraints that do not require tedious adjustment of target volume objectives.

  20. CDMA coverage under mobile heterogeneous network load

    NARCIS (Netherlands)

    Saban, D.; van den Berg, Hans Leo; Boucherie, Richardus J.; Endrayanto, A.I.

    2002-01-01

    We analytically investigate coverage (determined by the uplink) under non-homogeneous and moving traffic load of third generation UMTS mobile networks. In particular, for different call assignment policies, we investigate cell breathing and the movement of the coverage gap occurring between cells

  1. 5 CFR 531.402 - Employee coverage.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Employee coverage. 531.402 Section 531... GENERAL SCHEDULE Within-Grade Increases § 531.402 Employee coverage. (a) Except as provided in paragraph (b) of this section, this subpart applies to employees who— (1) Are classified and paid under the...

  2. 22 CFR 226.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Insurance coverage. 226.31 Section 226.31 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Property Standards § 226.31 Insurance coverage. Recipients...

  3. 14 CFR 1260.131 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided for property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  4. 2 CFR 215.31 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  5. 36 CFR 1210.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ....31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with NHPRC funds as provided to property owned by the recipient. Federally-owned property need not be insured unless required by the terms and conditions of the award. ...

  6. Coverage matters: insurance and health care

    National Research Council Canada - National Science Library

    Board on Health Care Services Staff; Institute of Medicine Staff; Institute of Medicine; National Academy of Sciences

    2001-01-01

    ...? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters...

  7. Legislating health care coverage for the unemployed.

    Science.gov (United States)

    Palley, H A; Feldman, G; Gallner, I; Tysor, M

    1985-01-01

    Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations.

  8. Negligible substrate clamping effect on piezoelectric response in (111)-epitaxial tetragonal Pb(Zr, Ti)O{sub 3} films

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Tomoaki, E-mail: t-yamada@nucl.nagoya-u.ac.jp [Department of Materials, Physics and Energy Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603 (Japan); PRESTO, Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012 (Japan); Yasumoto, Jun; Ito, Daisuke; Yoshino, Masahito; Nagasaki, Takanori [Department of Materials, Physics and Energy Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603 (Japan); Sakata, Osami [Synchrotron X-ray Station at SPring-8 and Synchrotron X-ray Group, National Institute for Materials Science, Sayo-cho, Sayo-gun, Hyogo 679-5148 (Japan); Department of Innovative and Engineered Material, Tokyo Institute of Technology, Yokohama 226-8503 (Japan); Imai, Yasuhiko [Japan Synchrotron Radiation Research Institute, SPring-8, Sayo-cho, Sayo-gun, Hyogo 679-5198 (Japan); Kiguchi, Takanori [Institute for Materials Research, Tohoku University, Sendai, Miyagi 980-8577 (Japan); Shiraishi, Takahisa; Shimizu, Takao; Funakubo, Hiroshi [Department of Innovative and Engineered Material, Tokyo Institute of Technology, Yokohama 226-8503 (Japan)

    2015-08-21

    The converse piezoelectric responses of (111)- and (001)-epitaxial tetragonal Pb(Zr{sub 0.35}Ti{sub 0.65})O{sub 3} [PZT] films were compared to investigate the orientation dependence of the substrate clamping effect. Synchrotron X-ray diffraction (XRD) and piezoelectric force microscopy revealed that the as-grown (111)-PZT film has a polydomain structure with normal twin boundaries that are changed by the poling process to inclined boundaries, as predicted by Romanov et al. [Phys. Status Solidi A 172, 225 (1999)]. Time-resolved synchrotron XRD under bias voltage showed the negligible impact of substrate clamping on the piezoelectric response in the (111)-PZT film, unlike the case for (001)-PZT film. The origin of the negligible clamping effect in the (111)-PZT film is discussed from the viewpoint of the elastic properties and the compensation of lattice distortion between neighboring domains.

  9. Negligible substrate clamping effect on piezoelectric response in (111)-epitaxial tetragonal Pb(Zr, Ti)O3 films

    International Nuclear Information System (INIS)

    Yamada, Tomoaki; Yasumoto, Jun; Ito, Daisuke; Yoshino, Masahito; Nagasaki, Takanori; Sakata, Osami; Imai, Yasuhiko; Kiguchi, Takanori; Shiraishi, Takahisa; Shimizu, Takao; Funakubo, Hiroshi

    2015-01-01

    The converse piezoelectric responses of (111)- and (001)-epitaxial tetragonal Pb(Zr 0.35 Ti 0.65 )O 3 [PZT] films were compared to investigate the orientation dependence of the substrate clamping effect. Synchrotron X-ray diffraction (XRD) and piezoelectric force microscopy revealed that the as-grown (111)-PZT film has a polydomain structure with normal twin boundaries that are changed by the poling process to inclined boundaries, as predicted by Romanov et al. [Phys. Status Solidi A 172, 225 (1999)]. Time-resolved synchrotron XRD under bias voltage showed the negligible impact of substrate clamping on the piezoelectric response in the (111)-PZT film, unlike the case for (001)-PZT film. The origin of the negligible clamping effect in the (111)-PZT film is discussed from the viewpoint of the elastic properties and the compensation of lattice distortion between neighboring domains

  10. Wideband giant optical activity and negligible circular dichroism of near-infrared chiral metamaterial based on a complementary twisted configuration

    International Nuclear Information System (INIS)

    Zhu, Weiren; Rukhlenko, Ivan D; Premaratne, Malin; Huang, Yongjun; Wen, Guangjun

    2013-01-01

    We theoretically analyze the near-infrared properties of a chiral metamaterial constituting an array of twisted crosses and complementary crosses made of silver. Through rigorous full-wave numerical simulations, we demonstrate that this type of metamaterial exhibits wideband giant optical activity, with a polarization azimuth rotation angle reaching values as large as 1900 ∘ per wavelength. Owing to the negligible loss at optical frequencies in the dielectric (magnesium fluoride) making up the metamaterial, we observe negligible circular dichroism and low dispersion of the polarization azimuth rotation angle over a wide frequency band. We envision that this type of chiral metamaterial will find extensive applications in optical communication systems and biological sensing. (paper)

  11. Interpregnancy intervals: impact of postpartum contraceptive effectiveness and coverage.

    Science.gov (United States)

    Thiel de Bocanegra, Heike; Chang, Richard; Howell, Mike; Darney, Philip

    2014-04-01

    The purpose of this study was to determine the use of contraceptive methods, which was defined by effectiveness, length of coverage, and their association with short interpregnancy intervals, when controlling for provider type and client demographics. We identified a cohort of 117,644 women from the 2008 California Birth Statistical Master file with second or higher order birth and at least 1 Medicaid (Family Planning, Access, Care, and Treatment [Family PACT] program or Medi-Cal) claim within 18 months after index birth. We explored the effect of contraceptive method provision on the odds of having an optimal interpregnancy interval and controlled for covariates. The average length of contraceptive coverage was 3.81 months (SD = 4.84). Most women received user-dependent hormonal contraceptives as their most effective contraceptive method (55%; n = 65,103 women) and one-third (33%; n = 39,090 women) had no contraceptive claim. Women who used long-acting reversible contraceptive methods had 3.89 times the odds and women who used user-dependent hormonal methods had 1.89 times the odds of achieving an optimal birth interval compared with women who used barrier methods only; women with no method had 0.66 times the odds. When user-dependent methods are considered, the odds of having an optimal birth interval increased for each additional month of contraceptive coverage by 8% (odds ratio, 1.08; 95% confidence interval, 1.08-1.09). Women who were seen by Family PACT or by both Family PACT and Medi-Cal providers had significantly higher odds of optimal birth intervals compared with women who were served by Medi-Cal only. To achieve optimal birth spacing and ultimately to improve birth outcomes, attention should be given to contraceptive counseling and access to contraceptive methods in the postpartum period. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. Alcoholic hepatitis with negligible sup(99m)Tc uptake and transient elevation of serum alpha-fetoprotein

    International Nuclear Information System (INIS)

    Hoshino, Hirosuke; Okumura, Makoto; Shimizu, Masanori; Eimoto, Tadaaki

    1981-01-01

    A 35 year old male with typical alcoholic hepatitis presented almost negligible uptake of sup(99m)Tc on the liver scan. Electron microscopic findings disclosing decreased number of Kupffer cells and impaired blood flow in the sinusoids may elucidate extremely diminshed uptake of isotope by the liver. Transient elevation of serum α-fetoprotein up to 3200 ng/ml observed during the active stage may indicate a regeneration process of hepatic necrosis occurred following the acute alcoholic hepatitis. (author)

  13. A phenomenological study of the effects of clinical negligence litigation on midwives in England: the personal perspective.

    Science.gov (United States)

    Robertson, Judith H; Thomson, Ann M

    2014-03-01

    to explore how midwives' personal involvement in clinical negligence litigation affects their emotional and psychological well-being. descriptive phenomenological study using semi-structured interviews. in-depth interviews were conducted in participants' homes or at their place of work and focused on participants' experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. unfamiliarity with the legal process when writing statements, attending case conferences and being a witness in court provoked significant stress for midwives. This was exacerbated by the prolonged nature of maternity claims. Support ranged from good to inadequate. Participants who no longer worked for the defendant Trust felt unsupported. Stress could manifest as physical and mental ill-health. Some midwives internalised the allegations of negligence believing their whole career had become worthless. Previous knowledge of the legal process ameliorated the experience. Midwives also exhibited anger and resentment when litigation concluded and some took years to heal from the experience. midwives come from a caring and relational paradigm. When interfacing with the adversarial and contentious paradigm of tort law, midwives can abreact and suffer emotional, physical and psychological harm. Support for midwives experiencing litigation must be improved. Understanding the effects of personal involvement in litigation is important in order to improve the quality of support for this group of midwives. It will also aid development of targeted education for undergraduate, post-graduate and in-service midwives. In the longer term it may help policy makers when considering reform of clinical negligence litigation and NHS employers to structure support mechanisms for staff involved. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Network television news coverage of environmental risks

    International Nuclear Information System (INIS)

    Greenberg, M.R.; Sandman, P.M.; Sachsman, D.V.; Salomone, K.L.

    1989-01-01

    Despite the criticisms that surround television coverage of environmental risk, there have been relatively few attempts to measure what and whom television shows. Most research has focused analysis on a few weeks of coverage of major stories like the gas leak at Bhopal, the Three Mile Island nuclear accident, or the Mount St. Helen's eruption. To advance the research into television coverage of environmental risk, an analysis has been made of all environmental risk coverage by the network nightly news broadcasts for a period of more than two years. Researchers have analyzed all environmental risk coverage-564 stories in 26 months-presented on ABC, CBS, and NBC's evening news broadcasts from January 1984 through February 1986. The quantitative information from the 564 stories was balanced by a more qualitative analysis of the television coverage of two case studies-the dioxin contamination in Times Beach, Missouri, and the suspected methyl isocyanate emissions from the Union Carbide plant in Institute, West Virginia. Both qualitative and quantitative data contributed to the analysis of the role played by experts and environmental advocacy sources in coverage of environmental risk and to the suggestions for increasing that role

  15. 23 CFR 646.109 - Types of coverage.

    Science.gov (United States)

    2010-04-01

    ... the railroad and employees of the railroad not covered by State workmen's compensation laws; (2... its agents, regardless of the negligence of the railroad; (4) Negligence of only the following classes...

  16. Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.

    Science.gov (United States)

    2016-11-04

    This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.

  17. 42 CFR 440.330 - Benchmark health benefits coverage.

    Science.gov (United States)

    2010-10-01

    ...) Federal Employees Health Benefit Plan Equivalent Coverage (FEHBP—Equivalent Health Insurance Coverage). A... coverage. Health benefits coverage that is offered and generally available to State employees in the State... 42 Public Health 4 2010-10-01 2010-10-01 false Benchmark health benefits coverage. 440.330 Section...

  18. Changes in drug utilization during a gap in insurance coverage: an examination of the medicare Part D coverage gap.

    Directory of Open Access Journals (Sweden)

    Jennifer M Polinski

    2011-08-01

    Full Text Available Nations are struggling to expand access to essential medications while curbing rising health and drug spending. While the US government's Medicare Part D drug insurance benefit expanded elderly citizens' access to drugs, it also includes a controversial period called the "coverage gap" during which beneficiaries are fully responsible for drug costs. We examined the impact of entering the coverage gap on drug discontinuation, switching to another drug for the same indication, and drug adherence. While increased discontinuation of and adherence to essential medications is a regrettable response, increased switching to less expensive but therapeutically interchangeable medications is a positive response to minimize costs.We followed 663,850 Medicare beneficiaries enrolled in Part D or retiree drug plans with prescription and health claims in 2006 and/or 2007 to determine who reached the gap spending threshold, n = 217,131 (33%. In multivariate Cox proportional hazards models, we compared drug discontinuation and switching rates in selected drug classes after reaching the threshold between all 1,993 who had no financial assistance during the coverage gap (exposed versus 9,965 multivariate propensity score-matched comparators with financial assistance (unexposed. Multivariate logistic regressions compared drug adherence (≤ 80% versus >80% of days covered. Beneficiaries reached the gap spending threshold on average 222 d ±79. At the drug level, exposed beneficiaries were twice as likely to discontinue (hazard ratio [HR]  = 2.00, 95% confidence interval [CI] 1.64-2.43 but less likely to switch a drug (HR  = 0.60, 0.46-0.78 after reaching the threshold. Gap-exposed beneficiaries were slightly more likely to have reduced adherence (OR  = 1.07, 0.98-1.18.A lack of financial assistance after reaching the gap spending threshold was associated with a doubling in discontinuing essential medications but not switching drugs in 2006 and 2007

  19. Predictors of Coordinated and Comprehensive Care Within a Medical Home for Children With Special Healthcare (CHSCN Needs

    Directory of Open Access Journals (Sweden)

    Ashley Walker

    2018-06-01

    Full Text Available The purpose of this study was to examine predictors of coordinated and comprehensive care within a medical home among children with special health care needs (CSHCN. The latest version of the National Survey of Children with Special Health Care Needs (NS-CSHCN employed a national random-digit-dial sample whereby US households were screened, resulting in 40,242 eligible respondents. Logistic regression analyses were performed modeling the probability of coordinated, comprehensive care in a medical home based on shared decision-making and other factors. A total of 29,845 cases were selected for inclusion in the model. Of these, 17,390 cases (58.3% met the criteria for coordinated, comprehensive care in a medical home. Access to a community-based service systems had the greatest positive impact on coordinated, comprehensive care in a medical home. Adequate insurance coverage and being White/Caucasian were also positively associated with the dependent variable. Shared decision-making was reported by 72% of respondents and had a negative, but relatively negligible impact on coordinated, comprehensive care in a medical home. Increasing age, non-traditional family structures, urban residence, and public insurance were more influential, and negatively impacted the dependent variable. Providers and their respective organizations should seek to expand and improve health and support services at the community level.

  20. Transplant recipients are vulnerable to coverage denial under Medicare Part D.

    Science.gov (United States)

    Potter, Lisa M; Maldonado, Angela Q; Lentine, Krista L; Schnitzler, Mark A; Zhang, Zidong; Hess, Gregory P; Garrity, Edward; Kasiske, Bertram L; Axelrod, David A

    2018-02-15

    Transplant immunosuppressants are often used off-label because of insufficient randomized prospective trial data to achieve organ-specific US Food and Drug Administration (FDA) approval. Transplant recipients who rely on Medicare Part D for immunosuppressant drug coverage are vulnerable to coverage denial for off-label prescriptions, unless use is supported by Centers for Medicare & Medicaid Services (CMS)-approved compendia. An integrated dataset including national transplant registry data and 3 years of dispensed pharmacy records was used to identify the prevalence of immunosuppression use that is both off-label and not supported by CMS-approved compendia. Numbers of potentially vulnerable transplant recipients were identified. Off-label and off-compendia immunosuppression regimens are frequently prescribed (3-year mean: lung 66.5%, intestine 34.2%, pancreas 33.4%, heart 21.8%, liver 16.5%, kidney 0%). The annual retail cost of these at-risk medications exceeds $30 million. This population-based study of transplant immunosuppressants vulnerable to claim denials under Medicare Part D coverage demonstrates a substantial gap between clinical practice, current FDA approval processes, and policy mandates for pharmaceutical coverage. This coverage barrier reduces access to life-saving medications for patients without alternative resources and may increase the risk of graft loss and death from medication nonadherence. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

  1. Device evaluation and coverage policy in workers' compensation: examples from Washington State.

    Science.gov (United States)

    Franklin, G M; Lifka, J; Milstein, J

    1998-09-25

    Workers' compensation health benefits are broader than general health benefits and include payment for medical and rehabilitation costs, associated indemnity (lost time) costs, and vocational rehabilitation (return-to-work) costs. In addition, cost liability is for the life of the claim (injury), rather than for each plan year. We examined device evaluation and coverage policy in workers' compensation over a 10-year period in Washington State. Most requests for device coverage in workers' compensation relate to the diagnosis, prognosis, or treatment of chronic musculoskeletal conditions. A number of specific problems have been recognized in making device coverage decisions within workers' compensation: (1) invasive devices with a high adverse event profile and history of poor outcomes could significantly increase both indemnity and medical costs; (2) many noninvasive devices, while having a low adverse event profile, have not proved effective for managing chronic musculoskeletal conditions relevant to injured workers; (3) some devices are marketed and billed as surrogate diagnostic tests for generally accepted, and more clearly proven, standard tests; (4) quality oversight of technology use among physicians may be inadequate; and (5) insurers' access to efficacy data adequate to make timely and appropriate coverage decisions in workers' compensation is often lacking. Emerging technology may substantially increase the costs of workers' compensation without significant evidence of health benefit for injured workers. To prevent ever-rising costs, we need to increase provider education and patient education and consent, involve the state medical society in coverage policy, and collect relevant outcomes data from healthcare providers.

  2. Summary of DOD Acquisition Program Audit Coverage

    National Research Council Canada - National Science Library

    2001-01-01

    This report will provide the DoD audit community with information to support their planning efforts and provide management with information on the extent of audit coverage of DoD acquisition programs...

  3. NOAA Weather Radio - County Coverage by State

    Science.gov (United States)

    Non-Zero All Hazards Logo Emergency Alert Description Event Codes Fact Sheet FAQ Organization Search Coverage Listings NWR Station Search Maps SAME SAME Coding Using SAME SAME Non-Zero Codes DOCUMENTS NWR

  4. Media Coverage of Nuclear Energy after Fukushima

    International Nuclear Information System (INIS)

    Oltra, C.; Roman, P.; Prades, A.

    2013-01-01

    This report presents the main findings of a content analysis of printed media coverage of nuclear energy in Spain before and after the Fukushima accident. Our main objective is to understand the changes in the presentation of nuclear fission and nuclear fusion as a result of the accident in Japan. We specifically analyze the volume of coverage and thematic content in the media coverage for nuclear fusion from a sample of Spanish print articles in more than 20 newspapers from 2008 to 2012. We also analyze the media coverage of nuclear energy (fission) in three main Spanish newspapers one year before and one year after the accident. The results illustrate how the media contributed to the presentation of nuclear power in the months before and after the accident. This could have implications for the public understanding of nuclear power. (Author)

  5. Media Coverage of Nuclear Energy after Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Oltra, C.; Roman, P.; Prades, A.

    2013-07-01

    This report presents the main findings of a content analysis of printed media coverage of nuclear energy in Spain before and after the Fukushima accident. Our main objective is to understand the changes in the presentation of nuclear fission and nuclear fusion as a result of the accident in Japan. We specifically analyze the volume of coverage and thematic content in the media coverage for nuclear fusion from a sample of Spanish print articles in more than 20 newspapers from 2008 to 2012. We also analyze the media coverage of nuclear energy (fission) in three main Spanish newspapers one year before and one year after the accident. The results illustrate how the media contributed to the presentation of nuclear power in the months before and after the accident. This could have implications for the public understanding of nuclear power. (Author)

  6. 22 CFR 518.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 518.31 Insurance coverage. Recipients shall, at a minimum, provide the...

  7. 7 CFR 3019.31 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... recipient. Federally-owned property need not be insured unless required by the terms and conditions of the... Standards § 3019.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance...

  8. 34 CFR 74.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... by the recipient. Federally-owned property need not be insured unless required by the terms and... Property Standards § 74.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent...

  9. 49 CFR 19.31 - Insurance coverage.

    Science.gov (United States)

    2010-10-01

    ... property owned by the recipient. Federally-owned property need not be insured unless required by the terms... Requirements Property Standards § 19.31 Insurance coverage. Recipients shall, at a minimum, provide the...

  10. 10 CFR 600.131 - Insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... provided to property owned by the recipient. Federally-owned property need not be insured unless required... Nonprofit Organizations Post-Award Requirements § 600.131 Insurance coverage. Recipients shall, at a minimum...

  11. 20 CFR 435.31 - Insurance coverage.

    Science.gov (United States)

    2010-04-01

    ... funds as provided to property owned by the recipient. Federally-owned property need not be insured... ORGANIZATIONS Post-Award Requirements Property Standards § 435.31 Insurance coverage. Recipients must, at a...

  12. 28 CFR 70.31 - Insurance coverage.

    Science.gov (United States)

    2010-07-01

    ... with Federal funds as provided to property owned by the recipient. Federally-owned property need not be...-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 70.31 Insurance coverage. Recipients...

  13. Coverage for SCS Pre-1941 Aerial Photography

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This shapefile was generated by the U.S. Bureau of Land Management (BLM) at the New Mexico State Office to show the coverage for the Pre-1941 aerial photography...

  14. Length and coverage of inhibitory decision rules

    KAUST Repository

    Alsolami, Fawaz

    2012-01-01

    Authors present algorithms for optimization of inhibitory rules relative to the length and coverage. Inhibitory rules have a relation "attribute ≠ value" on the right-hand side. The considered algorithms are based on extensions of dynamic programming. Paper contains also comparison of length and coverage of inhibitory rules constructed by a greedy algorithm and by the dynamic programming algorithm. © 2012 Springer-Verlag.

  15. Cooperative Cloud Service Aware Mobile Internet Coverage Connectivity Guarantee Protocol Based on Sensor Opportunistic Coverage Mechanism

    Directory of Open Access Journals (Sweden)

    Qin Qin

    2015-01-01

    Full Text Available In order to improve the Internet coverage ratio and provide connectivity guarantee, based on sensor opportunistic coverage mechanism and cooperative cloud service, we proposed the coverage connectivity guarantee protocol for mobile Internet. In this scheme, based on the opportunistic covering rules, the network coverage algorithm of high reliability and real-time security was achieved by using the opportunity of sensor nodes and the Internet mobile node. Then, the cloud service business support platform is created based on the Internet application service management capabilities and wireless sensor network communication service capabilities, which is the architecture of the cloud support layer. The cooperative cloud service aware model was proposed. Finally, we proposed the mobile Internet coverage connectivity guarantee protocol. The results of experiments demonstrate that the proposed algorithm has excellent performance, in terms of the security of the Internet and the stability, as well as coverage connectivity ability.

  16. A methodology for extending domain coverage in SemRep.

    Science.gov (United States)

    Rosemblat, Graciela; Shin, Dongwook; Kilicoglu, Halil; Sneiderman, Charles; Rindflesch, Thomas C

    2013-12-01

    We describe a domain-independent methodology to extend SemRep coverage beyond the biomedical domain. SemRep, a natural language processing application originally designed for biomedical texts, uses the knowledge sources provided by the Unified Medical Language System (UMLS©). Ontological and terminological extensions to the system are needed in order to support other areas of knowledge. We extended SemRep's application by developing a semantic representation of a previously unsupported domain. This was achieved by adapting well-known ontology engineering phases and integrating them with the UMLS knowledge sources on which SemRep crucially depends. While the process to extend SemRep coverage has been successfully applied in earlier projects, this paper presents in detail the step-wise approach we followed and the mechanisms implemented. A case study in the field of medical informatics illustrates how the ontology engineering phases have been adapted for optimal integration with the UMLS. We provide qualitative and quantitative results, which indicate the validity and usefulness of our methodology. Published by Elsevier Inc.

  17. Determination of negligible concentration threshold values for water pollution assessment; Ableitung von Geringfuegigkeitsschwellen zur Beurteilung von Grundwasserverunreinigungen

    Energy Technology Data Exchange (ETDEWEB)

    Trenck, K.T. von der [Landesanstalt fuer Umweltschutz Baden-Wuerttemberg, Karlsruhe (Germany); Roeder, R.; Slama, H. [Bayerisches Landesamt fuer Wasserwirtschaft, Muenchen (Germany); Markard, C.; Kuehl, C. [Umweltbundesamt, Berlin (Germany)

    1999-06-01

    The contribution summarizes the major aspects of results and proposals elaborated by a working group: Criteria for derivation of the negligible concentration threshold, and proposed threshold values for organic and inorganic substances dangerous to water. Evaluation criteria are explained for assessing human toxicity as well as ecotoxicity, and substance-specific evaluation criteria are listed. (orig./CB) [Deutsch] Hauptpunkte des Beitrags, der die Ergebnisse eines Arbeitskreises erlaeutert, sind: Ableitungskriterien fr die Geringfuegigkeitsschwelle und Vorschlag von Geringfuegigkeitsschwellen fr organische und anorganische Wasserschadstoffe. Darstellung der humantoxischen Bewertungskriterien, sowie oekotoxische Bewertungskriterien. Zusammenstellung der stoffspezifischen Bewertungskriterien. (orig./AJ)

  18. 45 CFR 148.124 - Certification and disclosure of coverage.

    Science.gov (United States)

    2010-10-01

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

  19. Health insurance coverage and impact: a survey in three cities in China.

    Science.gov (United States)

    Fang, Kuangnan; Shia, BenChang; Ma, Shuangge

    2012-01-01

    China has one of the world's largest health insurance systems, composed of government-run basic health insurance and commercial health insurance. The basic health insurance has undergone system-wide reform in recent years. Meanwhile, there is also significant development in the commercial health insurance sector. A phone call survey was conducted in three major cities in China in July and August, 2011. The goal was to provide an updated description of the effect of health insurance on the population covered. Of special interest were insurance coverage, gross and out-of-pocket medical cost and coping strategies. Records on 5,097 households were collected. Analysis showed that smaller households, higher income, lower expense, presence of at least one inpatient treatment and living in rural areas were significantly associated with a lower overall coverage rate. In the separate analysis of basic and commercial health insurance, similar factors were found to have significant associations. Higher income, presence of chronic disease, presence of inpatient treatment, higher coverage rates and living in urban areas were significantly associated with higher gross medical cost. A similar set of factors were significantly associated with higher out-of-pocket cost. Households with lower income, inpatient treatment, higher commercial insurance coverage, and living in rural areas were significantly more likely to pursue coping strategies other than salary. The surveyed cities and surrounding rural areas had socioeconomic status far above China's average. However, there was still a need to further improve coverage. Even for households with coverage, there was considerable out-of-pocket medical cost, particularly for households with inpatient treatments and/or chronic diseases. A small percentage of households were unable to self-finance out-of-pocket medical cost. Such observations suggest possible targets for further improving the health insurance system.

  20. 45 CFR 400.103 - Coverage of refugees who spend down to State financial eligibility standards.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Coverage of refugees who spend down to State... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Conditions of Eligibility for...

  1. 42 CFR 423.464 - Coordination of benefits with other providers of prescription drug coverage.

    Science.gov (United States)

    2010-10-01

    ... fees. CMS may impose user fees on Part D plans for the transmittal of information necessary for benefit...) Provides supplemental drug coverage to individuals based on financial need, age, or medical condition, and... effective exchange of information and coordination between such plan and SPAPs and entities providing other...

  2. Interference Impact on Coverage and Capacity for Low Power Wide Area IoT Networks

    DEFF Research Database (Denmark)

    Vejlgaard, Benny; Lauridsen, Mads; Nguyen, Huan Cong

    2017-01-01

    In this paper we analyze and discuss the coverage and capacity of Sigfox and LoRaWAN in a large scale urban environments covering 150 km2 in Northern Denmark. First, the study measures and analyzes interference in the European 868 MHz license free industrial, scientific, and medical band, creating...

  3. Does litigation increase or decrease health care quality?: a national study of negligence claims against nursing homes.

    Science.gov (United States)

    Stevenson, David G; Spittal, Matthew J; Studdert, David M

    2013-05-01

    The tort system is supposed to help improve the quality and safety of health care, but whether it actually does so is controversial. Most previous studies modeling the effect of negligence litigation on quality of care are ecologic. To assess whether the experience of being sued and incurring litigation costs affects the quality of care subsequently delivered in nursing homes. We linked information on 6471 negligence claims brought against 1514 nursing homes between 1998 and 2010 to indicators of nursing home quality drawn from 2 US national datasets (Online Survey, Certification, and Reporting system; Minimum Data Set Quality Measure/Indicator Reports). At the facility level, we tested for associations between 9 quality measures and 3 variables indicating the nursing homes' litigation experience in the preceding 12-18 months (total indemnity payments; total indemnity payments plus administrative costs; ≥ 1 paid claims vs. none). The analyses adjusted for quality at baseline, case-mix, ownership, occupancy, year, and facility and state random effects. Nearly all combinations of the 3 litigation exposure measures and 9 quality measures--27 models in all--showed an inverse relationship between litigation costs and quality. However, only a few of these associations were statistically significant, and the effect sizes were very small. For example, a doubling of indemnity payments was associated with a 1.1% increase in the number of deficiencies and a 2.2% increase in pressure ulcer rates. Tort litigation does not increase the quality performance of nursing homes, and may decrease it slightly.

  4. Reflectivity of stimulated back scattering in a homogeneous-slab medium in the case of negligible pump-wave damping

    International Nuclear Information System (INIS)

    Cho, G.S.; Cho, B.H.

    1981-01-01

    As to the backscatter instability which is one of nonlinear three-wave resonant interactions, the reflectivity(r) in the case of homogeneous-slab medium is calculated, assuming all the three wavepackets negligible damping caused by medium. The expression has turned out such that r = tanh 2 KAsub(p)L, where K, Asub(p), and L are the constant coupling coefficient, the constant pump-wave amplitude, and the thickness of the medium engaged in the interaction each. When this result is interpreted in terms of the stimulated Brillouin back-scattering in a so-called underdense plasma in controlled fusion, we find the reflectivity twice as large as that by others in the limit of large pump-wave damping, and unfitting to former experiments in the independence on the incident laser-light intensity. We see the incompatibility rise chiefly from neglecting the damping of pump-wave in the plasma. In contrast to the former results by others in the limit of large pump-wave damping, our result might be regarded as that for cases of negligible pump-wave damping, in general stimulated back-scattering phenomena. (author)

  5. The importance of least restrictive care: the clinical implications of a recent High Court decision on negligence.

    Science.gov (United States)

    Ryan, Christopher James; Callaghan, Sascha; Large, Matthew

    2015-08-01

    This paper aims to explain the meaning and implications for practice of the High Court of Australia's finding in the negligence case, Hunter and New England Local Health District v McKenna [2014] HCA 44. The facts of the case and the law of negligence are reviewed before reporting the Court's decision. The High Court found that the obligation upon doctors to provide the least restrictive option for care that was imposed by the, then applicable, Mental Health Act 1990 (NSW) was inconsistent with an obligation that might otherwise be imposed by a common law duty to have regard to the interests of those with whom a psychiatric patient may come into contact if not detained. The Court's finding underlines the importance of clinicians documenting their clinical reasoning around why their negotiated management plan was the option least restrictive of the patient's freedom and most protective of his or her human rights. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  6. Large roomtemperature magnetocaloric effect with negligible magnetic hysteresis losses in Mn1-xVxCoGe alloys

    International Nuclear Information System (INIS)

    Ma, S.C.; Zheng, Y.X.; Xuan, H.C.; Shen, L.J.; Cao, Q.Q.; Wang, D.H.; Zhong, Z.C.; Du, Y.W.

    2012-01-01

    The magnetic and magnetocaloric properties have been investigated in a series of Mn 1-x V x CoGe (x=0.01, 0.02, 0.03, and 0.05) alloys. The substitution of V for Mn reduces the structural transformation temperature of MnCoGe alloy effectively and results in a second-order magnetic transition in Mn 0.95 V 0.05 CoGe alloys. Large room temperature magnetocaloric effect and almost zero magnetic hysteresis losses are simultaneously achieved in the alloys with x=0.01, 0.02, and 0.03. The reasons for the negligible magnetic hysteresis losses and the potential application for the roomtemperature magnetic refrigeration are discussed. - Highlights: → V-substitution for Mn reduces the structural transformation temperature of MnCoGe. → FM-PM transition presents the second-order nature in Mn0.95V0.05CoGe. → The first-order FM-PM transitions are observed for alloys with x=0.01, 0.02, and 0.03. → Large room temperature MCEs are achieved in these alloys. → Negligible magnetic HL is achieved for these alloys simultaneously.

  7. Negligible senescence in the longest living rodent, the naked mole-rat: insights from a successfully aging species.

    Science.gov (United States)

    Buffenstein, Rochelle

    2008-05-01

    Aging refers to a gradual deterioration in function that, over time, leads to increased mortality risk, and declining fertility. This pervasive process occurs in almost all organisms, although some long-lived trees and cold water inhabitants reportedly show insignificant aging. Negligible senescence is characterized by attenuated age-related change in reproductive and physiological functions, as well as no observable age-related gradual increase in mortality rate. It was questioned whether the longest living rodent, the naked mole-rat, met these three strict criteria. Naked mole-rats live in captivity for more than 28.3 years, approximately 9 times longer than similar-sized mice. They maintain body composition from 2 to 24 years, and show only slight age-related changes in all physiological and morphological characteristics studied to date. Surprisingly breeding females show no decline in fertility even when well into their third decade of life. Moreover, these animals have never been observed to develop any spontaneous neoplasm. As such they do not show the typical age-associated acceleration in mortality risk that characterizes every other known mammalian species and may therefore be the first reported mammal showing negligible senescence over the majority of their long lifespan. Clearly physiological and biochemical processes in this species have evolved to dramatically extend healthy lifespan. The challenge that lies ahead is to understand what these mechanisms are.

  8. Policy Choices for Progressive Realization of Universal Health Coverage Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

    Science.gov (United States)

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa; Sommanustweechai, Angkana

    2016-07-31

    In responses to Norheim's editorial, this commentary offers reflections from Thailand, how the five unacceptable trade-offs were applied to the universal health coverage (UHC) reforms between 1975 and 2002 when the whole 64 million people were covered by one of the three public health insurance systems. This commentary aims to generate global discussions on how best UHC can be gradually achieved. Not only the proposed five discrete trade-offs within each dimension, there are also trade-offs between the three dimensions of UHC such as population coverage, service coverage and cost coverage. Findings from Thai UHC show that equity is applied for the population coverage extension, when the low income households and the informal sector were the priority population groups for coverage extension by different prepayment schemes in 1975 and 1984, respectively. With an exception of public sector employees who were historically covered as part of fringe benefits were covered well before the poor. The private sector employees were covered last in 1990. Historically, Thailand applied a comprehensive benefit package where a few items are excluded using the negative list; until there was improved capacities on technology assessment that cost-effectiveness are used for the inclusion of new interventions into the benefit package. Not only cost-effectiveness, but long term budget impact, equity and ethical considerations are taken into account. Cost coverage is mostly determined by the fiscal capacities. Close ended budget with mix of provider payment methods are used as a tool for trade-off service coverage and financial risk protection. Introducing copayment in the context of fee-for-service can be harmful to beneficiaries due to supplier induced demands, inefficiency and unpredictable out of pocket payment by households. UHC achieves favorable outcomes as it was implemented when there was a full geographical coverage of primary healthcare coverage in all districts and sub

  9. State Medicaid Expansions for Parents Led to Increased Coverage and Prenatal Care Utilization among Pregnant Mothers.

    Science.gov (United States)

    Wherry, Laura R

    2017-12-28

    To evaluate impacts of state Medicaid expansions for low-income parents on the health insurance coverage, pregnancy intention, and use of prenatal care among mothers who became pregnant. Person-level data for women with a live birth from the 1997-2012 Pregnancy Risk Assessment Monitoring System. The sample was restricted to women who were already parents using information on previous live births and combined with information on state Medicaid policies for low-income parents. I used a measure of expanded generosity of state Medicaid eligibility for low-income parents to estimate changes in health insurance, pregnancy intention, and prenatal care for pregnant mothers associated with Medicaid expansion. I found an increase in prepregnancy health insurance coverage and coverage during pregnancy among pregnant mothers, as well as earlier initiation of prenatal care, associated with the expansions. Among pregnant mothers with less education, I found an increase in the adequacy of prenatal care utilization. Expanded Medicaid coverage for low-income adults has the potential to increase a woman's health insurance coverage prior to pregnancy, as well as her insurance coverage and medical care receipt during pregnancy. © Health Research and Educational Trust.

  10. A QoS-Guaranteed Coverage Precedence Routing Algorithm for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Jiun-Chuan Lin

    2011-03-01

    Full Text Available For mission-critical applications of wireless sensor networks (WSNs involving extensive battlefield surveillance, medical healthcare, etc., it is crucial to have low-power, new protocols, methodologies and structures for transferring data and information in a network with full sensing coverage capability for an extended working period. The upmost mission is to ensure that the network is fully functional providing reliable transmission of the sensed data without the risk of data loss. WSNs have been applied to various types of mission-critical applications. Coverage preservation is one of the most essential functions to guarantee quality of service (QoS in WSNs. However, a tradeoff exists between sensing coverage and network lifetime due to the limited energy supplies of sensor nodes. In this study, we propose a routing protocol to accommodate both energy-balance and coverage-preservation for sensor nodes in WSNs. The energy consumption for radio transmissions and the residual energy over the network are taken into account when the proposed protocol determines an energy-efficient route for a packet. The simulation results demonstrate that the proposed protocol is able to increase the duration of the on-duty network and provide up to 98.3% and 85.7% of extra service time with 100% sensing coverage ratio comparing with LEACH and the LEACH-Coverage-U protocols, respectively.

  11. Bad news: The influence of news coverage and Google searches on Gardasil adverse event reporting.

    Science.gov (United States)

    Faasse, Kate; Porsius, Jarry T; Faasse, Jonathan; Martin, Leslie R

    2017-12-14

    Human papilloma virus vaccines are a safe and effective tool for reducing HPV infections that can cause cervical cancer. However, uptake of these vaccines has been suboptimal, with many people holding negative beliefs and misconceptions. Such beliefs have been linked with the experience of unpleasant side effects following medical treatment, and media coverage may heighten such concerns. The present study sought to assess the influence of news coverage (number of news articles per month) on adverse event reporting in response to Gardasil vaccination in New Zealand over a 7.5-year period, and whether the influence of news coverage was mediated by internet search activity (Google search volumes). Multiple linear regression analyses and simple mediation analyses were used, controlling for year and number of vaccinations delivered. News coverage in the previous month, and Google search volumes in the same month, were significant predictors of adverse event reporting, after accounting for vaccination rates and year. Concurrent Google search volumes partially mediated the effect of prior news coverage. The results suggest that some of the adverse events reported were not related to the vaccination itself, but to news coverage and internet search volumes, which may have contributed to public concerns about potentially unpleasant or harmful outcomes. These findings have implications for the importance of psychological and social factors in adverse event reporting, and the role of the news media in disseminating health information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation

    Directory of Open Access Journals (Sweden)

    Dreser Anahí

    2012-12-01

    Full Text Available Abstract Background Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. Methods We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. Results The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians’ consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. Conclusions The narrowly-focused and polarized media coverage ─centred on

  13. Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation.

    Science.gov (United States)

    Dreser, Anahí; Vázquez-Vélez, Edna; Treviño, Sandra; Wirtz, Veronika J

    2012-12-06

    Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians' consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. The narrowly-focused and polarized media coverage ─centred on problems of self- medication and economic impact ─ was a missed opportunity

  14. Conceptualising the lack of health insurance coverage.

    Science.gov (United States)

    Davis, J B

    2000-01-01

    This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

  15. Resolution, coverage, and geometry beyond traditional limits

    Energy Technology Data Exchange (ETDEWEB)

    Ronen, Shuki; Ferber, Ralf

    1998-12-31

    The presentation relates to the optimization of the image of seismic data and improved resolution and coverage of acquired data. Non traditional processing methods such as inversion to zero offset (IZO) are used. To realize the potential of saving acquisition cost by reducing in-fill and to plan resolution improvement by processing, geometry QC methods such as DMO Dip Coverage Spectrum (DDCS) and Bull`s Eyes Analysis are used. The DDCS is a 2-D spectrum whose entries consist of the DMO (Dip Move Out) coverage for a particular reflector specified by it`s true time dip and reflector normal strike. The Bull`s Eyes Analysis relies on real time processing of synthetic data generated with the real geometry. 4 refs., 6 figs.

  16. State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage - United States, 2016.

    Science.gov (United States)

    DiGiulio, Anne; Haddix, Meredith; Jump, Zach; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Asman, Kat; Armour, Brian S

    2016-12-09

    In 2015, 27.8% of adult Medicaid enrollees were current cigarette smokers, compared with 11.1% of adults with private health insurance, placing Medicaid enrollees at increased risk for smoking-related disease and death (1). In addition, smoking-related diseases are a major contributor to Medicaid costs, accounting for about 15% (>$39 billion) of annual Medicaid spending during 2006-2010 (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications are effective treatments for helping tobacco users quit (3). Insurance coverage for tobacco cessation treatments is associated with increased quit attempts, use of cessation treatments, and successful smoking cessation (3); this coverage has the potential to reduce Medicaid costs (4). However, barriers such as requiring copayments and prior authorization for treatment can impede access to cessation treatments (3,5). As of July 1, 2016, 32 states (including the District of Columbia) have expanded Medicaid eligibility through the Patient Protection and Affordable Care Act (ACA),* ,† which has increased access to health care services, including cessation treatments (5). CDC used data from the Centers for Medicare and Medicaid Services (CMS) Medicaid Budget and Expenditure System (MBES) and the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the number of adult smokers enrolled in Medicaid expansion coverage. To assess cessation coverage among Medicaid expansion enrollees, the American Lung Association collected data on coverage of, and barriers to accessing, evidence-based cessation treatments. As of December 2015, approximately 2.3 million adult smokers were newly enrolled in Medicaid because of Medicaid expansion. As of July 1, 2016, all 32 states that have expanded Medicaid eligibility under ACA covered some cessation treatments for all Medicaid expansion enrollees, with nine states covering all nine cessation treatments for all Medicaid expansion

  17. Presumption of Negligence

    DEFF Research Database (Denmark)

    Guerra, Alice; Luppi, Barbara; Parisi, Francesco

    This paper is about the incentive effects of legal presumptions. We analyze three interrelated effects of legal presumptions in a tort setting: (1) incentives to invest in evidence technology; (2) incentives to invest in care-type precautions; and (3) incentives to mitigate excessive activity lev...

  18. 29 CFR 2.13 - Audiovisual coverage prohibited.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audiovisual coverage prohibited. 2.13 Section 2.13 Labor Office of the Secretary of Labor GENERAL REGULATIONS Audiovisual Coverage of Administrative Hearings § 2.13 Audiovisual coverage prohibited. The Department shall not permit audiovisual coverage of the...

  19. 28 CFR 55.6 - Coverage under section 203(c).

    Science.gov (United States)

    2010-07-01

    ... THE VOTING RIGHTS ACT REGARDING LANGUAGE MINORITY GROUPS Nature of Coverage § 55.6 Coverage under section 203(c). (a) Coverage formula. There are four ways in which a political subdivision can become subject to section 203(c). 2 2 The criteria for coverage are contained in section 203(b). (1) Political...

  20. Microstrip Antenna Design for Femtocell Coverage Optimization

    Directory of Open Access Journals (Sweden)

    Afaz Uddin Ahmed

    2014-01-01

    Full Text Available A mircostrip antenna is designed for multielement antenna coverage optimization in femtocell network. Interference is the foremost concern for the cellular operator in vast commercial deployments of femtocell. Many techniques in physical, data link and network-layer are analysed and developed to settle down the interference issues. A multielement technique with self-configuration features is analyzed here for coverage optimization of femtocell. It also focuses on the execution of microstrip antenna for multielement configuration. The antenna is designed for LTE Band 7 by using standard FR4 dielectric substrate. The performance of the proposed antenna in the femtocell application is discussed along with results.

  1. Contraceptive Coverage and the Affordable Care Act.

    Science.gov (United States)

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Sobre leptospirose e informação: ampliando os conceitos de negligência em saúde

    Directory of Open Access Journals (Sweden)

    Cláudio Manuel Rodrigues

    2017-04-01

    Full Text Available Quando se utiliza a denominação “negligência” em saúde infere-se que não faltem recursos financeiros para lidar com determinadas doenças ou que existam tratamentos disponíveis, mas que são doenças ignoradas apesar de representarem um potencial risco ou um dano já instalado à saúde pública. O negligenciamento de uma doença possui um duplo significado. O primeiro faz menção ao discurso clássico da negligência decorrente da falta de ação dos atores centrais da saúde pública: indústria farmacêutica, governo e sistema de saúde. Já o segundo, em intrincado e concomitante arranjo, diz respeito ao negligenciamento das populações correlacionadas à pobreza, desenvolvendo um círculo vicioso que acorrenta, pelo menos, um bilhão de pessoas em todo o planeta, segundo dados da Organização Mundial de Saúde (OMS. Esta identifica apenas 17 doenças denominadas “negligenciadas” e que afetam populações de maior vulnerabilidade econômica e social, apesar de não incluir a leptospirose — uma zoonose emergente, endêmica e de incidência global. Tomando por proposta a ampliação do conceito de negligência em saúde, discute-se neste artigo o rompimento com o modelo hegemônico, levando-se em consideração o quanto desassistida seria a leptospirose como a antropozoonose de maior incidência mundial e com uma letalidade elevada em áreas de menor aporte econômico do planeta, apesar de não reconhecida em todo o seu potencial zoonótico por falta de dados confiáveis de carga de doença em populações humanas e animais.

  3. Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs.

    Science.gov (United States)

    Legorreta, Antonio P; Metz, R Douglas; Nelson, Craig F; Ray, Saurabh; Chernicoff, Helen Oster; Dinubile, Nicholas A

    2004-10-11

    Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations. This study ascertains the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system. A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit. Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year, P<.001). Having chiropractic coverage was associated with a 1.6% decrease (P = .001) in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization (per 1000 episodes) of plain radiographs (17.5 vs 22.7, P<.001), low back surgery (3.3 vs 4.8, P<.001), hospitalizations (9.3 vs 15.6, P<.001), and magnetic resonance imaging (43.2 vs 68.9, P<.001). Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode-related costs ($289 vs $399, P<.001). Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) positive risk selection; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatment profiles; and (4) lower health service costs associated with managed chiropractic care. Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs.

  4. Causation in negligence: from anti-jurisprudence to principle--individual responsibility as the cornerstone for the attribution of liability.

    Science.gov (United States)

    Bagaric, Mirko; Erbacher, Sharon

    2011-06-01

    Causation is one of the most esoteric and poorly defined legal principles. The common law standards of the "but for" test and common sense are, in reality, code for unconstrained judicial choice. This leads to a high degree of unpredictability in negligence cases. Changes to the causation standard following the torts reforms have done nothing to inject principle into this area of law: the concept of "appropriateness" is no more illuminating than common sense. Despite this, the trend of recent High Court decisions offers some prospect of clarifying the test for causation. Key themes to emerge are an increased emphasis on individual responsibility and the associated concept of coherency with other legal standards. This article examines the doctrinal reasons underpinning the increasingly important role of these ideals and suggests how they can be accommodated into the test for causation to inject greater coherence and predictability into this area of law.

  5. The German Final Repository Konrad for Low and Intermediate Level Waste with Negligible Heat Generation - Water Law Issues

    International Nuclear Information System (INIS)

    Boetsch, W.; Grundler, D.; Kugel, K.; Brennecke, P.; Steyer, S.

    2009-01-01

    A survey on the conceptual realization of the requirements due to water law aspects within the license the KONRAD repository for radioactive waste with negligible heat generation in Germany is given [1]. The regulatory decision for the implementation and operation of the repository KONRAD includes, among other things, water law issues. In particular, the KONRAD license includes waste requirements concerning non-radioactive hazardous material (waste package constituents) which have to be considered producing KONRAD waste packages. The intended philosophy of waste acceptance and waste package quality assurance measures to be considered by the KONRAD site operator as well as by the waste producer will be presented. It will demonstrate the selected procedure of the waste declaration and acceptance and describe the structure and logic of tools and aids to comply with the legal requirements of the license and its collateral clause issued under water law. (authors)

  6. Does litigation increase or decrease health care quality? A national study of negligence claims against nursing homes

    Science.gov (United States)

    Stevenson, David G.; Spittal, Matthew J.; Studdert, David M.

    2016-01-01

    Background The tort system is supposed to help improve the quality and safety of health care, but whether it actually does so is controversial. Most previous studies modeling the effect of negligence litigation on quality of care are ecologic. Objective To assess whether the experience of being sued and incurring litigation costs affects the quality of care subsequently delivered in nursing homes. Research Design, Subjects, Measures We linked information on 6,471 negligence claims brought against 1,514 nursing homes between 1998 and 2010 to indicators of nursing home quality drawn from two U.S. national datasets (Online Survey, Certification, and Reporting system; Minimum Data Set Quality Measure/Indicator Reports). At the facility level, we tested for associations between 9 quality measures and 3 variables indicating the nursing homes’ litigation experience in the preceding 12–18 months (total indemnity payments; total indemnity payments plus administrative costs; ≥1 paid claims vs. none). The analyses adjusted for quality at baseline, case-mix, ownership, occupancy, year, and facility and state random effects. Results Nearly all combinations of the 3 litigation exposure measures and 9 quality measures—27 models in all—showed an inverse relationship between litigation costs and quality. However only a few of these associations were statistically significant, and the effect sizes were very small. For example, a doubling of indemnity payments was associated with a 1.1% increase in the number of deficiencies and a 2.2% increase in pressure ulcer rates. Conclusions Tort litigation does not increase the quality performance of nursing homes, and may decrease it slightly. PMID:23552438

  7. 24 CFR 51.302 - Coverage.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Coverage. 51.302 Section 51.302 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... significantly prolongs the physical or economic life of existing facilities or which, in the case of Accident...

  8. 5 CFR 880.304 - FEGLI coverage.

    Science.gov (United States)

    2010-01-01

    ... under § 880.205, FEGLI premiums and benefits will be computed using the date of death established under...) RETIREMENT AND INSURANCE BENEFITS DURING PERIODS OF UNEXPLAINED ABSENCE Continuation of Benefits § 880.304 FEGLI coverage. (a) FEGLI premiums will not be collected during periods when an annuitant is a missing...

  9. 44 CFR 17.610 - Coverage.

    Science.gov (United States)

    2010-10-01

    ... SECURITY GENERAL GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (GRANTS) § 17.610 Coverage. (a) This... covered by this subpart, except where specifically modified by this subpart. In the event of any conflict... are deemed to control with respect to the implementation of drug-free workplace requirements...

  10. 77 FR 16453 - Student Health Insurance Coverage

    Science.gov (United States)

    2012-03-21

    ... eliminating annual and lifetime dollar limits would result in dramatic premium hikes for student plans and.... Industry and university commenters noted that student health insurance coverage benefits typically... duplication of benefits and makes student plans more affordable. Industry commenters noted that student health...

  11. Coverage of space by random sets

    Indian Academy of Sciences (India)

    Consider the non-negative integer line. For each integer point we toss a coin. If the toss at location i is a. Heads we place an interval (of random length) there and move to location i + 1,. Tails we move to location i + 1. Coverage of space by random sets – p. 2/29 ...

  12. 5 CFR 610.402 - Coverage.

    Science.gov (United States)

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS HOURS OF DUTY Flexible and Compressed Work Schedules § 610.402 Coverage. The regulations contained in this subpart apply only to flexible work schedules and compressed work schedules established under subchapter 11 of chapter 61 of...

  13. 14 CFR 205.5 - Minimum coverage.

    Science.gov (United States)

    2010-01-01

    ... 18,000 pounds maximum payload capacity, carriers need only maintain coverage of $2,000,000 per... than 30 seats or 7,500 pounds maximum cargo payload capacity, and a maximum authorized takeoff weight... not be contingent upon the financial condition, solvency, or freedom from bankruptcy of the carrier...

  14. 5 CFR 734.401 - Coverage.

    Science.gov (United States)

    2010-01-01

    ...) POLITICAL ACTIVITIES OF FEDERAL EMPLOYEES Employees in Certain Agencies and Positions § 734.401 Coverage. (a... Criminal Investigation of the Internal Revenue Service. (11) The Office of Investigative Programs of the... Firearms; (13) The Criminal Division of the Department of Justice; (14) The Central Imagery Office; (15...

  15. Danish Media coverage of 22/7

    DEFF Research Database (Denmark)

    Hervik, Peter; Boisen, Sophie

    2013-01-01

    ’s Danish connections through an analysis of the first 100 days of Danish media coverage. We scrutinised 188 articles in the largest daily newspapers to find out how Danish actors related to ABB’s ideas. The key argument is that the discourses and opinions reflect pre-existing opinions and entrenched...

  16. Binning metagenomic contigs by coverage and composition

    NARCIS (Netherlands)

    Alneberg, J.; Bjarnason, B.S.; Bruijn, de I.; Schirmer, M.; Quick, J.; Ijaz, U.Z.; Lahti, L.M.; Loman, N.J.; Andersson, A.F.; Quince, C.

    2014-01-01

    Shotgun sequencing enables the reconstruction of genomes from complex microbial communities, but because assembly does not reconstruct entire genomes, it is necessary to bin genome fragments. Here we present CONCOCT, a new algorithm that combines sequence composition and coverage across multiple

  17. From coverage to care: addressing the issue of churn.

    Science.gov (United States)

    Milligan, Charles

    2015-02-01

    In any given year, a significant number of individuals will move between Medicaid and qualified health plans (QHP). Known as "churn," this movement could disrupt continuity of health care services, even when no gap in insurance coverage exists. The number of people who churn in any given year is significant, and they often are significant utilizers of health care services. They could experience disruption in care in several ways: (1) changing carrier; (2) changing provider because of network differences; (3) a disruption in ongoing services, even when the benefit is covered in both programs (e.g., surgery that has been authorized but not yet performed; ongoing prescription medications for chronic illness; or some but not all therapy or counseling sessions have been completed); and (4) the loss of coverage for a service that is not a covered benefit in the new program. Many strategies are available to states to reduce the disruption caused by churn. The specific option, intervention, and set of policies in a given state will depend on its context. Policy makers would benefit from an examination and discussion of these issues. Copyright © 2015 by Duke University Press.

  18. Assessment of coverage levels of single dose measles vaccine

    International Nuclear Information System (INIS)

    Tariq, P.

    2003-01-01

    Objective: To study the consequences of low coverage levels of a single dose of measles vaccine. Results: mean age observed in measles cases was 2 years and 8 months with a range from 3 months to 8 years. Maximum number of cases reported were <1 year of age (n=22,32%). Fifty percent of cases were seen among vaccinated children. Seventy-five percent (n=51) had history of contact with a measles case. Pneumonia was the commonest complication followed by acute gastroenteritis, encephalitis, febrile convulsions, oral ulcers, oral thrush, eye changes of vitamin-A deficiency and pulmonary tuberculosis (T.B.) in descending order of frequency. Fifty four cases were successfully treated for complications of measles and discharged. Nine cases left against medical advice. Five patients died all of them had encephalitis either alone (n=1) or in combination with pneumonia and acute gastroenteritis (n=4). Conclusion: There is a dire need to increase the immunization coverage to reduce the rate of vaccine failure and achieve effective control of measles.(author)

  19. THEORETICAL AND CASE-LAW CONSIDERATIONS ON THE PROFESSIONAL NEGLIGENCE OF DOCTORS THAT COULD RESULT IN CRIMINAL, NOT ONLY CIVIL, LIABILITY

    Directory of Open Access Journals (Sweden)

    Adrian HĂRĂTĂU

    2017-05-01

    Full Text Available In this study we aimed to analyze guilt, in the form of negligence, that is governed in Romanian criminal laws in Article 16 paragraph (4 of the Criminal Code, as follows:“An offence is perpetrated in negligence when the offender:a foresees the outcome of his actions but does not accept it, deeming that it is unlikely for it to occur; b does not foresee the outcome of his actions, although he should and could have.”This form of guilt applies in the case of all incriminations stipulated in the criminal law perpetrated in a negligent manner, while keeping in mind that, in accordance with Article 16 paragraph (6 of the Criminal Code “an offence committed in negligence amounts to a criminal offence when expressly provided by law”.

  20. Proton Therapy Coverage for Prostate Cancer Treatment

    International Nuclear Information System (INIS)

    Vargas, Carlos; Wagner, Marcus; Mahajan, Chaitali; Indelicato, Daniel; Fryer, Amber; Falchook, Aaron; Horne, David C.; Chellini, Angela; McKenzie, Craig C.; Lawlor, Paula C.; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-01-01

    Purpose: To determine the impact of prostate motion on dose coverage in proton therapy. Methods and Materials: A total of 120 prostate positions were analyzed on 10 treatment plans for 10 prostate patients treated using our low-risk proton therapy prostate protocol (University of Florida Proton Therapy Institute 001). Computed tomography and magnetic resonance imaging T 2 -weighted turbo spin-echo scans were registered for all cases. The planning target volume included the prostate with a 5-mm axial and 8-mm superoinferior expansion. The prostate was repositioned using 5- and 10-mm one-dimensional vectors and 10-mm multidimensional vectors (Points A-D). The beam was realigned for the 5- and 10-mm displacements. The prescription dose was 78 Gy equivalent (GE). Results: The mean percentage of rectum receiving 70 Gy (V 70 ) was 7.9%, the bladder V 70 was 14.0%, and the femoral head/neck V 50 was 0.1%, and the mean pelvic dose was 4.6 GE. The percentage of prostate receiving 78 Gy (V 78 ) with the 5-mm movements changed by -0.2% (range, 0.006-0.5%, p > 0.7). However, the prostate V 78 after a 10-mm displacement changed significantly (p 78 coverage had a large and significant reduction of 17.4% (range, 13.5-17.4%, p 78 coverage of the clinical target volume. The minimal prostate dose was reduced 33% (25.8 GE), on average, for Points A-D. The prostate minimal dose improved from 69.3 GE to 78.2 GE (p < 0.001) with realignment for 10-mm movements. Conclusion: The good dose coverage and low normal doses achieved for the initial plan was maintained with movements of ≤5 mm. Beam realignment improved coverage for 10-mm displacements

  1. Financing universal coverage in Malaysia: a case study.

    Science.gov (United States)

    Chua, Hong Teck; Cheah, Julius Chee Ho

    2012-01-01

    care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.

  2. Analytical methodologies for broad metabolite coverage of exhaled breath condensate.

    Science.gov (United States)

    Aksenov, Alexander A; Zamuruyev, Konstantin O; Pasamontes, Alberto; Brown, Joshua F; Schivo, Michael; Foutouhi, Soraya; Weimer, Bart C; Kenyon, Nicholas J; Davis, Cristina E

    2017-09-01

    Breath analysis has been gaining popularity as a non-invasive technique that is amenable to a broad range of medical uses. One of the persistent problems hampering the wide application of the breath analysis method is measurement variability of metabolite abundances stemming from differences in both sampling and analysis methodologies used in various studies. Mass spectrometry has been a method of choice for comprehensive metabolomic analysis. For the first time in the present study, we juxtapose the most commonly employed mass spectrometry-based analysis methodologies and directly compare the resultant coverages of detected compounds in exhaled breath condensate in order to guide methodology choices for exhaled breath condensate analysis studies. Four methods were explored to broaden the range of measured compounds across both the volatile and non-volatile domain. Liquid phase sampling with polyacrylate Solid-Phase MicroExtraction fiber, liquid phase extraction with a polydimethylsiloxane patch, and headspace sampling using Carboxen/Polydimethylsiloxane Solid-Phase MicroExtraction (SPME) followed by gas chromatography mass spectrometry were tested for the analysis of volatile fraction. Hydrophilic interaction liquid chromatography and reversed-phase chromatography high performance liquid chromatography mass spectrometry were used for analysis of non-volatile fraction. We found that liquid phase breath condensate extraction was notably superior compared to headspace extraction and differences in employed sorbents manifested altered metabolite coverages. The most pronounced effect was substantially enhanced metabolite capture for larger, higher-boiling compounds using polyacrylate SPME liquid phase sampling. The analysis of the non-volatile fraction of breath condensate by hydrophilic and reverse phase high performance liquid chromatography mass spectrometry indicated orthogonal metabolite coverage by these chromatography modes. We found that the metabolite coverage

  3. Universal Health Insurance and the Reasons of not Coverage in Iran: Secondary Analysis of a National Household Survey

    Directory of Open Access Journals (Sweden)

    Shirin Nosratnejad

    2015-08-01

    Full Text Available Background and objectives : Universal insurance coverage is considered as one of the main goals of health systems around the world. Although Universal Health Insurance Law was legislated with the objective of covering all Iranian population under health insurance coverage in 1994, but imperfect insurance coverage has remained as a threatening dilemma. Heterogeneous statistics reported by insurer in Iran and the lack of appropriate, comprehensive databases have failed any judgments about the number of uninsured people and the reasons for it. Present study aimed to give better insight on insurance coverage among Iranian people and examine key reasons of imperfect coverage through a deep analysis of a national household survey. Material and Methods : Data which were collected from a national survey of health care utilization in Iran that covered over 102000 people of Iranians were analyzed. The survey had been implemented in 2007 by Iran's Ministry of Health. In order to identify possible reasons for imperfect coverage, national and international databases like SID, Iranmedex, ISC, Pubmed, Scopus, official statistics of Statistical Center of Iran (SCI, Iranian Social Security Organization (ISSO and Central Insurance of IRIRAN (CII were searched. Data management was accomplished in Microsoft Excel software.  Results : Study results showed that 85% of Iranian households had health insurance coverage, compared to 15% without any coverage. Medical services insurance fund had the greater proportion of coverage (59.27% and basic private insurance coverage was accountable for the least coverage (0.2%. More than half of households (51% stated financial inability to pay as the main reason for not getting coverage, followed by the lack of knowledge about insurance (12%, unemployment (12% and bypass by employers (10%. A worthwhile finding was that, 13% of households implied they felt no need to health insurance and 2% found it useless. Conclusion : Despite

  4. 21 CFR 26.33 - Product coverage.

    Science.gov (United States)

    2010-04-01

    ... the U.S. system as Class I/Class II-Tier 2 medical devices which are listed in appendix B of this... OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS...

  5. Negligent and intentional fires in Portugal: the role of human and biophysical drivers on the temporal distribution

    Science.gov (United States)

    Parente, Joana; Pereira, Mário; Amraoui, Malik; Tedim, Fantina

    2017-04-01

    Portugal is the European country with higher number of fires (NF) and burnt area (BA) per unit of land area. The annual number of fires for which the cause of fire is known is not constant and relatively small (typically less than 50% of annual number of records). Nevertheless, the analysis of the fire causes reveals that the vast majority (99%) of the fires in Portugal are of human origin and only a small fraction are of natural origin (1% caused by lightning). The study period will be the recent years of 2012 - 2014, when fire recording procedures are more reliable and the cause of ignition was assessed for more than 50% (19376) of the fires. The fires with approximately seventy different causes of fire defined/recognized by the Portuguese Forest Service (ICNF) were grouped into negligent, intentional and natural fires. For this study the authors proposes the use of the Nomenclature of Territorial Units for Statistics level II, which divides Portugal in 5 basic economic regions, namely Norte, Centro, Área Metropolitana de Lisboa, Alentejo, and Algarve. Most of the fires (54%) occur in the so-called critical period defined between July and September, but high wildfire activity may also occur in few periods of the remaining months (especially in February and March). The intentional fires represent 40% of total NF but accounts for 53% of total BA during the study period. The temporal distribution are described and interpreted in terms of the climate, fire weather, land use land cover (LULC), distance to communication routes (roads and railways) and topographic variables (altitude, slope) using statistical analysis and GIS techniques. Results points to: a) higher number of negligent than intentional fires; b) higher BA on critical period in years 2012 and 2013; c) decrease in time and decrease from critical period to non-critical period of the number of fires, in all regions; and d) the dominant role of fire weather in the observed temporal patterns. We strongly

  6. [Options for flap coverage in pressure sores].

    Science.gov (United States)

    Nae, S; Antohi, N; Stîngu, C; Stan, V; Parasca, S

    2010-01-01

    Despite improvements in reconstructive techniques for pressure sores, recurrences are still seen frequently, and success rate remains variable. During 2003 - 2007, at the Emergency Hospital for Plastic Surgery and Burns in Bucharest, 27 patients underwent surgical repair of 45 pressure sores located at sacral (22 ulcers), ischial (12 ulcers) and trochanteric (11 ulcers) regions. The mean patient age was 57, 1 years (range 26 to 82 years). Mean postoperative follow-up was 6 months (range 2 months - 2 years). There were 18 complications for the 45 sores (40%). At 6 months postoperatively, recurrence was noted in 12 ulcers (27%). Details regarding indications, contraindications, advantages and disadvantages for different coverage options are outlined. The authors advocate the importance of surgical coverage in reducing morbidity, mortality and treatment costs.

  7. Barriers and facilitators to influenza vaccination and vaccine coverage in a cohort of health care personnel.

    Science.gov (United States)

    Naleway, Allison L; Henkle, Emily M; Ball, Sarah; Bozeman, Sam; Gaglani, Manjusha J; Kennedy, Erin D; Thompson, Mark G

    2014-04-01

    Annual influenza vaccination is recommended for health care personnel (HCP). We describe influenza vaccination coverage among HCP during the 2010-2011 season and present reported facilitators of and barriers to vaccination. We enrolled HCP 18 to 65 years of age, working full time, with direct patient contact. Participants completed an Internet-based survey at enrollment and the end of influenza season. In addition to self-reported data, we collected information about the 2010-2011 influenza vaccine from electronic employee health and medical records. Vaccination coverage was 77% (1,307/1,701). Factors associated with higher vaccination coverage include older age, being married or partnered, working as a physician or dentist, prior history of influenza vaccination, more years in patient care, and higher job satisfaction. Personal protection was reported as the most important reason for vaccination followed closely by convenience, protection of patients, and protection of family and friends. Concerns about perceived vaccine safety and effectiveness and low perceived susceptibility to influenza were the most commonly reported barriers to vaccination. About half of the unvaccinated HCP said they would have been vaccinated if required by their employer. Influenza vaccination in this cohort was relatively high but still fell short of the recommended target of 90% coverage for HCP. Addressing concerns about vaccine safety and effectiveness are possible areas for future education or intervention to improve coverage among HCP. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  8. Worker Sorting, Taxes and Health Insurance Coverage

    OpenAIRE

    Kevin Lang; Hong Kang

    2007-01-01

    We develop a model in which firms hire heterogeneous workers but must offer all workers insurance benefits under similar terms. In equilibrium, some firms offer free health insurance, some require an employee premium payment and some do not offer insurance. Making the employee contribution pre-tax lowers the cost to workers of a given employee premium and encourages more firms to charge. This increases the offer rate, lowers the take-up rate, increases (decreases) coverage among high (low) de...

  9. Right-handers have negligibly higher IQ scores than left-handers: Systematic review and meta-analyses.

    Science.gov (United States)

    Ntolka, Eleni; Papadatou-Pastou, Marietta

    2018-01-01

    The relationship between intelligence and handedness remains a matter of debate. The present study is a systematic review of 36 studies (totaling 66,108 individuals), which have measured full IQ scores in different handedness groups. Eighteen of those studies were further included in three sets of meta-analyses (totaling 20,442 individuals), which investigated differences in standardized mean IQ scores in (i) left-handers, (ii) non-right-handers, and (iii) mixed-handers compared to right-handers. The bulk of the studies included in the systematic review reported no differences in IQ scores between left- and right-handers. In the meta-analyses, statistically significant differences in mean IQ scores were detected between right-handers and left-handers, but were marginal in magnitude (d=-0.07); the data sets were found to be homogeneous. Significance was lost when the largest study was excluded. No differences in mean IQ scores were found between right-handers and non-right-handers as well as between right-handers and mixed-handers. No sex differences were found. Overall, the intelligence differences between handedness groups in the general population are negligible. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Transfer of thallium from rape seed to rape oil is negligible and oil is fit for human consumption.

    Science.gov (United States)

    Loula, Martin; Kaňa, Antonín; Vosmanská, Magda; Koplík, Richard; Mestek, Oto

    2016-01-01

    Rape and other Brassicaceae family plants can accumulate appreciable amounts of thallium from the soil. Because some species of this family are common crops utilised as food for direct consumption or raw materials for food production, thallium can enter the food chain. A useful method for thallium determination is inductively coupled plasma mass spectrometry. The limit of detection (0.2 pg ml(-1) Tl or 0.02 ng g(-1) Tl, taking in the account dilution during sample decomposition) found in the current study was very low, and the method can be used for ultra-trace analysis. Possible transfer of thallium from rape seed to the rape oil was investigated in two ways. The balance of thallium in rape seed meal (content 140-200 ng g(-1) Tl) and defatted rape seed meal indicated that thallium did not pass into the oil (p thallium in six kinds of edible rape seed oil and three kinds of margarines showed that the amount of thallium in rape seed oil is negligible.

  11. Negligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy.

    Science.gov (United States)

    Mieras, Liesbeth; Anthony, Richard; van Brakel, Wim; Bratschi, Martin W; van den Broek, Jacques; Cambau, Emmanuelle; Cavaliero, Arielle; Kasang, Christa; Perera, Geethal; Reichman, Lee; Richardus, Jan Hendrik; Saunderson, Paul; Steinmann, Peter; Yew, Wing Wai

    2016-06-08

    Post-exposure prophylaxis (PEP) for leprosy is administered as one single dose of rifampicin (SDR) to the contacts of newly diagnosed leprosy patients. SDR reduces the risk of developing leprosy among contacts by around 60 % in the first 2-3 years after receiving SDR. In countries where SDR is currently being implemented under routine programme conditions in defined areas, questions were raised by health authorities and professional bodies about the possible risk of inducing rifampicin resistance among the M. tuberculosis strains circulating in these areas. This issue has not been addressed in scientific literature to date. To produce an authoritative consensus statement about the risk that SDR would induce rifampicin-resistant tuberculosis, a meeting was convened with tuberculosis (TB) and leprosy experts. The experts carefully reviewed and discussed the available evidence regarding the mechanisms and risk factors for the development of (multi) drug-resistance in M. tuberculosis with a view to the special situation of the use of SDR as PEP for leprosy. They concluded that SDR given to contacts of leprosy patients, in the absence of symptoms of active TB, poses a negligible risk of generating resistance in M. tuberculosis in individuals and at the population level. Thus, the benefits of SDR prophylaxis in reducing the risk of developing leprosy in contacts of new leprosy patients far outweigh the risks of generating drug resistance in M. tuberculosis.

  12. Recommendation system for immunization coverage and monitoring.

    Science.gov (United States)

    Bhatti, Uzair Aslam; Huang, Mengxing; Wang, Hao; Zhang, Yu; Mehmood, Anum; Di, Wu

    2018-01-02

    Immunization averts an expected 2 to 3 million deaths every year from diphtheria, tetanus, pertussis (whooping cough), and measles; however, an additional 1.5 million deaths could be avoided if vaccination coverage was improved worldwide. 1 1 Data source for immunization records of 1.5 M: http://www.who.int/mediacentre/factsheets/fs378/en/ New vaccination technologies provide earlier diagnoses, personalized treatments and a wide range of other benefits for both patients and health care professionals. Childhood diseases that were commonplace less than a generation ago have become rare because of vaccines. However, 100% vaccination coverage is still the target to avoid further mortality. Governments have launched special campaigns to create an awareness of vaccination. In this paper, we have focused on data mining algorithms for big data using a collaborative approach for vaccination datasets to resolve problems with planning vaccinations in children, stocking vaccines, and tracking and monitoring non-vaccinated children appropriately. Geographical mapping of vaccination records helps to tackle red zone areas, where vaccination rates are poor, while green zone areas, where vaccination rates are good, can be monitored to enable health care staff to plan the administration of vaccines. Our recommendation algorithm assists in these processes by using deep data mining and by accessing records of other hospitals to highlight locations with lower rates of vaccination. The overall performance of the model is good. The model has been implemented in hospitals to control vaccination across the coverage area.

  13. Do falls and falls-injuries in hospital indicate negligent care -- and how big is the risk? A retrospective analysis of the NHS Litigation Authority Database of clinical negligence claims, resulting from falls in hospitals in England 1995 to 2006.

    Science.gov (United States)

    Oliver, D; Killick, S; Even, T; Willmott, M

    2008-12-01

    Accidental falls are very common in older hospital patients -- accounting for 32% of reported adult patient safety incidents in UK National Health Service (NHS) hospitals and occurring with similar frequency in settings internationally. In countries where the population is ageing, and care is provided in inpatient settings, falls prevention is therefore a significant and growing risk-management issue. Falls may lead to a variety of harms and costs, are cited in formal complaints and can lead to claims of clinical negligence. The NHS Litigation Authority (NHSLA) negligence claims database provides a novel opportunity to systematically analyse such (falls-related) claims made against NHS organisations in England and to learn lessons for risk-management systems and claims recording. To describe the circumstances and injuries most frequently cited in falls-related claims; to investigate any association between the financial impact (total cost), and the circumstances of or injuries resulting from falls in "closed" claims; to draw lessons for falls risk management and for future data capture on falls incidents and resulting claims analysis; to identify priorities for future research. A keyword search was run on the NHSLA claims database for April 1995 to February 2006, to identify all claims apparently relating to falls. Claims were excluded from further analysis if, on scrutiny, they had not resulted from falls, or if they were still "open" (ie, unresolved). From the narrative descriptions of closed claims (ie, those for which the financial outcome was known), we developed categories of "principal" and "secondary" injury/harm and "principal" and "contributory" circumstance of falls. For each category, it was determined whether cases had resulted in payment and what total payments (damages and costs) were awarded. The proportions of contribution-specific injuries or circumstances to the number of cases and to the overall costs incurred were compared in order to identify

  14. An analysis of the policy coverage and examination of ...

    African Journals Online (AJOL)

    ... topics in subjects such as Life Sciences, Physical Sciences, Life Orientation, ... The aim of the research reported here was to investigate the coverage and ... In analysing the coverage and examination of environmental-impact topics, ...

  15. Assessment of Effective Coverage of Voluntary Counseling and ...

    African Journals Online (AJOL)

    Assessment of Effective Coverage of Voluntary Counseling and Testing ... The objective of this study was to assess effective coverage level for Voluntary Counseling and testing services in major health facilities ... AJOL African Journals Online.

  16. Determinants of vaccination coverage among pastoralists in north ...

    African Journals Online (AJOL)

    Determinants of vaccination coverage among pastoralists in north eastern Kenya. ... Attitudes, and Practices (KAPs) on vaccination coverage among settled and ... We used a structured instrument to survey pastoralist mothers with children ...

  17. Mobile-robot navigation with complete coverage of unstructured environments

    OpenAIRE

    García Armada, Elena; González de Santos, Pablo

    2004-01-01

    There are some mobile-robot applications that require the complete coverage of an unstructured environment. Examples are humanitarian de-mining and floor-cleaning tasks. A complete-coverage algorithm is then used, a path-planning technique that allows the robot to pass over all points in the environment, avoiding unknown obstacles. Different coverage algorithms exist, but they fail working in unstructured environments. This paper details a complete-coverage algorithm for unstructured environm...

  18. 42 CFR 457.410 - Health benefits coverage options.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Health benefits coverage options. 457.410 Section 457.410 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... State Plan Requirements: Coverage and Benefits § 457.410 Health benefits coverage options. (a) Types of...

  19. 7 CFR 457.172 - Coverage Enhancement Option.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Coverage Enhancement Option. 457.172 Section 457.172..., DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.172 Coverage Enhancement Option. The Coverage Enhancement Option for the 2009 and succeeding crop years are as follows: FCIC policies: United...

  20. 20 CFR 701.401 - Coverage under state compensation programs.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Coverage under state compensation programs...; DEFINITIONS AND USE OF TERMS Coverage Under State Compensation Programs § 701.401 Coverage under state compensation programs. (a) Exclusions from the definition of “employee” under § 701.301(a)(12), and the...

  1. 20 CFR 404.1065 - Self-employment coverage.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Self-employment coverage. 404.1065 Section... INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Self-Employment § 404.1065 Self-employment coverage. For an individual to have self-employment coverage under social security, the...

  2. 42 CFR 436.128 - Coverage for certain qualified aliens.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coverage for certain qualified aliens. 436.128... Mandatory Coverage of the Categorically Needy § 436.128 Coverage for certain qualified aliens. The agency... § 440.255(c) of this chapter to those aliens described in § 436.406(c) of this subpart. [55 FR 36820...

  3. 7 CFR 1737.31 - Area Coverage Survey (ACS).

    Science.gov (United States)

    2010-01-01

    ... an ACS are provided in RUS Telecommunications Engineering and Construction Manual section 205. (e... Studies-Area Coverage Survey and Loan Design § 1737.31 Area Coverage Survey (ACS). (a) The Area Coverage... the borrower's records contain sufficient information as to subscriber development to enable cost...

  4. 29 CFR 2.12 - Audiovisual coverage permitted.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Audiovisual coverage permitted. 2.12 Section 2.12 Labor Office of the Secretary of Labor GENERAL REGULATIONS Audiovisual Coverage of Administrative Hearings § 2.12 Audiovisual coverage permitted. The following are the types of hearings where the Department...

  5. SPT0346-52: NEGLIGIBLE AGN ACTIVITY IN A COMPACT, HYPER-STARBURST GALAXY AT z = 5.7

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Jingzhe; Gonzalez, Anthony H. [Department of Astronomy, University of Florida, Gainesville, FL 32611 (United States); Vieira, J. D.; Sreevani, J. [Department of Astronomy and Department of Physics, University of Illinois, 1002 West Green St., Urbana, IL 61801 (United States); Aravena, M. [Núcleo de Astronomía, Facultad de Ingeniería, Universidad Diego Portales, Av. Ejército 441, Santiago (Chile); Ashby, M. L. N. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Béthermin, M.; Breuck, C. de; Gullberg, B. [European Southern Observatory, Karl Schwarzschild Straße 2, D-85748 Garching (Germany); Bothwell, M. S. [Cavendish Laboratory, University of Cambridge, JJ Thompson Ave, Cambridge CB3 0HA (United Kingdom); Brandt, W. N. [Institute for Gravitation and the Cosmos, The Pennsylvania State University, University Park, PA 16802 (United States); Carlstrom, J. E. [Kavli Institute for Cosmological Physics, University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637 (United States); Chapman, S. C. [Dalhousie University, Halifax, Nova Scotia (Canada); Hezaveh, Y. [Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, CA 94305 (United States); Litke, K.; Marrone, D. P.; Spilker, J. S. [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Malkan, M. [Department of Physics and Astronomy, University of California, Los Angeles, CA 90095-1547 (United States); McDonald, M. [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, 37-582C, Cambridge, MA 02139 (United States); Murphy, E. J., E-mail: jingzhema@ufl.edu [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903 (United States); and others

    2016-12-01

    We present Chandra ACIS-S and Australia Telescope Compact Array (ATCA) radio continuum observations of the strongly lensed dusty, star-forming galaxy SPT-S J034640-5204.9 (hereafter SPT0346-52) at z = 5.656. This galaxy has also been observed with ALMA, HST , Spitzer , Herschel , Atacama Pathfinder EXperiment, and the Very Large Telescope. Previous observations indicate that if the infrared (IR) emission is driven by star formation, then the inferred lensing-corrected star formation rate (SFR) (∼4500 M {sub ☉} yr{sup −1}) and SFR surface density Σ{sub SFR} (∼2000 M {sub ☉} yr{sup −1} kpc{sup −2}) are both exceptionally high. It remained unclear from the previous data, however, whether a central active galactic nucleus (AGN) contributes appreciably to the IR luminosity. The Chandra upper limit shows that SPT0346-52 is consistent with being star formation dominated in the X-ray, and any AGN contribution to the IR emission is negligible. The ATCA radio continuum upper limits are also consistent with the FIR-to-radio correlation for star-forming galaxies with no indication of an additional AGN contribution. The observed prodigious intrinsic IR luminosity of (3.6 ± 0.3) × 10{sup 13} L {sub ☉} originates almost solely from vigorous star formation activity. With an intrinsic source size of 0.61 ± 0.03 kpc, SPT0346-52 is confirmed to have one of the highest Σ{sub SFR} of any known galaxy. This high Σ{sub SFR}, which approaches the Eddington limit for a radiation pressure supported starburst, may be explained by a combination of very high star formation efficiency and gas fraction.

  6. The Fallacy of the Longevity Elixir: Negligible Senescence May be Achieved, but Not by Using Something Physical.

    Science.gov (United States)

    Kyriazis, Marios; Apostolides, Andreas

    2015-01-01

    The process of aging is a continuum of degeneration which eventually leads to loss of function and clinically manifest disease. Yet, in the purely therapeutic sense, there is a distinct clinical and practical separation between age-related degenerative diseases and the background process of aging itself. It is quite possible that biomedical technologies will prove invaluable in treating or alleviating the impact of distinct age-related degenerative diseases such as cardiovascular disease, arthritis or dementia. However, when it comes to addressing the fundamental, background stochastic nature of aging, it is unlikely that regenerative biotechnologies will have any appreciable impact in continually counteracting the process. In this paper we discuss some essential conceptual obstacles, both functional and translational, which will prove overwhelming and which preclude the notion that aging can be eliminated by using physical therapies. Our reasoning is two-fold: 1. Disruptive regenerative biotechnologies interfere with the complex, dynamic topological architecture of the human organism, in a manner that will render them unsuitable for clinical use against all age-related degeneration. 2. Even if some regenerative biotechnological treatments are developed in the laboratory, the translational issues will be insurmountable, and the treatments will thus be practically unusable by the general public at large. Predictions about the near or mid-term development of rejuvenating biotechnologies are not sufficiently grounded, and do not provide a framework for effective practical achievement of negligible senescence. Instead, the answer must lie in more global and abstract methods which align well with evolutionary mechanisms based on techno-cultural societal necessities. These are likely to operate in a way which ultimately may downgrade the importance of human aging and make it an evolutionarily unnecessary process.

  7. SPT0346-52: NEGLIGIBLE AGN ACTIVITY IN A COMPACT, HYPER-STARBURST GALAXY AT z = 5.7

    International Nuclear Information System (INIS)

    Ma, Jingzhe; Gonzalez, Anthony H.; Vieira, J. D.; Sreevani, J.; Aravena, M.; Ashby, M. L. N.; Béthermin, M.; Breuck, C. de; Gullberg, B.; Bothwell, M. S.; Brandt, W. N.; Carlstrom, J. E.; Chapman, S. C.; Hezaveh, Y.; Litke, K.; Marrone, D. P.; Spilker, J. S.; Malkan, M.; McDonald, M.; Murphy, E. J.

    2016-01-01

    We present Chandra ACIS-S and Australia Telescope Compact Array (ATCA) radio continuum observations of the strongly lensed dusty, star-forming galaxy SPT-S J034640-5204.9 (hereafter SPT0346-52) at z = 5.656. This galaxy has also been observed with ALMA, HST , Spitzer , Herschel , Atacama Pathfinder EXperiment, and the Very Large Telescope. Previous observations indicate that if the infrared (IR) emission is driven by star formation, then the inferred lensing-corrected star formation rate (SFR) (∼4500 M ☉ yr −1 ) and SFR surface density Σ SFR (∼2000 M ☉ yr −1 kpc −2 ) are both exceptionally high. It remained unclear from the previous data, however, whether a central active galactic nucleus (AGN) contributes appreciably to the IR luminosity. The Chandra upper limit shows that SPT0346-52 is consistent with being star formation dominated in the X-ray, and any AGN contribution to the IR emission is negligible. The ATCA radio continuum upper limits are also consistent with the FIR-to-radio correlation for star-forming galaxies with no indication of an additional AGN contribution. The observed prodigious intrinsic IR luminosity of (3.6 ± 0.3) × 10 13 L ☉ originates almost solely from vigorous star formation activity. With an intrinsic source size of 0.61 ± 0.03 kpc, SPT0346-52 is confirmed to have one of the highest Σ SFR of any known galaxy. This high Σ SFR , which approaches the Eddington limit for a radiation pressure supported starburst, may be explained by a combination of very high star formation efficiency and gas fraction.

  8. From Negligence to Perception of Complexities in Adherence to Treatment Process in People with Diabetes: A Grounded Theory Study

    Directory of Open Access Journals (Sweden)

    Seyedeh Narjes Mousavizadeh

    2018-03-01

    Full Text Available Background: Poor adherence of patients with type 2 diabetes to treatment is one of the most complex and important clinical concerns. It is the main issue of the present decade and acknowledged as a challenge to control and treat diabetes. This study was carried out to explore and understand how adherence to treatment process occurs among Iranian patients with type 2 diabetes. Methods: The present study is qualitative with grounded theory approach. The data were collected from December 2015 to July 2016 in Tehran (Iran through individual semi-structured in-depth interviews, field notes, and memos from 21 patients with type 2 diabetes; combined with two members of their families and a healthcare professional. The data were analyzed based on Corbin and Strauss constant comparative analysis (2008. Results: Adherence to treatment is a transitional, interactive, and continuous process. For patients with diabetes, this process includes unperceived threat in diagnosis time (poor knowledge and skills, bottleneck of dependencies, superficial understanding of the new situation, bitter belief (downhill quality of life, physical and emotional treatment feedbacks, and adaptation to treatment (self-care dominance, regimen integration in daily activities. The process of adherence to treatment was influenced by knowledge and skill, social support, beliefs and values, psychological characteristics of people, and the nature of diabetes. Conclusion: Adherence to treatment in Iranian people with diabetes depends on the family and social context, which is challenging for the patient and leads to the negligence of health behaviors. It is vital for healthcare providers to identify these factors to encourage patients to adhere and commit to treatment in order to prevent irreversible complications of diabetes.

  9. From Negligence to Perception of Complexities in Adherence to Treatment Process in People with Diabetes: A Grounded Theory Study.

    Science.gov (United States)

    Mousavizadeh, Seyedeh Narjes; Ashktorab, Tahereh; Ahmadi, Fazlollah; Zandi, Mitra

    2018-03-01

    Poor adherence of patients with type 2 diabetes to treatment is one of the most complex and important clinical concerns. It is the main issue of the present decade and acknowledged as a challenge to control and treat diabetes. This study was carried out to explore and understand how adherence to treatment process occurs among Iranian patients with type 2 diabetes. The present study is qualitative with grounded theory approach. The data were collected from December 2015 to July 2016 in Tehran (Iran) through individual semi-structured in-depth interviews, field notes, and memos from 21 patients with type 2 diabetes; combined with two members of their families and a healthcare professional. The data were analyzed based on Corbin and Strauss constant comparative analysis (2008). Adherence to treatment is a transitional, interactive, and continuous process. For patients with diabetes, this process includes unperceived threat in diagnosis time (poor knowledge and skills, bottleneck of dependencies, superficial understanding of the new situation), bitter belief (downhill quality of life, physical and emotional treatment feedbacks), and adaptation to treatment (self-care dominance, regimen integration in daily activities). The process of adherence to treatment was influenced by knowledge and skill, social support, beliefs and values, psychological characteristics of people, and the nature of diabetes. Adherence to treatment in Iranian people with diabetes depends on the family and social context, which is challenging for the patient and leads to the negligence of health behaviors. It is vital for healthcare providers to identify these factors to encourage patients to adhere and commit to treatment in order to prevent irreversible complications of diabetes.

  10. Toward Better Access to Health Insurance Coverage for U.S. Retirees in Mexico

    OpenAIRE

    Warner David C.; Jahnke Lauren R.

    2001-01-01

    Many retirees from the United States of America have limited health insurance coverage while living in Mexico. Medicare and Medicaid benefits are not portable to other countries and Medigap (private insurance that supplements Medicare) is very limited. This causes economic and medical hardships and serves as a barrier to retirement to Mexico. Increasing numbers of U.S. retirees will be interested in moving to Mexico in the future because of the climate, the culture, and the lower cost of livi...

  11. The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

    Science.gov (United States)

    Shane, Dan M; Wehby, George L

    2017-09-01

    Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

  12. Accuracy of Coverage Survey Recall following an Integrated Mass Drug Administration for Lymphatic Filariasis, Schistosomiasis, and Soil-Transmitted Helminthiasis

    Science.gov (United States)

    Budge, Philip J.; Sognikin, Edmond; Akosa, Amanda; Mathieu, Els M.; Deming, Michael

    2016-01-01

    Background Achieving target coverage levels for mass drug administration (MDA) is essential to elimination and control efforts for several neglected tropical diseases (NTD). To ensure program goals are met, coverage reported by drug distributors may be validated through household coverage surveys that rely on respondent recall. This is the first study to assess accuracy in such surveys. Methodology/Principal Findings Recall accuracy was tested in a series of coverage surveys conducted at 1, 6, and 12 months after an integrated MDA in Togo during which three drugs (albendazole, ivermectin, and praziquantel) were distributed. Drug distribution was observed during the MDA to ensure accurate recording of persons treated during the MDA. Information was obtained for 506, 1131, and 947 persons surveyed at 1, 6, and 12 months, respectively. Coverage (defined as the percentage of persons taking at least one of the MDA medications) within these groups was respectively 88.3%, 87.4%, and 80.0%, according to the treatment registers; it was 87.9%, 91.4% and 89.4%, according to survey responses. Concordance between respondents and registers on swallowing at least one pill was >95% at 1 month and >86% at 12 months; the lower concordance at 12 months was more likely due to difficulty matching survey respondents with the year-old treatment register rather than inaccurate responses. Respondents generally distinguished between pills similar in appearance; concordance for recall of which pills were taken was over 80% in each survey. Significance In this population, coverage surveys provided remarkably consistent coverage estimates for up to one year following an integrated MDA. It is not clear if similar consistency will be seen in other settings, however, these data suggest that in some settings coverage surveys might be conducted as much as one year following an MDA without compromising results. This might enable integration of post-MDA coverage measurement into large, multipurpose

  13. Accuracy of Coverage Survey Recall following an Integrated Mass Drug Administration for Lymphatic Filariasis, Schistosomiasis, and Soil-Transmitted Helminthiasis.

    Science.gov (United States)

    Budge, Philip J; Sognikin, Edmond; Akosa, Amanda; Mathieu, Els M; Deming, Michael

    2016-01-01

    Achieving target coverage levels for mass drug administration (MDA) is essential to elimination and control efforts for several neglected tropical diseases (NTD). To ensure program goals are met, coverage reported by drug distributors may be validated through household coverage surveys that rely on respondent recall. This is the first study to assess accuracy in such surveys. Recall accuracy was tested in a series of coverage surveys conducted at 1, 6, and 12 months after an integrated MDA in Togo during which three drugs (albendazole, ivermectin, and praziquantel) were distributed. Drug distribution was observed during the MDA to ensure accurate recording of persons treated during the MDA. Information was obtained for 506, 1131, and 947 persons surveyed at 1, 6, and 12 months, respectively. Coverage (defined as the percentage of persons taking at least one of the MDA medications) within these groups was respectively 88.3%, 87.4%, and 80.0%, according to the treatment registers; it was 87.9%, 91.4% and 89.4%, according to survey responses. Concordance between respondents and registers on swallowing at least one pill was >95% at 1 month and >86% at 12 months; the lower concordance at 12 months was more likely due to difficulty matching survey respondents with the year-old treatment register rather than inaccurate responses. Respondents generally distinguished between pills similar in appearance; concordance for recall of which pills were taken was over 80% in each survey. In this population, coverage surveys provided remarkably consistent coverage estimates for up to one year following an integrated MDA. It is not clear if similar consistency will be seen in other settings, however, these data suggest that in some settings coverage surveys might be conducted as much as one year following an MDA without compromising results. This might enable integration of post-MDA coverage measurement into large, multipurpose, periodic surveys, thereby conserving resources.

  14. Accuracy of Coverage Survey Recall following an Integrated Mass Drug Administration for Lymphatic Filariasis, Schistosomiasis, and Soil-Transmitted Helminthiasis.

    Directory of Open Access Journals (Sweden)

    Philip J Budge

    2016-01-01

    Full Text Available Achieving target coverage levels for mass drug administration (MDA is essential to elimination and control efforts for several neglected tropical diseases (NTD. To ensure program goals are met, coverage reported by drug distributors may be validated through household coverage surveys that rely on respondent recall. This is the first study to assess accuracy in such surveys.Recall accuracy was tested in a series of coverage surveys conducted at 1, 6, and 12 months after an integrated MDA in Togo during which three drugs (albendazole, ivermectin, and praziquantel were distributed. Drug distribution was observed during the MDA to ensure accurate recording of persons treated during the MDA. Information was obtained for 506, 1131, and 947 persons surveyed at 1, 6, and 12 months, respectively. Coverage (defined as the percentage of persons taking at least one of the MDA medications within these groups was respectively 88.3%, 87.4%, and 80.0%, according to the treatment registers; it was 87.9%, 91.4% and 89.4%, according to survey responses. Concordance between respondents and registers on swallowing at least one pill was >95% at 1 month and >86% at 12 months; the lower concordance at 12 months was more likely due to difficulty matching survey respondents with the year-old treatment register rather than inaccurate responses. Respondents generally distinguished between pills similar in appearance; concordance for recall of which pills were taken was over 80% in each survey.In this population, coverage surveys provided remarkably consistent coverage estimates for up to one year following an integrated MDA. It is not clear if similar consistency will be seen in other settings, however, these data suggest that in some settings coverage surveys might be conducted as much as one year following an MDA without compromising results. This might enable integration of post-MDA coverage measurement into large, multipurpose, periodic surveys, thereby conserving

  15. Defining the essential anatomical coverage provided by military body armour against high energy projectiles.

    Science.gov (United States)

    Breeze, John; Lewis, E A; Fryer, R; Hepper, A E; Mahoney, Peter F; Clasper, Jon C

    2016-08-01

    Body armour is a type of equipment worn by military personnel that aims to prevent or reduce the damage caused by ballistic projectiles to structures within the thorax and abdomen. Such injuries remain the leading cause of potentially survivable deaths on the modern battlefield. Recent developments in computer modelling in conjunction with a programme to procure the next generation of UK military body armour has provided the impetus to re-evaluate the optimal anatomical coverage provided by military body armour against high energy projectiles. A systematic review of the literature was undertaken to identify those anatomical structures within the thorax and abdomen that if damaged were highly likely to result in death or significant long-term morbidity. These structures were superimposed upon two designs of ceramic plate used within representative body armour systems using a computerised representation of human anatomy. Those structures requiring essential medical coverage by a plate were demonstrated to be the heart, great vessels, liver and spleen. For the 50th centile male anthropometric model used in this study, the front and rear plates from the Enhanced Combat Body Armour system only provide limited coverage, but do fulfil their original requirement. The plates from the current Mark 4a OSPREY system cover all of the structures identified in this study as requiring coverage except for the abdominal sections of the aorta and inferior vena cava. Further work on sizing of plates is recommended due to its potential to optimise essential medical coverage. 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/

  16. Negligent and intentional fires in Portugal: the role of human and biophysical drivers on the spatial distribution

    Science.gov (United States)

    Parente, Joana; Pereira, Mário; Amraoui, Malik; Tedim, Fantina

    2017-04-01

    The European Mediterranean countries, such as Portugal, Spain, France, Italy and Greece, have the higher incidence of fire. Of these countries, Portugal present the highest average number of fires (NF) and one of the highest burnt area (BA), in spite of its relatively smaller land area. The study period is focused in the recent years of 2012 - 2014, when a total of 59 257 fires were recorded and the fire cause is known for more than 50% of the fire records. All fires with known causes were then classified into intentional (40% of the total number of fires) and negligent (60%), leading to a total of 45% of fires related with human factors and activities. Taking into account these values the authors believe it's necessary to better understand the fire regime of this type of fires for a better fire prevention, firefighting and crisis management. Accordingly, the use of statistical analysis and GIS techniques were used to assess the spatial distribution of the human caused fires in each of the NUTS (Nomenclature of Territorial Units for Statistics level I, which divides Portugal in 5 basic economic regions, namely Norte, Centro, Area Metropolitana de Lisboa, Alentejo, and Algarve. The number of fires distribution increases with latitude, making north of Portugal the region with the highest number of fires. The analysis will also aims to assess the role of the most important human and biophysical drivers of the spatial distribution, namely the population density, land use land cover (LULC), distance to communication routes (roads and railways) and topographic variables (altitude, slope). The results show that: a) population density is highly and positively correlated with the agglomeration of fire ignitions, but doesn't imply highest burned area; b) burnt area increase with the distance to roads and altitude; and, c) 58% of the fires occurred on agriculture areas and 33% of fires occurred in forest and scrubs areas. Acknowledgements: This work was supported by: (i) the

  17. Extent of Drug Coverage across Generic Drug Discount Programs offered by Community Pharmacies: A look at five Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Harshali K. Patel, MS

    2012-01-01

    Full Text Available Background: Chronic conditions are expensive to treat because of the ongoing prescription cost burden. Generic drug discount programs (GDDPs that offer generics at discounted price may prove beneficial to reduce pharmacy costs for the same.Objective: The objective of this study was to assess the extent to which GDDPs provide drug coverage for five common chronic conditions.Methods: A content analyses of preexisting information was conducted. Extent of coverage based on top 200 generic drugs prescribed during 2008 for the treatment of chronic conditions such as hypertension, mental disorders, arthritis, pulmonary/respiratory conditions, and diabetes were identified. Commonly prescribed medications for these diseases were identified using published peer reviewed clinical guidelines. List of drugs covered under a GDDP for stores, Wal-Mart, Walgreens, CVS, Kroger, HEB, Target, and Randalls were obtained and compared to assess drug coverage by retail dollar sales and sales volume. Descriptive statistics and frequency/percentage of coverage were reported using SAS 9.2.Results: GDDPs covered the highest number of drugs for hypertension (21-27 across different GDDPs and the least (3-5 across different GDDPs for pulmonary/respiratory conditions. Arthritis (5-11, mental disorders (6-11 and diabetes (5-7 had similar coverage. When compared to the top 200 drugs by retail dollars spent during 2008, hypertension (68%-87% and diabetes (63%-88% had the highest coverage followed by respiratory conditions (30%-50%, arthritis (22%-48%, and mental disorders (21%-38%. Similar result was obtained when GDDP coverage was compared with the top 200 generic drugs by sales volume, where diabetes (63-88% and hypertension (57%-74% had the highest coverage and mental disorders remained the lowest (23%-37%.Conclusion/Implications: Drug coverage in GDDPs varied by pharmacies across the five common chronic conditions evaluated which may limit accessibility of these programs for

  18. Income-related inequality in health insurance coverage: analysis of China Health and Nutrition Survey of 2006 and 2009

    OpenAIRE

    Liu, Jinan; Shi, Lizheng; Meng, Qingyue; Khan, M Mahmud

    2012-01-01

    Abstract Introduction China introduced the urban resident basic medical insurance (URBMI) in 2007 to cover children and urban unemployed adults, in addition to the new cooperative medical scheme (NCMS) for rural residents in 2003 and the basic health insurance scheme (BHIS) for urban employees in 1998. This study examined whether the overall income-related inequality in health insurance coverage improved during 2006 and 2009 in China. Methods The China Health and Nutrition Survey (CHNS) data ...

  19. Extending Coverage and Lifetime of K-coverage Wireless Sensor Networks Using Improved Harmony Search

    Directory of Open Access Journals (Sweden)

    Shohreh Ebrahimnezhad

    2011-07-01

    Full Text Available K-coverage wireless sensor networks try to provide facilities such that each hotspot region is covered by at least k sensors. Because, the fundamental evaluation metrics of such networks are coverage and lifetime, proposing an approach that extends both of them simultaneously has a lot of interests. In this article, it is supposed that two kinds of nodes are available: static and mobile. The proposed method, at first, tries to balance energy among sensor nodes using Improved Harmony Search (IHS algorithm in a k-coverage and connected wireless sensor network in order to achieve a sensor node deployment. Also, this method proposes a suitable place for a gateway node (Sink that collects data from all sensors. Second, in order to prolong the network lifetime, some of the high energy-consuming mobile nodes are moved to the closest positions of low energy-consuming ones and vice versa after a while. This leads increasing the lifetime of network while connectivity and k-coverage are preserved. Through computer simulations, experimental results verified that the proposed IHS-based algorithm found better solution compared to some related methods.

  20. Liability from the view of the medical physicist

    International Nuclear Information System (INIS)

    Shalek, R.J.

    1980-01-01

    The negligent performance of professional duties is the most probable type of legal action against a medical physicist. A mistake resulting from ignorance or inadvertence is an example; an error in professional judgement is not negligence if an ordinary, prudent physicist in the same situation would have made the same decision. A physicist or any hospital employee has a duty to protect his employer from liability even to the extent of reporting to the hospital medical practices which could harm the patient. Suggestions for reducing legal risk include recommendations for professional knowledge, record keeping and outside verification of important elements of operating systems

  1. Maximum permissible concentrations and negligible concentrations for phthalates (dibutylphthalate and di(2-ethylhexyl)phthlate), with emphasis on endocrine disruptive properties

    NARCIS (Netherlands)

    Wezel AP van; Posthumus R; Vlaardingen P van; Crommentuijn T; Plassche EJ van de; CSR

    This report presents maximal permissible concentrations (MPCs) and negligible concentrations (NCs) are derived for di-n-butylphthalate (DBP) and di(2-ethylhexyl)phthalate (DEHP). Phthalates are often mentioned as suspected endocrine disrupters. Data with endpoints related to the endocrine or

  2. Frequent LOH at hMLH1, a highly variable SNP in hMSH3, and negligible coding instability in ovarian cancer

    DEFF Research Database (Denmark)

    Arzimanoglou, I.I.; Hansen, L.L.; Chong, D.

    2002-01-01

    the mismatch DNA repair genes in ovarian cancer (OC), using a sensitive, accurate and reliable protocol we have developed. MATERIALS AND METHODS: A combination of high-resolution GeneScan software analysis and automated DNA cycle sequencing was used. RESULTS: Negligible coding MSI was observed in selected...

  3. Secondary poisoning of cadmium, copper and mercury: implications for the Maximum Permissible Concentrations and Negligible Concentrations in water, sediment and soil

    NARCIS (Netherlands)

    Smit CE; Wezel AP van; Jager T; Traas TP; CSR

    2000-01-01

    The impact of secondary poisoning on the Maximum Permissible Concentrations (MPCs) and Negligible Concentrations (NCs) of cadmium, copper and mercury in water, sediment and soil have been evaluated. Field data on accumulation of these elements by fish, mussels and earthworms were used to derive

  4. Negligible depletion solid-phase microextraction with radiolabeled analytes to study free concentrations and protein binding : an example with [3H]Estradiol

    NARCIS (Netherlands)

    Heringa, M.B.; Pastor, D.; Algra, J.; Vaes, W.H.J.; Hemmens, J.L.M.

    2002-01-01

    A new method is presented that enables sensitive measurement of free concentrations of radiolabeled ligands. Additionally, protein binding of radiochemicals in complex matrixes can be determined with this new technique that combines negligible depletion solid-phase microextraction (nd-SPME) with

  5. Falling through the Coverage Cracks: How Documentation Status Minimizes Immigrants' Access to Health Care.

    Science.gov (United States)

    Joseph, Tiffany D

    2017-10-01

    Recent policy debates have centered on health reform and who should benefit from such policy. Most immigrants are excluded from the 2010 Affordable Care Act (ACA) due to federal restrictions on public benefits for certain immigrants. But, some subnational jurisdictions have extended coverage options to federally ineligible immigrants. Yet, less is known about the effectiveness of such inclusive reforms for providing coverage and care to immigrants in those jurisdictions. This article examines the relationship between coverage and health care access for immigrants under comprehensive health reform in the Boston metropolitan area. The article uses data from interviews conducted with a total of 153 immigrants, health care professionals, and immigrant and health advocacy organization employees under the Massachusetts and ACA health reforms. Findings indicate that respondents across the various stakeholder groups perceive that immigrants' documentation status minimizes their ability to access health care even when they have health coverage. Specifically, respondents expressed that intersecting public policies, concerns that using health services would jeopardize future legalization proceedings, and immigrants' increased likelihood of deportation en route to medical appointments negatively influenced immigrants' health care access. Thus, restrictive federal policies and national-level anti-immigrant sentiment can undermine inclusive subnational policies in socially progressive places. Copyright © 2017 by Duke University Press.

  6. Civil liability and nuclear coverage: synthesis report

    International Nuclear Information System (INIS)

    1995-01-01

    The report has been written considering the advanced work which has been done by the Expert Committee, sponsored by the International Atomic Energy Agency (IAEA), Vienna, having the purpose to examine the modifications issued in course of Vienna Convention as well as the Paris convention and the complementary Brussels Convention, in view to adapt the legislation to the actual context and to answer the populations expectations. The work has been organized in three majors chapters: the first one in concerned to the damage definition, proposition to the to reach the environment, the prevention and charges. the research and military installations are also considered. The second chapter has been dedicated to the civil responsibility, its limits, financing modes, the national and international legal competence besides the litigation charges due to the nuclear accidents born on the occasion. In the third chapter the insurance considering the damage nature, the capacity to assure liability coverage and the damage management are harmonized

  7. Preclinical diagnosis and emergency medical care in case of radiation accidents

    International Nuclear Information System (INIS)

    Ohlenschlaeger, L.

    1990-01-01

    Reference is made to preclinical diagnosis and emergency medical care at the site of a potential radiation accident. Possibilities and limits, respectively, of the medical measures are shown. Cooperation between the experts of the technical and medical rescue services is described. Exposition to radiation for the emergency medical staff resulting from the medical care of contaminated persons, is negligible if the personal precautions are observed. (orig.) [de

  8. Expensive but worth it: older parents’ attitudes and opinions about the costs and insurance coverage for in vitro fertilization

    Science.gov (United States)

    Nachtigall, Robert D.; MacDougall, Kirstin; Davis, Anne C.; Beyene, Yewoubdar

    2011-01-01

    Objective To describe older parents’ attitudes and opinions about the costs and insurance coverage for IVF. Design Qualitative interview study. Setting Two Northern California IVF practices. Patient(s) Sixty women and 35 male partners in which the woman had delivered her first child after the age of 40 years using IVF. Intervention(s) Two in-depth interviews over 3 months. Main Outcome Measure(s) Thematic analysis of interview transcripts. Result(s) We found that although the costs of IVF were perceived as high, even by those with insurance or who could afford them, the cost of IVF relative to other expenses in life was dwarfed by the value attributed to having a child. Women were twice as likely as men to support insurance coverage for IVF. Both men and women with complete or partial IVF insurance coverage were more likely to support insurance than those without coverage. There was a broad range of attitudes and opinions about the appropriateness of IVF insurance coverage, which addressed questions of age, gender equality, reproductive choice, whether infertility is a medical illness, and the role of personal and societal economic equity and responsibility. Conclusion(s) Despite a generally favorable opinion about the appropriateness of insurance coverage by those who have successfully undergone IVF treatment, the affordability of IVF remains an unresolved dilemma in the United States. PMID:22118993

  9. Medical Litigation Across Specialties

    LENUS (Irish Health Repository)

    Murphy, JFA

    2013-07-01

    Medical negligence is a major cause of fear and anxiety for doctors. The threat of malpractice consists of 3 factors, the risk of a claim, the probability of a claim leading to a payment, and the size of the payment. The Clinical Indemnity Scheme (CIS) insures against indemnity payments but it cannot protect the doctor against the indirect consequences of litigation including stress, the long hours mounting a defence against the allegation, and the damage to one’s reputation. The adversarial tort system focuses on punishment, blame and compensation. The emotional anguish and potential damage to the doctor’s reputation can be considerable. Doctors subjected to malpractice suits regardless of the outcome may experience depression, anger, frustration and excessive use of alcohol

  10. Target Coverage in Wireless Sensor Networks with Probabilistic Sensors

    Science.gov (United States)

    Shan, Anxing; Xu, Xianghua; Cheng, Zongmao

    2016-01-01

    Sensing coverage is a fundamental problem in wireless sensor networks (WSNs), which has attracted considerable attention. Conventional research on this topic focuses on the 0/1 coverage model, which is only a coarse approximation to the practical sensing model. In this paper, we study the target coverage problem, where the objective is to find the least number of sensor nodes in randomly-deployed WSNs based on the probabilistic sensing model. We analyze the joint detection probability of target with multiple sensors. Based on the theoretical analysis of the detection probability, we formulate the minimum ϵ-detection coverage problem. We prove that the minimum ϵ-detection coverage problem is NP-hard and present an approximation algorithm called the Probabilistic Sensor Coverage Algorithm (PSCA) with provable approximation ratios. To evaluate our design, we analyze the performance of PSCA theoretically and also perform extensive simulations to demonstrate the effectiveness of our proposed algorithm. PMID:27618902

  11. Public Drug Plan Coverage for Children Across Canada: A Portrait of Too Many Colours

    Science.gov (United States)

    Ungar, Wendy J; Witkos, Maciej

    2005-01-01

    Background: As debate continues regarding pharmacare in Canada, little discussion has addressed appropriate drug plan coverage for vulnerable populations, such as children. The primary objective of this study was to determine the extent of medication coverage for children in publicly administered programs in each province across Canada. Methods: Data were collected on provincial, territorial and federal government drug plans, and 2003 formulary updates were obtained. A simulation model was constructed to demonstrate costs to a low-income family with an asthmatic child in each province. Programs were compared descriptively. The extent of interprovincial variation in 2003 formulary approvals was summarized statistically. Results: There was 39% variation between provinces with respect to 2003 formulary approvals (chi-square p Canada, only 8% of 2003 formulary approvals were indicated primarily for paediatric conditions. In the simulation model, costs were less than or equal to 3% of household income in provinces with plans for low-income families, catastrophic costs (Ontario) or for the population. Families who failed to qualify for low income plans or who resided in New Brunswick or Newfoundland faced costs up to 7% of household income. Interpretation: With regard to pharmaceutical benefits for children, provincial drug programs vary considerably in terms of whom they cover, what drugs are covered and how much subscribers must pay out of pocket. Unlike seniors and social assistance recipients, the provinces do not agree on the importance of providing comprehensive coverage for all children. For many Canadian children, significant financial barriers exist to medication access. PMID:19308106

  12. Improved Differential Evolution Algorithm for Wireless Sensor Network Coverage Optimization

    Directory of Open Access Journals (Sweden)

    Xing Xu

    2014-04-01

    Full Text Available In order to serve for the ecological monitoring efficiency of Poyang Lake, an improved hybrid algorithm, mixed with differential evolution and particle swarm optimization, is proposed and applied to optimize the coverage problem of wireless sensor network. And then, the affect of the population size and the number of iterations on the coverage performance are both discussed and analyzed. The four kinds of statistical results about the coverage rate are obtained through lots of simulation experiments.

  13. Vaccination Coverage Among Children Aged 2 Years - U.S. Affiliated Pacific Islands, April-October, 2016.

    Science.gov (United States)

    Tippins, Ashley; Murthy, Neil; Meghani, Mehreen; Solsman, Amy; Apaisam, Carter; Basilius, Merlyn; Eckert, Maribeth; Judicpa, Peter; Masunu, Yolanda; Pistotnik, Kelsey; Pedro, Daisy; Sasamoto, Jeremy; Underwood, J Michael

    2018-05-25

    Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, † USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau). § Differences in vaccination coverage between main and outer islands ¶ were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ≥3 doses of inactivated poliovirus vaccine (IPV); ≥1 dose of measles, mumps, and rubella vaccine (MMR); ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; ≥3 doses of hepatitis B (HepB) vaccine; and ≥4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ≥3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines †† was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions

  14. Uninsured Migrants: Health Insurance Coverage and Access to Care Among Mexican Return Migrants.

    Science.gov (United States)

    Wassink, Joshua

    2018-01-01

    Despite an expansive body of research on health and access to medical care among Mexican immigrants in the United States, research on return migrants focuses primarily on their labor market mobility and contributions to local development. Motivated by recent scholarship that documents poor mental and physical health among Mexican return migrants, this study investigates return migrants' health insurance coverage and access to medical care. I use descriptive and multivariate techniques to analyze data from the 2009 and 2014 rounds of Mexico's National Survey of Demographic Dynamics (ENADID, combined n=632,678). Analyses reveal a large and persistent gap between recent return migrants and non-migrants, despite rising overall health coverage in Mexico. Multivariate analyses suggest that unemployment among recent arrivals contributes to their lack of insurance. Relative to non-migrants, recently returned migrants rely disproportionately on private clinics, pharmacies, self-medication, or have no regular source of care. Mediation analysis suggests that returnees' high rate of uninsurance contributes to their inadequate access to care. This study reveals limited access to medical care among the growing population of Mexican return migrants, highlighting the need for targeted policies to facilitate successful reintegration and ensure access to vital resources such as health care.

  15. Dental Care Coverage and Use: Modeling Limitations and Opportunities

    Science.gov (United States)

    Moeller, John F.; Chen, Haiyan

    2014-01-01

    Objectives. We examined why older US adults without dental care coverage and use would have lower use rates if offered coverage than do those who currently have coverage. Methods. We used data from the 2008 Health and Retirement Study to estimate a multinomial logistic model to analyze the influence of personal characteristics in the grouping of older US adults into those with and those without dental care coverage and dental care use. Results. Compared with persons with no coverage and no dental care use, users of dental care with coverage were more likely to be younger, female, wealthier, college graduates, married, in excellent or very good health, and not missing all their permanent teeth. Conclusions. Providing dental care coverage to uninsured older US adults without use will not necessarily result in use rates similar to those with prior coverage and use. We have offered a model using modifiable factors that may help policy planners facilitate programs to increase dental care coverage uptake and use. PMID:24328635

  16. State contraceptive coverage laws: creative responses to questions of "conscience".

    Science.gov (United States)

    Dailard, C

    1999-08-01

    The Federal Employees Health Benefits Program (FEHBP) guaranteed contraceptive coverage for employees of the federal government. However, opponents of the FEHBP contraceptive coverage questioned the viability of the conscience clause. Supporters of the contraceptive coverage pressed for the narrowest exemption, one that only permit religious plans that clearly states religious objection to contraception. There are six of the nine states that have enacted contraceptive coverage laws aimed at the private sector. The statutes included a provision of conscience clause. The private sector disagrees to the plan since almost all of the employees¿ work for employers who only offer one plan. The scope of exemption for employers was an issue in five states that have enacted the contraceptive coverage. In Hawaii and California, it was exemplified that if employers are exempted from the contraceptive coverage based on religious grounds, an employee will be entitled to purchase coverage directly from the plan. There are still questions on how an insurer, who objects based on religious grounds to a plan with contraceptive coverage, can function in a marketplace where such coverage is provided by most private sector employers.

  17. Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

    Science.gov (United States)

    Nandi, Arijit; Loue, Sana; Galea, Sandro

    2009-12-01

    As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

  18. Toward better access to health insurance coverage for U.S. retirees in Mexico.

    Science.gov (United States)

    Warner, D C; Jahnke, L R

    2001-01-01

    Many retirees from the United States of America have limited health insurance coverage while living in Mexico. Medicare and Medicaid benefits are not portable to other countries and Medigap (private insurance that supplements Medicare) is very limited. This causes economic and medical hardships and serves as a barrier to retirement to Mexico. Increasing numbers of U.S. retirees will be interested in moving to Mexico in the future because of the climate, the culture, and the lower cost of living. The numbers are increasing as a result of several factors such as aging "baby boomers" and the rapidly growing Mexican-origin population in the U.S.A. who are citizens or permanent residents but would like to return to their communities of origin after working in the U.S.A. There are several policy initiatives that could provide opportunities for improving health insurance coverage for these retirees that could be cost-effective.

  19. Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela.

    Science.gov (United States)

    Bellorin-Font, Ezequiel; Pernalete, Nidia; Meza, Josefina; Milanes, Carmen Luisa; Carlini, Raul G

    2005-08-01

    Access to and coverage of renal replacement therapy in minorities and ethnic groups in Venezuela. Numerous studies have documented the presence of racial and minority disparities regarding the impact of renal disease and access to renal replacement therapy (RRT). This problem is less well documented in Latin America. Venezuela, like most countries in the region, is subject to severe constraints in the allocation of resources for high-cost chronic diseases, which limits the access of patients with chronic kidney disease to RRT. Although access to health care is universal, there is both a deficit in coverage and disparity in the access to RRT, largely as a result of socioeconomic limitations and budget constrains. With current rising trends of the incidence of end-stage renal disease (ESRD) and costs of medical technology, the long-term goal of complete RRT coverage will become increasingly out of reach. Current evidence suggests that prevention of progression of renal disease is possible at relatively low cost and broad coverage. Based on this evidence, the Ministry of Health has redesigned its policy with respect to renal disease based on 4 elements: 1. Prevention by means of early detection and referral to multidisciplinary health teams, as well as promotion of health habits in the community. 2. Prevention of progression of renal disease by pharmacologic and nonpharmacologic means. 3. An increase in the rate of coverage and reduction of disparities in the access to dialysis. 4. An increase in the rates of renal transplantation through better organ procurement programs and reinforcement of transplant centers. However, the projected increase in the number of patients with ESKD receiving RRT will represent a serious burden to the health care system. Therefore, implementation of these policies will require the involvement of international agencies as well as an adequate partnership between nephrologists and health care planners, so that meeting the increasing demands

  20. [Coverage for birth care in Mexico and its interpretation within the context of maternal mortality].

    Science.gov (United States)

    Lazcano-Ponce, Eduardo; Schiavon, Raffaela; Uribe-Zúñiga, Patricia; Walker, Dilys; Suárez-López, Leticia; Luna-Gordillo, Rufino; Ulloa-Aguirre, Alfredo

    2013-01-01

    To evaluate health coverage for birth care in Mexico within the frame of maternal mortality reduction. Two information sources were used: 1) The comparison between the results yield by the Mexican National Health and Nutrition Surveys 2006 and 2012 (ENSANUT 2006 and 2012), and 2) the databases monitoring maternal deaths during 2012 (up to December 26), and live births (LB) in Mexico as estimated by the Mexican National Population Council (Conapo). The national coverage for birth care by medical units is nearly 94.4% at the national level, but in some federal entities such as Chiapas (60.5%), Nayarit (87.8%), Guerrero (91.2%), Durango (92.5%), Oaxaca (92.6%), and Puebla (93.4%), coverage remains below the national average. In women belonging to any social security system (eg. IMSS, IMSS Oportunidades, ISSSTE), coverage is almost 99%, whereas in those affiliated to the Mexican Popular Health Insurance (which depends directly from the Federal Ministry of Health), coverage reached 92.9%. In terms of Maternal Mortality Ratio (MMR), there are still large disparities among federal states in Mexico, with a national average of 47.0 per 100 000 LB (preliminary data for 2012, up to December 26). The MMR estimation has been updated using the most recent population projections. There is no correlation between the level of institutional birth care and the MMR in Mexico. It is thus necessary not only to guarantee universal birth care by health professionals, but also to provide obstetric care by qualified personnel in functional health services networks, to strengthen the quality of obstetric care, family planning programs, and to promote the implementation of new and innovative health policies that include intersectoral actions and human rights-based approaches targeted to reduce the enormous social inequity still prevailing in Mexico.

  1. Universal coverage of IVF pays off.

    Science.gov (United States)

    Vélez, M P; Connolly, M P; Kadoch, I-J; Phillips, S; Bissonnette, F

    2014-06-01

    What was the clinical and economic impact of universal coverage of IVF in Quebec, Canada, during the first calendar year of implementation of the public IVF programme? Universal coverage of IVF increased access to IVF treatment, decreased the multiple pregnancy rate and decreased the cost per live birth, despite increased costs per cycle. Public funding of IVF assures equality of access to IVF and decreases multiple pregnancies resulting from this treatment. Public IVF programmes usually mandate a predominant SET policy, the most effective approach for reducing the incidence of multiple pregnancies. This prospective comparative cohort study involved 7364 IVF cycles performed in Quebec during 2009 and 2011 and included an economic analysis. IVF cycles performed in the five centres offering IVF treatment in Quebec during 2009, before implementation of the public IVF programme, were compared with cycles performed at the same centres during 2011, the first full calendar year following implementation of the programme. Data were obtained from the Canadian Assisted Reproductive Technologies Register (CARTR). Comparisons were made between the two periods in terms of utilization, pregnancy rates, multiple pregnancy rates and costs. The number of IVF cycles performed in Quebec increased by 192% after the new policy was implemented. Elective single-embryo transfer was performed in 1.6% of the cycles during Period I (2009), and increased to 31.6% during Period II (2011) (P IVF programme increased government costs per IVF treatment cycle from CAD$3730 to CAD$4759. Despite increased costs per cycle, the efficiency defined by the cost per live birth, which factored in downstream health costs up to 1 year post delivery, decreased from CAD$49 517 to CAD$43 362 per baby conceived by either fresh and frozen cycles. The costs described in the economic model are likely an underestimate as they do not factor in many of the long-term costs that can occur after 1 year of age. The

  2. Medical education teaching resources.

    Science.gov (United States)

    Jibson, Michael D; Seyfried, Lisa S; Gay, Tamara L

    2014-02-01

    Numerous monographs on psychiatry education have appeared without a review specifically intended to assist psychiatry faculty and trainees in the selection of appropriate volumes for study and reference. The authors prepared this annotated bibliography to fill that gap. The authors identified titles from web-based searches of the topics "academic psychiatry," "psychiatry education," and "medical education," followed by additional searches of the same topics on the websites of major publishers. Forty-nine titles referring to psychiatry education specifically and medical education generally were identified. The authors selected works that were published within the last 10 years and remain in print and that met at least one of the following criteria: (1) written specifically about psychiatry or for psychiatric educators; (2) of especially high quality in scholarship, writing, topic selection and coverage, and pertinence to academic psychiatry; (3) covering a learning modality deemed by the authors to be of particular interest for psychiatry education. The authors reviewed 19 books pertinent to the processes of medical student and residency education, faculty career development, and education administration. These included 11 books on medical education in general, 4 books that focus more narrowly on the field of psychiatry, and 4 books addressing specific learning modalities of potential utility in the mental health professions. Most of the selected works proved to be outstanding contributions to the medical education literature.

  3. Inequity between male and female coverage in state infertility laws.

    Science.gov (United States)

    Dupree, James M; Dickey, Ryan M; Lipshultz, Larry I

    2016-06-01

    To analyze state insurance laws mandating coverage for male factor infertility and identify possible inequities between male and female coverage in state insurance laws. We identified states with laws or codes related to infertility insurance coverage using the National Conference of States Legislatures' and the National Infertility Association's websites. We performed a primary, systematic analysis of the laws or codes to specifically identify coverage for male factor infertility services. Not applicable. Not applicable. Not applicable. The presence or absence of language in state insurance laws mandating coverage for male factor infertility care. There are 15 states with laws mandating insurance coverage for female factor infertility. Only eight of those states (California, Connecticut, Massachusetts, Montana, New Jersey, New York, Ohio, and West Virginia) have mandates for male factor infertility evaluation or treatment. Insurance coverage for male factor infertility is most specific in Massachusetts, New Jersey, and New York, yet significant differences exist in the male factor policies in all eight states. Three states (Massachusetts, New Jersey, and New York) exempt coverage for vasectomy reversal. Despite national recommendations that male and female partners begin infertility evaluations together, only 8 of 15 states with laws mandating infertility coverage include coverage for the male partner. Excluding men from infertility coverage places an undue burden on female partners and risks missing opportunities to diagnose serious male health conditions, correct reversible causes of infertility, and provide cost-effective treatments that can downgrade the intensity of intervention required to achieve a pregnancy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Modelling the implications of moving towards universal coverage in Tanzania.

    Science.gov (United States)

    Borghi, Josephine; Mtei, Gemini; Ally, Mariam

    2012-03-01

    A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to

  5. Negligible penetration of incidental amounts of alpha-hydroxy acid from rinse-off personal care products in human skin using an in vitro static diffusion cell model.

    Science.gov (United States)

    Okuda, M; Donahue, D A; Kaufman, L E; Avalos, J; Simion, F A; Story, D C; Sakaguchi, H; Fautz, R; Fuchs, A

    2011-12-01

    Alpha-hydroxy acids (AHAs), primarily glycolic and lactic acids, are widely used in cosmetics to alleviate dyspigmentation, photodamage, and other aging skin conditions and as pH adjusters. Glycolic acid reportedly enhances skin damage after repeated ultraviolet light exposure, e.g., increased sunburn cell formation. This study assessed potential in vitro skin penetration of lactic acid and malic acid incorporated into rinse-off personal care products, compared with rinse-off and leave-on exposures to glycolic acid (10%, pH 3.5) in a reference lotion. Radiolabeled AHA-fortified shampoo, conditioner, and lotion were evenly applied as single doses to human epidermal membranes mounted in static diffusion cells (not occluded). Exposures were 1-3 min (rinse-off) or 24 h (leave-on). Epidermal penetration of malic acid and lactic acid from the rinse-off shampoo and conditioner, respectively, was negligible, with >99% removed by rinsing, a negligible portion remaining in the stratum corneum (≤0.15%), and even less penetrating into the viable epidermis (≤0.04%). Glycolic acid penetration from the leave-on reference lotion was 1.42 μg equiv./cm2/h, with total absorbable dose recovery (receptor fluid plus epidermis) of 2.51%, compared to 0.009%, 0.003%, and 0.04% for the rinse-off reference lotion, shampoo (malic acid), and conditioner (lactic acid) exposures, respectively. Dermal penetration of AHAs into human skin is pH-, concentration-, and time-dependent. Alpha-hydroxy acids in rinse-off shampoos and conditioners are almost entirely removed from the skin within minutes by rinsing (resulting in negligible epidermal penetration). This suggests that ultraviolet radiation-induced skin effects of AHA-containing rinse-off products are negligible. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. IS OHS NEGLIGENCE AND EVASION AN “ERROR OF JUDGEMENT” OR “WHITE-COLLAR CRIME”? AN INTERPRETATION OF APPAREL MANUFACTURERS IN BANGLADESH

    OpenAIRE

    Muhammad Faisol Chowdhury

    2016-01-01

    This paper investigates the managerial interpretation of the terms “error of judgement” and “white-collar crime” in relation to the evasion or negligence observed in administering occupational health and safety (OHS) provisions in the apparel manufacturing sector of Bangladesh. The research is qualitative in nature and follows an interpretivist paradigm. The questionnaire responses were collected from 20 mid- and top-level managers from 10 large apparel manufacturing factories located on the ...

  7. Deep coverage of the beer proteome.

    Science.gov (United States)

    Grochalová, Martina; Konečná, Hana; Stejskal, Karel; Potěšil, David; Fridrichová, Danuše; Srbová, Eva; Ornerová, Kateřina; Zdráhal, Zbyněk

    2017-06-06

    We adopted an approach based on peptide immobilized pH gradient-isoelectric focusing (IPG-IEF) separation, coupled with LC-MS/MS, in order to maximize coverage of the beer proteome. A lager beer brewed using traditional Czech technology was degassed, desalted and digested. Tryptic peptides were separated by isoelectric focusing on an immobilized pH gradient strip and, after separation, the gel strip was divided into seven equally sized parts. Peptides extracted from gel fractions were analyzed by LC-MS/MS. This approach resulted in a three-fold increase in the number of proteins identified (over 1700) when compared to analysis of unfractionated beer processed by a filter-aided sample preparation (FASP). Over 1900 protein groups (PGs) in total were identified by both approaches. The study significantly extends knowledge about the beer proteome and demonstrates its complexity. Detailed knowledge of the protein content, especially gluten proteins, will enhance the evaluation of potential health risks related to beer consumption (coeliac disease) and will contribute to improving beer quality. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. [Universal coverage of health services in Mexico].

    Science.gov (United States)

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people.

  9. IS OHS NEGLIGENCE AND EVASION AN “ERROR OF JUDGEMENT” OR “WHITE-COLLAR CRIME”? AN INTERPRETATION OF APPAREL MANUFACTURERS IN BANGLADESH

    Directory of Open Access Journals (Sweden)

    Muhammad Faisol Chowdhury

    2016-12-01

    Full Text Available This paper investigates the managerial interpretation of the terms “error of judgement” and “white-collar crime” in relation to the evasion or negligence observed in administering occupational health and safety (OHS provisions in the apparel manufacturing sector of Bangladesh. The research is qualitative in nature and follows an interpretivist paradigm. The questionnaire responses were collected from 20 mid- and top-level managers from 10 large apparel manufacturing factories located on the outskirts of Dhaka. The research reveals that all of the respondents have adequate knowledge about the relevant OHS provisions and safety protocols imposed on them by the local government and the global supply chain. They believe that the correct administration of the OHS provisions will reduce workplace accidents effectively. The research unfolds that the respondents interpret in different ways the terms "error of judgement” and “white-collar crime” in association with OHS negligence and evasion. Although empirical evidence shows that this type of negligence and evasion are considered as white-collar crime and punishable, most of the respondents in this research do not subscribe to this notion and alternatively believe that it is an “error of judgement” and therefore non-punishable.

  10. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  11. Coverage of Entrepreneurship in Principles of Economics Textbooks: An Update.

    Science.gov (United States)

    Kent, Calvin A.; Rushing, Francis W.

    1999-01-01

    Updates a study of the coverage of entrepreneurship contained in principles of economics textbooks originally carried out in the mid-1980s. Analyzes coverage of the same topics in 14 popular introductory texts. Concludes that entrepreneurship still has not worked its way into economics-principles texts. (DSK)

  12. Local Coverage of Three Mile Island during 1981-82.

    Science.gov (United States)

    Friedman, Sharon M.

    Local newspaper coverage of the Three Mile Island (TMI) nuclear power plant accident was examined in a study to determine what changes, if any, were made by local media and what lessons they had learned from it. Data were collected through interviews with 21 media representatives. TMI coverage in the six newspapers was examined using each…

  13. Awareness and Coverage of the National Health Insurance Scheme ...

    African Journals Online (AJOL)

    Sub- national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion.

  14. Technical support for universal health coverage pilots in Karnataka ...

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

    Technical support for universal health coverage pilots in Karnataka and Kerala. This project will provide evidence-based support to implement universal health coverage (UHC) pilot activities in two Indian states: Kerala and Karnataka. The project team will provide technical assistance to these early adopter states to assist ...

  15. 29 CFR 1620.7 - “Enterprise” coverage.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false âEnterpriseâ coverage. 1620.7 Section 1620.7 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION THE EQUAL PAY ACT § 1620.7 “Enterprise” coverage. (a) The terms “enterprise” and “enterprise engaged in commerce or in the production of...

  16. original article assessment of effective coverage of hiv prevention of ...

    African Journals Online (AJOL)

    Abrham

    BACKGROUND: Coverage assessment of prevention of Pregnant Mother to Child Transmission. (PMTCT) of HIV service is useful to measure the health system effort or performance of health service delivery function and ... anti retroviral drugs, breast-feeding counseling and ... care service coverage to develop appropriate.

  17. Variability of surface ozone with cloud coverage over Kolkata, India

    Indian Academy of Sciences (India)

    Critical analysis of experimental surface ozone data and cloud coverage is reported over Kolkata during the period January 2011 to December 2011. Significant relationship between these two parameters is observed. Analysis shows that the trend of surface ozone concentration and cloud coverage follow opposite ...

  18. Improved HIV testing coverage after scale-up of ... - Lusaka

    African Journals Online (AJOL)

    Improved HIV testing coverage after scale-up of antiretroviral therapy programs in urban Zambia: Evidence from serial hospital surveillance. ... Background: We evaluated changing HIV testing coverage and prevalence rates before and after expanding city-wide antiretroviral therapy (ART) programs in Lusaka, Zambia.

  19. Physics-Aware Informative Coverage Planning for Autonomous Vehicles

    Science.gov (United States)

    2014-06-01

    Physics-Aware Informative Coverage Planning for Autonomous Vehicles Michael J. Kuhlman1, Student Member, IEEE, Petr Švec2, Member, IEEE, Krishnanand...Physics-Aware Informative Coverage Planning for Autonomous Vehicles 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  20. Higher Education Students' Perceptions of Environmental Issues and Media Coverage

    Science.gov (United States)

    Keinonen, Tuula; Palmberg, Irmeli; Kukkonen, Jari; Yli-Panula, Eija; Persson, Christel; Vilkonis, Rytis

    2016-01-01

    This study aims to find higher education students' perceptions about environmental issues and how the perceptions are related to perceptions of media coverage. This study investigates higher education students' perceptions of the seriousness of environmental issues and their relation to perceptions of media coverage. Higher education students…

  1. Dorsal hand coverage with free serratus fascia flap

    DEFF Research Database (Denmark)

    Fotopoulos, Peter; Holmer, Per; Leicht, Pernille

    2003-01-01

    in the flap, leaving the long thoracic nerve intact on the serratus muscle. Coverage of the flap with split-thickness skin graft is done immediately. The free serratus fascia flap is an ideal flap for dorsal hand coverage when the extensor tendons are exposed, especially because of low donor-site morbidity....

  2. Contraception coverage and methods used among women in South ...

    African Journals Online (AJOL)

    Background. Globally, family planning services are being strengthened and the range of contraceptive choices expanded. Data on contraceptive coverage and service gaps could help to shape these initiatives. Objective. To assess contraception coverage in South Africa (SA) and identify underserved populations and ...

  3. Anterior palatal island advancement flap for bone graft coverage ...

    African Journals Online (AJOL)

    ... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

  4. Coverage of the Stanford Prison Experiment in Introductory Psychology Courses

    Science.gov (United States)

    Bartels, Jared M.; Milovich, Marilyn M.; Moussier, Sabrina

    2016-01-01

    The present study examined the coverage of Stanford prison experiment (SPE), including criticisms of the study, in introductory psychology courses through an online survey of introductory psychology instructors (N = 117). Results largely paralleled those of the recently published textbook analyses with ethical issues garnering the most coverage,…

  5. US Media Coverage of Tobacco Industry Corporate Social Responsibility Initiatives.

    Science.gov (United States)

    McDaniel, Patricia A; Lown, E Anne; Malone, Ruth E

    2018-02-01

    Media coverage of tobacco industry corporate social responsibility (CSR) initiatives represents a competitive field where tobacco control advocates and the tobacco industry vie to shape public and policymaker understandings about tobacco control and the industry. Through a content analysis of 649 US news items, we examined US media coverage of tobacco industry CSR and identified characteristics of media items associated with positive coverage. Most coverage appeared in local newspapers, and CSR initiatives unrelated to tobacco, with non-controversial beneficiaries, were most commonly mentioned. Coverage was largely positive. Tobacco control advocates were infrequently cited as sources and rarely authored opinion pieces; however, when their voices were included, coverage was less likely to have a positive slant. Media items published in the South, home to several tobacco company headquarters, were more likely than those published in the West to have a positive slant. The absence of tobacco control advocates from media coverage represents a missed opportunity to influence opinion regarding the negative public health implications of tobacco industry CSR. Countering the media narrative of virtuous companies doing good deeds could be particularly beneficial in the South, where the burdens of tobacco-caused disease are greatest, and coverage of tobacco companies more positive.

  6. 12 CFR 717.20 - Coverage and definitions

    Science.gov (United States)

    2010-01-01

    ... REPORTING Affiliate Marketing § 717.20 Coverage and definitions (a) Coverage. Subpart C of this part applies...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed agent, and a consumer based on— (A) A financial contract...

  7. 12 CFR 334.20 - Coverage and definitions.

    Science.gov (United States)

    2010-01-01

    ... FAIR CREDIT REPORTING Affiliate Marketing § 334.20 Coverage and definitions. (a) Coverage. Subpart C of... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...

  8. 12 CFR 571.20 - Coverage and definitions.

    Science.gov (United States)

    2010-01-01

    ... Affiliate Marketing § 571.20 Coverage and definitions. (a) Coverage. Subpart C of this part applies to... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...

  9. Computing Convex Coverage Sets for Faster Multi-Objective Coordination

    NARCIS (Netherlands)

    Roijers, D.M.; Whiteson, S.; Oliehoek, F.A.

    2015-01-01

    In this article, we propose new algorithms for multi-objective coordination graphs (MO-CoGs). Key to the efficiency of these algorithms is that they compute a convex coverage set (CCS) instead of a Pareto coverage set (PCS). Not only is a CCS a sufficient solution set for a large class of problems,

  10. 20 CFR 404.1913 - Precluding dual coverage.

    Science.gov (United States)

    2010-04-01

    ... precluding dual coverage to avoid inequitable or anomalous coverage situations for certain workers. However... 404.1913 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY...) General. Employment or self-employment or services recognized as equivalent under the Act or the social...

  11. 28 CFR 55.7 - Termination of coverage.

    Science.gov (United States)

    2010-07-01

    ... VOTING RIGHTS ACT REGARDING LANGUAGE MINORITY GROUPS Nature of Coverage § 55.7 Termination of coverage. (a) Section 4(f)(4). A covered State, a political subdivision of a covered State, or a separately covered political subdivision may terminate the application of section 4(f)(4) by obtaining the...

  12. Tetanus toxoid immunization coverage among mothers of below one ...

    African Journals Online (AJOL)

    Poverty and lack of health facilities also contributed to the low level of immunization coverage. For TT immunization to improve in the area studied, factors impeding immunization must be addressed. Keywords: tetanus, immunization, coverage. African Journal of Clinical and Experimental Microbiology Vol. 6 (3) 2005: 233- ...

  13. A Fair Path Toward Universal Coverage: National Case Study for ...

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

    A Fair Path Toward Universal Coverage: National Case Study for Ethiopia, Uganda, and Zambia. As national health systems in developing countries make progress toward achieving universal health service coverage, many face ethical challenges. In its 2010 World Health Report, the World Health Assembly called on the ...

  14. Insurance premiums and insurance coverage of near-poor children.

    Science.gov (United States)

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

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

  15. Herbal remedy clinical trials in the media: a comparison with the coverage of conventional pharmaceuticals

    Directory of Open Access Journals (Sweden)

    Caulfield Timothy

    2008-11-01

    Full Text Available Abstract Background This study systematically compares newspaper coverage of clinical trials for herbal remedies, a popular type of complementary and alternative medicine, with clinical trials for pharmaceuticals using a comparative content analysis. This is a timely inquiry given the recognized importance of the popular press as a source of health information, the complex and significant role of complementary and alternative medicine in individual health-care decisions, and the trend toward evidence-based research for some complementary and alternative medical therapies. We searched PubMed for clinical trials, Lexis/Nexis for newspaper articles in the UK, US, Australia/New Zealand, and Factiva for Canadian newspaper articles from 1995 to 2005. We used a coding frame to analyze and compare 48 pharmaceutical and 57 herbal remedy clinical trials as well as 201 pharmaceutical and 352 herbal remedy newspaper articles. Results Herbal remedy clinical trials had similar Jadad scores to pharmaceutical trials but were significantly smaller and of shorter duration. The trials were mostly studies from Western countries and published in high-ranking journals. The majority of pharmaceutical (64% and herbal remedy (53% clinical trials had private sector funding involvement. A minority declared further author conflicts of interest. Newspaper coverage of herbal remedy clinical trials was more negative than for pharmaceutical trials; a result only partly explained by the greater proportion of herbal remedy clinical trials reporting negative results (P = 0.0201; χ2 = 7.8129; degrees of freedom = 2. Errors of omission were common in newspaper coverage, with little reporting of dose, sample size, location, and duration of the trial, methods, trial funding, and conflicts of interest. There was an under-reporting of risks, especially for herbal remedies. Conclusion Our finding of negative coverage of herbal remedy trials is contrary to the positive trends in most

  16. Cigarette advertising and media coverage of smoking and health.

    Science.gov (United States)

    Warner, K E

    1985-02-07

    In the US, media coverage of the health hazards of cigarette smoking is consored by the tobacco industry. Tobacco companies, which in 1983 alone spent US$2.5 billion on smoking promtion, are a major source of advertising revenue for many media organizations. As a result media organizations frequently refuse to publish antismoking information, tent to tone down coverage of antismoking news events, and often refuse to accept antismoking advertisements. In a 1983 "Newsweek" supplement on personal health, prepared by the American Medical Association, only 4 sentences were devoted to the negative effects of smoking. A spokesman for the association reported that "Newsweek" editors refused to allow the association to use the forum to present a strong antismoking message. In 1984 a similar type of health supplement, published by "Time," failed to mention smoking at all. An examination of 10 major women's magazines revealed that between 1967-79, 4 of the magazines published no articles about the hazards of smoking and only 8 such articles appeared in the other 6 magazines. All of these magazines carried smoking advertisements. During the same time period, 2 magazines, which refused to publish cigarette ads, published a total of 16 articles on the hazards of smoking. Small magazines which publish antismoking articles are especially vulnerable to pressure from the tobacco industry. For example, the tobacco industry canceled all its ads in "Mother Jones" after the magazine printed 2 antismoking articles. 22 out of 36 magazines refused to run antismoking advertisements when they were requested to do so. Due to poor media coverage, th public's knowledge of the hazards of smoking is deficient. Recent surveys found that 2/3 of the public did not know that smoking could cause heart attacks, and 1/2 of the respondents did not know that smoking is the major cause of lung cancer. An analysis of time trends in cigarette smoking indicates that the public does respond to antismoking

  17. Controlling coverage of solution cast materials with unfavourable surface interactions

    KAUST Repository

    Burlakov, V. M.; Eperon, G. E.; Snaith, H. J.; Chapman, S. J.; Goriely, A.

    2014-01-01

    Creating uniform coatings of a solution-cast material is of central importance to a broad range of applications. Here, a robust and generic theoretical framework for calculating surface coverage by a solid film of material de-wetting a substrate is presented. Using experimental data from semiconductor thin films as an example, we calculate surface coverage for a wide range of annealing temperatures and film thicknesses. The model generally predicts that for each value of the annealing temperature there is a range of film thicknesses leading to poor surface coverage. The model accurately reproduces solution-cast thin film coverage for organometal halide perovskites, key modern photovoltaic materials, and identifies processing windows for both high and low levels of surface coverage. © 2014 AIP Publishing LLC.

  18. Controlling coverage of solution cast materials with unfavourable surface interactions

    KAUST Repository

    Burlakov, V. M.

    2014-03-03

    Creating uniform coatings of a solution-cast material is of central importance to a broad range of applications. Here, a robust and generic theoretical framework for calculating surface coverage by a solid film of material de-wetting a substrate is presented. Using experimental data from semiconductor thin films as an example, we calculate surface coverage for a wide range of annealing temperatures and film thicknesses. The model generally predicts that for each value of the annealing temperature there is a range of film thicknesses leading to poor surface coverage. The model accurately reproduces solution-cast thin film coverage for organometal halide perovskites, key modern photovoltaic materials, and identifies processing windows for both high and low levels of surface coverage. © 2014 AIP Publishing LLC.

  19. Hospital exclusion clauses limiting liability for medical malpractice ...

    African Journals Online (AJOL)

    In 2002 the Supreme Court of Appeal ruling in Afrox Healthcare Beperk v. Strydom held that the common law allows hospitals to exclude liability for medical malpractice resulting in death or physical or psychological injury – except in the case of gross negligence. The effect of this judgment has now been superseded by the ...

  20. Chinese newspaper coverage of genetically modified organisms

    Directory of Open Access Journals (Sweden)

    Du Li

    2012-06-01

    Full Text Available Abstract Background Debates persist around the world over the development and use of genetically modified organisms (GMO. News media has been shown to both reflect and influence public perceptions of health and science related debates, as well as policy development. To better understand the news coverage of GMOs in China, we analyzed the content of articles in two Chinese newspapers that relate to the development and promotion of genetically modified technologies and GMOs. Methods Searching in the Chinese National Knowledge Infrastructure Core Newspaper Database (CNKI-CND, we collected 77 articles, including news reports, comments and notes, published between January 2002 and August 2011 in two of the major Chinese newspapers: People’s Daily and Guangming Daily. We examined articles for perspectives that were discussed and/or mentioned regarding GMOs, the risks and benefits of GMOs, and the tone of news articles. Results The newspaper articles reported on 29 different kinds of GMOs. Compared with the possible risks, the benefits of GMOs were much more frequently discussed in the articles. 48.1% of articles were largely supportive of the GM technology research and development programs and the adoption of GM cottons, while 51.9% of articles were neutral on the subject of GMOs. Risks associated with GMOs were mentioned in the newspaper articles, but none of the articles expressed negative tones in regards to GMOs. Conclusion This study demonstrates that the Chinese print media is largely supportive of GMOs. It also indicates that the print media describes the Chinese government as actively pursuing national GMO research and development programs and the promotion of GM cotton usage. So far, discussion of the risks associated with GMOs is minimal in the news reports. The media, scientists, and the government should work together to ensure that science communication is accurate and balanced.

  1. Chinese newspaper coverage of genetically modified organisms

    Science.gov (United States)

    2012-01-01

    Background Debates persist around the world over the development and use of genetically modified organisms (GMO). News media has been shown to both reflect and influence public perceptions of health and science related debates, as well as policy development. To better understand the news coverage of GMOs in China, we analyzed the content of articles in two Chinese newspapers that relate to the development and promotion of genetically modified technologies and GMOs. Methods Searching in the Chinese National Knowledge Infrastructure Core Newspaper Database (CNKI-CND), we collected 77 articles, including news reports, comments and notes, published between January 2002 and August 2011 in two of the major Chinese newspapers: People’s Daily and Guangming Daily. We examined articles for perspectives that were discussed and/or mentioned regarding GMOs, the risks and benefits of GMOs, and the tone of news articles. Results The newspaper articles reported on 29 different kinds of GMOs. Compared with the possible risks, the benefits of GMOs were much more frequently discussed in the articles. 48.1% of articles were largely supportive of the GM technology research and development programs and the adoption of GM cottons, while 51.9% of articles were neutral on the subject of GMOs. Risks associated with GMOs were mentioned in the newspaper articles, but none of the articles expressed negative tones in regards to GMOs. Conclusion This study demonstrates that the Chinese print media is largely supportive of GMOs. It also indicates that the print media describes the Chinese government as actively pursuing national GMO research and development programs and the promotion of GM cotton usage. So far, discussion of the risks associated with GMOs is minimal in the news reports. The media, scientists, and the government should work together to ensure that science communication is accurate and balanced. PMID:22551150

  2. Chinese newspaper coverage of genetically modified organisms.

    Science.gov (United States)

    Du, Li; Rachul, Christen

    2012-06-08

    Debates persist around the world over the development and use of genetically modified organisms (GMO). News media has been shown to both reflect and influence public perceptions of health and science related debates, as well as policy development. To better understand the news coverage of GMOs in China, we analyzed the content of articles in two Chinese newspapers that relate to the development and promotion of genetically modified technologies and GMOs. Searching in the Chinese National Knowledge Infrastructure Core Newspaper Database (CNKI-CND), we collected 77 articles, including news reports, comments and notes, published between January 2002 and August 2011 in two of the major Chinese newspapers: People's Daily and Guangming Daily. We examined articles for perspectives that were discussed and/or mentioned regarding GMOs, the risks and benefits of GMOs, and the tone of news articles. The newspaper articles reported on 29 different kinds of GMOs. Compared with the possible risks, the benefits of GMOs were much more frequently discussed in the articles. 48.1% of articles were largely supportive of the GM technology research and development programs and the adoption of GM cottons, while 51.9% of articles were neutral on the subject of GMOs. Risks associated with GMOs were mentioned in the newspaper articles, but none of the articles expressed negative tones in regards to GMOs. This study demonstrates that the Chinese print media is largely supportive of GMOs. It also indicates that the print media describes the Chinese government as actively pursuing national GMO research and development programs and the promotion of GM cotton usage. So far, discussion of the risks associated with GMOs is minimal in the news reports. The media, scientists, and the government should work together to ensure that science communication is accurate and balanced.

  3. Measuring coverage in MNCH: challenges and opportunities in the selection of coverage indicators for global monitoring.

    Directory of Open Access Journals (Sweden)

    Jennifer Harris Requejo

    Full Text Available Global monitoring of intervention coverage is a cornerstone of international efforts to improve reproductive, maternal, newborn, and child health. In this review, we examine the process and implications of selecting a core set of coverage indicators for global monitoring, using as examples the processes used by the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Accountability for Women's and Children's Health. We describe how the generation of data for global monitoring involves five iterative steps: development of standard indicator definitions and measurement approaches to ensure comparability across countries; collection of high-quality data at the country level; compilation of country data at the global level; organization of global databases; and rounds of data quality checking. Regular and rigorous technical review processes that involve high-level decision makers and experts familiar with indicator measurement are needed to maximize uptake and to ensure that indicators used for global monitoring are selected on the basis of available evidence of intervention effectiveness, feasibility of measurement, and data availability as well as programmatic relevance. Experience from recent initiatives illustrates the challenges of striking this balance as well as strategies for reducing the tensions inherent in the indicator selection process. We conclude that more attention and continued investment need to be directed to global monitoring, to support both the process of global database development and the selection of sets of coverage indicators to promote accountability. The stakes are high, because these indicators can drive policy and program development at the country and global level, and ultimately impact the health of women and children and the communities where they live.

  4. Coverage or Cover-up: A Comparison of Newspaper Coverage of the 19th Amendment and the Equal Rights Amendment.

    Science.gov (United States)

    Smith, Linda Lazier

    A study compared newspaper coverage of the women's suffrage movement in the 1920s with coverage of efforts to pass the Equal Rights Amendment in the 1970s and early 1980s, to see if the similar movements with different outcomes were treated similarly or differently by the press. A content analysis of relevant articles in the "New York…

  5. Cochlear implants and medical tourism.

    Science.gov (United States)

    McKinnon, Brian J; Bhatt, Nishant

    2010-09-01

    To compare the costs of medical tourism in cochlear implant surgery performed in India as compared to the United States. In addition, the cost savings of obtaining cochlear implant surgery in India were compare d to those of other surgical interventions obtained as a medical tourist. Searches were conducted on Medline and Google using the search terms: 'medical tourism', 'medical offshoring', 'medical outsourcing', 'cochlear implants' and 'cochlear implantation'. The information regarding cost of medical treatment was obtained from personal communication with individuals familiar with India's cochlear implantation medical tourism industry. The range of cost depended on length of stay as well as the device chosen. Generally the cost, inclusive of travel, surgery and device, was in the range of $21,000-30,000, as compared to a cost range of $40,000-$60,000 in the US. With the escalating cost of healthcare in the United States, it is not surprising that some patients would seek to obtain surgical care overseas at a fraction of the cost. Participants in medical tourism often have financial resources, but lack health insurance coverage. While cardiovascular and orthopedic surgery performed outside the United States in India at centers that cater to medical tourists are often performed at one-quarter to one-third of the cost that would have been paid in the United States, the cost differential for cochlear implants is not nearly as favorable.

  6. Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

    Science.gov (United States)

    Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

    2016-01-01

    Background China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. PMID:27564320

  7. Administrative compensation for medical injuries: lessons from three foreign systems.

    Science.gov (United States)

    Mello, Michelle M; Kachalia, Allen; Studdert, David M

    2011-07-01

    The United States requires patients injured by medical negligence to seek compensation through lawsuits, an approach that has drawbacks related to fairness, cost, and impact on medical care. Several countries, including New Zealand, Sweden, and Denmark, have replaced litigation with administrative compensation systems for patients who experience an avoidable medical injury. Sometimes called "no-fault" systems, such schemes enable patients to file claims for compensation without using an attorney. A governmental or private adjudicating organization uses neutral medical experts to evaluate claims of injury and does not require patients to prove that health care providers were negligent in order to receive compensation. Information from claims is used to analyze opportunities for patient safety improvement. The systems have successfully limited liability costs while improving injured patients' access to compensation. American policymakers may find many of the elements of these countries' systems to be transferable to demonstration projects in the U.S.

  8. A Corpus-Based Lexical Study on Frequency and Distribution of Coxhead's Awl Word Families in Medical Research Articles (RAs)

    Science.gov (United States)

    Chen, Qi; Guang-Chun, Ge

    2007-01-01

    We conducted a lexical study on the word frequency and the text coverage of the 570 word families from Coxhead's Academic Word List (AWL) in medical research articles (RAs) based on a corpus of 50 medical RAs written in English with 190425 running words. By computer analysis, we found that the text coverage of the AWL words accounted for around…

  9. Detecting Boundary Nodes and Coverage Holes in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Li-Hui Zhao

    2016-01-01

    Full Text Available The emergence of coverage holes in wireless sensor networks (WSNs means that some special events have broken out and the function of WSNs will be seriously influenced. Therefore, the issues of coverage holes have attracted considerable attention. In this paper, we focus on the identification of boundary nodes and coverage holes, which is crucially important to preventing the enlargement of coverage holes and ensuring the transmission of data. We define the problem of coverage holes and propose two novel algorithms to identify the coverage holes in WSNs. The first algorithm, Distributed Sector Cover Scanning (DSCS, can be used to identify the nodes on hole borders and the outer boundary of WSNs. The second scheme, Directional Walk (DW, can locate the coverage holes based on the boundary nodes identified with DSCS. We implement the algorithms in various scenarios and fully evaluate their performance. The simulation results show that the boundary nodes can be accurately detected by DSCS and the holes enclosed by the detected boundary nodes can be identified by DW. The comparisons confirm that the proposed algorithms outperform the existing ones.

  10. Ethical and medical dilemmas of space tourism

    Science.gov (United States)

    Marsh, Melinda

    Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.

  11. Progress toward universal health coverage in ASEAN.

    Science.gov (United States)

    Van Minh, Hoang; Pocock, Nicola Suyin; Chaiyakunapruk, Nathorn; Chhorvann, Chhea; Duc, Ha Anh; Hanvoravongchai, Piya; Lim, Jeremy; Lucero-Prisno, Don Eliseo; Ng, Nawi; Phaholyothin, Natalie; Phonvisay, Alay; Soe, Kyaw Min; Sychareun, Vanphanom

    2014-01-01

    The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and 'snowball' further data. We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1) financial constraints, including low levels of overall and government spending on health; 2) supply side constraints, including inadequate numbers and densities of health workers; and 3) the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should be explicitly considered to mitigate

  12. Progress toward universal health coverage in ASEAN

    Directory of Open Access Journals (Sweden)

    Hoang Van Minh

    2014-12-01

    Full Text Available Background: The Association of Southeast Asian Nations (ASEAN is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design: Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and ‘snowball’ further data. Results: We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1 financial constraints, including low levels of overall and government spending on health; 2 supply side constraints, including inadequate numbers and densities of health workers; and 3 the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should

  13. The challenges of social marketing of organ donation: news and entertainment coverage of donation and transplantation.

    Science.gov (United States)

    Harrison, Tyler R; Morgan, Susan E; Chewning, Lisa V

    2008-01-01

    While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.

  14. Dental Use and Expenditures for Older Uninsured Americans: The Simulated Impact of Expanded Coverage

    Science.gov (United States)

    Manski, Richard J; Moeller, John F; Chen, Haiyan; Schimmel, Jody; Pepper, John V; St Clair, Patricia A

    2015-01-01

    Objective To determine if providing dental insurance to older Americans would close the current gaps in dental use and expenditure between insured and uninsured older Americans. Data Sources/Study Setting We used data from the 2008 Health and Retirement Survey (HRS) supplemented by data from the 2006 Medical Expenditure Panel Survey (MEPS). Study Design We compared the simulated dental use and expenditures rates of newly insured persons against the corresponding rates for those previously insured. Data Collection/Extraction Methods The HRS is a nationally representative survey administered by the Institute for Social Research (ISR). The MEPS is a nationally representative household survey sponsored by the Agency for Healthcare Research and Quality (AHRQ). Principal Findings We found that expanding dental coverage to older uninsured Americans would close previous gaps in dental use and expense between uninsured and insured noninstitutionalized Americans 55 years and older. Conclusions Providing dental coverage to previously uninsured older adults would produce estimated monthly costs net of markups for administrative costs that comport closely to current market rates. Estimates also suggest that the total cost of providing dental coverage targeted specifically to nonusers of dental care may be less than similar costs for prior users. PMID:25040355

  15. Coverage of genomic medicine: information gap between lay public and scientists.

    Science.gov (United States)

    Sugawara, Yuya; Narimatsu, Hiroto; Fukao, Akira

    2012-01-01

    The sharing of information between the lay public and medical professionals is crucial to the conduct of personalized medicine using genomic information in the near future. Mass media, such as newspapers, can play an important role in disseminating scientific information. However, studies on the role of newspaper coverage of genome-related articles are highly limited. We investigated the coverage of genomic medicine in five major Japanese newspapers (Asahi, Mainichi, Yomiuri, Sankei, and Nikkei) using Nikkei Telecom and articles in scientific journals in PubMed from 1995 to 2009. The number of genome-related articles in all five newspapers temporarily increased in 2000, and began continuously decreasing thereafter from 2001 to 2009. Conversely, there was a continuous increasing trend in the number of genome-related articles in PubMed during this period. The numbers of genome-related articles among the five major newspapers from 1995 to 2009 were significantly different (P = 0.002). Commentaries, research articles, and articles about companies were the most frequent in 2001 and 2003, when the number of genome-related articles transiently increased in the five newspapers. This study highlights the significant gap between newspaper coverage and scientific articles in scientific journals.

  16. Massachusetts health reform: employer coverage from employees' perspective.

    Science.gov (United States)

    Long, Sharon K; Stockley, Karen

    2009-01-01

    The national health reform debate continues to draw on Massachusetts' 2006 reform initiative, with a focus on sustaining employer-sponsored insurance. This study provides an update on employers' responses under health reform in fall 2008, using data from surveys of working-age adults. Results show that concerns about employers' dropping coverage or scaling back benefits under health reform have not been realized. Access to employer coverage has increased, as has the scope and quality of their coverage as assessed by workers. However, premiums and out-of-pocket costs have become more of an issue for employees in small firms.

  17. 24/7 pediatric radiology attending coverage: times are changing

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, James S. [Feinberg School of Medicine at Northwestern University, Department of Medical Imaging, Ann and Robert H. Lurie Children' s Hospital of Chicago, IL (United States); Thakrar, Kiran H. [University of Chicago Pritzker School of Medicine, Body Imaging, NorthShore University HealthSystem, Chicago, IL (United States)

    2017-06-15

    The job of the pediatric radiologist long ago ceased to be an 8-to-5 role. Many practices have adopted evening shifts of in-house attending radiologists to cover the busy evening activity. With the ever-increasing role of imaging in clinical decisions and patient management, there is a need - if not a demand - to further extend attending pediatric radiology coverage. In this article, we discuss the needs and justification for extending pediatric radiology coverage at a tertiary-care children's hospital. We also describe the approach we took toward implementing 24/7 attending in-house coverage of pediatric radiology. (orig.)

  18. Did the Affordable Care Act's Dependent Coverage Mandate Increase Premiums?

    OpenAIRE

    Briggs Depew; James Bailey

    2014-01-01

    We investigate the impact of the Affordable Care Act's dependent coverage mandate on insurance premiums. The expansion of dependent coverage under the ACA allows young adults to remain on their parent's private health insurance plans until the age of 26. We find that the mandate has led to a 2.5-2.8 percent increase in premiums for health insurance plans that cover children, relative to single-coverage plans. We find no evidence that the mandate caused an increase in the amount of the employe...

  19. Pertussis: herd immunity and vaccination coverage in St Lucia.

    Science.gov (United States)

    Cooper, E; Fitch, L

    1983-11-12

    In a single complete epidemic in St Lucia, an island too small to support constant clinical pertussis, the pertussis case rates in small communities (villages and small towns) with differing levels of vaccination coverage of young children were compared. The association between greater vaccination coverage and greater herd immunity was clear, despite the imperfect protection given to individuals. An analysis in terms of population dynamics is evidence against the theory that endemic subclinical pertussis maintains transmission in a highly vaccinated population. We suggest that with a homogeneous vaccination coverage of 80% of 2-year-old children pertussis might be eradicated from the island, and that this is a practicable experiment.

  20. CHIP premiums, health status, and the insurance coverage of children.

    Science.gov (United States)

    Marton, James; Talbert, Jeffery C

    2010-01-01

    This study uses the introduction of premiums into Kentucky's Children's Health Insurance Program (KCHIP) to examine whether the enrollment impact of new premiums varies by child health type. We also examine the extent to which children find alternative coverage after premium nonpayment. Public insurance claims data suggest that those with chronic health conditions are less likely to leave public coverage. We find little evidence of a differential impact of premiums on enrollment among the chronically ill. Our survey of nonpayers shows that 56% of responding families found alternative private or public health coverage for their children after losing CHIP.

  1. Determination of negligible concentration threshold values for water pollution assessment; Ableitung von Geringfuegigkeitsschwellen zur Beurteilung von Grundwasserverunreinigungen. T. 2. Organische Parameter

    Energy Technology Data Exchange (ETDEWEB)

    Trenck, K.T. von der [Landesanstalt fuer Umweltschutz Baden-Wuerttemberg, Karlsruhe (Germany); Roeder, R.; Slama, H. [Bayerische Landesanstalt fuer Wasserforschung (BayLWF), Muenchen (Germany); Markard, C.; Kuehl, C. [Umweltbundesamt, Berlin (Germany)

    1999-12-01

    Part I of the status report contains the derivation criteria, the reasons for the inorganic parameters chosen, and explanations of terms and abbreviations. A table is presented which contains negligible concentration threshold values for selected parameters of inorganic and organic substances. [German] Der erste Teil des Statusberichts enthaelt eine ausfuehrliche Darstellung der Ableitungskriterien sowie die Begruendung fuer die anorganischen Parameter und Erlaeuterungen zu den Abkuerzungen und Begriffen. Entsprechende Konzentrationswerte fuer die Geringfuegigkeitsschwellen einer Auswahl an Parametern enthaelt eine in der vorliegenden Arbeit aufgefuehrte Tabelle getrennt nach anorganischen und organischen Stoffen. (orig.)

  2. Counselor Liability: Does the Risk Require Insurance Coverage?

    Science.gov (United States)

    Hendrickson, Robert M.

    1982-01-01

    Discusses the legal concept of liabiltiy and the potential risks facing the practicing counselor. Outlines the standard of care that psychiatrists must meet to protect themselves against negligence charges. Discusses actions resulting in false imprisonment, battery, infliction of mental distress, defamation, and "duty to warn." (RC)

  3. The Importance of the Medical Record: A Critical Professional Responsibility.

    Science.gov (United States)

    Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E

    2016-01-01

    Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology.

  4. The current situation of voluntary vaccination and the factors influencing its coverage among children in Takatsuki, Japan: focus on Hib and pneumococcal vaccines.

    Science.gov (United States)

    Tsuda, Yuko; Watanabe, Misuzu; Tanimoto, Yoshimi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Komiyama, Maki; Kono, Koichi

    2015-03-01

    This study aimed to understand the current scenario of voluntary vaccination and the factors influencing its coverage among 18-month-old children of Takatsuki City, Japan. Based on 1167 parents responses, we found that voluntary vaccination coverage rates were low when compared with routine vaccination rates. The children who were not the first born of the family and who had young and poorly educated parents were less likely to receive voluntary vaccination. Japanese government-supported vaccines, such as Haemophilus influenzae type b and pneumococcal vaccine, had a higher coverage than the vaccines for which parents had to bear the entire vaccination cost. Furthermore, it was found that mass communication media and family pediatricians were effective means to disseminate voluntary vaccination-related information. We envisage that an active participation of medical professionals, easy access to vaccinations, and mass awareness programs will increase voluntary vaccination coverage in Takatsuki. © 2013 APJPH.

  5. Controlling cost escalation of healthcare: making universal health coverage sustainable in China

    Science.gov (United States)

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

  6. Medical tourism.

    Science.gov (United States)

    Leggat, Peter

    2015-01-01

    Medical tourism is a burgeoning industry in our region. It involves patients travelling outside of their home country for medical treatment. This article provides an outline of the current research around medical tourism, especially its impact on Australians. Patients are increasingly seeking a variety of medical treatments abroad, particularly those involving cosmetic surgery and dental treatment, often in countries in South-East Asia. Adverse events may occur during medical treatment abroad, which raises medico-legal and insurance issues, as well as concerns regarding follow-up of patients. General practitioners need to be prepared to offer advice, including travel health advice, to patients seeking medical treatment abroad.

  7. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2018. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  8. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2016. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  9. Newspaper coverage of mental illness in England 2008-2011.

    Science.gov (United States)

    Thornicroft, Amalia; Goulden, Robert; Shefer, Guy; Rhydderch, Danielle; Rose, Diana; Williams, Paul; Thornicroft, Graham; Henderson, Claire

    2013-04-01

    Better newspaper coverage of mental health-related issues is a target for the Time to Change (TTC) anti-stigma programme in England, whose population impact may be influenced by how far concurrent media coverage perpetuates stigma and discrimination. To compare English newspaper coverage of mental health-related topics each year of the TTC social marketing campaign (2009-2011) with baseline coverage in 2008. Content analysis was performed on articles in 27 local and national newspapers on two randomly chosen days each month. There was a significant increase in the proportion of anti-stigmatising articles between 2008 and 2011. There was no concomitant proportional decrease in stigmatising articles, and the contribution of mixed or neutral elements decreased. These findings provide promising results on improvements in press reporting of mental illness during the TTC programme in 2009-2011, and a basis for guidance to newspaper journalists and editors on reporting mental illness.

  10. Land and federal mineral ownership coverage for northwestern Colorado

    Science.gov (United States)

    Biewick, L.H.; Mercier, T.J.; Levitt, Pam; Deikman, Doug; Vlahos, Bob

    1999-01-01

    This Arc/Info coverage contains land status and Federal mineral ownership for approximately 26,800 square miles in northwestern Colorado. The polygon coverage (which is also provided here as a shapefile) contains two attributes of ownership information for each polygon. One attribute indicates where the surface is State owned, privately owned, or, if Federally owned, which Federal agency manages the land surface. The other attribute indicates which minerals, if any, are owned by the Federal govenment. This coverage is based on land status and Federal mineral ownership data compiled by the U.S. Geological Survey (USGS) and three Colorado State Bureau of Land Management (BLM) former district offices at a scale of 1:24,000. This coverage was compiled primarily to serve the USGS National Oil and Gas Resource Assessment Project in the Uinta-Piceance Basin Province and the USGS National Coal Resource Assessment Project in the Colorado Plateau.

  11. [Gaps in effective coverage by socioeconomic status and poverty condition].

    Science.gov (United States)

    Gutiérrez, Juan Pablo

    2013-01-01

    To analyze, in the context of increased health protection in Mexico, the gaps by socioeconomic status and poverty condition on effective coverage of selected preventive interventions. Data from the National Health & Nutrition Survey 2012 and 2006, using previously defined indicators of effective coverage and stratifying them by socioeconomic (SE) status and multidimensional poverty condition. For vaccination interventions, immunological equity has been maintained in Mexico. For indicators related to preventive interventions provided at the clinical setting, effective coverage is lower among those in the lowest SE quintile and among people living in multidimensional poverty. Comparing 2006 and 2012, there is no evidence on gap reduction. While health protection has significantly increased in Mexico, thus reducing SE gaps, those gaps are still important in magnitude for effective coverage of preventive interventions.

  12. Relationships between length and coverage of decision rules

    KAUST Repository

    Amin, Talha M.; Chikalov, Igor; Moshkov, Mikhail; Zielosko, Beata

    2014-01-01

    The paper describes a new tool for study relationships between length and coverage of exact decision rules. This tool is based on dynamic programming approach. We also present results of experiments with decision tables from UCI Machine Learning Repository.

  13. Relationships between length and coverage of decision rules

    KAUST Repository

    Amin, Talha

    2014-02-14

    The paper describes a new tool for study relationships between length and coverage of exact decision rules. This tool is based on dynamic programming approach. We also present results of experiments with decision tables from UCI Machine Learning Repository.

  14. Surface Coverage in Wireless Sensor Networks Based on Delaunay Tetrahedralization

    International Nuclear Information System (INIS)

    Ribeiro, M G; Neves, L A; Zafalon, G F D; Valêncio, C; Pinto, A R; Nascimento, M Z

    2015-01-01

    In this work is presented a new method for sensor deployment on 3D surfaces. The method was structured on different steps. The first one aimed discretizes the relief of interest with Delaunay algorithm. The tetrahedra and relative values (spatial coordinates of each vertex and faces) were input to construction of 3D Voronoi diagram. Each circumcenter was calculated as a candidate position for a sensor node: the corresponding circular coverage area was calculated based on a radius r. The r value can be adjusted to simulate different kinds of sensors. The Dijkstra algorithm and a selection method were applied to eliminate candidate positions with overlapped coverage areas or beyond of surface of interest. Performance evaluations measures were defined using coverage area and communication as criteria. The results were relevant, once the mean coverage rate achieved on three different surfaces were among 91% and 100%

  15. Pericyte coverage of abnormal blood vessels in myelofibrotic bone marrows

    DEFF Research Database (Denmark)

    Zetterberg, Eva; Vannucchi, Alessandro M; Migliaccio, Anna Rita

    2007-01-01

    BACKGROUND AND OBJECTIVES: Myelofibrotic bone marrow displays abnormal angiogenesis but the pathogenic mechanisms of this are poorly understood. Since pericyte abnormalities are described on solid tumor vessels we studied whether vessel morphology and pericyte coverage in bone marrow samples from...

  16. Insurance Coverage and Whither Thou Goest for Health Info

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Insurance Coverage and Whither Thou Goest for Health Information in 2012, recently published in Volume 4, Issue 4 of the Medicare and Medicaid Research...

  17. 14 CFR 440.13 - Standard conditions of insurance coverage.

    Science.gov (United States)

    2010-01-01

    ... against that licensee, permittee or additional insured). (5) Each exclusion from coverage must be...; or (ii) Includes in each of its policies or insurance obtained under this part a contract clause in...

  18. Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL study.

    Directory of Open Access Journals (Sweden)

    Didier K Ekouevi

    Full Text Available Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT coverage in sub-Saharan are poorly understood.We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenatal quality, PMTCT quality, supplies available, patient satisfaction, patient understanding of medication, and infrastructure quality. Pearson correlations and Generalized Estimating Equations (GEE to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. Between July 2008 and May 2009, we collected data from 32 facilities; 78% were managed by the government health system. An opt-out approach for HIV testing was used in 100% of facilities in Zambia, 63% in Cameroon, and none in Côte d'Ivoire or South Africa. Using Pearson correlations, PMTCT coverage (median of 55%, (IQR: 33-68 was correlated with PMTCT quality score (rho = 0.51; p = 0.003; infrastructure quality score (rho = 0.43; p = 0.017; time spent at clinic (rho = 0.47; p = 0.013; patient understanding of medications score (rho = 0.51; p = 0.006; and patient satisfaction quality score (rho = 0.38; p = 0.031. PMTCT coverage was marginally correlated with the antenatal quality score (rho = 0.304; p = 0.091. Using GEE adjustment for clustering, the, antenatal quality score became more strongly associated with PMTCT coverage (p<0.001 and the PMTCT quality score and patient understanding of medications remained marginally significant.We observed a positive relationship between an antenatal quality score and PMTCT coverage but did not identify

  19. Estimated Budget Impact of Adopting the Affordable Care Act's Required Smoking Cessation Coverage on United States Healthcare Payers.

    Science.gov (United States)

    Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey

    2017-01-01

    Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact

  20. Duplicate Health Insurance Coverage: Determinants of Variation Across States

    OpenAIRE

    Luft, Harold S.; Maerki, Susan C.

    1982-01-01

    Although it is recognized that many people have duplicate private health insurance coverage, either through separate purchase or as health benefits in multi-earner families, there has been little analysis of the factors determining duplicate coverage rates. A new data source, the Survey of Income and Education, offers a comparison with the only previous source of state level data, the estimates from the Health Insurance Association of America. The R2 between the two sets is only .3 and certai...

  1. Primary care practice and health professional determinants of immunisation coverage.

    Science.gov (United States)

    Grant, Cameron C; Petousis-Harris, Helen; Turner, Nikki; Goodyear-Smith, Felicity; Kerse, Ngaire; Jones, Rhys; York, Deon; Desmond, Natalie; Stewart, Joanna

    2011-08-01

    To identify primary care factors associated with immunisation coverage. A survey during 2005-2006 of a random sample of New Zealand primary care practices, with over-sampling of practices serving indigenous children. An immunisation audit was conducted for children registered at each practice. Practice characteristics and the knowledge and attitudes of doctors, nurses and caregivers were measured. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. Associations of practice, doctor, nurse and caregiver factors with practice immunisation coverage were determined using multiple regression analyses. One hundred and twenty-four (61%) of 205 eligible practices were recruited. A median (25th-75th centile) of 71% (57-77%) of registered children at each practice was fully immunised. In multivariate analyses, immunisation coverage was higher at practices with no staff shortages (median practice coverage 76% vs 67%, P = 0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%, P= 0.005). Coverage was lower if the children's parents had received information antenatally, which discouraged immunisation (67% vs 73%, P = 0.008). Coverage decreased as socio-economic deprivation of the registered population increased (P < 0.001) and as the children's age (P = 0.001) and registration age (P = 0.02) increased. CONCLUSIONS Higher immunisation coverage is achieved by practices that establish an early relationship with the family and that are adequately resourced with stable and confident staff. Immunisation promotion should begin antenatally. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  2. Coverage and Connectivity Issue in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Rachit Trivedi

    2013-04-01

    Full Text Available Wireless sensor networks (WSNs are an emerging area of interest in research and development. It finds use in military surveillance, health care, environmental monitoring, forest fire detection and smart environments. An important research issue in WSNs is the coverage since cost, area and lifetime are directly validated to it.In this paper we present an overview of WSNs and try to refine the coverage and connectivity issues in wireless sensor networks.

  3. Graphene transfer process and optimization of graphene coverage

    OpenAIRE

    Sabki Syarifah Norfaezah; Shamsuri Shafiq Hafly; Fauzi Siti Fazlina; Chon-Ki Meghashama Lim; Othman Noraini

    2017-01-01

    Graphene grown on transition metal is known to be high in quality due to its controlled amount of defects and potentially used for many electronic applications. The transfer process of graphene grown on transition metal to a new substrate requires optimization in order to ensure that high graphene coverage can be obtained. In this work, an improvement in the graphene transfer process is performed from graphene grown on copper foil. It has been observed that the graphene coverage is affected b...

  4. The Liquidity Coverage Ratio: the need for further complementary ratios?

    OpenAIRE

    Ojo, Marianne

    2013-01-01

    This paper considers components of the Liquidity Coverage Ratio – as well as certain prevailing gaps which may necessitate the introduction of a complementary liquidity ratio. The definitions and objectives accorded to the Liquidity Coverage Ratio (LCR) and Net Stable Funding Ratio (NSFR) highlight the focus which is accorded to time horizons for funding bank operations. A ratio which would focus on the rate of liquidity transformations and which could also serve as a complementary metric gi...

  5. Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003

    Directory of Open Access Journals (Sweden)

    Collins Charles D

    2007-03-01

    Full Text Available Abstract Background In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS and Labour Insurance Scheme (LIS to the new Urban Employee Basic Health Insurance Scheme (BHIS. Methods This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. Results An examination of the data reveals a number of key points: a The overall coverage of the newly established scheme has decreased from 1998 to 2003. b The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. Conclusion The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in

  6. Medical Management

    Science.gov (United States)

    ... org Close Charcot-Marie-Tooth Disease (CMT) Medical Management Although there’s no cure for CMT, there are ... individualized physical therapy program. For more on medical management of CMT, see Surgery Sometimes, Bracing Often, Caution ...

  7. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  8. Medical Illustration

    Science.gov (United States)

    ... as medical books, journals, magazines, pharma or biotech marketing, films, online video, exhibits, posters, wall charts, educational ... of the health career profession with strong communication skills, medical illustrators work closely with clients to interpret ...

  9. [Neonatal screening - the challenge of an universal and effective coverage].

    Science.gov (United States)

    Botler, Judy; Camacho, Luiz Antônio Bastos; da Cruz, Marly Marques; George, Pâmela

    2010-03-01

    Newborn screening programs (NSP) aim to detect carriers of several congenital diseases among asymptomatic infants in order to warrant effective intervention. Specimen collection is the first step of a process that should be done in an universal and timely manner. A review of coverage and time of collection was done in NSP of several countries. The search was made in various sources, from 1998 to 2008, with "neonatal screening" and "coverage" as key words. The lack of a typical study design did not allow to the rigor required for a systematic review. Data were grouped in macro-regions. Canada had coverage of 71% in 2006 while the European coverage was of 69% in 2004, with data of 38 countries. In Asia and Pacific region, there were data of 19 countries. In Middle East and North Africa, there were data of 4 countries. In Latin America, the coverage was 49% in 2005, with data of 14 countries. In Brazil, coverage was 80%. Twelve reports had information about timeliness. The conclusion is that epidemiological transition has contributed to NSP success. Developed regions had more universal and timelier collection. In Brazil, government initiative increased access to the NSP, but late collections lead to the need of educational actions and participation of professional organizations in developing specific guidelines definition.

  10. Exploring the relationship between population density and maternal health coverage

    Directory of Open Access Journals (Sweden)

    Hanlon Michael

    2012-11-01

    Full Text Available Abstract Background Delivering health services to dense populations is more practical than to dispersed populations, other factors constant. This engenders the hypothesis that population density positively affects coverage rates of health services. This hypothesis has been tested indirectly for some services at a local level, but not at a national level. Methods We use cross-sectional data to conduct cross-country, OLS regressions at the national level to estimate the relationship between population density and maternal health coverage. We separately estimate the effect of two measures of density on three population-level coverage rates (6 tests in total. Our coverage indicators are the fraction of the maternal population completing four antenatal care visits and the utilization rates of both skilled birth attendants and in-facility delivery. The first density metric we use is the percentage of a population living in an urban area. The second metric, which we denote as a density score, is a relative ranking of countries by population density. The score’s calculation discounts a nation’s uninhabited territory under the assumption those areas are irrelevant to service delivery. Results We find significantly positive relationships between our maternal health indicators and density measures. On average, a one-unit increase in our density score is equivalent to a 0.2% increase in coverage rates. Conclusions Countries with dispersed populations face higher burdens to achieve multinational coverage targets such as the United Nations’ Millennial Development Goals.

  11. Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Katya Galactionova

    Full Text Available Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and

  12. Caring for the new uninsured: Hospital charity care for older people without coverage.

    Science.gov (United States)

    DeLia, Derek

    2006-12-01

    Despite near-universal coverage through Medicare, a number of elderly residents in the United States do not have health insurance coverage. To the author's knowledge, this study is the first to document trends in the use of hospital charity care by uninsured older people. Data from the New Jersey Charity Care Program, which subsidizes hospitals for services provided to low-income uninsured people, were used to analyze trends in charity care utilization by older people from 1999 to 2004. Charity care charges are standardized to uniform Medicaid reimbursement rates and inflation adjusted using the Medical Care Consumer Price Index. From 1999 to 2004, use of charity care by older people grew much faster than it did for younger patients. As a result, older people now account for a greater share of hospital charity care in New Jersey than children. Elderly users of charity care generated higher costs per patient than their younger counterparts. Cost differences were especially salient at the upper end of the distribution, where high-cost elderly patients used significantly more resources than high-cost patients in other age groups. These results highlight an emerging source of strain on the healthcare safety net and point to a growing population of uninsured residents who have costly and complex medical needs. Similar experiences are likely to be found in other states, especially those that have growing populations of elderly immigrants who are likely to lack health insurance.

  13. Vaccination coverage against pertussis in pregnant women of Catalonia in the first year of implementation of the immunisation program.

    Science.gov (United States)

    Fernández-Cano, María Isabel; Espada-Trespalacios, Xavier; Reyes-Lacalle, Azahara; Manresa Domínguez, Josep Maria; Armadans-Gil, Lluís; Campins-Martí, Magda; Falguera-Puig, Gemma; Toran Monserrat, Pere

    2017-11-01

    The re-emergence of pertussis and the severity of its complications in infants younger than 3 months, were determining factors for starting a vaccination program for pregnant women in the third trimester of gestation in Catalonia in February 2014. This was the first autonomous community to introduce it in Spain. The aim of the study was to estimate the coverage of the program in its first year of implementation. A retrospective analysis was performed on the data from the Primary Care Centre computerised medical records of pregnant women attending Sexual and Reproductive Health Care centres of the Metropolitan Nord area of the province of Barcelona, part of the Catalan Institute of Health. The overall coverage was estimated, as well as the sociodemographic variables of Tdap vaccination of women who had registered a delivery of a live birth between August 2014 and August 2015. A total of 6,697 deliveries of live births were recorded, and 1,713 pregnant women were vaccinated, which represented an overall coverage of 25.6% (95% CI; 24.1-26.1). Vaccination coverage was higher in pregnant women under 18 years and Spanish women (P=.018 and P=.036, respectively). The estimation of vaccine coverage against pertussis in pregnant women in the third trimester of pregnancy, after the first year of implementation of the program in a health area of Catalonia was lower than the objective set. Strategies need to be designed in order to improve program coverage. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  14. Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada.

    Science.gov (United States)

    Morgan, Steven G; Li, Winny; Yau, Brandon; Persaud, Nav

    2017-02-27

    Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians' pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. © 2017 Canadian Medical Association or its licensors.

  15. Radiation Physics for Medical Physicists

    CERN Document Server

    Podgorsak, Ervin B

    2010-01-01

    This well-received textbook and reference summarizes the basic knowledge of atomic, nuclear, and radiation physics that professionals working in medical physics and biomedical engineering need for efficient and safe use of ionizing radiation. Concentrating on the underlying principles of radiation physics, it covers the prerequisite knowledge for medical physics courses on the graduate and post-graduate levels in radiotherapy physics, radiation dosimetry, imaging physics, and health physics, thus providing the link between elementary physics on the one hand and the intricacies of the medical physics specialties on the other hand. This expanded and revised second edition offers reorganized and expanded coverage. Several of the original chapters have been split into two with new sections added for completeness and better flow. New chapters on Coulomb scattering; on energy transfer and energy absorption in photon interactions; and on waveguide theory have been added in recognition of their importance. Others tra...

  16. [Medical technology and medical education].

    Science.gov (United States)

    von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

    2010-08-01

    The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

  17. 78 FR 58202 - Federal Tort Claims Act (FTCA) Medical Malpractice Program Regulations: Clarification of FTCA...

    Science.gov (United States)

    2013-09-23

    ...) Medical Malpractice Program Regulations: Clarification of FTCA Coverage for Services Provided to Non... not limit coverage to childhood vaccinations; and (3) To add the following new example as subsection 6... that have substantial direct effects on the states, the relationship between the national government...

  18. Building high-coverage monolayers of covalently bound magnetic nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Mackenzie G.; Teplyakov, Andrew V., E-mail: andrewt@udel.edu

    2016-12-01

    Graphical abstract: - Highlights: • A method for forming a layer of covalently bound nanoparticles is offered. • A nearly perfect monolayer of covalently bound magnetic nanoparticles was formed on gold. • Spectroscopic techniques confirmed covalent binding by the “click” reaction. • The influence of the functionalization scheme on surface coverage was investigated. - Abstract: This work presents an approach for producing a high-coverage single monolayer of magnetic nanoparticles using “click chemistry” between complementarily functionalized nanoparticles and a flat substrate. This method highlights essential aspects of the functionalization scheme for substrate surface and nanoparticles to produce exceptionally high surface coverage without sacrificing selectivity or control over the layer produced. The deposition of one single layer of magnetic particles without agglomeration, over a large area, with a nearly 100% coverage is confirmed by electron microscopy. Spectroscopic techniques, supplemented by computational predictions, are used to interrogate the chemistry of the attachment and to confirm covalent binding, rather than attachment through self-assembly or weak van der Waals bonding. Density functional theory calculations for the surface intermediate of this copper-catalyzed process provide mechanistic insight into the effects of the functionalization scheme on surface coverage. Based on this analysis, it appears that steric limitations of the intermediate structure affect nanoparticle coverage on a flat solid substrate; however, this can be overcome by designing a functionalization scheme in such a way that the copper-based intermediate is formed on the spherical nanoparticles instead. This observation can be carried over to other approaches for creating highly controlled single- or multilayered nanostructures of a wide range of materials to result in high coverage and possibly, conformal filling.

  19. Immunization coverage among Hispanic ancestry, 2003 National Immunization Survey.

    Science.gov (United States)

    Darling, Natalie J; Barker, Lawrence E; Shefer, Abigail M; Chu, Susan Y

    2005-12-01

    The Hispanic population is increasing and heterogeneous (Hispanic refers to persons of Spanish, Hispanic, or Latino descent). The objective was to examine immunization rates among Hispanic ancestry for the 4:3:1:3:3 series (> or = 4 doses diphtheria, tetanus toxoids, and pertussis vaccine; > or = 3 doses poliovirus vaccine; > or = 1 doses measles-containing vaccine; > or = 3 doses Haemophilus influenzae type b vaccine; and > or = 3 doses hepatitis B vaccine). The National Immunization Survey measures immunization coverage among 19- to 35-month-old U.S. children. Coverage was compared from combined 2001-2003 data among Hispanics and non-Hispanic whites using t-tests, and among Hispanic ancestry using a chi-square test. Hispanics were categorized as Mexican, Mexican American, Central American, South American, Puerto Rican, Cuban, Spanish Caribbean (primarily Dominican Republic), other, and multiple ancestry. Children of Hispanic ancestry increased from 21% in 1999 to 25% in 2003. These Hispanic children were less well immunized than non-Hispanic whites (77.0%, +/-2.1% [95% confidence interval] compared to 82.5%, +/-1.1% (95% CI) > in 2003). Immunization coverage did not vary significantly among Hispanics of varying ancestries (p=0.26); however, there was substantial geographic variability. In some areas, immunization coverage among Hispanics was significantly higher than non-Hispanic whites. Hispanic children were less well immunized than non-Hispanic whites; however, coverage varied notably by geographic area. Although a chi-square test found no significant differences in coverage among Hispanic ancestries, the range of coverage, 79.2%, +/-5.1% for Cuban Americans to 72.1%, +/-2.4% for Mexican descent, may suggest a need for improved and more localized monitoring among Hispanic communities.

  20. Public health officials and MECs should be held liable for harm caused to patients through incompetence, indifference, maladministration or negligence regarding the availability of hospital equipment.

    Science.gov (United States)

    McQuoid-Mason, David Jan

    2016-06-17

    There have been several reports of state hospitals not having functional equipment such as radiological equipment. Where these are due to incompetence, Indifference, maladministration or negligence by the public officials concerned, they may be held personally liable for the resulting harm to patients. However, the courts have often observed that where the State has been sued vicariously for the wrongs of public officials, it has not obtained reimbursement from the offending official. It has therefore been suggested that irresponsible public servants should be sued in their personal capacity (in addition to the State), to prevent taxpayers always having to pay for their misdeeds. If an individual public official cannot afford to pay all the damages awarded, the injured party can recover the balance from the State by citing it as a vicarious joint wrongdoer.