Harrington, Charlene; Schnelle, John F.; McGregor, Margaret; Simmons, Sandra F.
Many U.S. nursing homes have serious quality problems, in part, because of inadequate levels of nurse staffing. This commentary focuses on two issues. First, there is a need for higher minimum nurse staffing standards for U.S. nursing homes based on multiple research studies showing a positive relationship between nursing home quality and staffing and the benefits of implementing higher minimum staffing standards. Studies have identified the minimum staffing levels necessary to provide care consistent with the federal regulations, but many U.S. facilities have dangerously low staffing. Second, the barriers to staffing reform are discussed. These include economic concerns about costs and a focus on financial incentives. The enforcement of existing staffing standards has been weak, and strong nursing home industry political opposition has limited efforts to establish higher standards. Researchers should study the ways to improve staffing standards and new payment, regulatory, and political strategies to improve nursing home staffing and quality. PMID:27103819
Mark, Barbara; Harless, David W; Spetz, Joanne
In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.
Adams, Matthew C.; And Others
Discusses school preventive maintenance and the variables associated with maintenance staffing standards that address a zero-based budgeting environment. Explores preventive-maintenance measurement for staffing requirements, defines staffing levels and job descriptions, and outlines the factors to consider when creating a maintenance program and…
Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L
There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.
... NATIONAL INDIAN GAMING COMMISSION 25 CFR Parts 543 and 547 Minimum Internal Control Standards [email protected] . SUPPLEMENTARY INFORMATION: Part 543 addresses minimum internal control standards (MICS) for Class II gaming operations. The regulations require tribes to establish controls and implement...
Baltzer, Kenneth Thomas
This paper investigates the impact of a non-discriminating minimum quality standard (MQS) on trade and welfare when the market is characterized by imperfect competition and asymmetric information. A simple partial equilibrium model of an international Cournot duopoly is presented in which a domes...... prefer different levels of regulation. As a result, international trade disputes are likely to arise even when regulation is non-discriminating....
Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack
This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Minimum appraisal standards. 564.4 Section 564.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.4 Minimum appraisal standards. For federally related transactions, all appraisals shall, at a minimum: (a...
... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Child Labor § 551.601 Minimum age standards. (a) 16-year... subject to its child labor provisions, with certain exceptions not applicable here. (b) 18-year minimum... occupation found and declared by the Secretary of Labor to be particularly hazardous for the employment of...
Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E
Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards. Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care. Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement. Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards. © 2017 Wiley Periodicals, Inc.
...--though less stringent than--the drop and count process for player interfaces and card tables. By removing... count standards for player interfaces and card games, and intends to address the issue comprehensively... surveillance of kiosks and for the collection and count of their contents. The Commission published a proposed...
..., if any), counted, inventoried, and secured by an authorized agent. (ii) Bingo card inventory records... comprehensive standards for the entire Class II gaming environment. The new sections include, for example: Card games; drop and count; surveillance; and gaming promotions and player tracking. The amendments also...
Evans, Barbara J; Jarvik, Gail P
This article provides a brief introduction to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule's minimum necessary standard, which applies to sharing of genomic data, particularly clinical data, following 2013 Privacy Rule revisions. This research used the Thomson Reuters Westlaw database and law library resources in its legal analysis of the HIPAA privacy tiers and the impact of the minimum necessary standard on genomic data sharing. We considered relevant example cases of genomic data-sharing needs. In a climate of stepped-up HIPAA enforcement, this standard is of concern to laboratories that generate, use, and share genomic information. How data-sharing activities are characterized-whether for research, public health, or clinical interpretation and medical practice support-affects how the minimum necessary standard applies and its overall impact on data access and use. There is no clear regulatory guidance on how to apply HIPAA's minimum necessary standard when considering the sharing of information in the data-rich environment of genomic testing. Laboratories that perform genomic testing should engage with policy makers to foster sound, well-informed policies and appropriate characterization of data-sharing activities to minimize adverse impacts on day-to-day workflows.
... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for the... SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.14 What are the minimum internal control standards for... and/or procedures that provide at least the level of control described by the standards in this...
... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for pull... SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.8 What are the minimum internal control standards for... and/or procedures that provide at least the level of control described by the standards in this...
Pandit, Jaideep J; Dexter, Franklin
At multiple facilities including some in the United Kingdom's National Health Service, the following are features of many surgical-anesthetic teams: i) there is sufficient workload for each operating room (OR) list to almost always be fully scheduled; ii) the workdays are organized such that a single surgeon is assigned to each block of time (usually 8 h); iii) one team is assigned per block; and iv) hardly ever would a team "split" to do cases in more than one OR simultaneously. We used Monte-Carlo simulation using normal and Weibull distributions to estimate the times to complete lists of cases scheduled into such 8 h sessions. For each combination of mean and standard deviation, inefficiencies of use of OR time were determined for 10 h versus 8 h of staffing. When the mean actual hours of OR time used averages standard deviation and relative cost of over-run to under-run. When mean > or = 8 h 50 min, 10 h staffing has higher OR efficiency. For 8 h 25 min standard deviation of 60 min and relative cost of over-run to under-run of 2.0 versus (b) 8 h 48 min for normal, standard deviation of 0 min and relative cost ratio of 1.50. Although the simplest decision rule would be to staff for 8 h if the mean workload is standard deviation 60 min, and relative cost ratio of 2.00, the inefficiency of use of OR time would be 34% larger if staffing were planned for 8 h instead of 10 h. For surgical teams with 8 h sessions, use the following decision rule for anesthesiology and OR nurse staffing. If actual hours of OR time used averages or = 8 h 50 min, plan 10 h staffing. For averages in between, perform the full analysis of McIntosh et al. (Anesth Analg 2006;103:1499-516).
Full Text Available Millions of people are affected by natural or man made disasters all over the world. The number of people affected by disasters increase globally, due to global climate changes, increasing poverty, low life standards, inappropriate infrastructure, lack of early response systems, abuse of natural sources, and beside these, nuclear weapons, wars and conflicts, terrorist actions, migration, displacement and population movements. 95 % of life loss due to disasters are in the underdeveloped or developing countries. Turkey is a developing country, highly affected by disasters. For coping with disasters, not only national action plans, but also International Action Plans and cooperations are needed. Since all the disasters have direct and indirect effects on health, applications of minimal health standarts in disaster response, will reduce the morbidity and mortality rates. In this paper, water supplies and sanitation, vector control, waste control, burial of corpses, nutrition and minimum health standards in disaster response, are reviewed. [TAF Prev Med Bull 2004; 3(12.000: 296-306
... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for bingo... SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.7 What are the minimum internal control standards for... utilized, alternate documentation and/or procedures that provide at least the level of control described by...
Amberg, Alexander; Barrett, Dave; Beale, Michael H.; Beger, Richard; Daykin, Clare A.; Fan, Teresa W.-M.; Fiehn, Oliver; Goodacre, Royston; Griffin, Julian L.; Hankemeier, Thomas; Hardy, Nigel; Harnly, James; Higashi, Richard; Kopka, Joachim; Lane, Andrew N.; Lindon, John C.; Marriott, Philip; Nicholls, Andrew W.; Reily, Michael D.; Thaden, John J.; Viant, Mark R.
There is a general consensus that supports the need for standardized reporting of metadata or information describing large-scale metabolomics and other functional genomics data sets. Reporting of standard metadata provides a biological and empirical context for the data, facilitates experimental replication, and enables the re-interrogation and comparison of data by others. Accordingly, the Metabolomics Standards Initiative is building a general consensus concerning the minimum reporting standards for metabolomics experiments of which the Chemical Analysis Working Group (CAWG) is a member of this community effort. This article proposes the minimum reporting standards related to the chemical analysis aspects of metabolomics experiments including: sample preparation, experimental analysis, quality control, metabolite identification, and data pre-processing. These minimum standards currently focus mostly upon mass spectrometry and nuclear magnetic resonance spectroscopy due to the popularity of these techniques in metabolomics. However, additional input concerning other techniques is welcomed and can be provided via the CAWG on-line discussion forum at http://msi-workgroups.sourceforge.net/ or http://Msifirstname.lastname@example.org. Further, community input related to this document can also be provided via this electronic forum. PMID:24039616
... Labor Standards Act minimum wage. 22.1002-4 Section 22.1002-4 Federal Acquisition Regulations System... its employees working on the contract less than the minimum wage specified in section 6(a)(1) of the... Service Contract Act of 1965, as Amended 22.1002-4 Application of the Fair Labor Standards Act minimum...
Gavigan, Margaret; Fitzpatrick, Therese A; Miserendino, Carole
The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.
... and well-being (see subpart C of this part); and (ii) The Act sets an 18-year minimum age with respect... hazardous for the employment of minors of such age or detrimental to their health or well-being (see subpart... regulation or by order that the employment of employees between the ages of 14 and 16 years in occupations...
... Sound Requirements for Hybrid and Electric Vehicles; Draft Environmental Assessment for Rulemaking To Establish Minimum Sound Requirements for Hybrid and Electric Vehicles; Proposed Rules #0;#0;Federal Register...-0148] RIN 2127-AK93 Federal Motor Vehicle Safety Standards; Minimum Sound Requirements for Hybrid and...
Delahunt, Eamonn; Thorborg, Kristian; Khan, Karim M
Groin pain in athletes is a priority area for sports physiotherapy and sports medicine research. Heterogeneous studies with low methodological quality dominate research related to groin pain in athletes. Low-quality studies undermine the external validity of research findings and limit the ability...... to generalise findings to the target patient population. Minimum reporting standards for research on groin pain in athletes are overdue. We propose a set of minimum reporting standards based on best available evidence to be utilised in future research on groin pain in athletes. Minimum reporting standards...... are provided in relation to: (1) study methodology, (2) study participants and injury history, (3) clinical examination, (4) clinical assessment and (5) radiology. Adherence to these minimum reporting standards will strengthen the quality and transparency of research conducted on groin pain in athletes...
Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M
The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.
... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for... THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.17 What are the minimum internal control standards for complimentary services or items? (a) Each Tribal gaming regulatory authority or...
... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum internal control standards for pari... INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.11 What are the minimum internal control... documentation and/or procedures that provide at least the level of control described by the standards in this...
..., and rules? 547.16 Section 547.16 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR... § 547.16 What are the minimum standards for game artwork, glass, and rules? This section provides standards for the display of game artwork, the displays on belly or top glass, and the display and...
... safety and quality for automotive adaptive equipment. 17.155 Section 17.155 Pensions, Bonuses, and... Minimum standards of safety and quality for automotive adaptive equipment. (a) The Under Secretary for... officials that it meets implicit standards of safety and quality adopted by the industry or as later...
... 25 Indians 2 2010-04-01 2010-04-01 false How do these regulations affect minimum internal control... COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.4 How do these regulations affect minimum internal control standards established in a Tribal-State compact? (a) If there is a...
... GAMES § 547.11 What are the minimum technical standards for money and credit handling? This section... interface is: (i) Involved in the play of a game; (ii) In audit mode, recall mode or any test mode; (iii...) For machine-readable vouchers and coupons, a bar code or other form of machine readable representation...
..., physical education, music, etc.) which are directly related to or affect student instruction shall provide....20 Section 36.20 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION MINIMUM ACADEMIC STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA FOR DORMITORY...
... random number generation? 547.14 Section 547.14 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF... CLASS II GAMES § 547.14 What are the minimum technical standards for electronic random number generation...) Unpredictability; and (3) Non-repeatability. (b) Statistical Randomness.(1) Numbers produced by an RNG shall be...
... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Parts 542 and 543 RIN 3141-AA-37 Minimum Internal Control Standards for Class II Gaming AGENCY: National Indian Gaming Commission. ACTION: Delay of effective date of final rule; request for comments. SUMMARY: The National Indian Gaming...
... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Parts 542 and 543 Minimum Internal Control Standards for Class II Gaming AGENCY: National Indian Gaming Commission, Interior. ACTION: Final rule; delay of effective date and request for comments. SUMMARY: The National Indian Gaming...
... DEPARTMENT OF THE INTERIOR National Indian Gaming Commission 25 CFR Parts 542 and 543 RIN 3141-AA-37 Minimum Internal Control Standards for Class II Gaming AGENCY: National Indian Gaming Commission. ACTION: Final rule; delay of effective date; suspension. SUMMARY: The National Indian Gaming Commission...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...
Mahlia, T.M.I.; Masjuki, H.H.; Saidur, R.; Choudhury, I.A.; NoorLeha, A.R.
The Malaysian economy has grown rapidly in the last two decades. This growth has increased the ownership of household electrical appliances, especially refrigerator-freezers. Almost every house in Malaysia owns a refrigerator-freezer. The Malaysia Energy Center considered implementing a minimum energy efficiency standard for household refrigerator-freezers sometime in the coming year. This paper attempts to predict the amount of energy savings in the residential sector by implementing a minimum energy efficiency standard for household refrigerator-freezers. The calculations are based on the growth of refrigerator-freezer ownership data in Malaysian households. By implementing the programs in 2004, about 8722 GWh will be saved in the year 2013. Therefore, efficiency improvement of this appliance will provide a significant impact in future electricity consumption in Malaysia
Wage and Labor Standards Administration (DOL), Washington, DC.
This report describes the 1966 amendments to the Fair Labor Standards Act and summarizes the findings of three 1969 studies of the economic effects of these amendments. The studies found that economic growth continued through the third phase of the amendments, beginning February 1, 1969, despite increased wage and hours restrictions for recently…
Full Text Available Policies Minimum Service Standards for Basic Education has rolled out since 2002 by the minister in accordance with the Decree No. 129a U 2004 About Minimum Service Standards Education is continually updated and lastly Regulation of the Minister of Education and Culture No. 23 of 2013. All of the district government town should achieve the target of achieving 100 per cent in each of the indicators listed in the minimum service standards for the end of 2014. achievement pad on each indicator is just one measure of the performance of the local government department of education. Unfortunately from the announced target for 27 indicators that exist almost all regions including local governments do not reach Tangerang Regency. It is necessary for measuring the performance of local authorities particularly the education department. One performance measure modern enough that measurements can be done that The Balance Scorecard BSc. In the Balanced Scorecard is a management tool contemporare complete measure company performance not only of the financial perspective but also non-financial performance such as Customer Perspective Internal Business Processes and Learning and Growth. This approach is actually ideally suited for multinational companies because this approach requires very expensive but can be used to measure the profit performance of the company in addition to the combination of a long-term strategic and short-strategic. Balanced Scorecard it can also be done in measuring the performance of public sector services as well by modifying a few things so it can be used to measure the performance of the public sector including the Performance Measurement Minimum Service Standards for Basic Education.
Letschert, Virginie [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Desroches, Louis-Benoit [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
As part of the ongoing effort to estimate the foreseeable impacts of aggressive minimum efficiency performance standards (MEPS) programs in the world’s major economies, Lawrence Berkeley National Laboratory (LBNL) has developed a scenario to analyze the technical potential of MEPS in 13 major economies around the world1 . The “best available technology” (BAT) scenario seeks to determine the maximum potential savings that would result from diffusion of the most efficient available technologies in these major economies.
... 25 Indians 1 2010-04-01 2010-04-01 false Are there any minimum employment standards for Indian country law enforcement personnel? 12.31 Section 12.31 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Qualifications and Training Requirements § 12.31 Are there any minimum employment standards...
... communications between system components? This section provides minimum standards for electronic data... 25 Indians 2 2010-04-01 2010-04-01 false What are the minimum technical standards for electronic data communications between system components? 547.15 Section 547.15 Indians NATIONAL INDIAN GAMING...
Scheepers, M.J.J.; Van Werven, M.J.N.; Seebregts, A.J.; Poort, J.P.; De Nooij, M.; Baarsma, B.E.
The development and use of a minimum reliability standard in the Dutch electricity market to guarantee an adequate balance between electricity demand and supply in the longer term are discussed. This standard can be based on the duration of a power outage and the related costs for society relative to the costs to prevent the power outage. The reliability standard can be translated in an adequacy standard when the reliability of foreign electricity supply to the Dutch market is taken into account. With a theoretical analysis and an assessment of the use of standards in foreign electricity markets and other sectors this study provides a survey of the use of standards in securing public interests. In electricity markets reliability standards can be used obligatory or only to inform market participants of the adequacy of supply preferred by consumers. If no standard is used, the market should rely on the economic incentives provided by contracts and liability. This study proposes to use a reliability standard for calculating the required generation capacity in an ex-ante market analysis using different future scenarios. On the basis of several market indicators, expected market developments can be monitored. Assessment of the market developments relative to the required generation capacity will give a signal to market participants with respect to the expected adequacy in the longer term (7 to 10 years). The assessment and the resulting signal should help to improve market transparency and assist producers, suppliers and consumers in their decisions towards an effective and efficient response on long-term market developments. Market monitoring results can be used by the government to take specific action, if necessary, to reduce barriers to invest. However, more general policy measures should not be linked to the monitoring results since this could provoke strategic behaviour [nl
Full Text Available Cellular therapies with CD4+ T regulatory cells (Tregs hold promise of efficacious treatment for the variety of autoimmune and allergic diseases as well as posttransplant complications. Nevertheless, current manufacturing of Tregs as a cellular medicinal product varies between different laboratories, which in turn hampers precise comparisons of the results between the studies performed. While the number of clinical trials testing Tregs is already substantial, it seems to be crucial to provide some standardized characteristics of Treg products in order to minimize the problem. We have previously developed reporting guidelines called minimum information about tolerogenic antigen-presenting cells, which allows the comparison between different preparations of tolerance-inducing antigen-presenting cells. Having this experience, here we describe another minimum information about Tregs (MITREG. It is important to note that MITREG does not dictate how investigators should generate or characterize Tregs, but it does require investigators to report their Treg data in a consistent and transparent manner. We hope this will, therefore, be a useful tool facilitating standardized reporting on the manufacturing of Tregs, either for research purposes or for clinical application. This way MITREG might also be an important step toward more standardized and reproducible testing of the Tregs preparations in clinical applications.
Taylor, Margaret [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Stanford Univ., CA (United States); Spurlock, C. Anna [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Yang, Hung-Chia [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
The dual purpose of this project was to contribute to basic knowledge about the interaction between regulation and innovation and to inform the cost and benefit expectations related to technical change which are embedded in the rulemaking process of an important area of national regulation. The area of regulation focused on here is minimum efficiency performance standards (MEPS) for appliances and other energy-using products. Relevant both to U.S. climate policy and energy policy for buildings, MEPS remove certain product models from the market that do not meet specified efficiency thresholds.
..., Randolph County, Takeoff Minimums and Obstacle DP, Orig El Dorado, KS, Captain Jack Thomas/El Dorado... Minimums and Obstacle DP, Amdt 3 Cook, MN, Cook Muni, Takeoff Minimums and Obstacle DP, Orig Duluth, MN...
Varman, M.; Masjuki, H.H.; Mahlia, T.M.I. [University of Malaya, Kuala Lumpur (Malaysia). Department of Mechanical Engineering
The popularization of 24 h pay-TV, interactive video games, web-TV, VCD and DVD in Malaysia are poised to have a large impact on overall TV electricity consumption in the country. With the increasing of overall TV energy consumption, energy efficiency standards are one of highly effective policies for decreasing electricity consumption in the residential sector. Energy efficiency standards are also capable of reducing consumer's electricity bill and contribute towards positive environmental impacts. This paper attempts to predict the amount of energy that can be saved in the residential sector by implementing minimum energy efficiency standard for television sets in Malaysia. Over the past 30 years, television ownership in Malaysian residents has increased from 186,036 units in 1970 to 2,741,640 units in 1991. This figure is expected to reach 6,201,316 units in the year 2010. Hence, efficiency improvement for this appliance will have a significant impact on the future of electricity consumption in this country. (author)
Shurberg, D.A.; Haber, S.B. [Brookhaven National Lab., Upton, NY (United States); Morisseau, D. [Nuclear Regulatory Commission, Washington, DC (United States)] [and others
The objective of this project is to provide a technical basis for the establishment of criteria for minimum staffing levels of licensed and non-licensed NPP shift personnel. Minimum staffing levels for the purpose of this study, are defined as those necessary for successful accomplishment of all safety and additional functions that must be performed in order for the licensee to meet applicable regulatory requirements. This project involves a multi-faceted approach to the investigation of the issue. Relevant NRC documentation was identified and reviewed. Using the information obtained from this documentation review, a test plan was developed to aid in the collection of further information regarding the adequacy of current shift staffing levels. The test plan addresses three different activities to be conducted to provide information to the NRC for use in the assessment of current minimum staffing levels. The first activity is collection of data related to industry shift staffing practices through site visits to seven nuclear power plants. The second activity is a simulator study, which will use licensed operator crews responding to a simulated event, under two different staffing levels. Finally, workload models will be constructed for both licensed and non-licensed personnel, using a priori knowledge of the simulator scenarios with data resulting from one of the staffing levels studied in the simulator, and the data collected from the site visits. The model will then be validated against the data obtained from the second staffing level studied in the simulator. The validated model can then be used to study the impact of changing staffing-related variables on the plant shift crew`s ability to effectively mitigate an event.
Letschert, Virginie E.; McNeil, Michael A.; Leiva Ibanez, Francisco Humberto; Ruiz, Ana Maria; Pavon, Mariana; Hall, Stephen
Minimum Efficiency Performance Standards (MEPS) have been chosen as part of Chile's national energy efficiency action plan. As a first MEPS, the Ministry of Energy has decided to focus on a regulation for lighting that would ban the sale of inefficient bulbs, effectively phasing out the use of incandescent lamps. Following major economies such as the US (EISA, 2007) , the EU (Ecodesign, 2009) and Australia (AS/NZS, 2008) who planned a phase out based on minimum efficacy requirements, the Ministry of Energy has undertaken the impact analysis of a MEPS on the residential lighting sector. Fundacion Chile (FC) and Lawrence Berkeley National Laboratory (LBNL) collaborated with the Ministry of Energy and the National Energy Efficiency Program (Programa Pais de Eficiencia Energetica, or PPEE) in order to produce a techno-economic analysis of this future policy measure. LBNL has developed for CLASP (CLASP, 2007) a spreadsheet tool called the Policy Analysis Modeling System (PAMS) that allows for evaluation of costs and benefits at the consumer level but also a wide range of impacts at the national level, such as energy savings, net present value of savings, greenhouse gas (CO2) emission reductions and avoided capacity generation due to a specific policy. Because historically Chile has followed European schemes in energy efficiency programs (test procedures, labelling program definitions), we take the Ecodesign commission regulation No 244/2009 as a starting point when defining our phase out program, which means a tiered phase out based on minimum efficacy per lumen category. The following data were collected in order to perform the techno-economic analysis: (1) Retail prices, efficiency and wattage category in the current market, (2) Usage data (hours of lamp use per day), and (3) Stock data, penetration of efficient lamps in the market. Using these data, PAMS calculates the costs and benefits of efficiency standards from two distinct but related perspectives: (1) The
... specifies the types of SIAPs and the effective dates of the associated Takeoff Minimums and ODPs. This..., Takeoff Minimums and Obstacle DP, Orig Dallas, TX, Dallas Love Field, RNAV (GPS) Z RWY 13L, Orig-B...
... types of SIAPs and the effective dates of the, associated Takeoff Minimums and ODPs. This amendment also..., TN, Memphis Intl, Takeoff Minimums and Obstacle DP, Amdt 3 Dallas, TX, Dallas-Love Field, Takeoff...
.../or affiliate(s); (d) The bank's liquidity, capital, risk asset and other ratios compared to the... individual minimum capital ratios. 3.11 Section 3.11 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY MINIMUM CAPITAL RATIOS; ISSUANCE OF DIRECTIVES Establishment of Minimum Capital...
Makgato, Stanford S; Chirwa, Evans M Nkhalambayausi
Key characteristics of coal samples from the supply stock to the newly commissioned South African National Power Utility's (Eskom's) Medupi Power Station - which receives its supply coal from the Waterberg coalfield in Lephalale (Limpopo Province, South Africa) - were evaluated. Conventional coal characterisation such as proximate and ultimate analysis as well as determination of sulphur forms in coal samples were carried out following the ASTM and ISO standards. Coal was classified as medium sulphur coal when the sulphur content was detected in the range 1.15-1.49 wt.% with pyritic sulphur (≥0.51 wt.%) and organic sulphur (≥0.49 wt.%) accounted for the bulk of the total sulphur in coal. Maceral analyses of coal showed that vitrinite was the dominant maceral (up to 51.8 vol.%), whereas inertinite, liptinite, reactive semifusinite and visible minerals occurred in proportions of 22.6 vol.%, 2.9 vol.%, 5.3 vol.% and 17.5 vol.%, respectively. Theoretical calculations were developed and used to predict the resultant SO 2 emissions from the combustion of the Waterberg coal in a typical power plant. The sulphur content requirements to comply with the minimum emissions standards of 3500 mg/Nm 3 and 500 mg/Nm 3 were found to be ≤1.37 wt.% and ≤0.20 wt.%, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.
... on a Class II gaming system? 547.12 Section 547.12 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM TECHNICAL STANDARDS FOR GAMING EQUIPMENT USED WITH THE PLAY... gaming system? This section provides standards for downloading on a Class II gaming system. (a) Downloads...
... 42 Public Health 1 2010-10-01 2010-10-01 false Facility staffing. 9.9 Section 9.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR... Biosafety Officer must have experience in developing and monitoring biohazards and dealing with biosafety...
Phenylketonuria (PKU, ORPHA716) is an inherited disorder that affects about one in every 10,000 children born in Europe. Early and continuous application of a modified diet is largely successful in preventing the devastating brain damage associated with untreated PKU. The management of PKU is inconsistent: there are few national guidelines, and these tend to be incomplete and implemented sporadically. In this article, the first-ever pan- European patient/carer perspective on optimal PKU care, the European Society for Phenylketonuria and Allied Disorders (E.S.PKU) proposes recommendations for a minimum standard of care for PKU, to underpin the development of new pan-European guideline for the management of PKU. New standards of best practice should guarantee equal access to screening, treatment and monitoring throughout Europe. Screening protocols and interpretation of screening results should be standardised. Experienced Centres of Expertise are required, in line with current European Union policy, to guarantee a defined standard of multidisciplinary treatment and care for all medical and social aspects of PKU. Women of childbearing age require especially intensive management, due to the risk of severe risks to the foetus conferred by uncontrolled PKU. All aspects of treatment should be reimbursed to ensure uniform access across Europe to guideline-driven, evidence-based care. The E.S.PKU urges PKU healthcare professionals caring for people with PKU to take the lead in developing evidence based guidelines on PKU, while continuing to play an active role in serving as the voice of patients and their families, whose lives are affected by the condition. PMID:24341788
M R Rajagopal
Full Text Available Background: It is important to ensure that minimum standards for palliative care based on available resources are clearly defined and achieved. Aims: (1 Creation of minimum National Standards for Palliative Care for India. (2 Development of a tool for self-evaluation of palliative care organizations. (3 Evaluation of the tool in India. In 2006, Pallium India assembled a working group at the national level to develop minimum standards. The standards were to be evaluated by palliative care services in the country. Materials and Methods: The working group prepared a "standards" document, which had two parts - the first composed of eight "essential" components and the second, 22 "desirable" components. The working group sent the document to 86 hospice and palliative care providers nationwide, requesting them to self-evaluate their palliative care services based on the standards document, on a modified Likert scale. Results: Forty-nine (57% palliative care organizations responded, and their self-evaluation of services based on the standards tool was analyzed. The majority of the palliative care providers met most of the standards identified as essential by the working group. A variable percentage of organizations had satisfied the desirable components of the standards. Conclusions: We demonstrated that the "standards tool" could be applied effectively in practice for self-evaluation of quality of palliative care services.
Fatihah Salleh, Siti; Eqwan Roslan, Mohd; Isa, Aishah Mohd; Faizal Basri Nair, Mohd; Syafiqah Salleh, Siti
One of Malaysia’s key strategies to promote efficient energy use in the country is to implement the minimum energy performance standards (MEPS) through the Electricity Regulations (Amendment) 2013. Five selected electrical appliances (refrigerator, air conditioner, television, domestic fans and lamp fittings) must comply with MEPS requirement in order to be sold in Malaysian market. Manufacturers, importers or distributors are issued Certificate of Approval (COA) if products are MEPS-compliant. In 2015, 1,215 COAs were issued but the number of MEPS products in the market is unknown. This work collects sales data from major manufacturers to estimate the annual sales of MEPS appliances and the cumulative electricity consumption and electricity saving. It was found that most products sold have 3-star rating and above. By year 2015, total cumulative electricity savings gained from MEPS implementation is 3,645 GWh, with air conditioner being the highest contributor (30%). In the future, it is recommended that more MEPS products and related incentives be introduced to further improve efficiency of energy use in Malaysia.
Lawrence K. K. Ho
Full Text Available This paper aims to highlight the significance of labour issues – namely, the minimum wage (MW and standard working hours (SWH – in shaping candidates’ electoral platforms in the 2012 chief executive (CE election of the Hong Kong Special Administrative Region (HKSAR under the sovereignty of the People’s Republic of China (PRC. We first offer a brief review of labour politics regarding the MW case as a precursor to the SWH drafting and enactment process. We then provide an analytical delineation of some of the labour and socio-economic dimensions of the CE electoral contest by comparing the candidates’ campaign planks in relation to SWH. We then attempt to predict the likely course of the SWH debate under the leadership of Leung Chun-ying, who eventually won the CE election and assumed power on 1 July 2012. We conclude by examining Leung’s social engineering attempts to increase popular support amongst low- and middle-income (LMI households as part of his long-term strategy for the 2017 CE elections and his broader Beijing-entrusted political agenda.
Full Text Available Generally, Minimum Energy Performance Standard (MEPS has been widespread across the country especially developed country. However, most consumers do not even know about the MEPS. Without sufficient knowledge, much energy have been wasted before this. The aim of this study is to review the implementation of MEPS of Asia country and to compare electricity consumption of home appliances with star rating and without star rating. In order to fulfil the objectives of the study, the equipment must be chosen correctly and must be learned properly. The home appliances that will be used also need to be chosen so that the comparison between the appliances will be matched correctly. To understand the results, the analysis was done using graphs and table. The purpose of using graph and table is to understand the comparison between appliances more clearly. The results show that home appliances with MEPS is more efficient on energy saving rather than without MEPS. This is the evidence as a method to educate a consumer on energy saving.
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA-200), FAA... Minimums and ODPs, in addition to their complex nature and the need for a special format make publication...
... amendments may have been issued previously by the FAA in a Flight Data Center (FDC) Notice to Airmen (NOTAM... close and immediate relationship between these SIAPs, Takeoff Minimums and ODPs, and safety in air... Vernon, WA, Skagit Rgnl, Takeoff Minimums and Obstacle DP, Amdt 2 Greybull, WY, South Big Horn County...
Bowblis, John R; Hyer, Kathryn
To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.
Full Text Available One of heatlh policies implemented by the hospital is the minimum service standards (MSS. MSS is a benchmark of hospital service quality in providing services to the public. Talking about health service quality problem, it was found out as the field fact that the achievement of MSS indicator in General Hospital of Dr. H. Koesnadi Bondowoso, Indonesia in 2016 still did not fulfill target of standard hospital service (type B and minimum service standard (MSS of hospital. This fact shows that the quality of health services in general hospital of dr. H. Koesnadi Bondowoso is still low. So, this research aims to describe the policy implementation of minimum service standard and to analyze the obstacles in the implementation of MSS policy at general hospital of dr. H. Koesnadi Bondowoso. So, this research would discuss the policy implementation of minimum service standards by using Edward III concept as a tool to analyze it. This research employed qualitative research with phenomenological approach. The results showed that the implementation of MSS policy of dr. H. Koesnadi Bondowoso general hospital still did not run well. This was due to several factors such as communication, bureaucratic structure, sources, dispositions (attitude and leadership in sectoral ego control. Sectoral ego can be shaped from educational background of specialist doctors who still adhered seniority and lack of individual role of implementor in building interpersonal communication and conflict management.
... Takeoff Minimums and ODPs are available online free of charge. Visit http://www.nfdc.faa.gov to register... Houston, TX, Ellington Field, TACAN RWY 35L, Orig Effective 8 MAR 2012 Wilmington, DE, New Castle, ILS OR...
..., Norman County Ada/Twin Valley, Takeoff Minimums and Obstacle DP, Orig Buffalo, MN, Buffalo Muni, Takeoff... 10 Bowling Green, OH, Wood County, RNAV (GPS) RWY 10, Orig-B Bowling Green, OH, Wood County, RNAV...
Miller, R.A.; Walker, R.D.; Carson, J.
(ampicillin, enrofloxacin, erythromycin, florfenicol, flumequine, gentamicin, ormetoprim/sulfadimethoxine, oxolinic acid, oxytetracycline and trimethoprim/sulfamethoxazole). Minimum inhibitory concentration (MIC) QC ranges were determined using dry- and frozen-form 96-well plates and cation-adjusted Mueller...
... lawful status will only be allowed to demonstrate U.S. citizenship. The state must retain copies or... copies of these documents must be retained for a minimum of seven years. Digital images of these...
... lawful status will only be allowed to demonstrate U.S. citizenship. The state must retain copies or... copies of these documents must be retained for a minimum of seven years. Digital images of these...
... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Minimum Property..., electrical, and elevators. (3) For purposes of this paragraph, a state or local code regulates an area if it...
..., ME, Wiscasset, Takeoff Minimums and Obstacle DP, Amdt 2 Alpena, MI, Alpena County Rgnl, RNAV (GPS) RWY 19, Orig Alpena, MI, Alpena County Rgnl, VOR RWY 19, Amdt 15 Oscoda, MI, Oscoda-Wurtsmith, RNAV...
..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... number of SIAPs, their complex nature, and the need for a special format make their verbatim publication...
... Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA-200), FAA Headquarters..., and the need for a special format make their verbatim publication in the Federal Register expensive...
... Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA-200), FAA Headquarters..., and the need for a special format make their verbatim publication in the Federal Register expensive...
..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... SIAPs, their complex nature, and the need for a special format make their verbatim publication in the...
..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... number of SIAPs, their complex nature, and the need for a special format make their verbatim publication...
... Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA-200), FAA Headquarters..., their complex nature, and the need for a special format make their verbatim publication in the Federal...
... Minimums and ODP copies may be obtained from: 1.FAA Public Inquiry Center (APA-200), FAA Headquarters..., their complex nature, and the need for a special format make their verbatim publication in the Federal...
... Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA-200), FAA Headquarters..., and the need for a special format make their verbatim publication in the Federal Register expensive...
..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... number of SIAPs, their complex nature, and the need for a special format make their verbatim publication...
... and Obstacle DP, Amdt 1 Pauls Valley, OK, Pauls Valley Muni, RNAV (GPS) RWY 17, Orig Madras, OR..., Amdt 1 Honesdale, PA, Cherry Ridge, Takeoff Minimums and Obstacle DP, Amdt 4 Pickens, SC, Pickens...
... sections and specifies the types of SIAPs and the effective dates of the associated Takeoff Minimums and... Dallas, TX, Collin County Rgnl at McKinney, ILS OR LOC RWY 17, Amdt 3A Dallas, TX, Dallas Love Field, ILS...
... the affected CFR sections and specifies the types of SIAPs and the effective dates of the, associated..., Takeoff Minimums and Obstacle DP, Amdt 2 Dallas, TX, Dallas Love Field, ILS OR LOC RWY 31R, ILS RWY 31R...
... gaming system accounting functions? 547.9 Section 547.9 Indians NATIONAL INDIAN GAMING COMMISSION... accounting functions? This section provides standards for accounting functions used in Class II gaming systems. (a) Required accounting data.The following minimum accounting data, however named, shall be...
...: Event Definition and action to be taken (i) Player interface power off during play This condition is reported by the affected component(s) to indicate power has been lost during game play. (ii) Player... INTERIOR HUMAN SERVICES MINIMUM TECHNICAL STANDARDS FOR GAMING EQUIPMENT USED WITH THE PLAY OF CLASS II...
... and enabling Class II gaming system components? 547.6 Section 547.6 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM TECHNICAL STANDARDS FOR GAMING EQUIPMENT USED... enabling Class II gaming system components? (a) General requirements. Class II gaming systems shall provide...
... applicable to Class II gaming systems? 547.7 Section 547.7 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM TECHNICAL STANDARDS FOR GAMING EQUIPMENT USED WITH THE PLAY... gaming systems? (a) General requirements. (1) The Class II gaming system shall operate in compliance with...
J. N. Kochenderfer; G. W. Wendel; H. Clay Smith
A "minimum-standard" forest truck road that provides efficient and environmentally acceptable access for several forest activities is described. Cost data are presented for eight of these roads constructed in the central Appalachians. The average cost per mile excluding gravel was $8,119. The range was $5,048 to $14,424. Soil loss was measured from several...
Reißhauer, A; Liebl, M E
Standards for what should be available in terms of equipment and services in a department of physical medicine caring for acute inpatients do not exist in Germany. The profile of a department determines the therapeutic services it focuses on and hence the technical facilities required. The German catalogue of operations and procedures defines minimum thresholds for treatment. In the opinion of the authors a department caring for inpatients with acute rheumatic diseases must, as a minimum, have the facilities and equipment necessary for offering thermotherapeutic treatment. Staff trained in physical therapeutic procedures and occupational therapy is also crucial. Moreover, it is desirable that the staff should be trained in manual therapy.
Recent events at the Peach Bottom nuclear power plant have demonstrated the need to establish a quantifiable basis for assessing the safety significance of long work hours on nuclear power plant operators. The incidents at TMI-2, Chernobyl, and Bhopal, which all occurred during the late evening/night shift, further highlight the importance of the relationship between shift scheduling and performance. The objective of this project is to estimate, using statistical analysis on data from the nuclear industry, the effects on safety of staffing levels, overtime, and shift scheduling for operators and maintenance personnel. Regarding staffing levels, the Nuclear Regulatory Commission (NRC) currently has no explicit regulation concerning the minimum acceptable levels of staffing in a plant that has an operating license. The NRC has no systematic method for collecting data on the number of licensed operators on the operating crews. In 1982 the NRC recommended that plants write into their technical specifications a model policy on overtime. Currently, 77 nuclear power plant units have the model policy or a modification of it written into their technical specifications; 33 units have no policy on overtime. The model policy sets limits on overtime for safety related personnel, although these limits can be exceeded with plant manger approval. The US nuclear power industry has three types of shift schedules: (1) forward-rotating 8-hour/day shift schedules, (2) backward-rotating 8-hour/day schedules, and (3) 12-hour/day schedules
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... special format make publication in the Federal Register expensive and impractical. Furthermore, airmen do...
...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0..., individual SIAP and Takeoff Minimums and ODP copies may be obtained from: 1. FAA Public Inquiry Center (APA... for a special format make publication in the Federal Register expensive and impractical. Furthermore...
... amendments may have been issued previously by the FAA in a Flight Data Center (FDC) Notice to Airmen (NOTAM... close and immediate relationship between these SIAPs, Takeoff Minimums and ODPs, and safety in air..., Melbourne Muni--John E Miller Field, RNAV (GPS) RWY 3, Amdt 1A Big Bear City, CA, Big Bear City, RNAV (GPS...
... amendments may have been issued previously by the FAA in a Flight Data Center (FDC) Notice to Airmen (NOTAM... close and immediate relationship between these SIAPs, Takeoff Minimums and ODPs, and safety in air.../Intl, RNAV (RNP) Z RWY 21, Orig-A Big Spring, TX, Big Spring Mc Mahon-Wrinkle, RNAV (GPS) RWY 6, Orig...
... amendments may have been issued previously by the FAA in a Flight Data Center (FDC) Notice to Airmen (NOTAM... close and immediate relationship between these SIAPs, Takeoff Minimums and ODPs, and safety in air..., Amdt 13A, CANCELLED Big Lake, AK, Big Lake, RNAV (GPS) RWY 7, Amdt 1 Big Lake, AK, Big Lake, RNAV (GPS...
... a Flight Data Center (FDC) Notice to Airmen (NOTAM) as an emergency action of immediate flight... existing or anticipated at the affected airports. Because of the close and immediate relationship between... Anchorage, AK, Merill Field, Takeoff Minimums and Obstacle DP, Amdt 1 Big Lake, AK, Big Lake, RNAV (GPS) RWY...
... SIAPs, Takeoff Minimums or ODPs, but instead refer to their depiction on charts printed by publishers of aeronautical materials. The advantages of incorporation by reference are realized and publication of the... Administration (NARA). For information on the availability of this material at NARA, call 202-741- 6030, or go to...
... SIAPs, Takeoff Minimums or ODPs, but instead refer to their depiction on charts printed by publishers of aeronautical materials. The advantages of incorporation by reference are realized and publication of the... Administration (NARA). For information on the availability of this material at NARA, call 202-741- 6030, or go to...
..., AL, Richard Arthur Field, RNAV (GPS) RWY 36, Amdt 1 Gulf Shores, AL, Jack Edwards, VOR-A, Amdt 3, CANCELLED Crossett, AR, Z M Jack Stell Field, Takeoff Minimums and Obstacle DP, Orig Springerville, AZ..., RNAV (GPS) RWY 10, Amdt 1 Ashland, KY, Ashland Rgnl, RNAV (GPS) RWY 28, Amdt 1 Nantucket, MA, Nantucket...
... as the anticipated impact is so minimal. For the same reason, the FAA certifies that this amendment will not have a significant economic impact on a substantial number of small entities under the... Rgnl, Takeoff Minimums and Obstacle DP, Orig Beaver Falls, PA, Beaver County, LOC RWY 10, Amdt 4...
... Minimums and Obstacle DP, Amdt 1 Hattiesburg, MS, Hattiesburg Bobby L Chain Muni, RNAV (GPS) Y RWY 13, Amdt 2 Hattiesburg, MS, Hattiesburg Bobby L Chain Muni, RNAV (GPS) Z RWY 13, Amdt 1 Wadesboro, NC, Anson.... Part 97 is amended to read as follows: Effective 10 MAR 2011 Hayward, CA, Hayward Executive, VOR OR GPS...
... (GPS) RWY 30L, Amdt 2 Wolf Point, MT, L.M.Clayton, Takeoff Minimums and Obstacle DP, Orig [[Page 4490..., Stockton Metropolitan, ILS OR LOC RWY 29R, Amdt 19 Avon Park, FL, Avon Park Executive, GPS RWY 4, Orig-A, CANCELLED Avon Park, FL, Avon Park Executive, GPS RWY 9, Orig-A, CANCELLED Avon Park, FL, Avon Park...
... Obstacle DP, Amdt 2 Swainsboro, GA, Emanuel County, VOR/DME-A, Amdt 3, CANCELED Tifton, GA, Henry Tift... Minimums and Obstacle DP, Amdt 1 Pensacola, FL, Pensacola Gulf Coast Rgnl, VOR RWY 8, Amdt 4 Augusta, GA, Augusta Rgnl at Bush Field, ILS OR LOC RWY 17, Amdt 9 Augusta, GA, Augusta Rgnl at Bush Field, ILS OR LOC...
..., CANCELED Kalamazoo, MI, Kalamazoo/Battle Creek Intl, RNAV (GPS) RWY 17, Amdt 1 Traverse City, MI, Cherry Capitol, GPS RWY 36, Orig-B, CANCELED Traverse City, MI, Cherry Capitol, RNAV (GPS) RWY 36, Orig Dodge..., Cassville Muni, Takeoff Minimums and Obstacle DP, Amdt 1 Fredericktown, MO, A. Paul Vance Fredericktown Rgnl...
... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration 14 CFR Part 97 [Docket No. 30856... advantages of incorporation by reference are realized and publication of the complete description of each.... Intl. 20-Sep-12 TX Houston Sugar Land Rgnl.... 2/8058 7/19/12 TAKEOFF MINIMUMS AND (OBSTACLE) DP, Amdt...
..., Takeoff Minimums and Obstacle DP, Orig East Troy, WI, East Troy Muni, GPS RWY 8, Orig, CANCELLED East Troy, WI, East Troy Muni, GPS RWY 26, Orig, CANCELLED East Troy, WI, East Troy Muni, RNAV (GPS) RWY 8, Orig East Troy, WI, East Troy Muni, RNAV (GPS) RWY 26, Orig East Troy, WI, East Troy Muni, VOR/DME-A, Amdt 1...
... Jackson, AL, Jackson Muni, RNAV (GPS) RWY 19, Orig Troy, AL, Troy Muni, ILS OR LOC RWY 7, Amdt 9 Troy, AL, Troy Muni, RNAV (GPS) RWY 7, Amdt 1 Troy, AL, Troy Muni, RNAV (GPS) RWY 25, Amdt 1 Vernon, AL, Lamar..., Amdt 1 East Troy, WI, East Troy Muni, Takeoff Minimums and Obstacle DP, Orig On June 09, 2010 (75 FR...
... specifies the types of SIAPs and the effective dates of the, associated Takeoff Minimums and ODPs. This... I), ILS RWY 13R (SA CAT II), Amdt 9 Dallas, TX, Dallas Love Field, ILS OR LOC Y RWY 13L, Amdt 32 Dallas, TX, Dallas Love Field, RNAV (GPS) Y RWY 13L, Amdt 1 Dallas, TX, Dallas Love Field, RNAV (GPS) Z...
... sections and specifies the types of SIAPs and the effective dates of the associated Takeoff Minimums and... Co Rgnl, ILS OR LOC RWY 29, Amdt 1A Dallas, TX, Dallas Love Field, RNAV (GPS) RWY 31L, Amdt 1A Dallas, TX, Dallas Love Field, RNAV (GPS) RWY 31R, Amdt 1A Effective 26 JULY 2012 Talkeetna, AK, Talkeetna...
... 29 Labor 1 2010-07-01 2010-07-01 true Payment of minimum wage specified in section 6(a)(1) of the... and Procedures § 4.2 Payment of minimum wage specified in section 6(a)(1) of the Fair Labor Standards... employees shall pay any employees engaged in such work less than the minimum wage specified in section 6(a...
.../1/10 LOC RWY 8, AMDT 5A. 21-Oct-10 AZ FORT HUACHUCA/ SIERRA VISTA MUNI- 0/5486 8/30/10 TAKEOFF MINIMUMS AND OBSTACLE DP, AMDT 2. SIERRA VISTA. LIBBY AAF. 21-Oct-10 LA LAKE CHARLES..... LAKE CHARLES RGNL... LOC/DME RWY 14, AMDT 8. 21-Oct-10 LA SLIDELL SLIDELL 0/7403 8/30/10 NDB RWY 36, ORIG-D. 21-Oct-10 FL...
... Minimums and (Obstacle) DP, Amdt 5 10/17/13 FL Orlando Orlando Intl........ 3/7948 9/10/13 ILS RWY 17R (CAT II), Amdt 5B 10/17/13 FL Orlando Orlando Intl........ 3/7952 9/10/13 ILS RWY 17L (CAT II), Amdt 1B 10/17/13 FL Orlando Orlando Intl........ 3/7956 9/10/13 RNAV (GPS) RWY 17L, Orig-A 10/17/13 FL Orlando...
... 19103, Telephone (215) 299-5400. ASTM C 12-91 Standard Practice for Installing Vitrified Clay Pipe Lines... C 216-91c Standard Specification for Facing Brick (Solid Masonry Units Made from Clay or Shale) ASTM.../78 77a Cast Iron Sanitary Drainage System with Hubless Pipe and Fittings—3/28/80 78 Polyethylene (PE...
O'Neill, Thomas R; Tannenbaum, Richard J; Tiffen, Jennifer
When nurses who are educated internationally immigrate to the United States, they are expected to have English language proficiency in order to function as a competent nurse. The purpose of this research was to provide sufficient information to the National Council of State Boards of Nursing (NCSBN) to make a defensible recommended passing standard for English proficiency. This standard was based upon the Test of English as a Foreign Language (TOEFL). A large panel of nurses and nurse regulators (N = 25) was convened to determine how much English proficiency is required to be minimally competent as an entry-level nurse. Two standard setting procedures, the Simulated Minimally Competent Candidate (SMCC) procedure and the Examinee Paper Selection Method, were combined to produce recommendations for each panelist. In conjunction with collateral information, these recommendations were reviewed by the NCSBN Examination Committee, which decided upon an NCSBN recommended standard, a TOEFL score of 220. Because the adoption of this standard rests entirely with the individual state, NCSBN has little more to do with implementing the standard, other than answering questions and providing documentation about the standard.
A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.
...., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing, and Technisource..., Insight Global Staffing, and Technisource, Scarborough, Maine. The workers are engaged in activities... leased workers from Balance Staffing, Insight Global Staffing, and Technisource, Scarborough, Maine, who...
Mahlia, T.M.I.; Masjuki, H.H.; Saidur, R.; Amalina, M.A.
The ownership of household electrical appliances especially refrigerator-freezer has increased rapidly in Malaysia. Almost every household in this country has a refrigerator-freezer. To reduce energy consumption in this sector the refrigerator is one of the top priorities of the energy efficiency program for household appliances. Malaysian authority is considering implementing minimum energy efficiency standards for refrigerator-freezer sometime in the coming year. This paper attempts to analyze cost-benefit of implementing minimum energy efficiency standards for household refrigerator-freezers in Malaysia. The calculations were made based on growth of ownership data for refrigerators in Malaysian households. The number of refrigerator-freezer has increased from 175,842 units in 1970 to 4,196,486 in 2000 and it will be about 11,293,043 in the year of 2020. Meanwhile it has accounted for about 26.3% of electricity consumption in a single household. Therefore, efficiency improvement of this appliance will give a significant impact in the future of electricity consumption in this country. Furthermore, it has been found that implementing an energy efficiency standard for household refrigerator-freezers is economically justified
... information technology? 542.16 Section 542.16 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE... standards for information technology? Link to an amendment published at 73 FR 60498, Oct. 10, 2008. This... adequately segregated and monitored to prevent error in general information technology procedures to go...
...: Harry J. Hodges, Flight Procedure Standards Branch (AFS-420), Flight Technologies and Programs Divisions..., SD, Rapid City Rgnl, ILS OR LOC RWY 32, Amdt 19 Newport News, VA, Newport News/Williamsburg Intl, ILS OR LOC RWY 7, Amdt 33 Newport News, VA, Newport News/Williamsburg Intl, ILS OR LOC RWY 25, Amdt 1...
D'Agostino, Fabio; Vellone, Ercole; Tontini, Francesco; Zega, Maurizio; Alvaro, Rosaria
The aim of a nursing data set is to provide useful information for assessing the level of care and the state of health of the population. Currently, both in Italy and in other countries, this data is incomplete due to the lack of a structured nursing documentation , making it indispensible to develop a Nursing Minimum Data Set (NMDS) using standard nursing language to evaluate care, costs and health requirements. The aim of the project described , is to create a computer system using standard nursing terms with a dedicated software which will aid the decision-making process and provide the relative documentation. This will make it possible to monitor nursing activity and costs and their impact on patients' health : adequate training and involvement of nursing staff will play a fundamental role.
Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy
Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.
Full Text Available Abstract. Some scholars argue that decentralization policy tends to create polarization, i.e. an increase of inequality/disparity among districts. To deal with this problem, Minimum Service Standards (MSS were introduced as a key strategy in decentralizing Indonesia. In this research, we tried to find out through MSS performance measurements whether imposing standards can be effective in a decentralized system by seeking its impacts on polarization/depolarization in the delivery of public services, specifically in the health sector. This question is basically a response to the common criticism that decentralization is good to create equality between central government and local governments but often does not work to achieve equality among local governments. Using self-assessment data from a sample of 54 districts from 534 districts in Indonesia, from 2010 to 2013, we found that the existence of depolarization in the delivery of public services could potentially occur among regions by reducing the gap between their public service performance and the targets of MSS. We acknowledge that there are weaknesses in the validity of the self-assessment data, caused by a lack of knowledge and skills to execute the self-assessment according to the official guidelines, by the overrating of target achievements, as well as the lack of data from independent sources to confirm the self-assessment outcomes. We also acknowledge that differences in financial capacity are still the main determinant why one district is more successful in achieving the MSS targets compared to other districts. Keywords. Decentralization, Public Service, Minimum Standard Service
low humidity and dust free environment for longer life of machines. Patient chair: A dental/cosmetic chair with adjustable task light is a suitable option for patient positioning. The chair should have the option to tilt head down or ′syncope position′ to facilitate resuscitation of a patient in vaso-vagal shock. Maintenance: Annual maintenance contract (AMC is essential after warranty period is over and is essential for insurance purposes. Mobile Laser Unit: Mobile laser units are of relevance in the Indian context to render laser facility available in smaller towns. A laser with fiber optic delivery system can be made mobile after consultation with supplier. However a laser with an articulated arm delivery cannot be made mobile. Proper packing with shock absorbing material is necessary during transportation. The area where lasers are to be moved to and operated should have appropriate facilities as mentioned above. Records: Patient′s health declaration questionnaires, laser register are essential records. Digital photography before and at regular intervals after procedure is an essential record. Detailed informed consent in patients language for each procedure explaining nature of procedure, anesthesia used, and machine used, post operative down time should be signed by patient. Drugs, anesthesia and sterilization: An electrocautery machine to control bleeding, equipments for airway maintenance, other instruments for emergency resuscitation and an emergency drug tray are essential. Standard sterilization practices are adopted. For most of laser procedures topical anesthesia is sufficient. Safe laser use: Protocols of safe laser use to avoid burns or eye damage to patients or operator are adopted. Reflective surfaces like mirrors, reflective jewelleries are not allowed in laser room. Machine should always be on standby mode when not in direct use. It should be used by authorized operator only. Eye protection: Goggles of sufficient optical density (OD intended
... any person who has decision-making authority over individual cases on a day-to-day basis and includes... such as legal, interviewer, investigative, accounting, clerical, and other supportive staff. (g) If it...; 64 FR 6250, Feb. 9, 1999; 68 FR 25304, May 12, 2003] Effective Date Note: At 73 FR 56443, Sept. 26...
Weidner, Theodore J.
Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)
Thorpe, S. J.; Fox, B.; Heath, A. B.; Scott, M.; de Haas, M.; Kochman, S.; Padilla, A.
The aim of this study was to evaluate a lyophilized monoclonal immunoglobulin M (IgM) anti-D preparation for use as an International Standard to specify a recommended minimum acceptable potency of anti-D blood-grouping reagents. The candidate International Standard (99/836) for specifying the
de Cruppé, Werner; Geraedts, Max
The minimum volume standards for hospitals in Germany, in force since 2004, provide four exemptions for non-complying hospitals. This study investigates the extent and importance of these exemptions for complex procedures on the oesophagus and pancreas for all non-complying hospitals and for the revised minimum volume regulations in force since the beginning of 2018. Longitudinal, descriptive analyses of data on minimum volume standards and their exemptions for complex procedures on the oesophagus and pancreas, as presented by the hospital quality report cards of the reporting years from 2006 to 2014. For each year and both procedures, about 120 hospitals with some 500 cases report non-compliance with the minimum volume standards. Of these a third report no exemptions (with 180 procedures), a third state emergencies (110), and another third report exemptions due to internal hospital restructuring (210). Ensuring geographical access to care as an exemption is of no importance. After the three year exemption period for installation of a new service line, 20% of the hospitals with procedures on the oesophagus and 30% on the pancreas complied with the minimum volume standards. After the two-year period for staff realignment, the figures were 40 and 50%, respectively. Exemptions do not entirely explain all procedures performed by hospitals not complying with the minimum volume standards. The revised minimum volume regulations' restructuring of exemptions to "emergencies" and "new or renewed service lines" with a two year exemption period, are concordant with the empirical findings of this study. Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available With the introduction of Solvency II a consistent market approach to the valuation of insurance assets and liabilities is required. For the best estimate of life annuity provisions one should estimate the longevity risk of the insured population in Slovenia. In this paper the current minimum standard in Slovenia for calculating pension annuities is tested using the Lee-Carter model. In particular, the mortality of the Slovenian population is projected using the best fit from the stochastic mortality projections method. The projected mortality statistics are then corrected with the selection effect and compared with the current minimum standard.
Mobley, Lee R; Magnussen, Jon
The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related to staffing levels in California hospitals in 1995 (prior to implementation of the new law). We are particularly interested in the affect of managed care penetration on this aspect of hospital efficiency because the call to legislative action was predicated on fears that hospitals were reducing staffing below optimal levels in response to managed care pressures. We derive a unique measure of excess staffing in hospitals based on a data envelopment analysis (DEA) production function model, which explicitly includes ancillary care among the inputs and outputs. This careful specification of production is important because ancillary care use has risen relative to daily hospital services, with the spread of managed care and advances in medical technology. We find that market share (adjusted for size) and market concentration are the major determinants of excess staffing while managed care penetration is insignificant. We also find that poor quality (outcomes worse than expected) is associated with less efficient staffing. These findings suggest that the larger, more efficient urban hospitals will be penalized more heavily under binding staffing ratios than smaller, less-urban hospitals.
Full Text Available This paper examines the phenomenon of incompatibility of the institutional structure of Regional Public Hospital which causes the disruption of the achievement of Minimum Service Standards (MSS indicator in the health sector, especially maternal health in the Provincial Government of Central Java. In Central Java, the largest number of maternal mortality rate was in the hospital in 2015 amounted to 85.71%. Meanwhile, the coverage rate of delivery assisted by health personnel in accordance with the indicator of MSS is 98.09%. In 2015, Central Java is the province with the second highest national of maternal mortality rate case amounted to 619 cases. The Provincial Government as the coordinator of MSS implementation in the region through the Bureau of Pemotda and the Cooperation of Regional Secretariat of Central Java has a significant role in the successful implementation of the Regulation of Minister of Health 43/2016 on MSS in Health Sector. In which MSS has a function to observe the implementation of health program in the region. This research uses a qualitative approach, the type of research is a case study and interactive model analysis from Miles, Huberman, and Saldana. The results of the analysis show that the implementation process of the policy in Bureau of Pemotda and the Cooperation of Regional Secretariat of Central Java has not run well obstructed by bureaucratic structure factor. It can be seen from the unfulfilled policy objective which is to provide convenience to local government in the preparation of planning document on the achievement of health MSS indicator. Although health MSS is achieved, it will not be able to reduce the maternal mortality rate.
Morin, Lucien; Cosman, J. W.
The United Nations Standard Minimum Rules for the Treatment of Prisoners do not express the basic principle that would support a serious educational approach to prison administration. The crucial missing rationale is the concept of the inherent dignity of the individual human prisoner. This concept has certain basic educational implications,…
Bustin, S.A.; Beaulieu, J.F.; Huggett, J.; Jaggi, R.; Kibenge, F.S.; Olsvik, P.A.; Penning, L.C.; Toegel, S.
MIQE précis: Practical implementation of minimum standard guidelines for fluorescence-based quantitative real-time PCR experiments Stephen A Bustin1 , Jean-François Beaulieu2 , Jim Huggett3 , Rolf Jaggi4 , Frederick SB Kibenge5 , Pål A Olsvik6 , Louis C Penning7 and Stefan Toegel8 1 Centre for
Ogochukwu, Emeka; Gbendu, Olaowei Godiva
The study was carried out in Salga Education Zone of Bayelsa State specifically to determine the extent of implementation of the minimum standards for basic education in order to ensure the realization of the second millennium development goal. The study adopted the descriptive research design. The population of the study comprised of all the…
Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti
This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.
As Unmanned Aircraft Systems (UAS) make their way to mainstream aviation operations within the National Airspace System (NAS), research efforts are underway to develop a safe and effective environment for their integration into the NAS. Detect and Avoid (DAA) systems are required to account for the lack of "eyes in the sky" due to having no human on-board the aircraft. The current NAS relies on pilot's vigilance and judgement to remain Well Clear (CFR 14 91.113) of other aircraft. RTCA SC-228 has defined DAA Well Clear (DAAWC) to provide a quantified Well Clear volume to allow systems to be designed and measured against. Extended research efforts have been conducted to understand and quantify system requirements needed to support a UAS pilot's ability to remain well clear of other aircraft. The efforts have included developing and testing sensor, algorithm, alerting, and display requirements. More recently, sensor uncertainty and uncertainty mitigation strategies have been evaluated. This paper discusses results and lessons learned from an End-to-End Verification and Validation (E2-V2) simulation study of a DAA system representative of RTCA SC-228's proposed Phase I DAA Minimum Operational Performance Standards (MOPS). NASA Langley Research Center (LaRC) was called upon to develop a system that evaluates a specific set of encounters, in a variety of geometries, with end-to-end DAA functionality including the use of sensor and tracker models, a sensor uncertainty mitigation model, DAA algorithmic guidance in both vertical and horizontal maneuvering, and a pilot model which maneuvers the ownship aircraft to remain well clear from intruder aircraft, having received collective input from the previous modules of the system. LaRC developed a functioning batch simulation and added a sensor/tracker model from the Federal Aviation Administration (FAA) William J. Hughes Technical Center, an in-house developed sensor uncertainty mitigation strategy, and implemented a pilot
Thwaites, D I
In 1989 IPSM brought out a policy document on the role of the physical scientist in radiotherapy. At roughly the same time IPSM also produced recommended minimum staffing levels for the medical physics support of radiotherapy, which drew heavily on comprehensive reviews of both physicist and physics technician staffing carried out by the Scottish Radiotherapy Physicists Group in 1980 (updated in 1989). The IPSM figures remain professional recommendations and have not been taken up by any official body. However some of the Scottish figures were included in a SHHD Planning Council Scientific Advisory report and so have some measure of official endorsement. All these figures were derived specifically for the UK situation of essentially regional oncology centres, where generally medium to large radiotherapy departments are the norm, to concentrate equipment, expertise and experience. Thus there are approximately 60 centres for a population of 55 million. In addition the recommendations reflect the typical structure of UK departments, in terms of professional roles and relationships. The current situation regarding physicist and physics technician numbers is reviewed, using evidence from recent surveys. The UK and other recommendations are applied to a number of representative centres and the figures obtained are compared to each other and to the actual staffing levels
Describes the STAF (Science Teacher's Authoring Facility) computer-assisted instruction system developed at Leeds University (England), focusing on STAF language and major program features. Although programs for the system emphasize physical chemistry and organic spectroscopy, the system and language are general purpose and can be used in any…
Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene
Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.
Lacasse, Anaïs; Roy, Jean-Sébastien; Parent, Alexandre J; Noushi, Nioushah; Odenigbo, Chúk; Pagé, Gabrielle; Beaudet, Nicolas; Choinière, Manon; Stone, Laura S; Ware, Mark A
To better standardize clinical and epidemiological studies about the prevalence, risk factors, prognosis, impact and treatment of chronic low back pain, a minimum data set was developed by the National Institutes of Health (NIH) Task Force on Research Standards for Chronic Low Back Pain. The aim of the present study was to develop a culturally adapted questionnaire that could be used for chronic low back pain research among French-speaking populations in Canada. The adaptation of the French Canadian version of the minimum data set was achieved according to guidelines for the cross-cultural adaptation of self-reported measures (double forward-backward translation, expert committee, pretest among 35 patients with pain in the low back region). Minor cultural adaptations were also incorporated into the English version by the expert committee (e.g., items about race/ethnicity, education level). This cross-cultural adaptation provides an equivalent French-Canadian version of the minimal data set questionnaire and a culturally adapted English-Canadian version. Modifications made to the original NIH minimum data set were minimized to facilitate comparison between the Canadian and American versions. The present study is a first step toward the use of a culturally adapted instrument for phenotyping French- and English-speaking low back pain patients in Canada. Clinicians and researchers will recognize the importance of this standardized tool and are encouraged to incorporate it into future research studies on chronic low back pain.
Hallbert, B.P.; Sebok, A.; Haugset, K.
Differences in the ways in which vendors expect the operations staff to interact with advanced passive plants by vendors have led to a need for reconsideration of the minimum shift staffing requirements of licensed Reactor Operators and Senior Reactor Operators contained in current federal regulations (i.e., 10 CFR 50.54(m)). A research project is being carried out to evaluate the impact(s) of advanced passive plant design and staffing of control room crews on operator and team performance. The purpose of the project is to contribute to the understanding of potential safety issues and provide data to support the development of design review guidance. Two factors are being evaluated across a range of plant operating conditions: control room crew staffing; and characteristics of the operating facility itself, whether it employs conventional or advanced, passive features. This paper presents the results of the first phase of the study conducted at the Loviisa nuclear power station earlier this year. Loviisa served as the conventional plant in this study. Data collection from four crews were collected from a series of design basis scenarios, each crew serving in either a normal or minimum staffing configuration. Results of data analyses show that crews participating in the minimum shift staffing configuration experienced significantly higher workload, had lower situation awareness, demonstrated significantly less effective team performance, and performed more poorly as a crew than the crews participating in the normal shift staffing configuration. The baseline data on crew configurations from the conventional plant setting will be compared with similar data to be collected from the advanced plant setting, and a report prepared providing the results of the entire study
Radiotherapy requires competent professional staff to ensure safe and effective patient treatment and management. There is a need to provide guidelines that recommend appropriate staffing levels to support the initiation of new services as well as the expansion or upgrade of existing services as even simple upgrades or replacement of existing equipment may have a significant impact on staffing needs. Similarly, the introduction of education and training programmes will require staffing adjustments. A calculation algorithm was developed to predict staffing levels based on the inputs that are known or can be easily estimated. This publication complements other IAEA publications used to support the initiation of basic radiation medicine services including Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, published in 2008
The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles, responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016.
Evans, Stephen; Christofides, Stelios; Brambilla, Marco
This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission's Radiation Protection Report No. 174: "Guidelines on medical physics expert", as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency. Copyright © 2016. Published by Elsevier Ltd.
The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline
Gabbay, Uri; Bukchin, Michael
Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity
Fields, Gary S.; Kanbur, Ravi
Textbook analysis tells us that in a competitive labor market, the introduction of a minimum wage above the competitive equilibrium wage will cause unemployment. This paper makes two contributions to the basic theory of the minimum wage. First, we analyze the effects of a higher minimum wage in terms of poverty rather than in terms of unemployment. Second, we extend the standard textbook model to allow for incomesharing between the employed and the unemployed. We find that there are situation...
Schnelle, John F; Schroyer, L Dale; Saraf, Avantika A; Simmons, Sandra F
Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload
Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?
Harris, John Alexander; Engberg, John; Castle, Nicholas George
The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m 2 ) to obesity Class IIIB (≥50 kg/m 2 ). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06-1.08) for Class I, 1.16 (95%CI 1.14-1.17) for Class II, 1.33 (95%CI 1.31-1.35) for Class IIIA, and 1.90 (95%CI 1.86-1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident's BMI increases, especially for BMI ≥40 kg/m 2 , the need for extensive staffing assistance with ADLs also increases substantially. Copyright © 2018 Elsevier Inc. All rights reserved.
The test methods used for PNL bioassay performance tests were evaluated by comparing the MDA based on performance tests results with MDA calculated by PNL using the bioassay laboratory's own quality control (QC) data. Two in vitro laboratories and two in vivo laboratories were studied and a correlation between the performance test MDA estimates and QC data was demonstrated. However, it was often necessary to examine the QC data to identify important characteristics of the blank distribution that affect the MDA calculation. Since the MDA equation must be based on the specific analysis and calculational methods of the procedure evaluated. Even when the correct MDA equation is applied, the MDA calculated will have a relatively large confidence interval when only a few replicates are used to estimate the standard deviation. For this reason, a relatively precise estimate of the MDA is generally only available when Poisson statistics may be applied. It was concluded that performance testing alone cannot provide all the information necessary to make an accurate estimate of the measurement process MDA. Review of the laboratory's QC data and the entire measurement procedure will be necessary. Specific recommendations for changes to draft ANSI N13.30 ''Performance Criteria for Radiobioassay'' are given. 10 refs., 18 figs., 11 tabs
RCN WALES is urging the public to sign an e-petition supporting draft legislation on safe staffing. The petition calls for support for the Safe Nursing Staffing Levels (Wales) Bill, drawn up by Welsh Liberal Democrat leader Kirsty Williams.
A. I. Tolstoy
Full Text Available Determining staffing policy implementation of information security tasks is given. The basic requirements that must be taken into account when developing policies are defined. The policy framework is determined and recommendations for the design of such policies are formulated. Requirements for the implementation of the policy are defined.
McPhail, Ruth; Fisher, Ron; Harvey, Michael; Moeller, Miriam
This article explores the evolution of international staffing in an increasingly globalized and hypercompetitive marketplace. As the issue of staff retention becomes critical in global organizations, it is important to understand the types of managers that may be on or assigned to overseas assignments. The purpose of this article is to present a…
Walton, David M; Macdermid, Joy C; Nielson, Warren; Teasell, Robert W; Chiasson, Marco; Brown, Lauren
Clinical measurement. To evaluate the intrarater, interrater, and test-retest reliability of an accessible digital algometer, and to determine the minimum detectable change in normal healthy individuals and a clinical population with neck pain. Pressure pain threshold testing may be a valuable assessment and prognostic indicator for people with neck pain. To date, most of this research has been completed using algometers that are too resource intensive for routine clinical use. Novice raters (physiotherapy students or clinical physiotherapists) were trained to perform algometry testing over 2 clinically relevant sites: the angle of the upper trapezius and the belly of the tibialis anterior. A convenience sample of normal healthy individuals and a clinical sample of people with neck pain were tested by 2 different raters (all participants) and on 2 different days (healthy participants only). Intraclass correlation coefficient (ICC), standard error of measurement, and minimum detectable change were calculated. A total of 60 healthy volunteers and 40 people with neck pain were recruited. Intrarater reliability was almost perfect (ICC = 0.94-0.97), interrater reliability was substantial to near perfect (ICC = 0.79-0.90), and test-retest reliability was substantial (ICC = 0.76-0.79). Smaller change was detectable in the trapezius compared to the tibialis anterior. This study provides evidence that novice raters can perform digital algometry with adequate reliability for research and clinical use in people with and without neck pain.
McHugh, Matthew D; Berez, Julie; Small, Dylan S
The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.
Khalil, M. Y.
Full text: The Instrumental Neutron Activation Analysis (INAA) Laboratory of Egypt Second Training and Research Reactor (ETRR-2) is increasingly requested to perform multi-element analysis to large number of samples from different origins. The INAA laboratory has to demonstrate competence by conforming to appropriate internationally and nationally accepted standards. The objective of this work is to determine the uncertainty budget and sensitivity of the INAA laboratory measurements. Concentrations of 9 elements; Mn, Na, K, Ca, Co, Cr, Fe, Rb, and Cs, were measured against a certified test sample. Relative, absolute, and Ko-IAEA standardization methods were employed and results compared. The flux was monitored using cadmium covered gold method, and multifoil (gold, nickel and zirconium) method. The combined and expanded uncertainties were estimated. Uncertainty of concentrations ranged between 2-21% depending on the standardization method used. The relative method, giving the lowest uncertainty, produced uncertainty budget between 2 and 11%. The minimum detectable concentration was the lowest for Cs ranging between 0.36 and 0.59 ppb and the highest being for K in the range of 0.32 to 8.64 ppm
Full Text Available Growing public school enrollment and the need to maintain or improve service to students has increased the demand for teachers, perhaps more rapidly than existing sources can accommodate. While some schools recruit well qualified teachers by offering higher salaries or better working conditions, others may satisfy their need for staff by relaxing hiring standards or assigning novice teachers to difficult classrooms. Schools' hiring policies have consequences for student success. Dropout rates tend to be higher where faculties include a greater percentage of minimally educated teachers or teachers with little experience. The relationship between dropout rate and teacher qualifications is independent of student poverty, school size, and location. A proposed strategy to reduce dropout rates is to encourage higher preparation and employment standards, and to provide appropriate classroom assignments, mentoring, and support for new teachers.
Andrew, R R
A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.
Kirby, Esther; Hurst, Keith
This major community, workload, staffing and quality study is thought to be the most comprehensive community staffing project in England. It involved over 400 staff from 46 teams in 6 localities and is unique because it ties community staffing activity to workload and quality. Scotland was used to benchmark since the same evidence-based Safer Nursing Care Tool methodology developed by the second-named author was used (apart from quality) and took into account population and geographical similarities. The data collection method tested quality standards, acuity, dependency and nursing interventions by looking at caseloads, staff activity and service quality and funded, actual, temporary and recommended staffing. Key findings showed that 4 out of 6 localities had a heavy workload index that stretched staffing numbers and time spent with patients. The acuity and dependency of patients leaned heavily towards the most dependent and acute categories requiring more face-to-face care. Some areas across the localities had high levels of temporary staff, which affected quality and increased cost. Skill and competency shortages meant that a small number of staff had to travel significantly across the county to deliver complex care to some patients.
Kamis-Gould, Edna; And Others
A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…
Dam, H. van; Leege, P.F.A. de
An analysis is presented of thermal systems with minimum critical mass, based on the use of materials with optimum neutron moderating and reflecting properties. The optimum fissile material distributions in the systems are obtained by calculations with standard computer codes, extended with a routine for flat fuel importance search. It is shown that in the minimum critical mass configuration a considerable part of the fuel is positioned in the reflector region. For 239 Pu a minimum critical mass of 87 g is found, which is the lowest value reported hitherto. (author)
Buerhaus, Peter I
The imposition of mandatory hospital nurse staffing ratios is among the more visible public policy initiatives affecting the nursing profession. Although the practice is intended to address problems in hospital nurse staffing and quality of patient care, this commentary argues that staffing ratios will lead to negative consequences for nurses involving the equity, efficiency, and costs of producing nursing care in hospitals. Rather than spend time and effort attempting to regulate nurse staffing, this commentary offers alternatives strategies that are directed at fixing the problems that motivate the advocates of staffing ratios.
Given a computation center with --10,000 MIPS supporting --1,000 users, what are the staffing requirements? The attempt in this paper is to list the functions and staff size required in a central computing or centrally supported computing complex. The organization assumes that although considerable computing power would exist (mostly for online) in the four interaction regions (IR) that there are functions/capabilities better performed outside the IR and in this model at a ''central computing facility.'' What follows is one staffing approach, not necessarily optimal, with certain assumptions about numbers of computer systems, media, networks and system controls, that is, one would get the best technology available. Thus, it is speculation about what the technology may bring and what it takes to operate it. From an end user support standpoint it is less clear, given the geography of an SSC, where and what the consulting support should look like and its location
Lievens, Yolande; Defourny, Noémie; Coffey, Mary
includes a detailed analysis of radiotherapy staffing (questionnaire items 47-60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40...... of countries can be distinguished on the basis of available personnel resources and socio-economic status. CONCLUSIONS: The average personnel figures in Europe are now consistent with, or even more favourable than the QUARTS recommendations, probably reflecting a combination of better availability as such......, in parallel with the current use of more complex treatments than a decade ago. A considerable variation in available personnel and delivered courses per year however persists among the highest and lowest staffing levels. This not only reflects the variation in cancer incidence and socio-economic determinants...
military-unique knowledge or skills required; (2) military incumbency is required by law, Executive Order, treaty or international agreement (e.g., DPH...civilian employment . 1 Thomas H. Barth et al., “(U) Staffing for Cyberspace Operations,” IDA Paper P...DoD cyberspace strategies, doctrine, and current concepts of operation and employment for CMF. Additionally, the team conducted interviews with
Neubert , Gilles; Adjadj , Philippe
International audience; For a long time, contingent staffing was considered as the responsability of the Human Resource department. The high needs of workforce flexibility combined with disseminated agencies have led some companies to a great number of labor suppliers. This situation has produced important cost variation, poor quality of service, and important risk due to the mistunderstanding by local managers of legal considerations. To face this situation, companies have started to move fr...
The operator of the Energy Department's Savannah River weapons plant has at least 1,800 more employees than it needs, and could save $400 million over a five-year period by cutting its staff accordingly, a DOE inspector general study says. Most of the boat - 1,206 employees - was attributed to excessive numbers of managers, with the inspector general concluding that Westinghouse Savannah River Co. had roughly twice as many layers of management than two other DOE weapons contractors. The study also concluded that Westinghouse in fiscal year 1992 significantly understated its actual staffing levels in reports to DOE, failing to disclose 1,765 full-time employees or the equivalent hours worked. Through such underreporting Westinghouse was able to open-quotes circumvent staffing ceilings established by the department,close quotes the study added. Overall, DOE Inspector General John Layton said Westinghouse's staff levels substantially exceeded those needed for efficient operation of the South Carolina nuclear weapons facility. Layton based his analysis on efficiency standards attained by other DOE weapons plant contractors, such as Martin Marietta Energy Systems at DOE's Oak Ridge, Tenn., plant and EG ampersand G Rocky Flats, as well as widely utilized worker performance requirements used by the Navy and private sector companies that perform work similar to that done at Savannah River
Pomery, Amanda; Schofield, Penelope; Xhilaga, Miranda; Gough, Karla
Across the globe, peer support groups have emerged as a community-led approach to accessing support and connecting with others with cancer experiences. Little is known about qualities required to lead a peer support group or how to determine suitability for the role. Organisations providing assistance to cancer support groups and their leaders are currently operating independently, without a standard national framework or published guidelines. This protocol describes the methods that will be used to generate pragmatic consensus-based minimum standards and an accessible structured interview with user manual to guide the selection and development of cancer support group leaders. We will: (A) identify and collate peer-reviewed literature that describes qualities of support group leaders through a systematic review; (B) content analyse eligible documents for information relevant to requisite knowledge, skills and attributes of group leaders generally and specifically to cancer support groups; (C) use an online reactive Delphi method with an interdisciplinary panel of experts to produce a clear, suitable, relevant and appropriate structured interview comprising a set of agreed questions with behaviourally anchored rating scales; (D) produce a user manual to facilitate standard delivery of the structured interview; (E) pilot the structured interview to improve clinical utility; and (F) field test the structured interview to develop a rational scoring model and provide a summary of existing group leader qualities. The study is approved by the Department Human Ethics Advisory Group of The University of Melbourne. The study is based on voluntary participation and informed written consent, with participants able to withdraw at any time. The results will be disseminated at research conferences and peer review journals. Presentations and free access to the developed structured interview and user manual will be available to cancer agencies. © Article author(s) (or their
Hahn, H.A.; Houghton, F.K.
This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development
Using the Spent Nuclear Fuel (SNF) Project's current process flow concepts and knowledge from cognizant engineering and operational personnel, an initial assessment of the SNF Project radiological exposure and resource requirements was completed. A small project team completed a step by step analysis of fuel movement in the K Basins to the new interim storage location, the Canister Storage Building (CSB). This analysis looked at fuel retrieval, conditioning of the fuel, and transportation of the fuel. This plan describes the staffing structure for fuel processing, fuel movement, and the maintenance and operation (M ampersand O) staffing requirements of the facilities. This initial draft does not identify the support function resources required for M ampersand O, i.e., administrative and engineering (technical support). These will be included in future revisions to the plan. This plan looks at the resource requirements for the SNF subprojects, specifically, the operations of the facilities, balances resources where applicable, rotates crews where applicable, and attempts to use individuals in multi-task assignments. This plan does not apply to the construction phase of planned projects that affect staffing levels of K Basins
Hahn, H.A.; Houghton, F.K.
This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development
Highlights: • Setting MEPS requires significant data, financial resources and technical capacity. • Application of best practice in technical disadvantaged countries (TDCs) was demonstrated. • Best practice was successfully applied to Brunei for its AC MEPS. • For Brunei, COP at 2.9 is recommended and 15% efficiency improvement is achievable. • The methodology is applicable to other appliances in any TDCs. - Abstract: Application of the best practice of setting minimum energy performance standards (MEPS) in technically disadvantaged countries (TDCs) faces many barriers. The best practice of determining MEPS has a comprehensive analytical framework including engineering-economic analysis, life-cycle cost-benefit analysis, as well stakeholders’ and market impact assessments. However, TDCs usually are lack of reference product classes, market data, and other necessary inputs data. This study demonstrated how to overcome those barriers to apply the best practice to TDCs using the actual experience in setting initial MEPS for Air Conditioners (ACs) in Brunei from scratch with limited secondary data as an example. The series of application works include definition of the product classes and the baseline group; collection of market data; formulation of cost-efficiency relationship from the market data; examination of the economic, environmental, and financial impacts of various MEPS options; revealing of the consumers’ willingness to pay; and analysis of the impacts and responses from the industry and consumers. The coordination with the compliance of the Montreal Protocol was also considered. The methodology should also be applicable to setting MEPF for other appliances in any TDCs.
Chaffe, B; Glencross, H; Jones, J; Staves, J; Capps-Jenner, A; Mistry, H; Bolton-Maggs, P; McQuade, M; Asher, D
The SHOT Adverse Incident Reporting Scheme has consistently reported an unacceptably high level of errors originating in the laboratory setting. In 2006 an initiative was launched in conjunction with the IBMS, SHOT, RCPath, BBTS, UK NEQAS, the NHSE NBTC and the equivalents in Scotland, Wales and Northern Ireland that led to the formation of the UK TLC. The UK TLC in considering the nature and spread of the errors documented by SHOT concluded that a significant proportion of these errors were most likely to be related to either the use of information technology or staff education, staffing levels, skill mix, training and competency issues. In the absence of any formal guidance on these matters, the UK TLC developed a series of recommendations using the results of two laboratory surveys conducted in 2007 and 2008.
Good news about nurse staffing levels can be hard to find, so how fantastic that a protracted campaign in Wales finally paid off last week with the passage of legislation to ensure hospital wards are staffed safely. Next month, the Queen will give royal assent to the Safe Nurse Staffing Levels (Wales) Bill, which will save lives, produce better outcomes and enhance the patient experience of care.
Deeken, Debra Jean; Wakefield, Douglas; Kite, Cora; Linebaugh, Jeanette; Mitchell, Blair; Parkinson, Deidre; Misra, Madhukar
Ensuring that the level of nurse staffing used to care for patients is appropriate to the setting and service intensity is essential for high-quality and cost-effective care. This article describes the development, validation, and implementation of the clinic technical skills permission list developed specifically to guide nurse staffing decisions in physician clinics of an academic medical center. Results and lessons learned in using this staffing guideline are presented.
Bilibino NPP has four 12 MW(e) water cooled graphite moderated channel reactors. The plant has been in operation since 1973 in conditions of isolated local energy system in a remote area with extreme climatic conditions. The plant accounts for almost 70 per cent of energy produced in the region, it also provides heating to the regional centre. The plant's organisational structure is on the whole consistent with the standard structure of other NPPs of ex-USSR. At the same time there are some specific features due to high cost of personnel in the prime cost of the generated energy. As a result a need arises to broaden the task of catering for each worker and, therefore, to extend and increase the level of training. The number of high-quality personnel is on the increase. A method of step-by-step training is widely used at all work areas for training operations personnel. At the end of each step a worker is engaged in independent activities at this work area. When a plant is located in a remote area efficient and effective maintenance becomes highly instrumental. The engineering and design support on the part of the utility and equipment manufacturer begins to play a greater role. Activities to optimise the plant organisational structure were mostly characterised by merging of subdivisions and by some change in the proportion of different categories of personnel. It would be an optimum decision to put all supporting services, namely, logistics, book-keeping and staffing departments, within the utility's authority. Operations experience of the Bilibino plant will certainly be valuable for projection, location choice and staffing of plants with small and medium reactors. (author)
Huang, Sean Shenghsiu; Bowblis, John R
Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes. Through the principal-agent theory, this article studies how managerial ownership of individual facilities affects NH outcomes. We use a unique panel dataset of Ohio NHs (2005-2010) to empirically examine the relationship between managerial equity ownership and NH staffing, quality, and financial performance. We identify facility administrators as owner-managers if they have more than 5% of the equity stakes or are relatives of the owners. The statistical analysis is based on the pooled ordinary least squares and NH-fixed effect models. We find that owner-managed NHs are associated with higher nursing staff levels compared to other FP NHs. Surprisingly, despite higher staffing levels, owner-managed NHs are not associated with better quality and we find no statistically significant difference in financial performance between owner-managed and nonowner-managed FP NHs. Our results do not support the principal-agent model and we offer alternative explanations for future research. Our findings provide empirical evidence that NH ownership structures are more nuanced than simply broadly categorizing facilities as FP or NFP, and our results do not fully align with the standard principal-agent model. The role of managerial ownership should be considered in future NH research and policy discussions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Minimum wage. 551.301 Section 551.301... FAIR LABOR STANDARDS ACT Minimum Wage Provisions Basic Provision § 551.301 Minimum wage. (a)(1) Except... employees wages at rates not less than the minimum wage specified in section 6(a)(1) of the Act for all...
van der Veen, Egbert; Veltman, Bart
Many rostering methods first create shifts from some given staffing levels, and after that create rosters from the set of created shifts. Although such a method has some nice properties, it also has some bad ones. In this paper we outline a method that creates rosters directly from staffing levels.
Small, Erika E.; Doll, Jessica L.; Bergman, Shawn M.; Heggestad, Eric D.
Developing students' practical skills in strategic staffing and selection within the classroom can be challenging. This article describes a staffing system simulation designed to engage students and develop applied skills in strategic recruiting, assessment, and evaluation of job applicants. Instructors looking for a multifaceted team project…
West, Elizabeth; Barron, David N; Harrison, David; Rafferty, Anne Marie; Rowan, Kathy; Sanderson, Colin
To investigate whether the size of the workforce (nurses, doctors and support staff) has an impact on the survival chances of critically ill patients both in the intensive care unit (ICU) and in the hospital. Investigations of intensive care outcomes suggest that some of the variation in patient survival rates might be related to staffing levels and workload, but the evidence is still equivocal. Information about patients, including the outcome of care (whether the patient lived or died) came from the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme. An Audit Commission survey of ICUs conducted in 1998 gave information about staffing levels. The merged dataset had information on 65 ICUs and 38,168 patients. This is currently the best available dataset for testing the relationship between staffing and outcomes in UK ICUs. A cross-sectional, retrospective, risk adjusted observational study. Multivariable, multilevel logistic regression. ICU and in-hospital mortality. After controlling for patient characteristics and workload we found that higher numbers of nurses per bed (odds ratio: 0.90, 95% confidence interval: [0.83, 0.97]) and higher numbers of consultants (0.85, [0.76, 0.95]) were associated with higher survival rates. Further exploration revealed that the number of nurses had the greatest impact on patients at high risk of death (0.98, [0.96, 0.99]) whereas the effect of medical staffing was unchanged across the range of patient acuity (1.00, [0.97, 1.03]). No relationship between patient outcomes and the number of support staff (administrative, clerical, technical and scientific staff) was found. Distinguishing between direct care and supernumerary nurses and restricting the analysis to patients who had been in the unit for more than 8h made little difference to the results. Separate analysis of in-unit and in-hospital survival showed that the clinical workforce in intensive care had a greater impact on ICU mortality than on
Kalisch, Beatrice; Lee, Kyung Hee
The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.
Ade-Oshifogun, Jochebed Bosede; Dufelmeier, Thaddeus
This article describes a quality improvement process for "do not return" (DNR) notices for healthcare supplemental staffing agencies and healthcare facilities that use them. It is imperative that supplemental staffing agencies partner with healthcare facilities in assuring the quality of supplemental staff. Although supplemental staffing agencies attempt to ensure quality staffing, supplemental staff are sometimes subjectively evaluated by healthcare facilities as "DNR." The objective of this article is to describe a quality improvement process to prevent and manage "DNR" within healthcare organizations. We developed a curriculum and accompanying evaluation tool by adapting Rampersad's problem-solving discipline approach: (a) definition of area(s) for improvement; (b) identification of all possible causes; (c) development of an action plan; (d) implementation of the action plan; (e) evaluation for program improvement; and (f) standardization of the process. Face and content validity of the evaluation tool was ascertained by input from a panel of experienced supplemental staff and nursing faculty. This curriculum and its evaluation tool will have practical implications for supplemental staffing agencies and healthcare facilities in reducing "DNR" rates and in meeting certification/accreditation requirements. Further work is needed to translate this process into future research. © 2012 Wiley Periodicals, Inc.
Shipanga, A.N.; Ellmann, A.
Full text: Introduction: Nuclear medicine in South Africa is developing fast. Much has changed since the constitution of a scientific model for determining an optimum number of radiographer posts in a Nuclear Medicine department in the late 1980's. Aim: The aim of this study was to ascertain whether the number of radiographers required by a Nuclear Medicine department can still be determined according to the norms established in 1988. Methods: A quantitative study using non-experimental evaluation design was conducted to determine the ratios between current radiographer workload and staffing norms. The workload ratios were analysed using the procedures statistics of the Nuclear Medicine department at Tygerberg Hospital. Radiographers provided data about their activities related to patient procedures, including information about the condition of the patients, activities in the radiopharmaceutical laboratory, and patient related administrative tasks. These were factored into an equation relating this data to working hours, including vacation and sick leave. The calculation of Activity Standards and an annual Standard Workload was used to finally calculate the staffing requirements for a Nuclear Medicine department. Results: Preliminary data confirmed that old staffing norms cannot be used in a modern Nuclear Medicine department. Protocols for several types of study have changed, including the additional acquisition of tomographic studies. Interest in the use of time-consuming non-imaging studies has been revived and should be factored Into the equation. Conclusions: All Nuclear Medicine departments In South Africa, where the types of studies performed have changed over the past years, should look carefully at their radiographer staffing ratio to ascertain whether the number of radiographers needed is adequate for the current workload. (author)
McHugh, Matthew D.; Ma, Chenjuan
Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. PMID:25121923
Houseman, Susan N.; Polivka, Anne E.
In this paper, we examine the job stability of workers in a wide range of flexible staffing arrangements: agency temporary, direct-hire temporary, on-call, contract company, independent contractor, and regular part-time work. We draw upon two data sources in our analysis. The first is a nationwide survey of employers on their use of flexible staffing arrangements conducted by the Upjohn Institute for Employment Research. This survey provides evidence on why employers use various types of flex...
Dorr, David A; Horn, Susan D; Smout, Randall J
To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.
Stone, Patricia W; Dick, Andrew; Pogorzelska, Monika; Horan, Teresa C; Furuya, E Yoko; Larson, Elaine
The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Our objectives were to provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States. A Web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network. The response rate was 66% (n = 289); data were examined on 821 professionals. Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (P hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%). Only 32% (n = 92) reported using an electronic surveillance system to track infections. This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization, and support in a select group of hospitals across the nation. Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time.
Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.
Nadolski, Charles; Britt, Pheraby; Ramos, Leah C
The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.
Three decades of operating experience in India has led to sustained high performance of NPPs. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. Specific qualification levels apply to each position - six at management positions, five licensed positions with the rest qualified through an equivalent training scheme. Practically all O and M activities are carried out on-site by the utility manpower with minimum involvement of contractors. The entire process of human resource development is in-house - with each NPP organisation comprised of 30% experienced staff transferred from older NPPs and 70% totally developed out of fresh recruits. Four to eight years lead time goes to qualify fresh recruits depending on the position. This optimisation of manpower is a result of continuous learning - through operating experience and regulatory feed back and self assessment for (i) optimising quantum of work load and (ii) improving productivity. For the first category, design improvements over older NPP's increased reliability, operability, maintainability and human factors are described separately in the companion paper. In this paper the organisation factors are discussed, starting with the initial lessons that demanded improved management and enhanced quality programmes and caused temporarily, high demand of staffing for bringing out new systems, e.g., (i) attaining maturity of units; (ii) standardising training, retraining and cross training and qualifications; (in) job rotations, (iv) in service inspection of reactor components; (v) quality audits. The experiences on subsequent optimisation of staffing levels are outlined. (author)
Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan
The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research
Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L
Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.
Grindle, Laurie; Hackenberg, Davis L.
UAS Integration in the NAS Project has: a) Developed Technical Challenges that are crucial to UAS integration, aligned with NASA's Strategic Plan and Thrusts, and support FAA standards development. b) Demonstrated rigorous project management processes through the execution of previous phases. c) Defined Partnership Plans. d) Established path to KDP-C. Request approval of Technical Challenges, execution of partnerships and plans, and execution of near-term FY17 activities. There is an increasing need to fly UAS in the NAS to perform missions of vital importance to National Security and Defense, Emergency Management, and Science. There is also an emerging need to enable commercial applications such as cargo transport (e.g. FedEx). Unencumbered NAS Access for Civil/Commercial UAS. Provide research findings, utilizing simulation and flight tests, to support the development and validation of DAA and C2 technologies necessary for integrating Unmanned Aircraft Systems into the National Airspace System.
Feng, Zhanlian; Grabowski, David C; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent
We examined the impact of state Medicaid payment rates and case-mix reimbursement on direct care staffing levels in US nursing homes. We used a recent time series of national nursing home data from the Online Survey Certification and Reporting system for 1996-2004, merged with annual state Medicaid payment rates and case-mix reimbursement information. A 5-category response measure of total staffing levels was defined according to expert recommended thresholds, and examined in a multinomial logistic regression model. Facility fixed-effects models were estimated separately for Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nurse Aide (CNA) staffing levels measured as average hours per resident day. Higher Medicaid payment rates were associated with increases in total staffing levels to meet a higher recommended threshold. However, these gains in overall staffing were accompanied by a reduction of RN staffing and an increase in both LPN and CNA staffing levels. Under case-mix reimbursement, the likelihood of nursing homes achieving higher recommended staffing thresholds decreased, as did levels of professional staffing. Independent of the effects of state, market, and facility characteristics, there was a significant downward trend in RN staffing and an upward trend in both LPN and CNA staffing. Although overall staffing may increase in response to more generous Medicaid reimbursement, it may not translate into improvements in the skill mix of staff. Adjusting for reimbursement levels and resident acuity, total staffing has not increased after the implementation of case-mix reimbursement.
The aim of this paper is to analyze the effectiveness of the minimum wage policy at the national level in Russia and its impact on living standards in the country. The analysis showed that the national minimum wage in Russia does not serve its original purpose of protecting the lowest wage earners and has no substantial effect on poverty reduction. The national subsistence minimum is too low and cannot be considered an adequate criterion for the setting of the minimum wage. The minimum wage d...
Hislop, Jane; Law, James; Rush, Robert; Grainger, Andrew; Bulley, Cathy; Reilly, John J; Mercer, Tom
The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays.Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day.Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h d(-1) offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.
Hsieh Tsungling; Yang Chihwei; Lin Chiuhsiangjoe
The key goals of staffing and qualifications review element are to ensure that the right numbers of people with the appropriate skills and abilities are available to support plant operations and events. If the staffing level is too few, excessive stress that caused human errors possibly will be placed on the operators. Accordingly, this study developed a staffing evaluation technique based on CPM-GOMS for the mental tasks such as operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation technique. The results indicated the performance of evaluated staffing level via the staffing evaluation technique was significantly higher than that of non-evaluated staffing level; thus, validity of the staffing evaluation technique can be accepted. Finally, the implications for managerial practice on the findings of this study were discussed. (author)
"Help Wanted" signs are springing up outside schools. The shortage of school administrators is not coming, it is here. To thwart the shortage and keep schools on the cutting edge, diligence in cultivating, training, and inspiring a new generation of school leaders--especially for the principalship, must be exercised. Staffing the Principalship…
Salt, John; Wood, Peter
This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…
Department of Health (Ireland)
Flexible Training Strategy (National Task Force on Medical Staffing) The Flexible Training Strategy, while endorsing flexible/part-time options recognises that the preferred option for the majority of doctors-in-training and consultants is most likely to continue to be full-time training and work. Click here to download PDF
Obtaining effective security resourcing and staffing for smaller healthcare facilities presents many difficulties, according to the author In this article, he provides guidance to security practitioners on taking existing data and translating it into a language that administration will understand and appreciate.
Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.
Workload on nursing wards depends highly on patient arrivals and patient lengths of stay, which are both inherently variable. Predicting this workload and staffing nurses accordingly is essential for guaranteeing quality of care in a cost effective manner. This paper introduces a stochastic method
Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.
Workloads in nursing wards depend highly on patient arrivals and lengths of stay, both of which are inherently variable. Predicting these workloads and staffing nurses accordingly are essential for guaranteeing quality of care in a cost-effective manner. This paper introduces a stochastic method
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State agency staffing requirements. 653.111 Section 653.111 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR SERVICES... ethnic characteristics in the work force shall be distributed in substantially the same proportion among...
Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is
Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses
Castle, Nicholas G.
Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…
Williams, Alicia D.; Protheroe, Nancy; Parks, Michael C.
Staffing patterns in American public-school systems are presented in this report of the 2000-01 school year. The report addresses the following: why information about staffing ratios is important; how many people currently work in public schools; what proportion of these are teachers, administrators, and support staff; current staffing patterns in…
.... In support of this goal, the competency requirements defined in the Technical Qualification Standards should be aligned with and integrated into the recruitment and staffing processes for technical positions...
van Oostveen, Catharina J.; Mathijssen, Elke; Vermeulen, Hester
To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). In response to rising health care demands due to ageing of the patient population and increasing
Unmanned Aircraft Systems Detect and Avoid System: End-to-End Verification and Validation Simulation Study of Minimum Operations Performance Standards for Integrating Unmanned Aircraft into the National Airspace System
Ghatas, Rania W.; Jack, Devin P.; Tsakpinis, Dimitrios; Sturdy, James L.; Vincent, Michael J.; Hoffler, Keith D.; Myer, Robert R.; DeHaven, Anna M.
As Unmanned Aircraft Systems (UAS) make their way to mainstream aviation operations within the National Airspace System (NAS), research efforts are underway to develop a safe and effective environment for their integration into the NAS. Detect and Avoid (DAA) systems are required to account for the lack of "eyes in the sky" due to having no human on-board the aircraft. The technique, results, and lessons learned from a detailed End-to-End Verification and Validation (E2-V2) simulation study of a DAA system representative of RTCA SC-228's proposed Phase I DAA Minimum Operational Performance Standards (MOPS), based on specific test vectors and encounter cases, will be presented in this paper.
Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health
... count begins, to ensure the accuracy of the equipment. (7) If a currency counter interface is used: (i.... 543.2 by adding a definition for currency cassette in alphabetical order to read as follows: Sec. 543.2 What are the definitions for this part? * * * * * Currency cassette. A locked compartment that...
.... Factory-Built Fireplaces, Seventh Edition—UL 127-1996, with 1999 revisions. Solid-Fuel Type Room Heaters, Fifth Edition—UL 1482, 1995, with 2000 revisions. Fireplace Stoves, Eight Edition, with 2000 revisions...
... definitions, add and amend existing definitions; amend the term ``variance'' as it applies to establishing an... and audit and accounting procedures into their respective sections. DATES: Submit comments on or... Commission agrees that it does not intend to limit the definition of charitable organizations to those with a...
Paes, B; Mitchell, A; Hunsberger, M; Blatz, S; Watts, J; Dent, P; Sinclair, J; Southwell, D
Advances in technology have improved the survival rates of infants of low birth weight. Increasing service commitments together with cutbacks in Canadian training positions have caused concerns about medical staffing in neonatal intensive care units (NICUs) in Ontario. To determine whether an imbalance exists between the supply of medical personnel and the demand for health care services, in July 1985 we surveyed the medical directors, head nurses and staff physicians of nine tertiary level NICUs and the directors of five postgraduate pediatric residency programs. On the basis of current guidelines recommending an ideal neonatologist:patient ratio of 1:6 (assuming an adequate number of support personnel) most of the NICUs were understaffed. Concern about the heavy work pattern and resulting lifestyle implications has made Canadian graduates reluctant to enter this subspecialty. We propose strategies to correct staffing shortages in the context of rapidly increasing workloads resulting from a continuing cutback of pediatric residency positions and restrictions on immigration of foreign trainees.
Dickstein, Y; Nir-Paz, R; Pulcini, C; Cookson, B; Beović, B; Tacconelli, E; Nathwani, D; Vatcheva-Dobrevska, R; Rodríguez-Baño, J; Hell, M; Saenz, H; Leibovici, L; Paul, M
We aimed to assess the current status of infectious diseases (ID), clinical microbiology (CM) and infection control (IC) staffing in hospitals and to analyse modifiers of staffing levels. We conducted an Internet-based survey of European Society of Clinical Microbiology and Infectious Diseases members and affiliates, collecting data on hospital characteristics, ID management infrastructure, ID/IC-related activities and the ratio of physicians per 100 hospital beds. Regression analyses were conducted to examine factors associated with the physician-bed ratio. Five hundred sixty-seven hospital responses were collected between April and June 2015 from 61 countries, 81.2% (384/473) from Europe. A specialized inpatient ward for ID patients was reported in 58.4% (317/543) of hospitals. Rates of antibiotic stewardship programmes (ASP) and surveillance activities in survey hospitals were high, ranging from 88% to 90% for local antibiotic guidelines and 70% to 82% for programmes monitoring hospital-acquired infections. The median ID/CM/IC physician per 100 hospital beds ratio was 1.12 (interquartile range 0.56-2.13). In hospitals performing basic ASP and IC (including local antibiotic guidelines and monitoring device-related or surgical site infections), the ratio was 1.21 (interquartile range 0.57-2.14). Factors independently associated with higher ratios included compliance with European Union of Medical Specialists standards, smaller hospital size, tertiary-care institution, presence of a travel clinic, beds dedicated to ID and a CM unit. More than half of respondents estimated that additional staffing is needed for appropriate IC or ID management. No standard of physician staffing for ID/CM/IC in hospitals is available. A ratio of 1.21/100 beds will serve as an informed point of reference enabling ASP and infection surveillance. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Kalisch, Beatrice J; Lee, Hyunhwa
This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.
This thesis deals with problems of takeover of employees in outsourcing. The capital purpose is to compare the staffing model of outsourcing in selected companies. To compare in selected companies I chose multi-criteria analysis. This thesis is dividend into six chapters. The first charter is devoted to the theoretical part. In this charter describes the basic concepts as outsourcing, personal aspects, phase of the outsourcing projects, communications and culture. The rest of thesis is devote...
Full Text Available Staffing in an organization can be defined as a series of processes and efforts to acquire, develop, motivate, and evaluate the overall human resources. It is required within the organization in achieving its goals. In staffing, putting a person in a work should be in accordance with his capabilities and expertise so that all are expected to be achieved. Job placement principle is the principle of humanity, democracy, the right man on the right place, equal pay for equal work, unity of direction, the principle of unity of purpose, unity of command, Efficiency and Productivity Work. The concept is the placement, promotion, transfer and demotion. Staffing in the Qur'an and Hadith seen from education management is an employee must complete properly, responsibility, trust, has the capability and expertise, serve, work ethic, strong and trustworthy, honest, sincere, true and trustful, physical and mental strength, and high manners. Professionalism in view of sharia is characterized by three things, namely ahliyah (expertise, himmatul 'charity (high work ethic, trustworthy (reliable.
Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus
Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.
U.S. Department of Health & Human Services — The Long-Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status that forms the foundation of the comprehensive...
Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E
The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the
Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine
To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.
This article reflects on the history of the NHS in Wales and how this has led to its current structure. How this structure supports integrated working across primary, community and secondary care and how further integration with social care is moving forward and its direct effects on district nursing are explored. This article describes how district nursing is meeting these challenges. Support for district nurses as part of integrated multiprofessional teams is being developed to promote appropriately staffed teams centred on meeting the requirements of people within a designated area and ensuring that home is the best and first place of care.
Maes, C.; Netočný, Karel
Roč. 8, č. 7 (2013), s. 9664-9677 ISSN 1941-6016 Institutional support: RVO:68378271 Keywords : MINEP Subject RIV: BE - Theoretical Physics http://www.scholarpedia.org/article/Minimum_entropy_production_principle
Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe
There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.
A Nuclear Criticality Technology and Safety Training Committee has been established within the U.S. Department of Energy (DOE) Nuclear Criticality Safety and Technology Project to review and, if necessary, develop standards for the training of personnel involved in nuclear criticality safety (NCS). The committee is exploring the need for developing a standard or other mechanism for establishing minimum qualifications for NCS professionals. The development of standards and regulatory guides for nuclear power plant personnel may serve as a guide in developing the minimum qualifications for NCS professionals
Bloom, J R; Alexander, J A; Nuchols, B A
The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.
.... Minimum distance estimation has been demonstrated better standard approaches, including maximum likelihood estimators and least squares, in estimating statistical distribution parameters with very small data sets...
Full Text Available A Review of: Moulaison, S. H., & Dykas, F. (2016. High-quality metadata and repository staffing: Perceptions of United States–based OpenDOAR participants. Cataloging & Classification Quarterly, 54(2, 101-116. http://dx.doi.org/10.1080/01639374.2015.1116480 Objective – To investigate the quality of institutional repository metadata, metadata practices, and identify barriers to quality. Design – Survey questionnaire. Setting – The OpenDOAR online registry of worldwide repositories. Subjects – A random sample of 50 from 358 administrators of institutional repositories in the United States of America listed in the OpenDOAR registry. Methods – The authors surveyed a random sample of administrators of American institutional repositories included in the OpenDOAR registry. The survey was distributed electronically. Recipients were asked to forward the email if they felt someone else was better suited to respond. There were questions about the demographics of the repository, the metadata creation environment, metadata quality, standards and practices, and obstacles to quality. Results were analyzed in Excel, and qualitative responses were coded by two researchers together. Main results – There was a 42% (n=21 response rate to the section on metadata quality, a 40% (n=20 response rate to the metadata creation section, and 40% (n=20 to the section on obstacles to quality. The majority of respondents rated their metadata quality as average (65%, n=13 or above average (30%, n=5. No one rated the quality as high or poor, while 10% (n=2 rated the quality as below average. The survey found that the majority of descriptive metadata was created by professional (84%, n=16 or paraprofessional (53%, n=10 library staff. Professional staff were commonly involved in creating administrative metadata, reviewing the metadata, and selecting standards and documentation. Department heads and advisory committees were also involved in standards and documentation
Belich, H.; Louzada, H.L.C. [Universidade Federal do Espirito Santo, Departamento de Fisica e Quimica, Vitoria, ES (Brazil)
We study the gauge sector of the Standard Model Extension (SME) with the Lorentz covariant deformed Heisenberg algebra associated to the minimum length. In order to find and estimate corrections, we clarify whether the violation of Lorentz symmetry and the existence of a minimum length are independent phenomena or are, in some way, related. With this goal, we analyze the dispersion relations of this theory. (orig.)
Belich, H.; Louzada, H. L. C.
We study the gauge sector of the Standard Model Extension (SME) with the Lorentz covariant deformed Heisenberg algebra associated to the minimum length. In order to find and estimate corrections, we clarify whether the violation of Lorentz symmetry and the existence of a minimum length are independent phenomena or are, in some way, related. With this goal, we analyze the dispersion relations of this theory.
... 29 Labor 1 2010-07-01 2010-07-01 true General minimum wage. 4.159 Section 4.159 Labor Office of... General minimum wage. The Act, in section 2(b)(1), provides generally that no contractor or subcontractor... a contract less than the minimum wage specified under section 6(a)(1) of the Fair Labor Standards...
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Minimum investment in capital stock. 931.3... CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL STOCK § 931.3 Minimum investment in capital stock. (a) A Bank shall require each member to maintain a minimum investment in the capital stock of the Bank, both...
CIVINS (Civilian Institutions) Thesis document This report was generated by accepting a report topic contained in a list of topics on the Civil Engineer Corps Graduate School Information web page. The topic request and description is noted as follows: Topic. How to Measure Staffing Requirements in ROICC offices and Other Acquisition Functions with a description. Description: We base current staffing requirements on history and only adjust from what we have used in the past years. It is sus...
Steach, John C.
This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…
Houseman, Susan N.
Use of flexible staffing arrangements--including temporary help agency, short-term, on-call, regular part-time, and contract workers--is widespread and two-thirds of employers believe this trend will increase in the near future. A study examined which employers use flexible staffing arrangements, why they use these arrangements, and their…
Background Understanding the quality loss implications of short staffing is essential in maintaining service quality on a limited budget. Objectives For elaborate financial control on staffing decisions, it is necessary to quantify the cost of the incidental quality loss that a given workload and
Whitebook, Marcy; Howes, Carollee; Phillips, Deborah
In 1988, the National Child Care Staffing Study first gathered information on staffing and quality from a sample of child care centers in five metropolitan areas--Atlanta, Boston, Detroit, Phoenix, and Seattle--and returned for updated information in 1992. In 1997, directors of the original sample of centers still in operation were contacted again…
Krüger, A J; Lossius, H M; Mikkelsen, S
All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...
National Institutes of Health (DHEW), Bethesda, MD. Resources Analysis Branch.
This summary report of staffing patterns in 6 medical schools established between 1952 and 1960 is the first phase of a proposed study of biomedical staffing requirements in institutions of higher education, 1965-1975. The 6 schools are: the University of Miami, Albert Einstein College of medicine at Yeshiva University, the University of Florida,…
.... The Department has determined that workers from Spherion Staffing were sufficiently under the control..., Including On-Site Leased Workers From Manpower and Spherion Staffing, Including On-Site Workers From Hagemeyer North America, Lake Mills, IA; Amended Certification Regarding Eligibility To Apply for Worker...
The staffing for a single-unit AP600 is estimated to require a staff for operation and maintenance about 32% smaller than current generation power plants of similar size. These staffing reductions are driven primarily by various features incorporated into the AP600 plant design. (author)
Bowblis, John R; Roberts, Amy Restorick
Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.
Debora L. Madsen
Full Text Available Institutional repositories (IRs have become established components of many academic libraries. As an IR matures it will face the challenge of how to scale up its operations to increase the amount and types of content archived. These challenges involve staffing, systems, workflows, and promotion. In the past eight years, Kansas State University's IR (K-REx has grown from a platform for student theses, dissertations, and reports to also include faculty works. The initial workforce of a single faculty member was expanded as a part of a library-wide reorganization, resulting in a cross-departmental team that is better able to accommodate the expansion of the IR. The resultant need to define staff responsibilities and develop resources to manage the workflows has led to the innovations described here, which may prove useful to the greater library community as other IRs mature.
... Resources, Inc., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc...., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc., Select Staffing, and... follows: ''All workers of Alternative Management Resources, Inc., Doepker Group, Inc., D.B.A. Time...
..., Inc., Including On-Site Leased Workers From Insight Global Stone Staffing, and Randstad Formerly Known..., Massachusetts, including on-site leased workers from Insight Global, Stone Staffing, Randstad formerly known as... Insight Global, Stone Staffing, Randstad, formerly known as Sapphire Technologies, were employed on-site...
Even, William; Macpherson, David
An in-depth analysis was made of how quickly most people move up the wage scale from minimum wage, what factors influence their progress, and how minimum wage increases affect wage growth above the minimum. Very few workers remain at the minimum wage over the long run, according to this study of data drawn from the 1977-78 May Current Population…
Hughes, Ronda G; Bobay, Kathleen L; Jolly, Nicholas A; Suby, Chrysmarie
This analysis compares the staffing implications of three measures of nurse staffing requirements: midnight census, turnover adjustment based on length of stay, and volume of admissions, discharges and transfers. Midnight census is commonly used to determine registered nurse staffing. Unit-level workload increases with patient churn, the movement of patients in and out of the nursing unit. Failure to account for patient churn in staffing allocation impacts nurse workload and may result in adverse patient outcomes. Secondary data analysis of unit-level data from 32 hospitals, where nursing units are grouped into three unit-type categories: intensive care, intermediate care, and medical surgical. Midnight census alone did not account adequately for registered nurse workload intensity associated with patient churn. On average, units were staffed with a mixture of registered nurses and other nursing staff not always to budgeted levels. Adjusting for patient churn increases nurse staffing across all units and shifts. Use of the discharges and transfers adjustment to midnight census may be useful in adjusting RN staffing on a shift basis to account for patient churn. Nurse managers should understand the implications to nurse workload of various methods of calculating registered nurse staff requirements. © 2013 John Wiley & Sons Ltd.
Kim, Yunmi; You, Sunju; Kim, Jinhyun
This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science
Melber, B.; Roussel, A.; Baker, K.; Durbin, N.; Hunt, P.; Hauth, J.; Forslund, C.; Terrill, E.; Gore, B.
The objective of this report is to identify how decisions are made regarding staffing levels and positions for a sample of U.S. nuclear power plants. In this report, a framework is provided for understanding the major forces driving staffing and the implications of staffing decisions for plant safety. The focus of this report is on driving forces that have led to changes in staffing levels and to the establishment of new positions between the mid-1980s and the early 1990s. Processes used at utilities and nuclear power plants to make and implement these staffing decisions are also discussed in the report. While general trends affecting the plant as a whole are presented, the major emphasis of this report is on staffing changes and practices in the operations department, including the operations shift crew. The findings in this report are based on interviews conducted at seven nuclear power plants and their parent utilities. A discussion of the key findings is followed by a summary of the implications of staffing issues for plant safety
Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob
The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223
Park, Claire Su-Yeon
To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.
Uguzzoni, A.; Gaertner, K.; Lulli, G.; Andersen, J.U.
A first estimate of the minimum yield was obtained from Lindhard's theory, with the assumption of a statistical equilibrium in the transverse phase-space of channeled particles guided by a continuum axial potential. However, computer simulations have shown that this estimate should be corrected by a fairly large factor, C (approximately equal to 2.5), called the Barrett factor. We have shown earlier that the concept of a statistical equilibrium can be applied to understand this result, with the introduction of a constraint in phase-space due to planar channeling of axially channeled particles. Here we present an extended test of these ideas on the basis of computer simulation of the trajectories of 2 MeV α particles in Si. In particular, the gradual trend towards a full statistical equilibrium is studied. We also discuss the introduction of this modification of standard channeling theory into descriptions of the multiple scattering of channeled particles (dechanneling) by a master equation and show that the calculated minimum yields are in very good agreement with the results of a full computer simulation
Mark, Barbara A; Harless, David W; McCue, Michael
While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market.
... Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... ISSUED UNDER AUTHORITY OF THE EXPORT APPLE ACT Regulations § 33.10 Minimum requirements. No person shall... shipment of apples to any foreign destination unless: (a) Apples grade at least U.S. No. 1 or U.S. No. 1...
... 7 Agriculture 2 2010-01-01 2010-01-01 false Minimum quantity. 35.13 Section 35.13 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... part, transport or receive for transportation to any foreign destination, a shipment of 25 packages or...
Marques de Sá, Joaquim P; Santos, Jorge M F; Alexandre, Luís A
This book explains the minimum error entropy (MEE) concept applied to data classification machines. Theoretical results on the inner workings of the MEE concept, in its application to solving a variety of classification problems, are presented in the wider realm of risk functionals. Researchers and practitioners also find in the book a detailed presentation of practical data classifiers using MEE. These include multi‐layer perceptrons, recurrent neural networks, complexvalued neural networks, modular neural networks, and decision trees. A clustering algorithm using a MEE‐like concept is also presented. Examples, tests, evaluation experiments and comparison with similar machines using classic approaches, complement the descriptions.
David Neumark; William Wascher
The primary goal of a national minimum wage floor is to raise the incomes of poor or near-poor families with members in the work force. However, estimates of employment effects of minimum wages tell us little about whether minimum wages are can achieve this goal; even if the disemployment effects of minimum wages are modest, minimum wage increases could result in net income losses for poor families. We present evidence on the effects of minimum wages on family incomes from matched March CPS s...
Maass, Kayse Lee; Liu, Boying; Daskin, Mark S; Duck, Mary; Wang, Zhehui; Mwenesi, Rama; Schapiro, Hannah
Increased nurse-to-patient ratios are associated negatively with increased costs and positively with improved patient care and reduced nurse burnout rates. Thus, it is critical from a cost, patient safety, and nurse satisfaction perspective that nurses be utilized efficiently and effectively. To address this, we propose a stochastic programming formulation for nurse staffing that accounts for variability in the patient census and nurse absenteeism, day-to-day correlations among the patient census levels, and costs associated with three different classes of nursing personnel: unit, pool, and temporary nurses. The decisions to be made include: how many unit nurses to employ, how large a pool of cross-trained nurses to maintain, how to allocate the pool nurses on a daily basis, and how many temporary nurses to utilize daily. A genetic algorithm is developed to solve the resulting model. Preliminary results using data from a large university hospital suggest that the proposed model can save a four-unit pool hundreds of thousands of dollars annually as opposed to the crude heuristics the hospital currently employs.
Sonne, Asger; Wulffeld, Sandra; Steinmetz, Jacob
INTRODUCTION: Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion...
Trinkoff, Alison M; Han, Kihye; Storr, Carla L; Lerner, Nancy; Johantgen, Meg; Gartrell, Kyungsook
The authors examined the relationship of staff turnover to selected nursing home quality outcomes, in the context of staffing and skill mix. Staff turnover is a serious concern in nursing homes as it has been found to adversely affect care. When employee turnover is minimized, better care quality is more likely in nursing homes. Data from the National Nursing Home Survey, a nationally representative sample of US nursing homes, were linked to Nursing Home Compare quality outcomes and analyzed using logistic regression. Nursing homes with high certified nursing assistant turnover had significantly higher odds of pressure ulcers, pain, and urinary tract infections even after controlling for staffing, skill mix, bed size, and ownership. Nurse turnover was associated with twice the odds of pressure ulcers, although this was attenuated when staffing was controlled. This study suggests turnover may be more important in explaining nursing home (NH) outcomes than staffing and skill mix and should therefore be given greater emphasis.
This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...
Donna R. Gillespie
Full Text Available In response to budget cuts in 2002, 4-H staffing models were restructured. The response by University of Idaho Extension was intended to continue meeting the needs of Idaho’s citizens with fewer UI Extension faculty. This staffing reorganization led to the formation of the District III 4-H Team who united to bring stronger 4-H programs to south central Idaho and expand programs to underserved audiences. Information from surveys and interviews over the past seven years reflects the effectiveness, challenges and successes of the District III 4-H Team. In Making the Best Better: 4-H Staffing Patterns and Trends in the Largest Professional Network in the Nation (2007, author Kirk A. Astroth notes a nationwide change in 4-H leadership at the county level from 4-H faculty to program assistants or coordinators. The information gathered in our research may help other states determine staffing models to meet the needs of clientele in these changing times.
Using a Resource-Based Theory/View of the firm, this study examined if increased inpatient staffing levels at military hospitals can generate a competitive advantage based on better patient quality outcomes...
Full Text Available Motivated by call center practice, we study the optimal staffing of many-server queues with impatient and repeat-calling customers. A call center is modeled as an M/M/s+M queue, which is developed to a behavioral queuing model in which customers come and go based on their satisfaction with waiting time. We explicitly take into account customer repeat behavior, which implies that satisfied customers might return and have an impact on the arrival rate. Optimality is defined as the number of agents that maximize revenues net of staffing costs, and we account for the characteristic that revenues are a direct function of staffing. Finally, we use numerical experiments to make certain comparisons with traditional models that do not consider customer repeat behavior. Furthermore, we indicate how managers might allocate staffing optimally with various customer behavior mechanisms.
The potential benefits of higher minimum wages come from the higher wages for affected workers, some of whom are in low-income families. The potential downside is that a higher minimum wage may discourage employers from using the low-wage, low-skill workers that minimum wages are intended to help. Research findings are not unanimous, but evidence from many countries suggests that minimum wages reduce the jobs available to low-skill workers.
Aiken, Linda H; Sloane, Douglas M; Bruyneel, Luk; Van den Heede, Koen; Griffiths, Peter; Busse, Reinhard; Diomidous, Marianna; Kinnunen, Juha; Kózka, Maria; Lesaffre, Emmanuel; McHugh, Matthew D; Moreno-Casbas, M T; Rafferty, Anne Marie; Schwendimann, Rene; Scott, P Anne; Tishelman, Carol; van Achterberg, Theo; Sermeus, Walter
Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. For this observational study, we obtained discharge data for 422,730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26,516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031-1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886-0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared
Department of Transportation — The AEG System is used to create, revise, approve, and distribute text of the MMEL and Flight Standard Board (FSB)/Type Rating Report. The MMEL specifies under what...
Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert
Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.
Lu, Minmin; Ruan, Hui; Xing, Weijie; Hu, Yan
The investigators examined how nurse staffing affects nurse job satisfaction and quality of care. Inadequate nurse staffing is a worldwide issue with profound effects on nurse job satisfaction and quality of care. Few studies have examined the relationship between nurse staffing and job satisfaction and quality of care in China. A cross-sectional design was adopted, wherein 873 nurses were surveyed on demographics, nurse staffing, job-related burnout, job dissatisfaction, intent to leave, and quality of care. The median patient-nurse ratio was five; 45.1% nurses reported high levels of job-related burnout, and 55.6%, job dissatisfaction. In adjusted regression models, patient-nurse ratios of four or less were related to a decrease in the odds of job dissatisfaction (odds ratio 0.55, 95% confidence interval 0.36-0.85) and increase in the odds of quality of care (odds ratio 1.78, 95% confidence interval 1.02-2.82). Nurse staffing is associated with job dissatisfaction and quality of care. Nurse managers should maintain an adequate level of nurse staffing, referring to the patient-nurse ratio. They should create new initiatives to increase job satisfaction among nurses and to evaluate their effects. © 2013 John Wiley & Sons Ltd.
Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert
Background Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result better financial performance, particularly in more competitive markets Purpose In this study we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. Methodology/Approach By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Findings Nurse staffing levels had a positive association with financial performance (β=3.3; p=0.02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Practice Implications Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost cutting measures may be inefficient and negatively affect financial performance. PMID:22543824
Rauch, Simon; Strapazzon, Giacomo; Brodmann, Monika; Fop, Ernst; Masoner, Christian; Rauch, Lydia; Forti, Alessandro; Pietsch, Urs; Mair, Peter; Brugger, Hermann
In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.
... capital and reserve requirements to be issued by order or regulation with respect to a product or activity... minimum capital requirements. Section 1362(a) establishes a minimum capital level for the Enterprises... entities required under this section.\\6\\ \\3\\ The Bank Act's current minimum capital requirements apply to...
As power generators around the world grapple with the challenges of the environment, deregulation, competitions and changing prices of fuels, the economics of running a future power plant are influenced significantly by the component of labour costs. These costs, from plant staff, corporate support and purchased services, will affect the overall plant economics. To achieve improved efficiency and effectiveness of organization structures and staff, vendors and utilities are working jointly to apply lessons learned for future designs. This paper will examine the experience gained to date with Canadian CANDU 6 type reactors both in Canada and abroad. The strategies which have been very successful will be reviewed, together with the results of collaboration between Atomic Energy of Canada and the utilities. An assessment of the staffing numbers is provided as a comparison between current number at a Canadian utility and the projected number from a future plant with the improvements in the design. The influence to the overall plant economics are discussed with some broad generalities that look at the effects of increasing and reducing staff levels showing the probable impact on capacity factor. The lessons from other plants can contribute significantly to the performance improvement process. The paper points to the need for a balanced approach in the future for the distribution of operating maintenance and administration (OM and A) cost between nuclear safety studies; maintenance programs and staff training. In the future, utilities, together with the designers, will have to greatly improve plant maintenance and training. The improved design features detailed in the paper will support this strategy by utilizing operational experience. (author)
Lin, Chiuhsiang Joe; Hsieh, Tsung-Ling; Lin, Shiau-Feng
Highlights: • A staffing evaluation principle was developed for the advanced main control room. • The principle proposed to improve situation awareness and mental workload. • The principle has good validity that was examined by experimental design. - Abstract: Situation awareness and mental workload, both of which influence operator performance in the advanced main control room of a nuclear power plant, can be affected by staffing level. The key goal of staffing is to ensure the proper number of personnel to support plant operations and events. If the staffing level is not adaptive, the operators may have low situation awareness and an excessive mental workload, which lead to human error. Accordingly, this study developed a staffing evaluation principle based on CPM-GOMS modeling for operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation principle. The results indicated that the situation awareness, mental workload, and operating performance of the staffing level determined by the staffing evaluation principle was significantly better than that of the non-evaluated staffing level; thus, the validity of the staffing evaluation technique is acceptable. The implications of the findings of this study on managerial practice are discussed
Simpson, Kathleen Rice; Lyndon, Audrey; Wilson, Jane; Ruhl, Catherine
To solicit input from registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) on critical considerations for review and revision of existing nurse staffing guidelines. Thematic analysis of responses to a cross-sectional on-line survey question: "Please give the staffing task force your input on what they should consider in the development of recommendations for staffing of perinatal units." Members of AWHONN (N = 884). Descriptions of staffing concerns that should be considered when evaluating and revising existing perinatal nurse staffing guidelines. Consistent themes identified included the need for revision of nurse staffing guidelines due to requirements for safe care, increases in patient acuity and complexity, invisibility of the fetus and newborn as separate and distinct patients, difficulties in providing comprehensive care during labor and for mother-baby couplets under current conditions, challenges in staffing small volume units, and the negative effect of inadequate staffing on nurse satisfaction and retention. Participants overwhelmingly indicated current nurse staffing guidelines were inadequate to meet the needs of contemporary perinatal clinical practice and required revision based on significant changes that had occurred since 1983 when the original staffing guidelines were published. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Lin, Chiuhsiang Joe, E-mail: firstname.lastname@example.org [Department of Industrial Management, National Taiwan University of Science and Technology, 43, Section 4, Keelung Road, Taipei 10607, Taiwan (China); Hsieh, Tsung-Ling, E-mail: email@example.com [Institute of Nuclear Energy Research, 1000, Wenhua Road, Chiaan Village, Lungtan 32546, Taiwan (China); Lin, Shiau-Feng, E-mail: firstname.lastname@example.org [Department of Industrial Engineering, Chung-Yuan Christian University, 200, Chung Pei Road, Chung-Li 32023, Taiwan (China)
Highlights: • A staffing evaluation principle was developed for the advanced main control room. • The principle proposed to improve situation awareness and mental workload. • The principle has good validity that was examined by experimental design. - Abstract: Situation awareness and mental workload, both of which influence operator performance in the advanced main control room of a nuclear power plant, can be affected by staffing level. The key goal of staffing is to ensure the proper number of personnel to support plant operations and events. If the staffing level is not adaptive, the operators may have low situation awareness and an excessive mental workload, which lead to human error. Accordingly, this study developed a staffing evaluation principle based on CPM-GOMS modeling for operations in the advanced main control room. A within-subject experiment was designed to examine the validity of the staffing evaluation principle. The results indicated that the situation awareness, mental workload, and operating performance of the staffing level determined by the staffing evaluation principle was significantly better than that of the non-evaluated staffing level; thus, the validity of the staffing evaluation technique is acceptable. The implications of the findings of this study on managerial practice are discussed.
Full Text Available Background Pharmacovigilance (PV data are crucial for ensuring safety and effectiveness of medicines after drugs have been granted marketing approval. This paper describes the PV systems of India, Uganda and South Africa based on literature and Key Informant (KI interviews and compares them with the World Health Organization’s (WHO’s minimum PV requirements for a Functional National PV System. Methods A documentary analysis of academic literature and policy reports was undertaken to assess the medicines regulatory systems and policies in the three countries. A gap analysis from the document review indicated a need for further research in PV. KI interviews covered topics on PV: structure and practices of the system; current regulatory policy; capacity limitations, staffing, funding and training; availability and reporting of data; and awareness and usage of the systems. Twenty interviews were conducted in India, 8 in Uganda and 11 in South Africa with government officials from the ministries of health, national regulatory authorities, pharmaceutical producers, Non-Governmental Organizations (NGOs, members of professional associations and academia. The findings from the literature and KI interviews were compared with WHO’s minimum requirements. Results All three countries were confronted with similar barriers: lack of sufficient funding, limited number of trained staff, inadequate training programs, unclear roles and poor coordination of activities. Although KI interviews represented viewpoints of the respondents, the findings confirmed the documentary analysis of the literature. Although South Africa has a legal requirement for PV, we found that the three countries uniformly lacked adequate capacity to monitor medicines and evaluate risks according to the minimum standards of the WHO. Conclusion A strong PV system is an important part of the overall medicine regulatory system and reflects on the stringency and competence of the regulatory
Full Text Available Although the statutory minimum wage is not a new category, in the Czech Republic we encounter the definition and regulation of a minimum wage for the first time in the 1990 amendment to Act No. 65/1965 Coll., the Labour Code. The specific amount of the minimum wage and the conditions of its operation were then subsequently determined by government regulation in February 1991. Since that time, the value of minimum wage has been adjusted fifteenth times (the last increase was in January 2007. The aim of this article is to present selected results of two researches of acceptance of the statutory minimum wage by Czech enterprises. The first research makes use of the data collected by questionnaire research in 83 small and medium-sized enterprises in the South Moravia Region in 2005, the second one the data of 116 enterprises in the entire Czech Republic (in 2007. The data have been processed by means of the standard methods of descriptive statistics and of the appropriate methods of the statistical analyses (Spearman correlation coefficient of sequential correlation, Kendall coefficient, χ2 - independence test, Kruskal-Wallis test, and others.
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Minimum regulatory capital requirement. 567.2... Regulatory Capital Requirements § 567.2 Minimum regulatory capital requirement. (a) To meet its regulatory capital requirement a savings association must satisfy each of the following capital standards: (1) Risk...
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Minimum angle of antenna elevation. 25.205 Section 25.205 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.205 Minimum angle of antenna elevation. (a) Earth station...
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Minimum liquidity requirements. 932.8 Section... CAPITAL STANDARDS FEDERAL HOME LOAN BANK CAPITAL REQUIREMENTS § 932.8 Minimum liquidity requirements. In addition to meeting the deposit liquidity requirements contained in § 965.3 of this chapter, each Bank...
Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane
To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. Seventy-five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.
Yoo, E J; Damaghi, N; Shakespeare, W G; Sherman, M S
Although evidence supports the impact of intensivist physician staffing in improving intensive care unit (ICU) outcomes, the optimal coverage for progressive care units (PCU) is unknown. We sought to determine how physician staffing models influence outcomes for intermediate care patients. We conducted a retrospective observational comparison of patients admitted to the medical PCU of an academic hospital during 12-month periods of high-intensity and low-intensity staffing. A total of 318 PCU patients were eligible for inclusion (143 high-intensity and 175 low-intensity). We found that low-intensity patients were more often stepped up from the emergency department and floor, whereas high-intensity patients were ICU transfers (61% vs 42%, P = .001). However, Mortality Probability Model scoring was similar between the 2 groups. In adjusted analysis, there was no association between intensity of staffing and hospital mortality (odds ratio, 0.84; 95% confidence interval, 0.36-1.99; P = .69) or PCU mortality (odds ratio, 0.96; 95% confidence interval, 0.38-2.45; P = .69). There was also no difference in subsequent ICU admission rates or in PCU length of stay. We found no evidence that high-intensity intensivist physician staffing improves outcomes for intermediate care patients. In a strained critical care system, our study raises questions about the role of the intensivist in the graded care options between intensive and conventional ward care. Copyright © 2015 Elsevier Inc. All rights reserved.
Patrician, Patricia A; Loan, Lori A; McCarthy, Mary S; Swiger, Pauline; Breckenridge-Sproat, Sara; Brosch, Laura Ruse; Jennings, Bonnie Mowinski
Two decades ago, findings from an Institute of Medicine (IOM) report sparked the urgent need for evidence supporting relationships between nurse staffing and patient outcomes. This article provides an overview of nurse staffing, practice environment, and patient outcomes research, with an emphasis on findings from military studies. Lessons learned also are enumerated. This study is a review of the entire Military Nursing Outcomes Database (MilNOD) program of research. The MilNOD, in combination with evidence from other health care studies, provides nurses and leaders with information about the associations between staffing, patient outcomes, and the professional practice environment of nursing in the military. Leaders, therefore, have useful empirical evidence to make data-driven decisions. The MilNOD studies are the basis for the current Army nursing dashboard, and care delivery framework, called the Patent CaringTouch System. Future research is needed to identify ideal staffing based on workload demands, and provide leaders with factors to consider when operationalizing staffing recommendations. Copyright © 2017 Elsevier Inc. All rights reserved.
Manheim, L M; Shortell, S M; McFall, S
Much concern has been raised about the effect of "corporatization" of health through the expansion of investor-owned hospital chains. One method of expansion is through hospital acquisition. At issue is the question of the effect of acquisitions on expenses and on such patient care inputs as staffing levels. In this article, we examine the effect of acquisition by one investor-owned chain on hospital costs and staffing. Subsequent to acquisition, hospital costs increase and staffing decreases, relative to competitor hospitals. However, since investor-owned hospitals not recently acquired do not have higher cost levels than their competitors, the increase in costs appears to be due to factors associated with the acquisition itself rather than factors associated with being an investor-owned hospital. Under the retrospective payment system in effect at the time, revenues also were higher for acquired hospitals. Under prospective payment, increasing revenues has been more difficult, decreasing acquisition incentives. PMID:2807933
Shin, Juh Hyun; Hyun, Ta Kyung
To investigate the relationship between nurse staffing and quality of care in nursing homes in Korea. This study used a cross-sectional design to describe the relationship between nurse staffing and 15 quality-of-care outcomes. Independent variables were hours per resident day (HPRD), skill mix, and turnover of each nursing staff, developed with the definitions of the Centers for Medicare & Medicaid Services and the American Health Care Association. Dependent variables were prevalence of residents who experienced more than one fall in the recent 3 months, aggressive behaviors, depression, cognitive decline, pressure sores, incontinence, prescribed antibiotics because of urinary tract infection, weight loss, dehydration, tube feeding, bed rest, increased activities of daily living, decreased range of motion, use of antidepressants, and use of restraints. Outcome variables were quality indicators from the U.S. Centers for Medicare & Medicaid and 2013 nursing home evaluation manual by the Korean National Health Insurance Service. The effects of registered nurse (RN) HPRD was supported in fall prevention, decreased tube feeding, decreased numbers of residents with deteriorated range of motion, and decreased aggressive behavior. Higher turnover of RNs related to more residents with dehydration, bed rest, and use of antipsychotic medication. Study results supported RNs' unique contribution to resident outcomes in comparison to alternative nurse staffing in fall prevention, decreased use of tube feeding, better range of motion for residents, and decreased aggressive behaviors in nursing homes in Korea. More research is required to confirm the effects of nurse staffing on residents' outcomes in Korea. We found consistency in the effects of RN staffing on resident outcomes acceptable. By assessing nurse staffing levels and compositions of nursing staffs, this study contributes to more effective long-term care insurance by reflecting on appropriate policies, and ultimately
Melber, B.; Hauth, J.; Terrill, E.; Berk, B.; Gore, B.
In this report an international review of regulatory and industry practices is provided in the area of nuclear power plant staffing during the 1980s in Canada, France, Germany, Japan, Sweden, and the United Kingdom. The objective of this review is to highlight trends in staffing regulatory approaches, industry practices, and issues of concern in other countries that have potential relevance to nuclear power plant staffing issues in the United States. The decade of the 1980s was marked by a great deal of growth in nuclear power operations internationally; however, growth of nuclear power is not expected to continue in the 1990s except in France and Japan. A continuum of regulatory approaches to staffing was identified, ranging from prescribed regulations that are applied to all licensees (Germany is most similar to the United States in this regard), to indirect staffing regulations where the regulatory authority oversees plant operating practices that are agreed to in the plant operating license (most notably, France and the United Kingdom). Most of the changes observed in staffing regulations and practices in the early 1980s were made in response to the accident at the Three Mile Island Unit 2 nuclear power plant (TMI) in 1979. These changes included the widespread issuance of new operator and licensing requirements and the establishment of national training centers. After the post-TMI changes were implemented, a period of relative stability followed. Changes in the latter half of the 1980s have focused on continuing improvements and additions to training curricula and methods, most notably increased reliance on simulator training
Konetzka, R Tamara; Yi, Deokhee; Norton, Edward C; Kilpatrick, Kerry E
To investigate the effects of Medicare's Prospective Payment System (PPS) for skilled nursing facilities (SNFs) and associated rate changes on quality of care as represented by staffing ratios and regulatory deficiencies. Online Survey, Certification and Reporting (OSCAR) data from 1996-2000 were linked with Area Resource File (ARF) and Medicare Cost Report data to form a panel dataset. A difference-in-differences model was used to assess effects of the PPS and the BBRA (Balanced Budget Refinement Act) on staffing and deficiencies, a design that allows the separation of the effects of the policies from general trends. Ordinary least squares and negative binomial models were used. The OSCAR and Medicare Cost Report data are self-reported by nursing facilities; ARF data are publicly available. Data were linked by provider ID and county. We find that professional staffing decreased and regulatory deficiencies increased with PPS, and that both effects were mitigated with the BBRA rate increases. The effects appear to increase with the percent of Medicare residents in the facility except, in some cases, at the highest percentage of Medicare. The findings on staffing are statistically significant. The effects on deficiencies, though exhibiting consistent signs and magnitudes with the staffing results, are largely insignificant. Medicare's PPS system and associated rate cuts for SNFs have had a negative effect on staffing and regulatory compliance. Further research is necessary to determine whether these changes are associated with worse outcomes. Findings from this investigation could help guide policy modifications that support the provision of quality nursing home care.
Quinn, T. A.; Granite, S.; Allessie, M. A.; Antzelevitch, C.; Bollensdorff, C.; Bub, G.; Burton, R. A. B.; Cerbai, E.; Chen, P. S.; Delmar, M.; DiFrancesco, D.; Earm, Y. E.; Efimov, I. R.; Egger, M.; Entcheva, E.; Fink, M.; Fischmeister, R.; Franz, M. R.; Garny, A.; Giles, W. R.; Hannes, T.; Harding, S. E.; Hunter, P. J.; Iribe, G.; Jalife, J.; Johnson, C. R.; Kass, R. S.; Kodama, I.; Koren, G.; Lord, P.; Markhasin, V. S.; Matsuoka, S.; McCulloch, A. D.; Mirams, G. R.; Morley, G. E.; Nattel, S.; Noble, D.; Olesen, S. P.; Panfilov, A. V.; Trayanova, N. A.; Ravens, U.; Richard, S.; Rosenbaum, D. S.; Rudy, Y.; Sachs, F.; Sachse, F. B.; Saint, D. A.; Schotten, U.; Solovyova, O.; Taggart, P.; Tung, L.; Varró, A.; Volders, P. G.; Wang, K.; Weiss, J. N.; Wettwer, E.; White, E.; Wilders, R.; Winslow, R. L.; Kohl, P.
Cardiac experimental electrophysiology is in need of a well-defined Minimum Information Standard for recording, annotating, and reporting experimental data. As a step towards establishing this, we present a draft standard, called Minimum Information about a Cardiac Electrophysiology Experiment
Robinson, Claire H; Annis, Ann M; Forman, Jane; Krein, Sarah L; Yankey, Nicholas; Duffy, Sonia A; Taylor, Beth; Sales, Anne E
To assess implementation of the Veterans Health Administration staffing methodology directive. In 2010 the Veterans Health Administration promulgated a staffing methodology directive for inpatient nursing units to address staffing and budget forecasting. A qualitative multi-case evaluation approach assessed staffing methodology implementation. Semi-structured telephone interviews were conducted from March - June 2014 with Nurse Executives and their teams at 21 facilities. Interviews focused on the budgeting process, implementation experiences, use of data, leadership support, and training. An implementation score was created for each facility using a 4-point rating scale. The scores were used to select three facilities (low, medium and high implementation) for more detailed case studies. After analysing interview summaries, the evaluation team developed a four domain scoring structure: (1) integration of staffing methodology into budget development; (2) implementation of the Directive elements; (3) engagement of leadership and staff; and (4) use of data to support the staffing methodology process. The high implementation facility had leadership understanding and endorsement of staffing methodology, confidence in and ability to work with data, and integration of staffing methodology results into the budgeting process. The low implementation facility reported poor leadership engagement and little understanding of data sources and interpretation. Implementation varies widely across facilities. Implementing staffing methodology in facilities with complex and changing staffing needs requires substantial commitment at all organizational levels especially for facilities that have traditionally relied on historical levels to budget for staffing. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.
Hesselfeldt, R; Steinmetz, J; Jans, H
This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients.......This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients....
Funder, Kamilia S; Rasmussen, L.S.; Hesselfeldt, R
BACKGROUND: Implementation of a physician-staffed helicopter emergency medical service (PS-HEMS) in Denmark was associated with lower 30-day mortality in severely injured trauma patients and less time on social subsidy. However, the reduced 30-day mortality in severely injured patients might...... be at the expense of a worse functional outcome and quality of life (QoL) in those who survive. The aim of this study was to investigate the effect of a physician-staffed helicopter on long-term QoL in trauma patients. METHODS: Prospective, observational study including trauma patients who survived at least 3 years...
Nims, Julia K; Stevens, Robert
Reference service remains a core function of modern libraries. However, how and where we provide assistance has evolved with changing technologies and the shifting habits and preferences of our users. One way libraries can provide the on-demand, in-person assistance while managing and developing new services and resources that will benefit current and future users is to reconsider how their reference points and services are staffed and adopt a staff-based reference model. In Implementing an Inclusive Staffing Model for Today's Reference Services, Nims, Storm, and Stevens describe step-by-step
The purpose of this safety guide is to provide recommendations for national authorities on the appropriate management system, organization and staffing for the regulatory body responsible for the regulation of nuclear facilities in order to achieve compliance with the applicable safety requirements. This safety guide covers the organization and staffing in relation to nuclear facilities such as: enrichment and fuel manufacturing plants. Nuclear power plants. Other reactors such as research reactors and critical assemblies. Spent fuel reprocessing plants. And radioactive waste management facilities such as treatment, storage and disposal facilities. This safety guide also covers issues related to the decommissioning of nuclear facilities, the closure of waste disposal facilities and site rehabilitation
... organization table, including: (a) The structure and composition of the Board of Directors of the RLF; (b) The... 45 Public Welfare 4 2010-10-01 2010-10-01 false Staffing and organization of the Revolving Loan... Hawaiian Revolving Loan Fund Demonstration Project § 1336.65 Staffing and organization of the Revolving...
New research needs, global developments and local shifts in emphasis are demanding a broader range of interactions by librarians with researchers and are challenging previous staffing structures. Research has a higher institutional profile and academic libraries have responded by creating new roles and staffing models, with stronger linkage across…
... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,014] Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing, Hawkins, WI; Notice of Negative...., Hawkins Window Division, including on-site leased workers of Nicolet Staffing, Hawkins, Wisconsin. Signed...
Kanda, Katsuya; Mezey, Mathy
Examined changes in resident acuity and registered nurse staffing in all nursing homes in Pennsylvania before and after introduction of Medicare Prospective Payment System (PPS) in 1983. Found that acuity of nursing home residents increased significantly since introduction of PPS, full-time registered nurse staffing remained unchanged, and…
Houseman, Susan N.
Workers in flexible staffing arrangementsincluding temporary agency, direct-hire temporary, on-call, and contract workersare much less likely than regular, direct-hire employees to be covered by laws mandating or regulating workplace benefits. They are also much less likely to receive pension, health insurance, and other benefits on the job.…
Liao, S.; van Delft, C.; Jouini, O.; Koole, G.M.
We consider a multi-period staffing problem in a single-shift call center. The call center handles inbound calls, as well as some alternative back-office jobs. The call arrival process is assumed to follow a doubly non-stationary stochastic process with a random mean arrival rate. The inbound calls
The article presents the goals, methods, and case examples of The Nutury, a predominantly male-staffed child care center serving single-parent children. The primary goal is to provide consistent relationships with men for children without a male model in their home. Clinical observations reveal positive life-styles and attitudes. (LPG)
Au, M.L.; DiSalvo, R.; Merschoff, E.
The report is a compilation of the data obtained from a survey of foreign nuclear power plant operator requirements. Included among the considerations are: (1) shift staffing; (2) operator eligibility; (3) operator training programs; (4) operator licensing or certification; and (5) operator retraining. The data obtained from this survey are presented in matrix form and contrasted with U.S. requirements
... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... refrigerators and trash compactors. The notice was published in the Federal Register on October 25, 2010 (75 FR...
... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... workers are engaged in the production of refrigerators and trash compactors. The notice was published in...
Experience from well operated nuclear power plants (NPPs) around the world indicates that an organizational structure which efficiently supports plant operation is essential in economically achieving both high level of safety and operational performance. At the same time energy markets are being opened to competition in many Member States. It is in consideration of this new competitive energy market that the overall objective of this document is to provide NPP managers information on lessons learned on improving the organization and staffing of NPP activities. Within this overall objective, specific objectives are to: Identify organisational design and staffing principles, Provide examples of how NPPs implement these principles, Identify typical NPP staffing levels, Factors affecting these levels, and staffing trends among various NPP types. Although it is not expected that any particular utility or NPP manager would consider all of the suggestions provided here to be appropriate, it is anticipated that nearly every NPP manager in IAEA Member States would find some ideas useful in improving the efficiency and effectiveness of NPP activities
Safety of public, occupational workers and the protection of environment should be assured while activities for economic and social progress are pursued. These activities include the establishment and utilisation of nuclear facilities and the use of radioactive sources. This safety guide provides guidance on the aspects of staffing, recruitment, training, qualification and certification of operating personnel of nuclear power plants
Felce, D.; Perry, J.
Background: There is little evidence to guide the commissioning of residential provision for adults with autistic spectrum disorder (ASD) in the UK. We aim to explore the degree and impact of diagnostic congregation among adults with intellectual disabilities (ID) and ASD living in staffed housing. Methods: One hundred and fifty-seven adults with…
North, Nicola; Leung, William; Ashton, Toni; Rasmussen, Erling; Hughes, Frances; Finlayson, Mary
To determine the rates and costs of nurse turnover, the relationships with staffing practises, and the impacts on outcomes for nurses and patients. In the context of nursing shortages, information on the rates and costs of nursing turnover can improve nursing staff management and quality of care. Quantitative and qualitative data were collected prospectively for 12 months. A re-analysis of these data used descriptive statistics and correlational analysis techniques. The cost per registered nurse turnover represents half an average salary. The highest costs were related to temporary cover, followed by productivity loss. Both are associated with adverse patient events. Flexible management of nursing resources (staffing below budgeted levels and reliance on temporary cover), and a reliance on new graduates and international recruitment to replace nurses who left, contributed to turnover and costs. Nurse turnover is embedded in staffing levels and practises, with costs attributable to both. A culture of turnover was found that is inconsistent with nursing as a knowledge workforce. Nurse managers did not challenge flexible staffing practices and high turnover rates. Information on turnover and costs is needed to develop strategies that retain nurses as knowledge-based workers. © 2012 Blackwell Publishing Ltd.
In fall of 2011 the University at Buffalo Libraries circulation department undertook Six Sigma training for the purpose of overhauling its student scheduling process. The department was able to mitigate significant staffing budgetary reductions and resource reallocations and to overcome the unique challenges of scheduling student labor for a…
Christopher E. Pelt, MD
Conclusions: A relatively simple change to staffing hours, using resources currently available to us, and little additional financial or institutional investment resulted in a significant improvement in the number of patients ambulating on POD 0, with a modest reduction in both LOS and inpatient costs.
Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin
In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…
... Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working On-Site at Tyler Pipe... MDS Industrial Resources, Inc., working on-site at Tyler Pipe Company, Waterworks Division, South... Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., working on-site at Tyler Pipe...
Tuck, Kathy D.; Holmes, Dwight R.
At the request of New Business Item: 89 (NBI: 89) adopted at the 2015 NEA Representative Assembly, this study examines the extent to which students have access to public school library/media centers with qualified staff and up-to-date resources. The study explores trends in library/media center openings and closings as well as staffing patterns…
Roberts, Amy Restorick; Bowblis, John R
Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009-2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed. © 2016 National Association of Social Workers.
American Federation of Teachers (NJ), 2008
Over the last generation, the instructional staffing system in American higher education has experienced a significant reduction in the proportion of jobs for full-time tenured and tenure-track faculty members and a dramatic growth in fixed-term full- and part-time instructional jobs without tenure. About 70 percent of the people teaching in…
Horstmann, S; Rizos, T; Güntner, J; Hug, A; Jenetzky, E; Krumsdorf, U; Veltkamp, R
Detecting paroxysmal atrial fibrillation (pAF) soon after acute cerebral ischaemia has a major impact on secondary stroke prevention. Recently, the STAF score, a composite of clinical and instrumental findings, was introduced to identify stroke patients at risk of pAF. We aimed to validate this score in an independent study population. Consecutive patients admitted to our stroke unit with acute ischaemic stroke were prospectively enrolled. The diagnostic work-up included neuroimaging, neuroultrasound, baseline 12-channel electrocardiogram (ECG), 24-h Holter ECG, continuous ECG monitoring, and echocardiography. Presence of AF was documented according to the medical history of each patient and after review of 12-lead ECG, 24-h Holter ECG, or continuous ECG monitoring performed during the stay on the ward. Additionally, a telephone follow-up visit was conducted for each patient after 3 months to inquire about newly diagnosed AF. Items for each patient-age, baseline NIHSS, left atrial dilatation, and stroke etiology according to the TOAST criteria - were assessed to calculate the STAF score. Overall, 584 patients were enrolled in our analysis. AF was documented in 183 (31.3%) patients. In multivariable analysis, age, NIHSS, left atrial dilatation, and absence of vascular etiology were independent predictors for AF. The logistic AF-prediction model of the STAF score revealed fair classification accuracy in receiver operating characteristic curve analysis with an area under the curve of 0.84. STAF scores of ≥5 had a sensitivity of 79% and a specificity of 74% for predicting AF. The value of the STAF score for predicting the risk of pAF in stroke patients is limited. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.
Krogh, Paul; Ernster, Jason; Knoer, Scott
The creation and implementation of data-driven staffing-to-demand models at two institutions are described. Predictive workload tools provide a guideline for pharmacy managers to adjust staffing needs based on hospital volume metrics. At Abbott Northwestern Hospital, management worked with the department's staff and labor management committee to clearly outline the productivity monitoring system and the process for reducing hours. Reference charts describing the process for reducing hours and a form to track the hours of involuntary reductions for each employee were created to further enhance communication, explain the rationale behind the new process, and promote transparency. The University of Minnesota Medical Center-Fairview, found a strong correlation between measured pharmacy workload and an adjusted census formula. If the daily census and admission report indicate that the adjusted census will provide enough workload for the fully staffed department, no further action is needed. If the census report indicates the adjusted census is less than the breakeven point, staff members are asked to leave work, either voluntarily or involuntarily. The opposite holds true for days when the adjusted census is higher than the breakeven point, at which time additional staff are required to synchronize worked hours with predicted workload. Successful staffing-to- demand models were implemented in two hospital pharmacies. Financial savings, as indicated by decreased labor costs secondary to reduction of staffed shifts, were approximately $42,000 and $45,500 over a three-month period for Abbott Northwestern Hospital and the University of Minnesota Medical Center-Fairview, respectively. Maintenance of 100% productively allowed the departments to continue to replace vacant positions and avoid permanent staff reductions.
Yilmaz, P.; Kottmann, R.; Field, D.; Knight, R.; Cole, J.R.; Amaral-Zettler, L.; Gilbert, J.A.; Karsch-Mizrachi, I.; Johnston, A.; Cochrane, G.; Vaughan, R.; Hunter, C.; Park, J.; Morrison, N.; Rocca-Serra, P.; Sterk, P.; Arumugam, M.; Baumgartner, L.; Birren, B.W.; Blaser, M.J.; Bonazzi, V.; Bork, P.; Buttigieg, P. L.; Chain, P.; Costello, E.K.; Huot-Creasy, H.; Dawyndt, P.; DeSantis, T.; Fierer, N.; Fuhrman, J.; Gallery, R.E.; Gibbs, R.A.; Giglio, M.G.; Gil, I. San; Gonzalez, A.; Gordon, J.I.; Guralnick, R.; Hankeln, W.; Highlander, S.; Hugenholtz, P.; Jansson, J.; Kennedy, J.; Knights, D.; Koren, O.; Kuczynski, J.; Kyrpides, N.; Larsen, R.; Lauber, C.L.; Legg, T.; Ley, R.E.; Lozupone, C.A.; Ludwig, W.; Lyons, D.; Maguire, E.; Methe, B.A.; Meyer, F.; Nakieny, S.; Nelson, K.E.; Nemergut, D.; Neufeld, J.D.; Pace, N.R.; Palanisamy, G.; Peplies, J.; Peterson, J.; Petrosino, J.; Proctor, L.; Raes, J.; Ratnasingham, S.; Ravel, J.; Relman, D.A.; Assunta-Sansone, S.; Schriml, L.; Sodergren, E.; Spor, A.; Stombaugh, J.; Tiedje, J.M.; Ward, D.V.; Weinstock, G.M.; Wendel, D.; White, O.; Wikle, A.; Wortman, J.R.; Glockner, F.O.; Bushman, F.D.; Charlson, E.; Gevers, D.; Kelley, S.T.; Neubold, L.K.; Oliver, A.E.; Pruesse, E.; Quast, C.; Schloss, P.D.; Sinha, R.; Whitely, A.
We present the Genomic Standards Consortium's (GSC) 'Minimum Information about an ENvironmental Sequence' (MIENS) standard for describing marker genes. Adoption of MIENS will enhance our ability to analyze natural genetic diversity across the Tree of Life as it is currently being documented by massive DNA sequencing efforts from myriad ecosystems in our ever-changing biosphere.
Yilmaz, Pelin; Kottmann, Renzo; Field, Dawn
Here we present a standard developed by the Genomic Standards Consortium (GSC) for reporting marker gene sequences--the minimum information about a marker gene sequence (MIMARKS). We also introduce a system for describing the environment from which a biological sample originates. The 'environment...
Karim, Mohd Zaini Abd; Chan, Sok-Gee; Hassan, Sallahuddin
Recently, the government has decided that Malaysia would introduce a minimum wage policy. However, some quarters argued against the idea of a nationwide minimum wage asserting that it will lead to an increase in the cost of doing business and thus will hurt Malaysian competitiveness. Although standard economic theory unambiguously implies that wage floors have a negative impact on employment, the existing empirical literature is not so clear. Some studies have found the expected negative impa...
... 29 Labor 3 2010-07-01 2010-07-01 false Industries eligible for minimum wage phase-in. 510.22... REGULATIONS IMPLEMENTATION OF THE MINIMUM WAGE PROVISIONS OF THE 1989 AMENDMENTS TO THE FAIR LABOR STANDARDS ACT IN PUERTO RICO Classification of Industries § 510.22 Industries eligible for minimum wage phase-in...
Kim, Youngsang; Ployhart, Robert E
This study integrates research from strategy, economics, and applied psychology to examine how organizations may leverage their human resources to enhance firm performance and competitive advantage. Staffing and training are key human resource management practices used to achieve firm performance through acquiring and developing human capital resources. However, little research has examined whether and why staffing and training influence firm-level financial performance (profit) growth under different environmental (economic) conditions. Using 359 firms with over 12 years of longitudinal firm-level profit data, we suggest that selective staffing and internal training directly and interactively influence firm profit growth through their effects on firm labor productivity, implying that staffing and training contribute to the generation of slack resources that help buffer and then recover from the effects of the Great Recession. Further, internal training that creates specific human capital resources is more beneficial for prerecession profitability, but staffing is more beneficial for postrecession recovery, apparently because staffing creates generic human capital resources that enable firm flexibility and adaptation. Thus, the theory and findings presented in this article have implications for the way staffing and training may be used strategically to weather economic uncertainty (recession effects). They also have important practical implications by demonstrating that firms that more effectively staff and train will outperform competitors throughout all pre- and postrecessionary periods, even after controlling for prior profitability. (c) 2014 APA, all rights reserved.
Kim, O. S.
Theoretically, the minimum radiation quality factor Q of an isolated resonance can be achieved in a spherical electrically small antenna by combining TM1m and TE1m spherical modes, provided that the stored energy in the antenna spherical volume is totally suppressed. Using closed-form expressions...... for a multiarm spherical helix antenna confirm the theoretical predictions. For example, a 4-arm spherical helix antenna with a magnetic-coated perfectly electrically conducting core (ka=0.254) exhibits the Q of 0.66 times the Chu lower bound, or 1.25 times the minimum Q....
Ms, Suzie Aparicio; Welch Bacon, Cailee E; Parsons, John T; Bay, R Curtis; Cohen, Randy P; DeZeeuw, Terry; McLeod, Tamara C Valovich
The "Appropriate Medical Coverage for Intercollegiate Athletics" (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Cross-sectional study. Web-based survey. Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1-3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured
Gallucci, Andrew R; Petersen, Jeffrey C
Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified. To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition. Cross-sectional study. Web-based survey. Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs. Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students. The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft 2 (290.3 ± 411 m 2 ) for the central athletic training facility, 1013 ± 1521 ft 2 (94 ± 141 m 2 ) for satellite athletic training facilities, 1272 ± 1334 ft 2 (118 ± 124 m 2 ) for game-day athletic training facilities, 388 ± 575 ft 2 (36 ± 53 m 2 ) for athletic training offices, and 424 ± 884 ft 2 (39 ± 82 m 2 ) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P facilities in recent years was common, and almost half of ATs reported that upgrades have been approved for the near future. This study provides benchmark descriptive data on athletic training staffing and
MS, Suzie Aparicio; Welch Bacon, Cailee E.; Parsons, John T.; Bay, R. Curtis; Cohen, Randy P.; DeZeeuw, Terry; McLeod, Tamara C. Valovich
Context The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. Objective To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. Main Outcome Measure(s) The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. Results The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). Conclusions The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their
Arguably, least action and minimum principles were offered or applied much earlier. This (or these) principle(s) is/are among the fundamental, basic, unifying or organizing ones used to describe a variety of natural phenomena. It considers the amount of energy expended in performing a given action to be the least required ...
Andersen, J.; Lessow, H; Schjær-Jacobsen, Hans
Coupling between minimum scattering antennas (MSA's) is investigated by the coupling theory developed by Wasylkiwskyj and Kahn. Only rotationally symmetric power patterns are considered, and graphs of relative mutual impedance are presented as a function of distance and pattern parameters. Crossed...
Haas, Sheila A; Vlasses, Frances; Havey, Julia
There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.
Isambert, Aurelie; Valero, Marc; Rousse, Carole; Blanchard, Vincent; Le Du, Dominique; Guilhem, Marie-Therese; Dieudonne, Arnaud; Pierrat, Noelle; Salvat, Cecile
The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. (authors)
Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile
The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Full Text Available Resource allocation could be influenced by various dynamic elements, such as the skills of engineers and the growth of skills, which requires managers to find an effective and efficient tool to support their staffing decision-making processes. Rescheduling happens commonly and frequently during the project execution. Control options have to be made when new resources are added or tasks are changed. In this paper we propose a software project staffing model considering dynamic elements of staff productivity with a Genetic Algorithm (GA and Hill Climbing (HC based optimizer. Since a newly generated reschedule dramatically different from the initial schedule could cause an obvious shifting cost increase, our rescheduling strategies consider both efficiency and stability. The results of real world case studies and extensive simulation experiments show that our proposed method is effective and could achieve comparable performance to other heuristic algorithms in most cases.
Janssens, Pim M. W.; Thorn, Petra; Castilla, Jose A.; Frith, Lucy; Crawshaw, Marilyn; Mochtar, Monique; Bjorndahl, Lars; Kvist, Ulrik; Kirkman-Brown, Jackson C.
An international working group was established with the aim of making recommendations on the number of offspring for a sperm donor that should be allowable in cases of international use of his sperm. Considerations from genetic, psychosocial, operational and ethical points of view were debated. For
...://www.archives.gov/federal_register/code_of_federal_regulations/ibr_locations.html; (ii) The product is... exposure must be expressed as total train miles traveled per year over the relevant railroad infrastructure...
The free movement of judgments in the European Area of Justice presupposes a high level of mutual trust between the judiciaries of the Member States. From the citizens' perspective, the key issue is the balancing of the fundamental rights of claimants and defendants, i.e. the right of access to
... requested CA gender when a call is initiated and, if a transfer occurs, at the time the call is transferred...) Relay services shall be capable of handling pay-per-call calls. (v) TRS providers are required to... calculation. (3) Equal access to interexchange carriers. TRS users shall have access to their chosen...
... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE DRIED PRUNES PRODUCED IN... handled fruit of a given variety or type. (2) Inferior meat condition means flesh which is fibrous, woody... excessive heat in dehydration to the extent that the characteristic appearance, flavor or edibility of the...
Goryakin, Yevgeniy; Griffiths, Peter; Maben, Jill
Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provided care. Therefore, we conducted a scoping literature review of economic evaluation studies which consider the link between nurse staffing, skill mix within the nursing team and between nurses and other medical staff to determine the nature of the available economic evidence. Scoping literature review. English-language manuscripts, published between 1989 and 2009, focussing on the relationship between costs and effects of care and the level of registered nurse staffing or nurse-physician substitution/nursing skill mix in the clinical team, using cost-effectiveness, cost-utility, or cost-benefit analysis. Articles selected for the review were identified through Medline, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and Google Scholar database searches. After selecting 17 articles representing 16 unique studies for review, we summarized their main findings, and assessed their methodological quality using criteria derived from recommendations from the guidelines proposed by the Panel on Cost-Effectiveness in Health Care. In general, it was found that nurses can provide cost effective care, compared to other health professionals. On the other hand, more intensive nurse staffing was associated with both better outcomes and more expensive care, and therefore cost effectiveness was not easy to assess. Although considerable progress in economic evaluation studies has been reached in recent years, a number of methodological issues remain. In the future
Griffiths, P; Goryakin, Y.; Maben, J.
OBJECTIVE: Several systematic reviews have suggested that greater nurse staffing as well as a greater proportion of registered nurses in the health workforce is associated with better patient outcomes. Others have found that nurses can substitute for doctors safely and effectively in a variety of settings. However, these reviews do not generally consider the effect of nurse staff on both patient outcomes and costs of care, and therefore say little about the cost-effectiveness of nurse-provide...
Dolinska, Nina; Hrlovic, Dzenita; Swane, Katarina
Increasing production costs and high pressure from the consumers are leading Swedish companies towards an expansion to China. Since more and more companies are moving their production, we found it interesting to study the problems they might encounter while employing personnel. The purpose of this dissertation is to analyse what staffing policies companies choose and variables that influence the decision at Swedish production plants in China. Ethnocentric, polycentric and geocentric polic...
Cho, Eunhee; Sloane, Douglas M; Kim, Eun-Young; Kim, Sera; Choi, Miyoung; Yoo, Il Young; Lee, Hye Sun; Aiken, Linda H
While considerable evidence has been produced showing a link between nursing characteristics and patient outcomes in the U.S. and Europe, little is known about whether similar associations are present in South Korea. To examine the effects of nurse staffing, work environment, and education on patient mortality. This study linked hospital facility data with staff nurse survey data (N=1024) and surgical patient discharge data (N=76,036) from 14 high-technology teaching hospitals with 700 or more beds in South Korea, collected between January 1, 2008 and December 31, 2008. Logistic regression models that corrected for the clustering of patients in hospitals were used to estimate the effects of the three nursing characteristics on risk-adjusted patient mortality within 30 days of admission. Risk-adjusted models reveal that nurse staffing, nurse work environments, and nurse education were significantly associated with patient mortality (OR 1.05, 95% CI 1.00-1.10; OR 0.52, 95% CI 0.31-0.88; and OR 0.91, CI 0.83-0.99; respectively). These odds ratios imply that each additional patient per nurse is associated with an 5% increase in the odds of patient death within 30 days of admission, that the odds of patient mortality are nearly 50% lower in the hospitals with better nurse work environments than in hospitals with mixed or poor nurse work environments, and that each 10% increase in nurses having Bachelor of Science in Nursing Degree is associated with a 9% decrease in patient deaths. Nurse staffing, nurse work environments, and percentages of nurses having Bachelor of Science in Nursing Degree in South Korea are associated with patient mortality. Improving hospital nurse staffing and work environments and increasing the percentages of nurses having Bachelor of Science in Nursing Degree would help reduce the number of preventable in-hospital deaths. Copyright © 2014 Elsevier Ltd. All rights reserved.
Weiss, Manfred; Marx, Gernot; Iber, Thomas
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society of Anesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.
Nantsupawat, Apiradee; Srisuphan, Wichit; Kunaviktikul, Wipada; Wichaikhum, Orn-Anong; Aungsuroch, Yupin; Aiken, Linda H
To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. Secondary data analysis of the 2007 Thai Nurse Survey. The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care. Nurses cared for an average of 10 patients each. Forty-one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00-1.03; p work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48-0.98; p work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02-1.05; p work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care. Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world. © 2011 Sigma Theta Tau International.
Hagopian, Amy; Mohanty, Manmath K; Das, Abhijit; House, Peter J
In one district of Orissa state, we used the World Health Organization's Workforce Indicators of Staffing Need (WISN) method to calculate the number of health workers required to achieve the maternal and child health 'service guarantees' of India's National Rural Health Mission (NRHM). We measured the difference between this ideal number and current staffing levels. We collected census data, routine health information data and government reports to calculate demand for maternal and child health services. By conducting 54 interviews with physicians and midwives, and six focus groups, we were able to calculate the time required to perform necessary health care tasks. We also interviewed 10 new mothers to cross-check these estimates at a global level and get assessments of quality of care. For 18 service centres of Ganjam District, we found 357 health workers in our six cadre categories, to serve a population of 1.02 million. Total demand for the MCH services guaranteed under India's NRHM outpaced supply for every category of health worker but one. To properly serve the study population, the health workforce supply should be enhanced by 43 additional physicians, 15 nurses and 80 nurse midwives. Those numbers probably under-estimate the need, as they assume away geographic barriers. Our study established time standards in minutes for each MCH activity promised by the NRHM, which could be applied elsewhere in India by government planners and civil society advocates. Our calculations indicate significant numbers of new health workers are required to deliver the services promised by the NRHM.
Ben-Shachar, B.; German, U.; Naim, E.
The TL-dose response was measured for the sensitive Harshaw manufactured phosphors (CaF 2 :Dy and CaF 2 :Tm), taking chips from the same batch and from different batches. The relative standard deviations were fitted to a semiempirical expression, from which the minimum measurable doses were derived and compared to the minimum measurable dose calculated by taking 3 times the standard deviation of unirradiated chips. The contribution of the individual calibration of each TLD chip was checked, as well
Halm, Margo; Peterson, Michelle; Kandels, Mary; Sabo, Julie; Blalock, Miriam; Braden, Rebecca; Gryczman, Anna; Krisko-Hagel, Kathryn; Larson, Dave; Lemay, Diane; Sisler, Bette; Strom, Linda; Topham, Debra
To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction. Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.
At the time of this study there were about 160 small and medium sized nuclear power reactors (referred to as SMRs) in operation worldwide, and about 25 more under construction. Operation and maintenance costs for operating SMRs represent a substantial portion of the cost of electricity produced. Of these costs, the direct and indirect cost of staff represents the major cost component. In recent years, particularly since 1990, there has been increased interest in SMRs by many developing countries wishing to take advantage of nuclear power and several small and medium reactor designs are in various stages of development. To enhance the economic competitive position of SMRs relative to alternative methods of electricity generation, it is essential to ensure that new SMRs can be operated reliably and efficiently using the optimum number of staff. This publication reviews the lessons learned from the reactor operation, and the insights gained through the design of new SMRs, with a view to optimizing staffing in order to improve overall plant economics without compromising safety.This publication is intended to evaluate the estimated staffing size of various SMRs, the staff qualification and training required for the operation of future SMRs. and the key issues which impact the staffing requirements that should be considered in the development and deployment of future SMRs
Leetz, Hans-Karl; Eipper, Hermann Hans; Gfirtner, Hans; Schneider, Peter; Welker, Klaus
To get a general idea of the actual staffing level situation in medical radiation physics in 1999 a survey was carried out by the task-group "Personalbedarf" of Deutsche Gesellschaft für Medizinische Physik (DGMP) among all DGMP-members who are active in this field. Main components for equipment and activities are defined in Report 8 and 10 of DGMP for staffing requirements in medical radiation physics. 322 forms were sent out, 173 of them have been evaluated. From the answers regarding equipment and activities numbers for staff are calculated by the methods given in Report 8 and 10 for this spot check target and compared with effective staffing levels. The data of the spot check are then extrapolated on total Germany. The result is a calculated deficit of 865 medical physicists for the whole physics staff, 166 of them in radiation therapy. From the age distribution of DGMP-members and the calculated deficit resulted a training capacity of about 100 medical physicists at all per year (19 in radiation therapy) if the deficit shall be cut back in 10 years.
Ivinger, Linnea; Lindvetter, Lisa
Theory suggests that there is a linkage between strategies and human resource staffing policies. Our aim with the dissertation was to test if such a linkage could be proven in Swedish MNCs. Also, indications spoke for ethnocentric tendencies in MNCs. We wanted to test if this was the reality for Swedish companies. In order to test the linkage we had to categorise the companies’ strategies and human resource staffing policies. By a survey we concluded that there was not full consistency in the...
S Barnert, Elizabeth; S Abrams, Laura; Maxson, Cheryl; Gase, Lauren; Soung, Patricia; Carroll, Paul; Bath, Eraka
Purpose Despite the existence of minimum age laws for juvenile justice jurisdiction in 18 US states, California has no explicit law that protects children (i.e. youth less than 12 years old) from being processed in the juvenile justice system. In the absence of a minimum age law, California lags behind other states and international practice and standards. The paper aims to discuss these issues. Design/methodology/approach In this policy brief, academics across the University of California campuses examine current evidence, theory, and policy related to the minimum age of juvenile justice jurisdiction. Findings Existing evidence suggests that children lack the cognitive maturity to comprehend or benefit from formal juvenile justice processing, and diverting children from the system altogether is likely to be more beneficial for the child and for public safety. Research limitations/implications Based on current evidence and theory, the authors argue that minimum age legislation that protects children from contact with the juvenile justice system and treats them as children in need of services and support, rather than as delinquents or criminals, is an important policy goal for California and for other national and international jurisdictions lacking a minimum age law. Originality/value California has no law specifying a minimum age for juvenile justice jurisdiction, meaning that young children of any age can be processed in the juvenile justice system. This policy brief provides a rationale for a minimum age law in California and other states and jurisdictions without one.
Barnert, Elizabeth S.; Abrams, Laura S.; Maxson, Cheryl; Gase, Lauren; Soung, Patricia; Carroll, Paul; Bath, Eraka
Purpose Despite the existence of minimum age laws for juvenile justice jurisdiction in 18 US states, California has no explicit law that protects children (i.e. youth less than 12 years old) from being processed in the juvenile justice system. In the absence of a minimum age law, California lags behind other states and international practice and standards. The paper aims to discuss these issues. Design/methodology/approach In this policy brief, academics across the University of California campuses examine current evidence, theory, and policy related to the minimum age of juvenile justice jurisdiction. Findings Existing evidence suggests that children lack the cognitive maturity to comprehend or benefit from formal juvenile justice processing, and diverting children from the system altogether is likely to be more beneficial for the child and for public safety. Research limitations/implications Based on current evidence and theory, the authors argue that minimum age legislation that protects children from contact with the juvenile justice system and treats them as children in need of services and support, rather than as delinquents or criminals, is an important policy goal for California and for other national and international jurisdictions lacking a minimum age law. Originality/value California has no law specifying a minimum age for juvenile justice jurisdiction, meaning that young children of any age can be processed in the juvenile justice system. This policy brief provides a rationale for a minimum age law in California and other states and jurisdictions without one. Paper type Conceptual paper PMID:28299968
framework of agreement with SPB AEP, VNIIAES determined manpower (man-hours) of maintenance and repair works and gave recommendations on the structure of NPP management and number of repair personnel and personnel which should be involved for the repair of 3rd category components and comprehensive inspection of the reactor in case of total unloading of the core. Also, experience gained in designing of Loviisa-1 and Loviisa-2 NPP for Finland (in cooperation with IVO company) assuming shopless management structure and components repair made by the involved companies, was taken into account. As a result of these efforts, the concept of staffing of WWER-640 reactor NPP was developed and approved. This concept was based on the following points: repair of the 1st category components (routine repair) is carried out by the NPP repair personnel; - repair works on 2nd category (medium) and 3rd category (capital) components are carried out by the manufacturers under agreement with the NPP; - repair works mentioned in the previous point are fulfilled by ''ATOMENERGOREMONT'' (in the restricted access areas) or by ''ENERGOREMONT'' local company of the NPP region; - incoming inspection was adopted for the components delivered to the NPP. The suppliers are informed on their obligation to eliminate all defects revealed at the stage of the incoming inspection (either on the NPP site or in the manufacturer's). For instance, hydraulic lock of Loviisa NPP was returned to Leningrad hydromechanical works for repair; - applications for the component improvement to meet new safety standards include requirements on the components quality and provision of diagnostics means allowing repair works to be fulfilled with respect to the current component conditions; - according to the new General safety requirements OPB-88/97, components of safety related systems of 1H, 2H and 3H grades are monitored by the Atomic Safety Authority of Russia, quality assurance program being provided; - shopless management
Geraedts, M; Kühnen, C; Cruppé, W de; Blum, K; Ohmann, C
In 2004 Germany introduced annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell transplantation, complex oesophageal, and pancreatic interventions. Hospitals that fail to reach the minimum volumes are no longer allowed to perform the respective procedures unless they raise one of eight legally accepted exceptions. The goal of our study was to investigate how many hospitals fell short of the minimum volumes in 2004, whether and how this was justified, and whether hospitals that failed the requirements experienced any consequences. We analysed data on meeting the minimum volume requirements in 2004 that all German hospitals were obliged to publish as part of their biannual structured quality reports. We performed telephone interviews: a) with all hospitals not achieving the minimum volumes for complex oesophageal, and pancreatic interventions, and b) with the national umbrella organisations of all German sickness funds. In 2004, one quarter of all German acute care hospitals (N=485) performed 23,128 procedures where minimum volumes applied. 197 hospitals (41%) did not meet at least one of the minimum volumes. These hospitals performed N=715 procedures (3.1%) where the minimum volumes were not met. In 43% of these cases the hospitals raised legally accepted exceptions. In 33% of the cases the hospitals argued using reasons that were not legally acknowledged. 69% of those hospitals that failed to achieve the minimum volumes for complex oesophageal and pancreatic interventions did not experience any consequences from the sickness funds. However, one third of those hospitals reported that the sickness funds addressed the issue and partially announced consequences for the future. The sickness funds' umbrella organisations stated that there were only sparse activities related to the minimum volumes and that neither uniform registrations nor uniform proceedings in case of infringements of the standards had been agreed upon. In spite of the
From the bestselling author of The Theoretical Minimum, an accessible introduction to the math and science of quantum mechanicsQuantum Mechanics is a (second) book for anyone who wants to learn how to think like a physicist. In this follow-up to the bestselling The Theoretical Minimum, physicist Leonard Susskind and data engineer Art Friedman offer a first course in the theory and associated mathematics of the strange world of quantum mechanics. Quantum Mechanics presents Susskind and Friedman’s crystal-clear explanations of the principles of quantum states, uncertainty and time dependence, entanglement, and particle and wave states, among other topics. An accessible but rigorous introduction to a famously difficult topic, Quantum Mechanics provides a tool kit for amateur scientists to learn physics at their own pace.
Qian, Shuai; Wang, Xia; Zhou, Jingjing
Signal-to-noise ratio and MTF are important indexs to evaluate the performance of optical systems. However,whether they are used alone or joint assessment cannot intuitively describe the overall performance of the system. Therefore, an index is proposed to reflect the comprehensive system performance-Minimum Resolvable Radiation Performance Contrast (MRP) model. MRP is an evaluation model without human eyes. It starts from the radiance of the target and the background, transforms the target and background into the equivalent strips,and considers attenuation of the atmosphere, the optical imaging system, and the detector. Combining with the signal-to-noise ratio and the MTF, the Minimum Resolvable Radiation Performance Contrast is obtained. Finally the detection probability model of MRP is given.
Employment Policies Inst. Foundation, Washington, DC.
This booklet, which is designed to clarify facts regarding the minimum wage's impact on marketplace economics, contains a total of 31 questions and answers pertaining to the following topics: relationship between minimum wages and poverty; impacts of changes in the minimum wage on welfare reform; and possible effects of changes in the minimum wage…
... planning staff at control areas and reliability coordinators concerning power system characteristics and... Coordination--Staffing). \\11\\ Mandatory Reliability Standards for the Bulk-Power System, Order No. 693, Federal... American bulk electric system are competent to perform those reliability-related tasks.\\22\\ The proposed...
...--Staffing). \\2\\ Mandatory Reliability Standards for the Bulk-Power System, Order No. 693, 72 FR 16416 (Apr... on the North American bulk electric system are competent to perform those reliability-related tasks... PER-004-2 will achieve a significant improvement in the reliability of the Bulk- Power System and...
... Section 27.204 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY CHEMICAL FACILITY ANTI-TERRORISM STANDARDS Chemical Facility Security Program § 27.204 Minimum concentration by security issue. (a) Release Chemicals—(1) Release-Toxic Chemicals. If a release-toxic chemical of interest...
... Language X. Voluntary Consensus Standards XI. Finding of No Significant Environmental Impact XII. Paperwork... the Current Fitness for Duty Requirements On September 3, 2010, the Nuclear Energy Institute (NEI... to the minimum days off requirements considered the collective advantages and disadvantages of having...
... AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Timber Sale Contracts Appraisal and Pricing.... No timber may be sold or cut under timber sale contracts for less than minimum stumpage rates except... amounts of material not meeting utilization standards of the timber sale contract. For any timber sale...
Single duct Variable Air Volume (VAV) systems are currently the most widely used type of HVAC system in the United States. When installing such a system, it is critical to determine the minimum airflow set point of the terminal box, as an optimally selected set point will improve the level of thermal comfort and indoor air quality (IAQ) while at the same time lower overall energy costs. In principle, this minimum rate should be calculated according to the minimum ventilation requirement based on ASHRAE standard 62.1 and maximum heating load of the zone. Several factors must be carefully considered when calculating this minimum rate. Terminal boxes with conventional control sequences may result in occupant discomfort and energy waste. If the minimum rate of airflow is set too high, the AHUs will consume excess fan power, and the terminal boxes may cause significant simultaneous room heating and cooling. At the same time, a rate that is too low will result in poor air circulation and indoor air quality in the air-conditioned space. Currently, many scholars are investigating how to change the algorithm of the advanced VAV terminal box controller without retrofitting. Some of these controllers have been found to effectively improve thermal comfort, indoor air quality, and energy efficiency. However, minimum airflow set points have not yet been identified, nor has controller performance been verified in confirmed studies. In this study, control algorithms were developed that automatically identify and reset terminal box minimum airflow set points, thereby improving indoor air quality and thermal comfort levels, and reducing the overall rate of energy consumption. A theoretical analysis of the optimal minimum airflow and discharge air temperature was performed to identify the potential energy benefits of resetting the terminal box minimum airflow set points. Applicable control algorithms for calculating the ideal values for the minimum airflow reset were developed and
Leary, Alison; Cook, Rob; Jones, Sarahjane; Smith, Judith; Gough, Malcolm; Maxwell, Elaine; Punshon, Geoffrey; Radford, Mark
Nursing is a safety critical activity but not easily quantified. This makes the building of predictive staffing models a challenge. The aim of this study was to determine if relationships between registered and non-registered nurse staffing levels and clinical outcomes could be discovered through the mining of routinely collected clinical data. The secondary aim was to examine the feasibility and develop the use of 'big data' techniques commonly used in industry for this area of healthcare and examine future uses. The data were obtained from 1 large acute National Health Service hospital trust in England. Routinely collected physiological, signs and symptom data from a clinical database were extracted, imported and mined alongside a bespoke staffing and outcomes database using Mathmatica V.10. The physiological data consisted of 120 million patient entries over 6 years, the bespoke database consisted of 9 years of daily data on staffing levels and safety factors such as falls. To discover patterns in these data or non-linear relationships that would contribute to modelling. To examine feasibility of this technique in this field. After mining, 40 correlations (pdata (such as the presence or absence of nausea) and staffing factors. Several inter-related factors demonstrated step changes where registered nurse availability appeared to relate to physiological parameters or outcomes such as falls and the management of symptoms. Data extraction proved challenging as some commercial databases were not built for extraction of the massive data sets they contain. The relationship between staffing and outcomes appears to exist. It appears to be non-linear but calculable and a data-driven model appears possible. These findings could be used to build an initial mathematical model for acute staffing which could be further tested. 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/.
Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M
Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.
Wright, R.Q.; Hopper, Calvin Mitchell
The OB-1 method for the calculation of the minimum critical mass of fissile actinides in metal/water systems was described in a previous paper. A fit to the calculated minimum critical mass data using the extended criticality parameter is the basis of the revised method. The solution density (grams/liter) for the minimum critical mass is also obtained by a fit to calculated values. Input to the calculation consists of the Maxwellian averaged fission and absorption cross sections and the thermal values of nubar. The revised method gives more accurate values than the original method does for both the minimum critical mass and the solution densities. The OB-1 method has been extended to calculate the uncertainties in the minimum critical mass for 12 different fissile nuclides. The uncertainties for the fission and capture cross sections and the estimated nubar uncertainties are used to determine the uncertainties in the minimum critical mass, either in percent or grams. Results have been obtained for U-233, U-235, Pu-236, Pu-239, Pu-241, Am-242m, Cm-243, Cm-245, Cf-249, Cf-251, Cf-253, and Es-254. Eight of these 12 nuclides are included in the ANS-8.15 standard.
Clark, Ann B.
Business and industry leaders do not flinch at the idea of placing top talent in struggling departments and divisions. This is not always the case in public education. The Charlotte-Mecklenburg Schools made a bold statement to its community in its strategic plan by identifying two key reform levers--(1) an effective principal leading each school;…
Since the restart of the LHC in November 2009, ATLAS has collected inelastic pp collisions to perform first measurements on charged particle densities. These measurements will help to constrain various models describing phenomenologically soft parton interactions. Understanding the trigger efficiencies for different event types are therefore crucial to minimize any possible bias in the event selection. ATLAS uses two main minimum bias triggers, featuring complementary detector components and trigger levels. While a hardware based first trigger level situated in the forward regions with 2.2 < |η| < 3.8 has been proven to select pp-collisions very efficiently, the Inner Detector based minimum bias trigger uses a random seed on filled bunches and central tracking detectors for the event selection. Both triggers were essential for the analysis of kinematic spectra of charged particles. Their performance and trigger efficiency measurements as well as studies on possible bias sources will be presented. We also highlight the advantage of these triggers for particle correlation analyses. (author)
Logvinov, Ilana I; Dexter, Franklin; Hindman, Bradley J; Brull, Sorin J
Work habits are non-technical skills that are an important part of job performance. Although non-technical skills are usually evaluated on a relative basis (i.e., "grading on a curve"), validity of evaluation on an absolute basis (i.e., "minimum passing score") needs to be determined. Survey and observational study. None. None. The theme of "work habits" was assessed using a modification of Dannefer et al.'s 6-item scale, with scores ranging from 1 (lowest performance) to 5 (highest performance). E-mail invitations were sent to all consultant and fellow anesthesiologists at Mayo Clinic in Florida, Arizona, and Minnesota. Because work habits expectations can be generational, the survey was designed for adjustment based on all invited (responding or non-responding) anesthesiologists' year of graduation from residency. The overall mean±standard deviation of the score for anesthesiologists' minimum expectations of nurse anesthetists' work habits was 3.64±0.66 (N=48). Minimum acceptable scores were correlated with the year of graduation from anesthesia residency (linear regression P=0.004). Adjusting for survey non-response using all N=207 anesthesiologists, the mean of the minimum acceptable work habits adjusted for year of graduation was 3.69 (standard error 0.02). The minimum expectations for nurse anesthetists' work habits were compared with observational data obtained from the University of Iowa. Among 8940 individual nurse anesthetist work habits scores, only 2.6% were habits scores were significantly greater than the Mayo estimate (3.69) for the minimum expectations; all Phabits of nurse anesthetists within departments should not be compared with an appropriate minimum score (i.e., of 3.69). Instead, work habits scores should be analyzed based on relative reporting among anesthetists. Copyright © 2017 Elsevier Inc. All rights reserved.
Fram, Nancy; Morgan, Beverley
Research shows that nurses want to provide more input into assessing patient acuity, changes in patient needs and staffing requirements. The Dashboard Project involved the further development and application of an electronic monitoring tool that offers a single source of nursing, patient and organizational information. It is designed to help inform nurse staffing decisions within a hospital setting. The Dashboard access link was installed in computers in eight nursing units within the Hamilton Health Sciences (HHS) network. The Dashboard indicators are populated from existing information/patient databases within the Decision Support Department at HHS. Committees composed of the unit manager, staff nurses, project coordinator, financial controller and an information controller met regularly to review the Dashboard indicators. Participants discussed the ability of the indicators to reflect their patients' needs and the feasibility of using the indicators to inform their clinical staffing plans. Project findings suggest that the Dashboard is a work in progress. Many of the indicators that had originally been incorporated were refined and will continue to be revised based on suggestions from project participants and further testing across HHS. Participants suggested the need for additional data, such as the time that nurses are off the unit (for code blue response, patient transfers and accompanying patients for tests); internal transfers/bed moves to accommodate patient-specific issues and particularly to address infection control issues; deaths and specific unit-centred data in addition to the generic indicators. The collaborative nature of the project enabled staff nurses and management to work together on a matter of high importance to both, providing valuable recommendations for shared nursing and interprofessional planning, further Dashboard development and project management.
Everhart, Damian; Schumacher, Jessica R; Duncan, R Paul; Hall, Allyson G; Neff, Donna F; Shorr, Ronald I
Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group. Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which "best practices" for fall prevention might be identified. In addition, administrators may be able
Kim, Yunmi; Lee, Ji Yun; Kang, Hyuncheol
This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.
Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.
This book supports trainee teachers in the Lifelong Learning Sector in the assessment of their numeracy knowledge. A self-audit section is included to help trainees understand their level of competence and confidence in numeracy and will help them identify any gaps in their knowledge and skills. This is followed by exercises and activities to support and enhance learning. The book covers all the content of the LLUK standards for the minimum core for numeracy. Coverage and assessment of the minimum core have to be embedded in all Certificate and Diploma courses leading to QTLS and ATLS status.
This book supports trainee teachers in the Lifelong Learning Sector in the assessment of their literacy knowledge. A self-audit section is included to help trainees understand their level of competence and confidence in literacy and will help them identify any gaps in their knowledge and skills. This is followed by exercises and activities to support and enhance learning. The book covers all the content of the LLUK standards for the minimum core for literacy. Coverage and assessment of the minimum core have to be embedded in all Certificate and Diploma courses leading to QTLS and ATLS status.
We present a general framework and method for detection of an object in a video based on apparent motion. The object moves relative to background motion at some unknown time in the video, and the goal is to detect and segment the object as soon it moves in an online manner. Due to unreliability of motion between frames, more than two frames are needed to reliably detect the object. Our method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.
Full Text Available We consider directed graphs where each edge is labeled with an integer weight and study the fundamental algorithmic question of computing the value of a cycle with minimum mean weight. Our contributions are twofold: (1 First we show that the algorithmic question is reducible in O(n^2 time to the problem of a logarithmic number of min-plus matrix multiplications of n-by-n matrices, where n is the number of vertices of the graph. (2 Second, when the weights are nonnegative, we present the first (1 + ε-approximation algorithm for the problem and the running time of our algorithm is ilde(O(n^ω log^3(nW/ε / ε, where O(n^ω is the time required for the classic n-by-n matrix multiplication and W is the maximum value of the weights.
We present a general framework and method for detection of an object in a video based on apparent motion. The object moves relative to background motion at some unknown time in the video, and the goal is to detect and segment the object as soon it moves in an online manner. Due to unreliability of motion between frames, more than two frames are needed to reliably detect the object. Our method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.
Lao, Dong; Sundaramoorthi, Ganesh
We present a general framework and method for detection of an object in a video based on apparent motion. The object moves relative to background motion at some unknown time in the video, and the goal is to detect and segment the object as soon it moves in an online manner. Due to unreliability of motion between frames, more than two frames are needed to reliably detect the object. Our method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.
Marimpi, Maria; Koning, Pierre
This paper performs a cross-country level analysis on the impact of the level of specific youth minimum wages on the labor market performance of young individuals. We use information on the use and level of youth minimum wages, as compared to the level of adult minimum wages as well as to the median
Carrington, William J.; Fallick, Bruce C.
Most workers who begin their careers in minimum-wage jobs eventually gain more experience and move on to higher paying jobs. However, more than 8% of workers spend at least half of their first 10 working years in minimum wage jobs. Those more likely to have minimum wage careers are less educated, minorities, women with young children, and those…
Page, Marianne E.; Spetz, Joanne; Millar, Jane
Although minimum wages are advocated as a policy that will help the poor, few studies have examined their effect on poor families. This paper uses variation in minimum wages across states and over time to estimate the impact of minimum wage legislation on welfare caseloads. We find that the elasticity of the welfare caseload with respect to the…
van Peijpe, T.
This article offers an overview of the Dutch legal system of minimum income protection through collective bargaining, social security, and statutory minimum wages. In addition to collective agreements, the Dutch statutory minimum wage offers income protection to a small number of workers. Its
Morrison, Aileen P; Tanasijevic, Milenko J; Torrence-Hill, Joi N; Goonan, Ellen M; Gustafson, Michael L; Melanson, Stacy E F
The timely availability of inpatient test results is a key to physician satisfaction with the clinical laboratory, and in an institution with a phlebotomy service may depend on the timeliness of blood collections. In response to safety reports filed for delayed phlebotomy collections, we applied Lean principles to the inpatient phlebotomy service at our institution. Our goal was to improve service without using additional resources by optimizing our staffing model. To evaluate the effect of a new phlebotomy staffing model on the timeliness of inpatient phlebotomy collections. We compared the median time of morning blood collections and average number of safety reports filed for delayed phlebotomy collections during a 6-month preimplementation period and 5-month postimplementation period. The median time of morning collections was 17 minutes earlier after implementation (7:42 am preimplementation; interquartile range, 6:27-8:48 am; versus 7:25 am postimplementation; interquartile range, 6:20-8:26 am). The frequency of safety reports filed for delayed collections decreased 80% from 10.6 per 30 days to 2.2 per 30 days. Reallocating staff to match the pattern of demand for phlebotomy collections throughout the day represents a strategy for improving the performance of an inpatient phlebotomy service.
This paper discusses lessons learned from the operation of the Gen II fleet of existing nuclear power plants (NPPs), in terms of staffing, that can be applied to the final design, deployment, and operation of new reactor designs. The most significant of these lessons is the need to appropriately staff the facility, having the right number of people with the required skills and experience. This begs the question of how to identify those personnel requirements. For NPPs, there are five key factors that ultimately will determine the effectiveness and costs of operating nuclear power plants (NPPs): 1) The Nuclear Steam Supply System (NSSS) and the layout of the plant site; 2) The processes which the operating organization applies; 3) The organizational structure of the operating organization; 4) The organizational culture of the operating organization, and 5) The regulatory framework under which the licensee must operate. In summary, this paper identifies opportunities to minimize staffing and costs learned from Gen II NPPs that may be applicable for new nuclear plants. (author)
Agus Arianto Toly
Full Text Available The high level of turnover intentions by accountant staffs had raised the potential cost for public accountant firms. The prior research done by Suwandi and Indriantoro (1999 had succesfully identified the process of turnover intentions, which related to the antecedents and consequences of job insecurity. The responses of 30 accountant staffs from some public accountant firms to a questionnaire designed to measure variables were analyzed using a Pearson's correlation coefficient. The result of this study was not generally consistent with Suwandi and Indriantoro (1999 because some hypotheses were rejected. This study identified that public accountant firm must be noticed organizational factors, such as organizational commitment, role conflict, role ambiguity, and organizational change. Abstract in Bahasa Indonesia : Tingkat keinginan berpindah yang tinggi para staf akuntan telah menimbulkan biaya potensial untuk Kantor Akuntan Publik (KAP. Penelitian sebelumnya yang dilakukan oleh Suwandi dan Indriantoro (1999 telah berhasil mengidentifikasi proses keinginan berpindah, yang berhubungan dengan anteseden dan konsekuensi dari ketidakamanan kerja. Respon 30 staf akuntan dari beberapa KAP terhadap kuesioner yang dibuat untuk mengukur berbagai variabel, dianalisis menggunakan kofisien korelasi Pearson. Hasil dari studi ini secara umum tidak konsisten dengan Suwandi dan Indriantoro (1999 karena ditolaknya beberapa hipotesis. Studi ini mengidentifikasi bahwa KAP harus memberi perhatian terhadap beberapa faktor organisasional, seperti komitmen organisasional, konflik peran, ketidakjelasan peran, dan perubahan organisasional. Kata kunci: konflik peran; ketidakjelasan peran; perubahan organisasional; ketidakamanan kerja; komitmen organisasional; keinginan berpindah.
Chapman, Susan A; Mulvihill, Linda; Herrera, Carolina
The Workload and Time Management Survey of Central Cancer Registries was conducted in 2011 to assess the amount of time spent on work activities usually performed by cancer registrars. A survey including 39 multi-item questions,together with a work activities data collection log, was sent by email to the central cancer registry (CCR) manager in each of the 50 states and the District of Columbia. Twenty-four central cancer registries (47%) responded to the survey.Results indicate that registries faced reductions in budgeted staffing from 2008-2009. The number of source records and total cases were important indicators of workload. Four core activities, including abstracting at the registry, visual editing,case consolidation, and resolving edit reports, accounted for about half of registry workload. We estimate an average of 12.4 full-time equivalents (FTEs) are required to perform all cancer registration activities tracked by the survey; however,estimates vary widely by registry size. These findings may be useful for registries as a benchmark for their own registry workload and time-management data and to develop staffing guidelines.
Pelt, Christopher E; Anderson, Mike B; Pendleton, Robert; Foulks, Matthew; Peters, Christopher L; Gililland, Jeremy M
An early physical therapy (PT) care pathway was implemented to provide same-day ambulation after total joint arthroplasty by changing PT staffing hours. After receiving an exemption from our institutional review board, we performed a secondary data analysis on a cohort of patients that underwent primary TJA of the hip or knee 6 months before and 12 months after implementation of the change. Data on same-day ambulation rates, length of stay (LOS), and in-hospital costs were reviewed. Early evaluation and mobilization of patients by PT improved on postoperative day (POD) 0 from 64% to 85% after the change ( P ≤ .001). The median LOS before the change was 3.27 days compared to 3.23 days after the change ( P = .014). Patients with higher American Society of Anesthesiologists scores were less likely to ambulate on POD 0 ( P = .038) and had longer hospital stays ( P < .001). Early mobilization in the entire cohort was associated with a greater cost savings ( P < .001). A relatively simple change to staffing hours, using resources currently available to us, and little additional financial or institutional investment resulted in a significant improvement in the number of patients ambulating on POD 0, with a modest reduction in both LOS and inpatient costs.
Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)
Canet, J; Moral, V; Villalonga, A; Pelegrí, D; Gomar, C; Montero, A
Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.
McNair, Douglas S
In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.
de Cordova, Pamela B; Phibbs, Ciaran S; Schmitt, Susan K; Stone, Patricia W
In hospitals, nurses provide patient care around the clock, but the impact of night staff characteristics on patient outcomes is not well understood. The aim of this study was to examine the association between night nurse staffing and workforce characteristics and the length of stay (LOS) in 138 veterans affairs (VA) hospitals using panel data from 2002 through 2006. Staffing in hours per patient day was higher during the day than at night. The day nurse workforce had more educational preparation than the night workforce. Nurses' years of experience at the unit, facility, and VA level were greater at night. In multivariable analyses controlling for confounding variables, higher night staffing and a higher skill mix were associated with reduced LOS. © 2014 Wiley Periodicals, Inc.
Full Text Available In the article the views of scientists on the role of incomes of the poorest people in providing of economic development of the country and consequences of increasing the minimum wage in Ukraine twice are investigated; the dynamics of change in Ukraine minimum wage during a decade are analyzed and decline in living standards of population during this period is shown; measures, which should be taken for non-inflationary growth in incomes of the population, are grounded; it is disclosed that such measures should include unification of income tax for individuals and single social contribution and restoration of a progressive taxation of incomes of the working population. Key words: minimum wage, household income, the poorest part of the population, the economy of country, tax system.
Kulahci, Murat; Ramirez, Jose; Tobias, Randy
Split-plot experiments are commonly used in industry for product and process improvement. Recent articles on designing split-plot experiments concentrate on minimum aberration as the design criterion. Minimum aberration has been criticized as a design criterion for completely randomized fractional...... factorial design and alternative criteria, such as the maximum number of clear two-factor interactions, are suggested (Wu and Hamada (2000)). The need for alternatives to minimum aberration is even more acute for split-plot designs. In a standard split-plot design, there are several types of two...... for completely randomized designs. Consequently, we provide a modified version of the maximum number of clear two-factor interactions design criterion to be used for split-plot designs....
Spicer, Rachel A; Salek, Reza; Steinbeck, Christoph
The Metabolomics Standards Initiative (MSI) guidelines were first published in 2007. These guidelines provided reporting standards for all stages of metabolomics analysis: experimental design, biological context, chemical analysis and data processing. Since 2012, a series of public metabolomics databases and repositories, which accept the deposition of metabolomic datasets, have arisen. In this study, the compliance of 399 public data sets, from four major metabolomics data repositories, to the biological context MSI reporting standards was evaluated. None of the reporting standards were complied with in every publicly available study, although adherence rates varied greatly, from 0 to 97%. The plant minimum reporting standards were the most complied with and the microbial and in vitro were the least. Our results indicate the need for reassessment and revision of the existing MSI reporting standards.
Kruger, Andreas J; Lockey, David; Kurola, Jouni
-staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...... have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care....
This thesis presents a general framework and method for detection of an object in a video based on apparent motion. The object moves, at some unknown time, differently than the “background” motion, which can be induced from camera motion. The goal of proposed method is to detect and segment the object as soon it moves in an online manner. Since motion estimation can be unreliable between frames, more than two frames are needed to reliably detect the object. Observing more frames before declaring a detection may lead to a more accurate detection and segmentation, since more motion may be observed leading to a stronger motion cue. However, this leads to greater delay. The proposed method is designed to detect the object(s) with minimum delay, i.e., frames after the object moves, constraining the false alarms, defined as declarations of detection before the object moves or incorrect or inaccurate segmentation at the detection time. Experiments on a new extensive dataset for moving object detection show that our method achieves less delay for all false alarm constraints than existing state-of-the-art.
Michael P. Barnes
Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of
Running Head: Evaluation of Contract Versus VA-Staffed CBOCs. Evaluating Contract versus VA-Staffed Community Based Outpatient Clinics (CBOCs) Using Patient Satisfaction and Access Measures in the Veterans Health Administration
staffed CBOC, with dependent variables adjusting for SHEP scores and case mix factors. The equation for the null hypothesis is Hho = In (estimated...that the model can be further improved through combining several of the satisfaction scores. The equation for the null hypothesis is that Hho = In
In the Minimum Additive Waste Stabilization(MAWS) concept, actual waste streams are utilized as additive resources for vitrification, which may contain the basic components (glass formers and fluxes) for making a suitable glass or glassy slag. If too much glass former is present, then the melt viscosity or temperature will be too high for processing; while if there is too much flux, then the durability may suffer. Therefore, there are optimum combinations of these two important classes of constituents depending on the criteria required. The challenge is to combine these resources in such a way that minimizes the use of non-waste additives yet yields a processable and durable final waste form for disposal. The benefit to this approach is that the volume of the final waste form is minimized (waste loading maximized) since little or no additives are used and vitrification itself results in volume reduction through evaporation of water, combustion of organics, and compaction of the solids into a non-porous glass. This implies a significant reduction in disposal costs due to volume reduction alone, and minimizes future risks/costs due to the long term durability and leach resistance of glass. This is accomplished by using integrated systems that are both cost-effective and produce an environmentally sound waste form for disposal. individual component technologies may include: vitrification; thermal destruction; soil washing; gas scrubbing/filtration; and, ion-exchange wastewater treatment. The particular combination of technologies will depend on the waste streams to be treated. At the heart of MAWS is vitrification technology, which incorporates all primary and secondary waste streams into a final, long-term, stabilized glass wasteform. The integrated technology approach, and view of waste streams as resources, is innovative yet practical to cost effectively treat a broad range of DOE mixed and low-level wastes
... the minimum wage required by section 6(a) of the Fair Labor Standards Act? 520.200 Section 520.200... lower than the minimum wage required by section 6(a) of the Fair Labor Standards Act? Section 14(a) of..., for the payment of special minimum wage rates to workers employed as messengers, learners (including...
Bowers, Robert M.; Kyrpides, Nikos C.; Stepanauskas, Ramunas; Harmon-Smith, Miranda; Doud, Devin; Reddy, T. B. K.; Schulz, Frederik; Jarett, Jessica; Rivers, Adam R.; Eloe-Fadrosh, Emiley A.; Tringe, Susannah G.; Ivanova, Natalia N.; Copeland, Alex; Clum, Alicia; Becraft, Eric D.; Malmstrom, Rex R.; Birren, Bruce; Podar, Mircea; Bork, Peer; Weinstock, George M.; Garrity, George M.; Dodsworth, Jeremy A.; Yooseph, Shibu; Sutton, Granger; Glöckner, Frank O.; Gilbert, Jack A.; Nelson, William C.; Hallam, Steven J.; Jungbluth, Sean P.; Ettema, Thijs J. G.; Tighe, Scott; Konstantinidis, Konstantinos T.; Liu, Wen-Tso; Baker, Brett J.; Rattei, Thomas; Eisen, Jonathan A.; Hedlund, Brian; McMahon, Katherine D.; Fierer, Noah; Knight, Rob; Finn, Rob; Cochrane, Guy; Karsch-Mizrachi, Ilene; Tyson, Gene W.; Rinke, Christian; Kyrpides, Nikos C.; Schriml, Lynn; Garrity, George M.; Hugenholtz, Philip; Sutton, Granger; Yilmaz, Pelin; Meyer, Folker; Glöckner, Frank O.; Gilbert, Jack A.; Knight, Rob; Finn, Rob; Cochrane, Guy; Karsch-Mizrachi, Ilene; Lapidus, Alla; Meyer, Folker; Yilmaz, Pelin; Parks, Donovan H.; Eren, A. M.; Schriml, Lynn; Banfield, Jillian F.; Hugenholtz, Philip; Woyke, Tanja
We present two standards developed by the Genomic Standards Consortium (GSC) for reporting bacterial and archaeal genome sequences. Both are extensions of the Minimum Information about Any (x) Sequence (MIxS). The standards are the Minimum Information about a Single Amplified Genome (MISAG) and the Minimum Information about a Metagenome-Assembled Genome (MIMAG), including, but not limited to, assembly quality, and estimates of genome completeness and contamination. These standards can be used in combination with other GSC checklists, including the Minimum Information about a Genome Sequence (MIGS), Minimum Information about a Metagenomic Sequence (MIMS), and Minimum Information about a Marker Gene Sequence (MIMARKS). Community-wide adoption of MISAG and MIMAG will facilitate more robust comparative genomic analyses of bacterial and archaeal diversity.
This article uses a strategic foresight tool, megatrends, to examine forces influencing long-term healthcare staffing in the rural United States. Two megatrends-exponential advances in science and technology and the continued evolution of the decentralized global marketplace-will influence and ultimately help shape the future of rural healthcare. Successful health ecosystems of the future will need to be customer-driven, more affordable, and tech-savvy. Successful evolution in an era of continuous change will require a blend of intentional engagement with stakeholders, strategic foresight, and future-focused leadership. More research is needed to fully understand not only the challenges of rural healthcare but also the emerging opportunities.
Dörrenbächer, Christoph; Gammelgaard, Jens; McDonald, Frank
captures the effects of PCN verses HCN managers on key characteristics of subsidiaries. The results of the study indicate that the PCN/HCN dichotomy widely used in the international staffing literature needs to take account of the following issues: First: The study confirms theoretical assumptions based...... on social capital theory that subsidiaries led by HCNs are more embedded in the host country's external environment (by having more frequent relationships with host country customers, suppliers and competitors). However, the study reveals that the assumed advantages PCN led subsidiaries have...... to the local institutional environment (HRM). Our study finds that this is also the case with regard to strategic decisions on financial control as well as on R&D and new product development. Third: On average, HCN led subsidiaries perform significantly better than PCN led subsidiaries with regard to sales...
Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane
To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.
KHNP, as an owner/operator organization, is responsible for all project activities including design, procurement, construction, and commissioning, for Korea's nuclear power plant (NPP) construction projects. Four separate functional offices of KHNP are set up to complete the construction management work. These offices are (1) home office, (2) field construction office, (3) field quality assurance office, and (4) field startup/commissioning office. This paper presents a staffing plan for the field construction office starting initial project implementation to final turnover to operations stages. It is recognized that the plan may not be applicable to other utility situations in terms of project management of site activity depending upon how the overall project contract is structured
Berg Jansson, Anna; Engström, Åsa
The aim of this study is to describe critical care nurses (CCN's) experiences of working with or as temporary agency staff. This explorative qualitative study is based on interviews with five agency CCNs and five regular CCNs, a total of ten interviews, focusing on the interviewees' experiences of daily work and temporary agency staffing. The interviews were analysed manually and thematically following an inductive approach. Four themes that illustrate both similarities and differences between regular and temporary agency CCNs emerged: "working close to patients versus being responsible for everything", "teamwork versus independence", "both groups needed" and "opportunities and challenges". The study findings illustrate the complexity of the working situation for agency and regular staff in terms of the organisation and management of the temporary agency nurses and the opportunities and challenges faced by both groups. Copyright © 2016 Elsevier Ltd. All rights reserved.
Valentine, Nancy M; Nash, Jan; Hughes, Douglas; Douglas, Kathy
Managing costs while retaining qualified nurses and finding workforce solutions that ensure the delivery of high-quality patient care is of primary importance to nurse leaders and executive management. Leading healthcare organizations are using open-shift management technology as a strategy to improve staffing effectiveness and the work environment. In many hospitals, open-shift management technology has become an essential workforce management tool, nursing benefit, and recruitment and retention incentive. In this article, the authors discuss how a successful nursing initiative to apply automation to open-shift scheduling and fulfillment across a 3-hospital system had a broad enterprise-wide impact resulting in dramatic improvements in nurse satisfaction, retention, recruitment, and the bottom line.
Brener, Nancy; Demissie, Zewditu
Schools are in a unique position to meet the mental and behavioral health needs of children and adolescents because approximately 95% of young people aged 7-17 years attend school. Little is known, however, about policies related to counseling, psychological, and social services staffing in school districts. This study analyzed the prevalence of such policies in public school districts in the U.S. Data from four cycles (2000, 2006, 2012, and 2016) of the School Health Policies and Practices Study, a national survey periodically conducted to assess policies and practices for ten components of school health, were analyzed in 2017. The survey collected data related to counseling, psychological, and social services among nationally representative samples of school districts using online or mailed questionnaires. Sampled districts identified respondents responsible for or most knowledgeable about the content of each questionnaire. The percentage of districts with a district-level counseling, psychological, and social services coordinator increased significantly from 62.6% in 2000 to 79.5% in 2016. In 2016, 56.3% of districts required each school to have someone to coordinate counseling, psychological, and social services at the school. Fewer districts required schools at each level to have a specified ratio of counselors to students (16.2% for elementary schools, 16.8% for middle schools, and 19.8% for high schools), and the percentage of districts with these requirements has decreased significantly since 2012. Increases in the prevalence of district-level staffing policies could help increase the quantity and quality of counseling, psychological, and social services staff in schools nationwide, which in turn could improve mental and behavioral health outcomes for students. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration
Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care. Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need. Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need. Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the
Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado
In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.
Houseman, Susan N.; Polivka, Anne E.
A study examined the job stability of workers in the following flexible staffing arrangements: agency temporary, direct-hire temporary, on-call, contract company, independent contractor, and regular part-time work. Two data sources were used in the analysis. The first was a nationwide survey of employers on their use of flexible staffing…
... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and Andrews International, Fort Smith... subject firm. The workers are engaged in the production of refrigerators and trash compactors. The company...
Heponiemi, Tarja; Elovainio, Marko; Kouvonen, Anne; Kuusio, Hannamaria; Noro, Anja; Finne-Soveri, Harriet; Sinervo, Timo
Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Cross-sectional questionnaire study. 1047 Finnish female staff members aged 18-69 years working in sheltered housing or nursing homes (units n=179). The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. 2011 Elsevier Ltd. All rights reserved.
Fitchett, Paul G.; Heafner, Tina L.; Harden, Susan B.
Moonlighting, an employment practice where individuals work outside of their primary job, is popular within the public education sector. Using data from the National Center for Education Statistics Schools and Staffing Survey, this study examined both the characteristics and motivations of public school teachers across moonlighting categories.…
... workers of Johnson Controls, Inc., including on-site leased workers from Valley Staffing, Hudson..., Wisconsin location of Johnson Controls, Inc. The Department has determined that these workers were sufficiently under the control of the subject firm to be considered leased workers. Based on these findings...
Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M
(1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Gross, Betheny; DeArmond, Michael; Goldhaber, Dan
Education reformers routinely call on school districts to stop hiring teachers based on seniority, which they argue interferes with effective staffing, especially in disadvantaged schools. The few researchers who have empirically studied the issue, however, disagree about whether seniority-based hiring is systematically associated with staffing…
Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.
Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.
... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,666] Badger Meter, Inc... of Badger Meter, Inc., including on-site leased workers from Sourcepoint Staffing, Milwaukee... workers are engaged in the production of flow measurement devices and automatic meter reading equipment...
... Division, Including On-Site Leased Workers From Manpower Staffing and Dow Cleaning Services, Malvern, AR..., and components. The company reports that workers from Dow Cleaning Services were employed on-site at... leased from Dow Cleaning Services working on-site at the Malvern, Arkansas location of Kohler Company...
Li Xiaoyu; Xu Gang
The calculation of the minimum emittance of three-bend achromats (TBAs) made by Mathematical software can ignore the actual magnets lattice in the matching condition of dispersion function in phase space. The minimum scaling factors of two kinds of widely used TBA lattices are obtained. Then the relationship between the lengths and the radii of the three dipoles in TBA is obtained and so is the minimum scaling factor, when the TBA lattice achieves its minimum emittance. The procedure of analysis and the results can be widely used in achromats lattices, because the calculation is not restricted by the actual lattice. (authors)
Eliav Danziger; Leif Danziger
This paper shows that a graduated minimum wage, in contrast to a constant minimum wage, can provide a strict Pareto improvement over what can be achieved with an optimal income tax. The reason is that a graduated minimum wage requires high-productivity workers to work more to earn the same income as low-productivity workers, which makes it more difficult for the former to mimic the latter. In effect, a graduated minimum wage allows the low-productivity workers to benefit from second-degree pr...
Although the statutory minimum wage is not a new category, in the Czech Republic we encounter the definition and regulation of a minimum wage for the first time in the 1990 amendment to Act No. 65/1965 Coll., the Labour Code. The specific amount of the minimum wage and the conditions of its operation were then subsequently determined by government regulation in February 1991. Since that time, the value of minimum wage has been adjusted fifteenth times (the last increase was in January 2007). ...
Illuminati, F.; Viola, L. [Dipartimento di Fisica, Padova Univ. (Italy)
We introduce a new variational characterization of Gaussian diffusion processes as minimum uncertainty states. We then define a variational method constrained by kinematics of diffusions and Schroedinger dynamics to seek states of local minimum uncertainty for general non-harmonic potentials. (author)
Barioli, F.; Barrett, W.; Fallat, S.M.; Hall, H.T.; Hogben, L.; Shader, B.L.; Driessche, van den P.; Holst, van der H.
The zero forcing number Z(G), which is the minimum number of vertices in a zero forcing set of a graph G, is used to study the maximum nullity/minimum rank of the family of symmetric matrices described by G. It is shown that for a connected graph of order at least two, no vertex is in every zero
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Minimum royalty. 281.30 Section 281.30 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE LEASING OF MINERALS OTHER THAN OIL, GAS, AND SULPHUR IN THE OUTER CONTINENTAL SHELF Financial Considerations § 281.30 Minimum royalty...
Ehrenberg, Ronald G.; And Others
Includes "Introduction" (Ehrenberg); "Effect of the Minimum Wage [MW] on the Fast-Food Industry" (Katz, Krueger); "Using Regional Variation in Wages to Measure Effects of the Federal MW" (Card); "Do MWs Reduce Employment?" (Card); "Employment Effects of Minimum and Subminimum Wages" (Neumark,…
Neumark, David; Nizalova, Olena
Exposure to minimum wages at young ages could lead to adverse longer-run effects via decreased labor market experience and tenure, and diminished education and training, while beneficial longer-run effects could arise if minimum wages increase skill acquisition. Evidence suggests that as individuals reach their late 20s, they earn less the longer…
Castle, Nicholas; Engberg, John B; Wagner, Laura M; Handler, Steven
This research examined resident and facility-specific factors associated with a diagnosis of a urinary tract infection (UTI) in the nursing home setting. Minimum Data Set and Online Survey, Certification and Reporting system data were used to identify all nursing home residents in the United States on April 1, 2006, who did not have a UTI ( n = 1,138,418). Residents were followed until they contracted a UTI (9.5%), died (8.3%), left the nursing home (33.2%), or the year ended (49.0%). A Cox proportional hazards model was estimated, controlling for resident and facility characteristics and for the state of residence. The presence of an indwelling catheter was the primary predictor of whether a resident contracted a UTI (adjusted incidence ratio = 3.35, p factors such as percentage of Medicaid residents, for-profit, and chain status was less significant. Estimates regarding staffing levels indicate that increased contact hours with more highly educated nursing staff are associated with less catheter use. Several facility-specific risk factors are of significance. Of significance, UTIs may be reduced by modifying factors such as staffing levels.
Lievens, Yolande; Defourny, Noémie; Coffey, Mary; Borras, Josep M; Dunscombe, Peter; Slotman, Ben; Malicki, Julian; Bogusz, Marta; Gasparotto, Chiara; Grau, Cai; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; Coucke, Philippe; Gabrovski, Roumen; Vosmik, Milan; Eriksen, Jesper Grau; Jaal, Jana; Dejean, Catherine; Polgar, Csaba; Johannsson, Jakob; Cunningham, Moya; Atkocius, Vydmantas; Back, Carlo; Pirotta, Martin; Karadjinovic, Vanja; Levernes, Sverre; Maciejewski, Boguslaw; Trigo, Maria Lurdes; Šegedin, Barbara; Palacios, Amalia; Pastoors, Bert; Beardmore, Charlotte; Erridge, Sara; Smyth, Gaile; Cleries Soler, Ramon
The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 47-60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.5-30.9) for radiation oncologists, 7.6 (0-19.7) for medical physicists, 3.5 (0-12.6) for dosimetrists, 26.6 (1.9-78) for RTTs and 14.8 (0.4-61.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9-348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85-757.7) and RTT and nurses 76.8 (range: 25.7-156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. The average personnel figures in Europe are now consistent with, or even more favourable than
Spooner, Amy J; Aitken, Leanne M; Corley, Amanda; Chaboyer, Wendy
Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited. Focus groups were conducted using a nominal group technique to generate and prioritise minimum dataset items. Nurses were presented with content from previous team leader handovers and asked to select which content items to include in a minimum dataset. Participant responses were summarised as frequencies and percentages. Seventeen senior nurses participated in three focus groups. Participants agreed that ISBAR (Identify-Situation-Background-Assessment-Recommendations) was a useful tool to guide clinical handover. Items recommended to be included in the minimum dataset (≥65% agreement) included Identify (name, age, days in intensive care), Situation (diagnosis, surgical procedure), Background (significant event(s), management of significant event(s)) and Recommendations (patient plan for next shift, tasks to follow up for next shift). Overall, 30 of the 67 (45%) items in the Assessment category were considered important to include in the minimum dataset and focused on relevant observations and treatment within each body system. Other non-ISBAR items considered important to include related to the ICU (admissions to ICU, staffing/skill mix, theatre cases) and patients (infectious status, site of infection, end of life plan). Items were further categorised into those to include in all handovers and those to discuss only when relevant to the patient. The findings suggest a minimum dataset for intensive care nursing team leader shift-to-shift handover should contain items within ISBAR along with unit and patient specific
Xu, Gang; Peng, Yue-Mei
For reaching a small emittance in a modern light source, triple bend achromats (TBA), theoretical minimum emittance (TME) and even multiple bend achromats (MBA) have been considered. This paper derived the necessary condition for achieving minimum emittance in TBA and MBA theoretically, where the bending angle of inner dipoles has a factor of 31/3 bigger than that of the outer dipoles. Here, we also calculated the conditions attaining the minimum emittance of TBA related to phase advance in some special cases with a pure mathematics method. These results may give some directions on lattice design.
Xu Gang; Peng Yuemei
For reaching a small emittance in a modern light source, triple bend achromats (TBA), theoretical minimum emittance (TME) and even multiple bend achromats (MBA) have been considered. This paper derived the necessary condition for achieving minimum emittance in TBA and MBA theoretically, where the bending angle of inner dipoles has a factor of 3 1/3 bigger than that of the outer dipoles. Here, we also calculated the conditions attaining the minimum emittance of TBA related to phase advance in some special cases with a pure mathematics method. These results may give some directions on lattice design. (authors)
John W. Lopresti; Kevin J. Mumford
This paper addresses the question of how a minimum wage increase affects the wages of low-wage workers. Most studies assume that there is a simple mechanical increase in the wage for workers earning a wage between the old and the new minimum wage, with some studies allowing for spillovers to workers with wages just above this range. Rather than assume that the wages of these workers would have remained constant, this paper estimates how a minimum wage increase impacts a low-wage worker's wage...
Stewart, Mark B.
This paper investigates possible spillover effects of the UK minimum wage. The halt in the growth in inequality in the lower half of the wage distribution (as measured by the 50:10 percentile ratio) since the mid-1990s, in contrast to the continued inequality growth in the upper half of the distribution, suggests the possibility of a minimum wage effect and spillover effects on wages above the minimum. This paper analyses individual wage changes, using both a difference-in-differences estimat...
Kandungan Prinsip Konservatisme DalamStandar Akuntansi Keuangan Berbasis IFRS(International Financial Reporting Standard)Ahmad JuandaStaf Pengajar Jurusan Akutansi, Fakultas Ekonomi dan BisnisUniversitas Muhammadiyah This study aims to reveal the content of the principle of conservatism contained in financial accounting standards (GAAP) results of the convergence of International Financial Reporting Standards (IFRS). The use of the principle of conservatism still...
Dutto, Moreno; Alfonzo, Santo; Rubbiani, Maristella
Failure to comply with requirements for proper storage and use of pesticides in farms can be extremely hazardous and the risk of accidents involving farm workers, other persons and even animals is high. There are still wide differences in the interpretation of the concept of "securing or making safe", by workers in this sector. One of the critical points detected, particularly in the fruit sector, is the establishment of an adequate storage site for plant protection products. The definition of "safe storage of pesticides" is still unclear despite the recent enactment of Legislative Decree 81/2008 regulating health and work safety in Italy. In addition, there are no national guidelines setting clear minimum criteria for storage of plant protection products in farms. The authors, on the basis of their professional experience and through analysis of recent legislation, establish certain minimum safety standards for storage of pesticides in farms.
An empirical consensus suggests that there are small employment effects of minimum wage increases. This paper argues that these are short-run elasticities. Long-run elasticities, which may differ from short-run elasticities, are policy relevant. This paper develops a dynamic industry equilibrium model of labor demand. The model makes two points. First, long-run regressions have been misinterpreted because even if the short- and long-run employment elasticities differ, standard methods would not detect a difference using US variation. Second, the model offers a reconciliation of the small estimated short-run employment effects with the commonly found pass-through of minimum wage increases to product prices.
Russell, C T; Jian, L K; Luhmann, J G
The end of the last solar cycle was at least 3 years late, and to date, the new solar cycle has seen mainly weaker activity since the onset of the rising phase toward the new solar maximum. The newspapers now even report when auroras are seen in Norway. This paper is an update of our review paper written during the deepest part of the last solar minimum . We update the records of solar activity and its consequent effects on the interplanetary fields and solar wind density. The arrival of solar minimum allows us to use two techniques that predict sunspot maximum from readings obtained at solar minimum. It is clear that the Sun is still behaving strangely compared to the last few solar minima even though we are well beyond the minimum phase of the cycle 23-24 transition.
Wolfe, Michael N.; Candland, Charles W.
Assesses the impact of increases in the minimum wage on salary schedules, provides guidelines for creating a philosophy to deal with the impact, and outlines options and presents recommendations. (IRT)
Goldfarb, Robert S.
The article reviews recent research examining the impact of minimum wage requirements on the size and distribution of teenage employment and earnings. The studies measure income distribution, employment levels and effect on unemployment. (MW)
Hamrock, B. J.; Dowson, D.
Formula predicts minimum film thickness required for fully-flooded ball bearings, gears, and cams. Formula is result of study to determine complete theoretical solution of isothermal elasto-hydrodynamic lubrication of fully-flooded elliptical contacts.
Roy, Rabindra Nath; Dasgupta, Samir; Bhattacharyya, Krishna Das; Misra, Raghu Nath; Roy, Sima; Saha, Indranil
ABSTRACT Lack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN). A cross-sectional study was carried out to estimate the nursing stuff requirement for the rural hospitals and provide a quantitative description of imbalances, if there is any, in the allocation at the district level during 2011. The average WISN turns out to be 0.35 for entire district, which means only 35% of the required nurses is available or 65% understaffed. So, there is an urgent need for more allocations and deployment of staff so that workload can be tackled and evenly distributed among all nursing personnel. PMID:25895199
Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.
The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory were 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs
Ellappan, Vijayan; Ashwini, J.
In programming change organizations from medium to inconceivable scale broadens, the issue of wander orchestrating is amazingly unusual and testing undertaking despite considering it a manual system. Programming wander-organizing requirements to deal with the issue of undertaking arranging and in addition the issue of human resource portion (also called staffing) in light of the way that most of the advantages in programming ventures are individuals. We propose a machine learning approach with finds respond in due order regarding booking by taking in the present arranging courses of action and an event based scheduler revives the endeavour arranging system moulded by the learning computation in perspective of the conformity in event like the begin with the Ander, the instant at what time possessions be free starting to ended errands, and the time when delegates stick together otherwise depart the wander inside the item change plan. The route toward invigorating the timetable structure by the even based scheduler makes the arranging method dynamic. It uses structure components to exhibit the interrelated surges of endeavours, slip-ups and singular all through different progression organizes and is adjusted to mechanical data. It increases past programming wander movement ask about by taking a gander at a survey based process with a one of a kind model, organizing it with the data based system for peril assessment and cost estimation, and using a choice showing stage.
Evans, KATE; Taper, JANETTE; Quintal, DEBORAH
The purpose of this study was to examine consumers' attitudes toward a supermarket nutrition centre staffed full time by a registered dietitian. A questionnaire was administered over three consecutive days in that store and in a control store that was similar to the experimental site in every way, except for the absence of a nutrition centre. Participants were chosen randomly at timed intervals in specific areas of the store. Of 428 customers approached, 232 agreed to participate in the survey. At the experimental site, 75% of the participants were extremely satisfied with the registered dietitian's services and 69% ranked having a registered dietitian on staff in any store as extremely important, compared to 31% at the control site (p importance of 13 required and optional services offered by the supermarkets, 15% of participants at the experimental site ranked having a registered dietitian on staff in the top five, compared with 4% at the control site (p service. There may therefore be an expanded role for registered dietitians in the supermarket setting.
Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T
Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.
Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto
Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.
Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.
The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs
Wogman, N.A.; Bond, L.J.; Waltar, A.E.; Leber, R.E.
The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of nuclear legacies, global security, nonproliferation, homeland security and national defense, radiobiology and nuclear energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. Current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs are presented. (author)
Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F
Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.
McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl
This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.
Louch, Gemma; O'Hara, Jane; Gardner, Peter; O'Connor, Daryl B
The association between poor staffing conditions and negative patient safety consequences is well established within hospital nursing. However, many studies have been limited to nurse population level associations, and have used routine data to examine relationships. As a result, it is less clear how these relationships might be manifested at the individual nurse level on a day-to-day basis. Furthermore, personality may have direct and moderating roles in terms of work environment and patient safety associations, but limited research has explored personality in this context. To further our understanding of these associations, this paper takes a within-person approach to examine nurses' daily perceptions of staffing and patient safety. In addition, we explore the potential role of personality factors as moderators of daily level associations. We recruited eighty-three hospital nurses from three acute NHS Trusts in the UK between March and July 2013. Nurses completed online end-of-shift diaries over three-five shifts which collected information on perceptions of staffing, patient-nurse ratio and patient safety (perceptions of patient safety, ability to act as a safe practitioner, and workplace cognitive failure). Personality was also assessed within a baseline questionnaire. Data were analysed using hierarchical linear modelling, and moderation effects of personality factors were examined using simple slopes analyses, which decomposed relationships at high and low levels of the moderator. On days when lower patient-nurse ratios were indicated, nurses reported being more able to act as a safe practitioner (p=.011) and more favourable perceptions of patient safety (p=workplace cognitive failure (p=personality factors. The findings elucidate the potential mechanisms by which patient safety risks arise within hospital nursing, and suggest that nurses may not respond to staffing conditions in the same way, dependent upon personality. Further understanding of these
Garri, Myropi; Konstantopoulos, Nikolaos
The research objective of this paper is to examine the staffing procedure of the internationalization department of the company in reference to the origin of the individuals selected to compose it. Subsequently, we endeavour to outline the identity of the individual at the head of internationalization, where a special department doesn’t exist. Additionally, we attempt to recognize the overall responsibilities and authority spaces of the internationalization manager. Results implied the prefer...
Newell, Felicia D; Williams, Patricia L; Watt, Cynthia G
This paper aims to assess the affordability of a nutritious diet for households earning minimum wage in Nova Scotia (NS) from 2002 to 2012 using an economic simulation that includes food costing and secondary data. The cost of the National Nutritious Food Basket (NNFB) was assessed with a stratified, random sample of grocery stores in NS during six time periods: 2002, 2004/2005, 2007, 2008, 2010 and 2012. The NNFB's cost was factored into affordability scenarios for three different household types relying on minimum wage earnings: a household of four; a lone mother with three children; and a lone man. Essential monthly living expenses were deducted from monthly net incomes using methods that were standardized from 2002 to 2012 to determine whether adequate funds remained to purchase a basic nutritious diet across the six time periods. A 79% increase to the minimum wage in NS has resulted in a decrease in the potential deficit faced by each household scenario in the period examined. However, the household of four and the lone mother with three children would still face monthly deficits ($44.89 and $496.77, respectively, in 2012) if they were to purchase a nutritiously sufficient diet. As a social determinant of health, risk of food insecurity is a critical public health issue for low wage earners. While it is essential to increase the minimum wage in the short term, adequately addressing income adequacy in NS and elsewhere requires a shift in thinking from a focus on minimum wage towards more comprehensive policies ensuring an adequate livable income for everyone.
Field, Dawn; Garrity, George; Gray, Tanya; Morrison, Norman; Selengut, Jeremy; Sterk, Peter; Tatusova, Tatiana; Thomson, Nicholas; Allen, Michael J; Angiuoli, Samuel V; Ashburner, Michael; Axelrod, Nelson; Baldauf, Sandra; Ballard, Stuart; Boore, Jeffrey; Cochrane, Guy; Cole, James; Dawyndt, Peter; De Vos, Paul; dePamphilis, Claude; Edwards, Robert; Faruque, Nadeem; Feldman, Robert; Gilbert, Jack; Gilna, Paul; Glöckner, Frank Oliver; Goldstein, Philip; Guralnick, Robert; Haft, Dan; Hancock, David; Hermjakob, Henning; Hertz-Fowler, Christiane; Hugenholtz, Phil; Joint, Ian; Kagan, Leonid; Kane, Matthew; Kennedy, Jessie; Kowalchuk, George; Kottmann, Renzo; Kolker, Eugene; Kravitz, Saul; Kyrpides, Nikos; Leebens-Mack, Jim; Lewis, Suzanna E; Li, Kelvin; Lister, Allyson L; Lord, Phillip; Maltsev, Natalia; Markowitz, Victor; Martiny, Jennifer; Methe, Barbara; Mizrachi, Ilene; Moxon, Richard; Nelson, Karen; Parkhill, Julian; Proctor, Lita; White, Owen; Sansone, Susanna-Assunta; Spiers, Andrew; Stevens, Robert; Swift, Paul; Taylor, Chris; Tateno, Yoshio; Tett, Adrian; Turner, Sarah; Ussery, David; Vaughan, Bob; Ward, Naomi; Whetzel, Trish; Gil, Ingio San; Wilson, Gareth; Wipat, Anil
With the quantity of genomic data increasing at an exponential rate, it is imperative that these data be captured electronically, in a standard format. Standardization activities must proceed within the auspices of open-access and international working bodies. To tackle the issues surrounding the development of better descriptions of genomic investigations, we have formed the Genomic Standards Consortium (GSC). Here, we introduce the minimum information about a genome sequence (MIGS) specification with the intent of promoting participation in its development and discussing the resources that will be required to develop improved mechanisms of metadata capture and exchange. As part of its wider goals, the GSC also supports improving the ‘transparency’ of the information contained in existing genomic databases. PMID:18464787
Field, D; Garrity, G; Gray, T
With the quantity of genomic data increasing at an exponential rate, it is imperative that these data be captured electronically, in a standard format. Standardization activities must proceed within the auspices of open-access and international working bodies. To tackle the issues surrounding the...... that will be required to develop improved mechanisms of metadata capture and exchange. As part of its wider goals, the GSC also supports improving the 'transparency' of the information contained in existing genomic databases....... the development of better descriptions of genomic investigations, we have formed the Genomic Standards Consortium (GSC). Here, we introduce the minimum information about a genome sequence (MIGS) specification with the intent of promoting participation in its development and discussing the resources...
Dunscombe, Peter; Grau, Cai; Defourny, Noémie; Malicki, Julian; Borras, Josep M.; Coffey, Mary; Bogusz, Marta; Gasparotto, Chiara; Slotman, Ben; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; De Hertogh, Olivier; Hadjieva, Tatiana; Petera, Jiri; Eriksen, Jesper Grau; Jaal, Jana; Bly, Ritva; Azria, David
Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need
Hennen, Thomas J., Jr.
Explains the need to establish a national system of standards for public libraries. Discusses local standards, state standards, and international standards, and suggests adopting a tiered approach including three levels: minimum standards; target standards; and benchmarking standards, as found in total quality management. (LRW)
Lee, Jeong Won; Park, Joongwoo Brian; Jo, Hang-Hyun; Yang, Jae-Suk; Moon, Hie-Tae
The entropy density is an intuitive and powerful concept to study the complicated nonlinear processes derived from physical systems. We develop the minimum entropy density method (MEDM) to detect the structure scale of a given time series, which is defined as the scale in which the uncertainty is minimized, hence the pattern is revealed most. The MEDM is applied to the financial time series of Standard and Poor’s 500 index from February 1983 to April 2006. Then the temporal behavior of structure scale is obtained and analyzed in relation to the information delivery time and efficient market hypothesis.
Santiago, C E
"This study examines the impact of minimum wage setting on labor migration. A multiple time series framework is applied to monthly data for Puerto Rico from 1970-1987. The results show that net emigration from Puerto Rico to the United States fell in response to significant changes in the manner in which minimum wage policy was conducted, particularly after 1974. The extent of commuter type labor migration between Puerto Rico and the United States is influenced by minimum wage policy, with potentially important consequences for human capital investment and long-term standards of living." excerpt
Lievens, Yolande; Defourny, Noémie; Coffey, Mary; Borras, Josep M.; Dunscombe, Peter; Slotman, Ben; Malicki, Julian; Bogusz, Marta; Gasparotto, Chiara; Grau, Cai; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; Coucke, Philippe; Gabrovski, Roumen; Vosmik, Milan; Eriksen, Jesper Grau; Jaal, Jana; Dejean, Catherine; Polgar, Csaba
Background: The ESTRO Health Economics in Radiation Oncology (HERO) project has the overall aim to develop a knowledge base of the provision of radiotherapy in Europe and build a model for health economic evaluation of radiation treatments at the European level. The first milestone was to assess the availability of radiotherapy resources within Europe. This paper presents the personnel data collected in the ESTRO HERO database. Materials and methods: An 84-item questionnaire was sent out to European countries, through their national scientific and professional radiotherapy societies. The current report includes a detailed analysis of radiotherapy staffing (questionnaire items 47–60), analysed in relation to the annual number of treatment courses and the socio-economic status of the countries. The analysis was conducted between February and July 2014, and is based on validated responses from 24 of the 40 European countries defined by the European Cancer Observatory (ECO). Results: A large variation between countries was found for most parameters studied. Averages and ranges for personnel numbers per million inhabitants are 12.8 (2.5–30.9) for radiation oncologists, 7.6 (0–19.7) for medical physicists, 3.5 (0–12.6) for dosimetrists, 26.6 (1.9–78) for RTTs and 14.8 (0.4–61.0) for radiotherapy nurses. The combined average for physicists and dosimetrists is 9.8 per million inhabitants and 36.9 for RTT and nurses. Radiation oncologists on average treat 208.9 courses per year (range: 99.9–348.8), physicists and dosimetrists conjointly treat 303.3 courses (range: 85–757.7) and RTT and nurses 76.8 (range: 25.7–156.8). In countries with higher GNI per capita, all personnel categories treat fewer courses per annum than in less affluent countries. This relationship is most evident for RTTs and nurses. Different clusters of countries can be distinguished on the basis of available personnel resources and socio-economic status. Conclusions: The average personnel
Khandelwal, Nita; Benkeser, David; Coe, Norma B; Engelberg, Ruth A; Curtis, J Randall
In the intensive care unit (ICU), complex decision making by clinicians and families requires good communication to ensure that care is consistent with the patients' values and goals. To assess the economic feasibility of staffing ICUs with a communication facilitator. Data were from a randomized trial of an "ICU communication facilitator" linked to hospital financial records; eligible patients (n = 135) were admitted to the ICU at a single hospital with predicted mortality ≥30% and a surrogate decision maker. Adjusted regression analyses assessed differences in ICU total and direct variable costs between intervention and control patients. A bootstrap-based simulation assessed the cost efficiency of a facilitator while varying the full-time equivalent of the facilitator and the ICU mortality risk. Total ICU costs (mean 22.8k; 95% CI, -42.0k to -3.6k; P = 0.02) and average daily ICU costs (mean, -0.38k; 95% CI, -0.65k to -0.11k; P = 0.006)] were reduced significantly with the intervention. Despite more contacts, families of survivors spent less time per encounter with facilitators than did families of decedents (mean, 25 [SD, 11] min vs. 36 [SD, 14] min). Simulation demonstrated maximal weekly savings with a 1.0 full-time equivalent facilitator and a predicted ICU mortality of 15% (total weekly ICU cost savings, $58.4k [95% CI, $57.7k-59.2k]; weekly direct variable savings, $5.7k [95% CI, $5.5k-5.8k]) after incorporating facilitator costs. Adding a full-time trained communication facilitator in the ICU may improve the quality of care while simultaneously reducing short-term (direct variable) and long-term (total) health care costs. This intervention is likely to be more cost effective in a lower-mortality population.
Christie, A.; Robertson, I.
Aim: To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. Materials and methods: A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Results: Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. Conclusion: A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. - Highlights: • A significant disparity exists between the level of nursing support provided in-hours and OOH. • This applies to both the availability of a nurse to scrub and to monitor the patient. • Having a dedicated 24/7 nursing rota is mandatory to providing a deliverable OOH service.
Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin
With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality
Yin, Huahua; He, Haiyan; Arbon, Paul; Zhu, Jingci; Tan, Jing; Zhang, Limei
To explore: the selection criteria for first responder nurses during disaster; scope of practice for disaster relief nurses; appropriate nurse - medical practitioner ratio at the disaster site. Nurses are key members of disaster response medical teams. A scarcity of literature exists relating to nurses attending disasters, their qualifications, experience, scope of practice and appropriate staffing ratios. Qualitative and quantitative data were collected via survey using self-developed questionnaires. Participants were 95 medical workers, who participated in emergency rescue teams following the 2008 Wenchuan earthquake in China. A response rate of 93·7% achieved. The questionnaire included questions relating to nurses: previous experience in disaster relief; scope of practice at the disaster site; optimal ratio of medical practitioners to nurses in disaster relief teams. Following a disaster, first responder nurses considered most suitable were those with at least three years clinical experience, particularly in the emergency department or having emergency rescue skills training. The scope of practice for disaster relief nurses was different to that of nurses working in a hospital. The majority of participants reported insufficient nurses during the relief effort, concluding the optimal ratio of medical practitioner to nurse should range between 1:1-1:2 depending on the task and situation. At the scene of disaster, the preferred first responder nurses were nurses: with emergency rescue training; experienced in the emergency department; with at least three years clinical experience. The scope of practice for first responder nurses needs to be extended. Appropriate nurse - medical practitioner ratios in responding medical teams is dependant on the specific medical requirements of the disaster. The recommendations made by this study provide a guide to ensure that nurses can contribute effectively as essential members of first responder emergency disaster relief teams
Seiler, F.A.; Alvarez, J.L.
Risk management implies that the risk manager can, by his actions, exercise at least a modicum of control over the risk in question. In the terminology of control theory, a management action is a control signal imposed as feedback on the system to bring about a desired change in the state of the system. In the terminology of risk management, an action is taken to bring a predicted risk to lower values. Even if it is assumed that the management action taken is 100% effective and that the projected risk reduction is infinitely well known, there is a lower limit to the desired effects that can be achieved. It is based on the fact that all risks, such as the incidence of cancer, exhibit a degree of variability due to a number of extraneous factors such as age at exposure, sex, location, and some lifestyle parameters such as smoking or the consumption of alcohol. If the control signal is much smaller than the variability of the risk, the signal is lost in the noise and control is lost. This defines a minimum controllable risk based on the variability of the risk over the population considered. This quantity is the counterpart of the minimum significant risk which is defined by the uncertainties of the risk model. Both the minimum controllable risk and the minimum significant risk are evaluated for radiation carcinogenesis and are shown to be of the same order of magnitude. For a realistic management action, the assumptions of perfectly effective action and perfect model prediction made above have to be dropped, resulting in an effective minimum controllable risk which is determined by both risk limits. Any action below that effective limit is futile, but it is also unethical due to the ethical requirement of doing more good than harm. Finally, some implications of the effective minimum controllable risk on the use of the ALARA principle and on the evaluation of remedial action goals are presented
The role and share of photovoltaic (PV) generated electricity in our nation's future energy arsenal is primarily dependent on its future production cost. This paper provides a framework for obtaining a minimum achievable electrical generating cost (a lower bound) for fixed, flat-plate photovoltaic systems. A cost of 2.8 $cent/kWh (1990$) was derived for a plant located in Southwestern USA sunshine using a cost of money of 8%. In addition, a value of 22 $cent/Wp (1990$) was estimated as a minimum module manufacturing cost/price
Environmental radiochemistry needs, for use in analytical intercomparision and as standard reference materials, very large homogeneous samples of a variety of matrices, each naturally contaminated by a variety of longer-lived radionuclides, at several different ranges of concentrations. The reasons for this need are discussed, and the minimum assortment of matrices of radionuclides, and of concentrations is established. Sources of suitable materials are suggested, and the international approach to meeting this need is emphasized
Environmental radiochemistry needs, for use in analytical inter-comparison and as standard reference materials, very large homogeneous samples of a variety of longer-lived radionuclides, at several different ranges of concentrations. The reasons for this need are discussed, and the minimum assortment of matrices, of radionuclides, and of concentrations is established. Sources of suitable materials are suggested, and the international approach to meeting this need is emphasized. (author)
Roatta , Luca
Assuming that space and time can only have discrete values, we obtain the expression of the minimum length and the minimum time interval. These values are found to be exactly coincident with the Planck's length and the Planck's time but for the presence of h instead of ħ .
Pennsylvania State Dept. of Public Instruction, Harrisburg.
MINIMUM AREA SPACE REQUIREMENTS IN SQUARE FOOTAGE FOR ELEMENTARY SCHOOL BUILDING FACILITIES ARE PRESENTED, INCLUDING FACILITIES FOR INSTRUCTIONAL USE, GENERAL USE, AND SERVICE USE. LIBRARY, CAFETERIA, KITCHEN, STORAGE, AND MULTIPURPOSE ROOMS SHOULD BE SIZED FOR THE PROJECTED ENROLLMENT OF THE BUILDING IN ACCORDANCE WITH THE PROJECTION UNDER THE…
Broersma, Haitze J.; Ryjacek, Z.; Schiermeyer, I.
Let G be a graph on n 3 vertices. Dirac's minimum degree condition is the condition that all vertices of G have degree at least . This is a well-known sufficient condition for the existence of a Hamilton cycle in G. We give related sufficiency conditions for the existence of a Hamilton cycle or a
Minimum risk pesticides pose little to no risk to human health or the environment and therefore are not subject to regulation under FIFRA. EPA does not do any pre-market review for such products or labels, but violative products are subject to enforcement.
Høholdt, Tom; Justesen, Jørn
We study codes constructed from graphs where the code symbols are associated with the edges and the symbols connected to a given vertex are restricted to be codewords in a component code. In particular we treat such codes from bipartite expander graphs coming from Euclidean planes and other...... geometries. We give results on the minimum distances of the codes....
A minimum maintenance solar pump (MMSP), Fig 1, has been simulated for Addis Ababa, taking solar meteorological data of global radiation, diffuse radiation and ambient air temperature as input to a computer program that has been developed. To increase the performance of the solar pump, by trapping the long-wave ...
Forchhammer, Søren; Wu, Xiaolin
Context quantization is a technique to deal with the issue of context dilution in high-order conditional entropy coding. We investigate the problem of context quantizer design under the criterion of minimum adaptive code length. A property of such context quantizers is derived for binary symbols....
Götz, E.; Klenner, K.; Lantelme, M.; Mohn, A.; Sauter, S.; Thöne, J.; Zellmann, E.; Drexler, H.; Jauslin, D.
The Minihouse is a prototupe for a sustainable townhouse. On a site of only 29 sqm it offers 154 sqm of urban life. The project 'Minimum Impact House' adresses two important questions: How do we provide living space in the cities without distroying the landscape? How to improve sustainably the
... dollar value to any non-financial factors that are considered by using performance-based specifications..., DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.27 Minimum criteria. In making the... used where possible and appropriate: (a) Operation costs; (b) Reliability of service; (c) Maintenance...
Fekete, S.P.; Haas, A.; Hemmer, M.; Hoffmann, M.; Kostitsyna, I.; Krupke, D.; Maurer, F.; Mitchell, J.S.B.; Schmidt, A.; Schmidt, C.; Troegel, J.
We consider the Minimum Perimeter Polygon Problem (MP3): for a given set V of points in the plane, find a polygon P with holes that has vertex set V , such that the total boundary length is smallest possible. The MP3 can be considered a natural geometric generalization of the Traveling Salesman
Electrons are heated at the minimum B location(s) created by the multipole field and the toroidal field. Resulting hot electrons can assist plasma confinement by (1) providing mirror, (2) creating azimuthally symmetric toroidal confinement, or (3) creating modified bumpy torus
Trifonov, D. A.
The completeness properties of the Schrodinger minimum uncertainty states (SMUS) and of some of their subsets are considered. The invariant measures and the resolution unity measures for the set of SMUS are constructed and the representation of squeezing and correlating operators and SMUS as superpositions of Glauber coherent states on the real line is elucidated.
Thodberg, Hans Henrik
The Minimum Description Length (MDL) approach to shape modelling is reviewed. It solves the point correspondence problem of selecting points on shapes defined as curves so that the points correspond across a data set. An efficient numerical implementation is presented and made available as open s...
Holm, Jacob; Rotenberg, Eva; Wulff-Nilsen, Christian
We give a new data structure for the fully-dynamic minimum spanning forest problem in simple graphs. Edge updates are supported in O(log4 n/log logn) expected amortized time per operation, improving the O(log4 n) amortized bound of Holm et al. (STOC’98, JACM’01).We also provide a deterministic data...
Neumark, David; Schweitzer, Mark; Wascher, William
This paper provides evidence on a wide set of margins along which labor markets can adjust in response to increases in the minimum wage, including wages, hours, employment, and ultimately labor income. Not surprisingly, the evidence indicates that low-wage workers are most strongly affected, while higher-wage workers are little affected. Workers…
Butler, R.W.; Davies, P.L.; Jhun, M.
Consistency is shown for the minimum covariance determinant (MCD) estimators of multivariate location and scale and asymptotic normality is shown for the former. The proofs are made possible by showing a separating ellipsoid property for the MCD subset of observations. An analogous property is shown
Smythe, C.M.; Eddy, J.A.
Sun-centered planetary conjunctions and tidal potentials are here constructed for the AD1645 to 1715 period of sunspot absence, referred to as the 'Maunder Minimum'. These are found to be effectively indistinguishable from patterns of conjunctions and power spectra of tidal potential in the present era of a well established 11 year sunspot cycle. This places a new and difficult restraint on any tidal theory of sunspot formation. Problems arise in any direct gravitational theory due to the apparently insufficient forces and tidal heights involved. Proponents of the tidal hypothesis usually revert to trigger mechanisms, which are difficult to criticise or test by observation. Any tidal theory rests on the evidence of continued sunspot periodicity and the substantiation of a prolonged period of solar anomaly in the historical past. The 'Maunder Minimum' was the most drastic change in the behaviour of solar activity in the last 300 years; sunspots virtually disappeared for a 70 year period and the 11 year cycle was probably absent. During that time, however, the nine planets were all in their orbits, and planetary conjunctions and tidal potentials were indistinguishable from those of the present era, in which the 11 year cycle is well established. This provides good evidence against the tidal theory. The pattern of planetary tidal forces during the Maunder Minimum was reconstructed to investigate the possibility that the multiple planet forces somehow fortuitously cancelled at the time, that is that the positions of the slower moving planets in the 17th and early 18th centuries were such that conjunctions and tidal potentials were at the time reduced in number and force. There was no striking dissimilarity between the time of the Maunder Minimum and any period investigated. The failure of planetary conjunction patterns to reflect the drastic drop in sunspots during the Maunder Minimum casts doubt on the tidal theory of solar activity, but a more quantitative test
Chatham, Robert L.; Thomas, Shelley
Discusses the International Civil Aviation Organization's (ICAO) Air Navigation's Commission approval of a task to develop minimum skill level requirements in English for air traffic control. The ICAO collaborated with the Defense Language Institute English Language Center to propose a minimum standard for English proficiency for international…
Oberholzer, Nicole; Kaserer, Alexander; Albrecht, Roland; Seifert, Burkhardt; Tissi, Mario; Spahn, Donat R; Maurer, Konrad; Stein, Philipp
Pain is frequently encountered in the prehospital setting and needs to be treated quickly and sufficiently. However, incidences of insufficient analgesia after prehospital treatment by emergency medical services are reported to be as high as 43%. The purpose of this analysis was to identify modifiable factors in a specific emergency patient cohort that influence the pain suffered by patients when admitted to the hospital. For that purpose, this retrospective observational study included all patients with significant pain treated by a Swiss physician-staffed helicopter emergency service between April and October 2011 with the following characteristics to limit selection bias: Age > 15 years, numerical rating scale (NRS) for pain documented at the scene and at hospital admission, NRS > 3 at the scene, initial Glasgow coma scale > 12, and National Advisory Committee for Aeronautics score helicopter emergency service associated with insufficient pain management. A total of 778 patients were included in the analysis. Insufficient pain management (NRS > 3 at hospital admission) was identified in 298 patients (38%). Factors associated with insufficient pain management were higher National Advisory Committee for Aeronautics scores, high NRS at the scene, nontrauma patients, no analgesic administration, and treatment by a female physician. In 16% (128 patients), despite ongoing pain, no analgesics were administered. Factors associated with this untreated persisting pain were short time at the scene (below 10 minutes), secondary missions of helicopter emergency service, moderate pain at the scene, and nontrauma patients. Sufficient management of severe pain is significantly better if ketamine is combined with an opioid (65%), compared to a ketamine or opioid monotherapy (46%, P = .007). In the studied specific Swiss cohort, nontrauma patients, patients on secondary missions, patients treated only for a short time at the scene before transport, patients who receive no
Allen, Robert William; Pruitt, Mark; Taaffe, Kevin M
The operating room (OR) is a major driver of hospital costs; therefore, operative time is an expensive resource. The training of surgical residents must include time spent in the OR, but that experience comes with a cost to the surgeon and hospital. The objective of this article is to determine the effect of surgical resident involvement in the OR on operative time and subsequent hospital labor costs. The Kruskal-Wallis statistical test is used to determine whether or not there is a difference in operative times between 2 groups of cases (with residents and without residents). This difference leads to an increased cost in associated hospital labor costs for the group with the longer operative time. Cases were performed at Greenville Memorial Hospital. Greenville Memorial Hospital is part of the larger healthcare system, Greenville Health System, located in Greenville, SC and is a level 1 trauma center with up to 33 staffed ORs. A total of 84,997 cases were performed at the partnering hospital between January 1st, 2011 and July 31st, 2015. Cases were only chosen for analysis if there was only one CPT code associated with the case and there were more than 5 observations for each group being studied. This article presents a comprehensive retrospective analysis of 29,134 cases covering 246 procedures. The analysis shows that 45 procedures took significantly longer with a resident present in the room. The average increase in operative time was 4.8 minutes and the cost per minute of extra operative time was determined to be $9.57 per minute. OR labor costs at the partnering hospital was found to be $2,257,433, or $492,889 per year. Knowing the affect on operative time and OR costs allows managers to make smart decisions when considering alternative educational and training techniques. In addition, knowing the connection between residents in the room and surgical duration could help provide better estimates of surgical time in the future and increase the predictability of
Mills, Michael D; Chan, Maria F; Prisciandaro, Joann I; Shepard, Jeff; Halvorsen, Per H
The AAPM has long advocated a consistent level of medical physics practice, and has published many recommendations and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physics practice. Despite these concerted and enduring efforts, the profession does not have clear and concise statements of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. To this end, the AAPM has recently endorsed the development of MPPGs, which may be generated in collaboration with other professional societies. The MPPGs are intended to be freely available to the general public. Accrediting organizations, regulatory agencies, and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider prudent in clinical practice settings. Support includes, but is not limited to, staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This article has described the purpose, scope, and process for the development of MPPGs.