An investigation of the international literature on nurse practitioner private practice models.

Science.gov (United States)

Currie, J; Chiarella, M; Buckley, T

2013-12-01

To investigate and synthesize the international literature surrounding nurse practitioner (NP) private practice models in order to provide an exposition of commonalities and differences. NP models of service delivery have been established internationally and most are based in the public healthcare system. In recent years, opportunities for the establishment of NP private practice models have evolved, facilitated by changes in legislation and driven by identification of potential patient need. To date, NP private practice models have received less attention in the literature and, to the authors' knowledge, this is the first international investigation of NP private practice models. Integrative literature review. A literature search was undertaken in October 2012. Database sources utilized included Medical Literature Analyses and Retrieval (MEDLINE), the Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest, Scopus and the Cochrane Database of Systematic Reviews (CDSR). The grey literature was also searched. The following Medical Subject Headings (MeSH) and search terms used both individually and in combination included nurse practitioners; private practice; joint practice; collaboration; and insurance, health and reimbursement. Once literature had been identified, a thematic analysis was undertaken to extract themes. Thirty manuscripts and five publications from the grey literature were included in the final review. Private practice NP roles were identified in five countries, with the majority of the literature emanating from the USA. The thematic analysis resulted in the identification of five themes: reimbursement, collaborative arrangements, legislation, models of care and acceptability. Proportionally, there are very few NPs engaged in private practice internationally. The most common NP private practice models were community based, with NPs working in clinic settings, either alone or with other health professionals. Challenges in the

Two management systems in a nursing private practice group.

Science.gov (United States)

Zahourek, R P

1979-09-01

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Media Ecology and the Blurring of Private and Public Practices

DEFF Research Database (Denmark)

de Franco, Chiara

2016-01-01

can produce changes in the social settings where international practices develop. It particular, it argues that the media ecology can affect the articulation of public and private and lead to the emergence of international practices where appropriate and competent behaviour reconstitute the private...... such a group has developed a Transnational Activist Network (TAN) bringing people together through shared private experiences.......This paper aims at posing the basis for a new conceptualization of the impact of ‘old’ and ‘new’ media in international politics by creating a dialogue between the practice theoretical approach in IR (Adler and Pouliot 2011) and the medium theory in media studies (Meyrowitz 1985). Building...

Private Pilot Practical Test Standards for Airplane (SEL, MEL, SES, MES)

Science.gov (United States)

1995-05-01

The Private Pilot - Airplane Practical Test Standards book has been : published by the Federal Aviation Administration (FAA) to establish the : standards for the private pilot certification practical tests for the airplane : category and the single-e...

An empirical analysis of public and private medical practice in Australia.

Science.gov (United States)

Cheng, Terence C; Joyce, Catherine M; Scott, Anthony

2013-06-01

The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

Science.gov (United States)

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perceptions of community health center impact on private primary care physician practice.

Science.gov (United States)

Duffrin, Christopher; Jackson, Natalie; Whetstone, Lauren; Cummings, Doyle; Watson, Ricky; Wu, Qiang

2014-01-01

Community health centers (CHCs) were created in the mid-1960s to expand access to care in impoverished and underserved areas. The number of CHC sites has more than tripled in eastern North Carolina from 28 primary care centers in 2000 to 89 in 2010. This study determined the perceptions of physicians on the impact of CHC expansion on the local practice environment. Descriptive statistics and correlations were used to compare responses regarding perceptions and differences between practice characteristics as well as physician ratios by year. Both CHC and private practice physician addresses were mapped using ArcGIS. Surveys were sent to 1422 (461 returns/32.5% response rate) primary care physicians residing in 43 predominantly rural eastern North Carolina counties. A large percentage of the respondents (82.7%) affirmed that they felt neutral or did not view CHCs to be competitors, whereas a minority (17%) did view them to be difficult to compete against. Forty-two percent of private practice respondents disagreed that CHCs offer a wider range of services despite significantly more CHC physicians than private practice respondents indicating that their facility provided basic services. The CHCs were perceived to offer a wider range of services, employ more staff, and have more practice locations than private practices. However, private practice physicians did not perceive CHCs to have a competitive advantage or to unfairly impact their practices, possibly due to inconsistent population growth in relation to the physician retention during the last 10 years.

The experiences of private somatology therapists on their self-management in a private practice

Directory of Open Access Journals (Sweden)

Karien Richter

2013-07-01

Full Text Available Somatology therapists have a demanding occupation, both physically and emotionally. Long working hours coupled with handling clients on a daily basis, notwithstanding the strain of ensuring high quality client care, are all aspects that place pressure on the therapist. These aspects, in the backdrop of a lack of self-management of a therapist, could result in impaired judgement and substandard performance in the workplace. The purpose of this study included exploring and describing the experiences of private somatology therapists in self-management, from which recommendations for improved self-management within private somatology practices were described. For the purpose of this study, self-management was defined as a method of managing not only the interaction with clients and work stressors, but also the feelings of the therapists, by practising a variety of techniques such as self-discipline. A descriptive, exploratory and contextual qualitative design was followed. The accessible population consisted of therapists (n = 15 practising at six private somatology facilities in the Pretoria North region. Purposeful sampling was followed. Ten individual unstructured interviews as well as a pilot study were conducted in which field notes were taken. Open-coding data analysis identified four themes with subthemes. Lincoln and Guba’s model was used to ensure trustworthiness and ethical considerations were followed throughout the process. Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment which we call the somatology practice.

The pattern of trauma in private general medical practice set-up Port ...

African Journals Online (AJOL)

BACKGROUND: Private general medical practice establishments appear to be treating a significant number of trauma cases including more serious ones. Aim: To find out the extent of such treatment of trauma and what has made this possible. METHODS: All trauma cases treated in a private general medical practice set up ...

WHAT ARE THEY BUYING IN PRIVATE TUITION? MICRO-LEVEL PERSPECTIVE ON THE PRACTICE OF PRIVATE TUITION BY GRADE 9 STUDENTS IN KALE TOWNSHIP, MYANMAR

OpenAIRE

Kam Tung Tuang Suante

2017-01-01

Private tuition is the practice of academic teaching and learning from outside of the school with a fee but a few of studies acknowledged what private tuition provides to the receivers beyond the teaching of academic subjects. This study explored the intensity and nature of private tuition through 1119 Grade 9 students’ survey reports and 18 interviewees’ responses. The study revealed the common practice of private tuition in Myanmar and 69.5% of the participants are in private boarding tuiti...

Does Ownership Matter? Employee Selection Practices in Private and Public Sectors

Directory of Open Access Journals (Sweden)

Codruţa OSOIAN

2011-06-01

Full Text Available The continuous need to adapt to the dynamics of the environment requires employers from both public and private sectors to select qualified human resources. It is people who lead the organization towards performance, and selecting competent employees is critical for competitive success. The paper is focused on the job selection practices implemented by hiring organizations in a developing country. Due to the differences that exist regarding the employee selection policy between public and private organizations, the paper aims to understand the characteristics of the job selection process according to the ownership of the employer agent. Based on a quantitative survey applied on 64 companies, the results analyze the main selection stages implemented in private vs. public sector employers in a developing country. While in private companies the most frequently used selection stages are the job selection interview, CVs screening and trial period, in public institutions the hiring process is based on the job selection interview, written knowledge tests, and practical tests. Compared to private companies, in public institutions the written knowledge tests rank a higher position in the selection stages hierarchy, but the private employers rely more on CVs screening stage than public institutions. Emphasis is laid on understanding the reasons leading to variations in job selection practices according to the ownership of the employing agent. The predictive validity of the job selection stages implemented by the companies is also discussed.

Private Practice Teachers in Public Schools: Reexamining Tensions between Professionalism and Bureaucratic Control.

Science.gov (United States)

Goldring, Ellen B.; Ogwa, Rodney

This paper examines the phenomenon of private-practice teachers in public schools. It helps frame the debates surrounding market-driven reforms that are aimed at freeing schools from bureaucratic control and raises several questions about the potential impact of private-practice teachers. It asks whether market-driven reforms within public schools…

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

Science.gov (United States)

Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

2006-11-01

Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting

Exploring healthcare communication models in private physiotherapy practice.

Science.gov (United States)

Hiller, Amy; Guillemin, Marilys; Delany, Clare

2015-10-01

This project explored whether models of healthcare communication are evident within patient-physiotherapist communication in the private practice setting. Using qualitative ethnographic methods, fifty-two patient-physiotherapist treatment sessions were observed and interviews with nine physiotherapists were undertaken. Data were analyzed using thematic analysis. In these clinical encounters physiotherapists led the communication. The communication was structured and focussed on physical aspects of the patient's presentation. These features were mediated via casual conversation and the use of touch to respond to the individual patient. Physiotherapists did not explicitly link their therapeutic communication style to established communication models. However, they described a purposeful approach to how they communicated within the treatment encounter. The communication occurring in the private practice physiotherapy treatment encounter is predominantly representative of a 'practitioner-centred' model. However, the subtle use of touch and casual conversation implicitly communicate competence and care, representative of a patient-centred model. Physiotherapists do not explicitly draw from theories of communication to inform their practice. Physiotherapists may benefit from further education to achieve patient-centred communication. Equally, the incorporation of casual conversation and the use of touch into theory of physiotherapy patient-centred communication would highlight these specific skills that physiotherapists already utilize in practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

USING A LOCUM TENENS IN A PRIVATE PRACTICE

African Journals Online (AJOL)

10332324

The focus of this article is only on medical practitioners in a private practice making ..... advisable and in the interest of the locum when signing a contract. .... 11.2 Any single act in the exercise of the calling of a medical practitioner (or dental.

The private-practice perspective of the manpower crisis in radiology: greener pastures?

Science.gov (United States)

Swayne, Lawrence C

2004-11-01

Rising consumer expectations and a rapidly aging population point to a long-term shortage of all physicians, including radiologists. While attention has been drawn to the escalating manpower crisis in academic radiology departments, the private-practice perspective has been generally overlooked. Although clinical workloads and income are higher in private practice, studies have shown higher satisfaction levels (likely because of a greater variety of work) among academic radiologists. As the distinction between community and teaching hospitals has become increasingly blurred, there is now considerable overlap in the skill sets, sources of job satisfaction, and stresses that are encountered in both practice settings. Perhaps more than at any time in the recent past, diagnostic radiologists in academic and private practice share more in common than any perceived differences. Both groups must work together in concert with the ACR to address the growing manpower shortage, as well as the other challenges that confront diagnostic radiology at the beginning of the 21st century.

Prioritizing lean management practices in public and private hospitals.

Science.gov (United States)

Hussain, Matloub; Malik, Mohsin

2016-05-16

Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

Infection control practice in private dental laboratories in Riyadh

International Nuclear Information System (INIS)

AlKheraif, Abdulaziz A; Mobarak, Fahmy A

2008-01-01

In view of the risk of infection of dental health care workers and patients, interruption of possible chains of infection is to be demanded. The objective of this study was to assess infection control practice in private dental laboratories in Riyadh City, Kingdom of Saudi Arabia. The study was conducted on thirty-two private dental laboratories in Riyadh City regarding infection control practiced by these laboratories. The instrument of the study consisted of ten open-ended questions that were asked from the laboratories directors. A large percentage of the surveyed laboratories (87.5 %) did not implement any infection control protocol during their practice. The mean number of impressions received per week was 16. Most of the surveyed laboratories (90.6 %) had no way of communication with the clinics regarding the disinfection procedures. The results indicated that 62.5 % of the laboratories reported that they were aware that they may get infection from non-disinfected items. Only a small percentage (6.2%) of the laboratories added disinfecting agent to pumice slurry. Wearing laboratory coats was reported by 75% of the laboratory workers. The use of gloves during work was reported by 59.3% of the laboratories while 56.2% reported the use protective eyewear. Only 21.8% of the laboratories use face masks during work. Construction of infection control manuals that contain updated and recommended guidelines to ensure aseptic practice in private dental laboratories is highly recommended. Also, a way of communication between dentists and dental technicians regarding disinfection of laboratory items should be strongly encouraged. (author)

Physical Education Policies and Practices in California Private Secondary Schools.

Science.gov (United States)

Kahan, David; McKenzie, Thomas L

2017-02-01

Physical education (PE) is mandated in most states, but few studies of PE in private schools exist. We assessed selected PE policies and practices in private secondary schools (grades 6 to 12) in California using a 15-item questionnaire related to school characteristics and their PE programs. Responding schools (n = 450; response rate, 33.8%) were from 37 counties. Most were coeducational (91.3%) and had a religious affiliation (83%). Secular schools had more PE lessons, weekly PE min, and smaller class sizes. Most schools met guidelines for class size, but few met national recommendations for weekly PE minutes (13.7%), not permitting substitutions for PE (35.6%), and programs being taught entirely by PE specialists (29.3%). Private schools, which serve about 5 million US children and adolescents, may be falling short in providing quality PE. School stakeholders should encourage adoption and implementation of policies and practices that abide by professional guidelines and state statutes.

Development of the private practice management standards for psychology.

Science.gov (United States)

Mathews, Rebecca; Stokes, David; Littlefield, Lyn; Collins, Leah

2011-01-01

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery. © 2010 National Association for Healthcare Quality.

Choosing academia versus private practice: factors affecting oral maxillofacial surgery residents' career choices.

Science.gov (United States)

Lanzon, Jesse; Edwards, Sean P; Inglehart, Marita R

2012-07-01

This study explored how residents who intend to enter private practice versus academic careers differ in their background and educational characteristics, engagement in different professional activities, professional values, and satisfaction. Survey data were collected from 257 residents in oral and maxillofacial surgery programs in the United States. The responses of the respondents who planned a career in private practice (65%) and who considered academia (35%) were compared with χ(2) and independent-sample t tests. Residents who considered academia were more likely to be women (29% vs 8%; P career compared with residents interested in private practice. Future clinicians placed a higher value on having manageable hours and more time performing outpatient procedures than future educators. These findings showed, first, that the characteristics at the beginning of residency programs that are likely to indicate an increased interest in academic careers are being a woman, from a non-European American background, and having an interest in research. Second, once residents are admitted, different types of surgeries and different types of professional activities tend to appeal to residents who want to practice in private practice settings versus work in academia. Third, residents interested in academia have a relatively lower level of satisfaction compared with residents interested in practicing outside of academia. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Audiology, Entrepreneurship and Innovation: A perspective on private practice

Directory of Open Access Journals (Sweden)

Alex Antonites

2013-12-01

Full Text Available Objective: This paper investigates the correlation and contact points between entrepreneurship as a discipline and the profession of audiology. The research focuses on specific areas of entrepreneurship (e.g. innovation as an entrepreneurial skill and the impact it has on audiology private practices as key role players in the biotechnology industry. Design: This study used a two-stage research design comprising of an exploratory study and a formal study to survey the entrepreneurial and business skills of audiologists as entrepreneurs in private practice. Findings: The findings describe severe deficiencies - specifically the business and entrepreneurial skill sets of the professional audiologist as an entrepreneur. The mind-set of the audiologist is not that of an entrepreneur, but rather of a small business owner. A lack of self-confidence to be creative, take risks, and identify new opportunities or innovate in terms of products, process and services was found. Audiologists are not necessarily concerned about the creation of employment, or the growth and profitability of their practices. Autonomy and security are the primary objectives of most practice owners. Keywords: Innovation, Entrepreneurs, Women Entrepreneurs, Entrepreneurship, Audiology, Biotechnology

Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India.

Science.gov (United States)

Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap

2015-06-01

The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use

Physiotherapy as a disciplinary institution in modern society - a Foucauldian perspective on physiotherapy in Danish private practice.

Science.gov (United States)

Praestegaard, Jeanette; Gard, Gunvor; Glasdam, Stinne

2015-01-01

In many Western countries, physiotherapy in a private context is practiced and managed within a neoliberal ideology. Little is known about how private physiotherapeutic practice functions, which is why this study aims to explore how physiotherapy is practiced from the perspective of physiotherapists in Danish private practice, within a Foucauldian perspective. This study consisted of 21 interviews with physiotherapists employed in private practice and observation notes of the clinic. Interviews and observation notes were analyzed through the lens of Foucault's concepts of discipline, self-discipline, power and resistance. Three categories were constructed: (1) the tacit transition from person to patient; (2) the art of producing docile bodies; and (3) the inhibition of freedom of action by practicing in private homes. From a Foucauldian perspective, private physiotherapeutic practices have a disciplinary function in modern society as the physiotherapists produce docile bodies through disciplinary technologies, whereby their business becomes profitable. Most patients support the physiotherapists' "regime of truth" but if they resist, they are either excluded or accepted as "abnormal" but as a necessary source of income. The physiotherapists appear to be unconscious of the bio-powers working "behind their backs" as they are subject to the Western medical logic, and the neoliberal framework that rules their businesses.

[Internet presence of neurologists, psychiatrists and medical psychotherapists in private practice].

Science.gov (United States)

Kuhnigk, Olaf; Ramuschkat, Meike; Schreiner, Julia; Anger, Anina; Reimer, Jens

2014-04-01

The world wide web provides new options to physicians in terms practice marketing, information brokerage, and process optimization. This study explores prevalence and content of homepages of neurologists, psychiatrists and medical psychotherapists in private practice. Through the legal bodies of physicians in private practice in six northern German states neurologists, psychiatrists and medical psychotherapists were identified. According to a standardized and operationalized criteria catalogue, homepages were rated. 1804 physicians were identified, 352 (19.5 %) had operated a homepage. Higher frequencies of homepages found for male physicians (vs. female physicians), practice centres (vs. single practices) and urban practices (vs. rural practices). In average, practices reached 18.8 (± 5.3) of 42 points; contact data and accessibility information were generally available; information as to qualification and specialization was provided more infrequently. Legal specifications were not considered in more than every second homepage, interactive elements like online appointment of follow-up prescription were only rarely offered. Only every fifth neurological or psychiatric practice operates an own homepage, higher competition (urban area) and higher professionalization (practice centres) seem to act as promotors. The legal framework has to be focused, and patient needs should be taken into account. © Georg Thieme Verlag KG Stuttgart · New York.

Effort-reward imbalance and depression among private practice physicians.

Science.gov (United States)

Tsutsumi, Akizumi; Kawanami, Shoko; Horie, Seichi

2012-02-01

Current private practice physicians provide medical services in a harsh economic situation. The effort-reward imbalance (ERI) model puts its emphasis on an imbalance between high efforts spent and low rewards received in occupational life. ERI model includes three different reward factors from task to organizational levels. We examined whether ERI in terms of low organizational reward (poor prospective and job insecurity) could be the most relevant and strongly associated with depression among private practice physicians. This is a cross-sectional questionnaire study of 1,103 private practice physicians who were currently working in clinical settings and completed the data of exposure and outcome. The study questionnaire was mailed to all the physicians listed as members of a local branch of the Japan Medical Association (n = 3,441) between November and December 2008. Outcomes were prevalence of depression as measured by the Center for Epidemiologic Studies Depression Scale and adjusted odds ratios (OR) of depression with respect to ERI. Fifty-seven percent of physicians were exposed to ERI, and 18% of the physicians were depressed. Logistic regression analyses revealed that ERI was significantly associated with depression (OR and 95% confidence interval = 3.57; 2.43-5.26). ERI with regard to organizational reward was most prevalent (60%) and had the strongest association with depression (5.14; 3.36-7.92). Predominant prevalence of ERI in terms of organizational level low reward and strong associations between the ERI component and depression suggests that countermeasures from social perspective are crucial.

Maternity leave policies in academic and private radiology practices

International Nuclear Information System (INIS)

Spirt, B.A.; Rauth, V.; Price, A.P.F.; Pagani, A.H.

1988-01-01

In 1987, the American Association of Women Radiologists surveyed both academic and private radiology departments regarding pregnancy and maternity leave policies. One hundred academic institutions (70% response), 30 radiotherapy departments (38% response), and 31 private practices responded. Details were obtained regarding maternity leave policy for residents and attending physicians; availability of paternity leave; policies regarding on-call time, fluoroscopy time and intracavitary/interstitial applications during pregnancy; and problems that occurred during resident or attending physician pregnancies. There was a wide range of responses regarding paid leave time, availability of additional time, and the use of vacation time during maternity leave

Physiotherapy practice in the private sector: organizational characteristics and models.

Science.gov (United States)

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

2014-08-29

Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

Physiotherapy as a disciplinary institution in modern society - A Foucauldian perspective on physiotherapy in Danish private practice

DEFF Research Database (Denmark)

Præstegaard, Jeanette

2015-01-01

In many Western countries, physiotherapy in a private context is practiced and managed within a neoliberal ideology. Little is known about how private physiotherapeutic practice functions, which is why this study aims to explore how physiotherapy is practiced from the perspective...

Ethical issues in physiotherapy--reflected from the perspective of physiotherapists in private practice.

Science.gov (United States)

Praestegaard, Jeanette; Gard, Gunvor

2013-02-01

An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are understood and experienced by Danish physiotherapists in outpatient, private practice. A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analyzed, using a phenomenological hermeneutic framework. One main theme emerged: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries. In an ethical perspective, physiotherapy in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized by asymmetrical power encounters where the parties are in close physical and emotional contact, practiced physiotherapy has many ethical issues embedded. Some physiotherapists meet these issues in a professional manner, but others meet them in unconscious or unprofessional ways. An explicit ethical consciousness among Danish physiotherapists in private practice seems to be needed. A debate of how to understand and respect the individual physiotherapist's moral versus the ethics of the profession needs to be addressed.

Practical Solutions for Addressing Labor-Related Barriers to Bhutan's Private Employment Growth

OpenAIRE

World Bank Group

2017-01-01

This note provides practical solutions for addressing the labor-related barriers that impede Bhutan's private sector employment growth: (i) lack of workers with relevant experience and skills, (ii) restrictions on employing non-Bhutanese workers, and (iii) lack of interest among Bhutanese workers in private sector employment opportunities (Enterprise Survey 2015). This note draws on intern...

New Digital Marketing Actors: Private Shopping Clubs and Their Advertising Practices

Directory of Open Access Journals (Sweden)

Nazlım Tüzel Uraltaş

2014-12-01

In the first part of the study the concept of digital marketing and its historical background will be explained. In the second part online shopping behavior, online shopping training activities in Turkey and private shopping clubs will be examined.  The last part of the study will deal with the advertising practices of private shopping clubs. The study is essentially a literature review; thus, the resources are mostly secondary in nature.

Comparison of Rate of Utilization of Medicare Services in Private Versus Academic Cardiology Practice.

Science.gov (United States)

Hovanesyan, Arsen; Rubio, Eduardo; Novak, Eric; Budoff, Matthew; Rich, Michael W

2017-11-15

Cardiovascular services are the third largest source of Medicare spending. We examined the rate of cardiovascular service utilization in the community of Glendale, CA, compared with the nearest academic medical center, the University of Southern California. Publicly available utilization data released by Medicare for the years 2012 and 2013 were used to identify all inpatient and outpatient cardiology services provided in each practice setting. The analysis included 19 private and 17 academic cardiologists. In unadjusted analysis, academic physicians performed half as many services per Medicare beneficiary per year as those in private practice: 2.3 versus 4.8, p cardiology practice settings in southern California, medical service utilization per Medicare beneficiary was nearly 2-fold higher in private practice than in the academic setting, suggesting that there may be opportunity for substantially reducing costs of cardiology care in the community setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Advanced psychiatric nurse practitioners' ideas and needs for supervision in private practice in South Africa.

Science.gov (United States)

Temane, Annie M; Poggenpoel, Marie; Myburgh, Chris P H

2014-04-07

Supervision forms an integral part of psychiatric nursing. The value of clinicalsupervision has been demonstrated widely in research. Despite efforts made toward advancedpsychiatric nursing, supervision seems to be non-existent in this field. The aim of this study was to explore and describe advanced psychiatric nursepractitioners' ideas and needs with regard to supervision in private practice in order tocontribute to the new efforts made in advanced psychiatric nursing in South Africa. A qualitative, descriptive, exploratory, and contextual design using a phenomenological approach as research method was utilised in this study. A purposive sampling was used. Eight advanced psychiatric nurse practitioners in private practice described their ideas and needs for supervision during phenomenological interviews. Tesch's method of open coding was utilised to analyse data. After data analysis the findings were recontextualised within literature. The data analysis generated the following themes - that the supervisor should have or possess: (a) professional competencies, (b) personal competencies and (c) specificfacilitative communication skills. The findings indicated that there was a need for supervision of advanced psychiatric nurse practitioners in private practice in South Africa. This study indicates that there is need for supervision and competent supervisors in private practice. Supervision can be beneficial with regard to developing a culture of support for advanced psychiatric practitioners in private practice and also psychiatric nurse practitioners.

Knowledge, Attitude and Practice of Private Medical Practitioners in ...

African Journals Online (AJOL)

Knowledge, Attitude and Practice of Private Medical Practitioners in Calabar towards Post-Abortion Care. ... The major reasons given by some of the doctors for not terminating unwanted pregnancies were religious, moral and ethical considerations rather than respect for the Nigerian abortion law. Only 18.2% of the doctors ...

A qualitative exploration of the factors influencing the job satisfaction and career development of physiotherapists in private practice.

Science.gov (United States)

Davies, J M; Edgar, S; Debenham, J

2016-09-01

The aim of this study was to investigate factors contributing to job satisfaction at different career stages, among private practice physiotherapists in Australia. Qualitative case study design utilising focus groups. Sixteen participants allocated to 3 focus groups: new graduates (n = 6), post graduates (n = 5) and practice owners (n = 5). Focus groups were transcribed verbatim and a thematic analysis was undertaken to determine themes and subthemes from each focus group. The key themes identified within each focus group included the role of peer support and mentoring, professional development, professional relationships, new graduate employment issues and career pathways within private practice. In particular, issues surrounding the new graduate experience in private practice were explored, with all groups noting lack of support and financial pressures were of concern. Findings demonstrated that new graduates are underprepared to work in private practice and modifications to the delivery of peer support, mentoring and professional development is required. Key recommendations include physiotherapy undergraduate program reform to reflect industry requirements in private practice, an increase in private practice clinical placement numbers, as well as streamlining the physiotherapy profession to improve career development pathways. Copyright © 2016 Elsevier Ltd. All rights reserved.

Attitude of clinical faculty members in Shiraz Medical University towards private practice physicians' participation in ambulatory care education

Directory of Open Access Journals (Sweden)

Khatereh Mahori

2002-04-01

Full Text Available Background: Improvement of medical education is necessary for meeting health care demands. Participation of private practice physicians in ambulatory care training is an effective method for enhancing medical students' skills. Purpose This study was undertaken to determine clinical professors' views about participation of physicians with private office in ambulatory care training. Methods: Participants composed of 162 Shiraz Medical University faculty members from 12 disciplines. A questionnaire requesting faculty members' views on different aspects of ambulat01y care teaching and interaction of community-based organizations was distributed. Results: Of 120 (74.1% respondents, 64 (54.2% believed that clinical settings of medical university are appropriate for ambulatory care training. Private practice physicians believed more than academic physicians without private office that private offices have wider range of patients, more common cases, and better follow up chance; and is also a better setting for learning ambulatory care compared with medical university clinical centers. Overall, 32 (29.1% respondent’s found the participation of physicians with private practice on medical education positive. Key words medical education, ambulatory medicine, private practice

[The ethical concerns of the private practice nurse].

Science.gov (United States)

Pivot, Annie

2015-12-01

Ethics, by its definition, is a philosophical discipline which enables human beings to behave, to act and to be, in the best way possible, between themselves and towards their environment. In private nursing practice, the ethical dimension is based on personal reflection which enables each individual to adapt their attitude in order to act for the best. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Public-private partnerships in translational medicine: concepts and practical examples.

Science.gov (United States)

Luijten, Peter R; van Dongen, Guus A M S; Moonen, Chrit T; Storm, Gert; Crommelin, Daan J A

2012-07-20

The way forward in multidisciplinary research according to former NIH's director Elias Zerhouni is to engage in predictive, personalized, preemptive and participatory medicine. For the creation of the optimal innovation climate that would allow for such a strategy, public-private partnerships have been widely proposed as an important instrument. Public-private partnerships have become an important instrument to expedite translational research in medicine. The Netherlands have initiated three large public-private partnerships in the life sciences and health area to facilitate the translation of valuable basic scientific concepts to new products and services in medicine. The focus of these partnerships has been on drug development, improved diagnosis and regenerative medicine. The Dutch model of public-private partnership forms the blueprint of a much larger European initiative called EATRIS. This paper will provide practical examples of public-private partnerships initiated to expedite the translation of new technology for drug development towards the clinic. Three specific technologies are in focus: companion diagnostics using nuclear medicine, the use of ultra high field MRI to generate sensitive surrogate endpoints based on endogenous contrast, and MRI guidance for High Intensity Focused Ultrasound mediated drug delivery. Copyright © 2012 Elsevier B.V. All rights reserved.

Practical private database queries based on a quantum-key-distribution protocol

International Nuclear Information System (INIS)

Jakobi, Markus; Simon, Christoph; Gisin, Nicolas; Bancal, Jean-Daniel; Branciard, Cyril; Walenta, Nino; Zbinden, Hugo

2011-01-01

Private queries allow a user, Alice, to learn an element of a database held by a provider, Bob, without revealing which element she is interested in, while limiting her information about the other elements. We propose to implement private queries based on a quantum-key-distribution protocol, with changes only in the classical postprocessing of the key. This approach makes our scheme both easy to implement and loss tolerant. While unconditionally secure private queries are known to be impossible, we argue that an interesting degree of security can be achieved by relying on fundamental physical principles instead of unverifiable security assumptions in order to protect both the user and the database. We think that the scope exists for such practical private queries to become another remarkable application of quantum information in the footsteps of quantum key distribution.

Asthma prescribing practices of government and private doctors in Malaysia--a nationwide questionnaire survey.

Science.gov (United States)

Loh, Li-Cher; Wong, Pel-Se

2005-03-01

A self-answered, anonymously completed questionnaire survey was performed between June 2002 and May 2003 where doctors from government and private sectors in Malaysia were invited to participate by post or during medical meetings. One hundred and sixteen government doctors and 110 private doctors provided satisfactorily completed questionnaires (effective respondent rate: 30.1%). The most preferred medications for 'first-line', 'second-line' and 'third-line' treatment were for government doctors: inhaled short-acting beta2-agonist (SABA) (98%), inhaled corticosteroids (CS) (75%), and leukotriene antagonist (52%); and for private doctors: oral SABA (81%), inhaled CS (68%), and oral CS (58%). The first choice inhaler device for most government and private doctors were metered dose inhalers, with cost and personal preferences (for private doctors), and technical ability (for government doctors) as the key considerations when deciding on the choice of device. This benchmark data on the asthma prescribing practices of a healthcare delivery system fully dichotomized into government and private sector, provides evidence for practice differences affected by the nature of the healthcare system, and might have implications on healthcare systems of other countries that share similarities with that of Malaysia.

Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

Science.gov (United States)

Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

2016-09-01

Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

Orthodontic treatment need among young Saudis attending public versus private dental practices in Riyadh.

Science.gov (United States)

Al-Jobair, Asma M; Baidas, Laila F; Al-Hamid, Anfal A; Al-Qahtani, Sara G; Al-Najjar, Amani T; Al-Kawari, Huda M

2016-01-01

To assess and compare the severity of malocclusion and orthodontic treatment need among young Saudis receiving free treatment at public dental practices versus those paying for treatment at private practices. This retrospective study evaluated the records of 300 patients (179 females, 121 males; age 13-21 years) treated at orthodontic clinics from 2013 through 2015. The public sample was selected from orthodontic clinics at the College of Dentistry, King Saud University (KSU); the private sample was selected from five private orthodontic clinics in Riyadh, Saudi Arabia. The records were examined for the severity of malocclusion and for orthodontic treatment need using the Dental Health Component of the Index of Orthodontic Treatment Need. The prevalence of each occlusal discrepancy and the Dental Health Component grade were recorded. The severity of malocclusion and orthodontic treatment need were compared between practice types, age groups, and sexes with the chi-square test. Displacement, increased overjet, and Class II and III malocclusion were the most common orthodontic problems in this study. Patients attending public clinics at KSU generally had more severe malocclusion than the patients attending private clinics. Seventy-seven percent of orthodontically treated patients at KSU clinics were in great need of treatment, compared with 58.5% of patients treated at private clinics ( P =0.003). Among the patients with great treatment need, approximately 62% of male patients and 70% of patients ≤16 years of age were treated at KSU clinics, compared with 38% and 48%, respectively, treated at private clinics ( P orthodontic treatment at public clinics at KSU had more severe malocclusion with greater need of orthodontic treatment than the patients paying for treatment at private clinics.

Learning management by self-employed occupational therapists in private practice.

Science.gov (United States)

Millsteed, Jeannine; Redmond, Janice; Walker, Elizabeth

2017-04-01

This study explored how occupational therapists in private practice developed the business skills needed to operate a successful private practice. The literature shows that many small-business owner-managers have poorly developed business skills, and some experience high rates of failure. This indicates that to be successful in private practice, occupational therapists need to gain mastery of management competencies in addition to their professional clinical competencies. A qualitative study, using in-depth interviews, collected data from twenty-six self-employed occupational therapists on their experiences of becoming a small-business owner-manager. A narrative analysis built an understanding about how these therapists developed their business competencies. Analysis revealed the factors affecting the development of business competencies were interactions between the initial motivations for start-up, growth aspirations and engagement with external business environments. Business competencies developed through a combination of formal learning prior to starting their businesses, and informal learning once their businesses were in operation. Lower level learning occurred in the routine and operational processes, with higher level learning through discontinuous events resulting in a transformation in the therapists' understanding about themselves as business owner-managers. Findings led to a proposition that occupational therapists make the transition to becoming successful small-business owner-manager through management learning that includes elements of self-reflection, identifying environmental opportunities and risks, developing capabilities, and strategic planning for growth and development. It provides insights on what occupational therapists need to consider to become successful small-business owner-managers. © 2016 Occupational Therapy Australia.

Ethical Issues related to First Time Patient Encounters – reflected from the perspective of physiotherapists in private practice

DEFF Research Database (Denmark)

Præstegaard, Jeanette; Gard, Gunvor

2011-01-01

of the physiotherapists in private practice. Methods A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance...... reflects and acts ethically. Further exploration of ethical issues in private practice is recommendable, and as management policy is deeply embedded within the Danish public sector there are reasons to explore public contexts of physiotherapy as well....... to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting...

A certified private practice - a report

International Nuclear Information System (INIS)

Boehm, J.

2005-01-01

Based on the requirements for internal quality assurance in our private practice a model for quality management was implemented. Using such a quality management system (QM-system) resulted in a systematic optimization and higher quality of operating procedures in all work areas. The realization of the new QM-system led to a higher transparency, improved economical efficiency, and an increase in personal motivation. Internal frictional losses could be effectively reduced saving time and money. The efforts in time, costs and personal resources during implementation of the QM-system, which had been considered as downsides in the beginning, are outweighed by the benefits by far according to our experience. In summary: ''We consider it worthwhile in all respects''. (orig.)

Inter-Professional Practices of Private-Sector Physiotherapists for Low Back Pain Management: Who, How, and When?

Science.gov (United States)

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

Purpose : Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method : A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec. Data were analyzed using descriptive and multiple regression analyses. Results : Physiotherapists reported frequent interactions with other physiotherapists (daily/weekly for 52.6%), family physicians (51.0%), and physiotherapy (PT) assistants (45.2%), but infrequent interactions with psychologists (3.6%), neurosurgeons (0.9%), and chiropractors (0.3%). Frequently reported means of interactions were written and oral messages sent through clients (55.1% and 24.1%, respectively), face-to-face unplanned discussions (41.9%), and faxed or mailed letters (23.2%). Variables associated with the intensity of inter-professional practices (mean of 6.7 [ SD 1.7] out of 10 on the Intensity of Interprofessional Practices Questionnaire for Private Sector Physiotherapists) were related to physiotherapists' clientele, social activities with other providers, and perceptions of inter-professional practices as well as organizational models, vision, and provision of PT training. Conclusions: There is room to improve inter-professional practices with private-sector physiotherapists involved in managing LBP. Targets for action include physiotherapists and their workplaces.

Practices regarding hospital waste management at public and private sector hospitals of Lahore

International Nuclear Information System (INIS)

Mahmood, S.; Din, N.U.; Mohsin, J.

2011-01-01

Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

Overview of the Global Trend in Private Medical Practice | Afolabi ...

African Journals Online (AJOL)

More over, many governments face various constraints that force them to prioritize and restrict government spending. This make it impossible for any government to provide free health care for her ever increasing population. Private medical practice is an alternative to complement government efforts in providing health care ...

Knowledge and practice regarding pulmonary tuberculosis among private practitioners

Directory of Open Access Journals (Sweden)

M Basu

2013-12-01

Full Text Available Background: India leads the world in its burden of tuberculosis (TB. General practitioners are the backbone of health care system. Objective: To assess the knowledge and practice of the allopathic private practitioners regarding TB. Method: In June 2012– October 2012, a cross-sectional study was conducted in West Bengal, India among 180 private practitioners who treat TB patients; using a self-administered semi-structured questionnaire. Results: About 58.3 % and 56.7 % study population knew full form of RNTCP (Revised National Tuberculosis Control Program and DOTS (Directly Observed Treatment Short Course respectively. The correct modes of transmission were expressed by 75.0 % of them. The most common symptom of TB was rightly answered by 46.7 %. About 43.3 % and 33.3 % replied correctly about number of sputum samples collected and timing of collection. More than half participants knew number of categories and 8.3 % knew categorisation correctly. About 66.7 % could correctly state the names of recommended 1st line anti-TB drugs; frequency of drug administration told correctly by 68.3 %. Very few Private Practitioners (PPs knew treatment regimens correctly for each category. Almost all participants knew that treatment under DOTS was given supervised. About 78.3 % PPs expressed correctly that treatment for TB was given in two phases; the duration of treatment of 6-8 months was stated by 53.3 %. Conclusion: Many gaps were found in the knowledge and practices of PPs regarding Tuberculosis. PPs should be properly trained and sensitized to use RNTCP guidelines.

Perinatal mortality disparities between public care and private obstetrician-led care: a propensity score analysis.

Science.gov (United States)

Adams, N; Tudehope, D; Gibbons, K S; Flenady, V

2018-01-01

To examine whether disparities in stillbirth, and neonatal and perinatal mortality rates, between public and private hospitals are the result of differences in population characteristics and/or clinical practices. Retrospective cohort study. A metropolitan tertiary centre encompassing public and private hospitals. Women accessed care from either a private obstetrician or from public models of care - predominantly midwife-led care or care shared between midwives, general practitioners, and obstetricians. A total of 131 436 births during 1998-2013: 69 037 public and 62 399 private. Propensity score matching was used to select equal-sized public and private cohorts with similar characteristics. Logistic regression analysis was then used to explore the impact of public-private differences in the use of assisted reproductive technologies, plurality, major congenital anomalies, birth method, and gestational age. Stillbirth, and neonatal and perinatal mortality rates. After controlling for maternal and pregnancy factors, perinatal mortality rates were higher in the public than in the private cohort (adjusted odds ratio, aOR 1.53; 95% confidence interval, 95% CI 1.29-1.80; stillbirth aOR 1.56, 95% CI 1.26-1.94; neonatal death aOR 1.48, 95% CI 1.15-1.89). These disparities reduced by 15.7, 20.5, and 19.6%, respectively, after adjusting for major congenital anomalies, birth method, and gestational age. Perinatal mortality occurred more often among public than private births, and this disparity was not explained by population differences. Differences in clinical practices seem to be partly responsible. The impact of differences in clinical practices on maternal and neonatal morbidity was not examined. Further research is required. Private obstetrician-led care: more obstetric intervention and earlier births reduce perinatal mortality. Background Babies born in Australian public hospitals tend to die more often than those born in private hospitals. Our aim was to determine

Private health purchasing practices in the public sector: a comparison of state employers and the Fortune 500.

Science.gov (United States)

Maxwell, James; Temin, Peter; Petigara, Tanaz

2004-01-01

State governments are influential purchasers of health benefits but have not been studied extensively. In a recent survey of senior benefit managers, we examine the extent to which states have followed the private-sector approach to purchasing health care. We found that states have adopted "industrial purchasing" practices similar to those of large private employers but offer greater choice of carriers and pay a higher percentage of premiums. Unions continue to influence health care purchasing in both the public and private sectors. Double-digit increases in health costs and the current budget crisis may force states to align their purchasing practices with the private sector to cut costs.

Using a Locum Tenens in a Private Practice

Directory of Open Access Journals (Sweden)

Magda Slabbert

2013-12-01

Full Text Available Many medical practitioners in private practice use a locum tenens when they themselves are not available to practice. The locums are often appointed without consideration of the legal consequences or requirements. Legislation distinguishes between an employee and an independent contractor. If the locum is appointed as an employee the doctrine of vicarious liability comes into play which is not the case with an independent contractor. Contracts currently available to appoint a locum give the contracting parties a choice between being appointed as an employee or an independent contractor; this should be changed in that all locums should be appointed as independent contractors especially if the working of the Consumer Protection Act is also taken into consideration. Furthermore, according to the rules of the Health Professions Council of South Africa (HPCSA the onus to ensure that the locum tenens is registered and fit to practice, rests with the principal.

Women's preferences and mode of delivery in public and private hospitals: a prospective cohort study.

Science.gov (United States)

Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H; Bonotti, Ana María; Izbizky, Gustavo H; Ferrary, Marta; Viergue, Nora; Vigil, Silvia I; Zalazar Denett, Gabriela; Belizán, José M

2016-02-08

Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women's preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women's preferences: a survey using a tailored questionnaire, and a discrete choice experiment. Only 8 and 6% of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40% ended their pregnancies by caesarean section in public and private hospitals, respectively. The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35% caesarean sections are unlikely related to their preferences for mode of delivery.

Profile of Immunization Practice by General Practitioners and Pediatricians in Private Setting

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Soedjatmiko Soedjatmiko

2017-12-01

Full Text Available Basic immunization coverage in Indonesia in 2013 was still low (59.2% (IBHS, 2013. Physicians’ attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner’s (GP and pediatrician’s attitude towards immunization and its coverage  in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians. Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices.  Key words: Attitude, general practitioners, immunization practice, private setting, pediatricians Gambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek Swasta Riset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%. Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap

Use and perception of nitrous oxide sedation by French dentists in private practice: a national survey.

Science.gov (United States)

Vilanova-Saingery, C; Bailleul-Forestier, I; Vaysse, F; Vergnes, J-N; Marty, M

2017-12-01

The aim of this national survey was to record the use of nitrous oxide and the perceptions of French dental practitioners to this form of sedation. The use of nitrous oxide sedation (NOS) has been authorised in private dental practice in France since December 2009 but, to date, no study implementing both quantitative and qualitative methods has explored such use. The data were collected using a Google Forms questionnaire. A mixed methodology was used for data analysis: a quantitative approach to explore the use of conscious sedation and a qualitative thematic approach (using Nvivo software) to determine the practitioner's perception of it. Responses were collected from 225 practitioners (19% of the target population of 1185). Most of the responders were trained in NOS use in private dental clinics. Seventy-three percent of those who trained privately actually used NOS, compared to 53% of those trained at university (p-value = 0.0052). Above all, NOS was used for children requiring restorative dentistry. The average price of the sedation was 50 Euros and it lasted, on average, for 37 min. The qualitative and thematic analysis revealed the financial and technical difficulties of implementing NOS in private practice. However, it also showed the benefits and pleasure associated with NOS use. This statistical survey of French dental practitioners offers an insight of the current state of the use of conscious sedation with nitrous oxide in private general dental practice in France. It also includes the first report of dental practitioners' perceptions of NOS use and may lead to a better understanding of the reasons why sedation is sometimes not used in private practice.

A brief history of equine private practice in South Africa

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C.H.B. Marlow

2010-05-01

Full Text Available Horse breeding in South Africa started in 1652, shortly after the 1st European settlement in the Cape. African horsesickness posed a serious problem and after a devastating outbreak of the disease in 1719, horses were largely replaced by oxen for agricultural and transport purposes but remained important from a sporting and military point of view. Examples of the latter are the export of horses for military use to India in the mid-19th century and for use in the Crimean War in 1854, reaching a zenith in the Anglo-Boer war in which an estimated 450 000 horses succumbed. Research and disease control and initially also health services were the responsibility of state veterinary authorities. Private equine practice was pioneered by Jack Boswell in the late 1930s, mainly involving race horses and Thoroughbred studs as part of a general practice. Specialised equine private practices were only initiated 10 years later and developed further during the 2nd half of the 20th century. These developments are described in some detail, including resumés of the veterinarians involved, clinical challenges encountered, scientific advances as well as developments in the equine industry with the emphasis on Thoroughbreds and the racing community. The regulatory environment, especially regarding the import and export of horses, and the role of various organisations and associations are also briefly discussed.

The pattern of mental disorders in private general practice: A six ...

African Journals Online (AJOL)

To determine the pattern of mental disorders in a private (general) practice in a selected Nigerian community, a cross- sectional, descriptive study was conducted. Two hundred and nine patients seen by a general practitioner (GP), and 291 patients (total 500) seen by a psychiatrist were retrospectively and prospectively ...

Solid waste management practices under public and private sector in Lahore, Pakistan

Directory of Open Access Journals (Sweden)

Usman Ashraf

2016-10-01

Full Text Available Solid waste management (SWM practices in Lahore, provincial capital of Punjab, were privatised in 2012. This study draws a comparison of solid waste management practices by public and private sector in Lahore. The comparison is done by taking following factors in consideration; administrative structure, waste collection, street sweeping, waste storage capacity and logistics, disposal, mechanical sweeping and washing, monitoring system. Privatisation of solid waste management in Lahore is celebrated as complete success story. In contrast to this, we found the results of privatisation are mixed. Privatisation has improved some components of the system. Monitoring system has been the key innovation under private sector. It has enabled better allocation, management and channelization of available resources. Yet little to no improvement has been done in street sweeping, disposal of waste and administrative structure of waste management in the city.

Retention of the rural allied health workforce in New South Wales: a comparison of public and private practitioners.

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Keane, Sheila; Lincoln, Michelle; Rolfe, Margaret; Smith, Tony

2013-01-27

Policy initiatives to improve retention of the rural health workforce have relied primarily on evidence for rural doctors, most of whom practice under a private business model. Much of the literature for rural allied health (AH) workforce focuses on the public sector. The AH professions are diverse, with mixed public, private or combined practice settings. This study explores sector differences in factors affecting retention of rural AH professionals. This study compared respondents from the 2008 Rural Allied Health Workforce (RAHW) survey recruiting all AH professionals in rural New South Wales. Comparisons between public (n = 833) and private (n = 756) groups were undertaken using Chi square analysis to measure association for demographics, job satisfaction and intention to leave. The final section of the RAHW survey comprised 33 questions relating to retention. A factor analysis was conducted for each cohort. Factor reliability was assessed and retained factors were included in a binary logistic regression analysis for each cohort predicting intention to leave. Six factors were identified: professional isolation, participation in community, clinical demand, taking time away from work, resources and 'specialist generalist' work. Factors differed slightly between groups. A seventh factor (management) was present only in the public cohort. Gender was not a significant predictor of intention to leave. Age group was the strongest predictor of intention to leave with younger and older groups being significantly more likely to leave than middle aged.In univariate logistic analysis (after adjusting for age group), the ability to get away from work did not predict intention to leave in either group. In multivariate analysis, high clinical demand predicted intention to leave in both the public (OR = 1.40, 95% CI = 1.08, 1.83) and private (OR = 1.61, 95% CI = 1.15, 2.25) cohorts. Professional isolation (OR = 1.39. 95% CI = 1.11, 1.75) and Participation in community (OR = 1

Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

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Feuerstein, Joseph D; Castillo, Natalia E; Siddique, Sana S; Lewandowski, Jeffrey J; Geissler, Kathy; Martinez-Vazquez, Manuel; Thukral, Chandrashekhar; Leffler, Daniel A; Cheifetz, Adam S

2016-03-01

Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings. We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures. Records were assessed for IBD history, medications, comorbidities, and hospitalizations. We also determined the number of patient visits to gastroenterologists in the past year, whether patients had a primary care physician at the same institution, and whether they were seen by a specialist in IBD or in conjunction with a trainee, and reviewed physician demographics. A univariate and multivariate statistical analysis was performed to determine which factors were associated with compliance of all core measures. Screening for tobacco abuse was the most frequently assessed core measure (89.6% of patients; n = 701 of 783), followed by location of IBD (80.3%; n = 629 of 783), and assessment for corticosteroid-sparing therapy (70.8%; n = 275 of 388). The least-frequently evaluated measures were pneumococcal immunization (16.7% of patients; n = 131 of 783), bone loss (25%; n = 126 of 505), and influenza immunization (28.7%; n = 225 of 783). Only 5.8% of patients (46 of 783) had all applicable core measures documented (24 in academic practice, none in clinical practice, and 22 in private practice). In the multivariate model, year of graduation from fellowship (odds ratio [OR], 2.184; 95% confidence interval [CI], 1.522-3.134; P measures. We found poor documentation of IBD quality measures in academic, clinical, and private gastroenterology practices. Interventions are necessary to improve reporting of quality measures. Copyright © 2016 AGA Institute. Published by Elsevier Inc

Physiotherapy in a Danish private context – a social and ethical practice

DEFF Research Database (Denmark)

Præstegaard, Jeanette

2014-01-01

, they require ethical reflections and pedagogical strategies in order to keep them in the business. Beneficence is seen as the core value of physiotherapeutic private practice and as having importance in different relationships: towards the patient, the physiotherapists themselves and their businesses...

Internationally Recommended Best Practices in Transportation Financing Public-Private Partnerships (P3s)

DEFF Research Database (Denmark)

Martin, Lawrence; Lawther, Wendell; Hodge, Graeme

2013-01-01

Transportation financing public-private partnerships (P3s) are a common practice in many countries. However, they represent a relatively new approach to transportation infrastructure financing for state and local governments in the United States. In a transportation financing P3 project, a private...... sector partner designs-builds-finances-operates- maintains (DBFOM) a transportation infrastructure asset (road, highway, bridge, tunnel, etc.) with an emphasis on financing. Under this type of arrangement, the private sector partner is primarily responsible for securing all or substantially all...... of the funding necessary to construct new transportation infrastructure and/or rehabilitate existing transportation infrastructure. This study reviews the international experience of national and sub-national governments with transportation financing P3s. The primary purpose of this study is to identify...

Are Australasian Genetic Counselors Interested in Private Practice at the Primary Care Level of Health Service?

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Sane, Vrunda; Humphreys, Linda; Peterson, Madelyn

2015-10-01

This study explored the perceived interest in development of private genetic counseling services in collaboration with primary care physicians in the Australasian setting by online survey of members of the Australasian Society of Genetic Counselors. Four hypothetical private practice models of professional collaboration between genetic counselors and primary care physicians or clinical geneticists were proposed to gauge interest and enthusiasm of ASGC members for this type of professional development. Perceived barriers and facilitators were also evaluated. 78 completed responses were included for analysis. The majority of participants (84.6 %) showed a positive degree of interest and enthusiasm towards potential for clinical work in private practice. All proposed practice models yielded a positive degree of interest from participants. Model 4 (the only model of collaboration with a clinical geneticist rather than primary care physician) was the clearly preferred option (mean = 4.26/5), followed by Model 2 (collaboration with a single primary care practice) (mean = 4.09/5), Model 3 (collaboration with multiple primary care clinics, multidisciplinary clinic or specialty clinic) (mean = 3.77/5) and finally, Model 1 (mean = 3.61/5), which was the most independent model of practice. When participants ranked the options in the order of preference, Model 4 remained the most popular first preference (44.6 %), followed by model 2 (21.6 %), model 3 (18.9 %) and model 1 was again least popular (10.8 %). There was no significant statistical correlation between demographic characteristics (age bracket, years of work experience, current level of work autonomy) and participants' preference for private practice models. Support from clinical genetics colleagues and the professional society was highly rated as a facilitator and, conversely, lack of such support as a significant barrier.

Recovery opportunities, work-home conflict, and emotional exhaustion among hematologists and oncologists in private practice.

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Nitzsche, Anika; Neumann, Melanie; Groß, Sophie E; Ansmann, Lena; Pfaff, Holger; Baumann, Walter; Wirtz, Markus; Schmitz, Stephan; Ernstmann, Nicole

2017-04-01

Hematologists and oncologists in private practice play a central role in the care provided for cancer patients. The present study analyzes stress and relaxation aspects in the work of hematologists and oncologists in private practice in Germany in relation to emotional exhaustion, as a core dimension of burnout syndrome. The study focuses on the opportunities for internal recovery using breaks and time out during the working day, the frequency of working on weekends and on vacation, and the physician's work-home and home-work conflict. Postulated associations between the constructs were analyzed using a structural equation model. If work leads to conflicts in private life (work-home conflict), it is associated with greater emotional exhaustion. Working frequently at the weekend is associated with greater work-home conflict and indirectly with greater emotional exhaustion. By contrast, the availability of opportunities to relax and recover during the working day is associated with less work-home conflict and indirectly with less emotional exhaustion. These results underline the importance of internal recovery opportunities during the working day and a successful interplay between working and private life for the health of outpatient hematologists and oncologists.

A Longitudinal Study of Changes in Marketing Practices at Private Christian Colleges

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Vander Schee, Brian A.

2009-01-01

This article presents the results of a longitudinal study investigating current marketing practices at selected church-related, private, four-year compared to those in place in 1997. The role that institutional selectivity plays in the use of marketing activities was also investigated. The researcher surveyed the admissions directors or enrollment…

HRM Practices in Public and Private Universities of Pakistan: A Comparative Study

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Iqbal, Muhammad Zafar; Arif, Muhammad Irfan; Abbas, Furrakh

2011-01-01

The purpose of this study was to compare the HRM practices of public and private universities in Punjab province of Pakistan. The data for the study was collected through a questionnaire comprising 30 items mainly related to job definition, training and development, compensation, team work, employee's participation and performance appraisal. The…

Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

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Yadav, A; Garg, S K; Chopra, H; Bajpai, S K; Bano, T; Jain, S; Kumar, A

2012-01-01

Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

Review of Private Sector Personnel Screening Practices

Science.gov (United States)

2000-10-01

private sector investigative sources or methods would be useful to the DoD for conducting national security background investigations. The federal government by and large examines more sources and conducts more thorough investigations than industry. In general, private employers (1) have less access to information about applicants...outsource many elements of background checks. It is recommended that the DoD periodically evaluate private sector screening programs and data sources in order to monitor

Leadership and Decision-Making Practices in Public versus Private Universities in Pakistan

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Zulfqar, A.; Valcke, M.; Devos, G.; Tuytens, M.; Shahzad, A.

2016-01-01

The goal of this study is to examine differences in leadership and decision-making practices in public and private universities in Pakistan, with a focus on transformational leadership (TL) and participative decision-making (PDM). We conducted semi-structured interviews with 46 deans and heads of department from two public and two private…

Job stress and job satisfaction of physicians in private practice: comparison of German and Norwegian physicians.

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Voltmer, Edgar; Rosta, Judith; Siegrist, Johannes; Aasland, Olaf G

2012-10-01

This study examined job satisfaction and job stress of German compared to Norwegian physicians in private practice. A representative sample of physicians in private practice of Schleswig-Holstein, Germany (N = 414) and a nationwide sample of Norwegian general practitioners and private practice specialists (N = 340) were surveyed in a cross-sectional design in 2010. The questionnaire comprised the standard instruments "Job Satisfaction Scale (JSS)" and a short form of the "Effort-Reward Imbalance Questionnaire (ERI)". Norwegian physicians scored significantly higher (job satisfaction scale compared to German physicians (M 5.57, SD 0.74 vs. M 4.78, SD 1.01). The effect size was highest for the items freedom to choose method (d = 1.012), rate of pay (d = 0.941), and overall job satisfaction (d = 0.931). While there was no significant difference in the mean of the overall effort scale between German and Norwegian physicians, Norwegian physicians scored significantly higher (p job satisfaction. Job satisfaction and reward were significantly higher in Norwegian than in German physicians. An almost threefold higher proportion of German physicians exhibited a high level of work-related stress. Findings call for active prevention and health promotion among stressed practicing physicians, with a special focus on improved working conditions.

Road casualties in work-related and private contexts: Occupational medical impact: Results from the ESPARR cohort.

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Fort, E; Pélissier, C; Fanjas, A; Charnay, P; Charbotel, B; Bergeret, A; Fontana, L; Hours, M

2018-05-22

Road accidents may impact victims' physical and/or mental health and socio-occupational life, notably including return to work. To assess whether the occupational medical consequences sustained by subjects injured in road accidents occurring in a work-related context differ from those associated with private accidents. 778 adults who were in work or occupational training at the time of their accident were included. Two groups were distinguished: 354 (45.5%) injured in road accidents occurring in a work-related context (commuting or on duty) and 424 (54.5%) injured in a private accident. The groups were compared on medical and occupational factors assessed on prospective follow-up at 6 months and 1 and 3 years. Multivariate analysis explored for factors associated at 6 months and 1 year with sick leave following the accident and duration of sick leave. There were no significant differences between groups for demographic data apart from a slightly higher injury severity in private accidents (32.5% of private accidents with MAIS3+(Maximum Abbreviated Injury Scale greater or equal to 3) vs. 23.7% for work-related accidents, p = 0.007). Victims of work-related accidents were more often on sick leave (OR = 1.8; 95% CI, 1.1-2.9). Although the length of sick leave is higher for work-related accidents that for private accidents, multivariate analysis showed that the injury severity and the post-traumatic stress disorder (PTSD) are significant factors to explain the time to return to work. There were no significant differences according to occupational impact during follow-up, notably including sick-leave duration, number of victims returning to work within 3 years and number of victims out of work due to incapacity. In the ESPARR (follow-up study of a road-accident population in the Rhône administrative county: Etude de Suivi d'une Population d'Accidentés de la Route dans le Rhône) cohort, the fact that a road accident occurred in a work-related context did not affect

Ethical Issues Raised by Private Practice Physiotherapy Are More Diverse than First Meets the Eye: Recommendations from a Literature Review

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Drolet, Marie-Josée; Williams-Jones, Bryn

2015-01-01

ABSTRACT Purpose: Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. Method: After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. Results: A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. Conclusions: The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported—through education, research, and good governance—in providing the best possible care for their patients. PMID:25931663

Ethical issues raised by private practice physiotherapy are more diverse than first meets the eye: recommendations from a literature review.

Science.gov (United States)

Hudon, Anne; Drolet, Marie-Josée; Williams-Jones, Bryn

2015-01-01

Physiotherapy in private practice differs from physiotherapy practised in a public setting in several ways, the most evident of which is the for-profit nature of private physiotherapy clinics; these differences can generate distinct and challenging ethical issues. The objectives of this article are to identify ethical issues encountered by physiotherapists in private practice settings and to identify potential solutions and recommendations to address these issues. After a literature search of eight databases, 39 studies addressing ethical issues in a private practice context were analyzed. A total of 25 ethical issues emerging from the included studies were classified into three main categories: (1) business and economic issues (e.g., conflicts of interests, inequity in a managed care context, lack of time affecting quality of care); (2) professional issues (e.g., professional autonomy, clinical judgment, treatment effectiveness, professional conduct); and (3) patients' rights and welfare issues (e.g., confidentiality, power asymmetries, paternalism vs. patient autonomy, informed consent). Recommendations as to how physiotherapists could better manage these issues were then identified and categorized. The physiotherapy community should reflect on the challenges raised by private practice so that professionals can be supported-through education, research, and good governance-in providing the best possible care for their patients.

A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention.

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Sacks, G; Swinburn, B; Kraak, V; Downs, S; Walker, C; Barquera, S; Friel, S; Hawkes, C; Kelly, B; Kumanyika, S; L'Abbé, M; Lee, A; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Rayner, M; Sanders, D; Snowdon, W; Vandevijvere, S

2013-10-01

Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first ('minimal') step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second ('expanded') step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third ('optimal') step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

Physician's sociodemographic profile and distribution across public and private health care: an insight into physicians' dual practice in Brazil.

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Miotto, Bruno Alonso; Guilloux, Aline Gil Alves; Cassenote, Alex Jones Flores; Mainardi, Giulia Marcelino; Russo, Giuliano; Scheffer, Mário César

2018-04-23

The intertwined relation between public and private care in Brazil is reshaping the medical profession, possibly affecting the distribution and profile of the country's medical workforce. Physicians' simultaneous engagement in public and private services is a common and unregulated practice in Brazil, but the influence played by contextual factors and personal characteristics over dual practice engagement are still poorly understood. This study aimed at exploring the sociodemographic profile of Brazilian physicians to shed light on the links between their personal characteristics and their distribution across public and private services. A nation-wide cross-sectional study using primary data was conducted in 2014. A representative sample size of 2400 physicians was calculated based  on the National Council of Medicine database registries; telephone interviews were conducted to explore physicians' sociodemographic characteristics and their engagement with public and private services. From the 2400 physicians included, 51.45% were currently working in both the public and private services, while 26.95% and 21.58% were working exclusively in the private and public sectors, respectively. Public sector physicians were found to be younger (PR 0.84 [0.68-0.89]; PR 0.47 [0.38-0.56]), less experienced (PR 0.78 [0.73-0.94]; PR 0.44 [0.36-0.53]) and predominantly female (PR 0.79 [0.71-0.88]; PR 0.68 [0.6-0.78]) when compared to dual and private practitioners; their income was substantially lower than those working exclusively for the private (PR 0.58 [0.48-0.69]) and mixed sectors (PR 0.31 [0.25-0.37]). Conversely, physicians from the private sector were found to be typically senior (PR 1.96 [1.58-2.43]), specialized (PR 1.29 [1.17-1.42]) and male (PR 1.35 [1.21-1.51]), often working less than 20 h per week (PR 2.04 [1.4-2.96]). Dual practitioners were mostly middle-aged (PR 1.3 [1.16-1.45]), male specialists with 10 to 30 years of medical practice (PR 1.23 [1

Private sector approaches to workforce enhancement.

Science.gov (United States)

Wendling, Wayne R

2010-06-01

This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as

School health services and its practice among public and private primary schools in Western Nigeria.

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Kuponiyi, Olugbenga Temitope; Amoran, Olorunfemi Emmanuel; Kuponiyi, Opeyemi Temitola

2016-04-06

Globally the number of children reaching school age is estimated to be 1.2 billion children (18% of the world's population) and rising. This study was therefore designed to determine the school health services available and its practices in primary schools in Ogun state, Western Nigeria. The study was a comparative cross-sectional survey of private and public primary schools in Ogun state using a multi-stage sampling technique. Participants were interviewed using a structured, interviewer administered questionnaire and a checklist. Data collected was analyzed using the SPSS version 15.0. A total of 360 head teachers served as respondents for the study with the overall mean age of 45.7 ± 9.9 years. More than three quarters of the respondents in both groups could not correctly define the school health programme. There were no health personnel or a trained first aider in 86 (47.8%) public and 110 (61.1%) private schools but a nurse/midwife was present in 57 (31.7%) and 27 (15.0%) public and private schools. (χ(2) = 17.122, P = 0.002). In about 95% of the schools, the teacher carried out routine inspection of the pupils while periodic medical examination for staff and pupils was carried out in only 13 (7.2%) public and 31 (17.2%) private schools (χ(2) = 8.398, P = 0.004). A sick bay/clinic was present in 26 (14.4%) and 67 (37.2%) public and private schools respectively (χ(2) = 24.371, P = 0.001). The practice of school health programme was dependent on the age (χ(2) = 12.53, P = 0.006) and the ethnicity of the respondents (χ(2) = 6.330, P = 0.042). Using multivariate analysis only one variable (type of school) was found to be a predictor of school health programme. (OR 4.55, CI 1.918-10.79). The study concludes that the practice of the various components of school health services was poor but better in private primary schools in Nigeria. Routine inspection by teachers was the commonest form of health appraisal. This may suggest that more health personnel need to

Academic Employees’ perceptions of Work - Life Balance practices: A Case Analysis of Private Universities in Ogun State, Nigeria

Directory of Open Access Journals (Sweden)

Anthonia Adenike Adeniji

2016-01-01

Full Text Available This study investigates academic employees' perceptions and experiences of work–life balance (WLB in private Universities in Ogun State. A descriptive research design involves in-depth interviews among 129 academic employees in private Universities in Ogun State. Specifically, the main objectives are to critically examine the practices of work-life balance in the Universities. The study assesses the types of WLB policies and practices within the Universities and factors which influence the employee’s perception of work-life balance within the framework of employment relationship in the various Universities in Nigeria. Using spill-over theory, the findings reveal various dimensions in the academic employees' concept of WLB and show that academic employee experience the strain of work intensification and long hours of work. There is a wide gap between corporate WLB practices and the academic employee understanding of WLB. The paper suggests policy implications which would aid the implementation of WLB policies within Private Universities and suggests directions for future research.

Public-private partnerships in practice: collaborating to improve health finance policy in Ghana and Kenya.

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Suchman, Lauren; Hart, Elizabeth; Montagu, Dominic

2018-06-13

Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why. Drawing on semi-structured interviews conducted with National Health Insurance (NHI) officials in Kenya and Ghana, as well as with staff from several international NGOs (INGOs) representing social franchise networks that are partnering to increase private provider accreditation into the NHIs, this article examines one example of public-private collaboration in practice. We found that interviewees initially had incomplete knowledge about the potential for cross-sector synergy, but both sides were motivated to work together around shared goals and the potential for mutual benefit. The public-private relationship then evolved over time through regular face-to-face interactions, reciprocal feedback, and iterative workplan development. This process led to a collegial relationship that also has given small private providers more voice in the health system. In order to sustain this relationship, we recommend that both public and private sector representatives develop formalized protocols for working together, as well as less formal open channels for communication. Models for aggregating small private providers and delivering them to government programmes as a package have potential to facilitate public-private partnerships as well, but there is little evidence on how these models work in LMICs thus far.

Radionuclide salivary imaging usefulness in a private otolaryngology practice

International Nuclear Information System (INIS)

Schall, G.L.; Smith, R.R.; Barsocchini, L.M.

1981-01-01

Radionuclide salivary gland scans were performed on 44 patients using sodium pertechnetate Tc 99m. The accuracy of the scans and their usefulness in the clinical treatment of the patients were reviewed. The scan provided helpful information in 31 of 38 cases in which adequate follow-up data were available, although it proved diagnostic in only six patients. It was particularly useful in the evaluation of primary salivary gland neoplasms, acute and chronic sialadenitis, and sialolithiasis, as well as in the differential diagnosis of xerostomia. The value of this procedure in the elucidation of a variety of morphologic and functional diseases of these glands warrants its greater application in private otolaryngologic practices

In private practice, informed consent is interpreted as providing explanations rather than offering choices: a qualitative study.

Science.gov (United States)

Delany, Clare M

2007-01-01

How do physiotherapists working in private practice understand and interpret the meaning and significance of informed consent in everyday clinical practice? Qualitative study using semi-structured interviews. Seventeen physiotherapists purposefully recruited from metropolitan private practices where treatment was on a one-on-one basis. Therapists defined informed consent as an implicit component of their routine clinical explanations, rather than a process of providing explicit patient choices. Therapists' primary concern was to provide information that led to a (therapist-determined) beneficial therapeutic outcome, rather than to enhance autonomous patient choice. Explicit patient choice and explicit informed consent were defined as important only if patients requested information or therapists recognised risks associated with the treatment. Physiotherapists defined informed consent within a context of achieving therapeutic outcomes rather than a context of respect for patient autonomy and autonomous choice. Physiotherapy practice guidelines developed to ensure compliance with ethical and legal obligations may therefore be followed only if they fit with therapists' understanding and interpretation of a desired therapeutic outcome.

Inequities in maternal postnatal visits among public and private patients: 2004 Pelotas cohort study

Directory of Open Access Journals (Sweden)

Marco Paula L

2009-09-01

Full Text Available Abstract Background The postnatal period is the ideal time to deliver interventions to improve the health of both the newborn and the mother. However, postnatal care shows low-level coverage in a large number of countries. The objectives of this study were to: 1 investigate inequities in maternal postnatal visits, 2 examine differences in postnatal care coverage between public and private providers and 3 explore the relationship between the absence of maternal postnatal visits and exclusive breastfeeding, use of contraceptive methods and maternal smoking three months after birth. Methods In the calendar year of 2004 a birth cohort study was started in the city of Pelotas, Brazil. Mothers were interviewed soon after delivery and at three months after birth. The absence of postnatal visits was defined as having no consultations between the time of hospital discharge and the third month post-partum. Logistic regression analysis was used to estimate the association between absence of postnatal visits and type of insurance scheme adjusting for potential confounding factors. Results Poorer women, black/mixed, those with lower level of education, single mothers, adolescents, multiparae, smokers, women who delivered vaginally and those who were not assisted by a physician were less likely to attend postnatal care. Postnatal visits were also less frequent among women who relied in the public sector than among private patients (72.4% vs 96% among public and private patients, respectively, x2 p Conclusion Postpartum care is available for every woman free of charge in the Brazilian Publicly-funded health care system. However, low levels of postpartum care were seen in the study (77%. Efforts should be made to increase the percentage of women receiving postpartum care, particularly those in socially disadvantaged groups. This could include locally-adapted health education interventions that address women's beliefs and attitudes towards postpartum care. There

Impact of the Medicare Chronic Disease Management program on the conduct of Australian dietitians' private practices.

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Jansen, Sarah; Ball, Lauren; Lowe, Catherine

2015-04-01

This study explored private practice dietitians' perceptions of the impact of the Australian Chronic Disease Management (CDM) program on the conduct of their private practice, and the care provided to patients. Twenty-five accredited practising dietitians working in primary care participated in an individual semistructured telephone interview. Interview questions focussed on dietitians' perceptions of the proportion of patients receiving care through the CDM program, fee structures, adhering to reporting requirements and auditing. Transcript data were thematically analysed using a process of open coding. Half of the dietitians (12/25) reported that most of their patients (>75%) received care through the CDM program. Many dietitians (19/25) reported providing identical care to patients using the CDM program and private patients, but most (17/25) described spending substantially longer on administrative tasks for CDM patients. Dietitians experienced pressure from doctors and patients to keep their fees low or to bulk-bill patients using the CDM program. One-third of interviewed dietitians (8/25) expressed concern about the potential to be audited by Medicare. Recommendations to improve the CDM program included increasing the consultation length and subsequent rebate available for dietetic consultations, and increasing the number of consultations to align with dietetic best-practice guidelines. The CDM program creates challenges for dietitians working in primary care, including how to sustain the quality of patient-centred care and yet maintain equitable business practices. To ensure the CDM program appropriately assists patients to receive optimal care, further review of the CDM program within the scope of dietetics is required.

An Assessment of Mississippi's Nonindustrial Private Forest Landowners' Knowledge of Forest Best Management Practices

Science.gov (United States)

Andrew James Londo; John Benkert Auel

2004-01-01

This study examined the knowledge levels of Mississippi nonindustrial private forest (NIPF) landowners relative to best management practices (BMPs) for water quality. Data were collected through surveys of participants in BMP programs held in conjunction with County Forestry Association (CFA) meetings throughout Mississippi during 2001-02. Ten CFAs participated in this...

The Role of HRM Practices in Predicting Faculty Turnover Intention: Empirical Evidence from Private Universities in Bangladesh

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Mohd H.R. Joarder

2012-04-01

Full Text Available The present study was designed to examine the relationship between human resource management practices and turnover intention among the faculty members of private universities in Bangladesh. The prime objective of this study was to understand whether the institution’s HRM practices can influence faculty turnover decision. A total of 317 faculty members of different private universities located in Dhaka Metropolitan Area(DMA participated in the survey and returned the questionnaire to the researchers which represented 57% response rate of the study. Multiple regression analyses were used to test thehypotheses of the study. The study found faculty compensation, supervisory support and job security as statistically significant predictors of faculty turnover intention. Therefore, privateuniversity management should pay much attention to this area of human resource practices (compensation, supervisory support, job security to retain the potential faculty, thus reducing turnover intention. Limitations and suggestions for latest news headline are forwarded.

Ethical issues in physiotherapy – Reflected from the perspective of physiotherapists in private practice

DEFF Research Database (Denmark)

Præstegaard, Jeanette; Gard, Gunvor

2013-01-01

Background: An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are u......Background: An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues......: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries. Conclusions: In an ethical perspective, physiotherapy...... in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized...

Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai.

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Tauro, Carolyn Kavita; Gawde, Nilesh Chandrakant

2015-01-01

Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai's private sector in comparison with International Standards for Tuberculosis Care (ISTC) 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8%) use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7%) and with prior history of antitubercular treatment (12.9%). About half of them (48%) request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector.

Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai

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Carolyn Kavita Tauro

2015-01-01

Full Text Available Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai’s private sector in comparison with International Standards for Tuberculosis Care (ISTC 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8% use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7% and with prior history of antitubercular treatment (12.9%. About half of them (48% request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector.

Antimalarial drug prescribing practice in private and public health facilities in South-east Nigeria: a descriptive study

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Okebe Joseph

2007-05-01

Full Text Available Abstract Background Nigeria's national standard has recently moved to artemisinin combination treatments for malaria. As clinicians in the private sector are responsible for attending a large proportion of the population ill with malaria, this study compared prescribing in the private and public sector in one State in Nigeria prior to promoting ACTs. Objective To assess prescribing for uncomplicated malaria in government and private health facilities in Cross River State. Method Audit of 665 patient records at six private and seven government health facilities in 2003. Results Clinicians in the private sector were less likely to record history or physical examination than those in public facilities, but otherwise practice and prescribing were similar. Overall, 45% of patients had a diagnostic blood slides; 77% were prescribed monotherapy, either chloroquine (30.2%, sulphadoxine-pyrimethamine (22.7% or artemisinin derivatives alone (15.8%. Some 20.8% were prescribed combination therapy; the commonest was chloroquine with sulphadoxine-pyrimethamine. A few patients (3.5% were prescribed sulphadoxine-pyrimethamine-mefloquine in the private sector, and only 3.0% patients were prescribed artemisinin combination treatments. Conclusion Malaria treatments were varied, but there were not large differences between the public and private sector. Very few are following current WHO guidelines. Monotherapy with artemisinin derivatives is relatively common.

Childhood diarrhoea management practices in Bangladesh: private sector dominance and continued inequities in care.

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Larson, Charles P; Saha, Unnati Rani; Islam, Rafiqul; Roy, Nikhil

2006-12-01

Monitoring for disparities in health and services received based upon gender, income, and geography should continue as renewed efforts to reduce under-five mortality are made in response to millennium development goal #4. The purpose of this survey was to provide a nationally representative description of current childhood diarrhoea management practices and disparities in Bangladesh. A nationally representative, cross-sectional, cluster-sample survey was carried out in randomly selected rural and urban populations across Bangladesh. The survey was completed over an 8 month period between November 2003 and June 2004. A total of 7308 children with a prevalent diarrhoeal illness episode within 560 clusters were identified and enrolled in the survey. In 61% of the cases help was sought from a health care provider, with over 90% practicing in the private sector. Caretaker practice disparities favouring males and higher income households were identified. Significant trends (P gender disparities were limited to females being less likely to receive an antibiotic, adj OR 0.74 (95% CI 0.65, 0.86). Households seeking help from a health provider overwhelmingly utilize the private sector in Bangladesh. Gender inequities in the utilization of licensed providers and purchase of antibiotics, favouring males were identified. Findings suggest that higher income, urban households tend to practice greater gender discrimination. In order to better understand health dynamics in urban populations, in particular slum-dwellers, there is a need to disaggregate survey data by household location.

Comparison of private versus academic practice for general surgeons: a guide for medical students and residents.

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Schroen, Anneke T; Brownstein, Michelle R; Sheldon, George F

2003-12-01

Medical students and residents often make specialty and practice choices with limited exposure to aspects of professional and personal life in general surgery. The purpose of this study was to portray practice composition, career choices, professional experiences, job satisfaction, and personal life characteristics specific to practicing general surgeons in the United States. A 131-question survey was mailed to all female members (n = 1,076) and a random 2:1 sample of male members (n = 2,152) of the American College of Surgeons in three mailings between September 1998 and March 1999. Respondents who were not actively practicing general surgery in the United States and both trainees and surgeons who did not fit the definition of private or academic practice were excluded. Detailed questions regarding practice attributes, surgical training, professional choices, harassment, malpractice, career satisfaction, and personal life characteristics were included. Separate five-point Likert scales were designed to measure influences on career choices and satisfaction with professional and personal matters. Univariate analyses were used to analyze responses by surgeon age, gender, and practice type. A response rate of 57% resulted in 1,532 eligible responses. Significant differences between private and academic practice were noted in case composition, practice structure, and income potential; no major differences were seen in malpractice experience. Propensity for marriage and parenthood differed significantly between men and women surgeons. Overall career satisfaction was very high regardless of practice type. Some differences by surgeon gender in perceptions of equal career advancement opportunities and of professional isolation were noted. This study offers a comprehensive view of general surgery to enable more informed decisions among medical students and residents regarding specialty choice or practice opportunities.

Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

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Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

2016-09-01

India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low

"Practical knowledge" and perceptions of antibiotics and antibiotic resistance among drugsellers in Tanzanian private drugstores

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Tomson Göran

2010-09-01

Full Text Available Abstract Background Studies indicate that antibiotics are sold against regulation and without prescription in private drugstores in rural Tanzania. The objective of the study was to explore and describe antibiotics sale and dispensing practices and link it to drugseller knowledge and perceptions of antibiotics and antibiotic resistance. Methods Exit customers of private drugstores in eight districts were interviewed about the drugstore encounter and drugs bought. Drugsellers filled in a questionnaire with closed- and open-ended questions about antibiotics and resistance. Data were analyzed using mixed quantitative and qualitative methods. Results Of 350 interviewed exit customers, 24% had bought antibiotics. Thirty percent had seen a health worker before coming and almost all of these had a prescription. Antibiotics were dispensed mainly for cough, stomachache, genital complaints and diarrhea but not for malaria or headache. Dispensed drugs were assessed as relevant for the symptoms or disease presented in 83% of all cases and 51% for antibiotics specifically. Non-prescribed drugs were assessed as more relevant than the prescribed. The knowledge level of the drugseller was ranked as high or very high by 75% of the respondents. Seventy-five drugsellers from three districts participated. Seventy-nine percent stated that diseases caused by bacteria can be treated with antibiotics but 24% of these also said that antibiotics can be used for treating viral disease. Most (85% said that STI can be treated with antibiotics while 1% said the same about headache, 4% general weakness and 3% 'all diseases'. Seventy-two percent had heard of antibiotic resistance. When describing what an antibiotic is, the respondents used six different kinds of keywords. Descriptions of what antibiotic resistance is and how it occurs were quite rational from a biomedical point of view with some exceptions. They gave rise to five categories and one theme: Perceiving antibiotic

20 CFR 1002.7 - How does USERRA relate to other laws, public and private contracts, and employer practices?

Science.gov (United States)

2010-04-01

... USERRA relate to other laws, public and private contracts, and employer practices? (a) USERRA establishes... law (including any local law or ordinance), contract, agreement, policy, plan, practice, or other... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does USERRA relate to other laws, public...

HRM in private and public organizations in Serbia

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Berber Nemanja

2016-01-01

Full Text Available Human resource management (HRM is a management concept which obtains many practices and activities. Although there is a substantial literature on HRM in the private sector, the practice of HRM in the public sector is still scarce. In the private sector, HRM is found as a factor for gaining competitive advantage, especially if HR practices are implemented in the way of high-performing working practice (HPWP. In the public sector, HRM is seen as paternalistic management, with the standardization of employment practices, collective bargaining and working practices that emphasize equal opportunities for employees. The goal of this research is to explore the characteristics and differences between HRM practice in organizations from the private and public sector. The subject of the research is HRM practice (staffing, training and development, compensation and benefits, and industrial relation and communication in the private and public organizations in the Republic of Serbia. The methodology of the paper includes exploration of the available literature on the theme and statistical analysis of the differences between HR practices in organizations from the private and public sector. The research is based on the HR data gathered in the second CRANET research round in Serbia, performed in 2015.

Nuclear decommissioning - practical experience of the private sector

International Nuclear Information System (INIS)

Brant, A.W.

1988-01-01

There is a growing requirement for decommissioning of redundant nuclear facilities. This has led to a number of opportunities for private sector organisations to carry out the work. This paper, based on two actual projects in the United Kingdom, outlines the input required from private sector contractors in executing such work. (author)

The Issue of Private Tuition: An Analysis of the Practice in Mauritius and Selected South-east Asian Countries

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Foondun, A. Raffick

2002-11-01

Private tuition is an issue of growing concern and is practised in both developed and developing countries. Although it has certain positive effects, it imposes a considerable financial burden on parents and often gives rise to abuses. The present study, which focuses on the primary level, addresses a number of questions, such as the extent of the practice, its implications, the various forms that it takes, attitudes towards it, why children take private tuition, why teachers provide it, and policies to deal with the issue. The discussion ends with a plea for more research on private tuition in order to provide a basis for policies to address the problem.

Water privatization, water source, and pediatric diarrhea in Bolivia: epidemiologic analysis of a social experiment.

Science.gov (United States)

Tornheim, Jeffrey A; Morland, Kimberly B; Landrigan, Philip J; Cifuentes, Enrique

2009-01-01

Water and sanitation services are fundamental to the prevention of pediatric diarrhea. To enhance both access to water and investment, some argue for the privatization of municipal water networks. Water networks in multiple Bolivian cities were privatized in the 1990s, but contracts ended following popular protests citing poor access. A population-based retrospective cohort study was conducted in two Bolivian cities. Data were collected on family water utilization and sanitation practices and on the prevalence of diarrhea among 596 children. Drinking from an outdoor water source (OR, 2.08; 95%CI, 1.25-3.44) and shorter in-home water boiling times (OR, 1.99; 95%CI, 1.19-3.34) were associated with prevalence of diarrhea. Increased prevalence was also observed for children from families using private versus public water services, using off-network water from cistern trucks, or not treating their water in-home. Results suggest that water source, water provider, and in-home water treatment are important predictors of pediatric diarrhea.

Public-Private Partnership as Political Phenomenon: Perspectives of Adaptation of Successful Foreign Practices to the Russian Reality

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Надежда Викторовна Шуленина

2013-12-01

Full Text Available Public-private partnership show great development in modern Russia. Since the technology of interaction between business and government came from abroad it requires detailed consideration of the successes and current practices in the modern world. It is particularly important to identify relationships between form of government and decision making, both for political and economic decisions, as in most cases, these factors have the strongest influence on the formation of public-private partnership as an institution of the modern political process in Russia.

Differences in characteristics among new pediatric neurology patients: the effect of a newly established private pediatric neurology practice.

Science.gov (United States)

Van Cleave, Jeanne; Woodruff, Brian; Freed, Gary L

2008-01-01

To investigate changes in volume and characteristics of new patients referred when a private pediatric neurology practice (PP) opened in 2004 in an area served primarily by an academic medical center's (AMC) pediatric neurology practice. Retrospective analysis of medical and billing records to examine changes in volume, diagnosis, and sociodemographic factors of new patients at the AMC from July 2004 to June 2005; the PP during the same period; and the AMC during the year before. One year after the PP opened, 40% more new pediatric neurology patients were seen in this area than the year before. Compared with the AMC, PP saw a greater proportion of seizures (34% vs 26%, P 20 miles from the practice (32% vs 64%, P pediatric neurology patients in this area. After the PP opened, the AMC continued to care for most patients with rare diseases and fewer financial resources. Future research should examine whether the increase in volume reflects relief of pent-up demand or increased referral rates due to eased access, and should elucidate how differences in patient populations at academic and private subspecialty practices relate to access to subspecialty care and financial well-being of academic practices.

Private Speech in Ballet

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Johnston, Dale

2006-01-01

Authoritarian teaching practices in ballet inhibit the use of private speech. This paper highlights the critical importance of private speech in the cognitive development of young ballet students, within what is largely a non-verbal art form. It draws upon research by Russian psychologist Lev Vygotsky and contemporary socioculturalists, to…

Perceptions of Parents on the Practice of Private Tuition in Public Learning Institutions in Kenya

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Mwebi, Robert B.; Maithya, Redempta

2016-01-01

The practice of private tuition outside normal class hours is a phenomenon which has prevailed in Kenyan basic learning institutions despite the repeated ban by the government. The purpose of the study was to establish parental perceptions on extra tuition in public schools in Kenya. Descriptive survey design was used for the study. A total of 40…

The business of medicine: how to overcome financial obstacles and secure financing for your private practice and ancillary services business.

Science.gov (United States)

Nayor, David

2012-01-01

Doctors across the country who operate private medical practices are facing increasing financial obstacles, namely shrinking income as a result of rising costs and lower reimbursements. In addition, as hospitals have become overburdened many physicians have opened up private surgical centers; magnetic resonance imaging and computed tomography and positron emission tomography scanning facilities; pathology labs; colonoscopy/endoscopy suites; lithotripsy centers; and other medical businesses typically performed within the hospital. Moreover, many doctors seek loans to purchase existing practices or for their capital contribution in medical partnerships. The past decade has thus seen a significant increase in the number of doctors taking out small business loans. Indeed, banks view the healthcare industry as a large growth market. This article includes practical information, advice, and resources to help doctors to secure bank financing for their practices, ancillary services business, real estate, and equipment on the best possible market terms.

Do Private Religious Practices Moderate the Relation between Family Conflict and Preadolescents' Depression and Anxiety Symptoms?

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Davis, Kelly A.; Epkins, Catherine C.

2009-01-01

We extended past research that focused on the relation between family conflict and preadolescents' depressive and anxiety symptoms. In a sample of 160 11- to 12-year-olds, we examined whether private religious practices moderated the relations between family conflict and preadolescents' depressive and anxiety symptoms. Although preadolescents'…

More "Private" than Private Institutions: Public Institutions of Higher Education and Financial Management

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Adams, Olin L., III; Robichaux, Rebecca R.; Guarino, A. J.

2010-01-01

This research compares the status of managerial accounting practices in public four-year colleges and universities and in private four-year colleges and universities. The investigators surveyed a national sample of chief financial officers (CFOs) at two points in time, 1998-99 and 2003-04. In 1998-99 CFOs representing private institutions reported…

Allocating Overhead Costs in a Navy Working Capital Fund Environment: An Analysis and Comparison of Current Navy Policy and Private Sector Practice

National Research Council Canada - National Science Library

Schulte, Steven

1999-01-01

.... The objective of this thesis was to evaluate the overhead allocation practices of five private sector organizations for the potential improvement of overhead allocation practices in Navy Working Capital Fund activities...

Sales with Privately Made Deed Over The Object Under Hak Tanggungan Based on The Authorization to Sell in Banking Practice

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Sri Budi Purwaningsih

2014-06-01

Full Text Available The extension of credit contain a risk that must be covered by the bank, because the credit is given now and pay later. To minimize the risk of loans, the bank will ask the debtor to provide collateral as a source of repayment of the debt if the debtor default or breach of the contract. According to Article 1131 Civil Code (KUH Perdata, all assets of a debtor, either moving or fixed objects, both existing and new will exist in the future, a guarantee for all debts of the engagement. This means that by itself or in order to pass laws providing collateral by a debtor to any creditor for all debtor's property. Sales with Privately Made Deed over the object in the hak tanggungan banking practices may be more effective and efficient both in terms of time and costs for the settlement of non-performing loans. But in practice, occurs some offense prescribed procedure leading to doubts about the legality aspect of sales with privately made deed over the object under hak tanggungan based on the authorization to sell in banking practice. How To Cite: Purwaningsih, S. (2014. Sales with Privately Made Deed Over The Object Under Hak Tanggungan Based on The Authorization to Sell in Banking Practice. Rechtsidee, 1(2, 191-204. doi:http://dx.doi.org/10.21070/jihr.v1i2.100

University clinic and private practice treatment outcomes in Class I extraction and nonextraction patients: A comparative study with the American Board of Orthodontics Objective Grading System.

Science.gov (United States)

Mislik, Barbara; Konstantonis, Dimitrios; Katsadouris, Alexios; Eliades, Theodore

2016-02-01

The aim of this study was to compare treatment outcomes in university vs private practice settings with Class I patients using the American Board of Orthodontics Objective Grading System. A parent sample of 580 Class I patients treated with and without extractions of 4 first premolars was subjected to discriminant analysis to identify a borderline spectrum of 66 patients regarding the extraction modality. Of these patients, 34 were treated in private orthodontic practices, and 32 were treated in a university graduate orthodontic clinic. The treatment outcomes were evaluated using the 8 variables of the American Board of Orthodontics Objective Grading System. The total scores ranged from 10 to 47 (mean, 25.44; SD, 9.8) for the university group and from 14 to 45 (mean, 25.94; SD, 7.7) for the private practice group. The university group achieved better scores for the variables of buccolingual inclination (mean difference, 2.28; 95% confidence interval [CI], 0.59, 3.98; P = 0.01) and marginal ridges (mean difference, 1.32; 95% CI, 0.28, 2.36; P = 0.01), and the private practice group achieved a better score for the variable of root angulation (mean difference, -0.65; 95% CI, -1.26, -0.03; P = 0.04). However, no statistically intergroup differences were found between the total American Board of Orthodontics Objective Grading System scores (mean difference, -0.5; 95% CI, -3.82, 4.82; P = 0.82). Patients can receive similar quality of orthodontic treatment in a private practice and a university clinic. The orthodontists in the private practices were more successful in angulating the roots properly, whereas the orthodontic residents accomplished better torque control of the posterior segments and better marginal ridges. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Physicians in private practice: reasons for being a social franchise member.

Science.gov (United States)

Huntington, Dale; Mundy, Gary; Hom, Nang Mo; Li, Qingfeng; Aung, Tin

2012-08-01

Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. (i) Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii) A 24 month prospective cohort study of 3 cohorts of physicians who had been in the franchise for 4 years, 2 years and new members to track monthly case load and revenue generated. The most common reasons for joining the franchise were access to high quality and cheap drugs (96.1%) and feelings of social responsibility, (95.2%). The effects of joining the franchise on the volume of family planning services is shown in the 2009 cohort where the average monthly service volume increased from 18.5 per physician to 70.6 per physician during their first 2 years in the franchise, (pfranchise membership, as the 2007 cohort reported increases of monthly average family planning service volume from 71.2 per physician to 102.8 per physician (pfranchise. The results for cohorts 2007 and 2005 also show a generalized trend in increasing income. The findings show how franchise membership impacts the volume of franchise and non-franchised services. The increases in client volumes translated directly into increases in earnings among the franchise members, an unanticipated effect for providers who joined in order to better serve the poor. This finding has implications for the social franchise business model that relies upon subsidized medical products to reduce financial barriers for the poor. The increases in out of pocket payments for health care services that were not price controlled by the franchise is a concern. As the field of social franchises continues to mature its business models towards more sustainable and cost recovery management practices, attention should be

Physicians in private practice: reasons for being a social franchise member

Science.gov (United States)

2012-01-01

Background Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. Methods (i) Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii) A 24 month prospective cohort study of 3 cohorts of physicians who had been in the franchise for 4 years, 2 years and new members to track monthly case load and revenue generated. Results The most common reasons for joining the franchise were access to high quality and cheap drugs (96.1%) and feelings of social responsibility, (95.2%). The effects of joining the franchise on the volume of family planning services is shown in the 2009 cohort where the average monthly service volume increased from 18.5 per physician to 70.6 per physician during their first 2 years in the franchise, (pfranchise membership, as the 2007 cohort reported increases of monthly average family planning service volume from 71.2 per physician to 102.8 per physician (pfranchise. The results for cohorts 2007 and 2005 also show a generalized trend in increasing income. Conclusions The findings show how franchise membership impacts the volume of franchise and non-franchised services. The increases in client volumes translated directly into increases in earnings among the franchise members, an unanticipated effect for providers who joined in order to better serve the poor. This finding has implications for the social franchise business model that relies upon subsidized medical products to reduce financial barriers for the poor. The increases in out of pocket payments for health care services that were not price controlled by the franchise is a concern. As the field of social franchises continues to mature its business models towards more sustainable and cost recovery

Factors for and against establishing and working in private practice correlated with work-related behavior and experience patterns of Ferman physicians in Schleswig-Holstein: A 2-year longitudinal study

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Edgar Voltmer

2017-06-01

Full Text Available Objectives: To identify factors in favor of or against establishing and working in private practice, to determine the quality of life and work-related behavior and experience patterns of German physicians working in private practice, and to analyze the correlation of those factors. Material and Methods: A representative sample of physicians in private practice in Schleswig-Holstein, Germany, was surveyed according to a 2-year longitudinal design (T1 – 2008, N = 549 and T2 – 2010, N = 414. The study included 22 items regarding the attractiveness of establishing and working in private practice, and the questionnaires: the Short Form-12 Health Survey (SF-12, and Work-related Behavior and Experience Pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster – AVEM. Results: Job satisfaction among those private practitioners decreased over time but their willingness to choose the profession once again remained unchanged. Patient care and the continuity of physician-patient relationship encouraged establishing and working in private practice; state regulation, financial risk, and administrative effort weighed against it. At both T1 and T2, physicians scored significantly lower for mental health than general population. About 20% of physicians showed a healthy behavior and experience pattern but 40% of them showed the pattern of reduced working motivation. About 20% of participants were at elevated risk for overexertion and for burnout. Physical and mental health as well as the total distribution of patterns did not change significantly during the 2-year observation period. Physicians at higher burnout risk rated tasks related to patient care considerably less positively than those with healthy pattern. Conclusions: In order to improve job satisfaction and quality of life, and to make private practice more attractive, those German physicians require a improved legislation, b educational programs that promote the attractiveness of private practice

The influence of early feeding practices on fruit and vegetable intake among preschool children in 4 European birth cohorts.

Science.gov (United States)

de Lauzon-Guillain, Blandine; Jones, Louise; Oliveira, Andreia; Moschonis, George; Betoko, Aisha; Lopes, Carla; Moreira, Pedro; Manios, Yannis; Papadopoulos, Nikolaos G; Emmett, Pauline; Charles, Marie Aline

2013-09-01

Fruit and vegetable intake in children remains below recommendations in many countries. The long-term effects of early parental feeding practices on fruit and vegetable intake are not clearly established. The purpose of the current study was to examine whether early feeding practices influence later fruit and vegetable intake in preschool children. The study used data from 4 European cohorts: the British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de l'Enfant study, the Portuguese Generation XXI Birth Cohort, and the Greek EuroPrevall study. Fruit and vegetable intake was assessed in each cohort by food-frequency questionnaire. Associations between early feeding practices, such as breastfeeding and timing of complementary feeding, and fruit and/or vegetable intake in 2-4-y-old children were tested by using logistic regressions, separately in each cohort, after adjustment for infant's age and sex and maternal age, educational level, smoking during pregnancy, and maternal fruit and vegetable intake. Large differences in early feeding practices were highlighted across the 4 European cohorts with longer breastfeeding duration in the Generation XXI Birth Cohort and earlier introduction to complementary foods in ALSPAC. Longer breastfeeding duration was consistently related to higher fruit and vegetable intake in young children, whereas the associations with age of introduction to fruit and vegetable intake were weaker and less consistent across the cohorts. Mothers' fruit and vegetable intake (available in 3 of the cohorts) did not substantially attenuate the relation with breastfeeding duration. The concordant positive association between breastfeeding duration and fruit and vegetable intake in different cultural contexts favors an independent specific effect.

16 CFR 2.3 - Policy as to private controversies.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Policy as to private controversies. 2.3 Section 2.3 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE... other action when the alleged violation of law is merely a matter of private controversy and does not...

Tuberculosis management practices of private practitioners in Pune municipal corporation, India.

Directory of Open Access Journals (Sweden)

Sandeep Bharaswadkar

Full Text Available BACKGROUND: Private Practitioners (PP are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India's Revised National Tuberculosis Control Programme (RNTCP to improve the quality of TB management through training of PP. METHODS: We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra. We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC. We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. RESULTS: Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249 of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249 of responses were consistent with ISTC treatment practices. However, 48% (120/249 PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249 PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. CONCLUSION: In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.

Tuberculosis management practices of private practitioners in Pune municipal corporation, India.

Science.gov (United States)

Bharaswadkar, Sandeep; Kanchar, Avinash; Thakur, Narendra; Shah, Shubhangi; Patnaik, Brinda; Click, Eleanor S; Kumar, Ajay M V; Dewan, Puneet Kumar

2014-01-01

Private Practitioners (PP) are the primary source of health care for patients in India. Limited representative information is available on TB management practices of Indian PP or on the efficacy of India's Revised National Tuberculosis Control Programme (RNTCP) to improve the quality of TB management through training of PP. We conducted a cross-sectional survey of a systematic random sample of PP in one urban area in Western India (Pune, Maharashtra). We presented sample clinical vignettes and determined the proportions of PPs who reported practices consistent with International Standards of TB Care (ISTC). We examined the association between RNTCP training and adherence to ISTC by calculating odds ratios and 95% confidence intervals. Of 3,391 PP practicing allopathic medicine, 249 were interviewed. Of these, 55% had been exposed to RNTCP. For new pulmonary TB patients, 63% (158/249) of provider responses were consistent with ISTC diagnostic practices, and 34% (84/249) of responses were consistent with ISTC treatment practices. However, 48% (120/249) PP also reported use of serological tests for TB diagnosis. In the new TB case vignette, 38% (94/249) PP reported use of at least one second line anti-TB drug in the treatment regimen. RNTCP training was not associated with diagnostic or treatment practices. In Pune, India, despite a decade of training activities by the RNTCP, high proportions of providers resorted to TB serology for diagnosis and second-line anti-TB drug use in new TB patients. Efforts to achieve universal access to quality TB management must account for the low quality of care by PP and the lack of demonstrated effect of current training efforts.

Evaluating the Quality of Website Information of Private-Practice Clinics Offering Cell Therapies in Japan.

Science.gov (United States)

Kashihara, Hidenori; Nakayama, Takeo; Hatta, Taichi; Takahashi, Naomi; Fujita, Misao

2016-05-24

Although the safety and effectiveness of stem cell therapies are yet to be proven, recent studies show that such therapies are being advertised with some questionable marketing techniques to effect positive portrayal of the therapies on the webpages of private-practice clinics to sell their therapies worldwide. In such context, those clinics communicate directly with consumers (patients and their family members) via the clinics' websites. Meanwhile, the Health Science Council at the Ministry of Health, Labour, and Welfare (MHLW) in Japan has pointed out noncompliance of some local clinics with the provisions concerning medical advertising in the Medical Care Act in the past. However, locally little is known about the current status of those clinics including the quality of their webpage information disseminated. To evaluate the quality of website information of private-practice clinics offering cell therapies in Japan. Twenty-four websites with 77 treatments from the Google search were identified for evaluation. The following three exploratory analyses were performed: first in order to ascertain web-based portrayal of private-practice clinics offering cell therapies, a descriptive analysis was conducted using a coding frame; second we evaluated the quality of the target website information from the viewpoint of the level of consideration taken for patients and their family members, using 10 quality criteria ("the Minimum Standard") from the e-Health Code of Ethics 2.0; third we counted and coded expressions that matched set categories for "name-dropping" and "personalized medicine" in the information posted on these websites. Analysis on the treatments (N=77) revealed 126 indications (multiple response): the top three indications were "cancer," "skin-rejuvenation/antiaging/anti-skin aging," and "breast augmentation/buttock augmentation." As for the portrayal of treatment risks and benefits, 78% (60/77) of treatments were mentioned with "benefits," whereas 77% (59

Public–private partnerships on cyber security: a practice of loyalty

DEFF Research Database (Denmark)

Christensen, Kristoffer Kjærgaard; Petersen, Karen Lund

2017-01-01

The governance of cyber-security risks is seen as increasingly important to the security of the nation. However, cyber-security risks are characterized by a fundamental uncertainty, which poses a great challenge to their governance and calls for new modes of organizing security politics. Public......–private partnerships (PPPs) are often seen as the answer to this challenge by enhancing flexibility and robustness through knowledge-sharing. Engaging with the literature on PPPs and the Danish practice on cyber security, we show how PPPs involve controversies over different threat realities of cyber security....... This plays out as controversies over what is considered threatened, the scope of the issue and the kind of expertise to be mobilized. Arguing that PPPs on security are not defined narrowly by short-sighted strategic self-interest but also loyalty and commitment, we suggest that the innovative potential...

Fuelling Economic Growth: The Role of Public–Private Sector ...

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

2009-04-26

Apr 26, 2009 ... At the same time, however, traditional sources of research funding – from ... Fuelling Economic Growth: The Role of Public–Private Sector ... IDRC congratulates first cohort of Women in Climate Change Science Fellows.

Referral system in the Asir Region, Saudi Arabia: knowledge, attitude, and practice of physicians working in urban areas--a comparative study of governmental and private health sectors.

Science.gov (United States)

al-Erian, R A; Mahfouz, A A; Alakija, W; al-Khozayem, A A

1994-01-01

A comparative study of knowledge, attitude and practice regarding referral system was undertaken among all governmental primary health care and private dispensary physicians (56 and 50 respectively) in Abha and Kamis, Asir Region. Results show that knowledge about referral is adequate in both groups, but the attitudes and practice of both groups need to be positively modified specially among the private sector physicians. The paper recommends more orientation programs for both groups of physicians and urges the private sector physicians to be more involved in Ministry of Health training programs and activities. Cooperation in referral between the private sector and government hospitals is seen as one way of improving health care in Saudi Arabia.

Telephone survey of private patients' views on continuity of care and registration with general practice in Ireland.

LENUS (Irish Health Repository)

Carmody, Patricia

2007-01-01

BACKGROUND: The desire of patients for personal continuity of care with a General Practitioner (GP) has been well documented, but not within non-registered private patients in Ireland. This study set out to examine the attitudes and reported behaviours of private fee-paying patients towards continuity of GP care and universal registration for patients. METHODS: Cross-sectional telephone survey of 400 randomly chosen fee-paying patients living within County Dublin. There is no formal system of registration with a GP for these patients. Main outcomes were attendance of respondents at primary health care facilities and their attitudes towards continuity of care and registration with a GP. Data was analysed using descriptive statistics and using parametric and non-parametric tests of association. Pearson correlation was used to quantify the association between the described variables and attitudes towards continuity and registration with a GP. Variables showing significance at the 5% level were entered into multiple linear regression models. RESULTS: 97% of respondents had seen a GP in the previous 5 years. The mean number of visits to the GP for respondents was 2.3 per annum. 89% of respondents had a regular GP and the mean length of time with their GP was 15.6 years. 96% preferred their personal medical care to be provided within one general practice. 16% of respondents had consulted a GP outside of their own practice in the previous year. They were more likely to be female, commute a longer distance to work or have poorer health status. 81% considered it important to be officially registered with a GP practice of their choice. CONCLUSION: Both personal and longitudinal continuity of care with a GP are important to private patients. Respondents who chose to visit GPs other than their regular GP were not easily characterised in this study and individual circumstances may lead to this behaviour. There is strong support for a system of universal patient registration

Golden Years or Retirement Fears? Private Pension Inequality Among Canada's Immigrants.

Science.gov (United States)

Curtis, Josh; Lightman, Naomi

2017-06-01

Currently, many immigrants are disqualified from Canada's public pension scheme because of residency requirements. In addition, decades of low income and labour market exclusion prohibit many Canadian immigrants from building adequate private pension savings throughout their working life. Together, these factors present serious concerns for immigrant seniors' economic well-being. Using Canadian census data spanning a twenty-year period (1991-2011), we find that income from personal savings plans and investments has declined sharply for both native-born and immigrant Canadians, with recent immigrant cohorts faring worst. However, since 1991, native-born and immigrant men living in Canada for 40-plus years had major gains in private employer pensions (Registered Pension Plans; [RPPs]). Yet RPP income for all other immigrant cohorts remained stable or declined during these decades. Thus, the data demonstrate a worrisome growing private savings gap between native-born men and all others in Canada, with newer immigrants and women faring worst.

Teacher Externships as a Practice of Inter-organizational Collaboration Between Institutions of Higher Education and Public and Private Organizations

DEFF Research Database (Denmark)

Linde, Stine; Just, Sine Nørholm

The present paper takes a practice theoretical approach (Rouse, 2006) to investigating the extent to which the phenomenon of teacher externships can be used as an initiative for creating long-lasting and strong collaborations between institutions of higher education and public and private...... at institutions of higher education within the region of Zealand, Denmark entered into collaborations with 35 public and private organizations, we present two preliminary conclusions: existing networks are strengthened and broadened through externships, and teachers feel enlightened by the experience...... on Danish universities to ‘turn to practice’, we ask how externships may contribute to the inter-organizational collaboration between institutions of higher education and public and private organizations. Based on a qualitative analysis of an externship program in which a total of 25 lecturers...

A profile of professional nursing practice in the private sector in the R.S.A.

Directory of Open Access Journals (Sweden)

S. Pera

1988-09-01

Full Text Available The purpose of this study was to develop a profile of professional nursing practice in private enterprise health care services in the Republic of South Africa. In the light of the future health care needs and the relationship between the private and public sector health care establishments, information about the role and task of the I professional nurse was needed. Information would provide a data base about the registered nurse and so facilitate future health care planning. An exploratory field study was undertaken to locate the various work environments of the registered nurse in four statistical urban regions. Questionnaires were handed out and collected from a proportional stratified sample of professional nurses who were working in thirteen types of health care environments in the period between I June 1983 and 30 September 1983. A return rate of 68 percent yielded 340 completed questionnaires from 501 registered nurses. The study revealed that the majority of nurses in the private sector were relatively young. White, female, English-speaking professionals who were practising in four broad areas of health care: • Custodial care environments such as residential homes for the aged, institutions for the chronic sick and frail aged, homes for children and homes for the adult handicapped. • Hospitals and related special health centres catering for drug addicts, alcoholics and patients suffering from psychiatric/nervous disorders. • Institutions for child and adult education which included crèches/nursery schools, primary and secondary hoarding schools, special schools for the handicapped, and university based student health centres. • Medical and dental consulting room practices. • Other entrepreneurial employment settings such as business and industrial occupational health care services, nursing service agencies, and mobile emergency care units.

REJUVENATING CHRONIC DISEASE MANAGEMENT IN MALAYSIAN PRIVATE GENERAL PRACTICE

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PITERMAN L

2010-01-01

Full Text Available Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden tothe patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary careglobally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT(strengths, weaknesses, opportunities and threats analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.

Control of type 2 diabetes mellitus among general practitioners in private practice in nine countries of Latin America.

Science.gov (United States)

Lopez Stewart, Gloria; Tambascia, Marcos; Rosas Guzmán, Juan; Etchegoyen, Federico; Ortega Carrión, Jorge; Artemenko, Sofia

2007-07-01

To better understand how diabetes care and control are being administered by general practitioners/nonspecialists in private practice in nine countries of Latin America, and to identify the most significant patient- and physician-related barriers to care. A multicenter, cross-sectional, epidemiological survey was conducted in nine countries in Latin America: Argentina, Brazil, Chile, Costa Rica, Ecuador, Guatemala, Mexico, Peru, and Venezuela. General practitioners in private practice were asked to provide care and control data for patients 18 to 75 years of age with type 2 diabetes mellitus (T2DM), including demographics, medical and medication history, laboratory exams, and information on the challenges of patient management. Of the 3 592 patient questionnaires returned by 377 physicians, 60% of the patients had a family history of diabetes, 58% followed a poor diet, 71% were sedentary, and 79% were obese or overweight. Poor glycemic control (fasting blood glucose >or= 110 mg/dL) was observed in 78% of patients. The number of patients with HbA1c 15 years). Considering the differences between private and public health care in Latin America, especially regarding the quality of care and access to medication, further studies are called for in the public setting. Overall, a more efficient and intensive program of T2DM control is required, including effective patient education programs, adjusted to the realities of Latin America.

Industry structures in private dental markets in Finland.

Science.gov (United States)

Widström, E; Mikkola, H

2012-12-01

To use industrial organisation and organisational ecology research methods to survey industry structures and performance in the markets for private dental services and the effect of competition. Data on practice characteristics, performance, and perceived competition were collected from full-time private dentists (n = 1,121) using a questionnaire. The response rate was 59.6%. Cluster analysis was used to identify practice type based on service differentiation and process integration variables formulated from the questionnaire. Four strategic groups were identified in the Finnish markets: Solo practices formed one distinct group and group practices were classified into three clusters Integrated practices, Small practices, and Loosely integrated practices. Statistically significant differences were found in performance and perceived competitiveness between the groups. Integrated practices with the highest level of process integration and service differentiation performed better than solo and small practices. Moreover, loosely integrated and small practices outperformed solo practises. Competitive intensity was highest among small practices which had a low level of service differentiation and was above average among solo practises. Private dental care providers that had differentiated their services from public services and that had a high number of integrated service production processes enjoyed higher performance and less competitive pressures than those who had not.

Physicians in private practice: reasons for being a social franchise member

Directory of Open Access Journals (Sweden)

Huntington Dale

2012-08-01

Full Text Available Abstract Background Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. Methods (i Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii A 24 month prospective cohort study of 3 cohorts of physicians who had been in the franchise for 4 years, 2 years and new members to track monthly case load and revenue generated. Results The most common reasons for joining the franchise were access to high quality and cheap drugs (96.1% and feelings of social responsibility, (95.2%. The effects of joining the franchise on the volume of family planning services is shown in the 2009 cohort where the average monthly service volume increased from 18.5 per physician to 70.6 per physician during their first 2 years in the franchise, (prd and 4th year of franchise membership, as the 2007 cohort reported increases of monthly average family planning service volume from 71.2 per physician to 102.8 per physician (p Conclusions The findings show how franchise membership impacts the volume of franchise and non-franchised services. The increases in client volumes translated directly into increases in earnings among the franchise members, an unanticipated effect for providers who joined in order to better serve the poor. This finding has implications for the social franchise business model that relies upon subsidized medical products to reduce financial barriers for the poor. The increases in out of pocket payments for health care services that were not price controlled by the franchise is a concern. As the field of social franchises continues to mature its business models towards more sustainable and cost recovery management practices, attention should be given towards

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers

Directory of Open Access Journals (Sweden)

Muller-Juge V

2017-12-01

Full Text Available Virginie Muller-Juge, Anne Catherine Pereira Miozzari, Arabelle Rieder, Jennifer Hasselgård-Rowe, Johanna Sommer, Marie-Claude Audétat Unit of Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland Purpose: The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva.Methods: Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach.Results: The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities.Conclusion: These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students’ academic training and the skills needed for

Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic.

Science.gov (United States)

Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans

2017-12-21

To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Observational cross-sectional study. Private practices and a university clinic in Germany in 2012. 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants' motives for or against completion of AD indicate that ADs are considered a kind of

Acute appendicitis in the public and private sectors in Cape Town, South Africa.

Science.gov (United States)

Yang, Estin; Cook, Colin; Kahn, Delawir

2015-07-01

South Africa has a low incidence of acute appendicitis, but poor outcomes. However, South African studies on appendicitis focus solely on public hospitals, neglecting those who utilize private facilities. This study aims to compare appendicitis characteristics and outcomes in public and private hospitals in South Africa. A prospective cohort study was conducted among two public and three private hospitals in the Cape Town metropole, from September 2013 to March 2014. Hospital records, operative notes, and histology results were reviewed for patients undergoing appendectomy for acute appendicitis. Patients were interviewed during their hospitalization and followed up at monthly intervals until normal function was attained. A total of 134 patients were enrolled, with 73 in the public and 61 in the private sector. Education and employment were higher among private sector patients. Public sector patients had a higher rupture rate (30.6 vs 13.2 %, p = 0.023). Times to presentation were not statistically different between the two cohorts. Public sector patients had longer hospital stays (5.3 vs 2.9 days, p = 0.036) and longer return to work times (23.0 vs 12.1 days, p public hospitals were more severe. Public sector patients in South Africa with appendicitis have higher rupture rates, worse complications, longer hospital stays, and longer recoveries than private sector patients. Patients with perforation had longer delays in presentation than patients without perforation.

Incidence of fractures among epilepsy patients: a population-based retrospective cohort study in the General Practice Research Database.

Science.gov (United States)

Souverein, Patrick C; Webb, David J; Petri, Hans; Weil, John; Van Staa, Tjeerd P; Egberts, Toine

2005-02-01

To compare the incidence of various fractures in a cohort of patients with epilepsy with a reference cohort of patients not having epilepsy. Patients were included in the epilepsy cohort if they had at least one diagnosis of epilepsy in their medical history and had sufficient evidence of "active" epilepsy (use of antiepileptic drugs, diagnoses) after the practice was included in the General Practice Research Database (GPRD). Two reference patients were sampled for each patient with epilepsy from the same practice. Primary outcome was the occurrence of any fracture during follow-up. Poisson regression analysis was used to estimate incidence density ratios (IDRs). The study population comprised 40,485 and 80,970 patients in the epilepsy and reference cohorts, respectively. The median duration of follow-up was approximately 3 years. The overall incidence rate in the epilepsy cohort was 241.9 per 10,000 person-years. This rate was about twice as high as that in reference cohort: age- and sex-adjusted IDR, 1.89 (95% CI, 1.81-1.98). When comparing IDRs among the different groups of fractures, the highest relative-risk estimate was found for hip and femur fractures (adjusted IDR, 2.79; 95% CI, 2.41-3.24). IDRs were consistently elevated across age and sex groups and across fracture subtypes. The overall risk of fractures was nearly twice as high among patients with epilepsy compared with the general population. The relative fracture risk was highest for hip and femur. Further study is necessary to elucidate whether this elevated risk is due to the disease, the use of antiepileptic drugs, or both.

Public-private interactions in global food safety governance.

Science.gov (United States)

Lin, Ching-Fu

2014-01-01

In response to an apparent decline in global food safety, numerous public and private regulatory initiatives have emerged to restore public confidence. This trend has been particularly marked by the growing influence of private regulators such as multinational food companies, supermarket chains and non-governmental organizations (NGOs), who employ private standards, certification protocols, third-party auditing, and transnational contracting practices. This paper explores how the structure and processes of private food safety governance interact with traditional public governance regimes, focusing on Global Good Agricultural Practices (GlobalGAP) as a primary example of the former. Due to the inefficiency and ineffectiveness of public regulation in the face of global problems, private governance in food safety has gradually replaced states' command-and-control regulation with more flexible, market-oriented mechanisms. The paper concludes by emphasizing the importance of constructive regime interaction instead of institutional boundary building to global food safety governance. Public and private ordering must each play a role as integral parts of a larger, dynamic and evolving governance complex.

Psychological distress as a predictor of frequent attendance in family practice: a cohort study

DEFF Research Database (Denmark)

Vedsted, Peter; Fink, Per; Olesen, Frede

2001-01-01

In cross-sectional studies, psychological distress has been associated with frequent health care utilization. However, there is a need for prospective studies to confirm these findings. This cohort study evaluated whether psychological distress predicted frequent attendance in family practice.......16 [0.99-1.36] for SCL and OR 1.31 [1.05-1.65] for Whiteley). Psychological distress involved an increased risk of future frequent attendance among adult patients consulting family practice in the daytime about an illness....

Prevalence of Low-Cost Generic Program Use in a Nationally Representative Cohort of Privately Insured Adults.

Science.gov (United States)

Pauly, Nathan James; Brown, Joshua David

2015-12-01

Administrative claims data are used for a wide variety of research and quality assurance purposes. Despite their utility, they are prone to medication exposure misclassification if medications are purchased without utilizing an insurance benefit. Low-cost generic programs (LCGPs) offered at major chain pharmacies are a relatively new and sparsely investigated source of exposure misclassification. Since they were implemented in 2006, LCGPs are now available at 8 of the 10 largest pharmacy chains and include a wide variety of medication classes. LCGP medications are often purchased out of pocket; thus, a pharmacy claim may never be submitted and exposure may go unobserved in claims data. There are little data regarding the utilization of these programs, and estimates of their use can provide important insights into the potential impact LCGPs may have on exposure misclassification in claims data. To (a) quantify the prevalence of LCGP users in a privately insured adult population, (b) assess patterns of LCGP use, and (c) compare clinical and demographic characteristics associated with LCGP users and nonusers. The study cohort consisted of 19,037 privately insured adults aged 18-64 who participated in the Medical Expenditure Panel Survey (MEPS) from 2007-2011. MEPS captures medication utilization at the pharmacy level, so prescription fills can be observed irrespective of a claim being filed. Pharmaceutical utilization was assessed at the individual level for each year of the study period, and LCGP use was recorded as a binary variable for each individual. An LCGP medication fill was identified if the total cost of the drug was paid out of pocket and matched the cost of medications listed on LCGP formularies available from Target, Walmart, CVS, or other major pharmacy retailers during these years. Cohort demographics and characteristics of interest included age, gender, race, employment status, marital status, family income, education level, residence in a metropolitan

Exploring Factors Affecting Voluntary Adoption of Electronic Medical Records Among Physicians and Clinical Assistants of Small or Solo Private General Practice Clinics.

Science.gov (United States)

Or, Calvin; Tong, Ellen; Tan, Joseph; Chan, Summer

2018-05-29

The health care reform initiative led by the Hong Kong government's Food and Health Bureau has started the implementation of an electronic sharing platform to provide an information infrastructure that enables public hospitals and private clinics to share their electronic medical records (EMRs) for improved access to patients' health care information. However, previous attempts to convince the private clinics to adopt EMRs to document health information have faced challenges, as the EMR adoption has been voluntary. The lack of electronic data shared by private clinics carries direct impacts to the efficacy of electronic record sharing between public and private healthcare providers. To increase the likelihood of buy-in, it is essential to proactively identify the users' and organizations' needs and capabilities before large-scale implementation. As part of the reform initiative, this study examined factors affecting the adoption of EMRs in small or solo private general practice clinics, by analyzing the experiences and opinions of the physicians and clinical assistants during the pilot implementation of the technology, with the purpose to learn from it before full-scale rollout. In-depth, semistructured interviews were conducted with 23 physicians and clinical assistants from seven small or solo private general practice clinics to evaluate their experiences, expectations, and opinions regarding the deployment of EMRs. Interview transcripts were content analyzed to identify key factors. Factors affecting the adoption of EMRs to record and manage health care information were identified as follows: system interface design; system functions; stability and reliability of hardware, software, and computing networks; financial and time costs; task and outcome performance, work practice, and clinical workflow; physical space in clinics; trust in technology; users' information technology literacy; training and technical support; and social and organizational influences. The

Government regulation of forestry practices on private forest land in the United States: an assessment of state government responsibilities and program performance

Science.gov (United States)

Paul V. Ellefson; Michael A. Kilgore; James E. Granskog

2006-01-01

In 2003, a comprehensive assessment of state government, forest practice regulatory programs in the United States was undertaken. Involved was an extensive review of the literature and information gathering h m program administration in all 50 states. The assessment determined that regulatory programs focus on a wide range of forestry practices applied to private...

The practice of commissioning healthcare from a private provider: learning from an in-depth case study.

Science.gov (United States)

Chambers, Naomi; Sheaff, Rod; Mahon, Ann; Byng, Richard; Mannion, Russell; Charles, Nigel; Exworthy, Mark; Llewellyn, Sue

2013-01-01

The direction of health service policy in England is for more diversification in the design, commissioning and provision of health care services. The case study which is the subject of this paper was selected specifically because of the partnering with a private sector organisation to manage whole system redesign of primary care and to support the commissioning of services for people with long term conditions at risk of unplanned hospital admissions and associated service provision activities. The case study forms part of a larger Department of Health funded project on the practice of commissioning which aims to find the best means of achieving a balance between monitoring and control on the one hand, and flexibility and innovation on the other, and to find out what modes of commissioning are most effective in different circumstances and for different services. A single case study method was adopted to explore multiple perspectives of the complexities and uniqueness of a public-private partnership referred to as the "Livewell project". 10 single depth interviews were carried out with key informants across the GP practices, the PCT and the private provider involved in the initiative. The main themes arising from single depth interviews with the case study participants include a particular understanding about the concept of commissioning in the context of primary care, ambitions for primary care redesign, the importance of key roles and strong relationships, issues around the adoption and spread of innovation, and the impact of the current changes to commissioning arrangements. The findings identified a close and high trust relationship between GPs (the commissioners) and the private commissioning support and provider firm. The antecedents to the contract for the project being signed indicated the importance of leveraging external contacts and influence (resource dependency theory). The study has surfaced issues around innovation adoption in the healthcare context

Is Satisfaction with the Acute-Care Experience Higher amongst Consumers Treated in the Private Sector? A Survey of Public and Private Sector Arthroplasty Recipients.

Science.gov (United States)

Naylor, Justine M; Descallar, Joseph; Grootemaat, Mechteld; Badge, Helen; Harris, Ian A; Simpson, Grahame; Jenkin, Deanne

2016-01-01

Consumer satisfaction with the acute-care experience could reasonably be expected to be higher amongst those treated in the private sector compared to those treated in the public sector given the former relies on high-level satisfaction of its consumers and their subsequent recommendations to thrive. The primary aims of this study were to determine, in a knee or hip arthroplasty cohort, if surgery in the private sector predicts greater overall satisfaction with the acute-care experience and greater likelihood to recommend the same hospital. A secondary aim was to determine whether satisfaction across a range of service domains is also higher in the private sector. A telephone survey was conducted 35 days post-surgery. The hospital cohort comprised eight public and seven private high-volume arthroplasty providers. Consumers rated overall satisfaction with care out of 100 and likeliness to recommend their hospital on a 5-point Likert scale. Additional Likert-style questions were asked covering specific service domains. Generalized estimating equation models were used to analyse overall satisfaction (dichotomised as ≥ 90 or sector reporting the best Likert response for each individual domain were compared using non-parametric tests. 457 survey respondents (n = 210 private) were included. Less patient-reported joint impairment pre-surgery [OR 1.03 (95% CI 1.01-1.05)] and absence of an acute complication (OR 2.13 95% CI 1.41-3.23) significantly predicted higher overall satisfaction. Hip arthroplasty [OR 1.84 (1.1-2.96)] and an absence of an acute complication [OR 2.31 (1.28-4.17] significantly predicted greater likelihood for recommending the hospital. The only care domains where the private out-performed the public sector were hospitality (46.7 vs 35.6%, p private sector are not more satisfied with their acute-care experience nor are they more likely to recommend their hospital provider. Rather, avoidance of complications in either sector appears to result in

Calculating Clinically Significant Change: Applications of the Clinical Global Impressions (CGI) Scale to Evaluate Client Outcomes in Private Practice

Science.gov (United States)

Kelly, Peter James

2010-01-01

The Clinical Global Impressions (CGI) scale is a therapist-rated measure of client outcome that has been widely used within the research literature. The current study aimed to develop reliable and clinically significant change indices for the CGI, and to demonstrate its application in private psychological practice. Following the guidelines…

Career intentions of medical students in the setting of Nepal's rapidly expanding private medical education system.

Science.gov (United States)

Huntington, Ian; Shrestha, Suvash; Reich, Nicholas G; Hagopian, Amy

2012-08-01

The number of medical students trained in Nepal each year has increased nearly fifty-fold in the last 15 years, primarily through the creation of private medical schools. It is unknown where this expanding cohort of new physicians will ultimately practice. We distributed an anonymous survey to students in their last 2 years of medical school at four medical schools in Nepal to examine two dimensions of career intention: the intention to practice in Nepal and the intention to practice in rural areas. Eighty-five per cent of the eligible study population participated, for a total of 469 medical students. Of these, 88% thought it was likely they would practice in Nepal and 88% thought it likely they would practice in urban areas. Those students who indicated a greater likelihood of practicing abroad came from families with higher incomes, were more likely to think earning a good salary was very important to their decision to become a physician, and were less likely to think they could earn a good salary in Nepal. Students whose tuition was paid by the government were no more likely to indicate an intention to practice in Nepal than students paying their own tuition at private medical schools. Students who indicated a greater likelihood of practicing in rural areas were more likely to be male, to have gone to a government secondary school, to have been born in a village, or to have received a scholarship from the Ministry of Education that requires rural service. Based on our findings, we suggest the following policy changes: (1) medical schools consider selecting for students from rural backgrounds or government secondary schools who are more likely to intend to practice in rural areas, and (2) increase the number of post-graduate positions--weighted toward rural health needs--to retain students in Nepal.

Integrating an Interprofessional Education Model at a Private University

Science.gov (United States)

Parker, Ramona Ann; Gottlieb, Helmut; Dominguez, Daniel G.; Sanchez-Diaz, Patricia C.; Jones, Mary Elaine

2015-01-01

In 2012, a private University in South Texas sought to prepare eight cohorts of 25 nursing, optometry, pharmacy, physical therapy, and health care administration students with an interprofessional education activity as a model for collaborative learning. The two semester interprofessional activity used a blended model (Blackboard Learn®,…

Comparing VA and private sector healthcare costs for end-stage renal disease.

Science.gov (United States)

Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S

2012-02-01

Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; Pprivate sector dialysis group (Pprivate sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.

Public Presentation versus Private Actions in Psychotherapy Research, Training and Practice.

Science.gov (United States)

McMullen, Linda M.

1995-01-01

Reacts to Martin's (1995) essay concerning scientism in psychotherapy. Contends that the image psychotherapists' present to the public is often quite different from private actions, and that a focus of these private actions might reveal not only a less scientific endeavor, but also a paradigm for future research. (JPS)

Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons.

NARCIS (Netherlands)

Donker, G.A.; Slotman, F.G.; Spreeuwenberg, P.; Francke, A.L.

2013-01-01

Background: Little is known about the quantity and reasons for use of palliative sedation in general practice. Aim: To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Design and setting: Dynamic cohort study using registrations and questionnaire

Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons

NARCIS (Netherlands)

Donker, G.A.; Slotman, F.G.; Spreeuwenberg, P.; Francke, A.L.

2013-01-01

Background: Little is known about the quantity and reasons for use of palliative sedation in general practice. Aim: To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Design and setting: Dynamic cohort study using registrations and questionnaire

Private Security Contractors in Darfur

DEFF Research Database (Denmark)

Leander, Anna

2006-01-01

This article argues that the role of Private Security Contractors in Darfur reflects and reinforces neo-liberal governmentality in contemporary security governance. It is an argument (in line with other articles in this special issue) which is more interested in discussing how the privatization....... It underlines that governance is increasingly taking place through a set of (quasi-) markets, it is marked by entrepreneurial values, and a hands off approach to governance. We then discuss the way this overall change is reflected in and reinforced by the role of private security contractors in Darfur. Drawing...... at these processes is necessary to understand the role of private security contractors in Darfur. But more than this, practices in Darfur entrench neo-liberal governmentality in security more generally. The managerial and `de-politicizing' approach to security in Darfur displaces alternative views not only...

Realities of Private VET Practice through VET Teachers' Lenses: Learning Contexts for International Students in Private VET in Australia

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Pasura, Rinos

2014-01-01

Since the introduction of the competitive vocational education and training market model in the Australia in the 1990s, the growth and participation of international students and private providers has led to sustained debates about training standards in commercial-for-profit, private registered training organisations. Much of this debate has been…

The Interplay of Institutional Logics in IT Public–Private Partnerships

DEFF Research Database (Denmark)

Beck, Roman; Marschollek, Oliver; Gregory, Robert

2015-01-01

- and private-side stakeholders. Our case study of an IT PPP reveals public- and private-side differences that initially impeded the establishment of a partnership; using institutional logics theory as meta-theoretical lens, we propose a model that explains how public and private parties managed to negotiate...... their mode of collaboration by balancing their competing institutional norms and practices which ultimately resulted in the convergence of the two divergent logics. Our paper contributes to theory and practice by (1) elucidating the theoretical foundations and role of institutional logics for IT project...

Human resource management practices in public and private ...

African Journals Online (AJOL)

The results, among others, showed that private schools generally better managed their human resources than the public ones. Hence, it was recommended that there should be standard guidelines for operators of schools while human resource managers in the school system should be groomed in managerial psychology.

Public Private Partnerships: deciphering meaning message and phenomenon

NARCIS (Netherlands)

E-H. Klijn (Erik-Hans)

2010-01-01

markdownabstract__Abstract__ There is no doubt that Public private partnerships have been a dominant issue in governmental rhetoric’s but also in governmental practice. In many countries governments have turned to the idea of public private partnerships, or partnerships in general, as a vehicle

Strange Bedfellows? Reaffirming Rehabilitation and Prison Privatization

Science.gov (United States)

Wright, Kevin A.

2010-01-01

Private prisons are here to stay irrespective of empirical findings for or against their existence in the corrections industry. It is necessary, therefore, to step back and consider them on a broader level to assess how they can benefit current penological practice. It will be argued that prison privatization creates an opportunity to reassess the…

Domestic waste disposal practice and perceptions of private sector waste management in urban Accra.

Science.gov (United States)

Yoada, Ramatta Massa; Chirawurah, Dennis; Adongo, Philip Baba

2014-07-08

Waste poses a threat to public health and the environment if it is not stored, collected, and disposed of properly. The perception of waste as an unwanted material with no intrinsic value has dominated attitudes towards disposal. This study investigates the domestic waste practices, waste disposal, and perceptions about waste and health in an urban community. The study utilised a mixed-method approach. A cross-sectional survey questionnaire and in-depth interview were used to collect data. A total of 364 household heads were interviewed in the survey and six key informants were interviewed with the in-depth interviews. The results of the study revealed that 93.1% of households disposed of food debris as waste and 77.8% disposed of plastic materials as waste. The study also showed that 61.0% of the households disposed of their waste at community bins or had waste picked up at their homes by private contractors. The remaining 39.0% disposed of their waste in gutters, streets, holes and nearby bushes. Of those who paid for the services of private contractors, 62.9% were not satisfied with the services because of their cost and irregular collection. About 83% of the respondents were aware that improper waste management contributes to disease causation; most of the respondents thought that improper waste management could lead to malaria and diarrhoea. There was a general perception that children should be responsible for transporting waste from the households to dumping sites. Proper education of the public, the provision of more communal trash bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases.

Domestic waste disposal practice and perceptions of private sector waste management in urban Accra

Science.gov (United States)

2014-01-01

Background Waste poses a threat to public health and the environment if it is not stored, collected, and disposed of properly. The perception of waste as an unwanted material with no intrinsic value has dominated attitudes towards disposal. This study investigates the domestic waste practices, waste disposal, and perceptions about waste and health in an urban community. Methods The study utilised a mixed-method approach. A cross-sectional survey questionnaire and in-depth interview were used to collect data. A total of 364 household heads were interviewed in the survey and six key informants were interviewed with the in-depth interviews. Results The results of the study revealed that 93.1% of households disposed of food debris as waste and 77.8% disposed of plastic materials as waste. The study also showed that 61.0% of the households disposed of their waste at community bins or had waste picked up at their homes by private contractors. The remaining 39.0% disposed of their waste in gutters, streets, holes and nearby bushes. Of those who paid for the services of private contractors, 62.9% were not satisfied with the services because of their cost and irregular collection. About 83% of the respondents were aware that improper waste management contributes to disease causation; most of the respondents thought that improper waste management could lead to malaria and diarrhoea. There was a general perception that children should be responsible for transporting waste from the households to dumping sites. Conclusion Proper education of the public, the provision of more communal trash bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases. PMID:25005728

Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study.

Science.gov (United States)

Chen, Cheng; Yan, Yan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zeng, Guangyu; Liu, Shiping; Sha, Tingting; Li, Ling

2018-01-01

Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

Public Intentions for Private Spaces: Exploring Architects’ Tactics to Shape Shared Space in Private-Led Residential Development

Directory of Open Access Journals (Sweden)

Saul Manuel Golden

2015-07-01

Full Text Available From the late 20th into the 21st centuries, the private market increasingly gained control from public authorities over strategic decisions affecting the quality of, and accessibility to, new urban development. This paper argues for architects to act more explicitly to promote greater open-ness and use-value, rather than more objectified and controlled exchange-value approaches to the public domain in private-led development. The paper analyses two London-based residential case studies and interviews with the architects about perceptions of, and approaches to, private-led development decision-making processes. It compares the individual practitioner’s experiences of architecture practice with explicit intentions to influence better quality shared city space, examining professional norms vis-à-vis commercial clients and wider society. The paper concludes that greater awareness of architects’ knowledge, skills, and a range of tactics to influence future shared environments can contribute to improved professional practice frameworks for more effective engagement in an increasingly globalised and privatised urban society.

Knowledge, attitude and practice of private practitioners regarding tb-dots in a rural district of Sindh, Pakistan

International Nuclear Information System (INIS)

Ahmed, M.; Fatmi, Z.; Ali, S.; Ahmed, S.; Ara, N.

2009-01-01

Tuberculosis is prevailing in both urban and rural areas of Pakistan. Knowledge, attitude and practice (KAP) of private practitioners (PPs) regarding tuberculosis management have been reported only in urban areas of Pakistan. This survey was conducted for the first time in a rural area of Sindh, Pakistan. This survey was conducted in January 2007 at Thatta, a rural district of Sindh, Pakistan. Study subjects were twenty-two allopathic qualified (MBBS) doctors of district Thatta, who were practicing in private setups for at least last one year. Before TB-DOTS training PPs had filled the KAP questionnaire regarding tuberculosis (TB) diagnosis and management through DOTS. Survey data was analysed through SPSS version 11.05 software. On average, five TB suspects per month were seen by each PP. Only 14% of PPs advised sputum microscopy solely for pulmonary TB diagnosis, while 86% of PPs used different combination of tests (chest x-ray/sputum microscopy/ESR/tuberculin test) for TB diagnosis. Over 40% PPs did not prescribe TB treatment regimen according to TB-DOTS category. Majority PPs (85%) did not follow the treatment through sputum microscopy and instead relied on clinical improvement and x-ray clearance. Nearly 60% of TB patients at PPs clinic did not show compliance to the TB treatment and none of PPs were following the retrieval of default cases. A gross lack of PPs knowledge and right practice regarding TB diagnosis and management through DOTS was identified and needed to be addressed through providing DOTS training. (author)

A medical student in private practice for a 1-month clerkship: a qualitative exploration of the challenges for primary care clinical teachers.

Science.gov (United States)

Muller-Juge, Virginie; Pereira Miozzari, Anne Catherine; Rieder, Arabelle; Hasselgård-Rowe, Jennifer; Sommer, Johanna; Audétat, Marie-Claude

2018-01-01

The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians' private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised final year medical students in their primary care private practice during a 1-month pilot clerkship in Geneva. Data were collected via a focus group using a semistructured interview guide. Participants were asked about their role as a supervisor and their difficulties and positive experiences. The text of the focus group was transcribed and analyzed qualitatively, with a deductive and inductive approach. The results show the nature of pressures felt by clinical teachers. First, participants experienced the difficulty of having dual roles: the more familiar one of clinician, and the new challenging one of teacher. Second, they felt compelled to fill the gap between the academic context and the private practice context. Clinical teachers were surprised by the extent of the adaptive load, cognitive load, and even the emotional load involved when supervising a trainee in their clinical practice. The context of this rotation demonstrated its utility and its relevance, because it allowed the students to improve their knowledge about the outpatient setting and to develop their professional autonomy and their maturity by taking on more clinical responsibilities. These findings show that future training programs will have to address the needs of clinical teachers as well as bridge the gap between students' academic training and the skills needed for outpatient care. Professionalizing the role of clinical teachers should contribute to reaching these goals.

Stockholders' interests in the energy system privatization

International Nuclear Information System (INIS)

Matei, Magdalena; Matei, Lucian

2004-01-01

The paper highlights the benefits and objectives of competition and privatization in the power sector. The reasons for electric utility privatization are numerous and vary from country to country. Some of the more evident reasons include the following: - Raising revenues for the state through asset sales; - Acquiring investment capital; - Improving managerial performance; - Moving toward market-determined prices; - Technology transfer; - Reducing the frequency of power shortages; - Reducing the cost of electricity to consumers through efficiency gain; - Taking advantage of creating national and regional power grids. Several objectives commonly associated with privatization, includes: - Improving access to private capital resources for the rehabilitation, replacement and eventual expansion of the electric power infrastructure; - Improving access to new technology and management practices designed to improve the performance of the sector; - Reducing corruption through the introduction of commercial practices which will lead to strengthened collections, transparent and accountable delivery of electricity and reduced political interference in commercial operations; - Improving customer service and customer choice through continued reform of the power sector as a result of innovation and reform introduced by the new owners; - Human resources development; - Improving environmental performance . The paper addresses the following items: - Some elements of a successful power sector privatization; - Stockholders' position versus privatization in Romania; - Managing 'The Change'; - Power sector privatization in Romania. The paper demonstrates that the power sector privatization is a key condition for EU's support for Romania accession. The international organization push towards this essential economic change, which will guarantee a real competition and a liberalized energy market in facto. Strategic privatization can be a positive step in improving energy service and

PROJECT BONDS IN FINANCING PUBLIC-PRIVATE PARTNERSHIPS IN UKRAINE

Directory of Open Access Journals (Sweden)

I. Ovsiannykova

2014-12-01

Full Text Available The theoretical principles concerning the financing of public private partnership' projects are deepened and practical recommendations for improving the procedure of raising funds for projects of public-private partnerships through the use project bonds are substantiated.

Productivity of nonindustrial private forests in western Washington: alternative futures.

Science.gov (United States)

Ralph J. Alig; Darius M. Adams

1995-01-01

Nonindustrial private timberlands in western Washington have high productive potential and contribute harvest amounts somewhat more than proportional to their area. Of all private ownerships they are influenced the most by land use shifts and are affected in important ways by forest practice regulations. About 1 million acres of nonindustrial private timberland contain...

Is Satisfaction with the Acute-Care Experience Higher amongst Consumers Treated in the Private Sector? A Survey of Public and Private Sector Arthroplasty Recipients

Science.gov (United States)

Naylor, Justine M.; Descallar, Joseph; Grootemaat, Mechteld; Badge, Helen; Harris, Ian A.; Simpson, Grahame; Jenkin, Deanne

2016-01-01

Background Consumer satisfaction with the acute-care experience could reasonably be expected to be higher amongst those treated in the private sector compared to those treated in the public sector given the former relies on high-level satisfaction of its consumers and their subsequent recommendations to thrive. The primary aims of this study were to determine, in a knee or hip arthroplasty cohort, if surgery in the private sector predicts greater overall satisfaction with the acute-care experience and greater likelihood to recommend the same hospital. A secondary aim was to determine whether satisfaction across a range of service domains is also higher in the private sector. Methods A telephone survey was conducted 35 days post-surgery. The hospital cohort comprised eight public and seven private high-volume arthroplasty providers. Consumers rated overall satisfaction with care out of 100 and likeliness to recommend their hospital on a 5-point Likert scale. Additional Likert-style questions were asked covering specific service domains. Generalized estimating equation models were used to analyse overall satisfaction (dichotomised as ≥ 90 or definitely recommend’ or ‘other’), whilst controlling for covariates. The proportions of consumers in each sector reporting the best Likert response for each individual domain were compared using non-parametric tests. Results 457 survey respondents (n = 210 private) were included. Less patient-reported joint impairment pre-surgery [OR 1.03 (95% CI 1.01–1.05)] and absence of an acute complication (OR 2.13 95% CI 1.41–3.23) significantly predicted higher overall satisfaction. Hip arthroplasty [OR 1.84 (1.1–2.96)] and an absence of an acute complication [OR 2.31 (1.28–4.17] significantly predicted greater likelihood for recommending the hospital. The only care domains where the private out-performed the public sector were hospitality (46.7 vs 35.6%, p private sector are not more satisfied with their acute

Knowledge of diabetes mellitus in privately- funded diabetic patients attending a rural optometric practice in Malmesbury, South Africa*

Directory of Open Access Journals (Sweden)

K. C. Phillips

2012-12-01

ment of DM. This study indicates that, despite access to private health care, these subjects level of knowledge of DM and its ocular effects was sub-optimal. It also indicated poor self-management practices of the diabetic patients towards diabetes care and management. Optometrists should form part of a team of health professionals to assist in the management of DM. (S Afr Optom 2012 71(2 70-77

Safe meat-handling knowledge, attitudes and practices of private and government meat processing plants' workers: implications for future policy.

Science.gov (United States)

Adesokan, H K; Raji, A O Q

2014-03-01

Food-borne disease outbreaks remain a major global health challenge and cross-contamination from raw meat due to poor handling is a major cause in developing countries. Adequate knowledge of meat handlers is important in limiting these outbreaks. This study evaluated and compared the safe meat-handling knowledge, attitudes and practices (KAP) of private (PMPP) and government meat processing plants' (GMPP) workers in south-western Nigeria. This cross sectional study comprised 190 meat handlers (PMPP = 55; GMPP = 135). Data concerning their safe meat-handling knowledge, attitudes and practices as well as their socio-demographic characteristics, such as age, gender and work experience were collected. A significant association was observed between the type of meat processing plants and their knowledge (p = 0.000), attitudes (p = 0.000) and practices (p = 0.000) of safe meat-handling. Meat handlers in the GMPP were respectively, about 17 times (OR = 0.060, 95% CI: 0.018-0.203), 57 times (OR = 0.019, 95% CI: 0.007-0.054) and 111 times (OR = 0.009, 95% CI: 0.001- 0.067) less likely to obtain good knowledge, attitude and practice level of safe meat-handling than those from PMPP. Further, KAP levels were significantly associated with age group, education and work experience (p < 0.05). Study findings suggest the need for future policy in food industry in developing countries to accommodate increased involvement of private sector for improved food safety and quality delivery. Public health education on safe food handling and hygiene should be on the front burner among food handlers in general.

Standards of teeth preparations for anterior resin bonded all-ceramic crowns in private dental practice in Jordan

Directory of Open Access Journals (Sweden)

Ziad Nawaf AL-Dwairi

2011-08-01

Full Text Available OBJECTIVES: To investigate if general dental practitioners (GDPs in private practice in Jordan follow universal guidelines for preparation of anterior teeth for resin bonded all-ceramic crowns (RBCs. MATERIAL AND METHODS: A sample (n=100 of laboratory models containing 208 tooth preparations for IPS Empress and In Ceram, featuring work from different GDPs, was obtained from 8 commercial dental laboratories. Aspects of preparations were quantified and compared with accepted criteria defined following a review of the literature and recommendations of the manufactures' guidelines. RESULTS: Subgingival margins on the buccal aspect were noticed in 36% of the preparations, 54% demonstrated overpreparation with a tendency to overprepare the teeth on the mesiodistal plane more than buccolingual plane. Twenty percent of samples presented a shoulder finish line while a chamfer margin design was noticed in 39%. Twenty-nine percent and 12% of samples had either a feathered or no clear margin design respectively. Incisal underpreparation was observed in 18% of dies of each type. Only 17% of all preparations were found to follow the recommended anatomical labial preparations while 29% of the RBC preparations were found to have the recommended axial convergence angle. In total, 43% of preparations were found to have the recommended depth of the finish line. CONCLUSIONS: It was found that relevant guidelines for RBC preparations were not being fully adhered to in private practice in Jordan.

Socioeconomic differences in the association between sickness absence and mortality: The prospective DREAM study of Danish private sector employees

DEFF Research Database (Denmark)

Lund, Thomas; Kivimäki, Mika; Christensen, Karl Bang

2008-01-01

OBJECTIVES: To examine duration of sickness absence as a risk marker for future mortality by socioeconomic position among all private sector employees in Denmark 1998-2004. Design, SETTING AND PARTICIPANTS: This prospective cohort study studied all residents in Denmark employed in the private sec...

Psychological distress as a predictor of frequent attendance in family practice: a cohort study

DEFF Research Database (Denmark)

Vedsted, Peter; Fink, Per; Olesen, Frede

2001-01-01

In cross-sectional studies, psychological distress has been associated with frequent health care utilization. However, there is a need for prospective studies to confirm these findings. This cohort study evaluated whether psychological distress predicted frequent attendance in family practice.......16 [0.99-1.36] for SCL and OR 1.31 [1.05-1.65] for Whiteley). Psychological distress involved an increased risk of future frequent attendance among adult patients consulting family practice in the daytime about an illness........ In 1990, 185 consecutive adults who consulted their primary care physician (PCP) about an illness were rated on two psychometric scales (Hopkins Symptom Check List [SCL-8] and Whiteley-7), and their annual number of face-to-face contacts with a family practice was followed until 1996. Frequent attenders...

Consensus double reading of mammograms in private practice

International Nuclear Information System (INIS)

Pacher, B.; Tscherney, R.; Litmann-Rowenta, B.; Liskutin, J.; Mazewski, I.; Leitner, H.; Tscholakoff, D.

2004-01-01

Purpose: To evaluate retrospectively the results of consensus double reading of mammograms in a private practice for a period of 1.5 years (November 2001 to March 2003). Materials and Method: Two independent experts with dedicated training read all mammograms on a weekly basis. All mammograms including sonographic examinations were evaluated independently and categorized using the Bl-RADS classification. The achieved consensus included a possible recommendation for recall or therapy. A total of 3936 mammograms and 1912 sonography studies were evaluated. All cases with BI-RADS 4 and 5 categories were compared with the histologic results. For a period of three months, the acceptance of double reading including a delay of the final report by one week was tested with a questionnaire and informed consent sheet. Results: BI-RADS categories 4 and 5 were found in 57 cases, with 41 consensus results by two independent readers and 26 carcinomas verified by histology. No consensus could be reached in 16 patients, of which 10 had a final histologic result, with 5 benign lesions and 5 carcinomas of less than 1 cm in diameter. Clinical symptoms or alterations were absent in all patients. The 5 carcinomas were discovered by the double reading procedure. The result of the questionnaire (695 questionnaires) showed a refusal rate of 0.7%, with only 5 women refusing the opportunity of double reading their mammograms. Conclusion: Double reading of mammograms by independent experts is feasible, shows a measurable increase in quality and is accepted by almost all women. (orig.)

Human Rights and Social Work, a recognizable relationship in private practice within the profession?

Directory of Open Access Journals (Sweden)

Berta A. Moneo-Estany

2018-05-01

Full Text Available This work revises the relationship of Social Work with Human Rights, understanding that Social Work has been and continues to be an ideal means for the social and political implementation of Human Rights. In this long-standing dialogue, events such as the recent economic crisis, the progressive specialization of social intervention, changes in the socio-demographic structure and the questioning of the Welfare State model have posed professional challenges to Social Work. Among these events, the re-reading of the free exercise of Social Work in Spain and its relationship with Human Rights. Without neglecting the principles and values characterizing Social Work since its beginning as a scientific discipline and its close relationship with Human Rights, the aim of this work is to identify whether or not the relationship between Human Rights and the private practice of Social Work is recognised. After a profuse bibliographic review it can be stated that sufficient evidences (theoretical evidences or practical experiences to make the reality of such relationship explicit have not been found. Everything suggests that the free exercise is a reality which still needs to methodize its practice and demonstrate its close relationship with the principles and values of Social Work and Human Rights.

Barriers to implementing evidence-based practice in a private ...

African Journals Online (AJOL)

A quantitative research design was used to collect data from nurses in a private ICU in the ... Although the findings were similar to other studies, this study showed that nurses ... working in the ICU and the position held; additional qualifications).

Private health insurance and access to healthcare.

Science.gov (United States)

Duggal, Ravi

2011-01-01

The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

Public or private care: where do specialists spend their time?

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Freed, Gary L; Turbitt, Erin; Allen, Amy

2017-10-01

Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and

Women Using Physics: Alternate Career Paths, The Private Sector

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Tams, Jessica

2006-12-01

For those who have spent their careers inside the safe walls of academia, the word is a little scary. Can I compete? Will I fit in? What do I need to know? Am I prepared? Will I succeed? While many would say: Yes! You are ready to excel! This isn’t actually the case. The private sector comes with many unanticipated shocks to many of us, especially women. This isn’t a group project. This session will discuss entering a quickly growing and competitive technical field and what one can do to prepare for continued success. Preparing and Entering the Private Sector * Women with technical skills are a desired part of the private workforcein general women posses stronger people skills, are more reliable and often more well rounded than their male counterparts. Key factors we will discuss to landing that first job: · Expand your knowledge base with current applications of technology · Preparing a solid employment pitch to highlight strengths: Overcoming stereotypes · Don’t show them your bad side: Why some student projects may hurt you · The private sector attitude toward performance and entry level expectations Excelling in the Private Sector * Now that we have landed a job * for better or worse we are now all about making money and exerting control. What to keep in mind while working in the private sector: · The formative first years: focus on your weaknesses and practice, practice, practice · Men & Women in the workplace: what women subconsciously do to hurt their careers · Politics: Working in a team environment · Polish & Detail & Reliabilit

Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

Directory of Open Access Journals (Sweden)

Sanjay Basu

Full Text Available INTRODUCTION: Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. METHODS AND FINDINGS: Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive

Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

Science.gov (United States)

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive dynamics" for funding appeared between the two sectors, such

Feasibility of selected private money

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Lukáš Nevěděl

2012-01-01

Full Text Available The goal of the entry: “Feasibility of selected private money” is the assessment of practicability of selected private money types as future currency especially in terms of attributes that the currency should meet to fulfil all claims required by its users. In the first step the features that the widely used currency has to have will be described and it will be analysed which of these features are characteristic for nowadays currencies (Czech crown and Euro too. In the second step private (unnationalized money will be described as well as several concepts derived from it. The paper will concern mainly on Hayek’s concept of private money and on particular variations of Local exchange trading systems. In the next part there will be pointed out good and bad features of these types of money, mainly from the view of characteristics that the proper currency should have. At the end it will be carried out the comparison of bad and good effects resulting from using of particular currencies types and I will decide about the applicability of analysed private money types. The paper uses the standard methods of scientific work. Firstly, the method of description is used to describe the development of private money concepts and characteristic features that the currency should have. Then, a comparative analysis is used to discuss the differences between contemporary currencies and unnationalized currencies as well as between required and real features of particular private money. At the end the method of synthesis, deduction and induction is used.

Learning to learn self-regulation in practice: a 2 cohort evaluation.

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Sharples, Kath; Moseley, Laurence G

2011-11-01

The transfer of nurse training into higher education following 'Project 2000' dramatically changed the status of student nurses. While the majority received a grant or bursary, students were no longer regarded as belonging to the hospital staffing complement. Elcock et al. (2007), argue that the intended advantage of supernumerary status following the move of nurse education into higher education has not been reflected in the student learning experience. Students have reported difficulties in being accepted into the community of practice, as they are no longer viewed as belonging in the professional sense to the practice environment (Cope et al., 2000). Students must therefore be prepared for their supernumerary role through the development of appropriate skills for learning in practice (Elcock et al., 2007). The Thames Valley University pre-registration nursing curriculum promotes the effective socialisation of students into the professional role (Fitzpatrick et al., 1996) through a 35-day practice orientation programme in the Common Foundation Programme. The results of a 2 cohort evaluation of a 35-day programme facilitated in the Brent and Harrow learning community indicate that novice pre-registration students will not always possess the self-directed ability to spontaneously engage with nursing care in practice. Students must be provided the opportunity to develop the skills that define the self-regulated learner (Langendyk, 2006). Students must be empowered to self-assess what they know and what they do not know. It is argued that in order to learn during practice experiences, the student nurse of today must first learn how to be self-regulated. Copyright © 2011 Elsevier Ltd. All rights reserved.

[The treatment needs of migrant children according to child and adolescent psychiatrists from medical clinics and in private practice].

Science.gov (United States)

Siefen, Georg; Kirkcaldy, Bruce; Adam, Hubertus; Schepker, Renate

2015-03-01

How does the German child and adolescent psychiatry system respond to the increasing number of migrant children and adolescents? Senior doctors from German child and adolescent psychiatric hospitals (Association of Medical Hospital Directors in Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany, BAG) completed a specially constructed questionnaire about the treatment needs of migrant children, while a «random, representative» sample of child and adolescent psychiatrists in private practice (German Professional Association for Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, BKJPP) was administered a slightly modified version. The 100 psychiatrists in private practice represented only about one-eighth of their group, whereas the 55 medical directors comprised a representative sample. One-third of the hospitals has treatments tailored to the specific needs of migrants. In both settings, however, competent interpreters were rarely found, despite the treatment problems arising from the understanding the illness by the parents, language problems, and the clinical knowledge of the patient. Cultural diversity is perceived as enriching. The migration background and the sex of child and adolescent psychiatrists influence the treatment of migrants. Facilitating the process of «cultural opening» in child and adolescent psychiatry involves enacting concrete steps, such as the funding of interpreter costs.

Human Resource Management Practices and Employees’ Satisfaction Towards Private Banking Sector in Bangladesh

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Md. Tofael Hossain Majumder

2012-01-01

Full Text Available Dramatic advances of Information and Communication Technology (ICT, changing mix and personal values of the workforce, emergence of the knowledge economy and increasing global competition have created enormous challenges on organizations. To cope with the challenges efficiently, human resource has been considered as one of the most important factors in today’s hyper-competitive market place. The focus of this study is to gain an insight into the current HRM practices and its impact on employee’s satisfaction on the private banking sector in Bangladesh. For conducting this research, 100 bank employees are selected from the chosen banks and out of this 88 employees responses properly, the response rate is 88 percent. The questionnaire consists of different questions on nine HRM dimensions such as recruitment and selection systems, compensation package, job security, career growth, training and development, management style, job design and responsibilities, reward and motivation and working environment. The questionnaire was developed by using a five point Likert scale. In this study, some statistical measures such as Z-test, mean and proportion analysis is used to examine employee’s satisfaction. The study reveals that all HRM dimensions exercised in the private banking sector of Bangladesh does not satisfied to the employees equally. Most of the employees are dissatisfied with compensation package followed by reward and motivation, career growth, training and development, management style, and job design and responsibilities. So, these HRM dimensions quality should be improved for the betterment of the bank’s success.

Private sector engagement in refugee education

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Zeena Zakharia

2018-02-01

Full Text Available The involvement of the private sector in providing education for Syrian refugees has much to commend it but greater consideration needs to be paid to the ethical and practical concerns that may arise.

How Do Urban Indian Private Practitioners Diagnose and Treat Tuberculosis? A Cross-Sectional Study in Chennai.

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Bronner Murrison, Liza; Ananthakrishnan, Ramya; Sukumar, Sumanya; Augustine, Sheela; Krishnan, Nalini; Pai, Madhukar; Dowdy, David W

2016-01-01

Private practitioners are frequently the first point of healthcare contact for patients with tuberculosis (TB) in India. Inappropriate TB management practices among private practitioners may contribute to delayed TB diagnosis and generate drug resistance. However, these practices are not well understood. We evaluated diagnostic and treatment practices for active TB and benchmarked practices against International Standards for TB Care (ISTC) among private medical practitioners in Chennai. A cross-sectional survey of 228 practitioners practicing in the private sector from January 2014 to February 2015 in Chennai city who saw at least one TB patient in the previous year. Practitioners were randomly selected from both the general community and a list of practitioners who referred patients to a public-private mix program for TB treatment in Chennai. Practitioners were interviewed using standardized questionnaires. Among 228 private practitioners, a median of 12 (IQR 4-28) patients with TB were seen per year. Of 10 ISTC standards evaluated, the median of standards adhered to was 4.0 (IQR 3.0-6.0). Chest physicians reported greater median ISTC adherence than other MD and MS practitioners (score 7.0 vs. 4.0, P5% of patients with cough for TB testing, 83% used smear microscopy for diagnosis, 33% monitored treatment response, and 22% notified TB cases to authorities. Of 228 practitioners, 68 reported referring all patients with new pulmonary TB for treatment, while 160 listed 27 different regimens; 78% (125/160) prescribed a regimen classified as consistent with ISTC. Appropriate treatment practices differed significantly between chest physicians and other MD and MS practitioners (54% vs. 87%, P<0.001). TB management practices in India's urban private sector are heterogeneous and often suboptimal. Private providers must be better engaged to improve diagnostic capacity and decrease TB transmission in the community.

How Do Urban Indian Private Practitioners Diagnose and Treat Tuberculosis? A Cross-Sectional Study in Chennai.

Directory of Open Access Journals (Sweden)

Liza Bronner Murrison

Full Text Available Private practitioners are frequently the first point of healthcare contact for patients with tuberculosis (TB in India. Inappropriate TB management practices among private practitioners may contribute to delayed TB diagnosis and generate drug resistance. However, these practices are not well understood. We evaluated diagnostic and treatment practices for active TB and benchmarked practices against International Standards for TB Care (ISTC among private medical practitioners in Chennai.A cross-sectional survey of 228 practitioners practicing in the private sector from January 2014 to February 2015 in Chennai city who saw at least one TB patient in the previous year. Practitioners were randomly selected from both the general community and a list of practitioners who referred patients to a public-private mix program for TB treatment in Chennai. Practitioners were interviewed using standardized questionnaires.Among 228 private practitioners, a median of 12 (IQR 4-28 patients with TB were seen per year. Of 10 ISTC standards evaluated, the median of standards adhered to was 4.0 (IQR 3.0-6.0. Chest physicians reported greater median ISTC adherence than other MD and MS practitioners (score 7.0 vs. 4.0, P5% of patients with cough for TB testing, 83% used smear microscopy for diagnosis, 33% monitored treatment response, and 22% notified TB cases to authorities. Of 228 practitioners, 68 reported referring all patients with new pulmonary TB for treatment, while 160 listed 27 different regimens; 78% (125/160 prescribed a regimen classified as consistent with ISTC. Appropriate treatment practices differed significantly between chest physicians and other MD and MS practitioners (54% vs. 87%, P<0.001.TB management practices in India's urban private sector are heterogeneous and often suboptimal. Private providers must be better engaged to improve diagnostic capacity and decrease TB transmission in the community.

Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation.

Science.gov (United States)

Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans

2014-12-01

The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx). © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

Hearing aid patients in private practice and public health (Veterans Affairs) clinics: are they different?

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Cox, Robyn M; Alexander, Genevieve C; Gray, Ginger A

2005-12-01

In hearing aid research, it is commonplace to combine data across subjects whose hearing aids were provided in different service delivery models. There is reason to question whether these types of patients are always similar enough to justify this practice. To explore this matter, this investigation evaluated similarities and differences in self-report data obtained from hearing aid patients derived from public health (Veterans Affairs, VA) and private practice (PP) settings. The study was a multisite, cross-sectional survey in which 230 hearing aid patients from VA and PP audiology clinic settings provided self-report data on a collection of questionnaires both before and after the hearing aid fitting. Subjects were all older adults with mild to moderately severe hearing loss. About half of them had previous experience wearing hearing aids. All subjects were fitted with wide-dynamic-range-compression instruments and received similar treatment protocols. Numerous statistically significant differences were observed between the VA and PP subject groups. Before the fitting, VA patients reported higher expectations from the hearing aids and more severe unaided problems compared with PP patients with similar audiograms. Three wks after the fitting, VA patients reported more satisfaction with their hearing aids. On some measures VA patients reported more benefit, but different measures of benefit did not give completely consistent results. Both groups reported using the hearing aids an average of approximately 8 hrs per day. VA patients reported age-normal physical and mental health, but PP patients tended to report better than typical health for their age group. These data indicate that hearing aid patients seen in the VA public health hearing services are systematically different in self-report domains from those seen in private practice services. It is therefore risky to casually combine data from these two types of subjects or to generalize research results from one

Implementation of Public-Private Partnership in Turkish Agricultural Sector

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Suleyman TULUCEOGLU

2017-05-01

Full Text Available In this study, it is aimed to determine the situation of the public-private partnership model in agriculture sector, which has been started to apply in Turkey since 1980’s and in which an extensive increase has been observed in the number of projects in some fields such as airport, hospital, electric, etc. in recent years. In this scope, the legislation and the practices related to public-private partnership in Turkish agricultural sector have been examined after referring the literature, development process, features, advantages/disadvantages and various models of public-private partnership model, and the situation in the World and Europe respectively. The findings collected indicate that the public-private partnership model has been applied especially in major-substructure projects such as construction of electric, airport, road and healthcare facilities in Turkey since 1990, and that the budget allocated into the projects of agricultural sector has been quite low in comparison with other fields, although the number of projects executed in agriculture sector has been quite much. However, it is predicted that the practices of public-private partnership in agriculture sector in Turkey will increase much more in line with the legislative arrangements implemented and increasing experience in the projects.

Private Sector and Enterprise Development

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

Ministry of Technical Education and Vocational Training ..... and ..structures that offer services to private sector enterprises and represent .... investment climate reform and the adoption of good governance practices. ..... Over two-thirds of the labour force in Jordan, the West Bank & Gaza, Iraq and Syria is in the service sector.

Pharmaceutical Public-Private Partnerships

DEFF Research Database (Denmark)

Bagley, Constance; Tvarnø, Christina D.

2014-01-01

This article provides a game theory and law-and-management analysis of for- profit pharmaceutical public-private partnerships, a complex type of legal arrangement in the highly regulated pharmaceutical industry. A pharmaceutical public-private partnership (PPPP) agreement is a legally binding...... and a practical perspective on how properly crafted PPPP arrangements can promote innovation more efficiently than traditional self-optimizing contracts. In particular, a properly framed binding contract, coupled with respect for positive incentives, can move the parties away from an inefficient prisoners...... systems to build and share innovation. When coupled with appropriate attention to the difficult task of coordinating the actions of interdependent actors, a PPPP arrangement can enhance the likelihood of successful commercialization of pharmacological discoveries by flipping the par- ties’ incentives...

Interprofessional Communities of Practice in Continuing Medical Education for Promoting and Sustaining Practice Change: A Prospective Cohort Study.

Science.gov (United States)

Barker, Megan; Lecce, Julia; Ivanova, Anna; Zawertailo, Laurie; Dragonetti, Rosa; Selby, Peter

2018-01-01

Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enhancement in Applied Counselling and Health [TEACH] Project) to promote and sustain practice change. A prospective cohort design was utilized to examine the long-term impact of the TEACH CoP on practice change. An online survey was administered to TEACH-trained practitioners to assess perceived feasibility, importance, and confidence related to course competencies, involvement in TEACH CoP activities, engagement in knowledge transfer (KT), and implementation of new programming. Chi-square tests were used to detect differences in KT and program development associated with CoP participation. Course competency scores from immediate postcourse surveys and long-term follow-up surveys were compared. No significant differences in participant characteristics were found between those who did (n = 300) and did not (n = 122) participate in the TEACH CoP. Mean self-perceived competency scores were greater immediately after course than at long-term follow-up; however, self-ratings of competency in pharmacological interventions and motivational interviewing were higher at follow-up. TEACH CoP participation was associated with significantly greater engagement in KT and implementation of new programming after training. The findings from this evaluation suggest the value of interprofessional CoPs offered posttraining as a mechanism to enhance practice. CME providers should consider offering CoPs as a component of training programs to promote and sustain practice change.

[Health care waste management of potentially infectious medical waste by healthcare professionals in a private medical practice: a study of practices].

Science.gov (United States)

Brunot, Alain; Thompson, Céline

2010-01-01

A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection.

Pricing and competition in the private dental market in Finland.

Science.gov (United States)

Widström, E; Väisänen, A; Mikkola, H

2011-06-01

To investigate how the prices were set in private dental care, which factors determined prices and whether the recent National Dental Care Reform had increased competition in the dental care market in Finland. A questionnaire to all full time private dentists (n = 1,121) in the ten largest cities. Characteristics of the practice, prices charged, price setting, perceived competition and expectations for the practices were requested. The response rate was 59.6%. Correlation analysis (Pearson's) was used to study relationships between the prices of different treatment items. Linear regression analysis was used to study determinants of the price of a one surface filling. Most dentists' fee schedules were based on the price of a one surface filling and updated annually. Changes in practice costs calculated by the dentists' professional association and information on average prices charged on dental treatments in the country influenced pricing. High price levels were associated with specialisation, working in a group practice, working close to many other practices or in a town with a dental school. Less than half of the respondents had faced competition in dental services and price competition was insignificant. Price setting followed traditional patterns and private markets in dental services were not found to be very competitive.

Inflammatory eye reactions in patients treated with bisphosphonates and other osteoporosis medications - cohort analysis using a national prescription database

DEFF Research Database (Denmark)

Pazianas, Michael; Clark, Emma M; Eiken, Pia Agnete

2013-01-01

Ocular inflammatory reactions have been described in patients on bisphosphonate treatment. We estimated the incidence rate of ocular inflammation at 3 and 12 months in patients treated for osteoporosis using a register based cohort linked to prescription data (hospitals and private practice.......4%) of patients on osteoporosis therapy filled one or more prescriptions for TES. TES treatment rates (per 1000 patient years) in the first year of osteoporosis treatment were 44 (95% confidence interval (CI) 42-46) for alendronate, 40 (95% CI 38-43) for etidronate, 45 (95% CI 35-57) for risedronate, 32 (95% CI...

Obstetric risk avoidance: Will anyone be offering obstetrics in private ...

African Journals Online (AJOL)

By the end of the decade indemnifying obstetric risk will probably be too expensive for doctors in private practice. Non-indemnified doctors will be unable or unwilling to do private deliveries; however, women will still fall pregnant and require delivery. These women will inevitably be forced to deliver in provincial facilities, ...

Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

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Peter Waiswa

2015-03-01

Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

Nigerian Journal of General Practice: Submissions

African Journals Online (AJOL)

Author Guidelines. The Nigerian Journal of General Practice is the Official Publication of the Association of General and Private Medical Practitioners of Nigeria [AGPMPN] and a forum for family private/general practice medicine education and research. The Nigerian Journal of General Practice invites scholarly manuscripts ...

Information Technology Practices Amongst Dental Undergraduate Students at a Private Dental Institution in India

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S. Kumar

2009-09-01

Full Text Available Objective: In dental and medical education, information and communication technology (ICT has been playing an important role and its use is rapidly increasing. In developing countries, however, information technology is still only available to a minority of health professionals. The present study aimed to assess the level of computer use among dental undergraduate students pursuing their career at a private dental institution in India.Materials and Methods: The study population comprised dental undergraduate students from first to fourth year pursuing their career in a private dental institution of India. Informationtechnology practices were assessed using a questionnaire that consisted of 14 questions.Results: In total, 247 students with an overall response rate of 66% participated in the study. Only 58.3% of the study population mentioned that they had access to computers.Students from preclinical years reported to be competent in IT skills more frequently than the clinical year students (chi square test, P=0.007. Compared to women, men used computers more regularly both for academic activities (P=0.082 and personal use (P=0.006.Similarly, students of clinical years used computers more than preclinical students for both purposes (academic activities, P=0.045; personal use, P=0.124.Conclusion: The present study revealed that computer literacy of Indian dental undergraduate students was comparable with students of other countries whereas accessibility of IT sources was poor. Expansion of computer-assisted learning which requires careful strategic planning, resource sharing, staff incentives, active promotion of multidisciplinary working, and effective quality control should be implemented.

Private healthcare quality: applying a SERVQUAL model.

Science.gov (United States)

Butt, Mohsin Muhammad; de Run, Ernest Cyril

2010-01-01

This paper seeks to develop and test the SERVQUAL model scale for measuring Malaysian private health service quality. The study consists of 340 randomly selected participants visiting a private healthcare facility during a three-month data collection period. Data were analyzed using means, correlations, principal component and confirmatory factor analysis to establish the modified SERVQUAL scale's reliability, underlying dimensionality and convergent, discriminant validity. Results indicate a moderate negative quality gap for overall Malaysian private healthcare service quality. Results also indicate a moderate negative quality gap on each service quality scale dimension. However, scale development analysis yielded excellent results, which can be used in wider healthcare policy and practice. Respondents were skewed towards a younger population, causing concern that the results might not represent all Malaysian age groups. The study's major contribution is that it offers a way to assess private healthcare service quality. Second, it successfully develops a scale that can be used to measure health service quality in Malaysian contexts.

Contractual Obligations under the Private International Law in Albania.

Directory of Open Access Journals (Sweden)

Ervis Çela

2014-07-01

This work as based on the ex-positio sinkronik system aims at giving a minimum contribution in the application of the international private law and clarifies the omission, collision and legal problematic aspects in practice. At the end of this work, there are our conclusions which serve as a deduction over the analysis and studies done to this part of the private international law.

Differences in essential newborn care at birth between private and public health facilities in eastern Uganda.

Science.gov (United States)

Waiswa, Peter; Akuze, Joseph; Peterson, Stefan; Kerber, Kate; Tetui, Moses; Forsberg, Birger C; Hanson, Claudia

2015-01-01

In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (pprivate facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was slightly lower in private compared to public facilities, calling for quality improvement in both

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

Science.gov (United States)

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Introduction Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Methods and Findings Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for

XPIR : Private Information Retrieval for Everyone

Directory of Open Access Journals (Sweden)

Aguilar-Melchor Carlos

2016-04-01

Full Text Available A Private Information Retrieval (PIR scheme is a protocol in which a user retrieves a record from a database while hiding which from the database administrators. PIR can be achieved using mutuallydistrustful replicated databases, trusted hardware, or cryptography. In this paper we focus on the later setting which is known as single-database computationally- Private Information Retrieval (cPIR. Classic cPIR protocols require that the database server executes an algorithm over all the database content at very low speeds which impairs their usage. In [1], given certain assumptions, realistic at the time, Sion and Carbunar showed that cPIR schemes were not practical and most likely would never be. To this day, this conclusion is widely accepted by researchers and practitioners. Using the paradigm shift introduced by lattice-based cryptography, we show that the conclusion of Sion and Carbunar is not valid anymore: cPIR is of practical value. This is achieved without compromising security, using standard crytosystems, and conservative parameter choices.

Private and public consumption across generations in Australia.

Science.gov (United States)

Rice, James M; Temple, Jeromey B; McDonald, Peter F

2017-12-01

To investigate intergenerational equity in consumption using the Australian National Transfer Accounts (NTA). Australian NTA estimates of consumption were used to investigate disparities in consumption between people of different ages and generations in Australia between 1981-1982 and 2009-2010. There is a clear patterning of consumption by age, with the distribution by age of consumption funded by the private sector being very different to that of consumption funded by the public sector. Australians have achieved notable equality in total consumption among people between the ages of 20 and 75 years. Substantial disparities exist, however, between different generations, with earlier generations experiencing lower levels of total consumption in real terms at particular ages than later generations. An accurate picture of intergenerational equity in consumption requires consideration of both cohorts and cross sections, as well as consumption funded by both the public and the private sectors. © 2017 AJA Inc.

Gender differences in the professional and private lives of plastic surgeons.

Science.gov (United States)

Halperin, Terri J; Werler, Martha M; Mulliken, John B

2010-06-01

There are over 700 female members in the American Society of Plastic Surgeons. The purpose of this study was to assess possible differences between female and male plastic surgeons with respect to their practice characteristics, duration of practice, and some aspects of their private lives. We designed a 41 question survey to compare the practice features and personal demographics of female and male members of the American Society of Plastic Surgeons. A total of 1498 questionnaires were sent via e-mail to all female members (n = 687) and a random cohort of male members (n = 811). The respondents were age stratified by decade and their responses were compared by gender using chi tests. The overall response rate was 36.3%: 337 females (49%) and 207 males (25.5%) (P women had no children, as compared to 11.5% of men (P Men also tended to have more children than their female counterparts, across all age groups. The majority of women (58.8%) delayed child-rearing until after residency, as compared to only 25.7% of men (P earn an income greater than $400,000 per year (P < 0.001). Of 39 respondents who stated that they were no longer practicing, 21 (54%) were male and 18 (46%) were female (P = NS). Female plastic surgeons are significantly more likely to be unmarried, to postpone having children or be childless, as compared to their male counterparts. Furthermore, female plastic surgeons have a lower income than their male colleagues despite similar hours and practice profile. Nevertheless, female plastic surgeons appear to have similar career satisfaction and are no more likely to retire earlier or more frequently than male plastic surgeons.

Exploring Responsibility. Public and Private in Human Rights Protection

OpenAIRE

Bexell, Magdalena

2005-01-01

The theory and practice of international relations are replete with dilemmas related to the distribution of responsibility for human rights protection. Institutionalized notions of public and private empower and shape knowledge of what the spheres of responsibility signify for different kinds of actors. This study examines how the public-private distinction is manifested in controversy concerning the character of corporate social responsibility. The study develops a conceptual framework cente...

'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa.

Science.gov (United States)

Ashmore, John

2013-01-03

There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist 'dual practice', that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel 'needed' and 'relevant'. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision-making, inter alia. These interventions may be more cost

Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

Science.gov (United States)

Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

2012-07-01

The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise

Risk reduction and the privatization option: First principles

International Nuclear Information System (INIS)

Bjornstad, D.J.; Jones, D.W.; Russell, M.; Cummings, R.C.; Valdez, G.; Duemmer, C.L.

1997-01-01

The Department of Energy's Office of Environmental Restoration and Waste Management (EM) faces a challenging mission. To increase efficiency, EM is undertaking a number of highly innovative initiatives--two of which are of particular importance to the present study. One is the 2006 Plan, a planning and budgeting process that seeks to convert the clean-up program from a temporally and fiscally open-ended endeavor to a strictly bounded one, with firm commitments over a decade-long horizon. The second is a major overhauling of the management and contracting practices that define the relationship between the Department and the private sector, aimed at cost reduction by increasing firms' responsibilities and profit opportunities and reducing DOE's direct participation in management practices and decisions. The goal of this paper is to provide an independent perspective on how EM should create new management practices to deal with private sector partners that are motivated by financial incentives. It seeks to ground this perspective in real world concerns--the background of the clean-up effort, the very difficult technical challenges it faces, the very real threats to environment, health and safety that have now been juxtaposed with financial drivers, and the constraints imposed by government's unique business practices and public responsibilities. The approach is to raise issues through application of first principles. The paper is targeted at the EM policy officer who must implement the joint visions of the 2006 plan and privatization within the context of the tradeoff between terminal risk reduction and interim risk management

Risk reduction and the privatization option: First principles

Energy Technology Data Exchange (ETDEWEB)

Bjornstad, D.J.; Jones, D.W.; Russell, M. [Joint Inst. for Energy and Environment, Knoxville, TN (United States); Cummings, R.C.; Valdez, G. [Georgia State Univ., Atlanta, GA (United States); Duemmer, C.L. [Hull, Duemmer and Garland (United States)

1997-06-25

The Department of Energy`s Office of Environmental Restoration and Waste Management (EM) faces a challenging mission. To increase efficiency, EM is undertaking a number of highly innovative initiatives--two of which are of particular importance to the present study. One is the 2006 Plan, a planning and budgeting process that seeks to convert the clean-up program from a temporally and fiscally open-ended endeavor to a strictly bounded one, with firm commitments over a decade-long horizon. The second is a major overhauling of the management and contracting practices that define the relationship between the Department and the private sector, aimed at cost reduction by increasing firms` responsibilities and profit opportunities and reducing DOE`s direct participation in management practices and decisions. The goal of this paper is to provide an independent perspective on how EM should create new management practices to deal with private sector partners that are motivated by financial incentives. It seeks to ground this perspective in real world concerns--the background of the clean-up effort, the very difficult technical challenges it faces, the very real threats to environment, health and safety that have now been juxtaposed with financial drivers, and the constraints imposed by government`s unique business practices and public responsibilities. The approach is to raise issues through application of first principles. The paper is targeted at the EM policy officer who must implement the joint visions of the 2006 plan and privatization within the context of the tradeoff between terminal risk reduction and interim risk management.

Barriers to implementing evidence-based practice in a private intensive care unit in the Eastern Cape

Directory of Open Access Journals (Sweden)

Portia Janine Jordan

2016-11-01

Full Text Available Background. Evidence-based practices (EBPs have been promoted to enhance the delivery of patient care, reduce cost, increase patient and family satisfaction and contribute to professional development. Individual and organisational barriers can hamper the implementation of EBP, which can be detrimental to healthcare delivery. Objective. To determine the individual and organisational implementation barriers of EBP among nurses in a private intensive care unit (ICU. Methods. A quantitative research design was used to collect data from nurses in a private ICU in the Eastern Cape Province, South Africa. The structured questionnaire (Cronbach’s alpha: 0.72 was administered to 70 respondents, with a response rate of 93%. Results. Barriers at individual level were identified, and include lack of familiarity with EBP, individual perceptions that underpin clinical decision-making, lack of access to information required for EBP, inadequate sources to access evidence, inability to synthesise the literature available, and resistance to change. Barriers related to organisational support, change and operations were identified. Conclusion. Although the findings were similar to other studies, this study showed that nurses younger than 40 years of age were more familiar with the concepts of EBP. Physicians were perceived as not being very supportive of EBP implementation. In order to enhance healthcare delivery in the ICUs, nurse managers need to take cognisance of the individual and organisational barriers that might hamper the implementation of EBP.

A South African public-private partnership HIV treatment model: viability and success factors.

Science.gov (United States)

Igumbor, Jude; Pascoe, Sophie; Rajap, Shuabe; Townsend, Wendy; Sargent, John; Darkoh, Ernest

2014-01-01

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the model's ability to maintain treatment outcomes over time. The study used a retrospective design based on the electronic records of patients who were down-referred from government hospitals to selected private general medical practitioners (GPs) between November 2005 and October 2012. In total, 2535 unique patient records from 40 GPs were reviewed. The survival functions for mortality and attrition were calculated. Cumulative incidence of mortality for different time cohorts (defined by year of treatment initiation) was also established. The median number of patients per GP was 143 (IQR: 66-246). At the time of down-referral to private GPs, 13.8% of the patients had CD4 count private sector based programme can be effectively and efficiently used to either target specific health concerns, key populations or serve as a stop-gap measure to meet urgent health needs.

Public-Private Partnership as an Institutional Instrument of Investment in the Country’s Economy

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Dergachova Viktoriia V.

2018-01-01

Full Text Available The article is aimed at researching the world experience of efficient interaction between the public and private sectors, defining the main advantages of the implementation of public-private partnership (PPP relations, identifying problems in the legislative base on regulation of the PPP process in Ukraine. Introduction and formation of public-private partnership as an instrument of attraction of investment resources and interaction of public and private sectors are considered. It has been found that lack of financing and negative experience of privatization of the State property caused the introduction of the PPP institute in the world practice. However, there is no single unified approach to the regulation of relations in the sphere of PPP presently, which would meet the needs of all countries. In Ukraine, this mechanism is being implemented, but it is not a widespread practice because of terminological discrepancies and lack of a uniform procedure for providing the State support to the implementation of PPP. The advantages of the PPP implementation for the public and private sectors have been determined.

40 CFR 171.5 - Standards for certification of private applicators.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Standards for certification of private applicators. 171.5 Section 171.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... practical knowledge of the pest problems and pest control practices associated with his agricultural...

Regional cost information for private timberland conversion and management.

Science.gov (United States)

Lucas S Bair; Ralph J. Alig

2006-01-01

Cost of private timber management practices in the United States are identified, and their relationship to timber production in general is highlighted. Costs across timber-producing regions and forest types are identified by forest type and timber management practices historically applied in each region. This includes cost estimates for activities such as forest...

Public, private and personal: qualitative research on policymakers' opinions on smokefree interventions to protect children in 'private' spaces.

Science.gov (United States)

Rouch, Gareth; Thomson, George; Wilson, Nick; Hudson, Sheena; Edwards, Richard; Gifford, Heather; Lanumata, Tolotea

2010-12-31

Governments use law to constrain aspects of private activities for purposes of protecting health and social wellbeing. Policymakers have a range of perceptions and beliefs about what is public or private. An understanding of the possible drivers of policymaker decisions about where government can or should intervene for health is important, as one way to better guide appropriate policy formation. Our aim was to identify obstacles to, and opportunities for, government smokefree regulation of private and public spaces to protect children. In particular, to seek policymaker opinions on the regulation of smoking in homes, cars and public parks and playgrounds in a country with incomplete smokefree laws (New Zealand). Case study, using structured interviews to ask policymakers (62 politicians and senior officials) about their opinions on new smokefree legislation for public and private places. Supplementary data was obtained from the Factiva media database, on the views of New Zealand local authority councillors about policies for smokefree outdoor public places. Overall, interviewees thought that government regulation of smoking in private places was impractical and unwise. However, there were some differences on what was defined as 'private', particularly for cars. Even in public parks, smoking was seen by some as a 'personal' decision, and unlikely to be amenable to regulation. Most participants believed that educative, supportive and community-based measures were better and more practical means of reducing smoking in private places, compared to regulation. The constrained view of the role of regulation of smoking in public and private domains may be in keeping with current political discourse in New Zealand and similar Anglo-American countries. Policy and advocacy options to promote additional smokefree measures include providing a better voice for childrens' views, increasing information to policymakers about the harms to children from secondhand smoke and the

Strategy in the Public and Private Sectors

DEFF Research Database (Denmark)

Alford, John; Greve, Carsten

2017-01-01

Strategic concepts and practices first evolved in the private sector, so they evoked much controversy when they migrated to the public sector from the late 1970s onwards. Partly this was about their (in)applicability to the distinctive features of government organizations, in particular their focus...... on public as well as private value, their situation in a political rather than a market environment, their almost exclusive capacity to use legal authority to achieve purposes, and the extent to which they often need to share power over personnel and resources with other public sector agencies....... These and other factors complicated efforts to apply New Public Management and similar frameworks in strategy concepts in a governmental context. Partly also the traditional private-sector focus on single organizations did not resonate with the growth of network governance from the 1990s. The authors argue...

PUBLIC-PRIVATE PARTNERSHIP IN SOCIOECONOMIC DEVELOPMENT OF THE MUSEUMS: UNUSED MODERNIZATION RESOURCE

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N. V. Polyanskova

2015-01-01

Full Text Available Summary. Public-private partnership practically in all developed and developing countries of the world is recognized as the effective mechanism of social and economic tasks realization of society and state. The most popular use of the economic cooperation tools between business and government in areas such as the creation and modernization of infrastructure, transport infrastructure, road construction, municipal services (housing and communal services, the military-industrial complex, less social infrastructure. A large number of scientific, educational, recommendatory, reference and other books of domestic and foreign authors is developed for each of the called directions, various models of projects implementation of public-private partnership are developed and perfected. Unfortunately, to the sphere of culture it isn't paid due attention. State-private and municipal and private partnership in practice are quite successfully used for increase of efficiency of activity of establishments and objects of culture, but this positive experience isn't systematized and not fixed anywhere, the conceptual model of public-private partnership projects in culture is also not developed. Thus, a research objective is to design initiatives development and offers on modernization of the culture sphere on the basis of instruments of public-private partnership. The subject of the study is a set of administrative, economic and legal relations arising in the implementation of projects in the sphere of the Samara region culture on the basis of public-private partnerships. This article presents the results of a public-private partnerships study as uninvolved resource of the culture sphere modernization and the public-private partnership model developed by authors for projects in this sphere.

The formation of nurses in residency programs in public and private intensive care units

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Iasmim Lima Aguiar

Full Text Available This qualitative study aimed to acknowledge the importance of practice in public and private institutions in the training of nurses in residency programs. Data were collected at two hospitals between February and March 2013, through interviews. From their analysis the following categories emerged: experience of graduate nurses in residency programs in ICUs of public and private institutions and potential for learning in public and private institutions regarding the training of nurses. Differences were detected in the work process and in the profile of patients between the public and private fields, and dissociation between caring and management functions carried out by residents was demonstrated. It was concluded that the development of practices in public and private institutions provides different and complementary experiences which prepare residents for management and care activities, improve management and technical assistance skills, encourages the exercise of in-service education and, by means of surveys, the search for solutions to problems that emerge from daily work.

Infant Feeding Practices in a Multi-Ethnic Asian Cohort: The GUSTO Study

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Jia Ying Toh

2016-05-01

Full Text Available The optimal introduction of complementary foods provides infants with nutritionally balanced diets and establishes healthy eating habits. The documentation of infant feeding practices in multi-ethnic Asian populations is limited. In a Singapore cohort study (GUSTO, 842 mother-infant dyads were interviewed regarding their feeding practices when the infants were aged 9 and 12 months. In the first year, 20.5% of infants were given dietary supplements, while 5.7% took probiotics and 15.7% homeopathic preparations. At age 9 months, 45.8% of infants had seasonings added to their foods, increasing to 56.3% at 12 months. At age 12 months, 32.7% of infants were given blended food, although 92.3% had begun some form of self-feeding. Additionally, 87.4% of infants were fed milk via a bottle, while a third of them had food items added into their bottles. At both time points, more than a third of infants were provided sweetened drinks via the bottle. Infants of Indian ethnicity were more likely to be given dietary supplements, have oil and seasonings added to their foods and consumed sweetened drinks from the bottle (p < 0.001. These findings provide a better understanding of variations in infant feeding practices, so that healthcare professionals can offer more targeted and culturally-appropriate advice.

Management of childhood diarrhea among private providers in Uttar Pradesh, India

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Christa L. Fisher Walker

2016-06-01

Full Text Available In Uttar Pradesh (UP, India, a new initiative to introduce zinc and reinvigorate ORS for diarrhea treatment in the public and private sectors was rolled out in selected districts. We conducted an external evaluation of the program that included assessing the knowledge and practices of private sector providers 6 months after the initial program rollout.

Physicians in private practice: reasons for being a social franchise member

OpenAIRE

Huntington Dale; Mundy Gary; Hom Nang; Li Qingfeng; Aung Tin

2012-01-01

Abstract Background Evidence is emerging on the cost-effectiveness, quality and health coverage of social franchises. But little is known about the motivations of providers to join or remain within a social franchise network, or the impact that franchise membership has on client volumes or revenue earnings. Methods (i) Uncontrolled facility based of a random sample of 230 franchise members to assess self-reported motivations; (ii) A 24 month prospective cohort study of 3 cohorts of physicians...

Guidelines for starting today's private practice

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Schmitz ED

2012-11-01

Full Text Available No abstract available. Article truncated at 150 words. Starting a new practice may seem like a daunting task. The purpose of this article is to demystify the process of creating a new practice from the beginning. The cardinal rule is to keep costs low and not to outsource work that can easily be performed by any competent physician and staff. You do not need a manager, lawyer, business partner, coder or biller individually; you may be able to perform many of these services yourself. What you do need is a commitment to making your practice a success. Do not spend too much on your office space, furnishings or equipment. Start with the bare essentials. Immediately start applying to all insurance companies especially Medicare. Request an employer identification number. Set up a basic business banking account and submit the account number to the insurance companies you plan to work with. You can purchase an entire electronic healthcare record (EHR …

Referral of children seeking care at private health facilities in Uganda

DEFF Research Database (Denmark)

Mbonye, Anthony K.; Buregyeya, Esther; Rutebemberwa, Elizeus

2017-01-01

Background In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health...... facilities in order to explore ways of improving treatment and referral of sick children in this sector. Methods A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant...... interviews with private providers and community members. Results A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick...

Surveys of Current Teaching and Practice for Impressions for Complete Dentures.

Science.gov (United States)

Hussain, N; Jabbar, H; Hayati, M; Wu, J; Hyde, T P

2018-03-08

The 3 objectives are to assess current preferences for impressions for complete dentures, audit practice and compare practice to current UK teaching. Three surveys where undertaken; a survey of GDPs preferences, an audit of practice and a survey of teaching in UK dental schools. UK Universities advocate border moulded custom trays. In stated preferences, 99% of practitioners used custom trays for private practice; 67% for NHS work. In actual use, the audit found 91% practitioners in private practice used custom trays; in NHS practice 78% did so. The most widely taught materials were silicone (43%), alginate (29%), & zinc oxide eugenol paste (19%). In practitioners stated preferences, 97% of NHS and 53% of private dentists listed alginate as an option; however the audit showed only 74% (NHS) and 52% (private) actually used alginate, with 20% (NHS) and 48% (private) using silicone. Definitive impressions in custom trays are used by GDPs for both private and NHS work; they are universally taught at UK dental schools. Alginate is popular in NHS practice; however, silicone is more widely taught in UK Universities. The use of silicone materials for definitive impressions has increased since 1999. In UK private practice silicone usage is aligned in popularity with alginate. Copyright© 2018 Dennis Barber Ltd.

Reasserting the commons: Pastoral contestations of private and state lands in East Africa

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John G. Galaty

2016-09-01

Full Text Available The theory that land holding is inexorably evolving from common to private or state tenure is challenged by facts on the ground that this paper will examine. ‘Tenure’ is interpreted both in terms of formal law and informal practices. While the association between privatization and land fragmentation is clear, property theory has influenced privatization so the process cannot be used to validate the evolutionary model of transitions from open access to common property to private property. Although in many settings common and state property has given way to privatization, in other cases private or state property has reverted to common holdings. A dynamic tenure model would demonstrate the conditions under which tenure transitions occur between common, private and state property, as the balance between transaction and exclusion costs shifts, or when the boundaries of tenure forms weaken to allow open access to occur. Examining three scenes of tenure transitions involving Kenyan pastoralists (Laikipia County, the Rift Valley, Narok County and Kajiado County, this paper examines cases in which transaction and exclusion dynamics – which are metaphors for the institutional effects of social and territorial relations- lead to changing land-use practices and tenure transitions. In semi-arid pastoral regions, we find more fluid systems of tenure than the inexorable spread of privatization through formalized land rights and increasing land fragmentation would have suggested should occur in the 21st century.

How private are Europe's private forests?

DEFF Research Database (Denmark)

Nichiforel, Liviu; Keary, Kevin; Deuffic, Philippe

2018-01-01

Private forests are widespread in Europe providing a range of ecosystem services of significant value to society, and there are calls for novel policies to enhance their provision and to face the challenges of environmental changes. Such policies need to acknowledge the importance of private...... across jurisdictions, we constructed an original Property Rights Index for Forestry encompassing five rights domains (access, withdrawal, management, exclusion and alienation). We documented substantial variation of the private forest owners' rights, and notably to i) make decisions in operational...... management and the formulation of management goals, ii) withdraw timber resources from their forest, and iii) exclude others from the use of forest resources. We identified broad relations between the scope for decision making of private forest owners and jurisdictions' former socio-political background...

Contracting between public agencies and private psychiatric inpatient facilities.

Science.gov (United States)

Fisher, W H; Dorwart, R A; Schlesinger, M; Davidson, H

1991-08-01

Purchasing human services through contracts with private providers has become an increasingly common practice over the past 20 years. Using data from a national survey of psychiatric inpatient facilities, this paper examines the extent to which psychiatric units in privately controlled general hospitals and private psychiatric specialty hospitals (N = 611) participate in contractual arrangements to provide services to governmental bodies. It also examines how the likelihood of such a practice is affected by hospital characteristics (general or specialty, for profit or nonprofit) and features of hospitals' environments, including the competitiveness of the market for psychiatric inpatient care and the population's need for services in the hospital's county. The findings indicate that nonprofit psychiatric specialty hospitals were more likely than other types of hospitals to enter into such contracts, and that forces such as local competition and need for services were not predictors of such involvement. Contracting was shown to have a significant impact on the level of referrals a hospital accepted, but these levels were also affected by competition and need. Among hospitals with public contracts, referral acceptance from public agencies was unaffected by these factors, but they did have a significant effect on referral acceptance by hospitals without public contracts. These data suggest that public agencies contracting for services with private hospitals may represent a means by which "public sector" patients may gain access to private providers. Further, this mechanism may impose sufficient structure and regulation on the acceptance of such patients that many concerns of hospital administrators regarding patients who are costly and difficult to treat and discharge can be allayed.

VMware private cloud computing with vCloud director

CERN Document Server

Gallagher, Simon

2013-01-01

It's All About Delivering Service with vCloud Director Empowered by virtualization, companies are not just moving into the cloud, they're moving into private clouds for greater security, flexibility, and cost savings. However, this move involves more than just infrastructure. It also represents a different business model and a new way to provide services. In this detailed book, VMware vExpert Simon Gallagher makes sense of private cloud computing for IT administrators. From basic cloud theory and strategies for adoption to practical implementation, he covers all the issues. You'll lea

Private Schools

Data.gov (United States)

Department of Homeland Security — This Private Schools feature dataset is composed of all Private elementary and secondary education features in the United States as defined by the Private School...

Practice improvement, part II: trends in employment versus private practice.

Science.gov (United States)

Coleman, Mary Thoesen; Roett, Michelle A

2013-11-01

A growing percentage of physicians are selecting employment over solo practice, and fewer family physicians have hospital admission privileges. Results from surveys of recent medical school graduates indicate a high value placed on free time. Factors to consider when choosing a practice opportunity include desire for independence, decision-making authority, work-life balance, administrative responsibilities, financial risk, and access to resources. Compensation models are evolving from the simple fee-for-service model to include metrics that reward panel size, patient access, coordination of care, chronic disease management, achievement of patient-centered medical home status, and supervision of midlevel clinicians. When a practice is sold, tangible personal property and assets in excess of liabilities, patient accounts receivable, office building, and goodwill (ie, expected earnings) determine its value. The sale of a practice includes a broad legal review, addressing billing and coding deficiencies, noncompliant contractual arrangements, and potential litigations as well as ensuring that all employment agreements, leases, service agreements, and contracts are current, have been executed appropriately, and meet regulatory requirements. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Interval between onset of psoriasis and psoriatic arthritis comparing the UK Clinical Practice Research Datalink with a hospital-based cohort.

Science.gov (United States)

Tillett, William; Charlton, Rachel; Nightingale, Alison; Snowball, Julia; Green, Amelia; Smith, Catherine; Shaddick, Gavin; McHugh, Neil

2017-12-01

To describe the time interval between the onset of psoriasis and PsA in the UK primary care setting and compare with a large, well-classified secondary care cohort. Patients with PsA and/or psoriasis were identified in the UK Clinical Practice Research Datalink (CPRD). The secondary care cohort comprised patients from the Bath PsA longitudinal observational cohort study. For incident PsA patients in the CPRD who also had a record of psoriasis, the time interval between PsA diagnosis and first psoriasis record was calculated. Comparisons were made with the time interval between diagnoses in the Bath cohort. There were 5272 eligible PsA patients in the CPRD and 815 in the Bath cohort. In both cohorts, the majority of patients (82.3 and 61.3%, respectively) had psoriasis before their PsA diagnosis or within the same calendar year (10.5 and 23.8%), with only a minority receiving their PsA diagnosis first (7.1 and 14.8%). Excluding those who presented with arthritis before psoriasis, the median time between diagnoses was 8 years [interquartile range (IQR) 2-15] in the CPRD and 7 years (IQR 0-20) in the Bath cohort. In the CPRD, 60.1 and 75.1% received their PsA diagnosis within 10 and 15 years of their psoriasis diagnosis, respectively; this was comparable with 57.2 and 67.7% in the Bath cohort. A similar distribution for the time interval between psoriasis and arthritis was observed in the CPRD and secondary care cohort. These data can inform screening strategies and support the validity of data from each cohort. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

PRIVATE LAW EFFECTS OF THE NON-RECOGNITION OF STATES' EXISTENCE AND TERRITORIAL CHANGES

Directory of Open Access Journals (Sweden)

Ioan-Luca VLAD

2015-07-01

Full Text Available The study presents an outline of the effects in private law (including private international law of the non-recognition of a state or a change of territory. Specifically, it addresses the question of what measures can another state take, in the field of private law, in order to give effect to its policy of not recognizing a state or a territorial annexation, and, in parallel, what are the means available to private parties with links to the unrecognized state or territory. The study is structured in two parts, namely 1 the effects in private law of the non-recognition of a state; and 2 the effect in private law of the non-recognition of an annexation of territory. I will make specific references in particular to the situation in Transnistria and Crimea, as examples of the two issues being addressed. The study intends to be a guide of past and present state practice at the legislative and judicial level, as well as presenting the connections between instruments of public international law, such as Sanctions Resolutions of the UN Security Council, and normative instruments of private law, such as rules of civil procedure, which must adapt to the policy of non-recognition adopted by (or imposed on states. The study also presents specific examples of situations or administrative practices which create practical problems, and result from the existence of a non-recognized entity or change of territory: issues like air traffic coordination, postal traffic, the change in the official currency of a territory, questions of citizenship etc., the aim being to present the reader with a full picture of the issues and intricacies resulting from irregularities existing at the level of the international community of states.

Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

Science.gov (United States)

Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul

2013-10-28

The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

Privatization and the allure of franchising: a Zambian feasibility study.

Science.gov (United States)

Fiedler, John L; Wight, Jonathan B

2003-01-01

Efforts to privatize portions of the health sector have proven more difficult to implement than had been anticipated previously. One common bottleneck encountered has been the traditional organizational structure of the private sector, with its plethora of independent, single physician practices. The atomistic nature of the sector has rendered many privatization efforts difficult, slow and costly-in terms of both organizational development and administration. In many parts of Africa, in particular, the shortages of human and social capital, and the fragile nature of legal institutions, undermine the appeal of privatization. The private sector is left with inefficiencies, high prices and costs, and a reduced effective demand. The result is the simultaneous existence of excess capacity and unmet need. One potential method to improve the efficiency of the private sector, and thereby enhance the likelihood of successful privatization, is to transfer managerial technology--via franchising--from models that have proven successful elsewhere. This paper presents a feasibility analysis of franchizing the successful Bolivian PROSALUD system's management package to Zambia. The assessment, based on PROSALUD's financial model, demonstrates that technology transfer requires careful adaptation to local conditions and, in this instance, would still require significant external assistance.

[Early suspension of private practice: the current trends for general practitioners in three counties in western France].

Science.gov (United States)

Delansorne, Fanny; Buis, Hélène; Robino, Stéphane; Tomas, Josiane; Huez, Jean-François; Fanello, Serge

2009-01-01

The purpose of this study is to conduct a census of general practitioners in order to better understand their early withdrawal from primary care practice and to assess the impact of such withdrawal on current medical demography. The study covers the withdrawals from January 2000 to December 2005 in three western French counties. Data were collected through the district councils of the practitioners'guild, followed by a questionnaire filled in by 75 doctors. The participation rate was 60%. The study reveals that only 29% of these withdrawals are due to retirement. More than one in two doctors left to pursue another paid employment, and more than 25% chose to relocate their practice in a different area of the county. Two thirds of them were practicing in rural or semi-rural locations. Less than half, 47%, were replaced by a successor. General practitioners surveyed did not stop all professional medical care provision and service activities. Their careers are complex, and they are mobile professionals. The main reasons for suspending their activities in a given location were essentially related to the difficulties they had in dealing with their work loads and in maintaining a healthy work-life balance. They have noted that they will leave a range of possibilities open, either looking for private practice or not, exploring the possibility of primary care or not; the basis of their decision is whether a new position will correspond to their desire of mobility and meet their needs for more free.

Good practices in health care "management experimentation models": insights from an international public-private partnership on transplantation and advanced specialized therapies.

Science.gov (United States)

Longo, Maria Cristina

2015-01-01

The research analyzes good practices in health care "management experimentation models," which fall within the broader range of the integrative public-private partnerships (PPPs). Introduced by the Italian National Healthcare System in 1991, the "management experimentation models" are based on a public governance system mixed with a private management approach, a patient-centric orientation, a shared financial risk, and payment mechanisms correlated with clinical outcomes, quality, and cost-savings. This model makes public hospitals more competitive and efficient without affecting the principles of universal coverage, solidarity, and equity of access, but requires higher financial responsibility for managers and more flexibility in operations. In Italy the experience of such experimental models is limited but successful. The study adopts the case study methodology and refers to the international collaboration started in 1997 between two Italian hospitals and the University of Pittsburgh Medical Center (UPMC - Pennsylvania, USA) in the field of organ transplants and biomedical advanced therapies. The research allows identifying what constitutes good management practices and factors associated with higher clinical performance. Thus, it allows to understand whether and how the management experimentation model can be implemented on a broader basis, both nationwide and internationally. However, the implementation of integrative PPPs requires strategic, cultural, and managerial changes in the way in which a hospital operates; these transformations are not always sustainable. The recognition of ISMETT's good management practices is useful for competitive benchmarking among hospitals specialized in organ transplants and for its insights on the strategies concerning the governance reorganization in the hospital setting. Findings can be used in the future for analyzing the cross-country differences in productivity among well-managed public hospitals.

Twilight Policing. Private Security in Durban, South Africa

NARCIS (Netherlands)

Diphoorn, T.G.

2013-01-01

This ethnography analyses the everyday policing practices of armed response officers in Durban, South Africa. Armed response officers are private security officers who patrol communities in vehicles and respond to distress calls from clients. This study considers their interactions with other

Insights of private general practitioners in group practice on the introduction of National Health Insurance in South Africa

Directory of Open Access Journals (Sweden)

Shabir Moosa

2016-06-01

Full Text Available Background: The South African government intends to contract with ‘accredited provider groups’ for capitated primary care under National Health Insurance (NHI. South African solo general practitioners (GPs are unhappy with group practice. There is no clarity on the views of GPs in group practice on contracting to the NHI. Objectives: To describe the demographic and practice profile of GPs in group practice in South Africa, and evaluate their views on NHI, compared to solo GPs. Methods: This was a descriptive survey. The population of 8721 private GPs in South Africa with emails available were emailed an online questionnaire. Descriptive statistical analyses and thematic content analysis were conducted. Results: In all, 819 GPs responded (568 solo GPs and 251 GPs in groups. The results are focused on group GPs. GPs in groups have a different demographic practice profile compared to solo GPs. GPs in groups expected R4.86 million ($0.41 million for a hypothetical NHI proposal of comprehensive primary healthcare (excluding medicines and investigations to a practice population of 10 000 people. GPs planned a clinical team of 8 to 12 (including nurses and 4 to 6 administrative staff. GPs in group practices saw three major risks: patient, organisational and government, with three related risk management strategies. Conclusions: GPs can competitively contract with NHI, although there are concerns. NHI contracting should not be limited to groups. All GPs embraced strong teamwork, including using nurses more effectively. This aligns well with the emergence of family medicine in Africa. Keywords: Capitation, human resource, primary health care,  family medicine, South Africa, health systems

Cohort profile

DEFF Research Database (Denmark)

Maret-Ouda, John; Wahlin, Karl; Artama, Miia

2017-01-01

Purpose: To describe a newly created all-Nordic cohort of patients with gastro-oesophageal reflux disease (GORD), entitled the Nordic Antireflux Surgery Cohort (NordASCo), which will be used to compare participants having undergone antireflux surgery with those who have not regarding risk...... age at primary antireflux surgery ranged from 47 to 52 years in the different countries. The coding practices of GORD seem to have differed between the Nordic countries. Future plans: The NordASCo will initially be used to analyse the risk of developing known or potential GORD-related cancers, that is......, tumours of the oesophagus, stomach, larynx, pharynx and lung, and to evaluate the mortality in the short-term and long-term perspectives. Additionally, the cohort will be used to evaluate the risk of non-malignant respiratory conditions that might be caused by aspiration of gastric contents....

Private prisons

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Dimovski Darko

2014-01-01

Full Text Available The author, based on the circumstances that contributed to the creation of private prisons, has explained the historical development of private prisons in the United States and Great Britain. After that, the author has analyzed the strengths and weaknesses of the prison run by private companies. Namely, the author has, stating the benefits of private prisons (reduced overcrowding penitencijarnih institution, cheaper accommodation cost per prisoner, provide better services, the possibility of applying a new philosophy in the manner of execution of sentence, with modern Penitentiary program, with the aim of re-socialization and the reduction of recidivism and weaknesses of the private prisons (the question of legitimac, a chronic lack of space in the Penitentiary system is not solved, business-oriented policies of private prisons, less salaries, poor performance of the security service, worst food, weak enforcement of parole, lack of appropriate penitentiary program, wanted to draw attention to the professional public about controversy of the introduction private companies in the management structure of penitentiary institutions . As the Republic of Serbia is, constantly in the last twenty years, faced with the increasing number of inmates, as well as the chronic shortage of money, which affects on the situation in industrial areas of prisons, there are options to give licenses to private companies to manage prisons. Therefore, the author has paid special attention to potential problems of introducing private prisons in the penitentiary system in Serbia.

Advanced practice nurses: starting an independent practice.

Science.gov (United States)

Lambert, V A; Lambert, C E

1996-01-01

Independent or private practice is the delivery of nursing services provided by nurses over which nurses have full control. With a changing healthcare system, nurses are in a prime position to negotiate the delivery of appropriate, acceptable, and cost-effective health care as independent practitioners. This article addresses the mission and goals of independent practice, community need, business structure of the practice, housing the practice, legal considerations, financing the practice, marketing issues, clientele, record keeping, and reimbursement.

Public and private in the post-soviet area: the problem of demarcation

Directory of Open Access Journals (Sweden)

M. I. Zaidel

2014-01-01

Full Text Available The article focuses on the problem of determination of public and private in the post­soviet area. Formation of these spheres should be a logical conclusion of successful transformation and modernization process in ex­soviet republics and getting all spheres of civil life out of the state control. Historical specific is underlined; it is given the determination and main characteristics of public and private. It is given two main approaches’ ways of interpretation the phenomena and formation of public sphere according to H. Arendt and Ju. Hubermas. The specific of formation and demarcation of public and private spheres in the post­soviet area is analyzed. The boundaries between public and private spheres were deformed by the soviet state and communist society. As a result it was built hierarchical relations among the state, society and ruler; it is typical for power centralized societies. The determining factor of institutional heritage in the processes of state­making is underlined. The deformation of division of state, public and private spheres is caused by combining of traditional and modern institutes and practices; as a result social practices that are against of logic of modern society slow down the development of market­oriented economy and modernization of institutions.

Can mothers rely on the Brazilian health system for their deliveries? An assessment of use of the public system and out-of-pocket expenditure in the 2004 Pelotas Birth Cohort Study, Brazil

Directory of Open Access Journals (Sweden)

Bertoldi Andréa D

2008-03-01

Full Text Available Abstract Background In a country where comprehensive free health care is provided via a public health system (SUS, an unexpected high frequency of catastrophic out-of-pocket expenditure has been described. We studied how deliveries were financed among mothers of a birth cohort and whether they were an important source of household out-of-pocket expenditure. Methods All deliveries occurring in the city of Pelotas, Brazil, during 2004, were recruited for a birth cohort study. All mothers were interviewed just after birth and three months later. Comprehensive data on the pregnancy, delivery, birth conditions and newborn health were collected, along with detailed information on expenses related to the delivery. Results The majority of the deliveries (81% were financed by the public health system, a proportion that increased to more than 95% among the 40% poorest mothers. Less than 1% of these mothers reported some out-of-pocket expenditure. Even among those mothers covered by a private health plan, nearly 50% of births were financed by the SUS. Among the 20% richest, a third of the deliveries were paid by the SUS, 50% by private health plans and 17% by direct payment. Conclusion The public health system offered services in quantity and quality enough to attract even beneficiaries of private health plans and spared mothers from the poorest strata of the population of practically any expense.

16 CFR 310.7 - Actions by states and private persons.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Actions by states and private persons. 310.7 Section 310.7 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS... complaint and any other pleadings to be filed with the court. If prior notice is not feasible, the state or...

The role of private developers in local infrastructure provision in Malaysia

Science.gov (United States)

Salleh, Dani; Okinono, Otega

2016-08-01

Globally, the challenge of local infrastructure provision has attracted much debate amongst different nations including Malaysia, on how to achieve an effective and efficient infrastructural management. This approach therefore, has intensified the efforts of local authorities in incorporating private developers in their developmental agenda in attaining a sustainable infrastructural development in local areas. Basically, the knowledge of the need for adequate provision of local infrastructure is well understood by both local and private authorities. Likewise, the divergent opinions on the usage of private delivery services. Notwithstanding the common perception, significant loopholes have been identified on the most appropriate and ideal approach and practices to adopt in enhancing local infrastructure development. The study therefore examined the role of private developers in local infrastructure provision and procedure adopted by both local authorities and the privates sector in local infrastructure development. Data was obtained using the questionnaire through purposive sampling, administered to 22 local authorities and 16 developers which was descriptively analysed. Emanating from the study findings, the most frequently approved practices by local authorities are joint venture and complete public delivery systems. Likewise, negotiation was identified as a vital tool for stimulating the acquisition of local infrastructure provision. It was also discovered the one of the greatest challenge in promoting private sector involvement in local infrastructure development is due to unregulated-procedure. The study therefore recommends, there is need for local authorities to adopt a collective and integrated approach, nevertheless, cognisance and priority should be given to developing a well-structured and systematic process of local infrastructure provision and development.

A systematic assessment of the concept and practice of public-private mix for tuberculosis care and control.

Science.gov (United States)

Malmborg, Rasmus; Mann, Gillian; Squire, S Bertel

2011-11-10

The STOP TB Partnership aims to improve global tuberculosis (TB) control through expanding access to the directly observed treatment short course (DOTS) strategy. One approach to this is 'Engaging all Care Providers', which evolved from 'Public-Private Mix (PPM) DOTS'. The overall aim of this study was to systematically assess whether and to what degree the STOP TB Partnership's four global objectives of engaging all care providers are met through existing PPM interventions. These four objectives are; 1) Increase TB case detection; 2) Improve TB treatment outcomes; 3) Enhance access and equity; 4) Reduce financial burden on patients. The specific objectives of this assessment were to 1) Understand what PPM means to the STOP TB Partnership's PPM Subgroup and to National Tuberculosis Programme managers; 2) Scope the nature of existing country-level PPM interventions and 3) Review PPM practice against the global PPM objectives. We undertook a systematic, multi-facetted assessment. The methods included interviews with National Tuberculosis Programme managers from high burden countries, clarification of key issues with the STOP TB Partnership PPM secretariat and a review of publicly accessible reports and published articles on PPM projects. Both the literature review and interviews with the National Tuberculosis Programme managers yielded data on project characteristics; PPM models at country level; National Tuberculosis Programme partners; and mechanisms for engagement. Matrices were developed from the literature review and the interviews to show the relationship between services and service providers for different PPM projects. Data from the literature were assessed against each of the four global PPM objectives. Twelve National Tuberculosis Programme managers from high burden countries were interviewed about the scope of PPM partnerships. Understanding of PPM and types of engaged providers varied considerably; 'private-for-profit qualified clinical providers' were

Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

Science.gov (United States)

Johnston, Lee M; Finegood, Diane T

2015-03-18

Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

Private lands habitat programs benefit California's native birds

Directory of Open Access Journals (Sweden)

Ryan T. DiGaudio

2015-10-01

Full Text Available To address the loss of wetlands and riparian forests in California, private lands habitat programs are available through U.S. federal and state government agencies to help growers, ranchers and other private landowners create and enhance wildlife habitat. The programs provide financial and technical assistance for implementing conservation practices. To evaluate the benefits of these programs for wildlife, we examined bird use of private wetlands, postharvest flooded croplands and riparian forests enrolled in habitat programs in the Central Valley and North Coast regions of California. We found that private Central Valley wetlands supported 181 bird species during the breeding season. During fall migration, postharvest flooded croplands supported wetland-dependent species and a higher density of shorebirds than did semipermanent wetlands. At the riparian sites, bird species richness increased after restoration. These results demonstrated that the programs provided habitat for the species they were designed to protect; a variety of resident and migratory bird species used the habitats, and many special status species were recorded at the sites.

Public Supervision over Private Relationships : Towards European Supervision Private Law?

NARCIS (Netherlands)

Cherednychenko, O.O.

2014-01-01

The rise of public supervision over private relationships in many areas of private law has led to the development of what, in the author’s view, could be called ‘European supervision private law’. This emerging body of law forms part of European regulatory private law and is made up of

[Personalized medicine, privatized medicine? legal and public health stakes].

Science.gov (United States)

Rial-Sebbag, Emmanuelle

2014-11-01

Personalized medicine is booming. It tends to provide a medical management "tailored" for groups of patients, or for one unique patient, but also to identify risk groups to develop public health strategies. In this context, some radicalization phenomenon can emerge, leading to not only personalized medicine but also privatized medicine, which can lead to a capture of the medical public resource. If the "privatization" of medicine is not limited to producing adverse effects, several potentially destabilizing phenomena for patients still remain. First, some objective factors, like the adjustment of scientific prerequisites, are emerging from personalized medicine practices (clinical trial, public health policy) and are interfering with the medical doctor/patient relationship. Another risk emerges for patients concomitantly to their demand for controlling their own health, in terms of patients' security although these risks are not clearly identified and not effectively communicated. These practices, related to a privatized medicine, develop within the healthcare system but also outside, and the government and legislators will have to take into account these new dimensions in drafting their future regulations and policies. © 2014 médecine/sciences – Inserm.

RN work engagement in generational cohorts: the view from rural US hospitals.

Science.gov (United States)

Sullivan Havens, Donna; Warshawsky, Nora E; Vasey, Joseph

2013-10-01

To describe staff nurse work engagement, identify predictors by generational cohort, present implications for nurse managers and suggest future research. A global nurse shortage looms. While an adequate supply of nurses is needed to ensure access to care, access to quality care may be enhanced by an adequate supply of highly engaged nurses-those who are dedicated, energized, and absorbed. Nurses have long reported the presence of energy depleting practice environments. Nurses practicing in professional practice environments may be more engaged. A non-experimental survey design was executed. Direct care Registered Nurses (n = 747) working in five rural acute care hospitals completed questionnaires to assess work engagement (Utrecht Work Engagement Scale-9), decisional involvement (Decisional Involvement Scale), relational coordination (Relational Coordination Survey) and the nursing practice environment (Practice Environment Scale of the Nursing Work Index). Descriptive, correlational and regression analyses examined work engagement and predictors by generational cohort. With the exception of the absorption component, no statistically significant differences in engagement emerged across generational cohorts. Predictors of engagement differed by cohort, however across all cohorts, professional nursing practice environments predicted nurse work engagement. Professional nursing practice environments are significantly associated with nurse work engagement. Enhancing nurse work engagement is a complex challenge. Generational cohorts may respond to different strategies to enhance engagement. © 2013 John Wiley & Sons Ltd.

When the business of nursing was the nursing business: the private duty registry system, 1900-1940.

Science.gov (United States)

Whelan, Jean C

2012-05-31

In the initial decades of the 20th century, most nurses worked in the private sector as private duty nurses dependent on their own resources for securing and obtaining employment with individual patients. To organize and systematize the ways in which nurses sought jobs, a structure of private duty registries, agencies which connected nurses with patients, was established via professional nurse associations. This article describes the origins of the private duty nurse labor market as the main employment field for early nurses and ways in which the private duty registry system connected nurses and patients. The impact of professional nurses associations and two registries, (New York and Chicago) illustrates how the business of nursing was carried out, including registry formation, operation, and administration. Private duty nurses are compelling examples of a previous generation of nurse entrepreneurs. The discussion identifies problems and challenges of private nursing practice via registries, including the decline and legacy of this innovative nurse role. The story of early 20th century nurse owned and operated registries provides an early and critical historical illustration of the realization of nurse power, entrepreneurship, and control over professional practice that we still learn from today.

Private Finance 2 (PF2): Re-inventing the Wheel?

Science.gov (United States)

Zawawi, N. A. W. A.; Abdul-Aziz, A. R.; Khamidi, M. F.; Othman, I.; Idrus, A.; Umar, A. A.

2013-06-01

The Procurement policy of any government is the most influential factor in determining the efficiency of infrastructure and service provision like roads, water supply and energy. The UK's HM Treasury released its new guidelines on private involvement in infrastructures provision and services towards reforming the popular Private Finance Initiatives (PFI) policy. This new approach, it now refers to as the Private Finance 2 (PF2) is meant to correct the imperfections which have bedeviled the older version-PFI. However, the 'new guidelines' contained nothing really new in the area of private financing and operation of public infrastructures, at best it is akin to 're-inventing the wheel' rather than being 'new'. While dwelling extensively on issues relating to cheaper financing sources, risks transfer, counterpart funding by government and improving public sector procurement skills, this paper argues that some countries in the developing world have long recognised these issues and taken practical steps to correct them.

Private Finance 2 (PF2): Re-inventing the Wheel?

International Nuclear Information System (INIS)

Zawawi, N A W A; Khamidi, M F; Othman, I; Umar, A A; Abdul-Aziz, A R; Idrus, A

2013-01-01

The Procurement policy of any government is the most influential factor in determining the efficiency of infrastructure and service provision like roads, water supply and energy. The UK's HM Treasury released its new guidelines on private involvement in infrastructures provision and services towards reforming the popular Private Finance Initiatives (PFI) policy. This new approach, it now refers to as the Private Finance 2 (PF2) is meant to correct the imperfections which have bedeviled the older version-PFI. However, the 'new guidelines' contained nothing really new in the area of private financing and operation of public infrastructures, at best it is akin to 're-inventing the wheel' rather than being 'new'. While dwelling extensively on issues relating to cheaper financing sources, risks transfer, counterpart funding by government and improving public sector procurement skills, this paper argues that some countries in the developing world have long recognised these issues and taken practical steps to correct them.

Private and Non-Private Disc Herniation Patients: Do they Differ?

Science.gov (United States)

Gregebo, Birgitta; Dai, Deliang; Schillberg, Birgitta; Baehr, Martin; Nyström, Bo; Taube, Adam

2014-01-01

In the 2006 yearly report from the Swedish National Register for Lumbar Spine Surgery it was claimed that international studies show obvious differences between private and non-private patients with regard to results from back surgery. Therefore our aim was to reveal such possible differences by comparing the two categories of patients at a private clinic. The material comprises 1184 patients operated on for lumbar disc herniation during the period of 1987 to 2007. Basic pre-operative data were obtained from the medical records and follow-up was performed by a questionnaire around 5 years post-operatively. Small but statistically significant differences between private and non-private patients were seen pre-operatively regarding the proportions of a/ men and women in the samples, b/ those with physically demanding jobs, c/ those on sick leave and d/ those with lumbar pain. Over the years the admitted private patients had a decreasing mean duration of symptoms which was not seen in the non-private patients. No apparent differences (n.s.) were seen between the two categories of patients pre-operatively regarding age, presence and level of leg pain or the proportion who smoked. Post-operative improvement in leg and lumbar pain was very similar in private and non-private patients as was satisfaction with the results and the proportion of patients returning to work. Despite small pre-operative differences concerning some variables and a significant difference in symptom duration between private and non-private disc herniation patients, the final clinical results were very similar.

Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000-2008): a linked data population-based cohort study.

Science.gov (United States)

Dahlen, Hannah G; Tracy, Sally; Tracy, Mark; Bisits, Andrew; Brown, Chris; Thornton, Charlene

2014-05-21

To examine the rates of obstetric intervention and associated perinatal mortality and morbidity in the first 28 days among low-risk women giving birth in private and public hospitals in NSW (2000-2008). Linked data population-based retrospective cohort study involving five data sets. New South Wales, Australia. 691 738 women giving birth to a singleton baby during the period 2000-2008. Rates of neonatal resuscitation, perinatal mortality, neonatal admission following birth and readmission to hospital in the first 28 days of life in public and private obstetric units. Rates of obstetric intervention among low-risk women were higher in private hospitals, with primiparous women 20% less likely to have a normal vaginal birth compared to the public sector. Neonates born in private hospitals were more likely to be less than 40 weeks; more likely to have some form of resuscitation; less likely to have an Apgar birth admission and to be readmitted to hospital in the first 28 days for birth trauma (5% vs 3.6%); hypoxia (1.7% vs 1.2%); jaundice (4.8% vs 3%); feeding difficulties (4% vs 2.4%) ; sleep/behavioural issues (0.2% vs 0.1%); respiratory conditions (1.2% vs 0.8%) and circumcision (5.6 vs 0.3%) but they were less likely to be admitted for prophylactic antibiotics (0.2% vs 0.6%) and for socioeconomic circumstances (0.1% vs 0.7%). Rates of perinatal mortality were not statistically different between the two groups. For low-risk women, care in a private hospital, which includes higher rates of intervention, appears to be associated with higher rates of morbidity seen in the neonate and no evidence of a reduction in perinatal mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Private inherited microdeletion/microduplications: implications in clinical practice.

Science.gov (United States)

Mencarelli, Maria Antonietta; Katzaki, Eleni; Papa, Filomena Tiziana; Sampieri, Katia; Caselli, Rossella; Uliana, Vera; Pollazzon, Marzia; Canitano, Roberto; Mostardini, Rosa; Grosso, Salvatore; Longo, Ilaria; Ariani, Francesca; Meloni, Ilaria; Hayek, Josef; Balestri, Paolo; Mari, Francesca; Renieri, Alessandra

2008-01-01

The introduction of array-CGH analysis is allowing the identification of novel genomic disorders. However, this new high-resolution technique is also opening novel diagnostic challenges when inherited private CNVs of unclear clinical significance are found. Oligo array-CGH analysis of 84 patients with mild to severe mental retardation associated with multiple congenital anomalies revealed 10 private CNVs inherited from a healthy parent. Three were deletions (7q31, 14q21.1, Xq25) and seven duplications (12p11.22, 12q21.31, 13q31.1, 17q12, Xp22.31, Xq28) ranging between 0.1 and 3.8Mb. Six rearrangements were not polymorphic. Four overlapped polymorphic regions to the extent of 10-61%. In one case the size was different between the proband and the healthy relative. Three small rearrangements were gene deserts. The remaining seven had a mean gene content of five (ranging from 1 to 18). None of the rearranged genes is known to be imprinted. Three disease-genes were found in three different cases: KAL1 in dupXp22.31, STS in another dupXp22.31 and TCF2 in dup17q12. The patient carrying the last duplication presents sex reversal, Peters' anomaly and renal cysts and the duplication is located 4Mb away from the HSD17B1 gene, coding a key enzyme of testosterone biosynthesis. Considering the overlap with polymorphic regions, size-identity within the family, gene content, kind of rearrangement and size of rearrangement we suggest that at least in five cases the relationship to the phenotype has not to be excluded. We recommend to maintain caution when asserting that chromosomal abnormalities inherited from a healthy parent are benign. A more complex mechanism may in fact be involved, such as a concurrent variation in the other allele or in another chromosome that influences the phenotype.

Preliminary Evaluation of a Practice-Based EBVM Skills Development Program

Directory of Open Access Journals (Sweden)

Ava Firth

2016-12-01

Full Text Available Whilst there is a small body of research that investigates the development of EBVM skills in veterinary undergraduates there is a paucity of research that aims to understand the development of EBVM skills in practice-based post-graduate veterinary surgeons. This paper is a small step in remedying that shortfall. In particular, the paper provides a progress report on an RCVS Knowledge funded study that is evaluating a practice-based EBVM development program. The program is being conducted with a cohort of 20 veterinary surgeons and veterinary nurses employed in a private practice veterinary company across multiple sites. The facilitated instruction approach incorporates multiple supports including; group based and one-to-one, synchronous and asynchronous, and, face-to-face and online strategies. This paper will provide details of both the facilitation and evaluation approaches that have been adopted. The paper will also report on preliminary results of the evaluation which focuses on barriers and facilitators to EBVM development.This is a podcast of Ava and Ian's talk at the Veterinary Evidence Today conference, Edinburgh November 2, 2016.

Private power in China

International Nuclear Information System (INIS)

Daniel, Martin

1999-10-01

Contains Executive Summary and Chapters on: Introduction; Political and economic background; Energy supply; The Chinese electricity sector; Private power in China; Issues for private investors; Fuel choice in private projects; Private investors in China; Listed Chinese generators; Private power prospects; Implemented private generation projects; Planned private Generation Projects; Plants owned by listed Chinese generators. (Author)

Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study.

Science.gov (United States)

Adaji, Akuh; Newcomb, Richard D; Wang, Zhen; Williams, Mark

2018-01-01

The impact of "real world" collaborative care on depression and absenteeism for depressed employees seen in primary care practices using objective employer absence data. A retrospective cohort study comparing depressed employees seen in primary care practices who enrolled for a "real world" collaborative care program to practice as usual (PAU) on objective absence days and depression response and remission at 6, and 12-month time periods. Absence days were more in the collaborative care group compared with the PAU group at 3 and 6 months but at 12 months the difference was no longer statistically significant. Collaborative care led to better response and remission depression scores compared with PAU at 12 months. Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work.

Enhancing private sector engagement: Louisiana's business emergency operations centre.

Science.gov (United States)

Day, Jamison M; Strother, Shannon; Kolluru, Ramesh; Booth, Joseph; Rawls, Jason; Calderon, Andres

2010-07-01

Public sector emergency management is more effective when it coordinates its efforts with private sector companies that can provide useful capabilities faster, cheaper and better than government agencies. A business emergency operations centre (EOC) provides a space for private sector and non-governmental organisations to gather together in support of government efforts. This paper reviews business-related EOC practices in multiple US states and details the development of a new business EOC by the State of Louisiana, including lessons learned in response to the May 2010 oil spill.

Privatization and Education

Science.gov (United States)

Dash, Neena

2009-01-01

This paper highlights emerging trends, programmes and policies in privatization of education in Western countries. These trends are educational vouchers, choice of private schools, private school liberalization, private contracting of specific services, tuition tax credits and deductions for parents ,subsidies and assistance grants to private…

Specific infant feeding practices do not consistently explain variation in anthropometry at age 1 year in urban United States, Mexico, and China cohorts.

Science.gov (United States)

Woo, Jessica G; Guerrero, M Lourdes; Ruiz-Palacios, Guillermo M; Peng, Yong-mei; Herbers, Patricia M; Yao, Wen; Ortega, Hilda; Davidson, Barbara S; McMahon, Robert J; Morrow, Ardythe L

2013-02-01

Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant's birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry.

Exploring a public-private partnership new-graduate physiotherapy recruitment program: a qualitative study.

Science.gov (United States)

Schmidt, David; Dmytryk, Neil

2014-12-01

Difficulty in attracting allied health staff to rural areas is well known. In 2012, a small rural health facility and local private practice created an informal public-private partnership to recruit two new-graduate physiotherapists. Graduates were employed part-time in both the public and private sectors. This qualitative case study employed an appreciative enquiry framework to explore this partnership model. Three focus groups were held, and a combination of content and thematic analysis was used to derive and organise themes arising from the data. A regional public health service and private physiotherapy practice in the Bega Valley region of south-eastern New South Wales, Australia. New-graduate and second-year physiotherapists (n = 5), private sector managers (n = 3), and public sector managers (n = 4). Perceived benefits of the partnership model and improvements that could be made to further develop the model. Organisational benefits of a shared public-private role included the ability to attract high-quality applicants to difficult-to-fill positions, reduced the risk of new-graduate attrition due to social isolation, enhanced networking between sectors, and enhanced staff skill development through a broad range of clinical and non-clinical experiences. The model relied on management flexibility and has potential to expand to other areas and professions. Dedicated funding support, targeted recruitment strategies and increased planning to ease the transition into the workplace would further enhance the model. An informal public-private partnership to overcome established workforce shortages has proven successful to the benefit of the new graduates and both the public and private sectors. © 2014 National Rural Health Alliance Inc.

Antibiotic prescribing in public and private practice: a cross-sectional study in primary care clinics in Malaysia.

Science.gov (United States)

Ab Rahman, Norazida; Teng, Cheong Lieng; Sivasampu, Sheamini

2016-05-17

Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing

Do Catalan private hospitals enjoy financial health?

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Judit Creixans Tenas

2016-02-01

Full Text Available Purpose: The present study reflects the economic and financial analysis of  private hospitals with non-charitable character in Catalonia 2008-2013. The private health sector is considered to be a service activity that develops an important social role. The study positions these analysed centers in the Catalan and Spanish health sector and presents the main economic and financial indicators to diagnose the situation of these companies during the period indicated by analysing short and long-term results and analysis of changes in equity and cash flows of the wineries. Design/methodology/approach: The data used comes from the statements of the Catalan hospital centers in the period 2008-2013 and in particular, it contains a sample of 94 Catalan private hospitals, that mostly are considered large-level accounting (according to the General Accounting Plan. The economic and financial  analysis has carried out using descriptive statistics and analysis results and conclusions have been reached. Findings: The study noted that enables private hospitals in this period have a healthy economic and financial status, although it should improve the management of assets. Most sales are concentrated with a small number of hospitals and, regarding the evolution of the results, produces two distinct stages, the first period of decrease (2008-2010 and the second period of growth and recovery from 2011.. Research limitations/implications: It would be desirable to perform the same study by the Spanish private hospitals in order to compare the economic and financial analysis of the Catalan private sector with the Spanish private sector. Practical implications: It allows us to assess the projection of this sector in recent years in Catalonia in order to take the appropriate economic decisions in this regard. Social implications: The results show the changes that have occurred over the years in the economic crisis of the period analysed. Originality / value: For

Practical quantum private query with better performance in resisting joint-measurement attack

Science.gov (United States)

Wei, Chun-Yan; Wang, Tian-Yin; Gao, Fei

2016-04-01

As a kind of practical protocol, quantum-key-distribution (QKD)-based quantum private queries (QPQs) have drawn lots of attention. However, joint-measurement (JM) attack poses a noticeable threat to the database security in such protocols. That is, by JM attack a malicious user can illegally elicit many more items from the database than the average amount an honest one can obtain. Taking Jacobi et al.'s protocol as an example, by JM attack a malicious user can obtain as many as 500 bits, instead of the expected 2.44 bits, from a 104-bit database in one query. It is a noticeable security flaw in theory, and would also arise in application with the development of quantum memories. To solve this problem, we propose a QPQ protocol based on a two-way QKD scheme, which behaves much better in resisting JM attack. Concretely, the user Alice cannot get more database items by conducting JM attack on the qubits because she has to send them back to Bob (the database holder) before knowing which of them should be jointly measured. Furthermore, JM attack by both Alice and Bob would be detected with certain probability, which is quite different from previous protocols. Moreover, our protocol retains the good characters of QKD-based QPQs, e.g., it is loss tolerant and robust against quantum memory attack.

Group supervision in a private setting: Practice and method for theory and practice in psychotherapy

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Graziana Mangiacavallo

2015-05-01

Full Text Available The report aims to tell the experience of a supervision group in a private setting. The group consists of professional psychotherapists driven by the more experienced practitioner, who shares a clinical reasoning on psychotherapy with younger colleagues. The report aims to present the supervision group as a methode and to showcase its features. The supervision group becomes a container of professional experiences that speak of the new way of doing psychotherapy. 

Treatment of DOE and commercial mixed waste by the private sector

Energy Technology Data Exchange (ETDEWEB)

Garrison, T.W.; Apel, M.L.; Owens, C.M.

1993-03-01

This paper presents a conceptual approach for private sector treatment of mixed low-level radioactive waste generated by the US Department of Energy and commercial industries. This approach focuses on MLLW treatment technologies and capacities available through the private sector in the near term. Wastestream characterization data for 108 MLLW streams at the Idaho National Engineering Laboratory (INEL) were collected and combined with similar data for MLLWs generated through commercial practices. These data were then provided to private treatment facilities and vendors to determine if, and to what extent, they could successfully treat these wastes. Data obtained from this project have provided an initial assessment of private sector capability and capacity to treat a variety of MLLW streams. This information will help formulate plans for future treatment of these and similar wastestreams at DOE facilities. This paper presents details of the MLLW data-gathering efforts used in this research, private sector assessment methods employed, and results of this assessment. Advantages of private sector treatment, as well as barriers to its present use, are also addressed.

Opportunities outside private practice before 1860.

Science.gov (United States)

Deacon, Harriet; van Heyningen, Elizabeth

2004-01-01

This chapter discusses the restrictions and opportunities which salaried employment offered Cape doctors in the pay of government and charitable organisations during the first two thirds of the nineteenth century. Although Cape doctors often acted as agents of the colonial state there were many nuances within this relationship. While military doctors played an important role in the profession during the first few decades of the century, by the 1840s civilian doctors were beginning to assert greater influence in Cape Town, if not yet in the Eastern Cape. Hospital posts and an expanding network of charitable organisations and government-funded district surgeoncies provided part-time employment for some doctors throughout the colony. This helped urban-based doctors to sustain practices and encouraged more doctors to practice in the smaller country towns serving large farming areas.

Preschool Math Exposure in Private Center-Based Care and Low-SES Children's Math Development

Science.gov (United States)

Bachman, Heather J.; Degol, Jessica L.; Elliott, Leanne; Scharphorn, Laura; El Nokali, Nermeen E.; Palmer, Kalani M.

2018-01-01

Research Findings: The present study examined the amount of exposure to math activities that children of low socioeconomic status (SES) encounter in private community-based preschool classrooms and whether greater time in these activities predicted higher math skills. Three cohorts of 4- to 5-year-old children were recruited from 30 private…

IMPROVED FARMER’S CAPASITY MODEL OF PRIVATE FOREST MANAGEMENT: STUDIES IN RANGGANG VILLAGE, SOUTH KALIMANTAN

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Idin Saepudin Ruhimat

2015-05-01

Full Text Available Farmer’s capacity is one of the important factors that determine the success of private forest management. However, the farmer’s capacity level in several places is still low so that potentially to inhibiting successful of private forests management practices. This study aims to analyze the factors that affect farmer’s capacity level of private forests management practices, and to formulate improved farmer’s capacity model of private forests management in Ranggang Village, South Kalimantan. The data was analyzed by Structural Equation Model (SEM with the help of SmartPls 2.0 M3. Results showed (1 learning experience level directly affect to farmer’s capacity while farmer’s characteristics, external support, social and cultural environment supporting, the role of extension, and information availability indirectly affect to farmer’s capacity of private forests management in Ranggang Village, and (2 improved farmer’s capacity model can be done by improving the farmer’s learning experience through intensive, scheduled, and suistainable education, training and extension with stakeholders support. 

Privatization of Electricity Service Delivery in Developing Nations: Issues and Challenges

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Olamide Eniola Victor

2015-09-01

Full Text Available The provision of public utilities and infrastructures particularly electricity by the public sector (Government especially in the Developing Nations has been heavily criticized. This has been attributed to many reasons including poor electricity supply, poor distribution of service delivery of electricity due to the absence of spatial planning, insufficient government investment into the power industry, ineptitude operation on the part of the technicians, poor administration and managerial control. However, efforts to move away from government ownership, control or participation in this sector of economy towards free enterprise and increased inclusive private sector participation known as privatization, has been adopted as one of the solutions. This paper presents a critical review of privatization practices of alternative Service Delivery approach of selected Asian and African nations. The paper would elicit the common variants of privatization models adopted by these nations and the different implementation strategies which resulted in divergence in effectiveness and efficiency in the service delivery of electricity. The selected Asian countries are; Malaysia, India, and China, while the selected African nations are Nigeria, Cameroun and South Africa. The paper will draw from the literatures the various approaches, concepts adopted, practices, issues and challenges faced by these countries.

Private prayer among Alzheimer's caregivers: mediating burden and resiliency.

Science.gov (United States)

Wilks, Scott E; Vonk, M Elizabeth

2008-01-01

This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.

Theoretical frameworks used to discuss ethical issues in private physiotherapy practice and proposal of a new ethical tool.

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Drolet, Marie-Josée; Hudon, Anne

2015-02-01

In the past, several researchers in the field of physiotherapy have asserted that physiotherapy clinicians rarely use ethical knowledge to solve ethical issues raised by their practice. Does this assertion still hold true? Do the theoretical frameworks used by researchers and clinicians allow them to analyze thoroughly the ethical issues they encounter in their everyday practice? In our quest for answers, we conducted a literature review and analyzed the ethical theoretical frameworks used by physiotherapy researchers and clinicians to discuss the ethical issues raised by private physiotherapy practice. Our final analysis corpus consisted of thirty-nine texts. Our main finding is that researchers and clinicians in physiotherapy rarely use ethical knowledge to analyze the ethical issues raised in their practice and that gaps exist in the theoretical frameworks currently used to analyze these issues. Consequently, we developed, for ethical analysis, a four-part prism which we have called the Quadripartite Ethical Tool (QET). This tool can be incorporated into existing theoretical frameworks to enable professionals to integrate ethical knowledge into their ethical analyses. The innovative particularity of the QET is that it encompasses three ethical theories (utilitarism, deontologism, and virtue ethics) and axiological ontology (professional values) and also draws on both deductive and inductive approaches. It is our hope that this new tool will help researchers and clinicians integrate ethical knowledge into their analysis of ethical issues and contribute to fostering ethical analyses that are grounded in relevant philosophical and axiological foundations.

Influence of consumer behaviour on the energy requirement of private households. Einfluss des Verbraucherverhaltens auf den Energiebedarf privater Haushalte

Energy Technology Data Exchange (ETDEWEB)

1982-01-01

The papers read at the meeting deal with the causes and effects of consumer tendencies towards careful use of energy in private households. The technical, social, and economic marginal conditions are thereby set into relief. Specific statements have only become possible since social scientists and engineers have jointly evolved practicable methods to analyze consumer behaviour.

Business ethics of private general practitioners in KwaDukuza, KwaZulu-Natal

Science.gov (United States)

Morris, Gary

2010-01-01

ABSTRACT Background Private general practitioners (GPs) have been criticised by the lay press citing unethical practice and the acceptance of kickbacks. In 2003, the Ethics Institute of South Africa conducted a national study of all doctors and also accused private GPs of unethical practice. In countries such as South Africa, with a practice of fee-for-service payments, there may be a temptation to put material interests above the best interests of patients. Private GPs, on the other hand, are of the opinion that the press and the Ethics Institute publication have unfairly singled them out. Objective To detect whether private GPs in KwaDukuza perceive their colleagues to be practising ethically. Method The study entailed a cross-sectional descriptive study design, in which all 30 private GPs based in KwaDukuza, KwaZulu-Natal, were asked to complete a self-administered questionnaire during 2003. The survey was done on a voluntary basis and anonymity and confidentiality was maintained. Results Twenty-five doctors returned completed questionnaires (an 83.3% response rate). Seventy per cent perceived their peers to be practicing ethically, while 48% (12/25) reported that they did not observe any medical misconduct by their colleagues. The majority of the respondents (76%) reported that they did not know of any colleague who supplemented his or her income through the over-servicing of patients. The majority of the respondents (84%) also reported that their colleagues never accepted cash payments that were not declared for income tax purposes. Medically unnecessary tests are a form of unethical behaviour pertaining to over-servicing, and 64% of the respondents reported that medically unnecessary tests to satisfy patient requests were not an important reason for performing these tests. The doctors expressed high stress levels from multiple stressors in their occupation. Conclusion GPs in KwaDukuza indicated that they were under stress, but still practised ethically. The

Privat boligudlejning

DEFF Research Database (Denmark)

Andersen, Hans Skifter

2008-01-01

for private udlejningsboligers pris, økonomi og kvalitet. Det økonomiske afkast af investering i private udlejningsejendomme har været højt i de sidste 10 år, men fortrinsvist pga. værdistigninger. For tiden er disse gået i stå, hvilket gør den økonomiske fremtid for den private udlejningssektor mindre...

Determinants related to gender differences in general practice utilization: Danish Diet, Cancer and Health Cohort.

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Jørgensen, Jeanette Therming; Andersen, John Sahl; Tjønneland, Anne; Andersen, Zorana Jovanovic

2016-09-01

This study aims to describe the determinants related to gender differences in the GP utilization in Danish population aged 50-65 years. Cohort-based cross-sectional study. Danish general practice. Totally, 54,849 participants of the Danish Diet, Cancer and Health cohort (50-65 years). The sum of cohort members' face-to-face consultations with general practitioner (GP) at the cohort baseline year (1993-1997). We obtained data on GP visits from the Danish National Health Service Register at the cohort baseline (1993-1997), when information on lifestyle (smoking, body mass index (BMI), alcohol use, physical activity), medical conditions (somatic and mental), employment, education, gravidity, and hormone therapy (HT) use was collected by questionnaire. Women had on average 4.1 and men 2.8 consultations per year. In a crude model, women had 47% higher rate of GP visits than men (incidence rate ratio: 1.47; 95% Confidence Interval: 1.45-1.50), which remained unchanged after adjustment for lifestyle, socio-demographic and medical factors, but attenuated to 18% (1.18; 1.13-1.24) after adjustment for female factors (gravidity and post-menopausal HT. In a fully adjusted model, subjects with hypertension (1.63; 1.59-1.67), mental illness (1.63; 1.61-1.66), diabetes (1.56; 1.47-1.65), angina pectoris (1.28; 1.21-1.34), and unemployed persons (1.19; 1.18-1.21) had highest rates of GP visits. Gravidity and HT use explain a large proportion, but not all of the gender difference in GP utilization. Medical conditions (somatic and mental) and unemployment are the main determinants of GP utilization in men and women, while lifestyle has minor effect. Key points Female gender remained a dominant determinant of GP utilization, after adjustment for lifestyle, socio-demography, medical and gender specific factors, with females consulting their GP 18% more often than males. Female reproductive factors (use of postmenopausal hormone therapy and gravidity) explained a large proportion of

Shifting Kenya's Private Sector into Higher Gear : A Trade and Competitiveness Agenda

OpenAIRE

World Bank Group

2016-01-01

Shifting Kenya’s private sector into higher gear: a trade and competitiveness agenda’ was born out of the World Bank’s Trade and Competitiveness (T&C) Global Practice recent stock taking of its work in Kenya. This was part of a Programmatic Approach that aimed to organize T&C’s knowledge, advisory, and convening services to address Kenya’s development challenges in the private sector space...

Use of fertility drugs and risk of ovarian cancer: Danish population based cohort study

OpenAIRE

Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten; Kj?r, Susanne Kr?ger

2009-01-01

Objective To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Design Population based cohort study. Setting Danish hospitals and private fertility clinics. Participants 54?362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), and the median age at the end of follow-up was 47 (range 18-81) years. In...

Implications of failure to achieve a result from prenatal maternal serum cell-free DNA testing: a historical cohort study.

Science.gov (United States)

Chan, N; Smet, M-E; Sandow, R; da Silva Costa, F; McLennan, A

2017-11-01

To investigate the pregnancy outcomes in a cohort of women who failed to obtain a result in non-invasive prenatal testing (NIPT). Historical cohort study. A multicentre private practice in Sydney, Australia. Women who failed to obtain a result from NIPT (n = 131). The maternal characteristics, antenatal investigations and pregnancy outcomes for these women were compared with those who obtained a result at the same practice and to the general Australian obstetric population. Antenatal investigations: pregnancy-associated plasma protein-A (PAPP-A), free β-human chorionic gonadotrophin (β-hCG), placental growth factor (PlGF), uterine artery pulsatility index (PI), mean arterial pressure (MAP). Pregnancy outcomes: chromosomal abnormality, pre-eclampsia, gestational diabetes, small-for-gestational-age (SGA), preterm delivery. Only 1.1% of NIPT samples failed to return a result. This cohort was significantly older and had significantly increased weight compared with the general Australian obstetric population. Pregnancy outcomes were available for 94% of the cohort. There were significantly higher rates of chromosomal aneuploidies (6.5% versus 0.2%, P < 0.0001), pre-eclampsia (11% versus 1.5%, P < 0.0001) and gestational diabetes (23% versus 7.5%, P < 0.0001) compared with the general obstetric population. Rates of preterm delivery and SGA were elevated but did not reach significance. Antenatal investigations demonstrated decreased PAPP-A MoM (0.75 versus 1.14, P < 0.0001), decreased free β-hCG (0.71 versus 1.01, P < 0.0001) and increased uterine artery PI (1.79 versus 1.65, P = 0.02). Women who fail to obtain a result from NIPT are at increased risk of adverse pregnancy outcomes, in particular chromosomal aneuploidy, gestational diabetes and pre-eclampsia. None received. Women who fail to obtain a result from cell-free DNA NIPT are at increased risk of adverse pregnancy outcomes. © 2017 Royal College of Obstetricians and Gynaecologists.

Private and Public Sector Enterprise Resource Planning System Post-Implementation Practices: A Comparative Mixed Method Investigation

Science.gov (United States)

Bachman, Charles A.

2010-01-01

While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the public sector lagged by several years. This research conducted a mixed method, comparative assessment of post "go-live" ERP implementations between public and private sector organization. Based on a…

Beyond the financial logic: realizing valuable outcomes in public-private partnerships in Flanders and Ontario

NARCIS (Netherlands)

van den Hurk, M.; Hueskes, M.

2017-01-01

The value of public–private partnerships has typically been sought in financial and budgetary benefits. In both research and practice, important aspects of nonfinancial value have remained under the radar. This article discusses four “white raven” public–private partnerships that have shown rather

Private Water Projects

OpenAIRE

Izaguirre, Ada Karina; Hunt, Catherine

2005-01-01

Drawing on the World Bank's Private Participation in Infrastructure Project Database, this Note reviews developments in the water and sewerage sector of developing countries in 2004 and changes in private participation in the sector since 2001. Data for 2004 show that total investment in water and sewerage projects with private participation amounted to nearly US$2 billion. Recent private ...

Private Sector-led Urban Development Projects. Management, Partnerships and Effects in the Netherlands and the UK

OpenAIRE

Erwin Heurkens

2012-01-01

Central to this research lays the concept of private sector-led urban development projects (Heurkens, 2010). Such projects involve project developers taking a leading role and local authorities adopting a facilitating role, in managing the development of an urban area, based on a clear public-private role division. Such a development strategy is quite common in Anglo-Saxon urban development practices, but is less known in Continental European practices. Nonetheless, since the beginning of the...

The study and practice of public-private partnerships in the Low Countries

NARCIS (Netherlands)

Hueskes, Marlies; Koppenjan, Joop; Verweij, Stefan

2016-01-01

Public-Private Partnerships (PPPs) have attracted considerable attention in the Netherlands and Flanders (Belgium), as witnessed by the recent wave of doctoral theses on this topic. This paper presents a review of fourteen Dutch and Flemish doctoral theses, published in the period 2012-2015. The

‘Persons of versatility’: private security officers and private policing in residential estates in Hong Kong

OpenAIRE

Kwong, Wilkie

2013-01-01

This study is the result of exploratory research on the daily lives and experiences of private security officers working in Hong Kong housing estates. As the first qualitative investigation of its kind, it examined two case studies of separate estates through the lens of Nodal Governance, which involved interviews with security practitioners and end-users, work practice observations, and documentary analysis. Security officers were found to ‘wear many hats’. Apart from crime prevention, the ...

Ensuring living condition for ageing population by public–private partnership (PPP

Directory of Open Access Journals (Sweden)

Konjar Miha

2018-01-01

Full Text Available Lack of financial resources has become one of the main issues in fulfilling social and physical needs in urban development. The declining levels of public resources make the collaboration between public and private investors necessary. When facing the challenges of ageing population, shared investment may contribute to the appropriate development of sheltered housing to meet the goals of spatial planning as well as certain standards at the level of urban design. By ensuring appropriate living conditions for all generations such urban PPP projects may contribute to the fulfilment of the public interest. The paper presents practice of PPP implementation in Ljubljana, Slovenia, where local authority with the collaboration of private partners ensured more than 400 sheltered apartments in the last years. Examples show the extension of the idea from the 70s onwards in finding new models of housing for the aging population. The development of new models can be a good example of strengthening the cooperation between public and private partners in the field of urban development practice.

Ensuring living condition for ageing population by public-private partnership (PPP)

Science.gov (United States)

Konjar, Miha; Nikšič, Matej; Grom, Janez Peter; Mujkić, Sabina; Fikfak, Alenka

2018-03-01

Lack of financial resources has become one of the main issues in fulfilling social and physical needs in urban development. The declining levels of public resources make the collaboration between public and private investors necessary. When facing the challenges of ageing population, shared investment may contribute to the appropriate development of sheltered housing to meet the goals of spatial planning as well as certain standards at the level of urban design. By ensuring appropriate living conditions for all generations such urban PPP projects may contribute to the fulfilment of the public interest. The paper presents practice of PPP implementation in Ljubljana, Slovenia, where local authority with the collaboration of private partners ensured more than 400 sheltered apartments in the last years. Examples show the extension of the idea from the 70s onwards in finding new models of housing for the aging population. The development of new models can be a good example of strengthening the cooperation between public and private partners in the field of urban development practice.

Studying and Comparing Knowledge Management Dimensions between Public and Private Organization

Directory of Open Access Journals (Sweden)

Shahriyar Azizi

2010-03-01

Full Text Available By reviewing the literature of KM, it can be understood that there are different views about(to knowledge management and its applications in public and private sectors which is due to the structural difference between these two economic sectors. In order to be able to exploit the benefits of knowledge management in public sector adequately, it is necessary to identify the best practices of KM. To understand the differences between knowledge management in public and private sector and benchmark capabilities of private sector in public sector, is one of the ways to achieve this goal. In this study, we used survey study and questionnaire tool in order to identify these differences in banks. Results suggest that just in two dimensions of information technology and knowledge management, among five identified dimensions, there is a meaningful difference between public and private banks.

A Proposal for Public and Private Partnership in Extension.

Science.gov (United States)

Krell, Rayda K; Fisher, Marc L; Steffey, Kevin L

2016-01-01

Public funding for Extension in the United States has been decreasing for many years, but farmers' need for robust information on which to make management decisions has not diminished. The current Extension funding challenges provide motivation to explore a different model for developing and delivering extension. The private sector has partnered with the public sector to fund and conduct agricultural research, but partnering on extension delivery has occurred far less frequently. The fundamental academic strength and established Extension network of the public sector combined with the ability of the private sector to encourage and deliver practical, implementable solutions has the potential to provide measurable benefits to farmers. This paper describes the current Extension climate, presents data from a survey about Extension and industry relationships, presents case studies of successful public- and private-sector extension partnerships, and proposes a framework for evaluating the state of effective partnerships. Synergistic public-private extension efforts could ensure that farmers receive the most current and balanced information available to help with their management decisions.

Characteristics of private abortion services in Mexico City after legalization.

Science.gov (United States)

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

2010-11-01

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

Motivational Need Hierarchy of Employees in Public and Private Commercial Banks

OpenAIRE

Md. Hasebur Rahman; Sheikh M. Nurullah

2014-01-01

This study presents a theoretical-empirical reflection about concepts, models, and practices of Maslow’s Model of Need-Hierarchy in public and private commercial banks in Bangladesh. The empirical part of this study, comprising 130 samples, has been collected through a structured questionnaire. The study reveals that employees of commercial banks have high use of lower level needs and moderate use of upper level needs. The study also reveals employees of private commercial banks have a sligh...

Bounds on the sample complexity for private learning and private data release

Energy Technology Data Exchange (ETDEWEB)

Kasiviswanathan, Shiva [Los Alamos National Laboratory; Beime, Amos [BEN-GURION UNIV.; Nissim, Kobbi [BEN-GURION UNIV.

2009-01-01

Learning is a task that generalizes many of the analyses that are applied to collections of data, and in particular, collections of sensitive individual information. Hence, it is natural to ask what can be learned while preserving individual privacy. [Kasiviswanathan, Lee, Nissim, Raskhodnikova, and Smith; FOCS 2008] initiated such a discussion. They formalized the notion of private learning, as a combination of PAC learning and differential privacy, and investigated what concept classes can be learned privately. Somewhat surprisingly, they showed that, ignoring time complexity, every PAC learning task could be performed privately with polynomially many samples, and in many natural cases this could even be done in polynomial time. While these results seem to equate non-private and private learning, there is still a significant gap: the sample complexity of (non-private) PAC learning is crisply characterized in terms of the VC-dimension of the concept class, whereas this relationship is lost in the constructions of private learners, which exhibit, generally, a higher sample complexity. Looking into this gap, we examine several private learning tasks and give tight bounds on their sample complexity. In particular, we show strong separations between sample complexities of proper and improper private learners (such separation does not exist for non-private learners), and between sample complexities of efficient and inefficient proper private learners. Our results show that VC-dimension is not the right measure for characterizing the sample complexity of proper private learning. We also examine the task of private data release (as initiated by [Blum, Ligett, and Roth; STOC 2008]), and give new lower bounds on the sample complexity. Our results show that the logarithmic dependence on size of the instance space is essential for private data release.

“Crossing over”: appropriate private sector principles, to operate more reliable public sector water services

OpenAIRE

Kevin Wall

2008-01-01

Private sector institutions utilise many different business methods, some of which can selectively be adapted for use by organisations outside the private sector, to the benefit of their service delivery responsibilities. But the best of the appropriate practices from the private sector have often “not crossed over”. The Water Research Commission (WRC) of South Africa, working in collaboration with the Council for Scientific and Industrial Research (CSIR), finds that the concept of franch...

Prevalence of illicit drug use in pregnant women in a Wisconsin private practice setting.

Science.gov (United States)

Schauberger, Charles W; Newbury, Emily J; Colburn, Jean M; Al-Hamadani, Mohammed

2014-09-01

We sought to measure the prevalence of illicit drug use in our obstetric population, to identify the drugs being used, and to determine whether a modified version of the 4Ps Plus screening tool could serve as an initial screen. In this prospective study, urine samples of 200 unselected patients presenting for initiation of prenatal care in a Wisconsin private practice were analyzed for evidence of the use of illicit drugs. Of 200 patients, 26 (13%) had evidence of drugs of abuse in their urine samples. Marijuana (7%) and opioids (6.5%) were the most commonly identified drugs. Adding 5 questions about drug or alcohol use to the obstetric intake questionnaire proved sensitive in identifying patients with high risks of having a positive drug screen. The rate of drug use in our low-risk population was higher than expected and may reflect increasing rates of drug use across the United States. Enhanced screening should be performed to identify patients using illicit drugs in pregnancy to improve their care. Medical centers and communities may benefit from periodic testing of their community prevalence rates to aid in appropriate care planning. Copyright © 2014 Mosby, Inc. All rights reserved.

Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.

Science.gov (United States)

Fary, Robyn E; Slater, Helen; Chua, Jason; Ranelli, Sonia; Chan, Madelynn; Briggs, Andrew M

2015-07-01

To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study. Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT. Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain. RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term. © 2015, American College of Rheumatology.

Attitudes and Perceptions about Private Philanthropic Giving to Arizona Community Colleges and Universities: Implications for Practice

Science.gov (United States)

Martinez, George Andrew

2009-01-01

Wide disparity exists in philanthropic giving to public, two-year community colleges as compared to public, four-year universities. Recent estimates indicate that 0.5 to 5% of all private philanthropic giving to U.S. higher education annually goes to public, two-year community colleges, with the remainder going to public and private four-year…

Private Labels

OpenAIRE

Kolmačková, Zuzana

2013-01-01

This Bachelor Thesis titled Private labels deals with distribution strategy based on the introduction of private labels especially in retail chains. At the beginning it is focused on the general concept of private label offered by retailers, where is mentioned basic characteristics, history and structuring of distribution brands. Subsequently this thesis informs readers about the introduction of new special distribution brands, which focus primarily on the new consumption habits of customers....

Sharing and Discussing News in Private Social Media Groups

DEFF Research Database (Denmark)

Swart, Joëlle; Peters, Chris; Broersma, Marcel

2018-01-01

and their associated following, sharing and discussion practices. Specifically, it studies the role of news in six focus groups consisting of people who know each other offline and simultaneously communicate regularly through private Facebook or WhatsApp groups, and who interact primarily in relation...

Synthesis of public-private partnerships : potential issues and best practices for program and project implementation and administration.

Science.gov (United States)

2015-08-01

Public-private partnerships (P3s or PPPs) offer an innovative procurement method for the public sector. : P3s involve collaborations between the public and private sectors to finance, develop or maintain transportation : infrastructure. In an era of ...

The Effect of Private Brands on Business Performance in Retail

Directory of Open Access Journals (Sweden)

Radojko LUKIĆ

2011-06-01

Full Text Available In the length of time many new retail features were developed, as a part of the total value chain (from manufacturer to customer. One such feature is: the development of private brands (private-label merchandise, private-label brands, store brands, house brands, own brands. Because of economic importance, both in theory and in practice, more complex stress was put on its research from various perspectives: the individual countries and regions - geographic, retail companies and formats (types of stores, product categories, as well as from the perspective of the perception of customers / consumers. In the context of it, special empirical emphasis was placed on the effects of private brands on business performance in retail, in particular, on cost, gross margin, profit, in other words, on profit indicators, such as: rate of profits from sales, profit rate of assets and the rate of profit of the share capital. Having such starting point, this paper attempts to, as thoroughly as it can, primarily empirically, investigate the impact of the development of private brands in the retail business performance. Using the latest available relevant data gathered from various scientific and professional sources, including well-known agencies that primarily conduct empirical analysis of private brands in some countries, companies and retail formats and product categories. The results should serve as a reliable basis for creating the most efficient strategy for managing the development of private brands in order to improve business performance in retail. This is especially true of the so-called "emerging market" private brands, as it is the case with Serbia.

76 FR 71329 - Request for Information Regarding Private Education Loans and Private Educational Lenders

Science.gov (United States)

2011-11-17

... Regarding Private Education Loans and Private Educational Lenders AGENCY: Bureau of Consumer Financial... Justice and the Federal Trade Commission, to prepare a Report on Private Education Loans and Private... Justice and the Federal Trade Commission, to prepare a Report on Private Education Loans and Private...

The Canadian Forces Use of Private Security in Afghanistan: A Consequence of National Decisions

Science.gov (United States)

2013-12-10

should bind PSCs actions.21 This document laid out guiding principles and best practices but fell...use the terms in this 28Stanley, 168. 29Major Kevin Clarke, “ Microeconomics , Private Security and the Significance to Operational Planning...Clarke, Kevin. “ Microeconomics , Private Security and the Significance to Operational Planning.” Master’s thesis, School of Advanced Military Studies

Implications of private sector Hib vaccine coverage for the introduction of public sector Hib-containing pentavalent vaccine in India: evidence from retrospective time series data.

Science.gov (United States)

Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Hasan Farooqui, Habib; Zodpey, Sanjay P

2015-02-23

Haemophilus influenzae type b (Hib) vaccine has been available in India's private sector market since 1997. It was not until 14 December 2011 that the Government of India initiated the phased public sector introduction of a Hib (and DPT, diphtheria, pertussis, tetanus)-containing pentavalent vaccine. Our objective was to investigate the state-specific coverage and behaviour of Hib vaccine in India when it was available only in the private sector market but not in the public sector. This baseline information can act as a guide to determine how much coverage the public sector rollout of pentavalent vaccine (scheduled April 2015) will need to bear in order to achieve complete coverage. 16 of 29 states in India, 2009-2012. Retrospective descriptive secondary data analysis. (1) Annual sales of Hib vaccines, by volume, from private sector hospitals and retail pharmacies collected by IMS Health and (2) national household surveys. State-specific Hib vaccine coverage (%) and its associations with state-specific socioeconomic status. The overall private sector Hib vaccine coverage among the 2009-2012 birth cohort was low (4%) and varied widely among the studied Indian states (minimum 0.3%; maximum 4.6%). We found that private sector Hib vaccine coverage depends on urban areas with good access to the private sector, parent's purchasing capacity and private paediatricians' prescribing practices. Per capita gross domestic product is a key explanatory variable. The annual Hib vaccine uptake and the 2009-2012 coverage levels were several times higher in the capital/metropolitan cities than the rest of the state, suggesting inequity in access to Hib vaccine delivered by the private sector. If India has to achieve high and equitable Hib vaccine coverage levels, nationwide public sector introduction of the pentavalent vaccine is needed. However, the role of private sector in universal Hib vaccine coverage is undefined as yet but it should not be neglected as a useful complement to

Recent trends in dental visits and private dental insurance, 1989 and 1999.

Science.gov (United States)

Wall, Thomas P; Brown, L Jackson

2003-05-01

This article describes recent trends in dental visits and private dental insurance in the United States. This study is based on the analyses of data regarding dental visits and private dental insurance among the population 2 years of age or older from the 1989 and 1999 National Health Interview Surveys. Overall, the percentage of the population with a dental visit rose from 57.2 percent in 1989 to 64.1 percent in 1999, while the percentage with private dental insurance fell from 40.5 percent to 35.2 percent. Although a higher percentage of people with private dental insurance reported having a dental visit than did those without private dental insurance in both years, the increase from 1989 to 1999 in the percentage of those with a visit was larger among the uninsured. If this trend persists, a smaller portion of practicing dentist's clientele will be insured. This may affect demand for services, as well as front office operations.

Current management and prognostic factors in physiotherapy practice for patients with shoulder pain: design of a prospective cohort study.

Science.gov (United States)

Karel, Yasmaine H J M; Scholten-Peeters, Wendy G M; Thoomes-de Graaf, Marloes; Duijn, Edwin; Ottenheijm, Ramon P G; van den Borne, Maaike P J; Koes, Bart W; Verhagen, Arianne P; Dinant, Geert-Jan; Tetteroo, Eric; Beumer, Annechien; van Broekhoven, Joost B; Heijmans, Marcel

2013-02-11

Shoulder pain is disabling and has a considerable socio-economic impact. Over 50% of patients presenting in primary care still have symptoms after 6 months; moreover, prognostic factors such as pain intensity, age, disability level and duration of complaints are associated with poor outcome. Most shoulder complaints in this group are categorized as non-specific. Musculoskeletal ultrasound might be a useful imaging method to detect subgroups of patients with subacromial disorders.This article describes the design of a prospective cohort study evaluating the influence of known prognostic and possible prognostic factors, such as findings from musculoskeletal ultrasound outcome and working alliance, on the recovery of shoulder pain. Also, to assess the usual physiotherapy care for shoulder pain and examine the inter-rater reliability of musculoskeletal ultrasound between radiologists and physiotherapists for patients with shoulder pain. A prospective cohort study including an inter-rater reliability study. Patients presenting in primary care physiotherapy practice with shoulder pain are enrolled. At baseline validated questionnaires are used to measure patient characteristics, disease-specific characteristics and social factors. Physical examination is performed according to the expertise of the physiotherapists. Follow-up measurements will be performed 6, 12 and 26 weeks after inclusion. Primary outcome measure is perceived recovery, measured on a 7-point Likert scale. Logistic regression analysis will be used to evaluate the association between prognostic factors and recovery. The ShoCoDiP (Shoulder Complaints and using Diagnostic ultrasound in Physiotherapy practice) cohort study will provide information on current management of patients with shoulder pain in primary care, provide data to develop a prediction model for shoulder pain in primary care and to evaluate whether musculoskeletal ultrasound can improve prognosis.

Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study.

Science.gov (United States)

Dahlqvist, Kristina; Jonsson, Maria

2017-11-14

To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies.

The Impact of Human Resource Management Practices on ...

African Journals Online (AJOL)

The focus of this paper is on the impact of HRM practices on private sector organisations performance in Nigeria. Guinness Nigeria Plc is a private sector driving entity. Its human resource practices can be crucial to its performance. The purpose of this study therefore was to assess whether Guinness‟s human resource ...

Private costs almost equal health care costs when intervening in mild Alzheimer's: a cohort study alongside the DAISY trial

DEFF Research Database (Denmark)

Søgaard, Rikke; Sørensen, Jan; Waldorff, Frans B

2009-01-01

BACKGROUND: Alzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide. Recent studies have evaluated the effect of early interventions for dementia, but few studies have considered private time and transportation costs associated with the intervention. Thi...... in access to health care. TRIAL REGISTRATION: Current Controlled Trials ISRCTN74848736....... of counselling sessions, courses and informational packages. The typical duration of the intervention was 7 months. A micro-costing approach was applied using prospectively collected data on resource utilisation that included estimates of participant time and transportation. Precision estimates were calculated...... using a bootstrapping technique and structural uncertainty was assessed with sensitivity analysis. RESULTS: The direct intervention cost was estimated at EUR 1,070 (95% CI 1,029;1,109). The total cost (including private costs) was estimated at EUR 2,020 (95% CI 1,929;2,106) i.e. the ratio of private...

Building a successful trauma practice in a community setting.

Science.gov (United States)

Althausen, Peter L

2011-12-01

The development of a busy community-based trauma practice is a multifaceted endeavor that requires good clinical judgment, business acumen, interpersonal skills, and negotiation tactics. Private practice is a world in which perfect outcomes are expected and efficiency is paramount. Successful operative outcomes are dependent on solid clinical training, good preoperative planning, and communication with mentors when necessary. Private practitioners must display confidence, polite behavior, and promptness. Maintaining availability for consultation from emergency room physicians, private practice physicians, and local orthopaedic surgeons is a powerful marketing tool. Orthopaedic trauma surgery has been shown to be a profitable field for hospitals and private practitioners. However, physician success depends on a sound understanding of hospital finance, marketing skills, and knowledge of billing and coding. As the financial pressures of medical care increase, hospital negotiation will be paramount, and private practitioners must combine clinical and business skills to provide good patient care while maintaining independence and financial security.

Organizational culture of a private hospital.

Science.gov (United States)

Vegro, Thamiris Cavazzani; Rocha, Fernanda Ludmilla Rossi; Camelo, Silvia Helena Henriques; Garcia, Alessandra Bassalobre

2016-06-01

Objective To assess the values and practices that characterize the organizational culture of a private hospital in the state of São Paulo in the perspective of nursing professionals. Methods Quantitative, descriptive, cross-sectional study. Data collection was conducted between January and March 2013 using the Brazilian Instrument for Assessing Organizational Culture. Twenty-one nurses and sixty-two nursing aides and technicians participated in the study. The responses of the participants were coded into numerical categories, generating an electronic database to be analyzed by means of the software Statistical Package for the Social Sciences. Results Scores of cooperative professionalism values (3.24); hierarchical strictness values (2.83); individual professionalism values (2.69); well-being values (2.71); external integration practices (3.73); reward and training practices (2.56); and relationship promotion practices (2.83). Conclusion In the perception of workers, despite the existence of hierarchical strictness there is cooperation at work and the institution pursues customer satisfaction and good interpersonal relationships.

The challenge of using standard contracts in public-private partnerships

NARCIS (Netherlands)

van den Hurk, M.; Verhoest, K.

2016-01-01

A call for an increased use of standard contracts in public-private partnerships (PPPs) for infrastructure development is noticeable in practice. These contracts are expected to simplify and improve procurement by creating opportunities for learning, lower transaction costs, and better competition.

Private Equity Waves

NARCIS (Netherlands)

J.T.J. Smit (Han); W.A. van den Berg (Ward)

2006-01-01

textabstractThis study presents a dynamic model for the private equity market in which information revelation and uncertainty rationally explain the cyclical pattern of investment flows into private equity. The net benefit of private equity over public equity is i) uncertain and ii) agents have

The role of job satisfaction, job dissatisfaction and demographic factors on physicians' intentions to switch work sector from public to private.

Science.gov (United States)

Kankaanranta, Terhi; Nummi, Tapio; Vainiomäki, Jari; Halila, Hannu; Hyppölä, Harri; Isokoski, Mauri; Kujala, Santero; Kumpusalo, Esko; Mattila, Kari; Virjo, Irma; Vänskä, Jukka; Rissanen, Pekka

2007-09-01

This study is based on a unique data set for the years 1988-2003 and uses structural equation models to examine the impact of job satisfaction and job dissatisfaction on physicians' intention to switch from public- to private-sector work. In Finland, physicians who work primarily in a public-hospital or health-centre setting can also run a private practice. Therefore, we also analysed the impact of having a private practice on a physician's intention to change sector. We found that private practice had a positive, statistically significant effect on the intention to switch sector in 1998 and 2003. Results also suggest that job satisfaction decreases a physician's intention to switch sector, although for 1998 it had no effect. Surprisingly, job dissatisfaction significantly increased the physicians' intentions to leave the public sector only in the 1988 data.

Institutional and Strategic Barriers to Public-Private Partnership: An Analysis of Dutch Cases.

NARCIS (Netherlands)

E-H. Klijn (Erik-Hans); G.R. Teisman (Geert)

2003-01-01

textabstractPublic Private Partnerships (PPP) have been much discussed throughout Europe, but does the practice match the idea of cooperating actors who achieve added value together and share risks? An analysis of three cases of PPP in The Netherlands suggests that practice tends to be less ideal

The Business Side of a Successful Career Practice.

Science.gov (United States)

VanLier, Vivian

People launch a private career practice for many reasons. Often the motivation is to seek a working life with more control over--and flexibility relating to--time, freedom, location, work style, client base, family life, etc. Career practitioners who launch a private practice have often worked in the academic, government, military or non-profit…

Public Private Partnerships: Identifying Practical Issues for an Accounting Research Agenda

OpenAIRE

Nick Sciulli

2014-01-01

This article provides a structured framework for research into the accounting implications of Public Private Partnerships (PPPs). PPPs worldwide have taken on increasing significance as a tool that governments can use to develop infrastructure and for the delivery of services. Given the minimal coverage in the literature of the Victorian State Government experience to date regarding the efficacy of PPPs, this report establishes a number of parameters from which academics can conduct research ...

INSTITUTIONAL PROVIDER OF THE STATE-PRIVATE PARTNERSHIP IN UKRAINE AND ABROAD

Directory of Open Access Journals (Sweden)

Dubinina M.

2018-03-01

Full Text Available Introduction. The article is concerned with the public-private partnership (PPP, which is being formed following the consolidation of efforts of state authorities, local governments and business structures. The paper examines the world practice of public-private partnership projects, their most common types in different countries. Such projects involve the interaction of central or local authorities and the private sector, based on a long-term service agreement traditionally provided by public/communal enterprises. The purpose of the article is to study the institutional provision of world experience of public-private partnership aimed at improving its development in Ukraine. Results. We have carried out the analysis of the possible interaction of public-private partnership within the system of modernization and innovative development of the agrarian sector of the economy, the author also took into account the current state, tendencies of agricultural development in Ukraine. The studies have shown that various methods, models, forms of state cooperation and agribusiness have become increasingly widespread over the last years. Public-private partnerships, which, depending on the nature of the tasks to be solved, can be divided into separate models , are more widespread, we consider. Accordingly, the objectives of public-private partnership distinguish organizational models, different models of integration, models of financing. The conducted studies allow to propose the most effective models of state-private interaction, aimed at achieving modernization and innovative development of agriculture. It was revealed that the main problem is the development of procedures and stimulation of processes that ensure the effectiveness of public-private partnership and the establishment of new institutions. We systematized the basic normative acts regulating public-private partnership in Ukraine. Proposals have been developed that will increase the quantity

Organic food certification in South Africa: A private sector ...

African Journals Online (AJOL)

Organic production targets the development of a sustainable cultivation system and a variety of high-quality products with an emphasis on environmental protection and high standards of animal protection. In South Africa the organic sector pioneered private practices and systems in small informal groups to guide the public ...

Factors in Sustainable Development: Current and Innovative Livestock and Range Management Practices as Perceived by Cattle-Producing Ejidatarios and Private Cattle Ranchers of Sonora, Mexico. A Summary Report of Research. Department Information Bulletin 99-4.

Science.gov (United States)

Hamlett, Peggy J.

A study was conducted to identify and compare livestock production and range management practices currently in use in the Texas/Mexico border corridor, and to determine the acceptance of selected innovative practices among cattle ranchers in the State of Sonora, Mexico. Information was collected from private livestock producers who were members of…

Patient satisfaction with private physiotherapy for musculoskeletal pain.

LENUS (Irish Health Repository)

Casserley-Feeney, Sarah N

2008-01-01

BACKGROUND: Despite emphasis on patient centred healthcare, healthcare professionals have been slow to use validated measurements of patient satisfaction in physiotherapy practice. The aim of this cross sectional survey was to measure patient satisfaction with private physiotherapy in Ireland, for patients with musculoskeletal pain, using a previously validated survey instrument. METHODS: A multidimensional patient satisfaction questionnaire \\'PTOPS\\

Gender segregation by occupation in the public and the private sector : the case of Spain

OpenAIRE

Mora, Ricardo; Ruiz-Castillo, Javier

2003-01-01

In many countries, recruiting and promotion procedures in the public sector would appear to leave less room for gender discrimination than in the private sector. Using data for Spain in 1977 and 1992, this paper explores the consequences of these practices for gender segregation in those occupations where there is a private and a public sector of a minimum size. In particular, an additive index based on the entropy concept is used to compare occupational gender segregation in the private vers...

Specific Infant Feeding Practices Do Not Consistently Explain Variation in Anthropometry at Age 1 Year in Urban United States, Mexico, and China Cohorts12

Science.gov (United States)

Woo, Jessica G.; Guerrero, M. Lourdes; Ruiz-Palacios, Guillermo M.; Peng, Yong-mei; Herbers, Patricia M.; Yao, Wen; Ortega, Hilda; Davidson, Barbara S.; McMahon, Robert J.; Morrow, Ardythe L.

2013-01-01

Infant feeding practices generally influence infant growth, but it is unclear how introduction of specific foods affects growth across global populations. We studied 3 urban populations in the Global Exploration of Human Milk study to determine the association between infant feeding and anthropometry at 1 y of age. Three hundred sixty-five breastfeeding mother-infant pairs (120 US, 120 China, and 125 Mexico) were recruited soon after the infant’s birth. Enrollment required agreement to breastfeed ≥75% for at least 3 mo. Weekly, 24-h, food frequency data were conducted on infants for 1 y and exclusive breastfeeding (EBF) duration and timing of specific complementary food introduction were calculated. Weight and length were measured at age 1 y and anthropometry Z-scores calculated using WHO standards. Cohorts in the 3 urban populations (Shanghai, China; Cincinnati, USA; and Mexico City, Mexico) differed by median EBF duration (5, 14, and 7 wk, respectively; P Mexico City infants (P < 0.001). Adjusting for nonfeeding covariates, the only feeding variable associated with anthropometry was EBF duration, which was modestly inversely associated with weight-for-age but not length-for-age or BMI Z-scores at 1 y. Although feeding variables differed by cohort, their impact on anthropometry differences was not consistent among cohorts. Overall, across these urban, international, breast-fed cohorts, differences in specific feeding practices did not explain the significant variation in anthropometry. PMID:23236024

State-private partnership: aspects of application in the agricultural sphere

Directory of Open Access Journals (Sweden)

E. R. Zakirova

2017-01-01

Full Text Available The relevance of the study is determined by the importance of using the mechanism of public-private partnership in the agro-industrial complex, which allows, under conditions of mutual benefit for the state and business, to expand the resource base and channel untapped resources to sustainable agricultural development. The aim of the article is to study theoretical approaches and substantiate practical recommendations aimed at improving the mechanism of public-private partnership in the Russian agro-industrial complex. In preparing the article, general scientific methods of research were used: analysis and synthesis, generalization, comparison, classification. Results. The mechanism of public-private partnership in modern conditions is investigated, its definitions and essence are analyzed, its importance as an effective form of realization of investment activity is defined. The benefits of implementing public-private partnership projects for the state, business and the whole economy are systematized. Key risks for participants of public-private partnership are highlighted. The foreign experience of realization of joint projects of the state and business is analyzed. Features of public-private partnership in Russia are considered, tendencies of its development are determined. It is established that the agro-industrial complex as a sphere of application of public-private partnership needs special attention, since it is responsible for life support and ensures food security of the country. The program-targeted approach is analyzed, which is implemented in the form of the State Program for the Development of Agriculture and Regulation of Agricultural Products, Raw Materials and Foodstuffs of the Russian Federation. The government benefits from investing in the development of the agro-industrial complex are determined. The directions of methodical work in the sphere of the implementation of public-private projects are singled out. It is concluded

Robust Public Key Cryptography — A New Cryptosystem Surviving Private Key Compromise

Science.gov (United States)

Shaik, Cheman

A weakness of the present-day public key cryptosystems is that these cryptosystems do not survive private-key compromise attacks resulting from an internal breach of trust. In a competitive business environment, private key compromise is a common incident that voids the strength of public key cryptosystems such as RSA and ECC. Bribing corporate employees to disclose their secret keys and inadvertently disclosing secret information are among a plethora of practical attacks that occur at the implementation level. Once a breach of trust takes place and subsequently the private key is revealed, any public key cryptosystem fails to secure electronic data in Internet communications. The revealed key may be used by an attacker to decipher the intercepted data at an intermediary router. This weakness of public key cryptography calls for an additional security measure that enables encryptions to survive private key compromise attacks.

Practice management.

Science.gov (United States)

Althausen, Peter L; Mead, Lisa

2014-07-01

The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

Inviting In the Private Sector

Science.gov (United States)

2002-10-01

private sector . After all, corruption does not just involve government. Business people and lawyers and citizens pay the bribes, even as they condemn bribery. They should be invited to become part of the solution. But how? The first point to note is that business people and citizens know where corruption exists and how corrupt systems work. Citizens understand how bribery shapes the services they receive or don’t receive. Accountants know the illicit games played with audits and taxes. Lawyers understand corrupt legal practices. Business people know all about corrupt

Privatization in economic theory

Directory of Open Access Journals (Sweden)

Drakić Maja

2007-01-01

Full Text Available In reality privatization has never occurred according to the handbook rules of ordinary market transactions. Not even in advanced market economies can privatization transactions be described by the Walrasian or Arrowian, or Leontiefian equilibrium models, or by the equilibrium models of the game theory. In these economies transactions of privatization take place in a fairly organic way – which means that those are driven by the dominance of private property rights and in a market economy. But despite this fact Western privatization also some peculiar features as compared to ordinary company takeovers, since the state as the seller may pursue non – economic goals. Changes in the dominant form of property change positions and status of many individuals and groups in the society. That’s why privatization can even less be explained by ordinary market mechanisms in transition countries where privatizing state-owned property have happened in a mass scale and where markets and private property rights weren't established at the time process of privatization began. In this paper I’ll discuss and analyze the phenomenon of privatization in context of different economic theories arguing that empirical results go in favor of the public choice theory (Buchanan, 1978, theory of "economic constitution" (Brennan and Buchanan 1985, (Buchanan and Tullock, 1989, and theory of "collective action" (Olson, 1982. These theories argues that transition from one economic system into another, for example transition from collectivistic, socialistic system into capitalism and free market economy with dominant private property, will not happen through isolated changes of only few economic institutions, no matter how deep that changes would be. In other words privatization can not give results if it's not followed by comprehensive change of economic system because privatized companied wouldn't be able to operate in old environment.

The experiences of private somatology therapists on their self ...

African Journals Online (AJOL)

Informed consent was granted by the private somatology practices and the therapists. One of the themes indicated that self-management strategies should be displayed, in order to gain a sense of control. The study identified that there is a definite need to nurture the therapist within this demanding working environment ...

Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention.

Science.gov (United States)

Mugo, Peter M; Duncan, Sarah; Mwaniki, Samuel W; Thiong'o, Alexander N; Gichuru, Evanson; Okuku, Haile Selassie; van der Elst, Elise M; Smith, Adrian D; Graham, Susan M; Sanders, Eduard J

2013-11-01

While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya. In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines. Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2-10) at pharmacies, 3 (1-3) at private clinics and 5 (2-17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews. In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes.

On a Malware Targeting Private Telephony Networks during Cyber Conflict

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I. I. Androulidakis

2013-06-01

Full Text Available Telecommunication networks have long ago entered the Critical Infrastructure domain. Apart from the public telephony network, there is a parallel private telephony network, consisting of Private Branch Exchanges (PBXs that serve the communication needs of private or public entities. Their penetration in the market is substantial. As a result, thousands of PBX installations are present in every country serving many times more users in vital infrastructures (including health, safety, security, economy, energy. Therefore, attacking PBXs can have critical effects that disrupt society and can clearly be used in warlike situations. PBXs are an integral part of the critical infrastructure, along with the public telephony network. The contribution of this work focuses on the theoretical and practical capabilities of a malware able to target PBXs. Such an occurrence would have devastating effects on the communication confidentiality, integrity and availability.

Arbitrability of Disputes Related to the Privatization of State-Owned Property in Ukraine

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Oleksandr Frolov

2016-01-01

Full Text Available The article is devoted to the analysis of arbitrability of disputes between a privatization body and purchaser arising out of a sale and purchase agreement of a privatization object or relating thereto. Author reached a conclusion that before the Law of Ukraine on Enactment of Some Laws of Ukraine Aimed at the Improvement of Privatization Process dated 16 February 2016 No. 1005-VIII entered into force disputes in relation to alienation to privatization objects could have been referred to international commercial arbitration.Based on the analysis of court practice in relation to sale and purchase agreements which contained arbitration clauses, author reached a conclusion thatsome of the arguments against arbitrability of this category of disputes did not lose their relevance even after the said law entered into force.

Social Security privatization in Latin America.

Science.gov (United States)

Kritzer, B E

2000-01-01

The new, partially privatized social security system adopted by Chile in 1981 has attracted attention in many parts of the world. Since then, a number of Latin American countries have implemented the Chilean model, with some variations: either with a single- or multi-tier system, or with a period of transition to take care of those in the labor force at the time of the change. The single-tier version consists of a privatized program with individual accounts in pension fund management companies. Multi-tier systems have a privatized component and retain some form of public program. This article describes each of the new programs in Latin America, their background, and similarities and differences among them. Much more information is available for Chile than for the other countries (in part because Chile has the oldest system), enough to be able to evaluate what, in most cases, is the most accurate information. That is often not the case for the other countries, especially when dealing with subjects such as transition costs and net rates of return (rates of return minus administrative fees). No country has copied the Chilean system exactly. Bolivia, El Salvador, and Mexico have closed their public systems and set up mandatory individual accounts. Argentina has a mixed public/private system with three tiers. In Colombia and Peru, workers have a choice between the public and private programs. Uruguay created a two-tier mixed system. Costa Rica has a voluntary program for individual accounts as a supplement to the pay-as-you-go program and has just passed a law setting up mandatory accounts containing employer contributions for severance pay. All of the countries continue to face unresolved issues, including: High rates of noncompliance--the percentage of enrollees who do not actively and regularly contribute to their accounts--which could lead to low benefits and greater costs to the governments that offer a guaranteed minimum benefit; Proportionately lower benefits for

Privatization Framework: Political Economy Perspective

OpenAIRE

Bastian, Indra

2009-01-01

Privatization has been recognized as a worldwide phenomenon. In this pa-per, a political economy approach is developed to analyze privatization. The ap-proach assumes that political economy and privatization overlap in people’s need. So, the framework of political economy in privatization is based on the ‘need’ phi-losophy. Government and private sectors are contrasted in this respect, leading to a conclusion on privatization as a method to manage the economy. Keywords: privatization, politic...

Workplace bullying, sleep problems and leisure-time physical activity: a prospective cohort study

DEFF Research Database (Denmark)

Hansen, Åse Marie; Gullander, Maria; Hogh, Annie

2015-01-01

and Harassment (WBH) cohort (N=3278) or the Psychosocial Risk Factors for Stress and Mental Disease (PRISME) cohort (N=4455). We measured workplace bullying using one question that was preceded by a definition of bullying. We used the Karolinska sleep questionnaire to assess sleep problems. The number of hours......OBJECTIVES: Workplace bullying is a potent stressor that may increase sleep problems. Since physical fitness improves resilience to stress, it seems plausible that recreational physical activities may moderate the association between bullying and sleep. The study aimed to examine prospectively...... whether (i) bullying increases the risk of sleep problems, and (ii) the association between bullying and sleep problems is moderated by leisure-time physical activity (LTPA). METHODS: The study sample comprised a cohort of public and private sector employees, who were enrolled into the Work Bullying...

Private Roads

NARCIS (Netherlands)

Verhoef, Erik T.

2007-01-01

This paper studies the efficiency impacts of private toll roads in initially untolled networks. The analysis allows for capacity and toll choice by private operators, and endogenizes entry and therewith the degree of competition, distinguishing and allowing for both parallel and serial competition.

The Localization Characteristic of the Idea and Mission of Private Universities in China

Directory of Open Access Journals (Sweden)

Fan Jixuan

2013-12-01

Full Text Available The idea and mission of college and university are always assuming a fluxion accompanied with social upheaval. The Chinese private universities' idea and mission take on local characteristic: “As the foundation of a nation, education should meet the needs of social development, should take the responsibility of practical application and take service for the community”, “Education should place people first, attach great importance to the improvement of the students' individual quality and put heavy emphasis on the service quality”, which have become the important content of the faith of Chinese private universities; “To strengthen the internationalization and to open running college”, which is the new direction of faith of Chinese private universities. It became those private universities’ bounden duty to translate normal human resources into quality human capital. So, those private universities have the responsibilities and missions to construct human resources powerful nation, to popular higher education with high standard satisfied by people.

Referral of children seeking care at private health facilities in Uganda.

Science.gov (United States)

Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

2017-02-14

In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health facilities in order to explore ways of improving treatment and referral of sick children in this sector. A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant interviews with private providers and community members. A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral facilities, inadequate finances at household level; while the perception that referral leads to loss of prestige and profit was a major constraint to private providers. In conclusion, the results show that referral of sick children at private health facilities faces many challenges at provider, caretaker, household and community levels. Thus, interventions to address constraints to referral of sick children are urgently needed.

[The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort study: To better understand chronic kidney disease].

Science.gov (United States)

Stengel, Bénédicte; Combe, Christian; Jacquelinet, Christian; Briançon, Serge; Fouque, Denis; Laville, Maurice; Frimat, Luc; Pascal, Christophe; Herpe, Yves-Édouard; Morel, Pascal; Deleuze, Jean-François; Schanstra, Joost P; Pisoni, Ron L; Robinson, Bruce M; Massy, Ziad A

2016-04-01

Preserving kidney function and improving the transition from chronic kidney disease to end stage is a research and healthcare challenge. The national Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort was established to identify the determinants, biomarkers and practice patterns associated with chronic kidney disease outcomes. The study will include more than 3000 adult patients with moderate to advanced chronic kidney disease from a representative sample of 40 nephrology clinics with respect to regions and legal status, public or private. Patients are recruited during a routine visit and followed for 5 years, before and after starting renal replacement therapy. Patient-level clinical, biological, and lifestyle data are collected annually, as well as provider-level data on clinical practices, coordinated with the International Chronic Kidney Disease Outcomes and Practice Pattern Study. Blood and urine samples are stored in a biobank. Major studied outcomes include survival, patient-reported outcomes, disease progression and hospitalizations. More than 13,000 eligible patients with chronic kidney disease were identified, 60% with stage 3 and 40% with stage 4. Their median age is 72 years [interquartile range, 62-80 years], 60% are men and 38% have diabetes. By the end of December 2015, 2885 patients were included. The CKD-REIN cohort will serve to improve our understanding of chronic kidney disease and provide evidence to improve patient survival and quality of life as well as health care system performances. Copyright © 2016 Association Société de néphrologie. All rights reserved.

Online Learning Trends in Private-Sector Colleges and Universities

Science.gov (United States)

Seaman, Jeff

2011-01-01

For the past eight years, the Babson Survey Research Group has conducted surveys of higher education institutions on their attitudes, beliefs, and practices concerning online education. This current report is a new analysis of this collection of data, focusing on the role of online education among private-sector colleges and universities. For the…

Quality of Life and Job Satisfaction of Dispensing Pharmacists Practicing in Tehran Private-sector Pharmacies.

Science.gov (United States)

Majd, Marzieh; Hashemian, Farshad; Younesi Sisi, Farnaz; Jalal, Masoud; Majd, Zahra

2012-01-01

As there is no evidence of previous studies on evaluating the level of job satisfaction and the major causes of dissatisfaction among the pharmacists in Iran, this study was designed. This study is a cross-sectional descriptive analysis of pharmacists practicing in Tehran private-sector pharmacies. We selected a stratified random sampling using number of prescriptions as a variable for stratification. The questionnaire was divided into three sections containing the demographic characteristics, general health perception and job satisfaction. Of all the participants, 62% were the owners of pharmacies and 38% were pharmacists in charge (non-owner). Seventy-eight percent of respondents reported satisfaction about their psychological and physical state. Just 11% of pharmacists were financially satisfied and 49% felt relaxed at the workplace. There was no correlation between the satisfaction and owning the pharmacy or sex of respondents. Spearman›s correlation showed that the income satisfaction correlated negatively with age (p ≤ 0.001) and years of experience (p women (p quality of life among the respondents were at satisfactory level. However, work-related satisfaction was not high enough and most interviewed pharmacists were financially dissatisfied.

The effect of a multifaceted evidence-based practice programme for nurses on knowledge, skills, attitudes, and perceived barriers: A cohort study.

Science.gov (United States)

van der Goot, Wieke E; Keers, Joost C; Kuipers, Ruud; Nieweg, Roos M B; de Groot, Martijn

2018-04-01

The Dutch professional nursing standard of 2012 stipulates that Dutch nursing practices are to be evidence-based. Not all practicing nurses can satisfy these requirements, therefore, an educational programme about Evidence-Based Practice (EBP) was developed for a Dutch teaching hospital. The aim of this study was to measure the effects of a six month in-house EBP programme on knowledge, skills, attitudes, and perceived barriers of nurses (four European Credits equals two US Credit Hours). A multiple-cohort study was conducted with a pre-post-test design. In the period of 2011-2015, a total of 58 nurses (9 cohorts) followed the programme. Baseline and follow-up assessments consisted of three questionnaires each: the Dutch Modified Fresno, the two subscales of the McColl questionnaire, and the BARRIER scale to assess knowledge and skills, attitudes, and perceived barriers, respectively. Fifty nurses completed both assessments. The results demonstrated that actual knowledge and skills significantly increased by approximately 40%. Self-perceived knowledge increased significantly, while attitudes towards EBP remained (moderately) positive. Perceived barriers did not notably change except for the Research subscale which received many "no opinion" responses prior to the programme but fewer afterwards. Our multifaceted in-house EBP programme led to a significant improvement of approximately 40% in EBP knowledge and skills of participating nurses. Most nurses who followed the EBP programme are currently applying their knowledge and skills in practice. Managerial support and allocated time for EBP are important facilitators for its implementation. Furthermore, to maintain and expand nurses' EBP knowledge and skills and translate them into practice, follow-up interventions, such as journal clubs, may well be beneficial. Based on the positive results of our programme, we will implement it throughout the hospital with an emphasis on training more groups of nurses. Copyright �

Orthodontic practices in Australasia: practice activity.

Science.gov (United States)

Mathew, Rachael; Sampson, Wayne J; Spencer, A John

2005-05-01

To collect baseline data on practice types and services provided by orthodontists in Australia and New Zealand. A total of 510 questionnaires was sent and 258 were returned. The response rate was 53 per cent. The average age of respondents was 50 years (SD: 9.8 years) with female orthodontists being younger (Mean: 42.3 years; SD: 6.5). The ratio of responding female to male orthodontists was 1:8.8. Overall, more orthodontists were in solo private practice than associateships or partnerships. New Zealand orthodontists were more likely to be in associateships. Australian orthodontists had twice the number of practices (Mean: 2.4; SD: 1.4) than their New Zealand counterparts (Mean: 1.1; SD: 0.3). Orthodontists estimated they saw a mean of 21.3 (SD: 11.3) patients per day. Older orthodontists saw few patients in a day and spent fewer hours in any practice activity in a week. The mean waiting time for a consultation appointment in the private sector in New Zealand was nearly twice that in Australia. There was a significant association between male orthodontists and referral of patients by general dental practitioners. More than three quarters of respondents incorporated retention fees into the treatment fee. Overall, orthodontists were satisfied with the workload and did not want more orthodontists in their geographical area. This study provides a sound basis for consideration of challenges in practice and changes over time.

Equitable Financial Evaluation Method for Public-Private Partnership Projects

Institute of Scientific and Technical Information of China (English)

KE Yongjian; LIU Xinping; WANG Shouqing

2008-01-01

The feasibility study of a public-private partnership (PPP) project is regarded as one of the critical factors for successful implementation,but unfortunately the common financial evaluation methods currently used only represent the benefits of the private sector.There is,therefore,an urgent need to develop an equitable financial evaluation method for PPP projects.This paper presents a comprehensive literature review that examines international practices.An equitable financial evaluation method was then developed taking into account the inherent characteristics of PPP projects using six separate indicators and Monte Carlo simulations.The result for a bridge project in Romania shows that the method combines the viewpoints of all the relevant stakeholders to achieve an equitable financial evaluation of PPP projects.

Closing the Gap: Communicating to Change Gardening Practices in Support of Native Biodiversity in Urban Private Gardens

Directory of Open Access Journals (Sweden)

Yolanda M. van Heezik

2012-03-01

Full Text Available Private gardens collectively comprise the largest green space in most cities and the greatest potential for increasing the extent of wildlife-friendly and native-dominated habitat, improving the quality of ecosystem services, and providing opportunities for urban dwellers to reconnect with nature. Because attitudes and values driving landscape preferences in gardens are complex and often not conducive to biodiversity, and a gap exists between the possession of knowledge or values and the expression of pro-environmental behavior, facilitating change in gardening behavior is challenging. We attempted to improve knowledge and influence values, attitudes, and gardening behavior of 55 householders in favor of native biodiversity and environmentally friendly practices, through a two-way communication process, or interactive dialog, during a process of biodiversity documentation of their gardens. Informative feedback on their garden with a normative component was also provided. Despite being well educated and knowledgeable about common species at the start of the study, an increase in knowledge and shift in attitude was detected in 64% of householders: 40% reported a greater understanding of wildlife, and 26% made changes in their gardens, 13% to support native biodiversity. The normative component of our feedback information was of particular interest to 20% of householders. Because neighborhood norms influence gardening practices, changes adopted by a proportion of householders should be perpetuated across neighborhoods. The process of biodiversity assessment, dialog, and feedback was effective in improving knowledge of wildlife and native species, and stimulated a shift in attitude that resulted in native-friendly gardening practices. These changes were detected primarily through open self-report questions, rather than quantitative measures.

PrivateRide: A Privacy-Enhanced Ride-Hailing Service

Directory of Open Access Journals (Sweden)

Pham Anh

2017-04-01

Full Text Available In the past few years, we have witnessed a rise in the popularity of ride-hailing services (RHSs, an online marketplace that enables accredited drivers to use their own cars to drive ride-hailing users. Unlike other transportation services, RHSs raise significant privacy concerns, as providers are able to track the precise mobility patterns of millions of riders worldwide. We present the first survey and analysis of the privacy threats in RHSs. Our analysis exposes high-risk privacy threats that do not occur in conventional taxi services. Therefore, we propose PrivateRide, a privacy-enhancing and practical solution that offers anonymity and location privacy for riders, and protects drivers’ information from harvesting attacks. PrivateRide lowers the high-risk privacy threats in RHSs to a level that is at least as low as that of many taxi services. Using real data-sets from Uber and taxi rides, we show that PrivateRide significantly enhances riders’ privacy, while preserving tangible accuracy in ride matching and fare calculation, with only negligible effects on convenience. Moreover, by using our Android implementation for experimental evaluations, we show that PrivateRide’s overhead during ride setup is negligible. In short, we enable privacy-conscious riders to achieve levels of privacy that are not possible in current RHSs and even in some conventional taxi services, thereby offering a potential business differentiator.

Evaluating a dental practice for purchase or associateship.

Science.gov (United States)

Diecidue, Robert J

2008-07-01

Private dental practice can be achieved through either outright ownership or an associateship in conjunction with senior dentists; the decision depends on personal and professional objectives and goals. Once a decision is made, the time and effort required to identify an appropriate practice, negotiate the terms of purchase or associateship, and transition to the new practice can be daunting. This article reviews the process and provides an overview of the general steps involved in the evaluation of a dental practice for purchase or associateship. With appropriate knowledge and preparation, due diligence, and ethical and sensitive behavior, transitioning to private practice can be successful and lead to professional and personal fulfillment.

Interests and Advantages of the Private Sector in the State-Private Partnership

OpenAIRE

Brailovskiy Ilya A.

2013-01-01

The article is devoted to analysis of interests that stimulate a private partner to joint activity with the state and advantages they obtain from realisation of projects of the state-private partnership (SPP). It marks out main features and fields of application of the state-private partnership. It underlines that an important prerequisite for motivation of the private sector to enter into partnership relations with the state is observance of clear law competent formal rules in the institutio...

[Private health insurance in Brazil: approaches to public/private patterns in healthcare].

Science.gov (United States)

Sestelo, José Antonio de Freitas; Souza, Luis Eugenio Portela Fernandes de; Bahia, Lígia

2013-05-01

This article draws on a previous review of 270 articles on private health plans published from 2000 to 2010 and selects 17 that specifically address the issue of the relationship between the public and private healthcare sectors. Content analysis considered the studies' concepts and terms, related theoretical elements, and predominant lines of argument. A reading of the argumentative strategies detected the existence of a critical view of the modus operandi in the public/private relationship based on Social Medicine and the theoretical tenets of the Brazilian Health Reform Movement. The study also identified contributions based on neoliberal business approaches that focus strictly on economic issues to discuss private health insurance. Understanding the public/private link in healthcare obviously requires the development of a solid empirical base, analyzed with adequate theoretical assumptions due to the inherent degree of complexity in the public/private healthcare interface.

A systematic framework for infrastructure development through public private partnerships

Directory of Open Access Journals (Sweden)

Xueqing Zhang

2013-03-01

Full Text Available Public–private partnerships (PPPs play an important role in bringing private sector competition to public monopolies in infrastructure development and service provision and in merging the resources of both public and private sectors to better serve the public needs. However, in worldwide practices, there are mixed results, substantial controversy, criticism and conflict over PPPs. This paper proposes a systematic framework for the delivery of public works and services through PPPs in general. Justified by public procurement principles, aimed at a public–private win–win solution, and based on worldwide best industrial practices and lessons from unsuccessful projects, this framework integrates the four broadly divided stages that repeat over time: (1 design of a workable concession, (2 competitive concessionaire selection, (3 financial regulation, and (4 periodic reconcession and rebidding. The four-stage framework takes into account the requirements of public services, realignment of responsibility and reward among multiple participants in PPPs, the monopolistic rights of the concessionaire, and the wide range of risks and uncertainties in the long concession period. Varying competition elements are incorporated in each of the four stages for continuous performance improvement in the delivery of public works and services. The design of the right concession forms the base on which other stages are implemented in addition to planning the project and allocating risks for enhanced efficiency. The financial regulation allows the government to address changing conditions and to regulate the concession for efficient operation with due discretion, whereas the competitive concessionaire selection and periodic reconcession and rebidding play critical roles in achieving innovation, efficiency and cost effectiveness through direct competition rather than government discretionary intervention.

The development of a talent management framework for the private sector

Directory of Open Access Journals (Sweden)

Ebben S. van Zyl

2017-04-01

Full Text Available Orientation: Talent management is a strategic priority especially for profit-generating organisations in the private sector. Limited research has been conducted on the theoretical development of talent management. The need for talent management is also triggered by a need to align and integrate people management practices with those of the organisation in order to achieve strategic execution and operational excellence. Research purpose: The primary aim of the study was to develop a talent management framework for the private sector. The research proposed to conduct an in-depth exploration of talent management practices in key and leading organisations already in the mature stages of talent management implementation in South Africa. Motivation of the study: There is a need for the development of best practices in talent management – where talent management strategy is designed to deliver corporate and human resource management strategies. The formal talent management initiative would be linked to the human resources management function and will flow vertically from the corporate strategy-making process. Research approach, design and method: The modernist qualitative research approach was applied to the study. Data were collected through semi-structured interviews (18 persons were interviewed in total. Analytical induction method was instrumental in facilitating the overall data analysis, while constructivist grounded theory assisted with the operationalisation of the data analysis. Main findings: The study has mapped out key dimensions which are essential for the implementation of talent management. The dimensions of talent management are attraction, sourcing and recruitment, deployment and transitioning, growth and development, performance management, talent reviews, rewarding and recognising, engagement and retention. With each of the above-mentioned dimensions, the activities that are to be carried out to achieve the outcome of each

Defense Inventory Management: Expanding Use of Best Practices for Hardware Items Can Reduce Logistics Costs

National Research Council Canada - National Science Library

1998-01-01

...) logistics practices with those of the private sector. We are continuously examining DOD'S inventory management practices to identify areas where costs can be reduced and problems can be avoided by using leading private sector practices...

Behaviorism, private events, and the molar view of behavior.

Science.gov (United States)

Baum, William M

2011-01-01

Viewing the science of behavior (behavior analysis) to be a natural science, radical behaviorism rejects any form of dualism, including subjective-objective or inner-outer dualism. Yet radical behaviorists often claim that treating private events as covert behavior and internal stimuli is necessary and important to behavior analysis. To the contrary, this paper argues that, compared with the rejection of dualism, private events constitute a trivial idea and are irrelevant to accounts of behavior. Viewed in the framework of evolutionary theory or for any practical purpose, behavior is commerce with the environment. By its very nature, behavior is extended in time. The temptation to posit private events arises when an activity is viewed in too small a time frame, obscuring what the activity does. When activities are viewed in an appropriately extended time frame, private events become irrelevant to the account. This insight provides the answer to many philosophical questions about thinking, sensing, and feeling. Confusion about private events arises in large part from failure to appreciate fully the radical implications of replacing mentalistic ideas about language with the concept of verbal behavior. Like other operant behavior, verbal behavior involves no agent and no hidden causes; like all natural events, it is caused by other natural events. In a science of behavior grounded in evolutionary theory, the same set of principles applies to verbal and nonverbal behavior and to human and nonhuman organisms.

Behaviorism, Private Events, and the Molar View of Behavior

Science.gov (United States)

Baum, William M

2011-01-01

Viewing the science of behavior (behavior analysis) to be a natural science, radical behaviorism rejects any form of dualism, including subjective–objective or inner–outer dualism. Yet radical behaviorists often claim that treating private events as covert behavior and internal stimuli is necessary and important to behavior analysis. To the contrary, this paper argues that, compared with the rejection of dualism, private events constitute a trivial idea and are irrelevant to accounts of behavior. Viewed in the framework of evolutionary theory or for any practical purpose, behavior is commerce with the environment. By its very nature, behavior is extended in time. The temptation to posit private events arises when an activity is viewed in too small a time frame, obscuring what the activity does. When activities are viewed in an appropriately extended time frame, private events become irrelevant to the account. This insight provides the answer to many philosophical questions about thinking, sensing, and feeling. Confusion about private events arises in large part from failure to appreciate fully the radical implications of replacing mentalistic ideas about language with the concept of verbal behavior. Like other operant behavior, verbal behavior involves no agent and no hidden causes; like all natural events, it is caused by other natural events. In a science of behavior grounded in evolutionary theory, the same set of principles applies to verbal and nonverbal behavior and to human and nonhuman organisms. PMID:22532740

The Amazon Monopoly: Is Amazon’s Private Label Business the Tipping Point?

OpenAIRE

Faherty, Emily; Huang, Kevin; Land, Robert

2017-01-01

The purpose of this paper is to consider if Amazon’s increase in private label brands is the tipping point for transforming the e-commerce giant into a monopoly. To lay the foundation, we initially explore the culture, leadership, and business practices which are unique to Amazon that enabled the company to become one of the U.S.’s largest and fastest growing e-commerce websites. Introduced in 2009, Amazon’s private label business has further propelled Amazon’s growth while creating a competi...

Improving Financial Education and Awareness on Insurance and Private Pensions

Science.gov (United States)

OECD Publishing (NJ3), 2008

2008-01-01

With public pensions under pressure and private pensions exposed to risk, individuals face an increasing variety of financial risks, particularly those linked to their retirement. This book analyzes the level of risk awareness of consumers and highlights good practices governments might initiate to enhance consumers' awareness and education on…

Cross-sectional survey of treatment practices for urethritis at pharmacies, private clinics and government health facilities in coastal Kenya: many missed opportunities for HIV prevention

Science.gov (United States)

Mugo, Peter M; Duncan, Sarah; Mwaniki, Samuel W; Thiong'o, Alexander N; Gichuru, Evanson; Okuku, Haile Selassie; van der Elst, Elise M; Smith, Adrian D; Graham, Susan M; Sanders, Eduard J

2013-01-01

Background While bacterial sexually transmitted infections (STIs) are important cofactors for HIV transmission, STI control has received little attention in recent years. The aim of this study was to assess STI treatment and HIV testing referral practices among health providers in Kenya. Methods In 2011 we assessed quality of case management for male urethritis at pharmacies, private clinics and government health facilities in coastal Kenya using simulated visits at pharmacies and interviews at pharmacies and health facilities. Quality was assessed using Ministry of Health guidelines. Results Twenty (77%) of 26 pharmacies, 20 (91%) of 22 private clinics and all four government facilities in the study area took part. The median (IQR) number of adult urethritis cases per week was 5 (2–10) at pharmacies, 3 (1–3) at private clinics and 5 (2–17) at government facilities. During simulated visits, 10% of pharmacies prescribed recommended antibiotics at recommended dosages and durations and, during interviews, 28% of pharmacies and 27% of health facilities prescribed recommended antibiotics at recommended dosages and durations. Most regimens were quinolone-based. HIV testing was recommended during 10% of simulated visits, 20% of pharmacy interviews and 25% of health facility interviews. Conclusions In an area of high STI burden, most men with urethritis seek care at pharmacies and private clinics. Most providers do not comply with national guidelines and very few recommend HIV testing. In order to reduce the STI burden and mitigate HIV transmission, there is an urgent need for innovative dissemination of up-to-date guidelines and inclusion of all health providers in HIV/STI programmes. PMID:23698510

Setting up virtual private network

International Nuclear Information System (INIS)

Huang Hongmei; Zhang Chengjun

2003-01-01

Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise's network function and enlarges its private scope. The text introduces virtual private network's principal, privileges and protocols that use in virtual private network. At last, this paper introduces several setting up virtual private network's technologies which based on LAN

Setting up virtual private network

International Nuclear Information System (INIS)

Huang Hongmei; Zhang Chengjun

2003-01-01

Setting up virtual private network for business enterprise provides a low cost network foundation, increases enterprise network function and enlarges its private scope. This text introduces virtual private network principal, privileges and protocols applied in virtual private network. At last, this paper introduces several setting up virtual private network technologies which is based on LAN

[The QuIK-Registry of the German Society of Cardiologists in private practice: countrywide and benchmarking quality assurance in invasive cardiology].

Science.gov (United States)

Albrecht, A; Levenson, B; Göhring, S; Haerer, W; Reifart, N; Ringwald, G; Troger, B

2009-10-01

QuIK is the German acronym for QUality Assurance in Invasive Cardiology. It describes the continuous project of an electronic data collection in Cardiac catheterization laboratories all over Germany. Mainly members of the German Society of Cardiologists in Private Practice (BNK) participate in this computer based project. Since 1996 data of diagnostic and interventional procedures are collected and send to a registry-center where a regular benchmarking analysis of the results is performed. Part of the project is a yearly auditing process including an on-site visit to the cath lab to guarantee for the reliability of information collected. Since 1996 about one million procedures have been documented. Georg Thieme Verlag KG Stuttgart , New York.

Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

Science.gov (United States)

Beveridge, Scott; Garcia, Jorge; Siblo, Matt

2015-01-01

Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

Comparing Performance of Government and Private Clients in Construction Projects: Contractors’ Perspective

Directory of Open Access Journals (Sweden)

Jati Utomo Dwi Hatmoko

2016-09-01

Full Text Available By nature, government and private projects have different characteristics, which influence client performance. This research aims to compare performance of government and private clients in construction projects as perceived by contractors. Six client performance indicators were used, i.e. understanding of project requirements, financial, decision making, management skills, supports for contractor, and client’s attitude. Data were collected through questionnaire surveys filled in by 117 respondents. The results show that there is a significant difference between both types of client performance. Three variables related to financial indicators, i.e. timely payment, owner value estimate, and payment approval, rank in the bottom three of the government client performance, but in contrast rank in the top three of the private ones. These results suggest that the government clients’ performance is perceived inferior to the private ones. Establishing a clients’ forum for sharing knowledge and best practices would be a strategic solution to enhance clients’ capacities.

Accelerating TB notification from the private health sector in Delhi, India.

Science.gov (United States)

Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

2016-01-01

In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Public and private dental services in NSW: a geographic information system analysis of access to care for 7 million Australians.

Science.gov (United States)

Willie-Stephens, Jenny; Kruger, Estie; Tennant, Marc

2014-06-01

To investigate the distribution of public and private dental practices in NSW in relation to population distribution and socioeconomic status. Dental practices (public and private) were mapped and overlayed with Census data on Collection District population and Socio-Economic Indexes for Areas (SEIFA). Overall, there was an uneven geographic distribution of public and private dental practices across NSW. When the geographic distribution was compared to population socioeconomics it was found that in rural NSW, 12% of the most disadvantaged residents lived further than 50km from a public dental practice, compared to 0% of the least disadvantaged. In Sydney, 9% of the three most disadvantaged groups lived greater than 7.5km from a public dental practice, compared to 21% of the three least disadvantaged groups. The findings of this study can contribute to informing decisions to determine future areas for focus of dental resource development (infrastructure and workforce) and identifying subgroups in the population (who are geographically isolated from accessing care) where public health initiatives focused on amelioration of disease consequences should be a focus.

Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.

Science.gov (United States)

Hahn, Robert A; Middleton, Jennifer Cook; Elder, Randy; Brewer, Robert; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci L; Chattopadhyay, Sajal; Lawrence, Briana; Campbell, Carla Alexia

2012-04-01

Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms. The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies. A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms. According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption. Published by Elsevier Inc.

To develop a public private partnership model of disease notification as a part of integrated disease surveillance project (IDSP for private medical practitioners in Mumbai City, India

Directory of Open Access Journals (Sweden)

Ratnendra R. Shinde

2013-01-01

Full Text Available Background The main objective of Integrated Disease Surveillance Project (IDSP was early detection of disease outbreaks. This could be possible only when the public health authorities have a strong and effective surveillance system in collaboration with Private Health Sector. Objectives 1 To assess knowledge, attitude & practice about notification of diseases amongst Private Medical Practitioners (PMPs. 2 To find out barriers experienced by PMPs in reporting of diseases under surveillance. 3 To assess feasibility of various alternative ways of reporting convenient for PMPs. 4 To develop a Public Private Partnership Model of disease notification based on feasible options obtained in the study. Materials and Methods This study was a cross-sectional descriptive study conducted in the F South Municipal ward of Mumbai city during April-May 2011. Two stage simple random sampling was used to select 104 PMPs for the study. Results and Conclusions Nearly 98% PMPs felt importance of notification in health system, but only 46% had practiced it. Most common reason for non-reporting was lack of information about reporting system. The convenient way of reporting for PMPs was to report to the nearest health post personally or to District Surveillance Unit through SMS/phone call and both at weekly interval.

Quantum solution to a class of two-party private summation problems

Science.gov (United States)

Shi, Run-Hua; Zhang, Shun

2017-09-01

In this paper, we define a class of special two-party private summation (S2PPS) problems and present a common quantum solution to S2PPS problems. Compared to related classical solutions, our solution has advantages of higher security and lower communication complexity, and especially it can ensure the fairness of two parties without the help of a third party. Furthermore, we investigate the practical applications of our proposed S2PPS protocol in many privacy-preserving settings with big data sets, including private similarity decision, anonymous authentication, social networks, secure trade negotiation, secure data mining.

Bioethics and University: The University Hospital, Private or Public Institution?

Directory of Open Access Journals (Sweden)

José Nel Carreño R., MD, esp.

2007-12-01

Full Text Available In order to acquire a real and useful knowledgeof medicine, the practice in the hospital setting is indispensable. Public, former charity hospitals have been the scenary for student practice. In a paternalistic model of medicine this was understandable.Nevertheless now that the model has changed to a more respectful of autonomy and justice this discrimination appears as unethical. There are no real reasons to discriminate educationin such a way. Medical education should happen in both the public and private sector.

Private forest owners and invasive plants: risk perception and management

Science.gov (United States)

A. Paige Fischer; Susan Charnley

2012-01-01

We investigated nonindustrial private forest (NIPF) owners' invasive plant risk perceptions and mitigation practices using statistical analysis of mail survey data and qualitative analysis of interview data collected in Oregon's ponderosa pine zone. We found that 52% of the survey sample was aware of invasive plant species considered problematic by local...

Private Water Districts

Data.gov (United States)

California Natural Resource Agency — Private Water District boundaries are areas where private contracts provide water to the district in California. This database is designed as a regions polygon...

Private Sector-led Urban Development Projects. Management, Partnerships and Effects in the Netherlands and the UK

Directory of Open Access Journals (Sweden)

Erwin Heurkens

2012-09-01

Full Text Available Central to this research lays the concept of private sector-led urban development projects (Heurkens, 2010. Such projects involve project developers taking a leading role and local authorities adopting a facilitating role, in managing the development of an urban area, based on a clear public-private role division. Such a development strategy is quite common in Anglo-Saxon urban development practices, but is less known in Continental European practices. Nonetheless, since the beginning of the millennium such a development strategy also occurred in the Netherlands in the form of ‘concessions’. However, remarkably little empirical knowledge is available about how public and private actors collaborate on and manage private sector-led urban development projects. Moreover, it remains unclear what the effects of such projects are. This dissertation provides an understanding of the various characteristics of private sector-led urban development projects by conducting empirical case study research in the institutional contexts of the Netherlands and the UK. The research provides an answer to the following research question: What can we learn from private sector-led urban development projects in the Netherlands and UK in terms of the collaborative and managerial roles of public and private actors, and the effects of their (interactions? Indications for a market-oriented Dutch urban development practice Urban development practice in the Netherlands has been subject to changes pointing towards more private sector involvement in the built environment in the past decades. Although the current economic recession might indicate otherwise, there are several motives that indicate a continuation of private sector involvement and a private leadership role in Dutch urban development projects in the future. First, a shift towards more market-oriented development practice is the result of an evolutionary process of increased ‘neoliberalization’ and the

PRIVATE SECTOR IN HEALTH CARE DELIVERY: A REALITY AND A CHALLENGE IN PAKISTAN.

Science.gov (United States)

Shaikh, Babar Tasneem

2015-01-01

Under performance of the public sector health care system in Pakistan has created a room for private sector to grow and become popular in health service delivery, despite its questionable quality, high cost and dubious ethics of medical practice. Private sector is no doubt a reality; and is functioning to plug many weaknesses and gaps in health care delivery to the poor people of Pakistan. Yet, it is largely unregulated and unchecked due to the absence of writ of the state. In spite of its inherent trait of profit making, the private sector has played a significant and innovative role both in preventive and curative service provision. Private sector has demonstrated great deal of responsiveness, hence creating a relation of trust with the consumers of health in Pakistan, majority of who spend out of their pocket to buy 'health'. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor's access to health care system.

PROBLEMS OF PUBLIC-PRIVATE PARTNERSHIP IN UKRAINE AND WAYS OF SOLVING THEM

Directory of Open Access Journals (Sweden)

Maksim Levochkin

2016-11-01

implementation of public and private partnership in Ukraine according to the Concept of Development of Public and Private Partnership in Ukraine are identified, including the identification of priority areas for the development of PPPs; improving the investment climate and business environment in the context of the development of PPPs; the development of the authorized state body responsible for the development of PPPs; strengthening the functions of local authorities in the area of PPPs; improving funding mechanisms for PPP projects; activation of the development institutions in the PPP management system; elimination of contradictions and shortcomings of the legal framework of PPP; improving the cooperation of the authorities with civil society institutions for the implementation of PPP projects. Purpose. This article provides for achieving the following objectives: 1 the study of problems of public-private partnership in Ukraine; 2 identification of solutions thereto. The subject of the research is the mechanism of public-private partnership, its problems and solutions thereto. Methodology. In this work the following general scientific and special methods of study were used: comparative and legal, historical, dialectical, analytical and synthetic, formal and logical and statistical methods. Results. The findings allowed drawing specific suggestions for overcoming the problems of public and private partnership in Ukraine. The practical significance of the findings is that the article thoroughly investigated the situation and problems of public and private partnership in Ukraine. Value/originality. This article is a completely original investigation, is practical and can be used for further scientific work.

The Compensation and Benefits System: Private Companies vs. Budgetary System

Directory of Open Access Journals (Sweden)

Aldea Bogdan

2015-12-01

Full Text Available The economic evolution of the last decades has entailed major changes concerning the Human Resource Management practices, in both private and budgetary sector of Romania. In order to maintain efficiency and market competitivity, a company must adapt to these changes by altering its human resource strategy since managers are encountering increasingly complex challenges as to attracting, motivating and retaining employees. Such an objective might be accomplished by elaborating a competitive system of employee compensation. This article focuses on the stage reached by the Human Resource Management in the compensation and benefits system of the private and budgetary sector. For the latter, we are focusing on the romanian system of higher education. This study demonstrates that the compensation and benefits system which is implemented in romanian universities is limited and can offer few opportunities as compared to the one implemented by private companies. It is worth saying that the legal system has a negative impact in this matter.

Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France-The EPIPAGE-2 Cohort Study.

Science.gov (United States)

Pierrat, Veronique; Coquelin, Anaëlle; Cuttini, Marina; Khoshnood, Babak; Glorieux, Isabelle; Claris, Olivier; Durox, Mélanie; Kaminski, Monique; Ancel, Pierre-Yves; Arnaud, Catherine

2016-10-01

To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. Prospective national cohort study of all births before 32 weeks of gestation. Twenty-five French regions. All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). None. Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8-7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies.

The impact of public versus private insurance on trauma patients.

Science.gov (United States)

Jentzsch, Thorsten; Neuhaus, Valentin; Seifert, Burkhardt; Osterhoff, Georg; Simmen, Hans-Peter; Werner, Clément M L; Moos, Rudolf

2016-01-01

The socioeconomic status has been associated with disparities in the incidence and mortality of traumatic injuries. However, there is a lack of studies on the level of health insurance with regard to various epidemiologic data of traumatic injuries, which this study opted to clarify. All consecutive 6595 patients admitted to a level one trauma center in 2012 and 2013 were included in this retrospective cohort study. Patients were grouped according to their health insurance status (public versus private extended health care insurance) and compared with regard to several epidemiologic variables, that is, the type of injuries, inhospital outcome, and surgical procedures. Public insurance coverage was significantly more common than private insurance (75% versus 25%). Public insurance was associated with younger age, male sex, transfers to another hospital or mental institution, head concussions, head fractures, and increased mortality. Contrarily, patients with private insurance were more often associated with longer hospital stay, discharge to a rehabilitation clinic, fractures of the proximal humerus, and shoulder dislocations. However, there were no significant differences for the remaining majority of studied variables. In a trauma setting, the level of insurance does not seem to play a crucial role in most types of injuries and surgical procedures in a country with a high level of obligatory health care coverage. Nonetheless, it appears that publicly insured patients are more commonly younger, males, transferred to another hospital more often, more prone to head trauma, and subject to increased mortality, whereas privately insured patients show longer hospital stays, increased transfers to rehabilitation clinics, and more fractures of the proximal humerus. Copyright © 2016 Elsevier Inc. All rights reserved.

Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London.

Science.gov (United States)

Kohut, Kelly; D'Mello, Lucia; Bancroft, Elizabeth K; Thomas, Sarah; Young, Mary-Anne; Myhill, Kathryn; Shanley, Susan; Briggs, Brian H J; Newman, Michelle; Saraf, Ifthikhar M; Cox, Penny; Scambler, Sarah; Wagman, Lyndon; Wyndham, Michael T; Eeles, Rosalind A; Ferris, Michelle

2012-03-01

At present cancer genetics referrals are reactive to individuals asking for a referral and providing a family history thereafter. A previous pilot study in a single General Practice (GP) catchment area in North London showed a 1.5-fold increase in breast cancer risk in the Ashkenazi Jewish population compared with the non-Ashkenazi mixed population. The breast cancer incidence was equal in the Ashkenazim in both pre- and postmenopausal groups. We wanted to investigate the effect of proactively seeking family history data from the entire female population of the practice to determine the effect on cancer genetics referral. Objectives To determine the need for cancer genetics intervention for women in a single GP catchment area. (1) to determine the incidence and strength of family history of cancer in women aged over 18 in the practice, (2) to offer cancer genetics advice and determine the uptake of counselling in those with a positive family history, (3) to identify potential BRCA1/BRCA2 gene mutation carriers who can be offered clinical follow up with appropriate translational research studies. Design Population-based cohort study of one General Practice female population. Participants Three hundred and eighty-three women over the age of 18 from one General Practice who responded to a questionnaire about family history of cancer. The whole female adult GP population was the target and the total number sampled was 3,820. Results 10% of patients completed the questionnaire (n = 383). A family history of cancer was present in 338 cases, 95 went on to have genetic counselling or had previously had counselling and 47 were genetically tested. We identified three carriers of an Ashkenazi Jewish founder mutation in BRCA1. Conclusions Response rate to a family history questionnaire such as that used in genetics centres was low (10%) and other approaches will be needed to proactively assess family history. Although the Ashkenazim are present in 39% of the GP catchment

Public-Private Partnership as Incentive Institution of Entrepreneurship

Directory of Open Access Journals (Sweden)

Elena S. Averkieva

2017-03-01

Full Text Available The interaction system of national public and private sectors institutions is becoming increasingly important in the conditions that characterize the current stage of economic development (such as globalization and post-industrialization trends, geopolitical threats, transformation of production and financial processes. Instability and the dependence of national economies from external environment factors, exposure to systemic crises increase the vulnerability of national business and require the state institutions’ activation in order to support and promote national business initiatives. In these circumstances, one of the most adequate to modern realities forms of entrepreneurial activity stimulation is the public-private partnership model, which proved to be highly effective, both in foreign countries and in Russia. The author reveals potential of public-private partnership as an institution to stimulate entrepreneurial activity by analyzing features of its organizational and management mechanism in the Russian Federation. The practical aspects of the introduction of the public-private partnership model are studied on the example of the Rostov region. The author shows that the implemented programs to encourage entrepreneurship through PPP projects have a positive effect, but at the same time remain a number of problems in the development of the business sector in Russia. The improving ways of the interaction mechanism between government and business at the regional level are identified based on the assessing results of the PPP level in Russia as a whole and in separate regions, implemented by the Association "Center for PPP development".

Homeopathic medical practice: Long-term results of a cohort study with 3981 patients

Directory of Open Access Journals (Sweden)

Baur Roland

2005-11-01

Full Text Available Abstract Background On the range of diagnoses, course of treatment, and long-term outcome in patients who chose to receive homeopathic medical treatment very little is known. We investigated homeopathic practice in an industrialized country under everyday conditions. Methods In a prospective, multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland, data from all patients (age >1 year consulting the physician for the first time were observed. The main outcome measures were: Patient and physician assessments (numeric rating scales from 0 to 10 and quality of life at baseline, and after 3, 12, and 24 months. Results A total of 3,981 patients were studied including 2,851 adults (29% men, mean age 42.5 ± 13.1 years; 71% women, 39.9 ± 12.4 years and 1,130 children (52% boys, 6.5 ± 3.9 years; 48% girls, 7.0 ± 4.3 years. Ninety-seven percent of all diagnoses were chronic with an average duration of 8.8 ± 8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children. Disease severity decreased significantly (p Conclusion Disease severity and quality of life demonstrated marked and sustained improvements following homeopathic treatment period. Our findings indicate that homeopathic medical therapy may play a beneficial role in the long-term care of patients with chronic diseases.

Child discipline and nurturing practices among a cohort of Pacific mothers living in New Zealand.

Science.gov (United States)

Cowley-Malcolm, Esther Tumama; Fairbairn-Dunlop, Tagaloa Peggy; Paterson, Janis; Gao, Wanzhen; Williams, Maynard

2009-02-01

The Pacific Islands Families (PIF) study is a longitudinal investigation of a cohort (N=1376) of Pacific infants born in New Zealand (NZ), and their mothers and fathers. The PIF study aimed to determine: (1) the prevalence of disciplinary and nurturing parenting practices used with children at 12 months of age, and (2) the demographic, maternal and lifestyle factors associated with parenting practices. At the 12-month measurement point, mothers (N=1207) were interviewed about their parenting practices using a modified version of the Parent Behaviour Checklist. High nurturance was significantly associated with Samoan ethnicity and post school qualifications, and low nurturance was significantly associated with post-natal depression, alcohol consumption and gambling. At the univariate level, high discipline scores were significantly associated with gambling, postnatal depression and lack of alignment to either Pacific or to European traditions. However the strongest association with discipline was the ethnicity variable with Tongan mothers reporting significantly higher disciplinary behaviours that all other ethnicities. It is clear that there are a number of common underlying lifestyle issues that need to be considered when dealing with parenting problems in families with young children. However specific to Pacific families, is Tongan ethnicity accounting for a strong cultural effect on parenting style, in particular high discipline scores relative to other Pacific groups. This important finding may be used to guide social policy and prevention programmes that are focused on the wellbeing of Pacific mothers and their children.

Disparities in Private Health Insurance Coverage of Skilled Care

Directory of Open Access Journals (Sweden)

Stacey A. Tovino

2017-10-01

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

Privatization an a national business

Directory of Open Access Journals (Sweden)

Andrzej Tokarski

2009-12-01

Full Text Available Privatization is a very complicated process that builds a market economy. It entails numerous problems, the overcoming of which depends on the pace and scale of privatization in a particular country. The privatization process of the Polish economy is assessed differently, and still raises a lot of controversy and debate, not only for the economy, but also politics. This is particularly the privatization of state assets. Privatization was one of the foundations for political transformation in Poland and other Central- and Eastern European countries. Some say that was a great success, while for others it was a field for plunder and affairs. Who is right? Is privatization a success or a failure? This paper aims to present the arguments posed by both supporters and opponents of the privatization in Poland.

An Investigation of Communication Values and Normative Principles Embedded in a Public/Private Partnership

National Research Council Canada - National Science Library

MacDonald, Jessica

2004-01-01

.... People cannot work together to solve these problems without communication. this dissertation project examines espoused and embedded preferences for specific communication practices in the context of a public/private partnership...

Understanding the MBA Gender Gap: Women Respond to Gender Norms by Reducing Public Assertiveness but Not Private Effort.

Science.gov (United States)

Wallen, Aaron S; Morris, Michael W; Devine, Beth A; Lu, Jackson G

2017-08-01

Women's underperformance in MBA programs has been the subject of recent debate and policy interventions, despite a lack of rigorous evidence documenting when and why it occurs. The current studies document a performance gap, specifying its contours and contributing factors. Two behaviors by female students that may factor into the gap are public conformity and private internalization. We predicted that women conform to the norm associating maleness with technical prowess by minimizing their public assertiveness in class discussions and meetings, but that they do not internalize the norm by reducing private effort. Data from multiple cohorts of a top-ranked MBA program reveal female underperformance occurred in technical subjects (e.g., accounting), but not social subjects (e.g., marketing). As predicted, the gender effect ran not through private effort but through public assertiveness, even controlling for gender differences in interests and aptitudes. These findings support some current policy interventions while casting doubt on others.

Between Public - Private Partnerships and public finance in the public infrastructure sector: The water and sanitation sector in Albania

Directory of Open Access Journals (Sweden)

Fjona Zeneli

2017-03-01

Full Text Available It’s known in the literature that public-private partnerships (PPPs are one the main instruments that permit private collaboration in projects that are public otherwise. It’s also clear that their implementation is different depending on the rules of the countries, their market level of acceptance etc. The first objective of this paper is to revise PPPs projects in the water sector in Albania, seen in the context of alternative financing ways for joint-stock companies of Albanian water sector, due to the nature of the market (a developing emerging market, in the context of bad financial times after 2008 (the start of the international financial crisis. The second objective is to describe the development of the Albanian legislation for management contracts introduced for the first time in the waters and sanitation sector in 2004 and privatization practices in public sector. The main conclusion is that in the developing markets creating possibilities for private sector participation in the infrastructure public services (especially in the drinking water and sanitation sector will be seen with skepticism because of failed previous privatization practices or the sensitivity degree of the water sector related to the penetration level of private factor in the sector. Public finance will be explored as a convenient alternative.

Occupational Stress in Dental Practice amongst Government ...

African Journals Online (AJOL)

Objectives: The aim of this study is to compare the level of occupational stress amongst government-employed and private dental practitioners in eastern Nigeria. Materials and methods: A total of 62 questionnaires were randomly distributed among government-employed and private practicing dental surgeons with five ...

Public-Private Partnerships

DEFF Research Database (Denmark)

Helby Petersen, Ole

This PhD dissertation studies national similarities and differences in policy and regulation of public-private partnerships (PPPs), with an empirical focus on Denmark and Ireland. The starting point and motivation for the study is the observation that whereas PPPs are often depicted in the academic...... time, and how can their similarities and differences be explained?; (iii) how do differing national policy and regulation frameworks serve to facilitate or hinder the formation of PPPs, exemplified by four case studies from the schools sector?; (iv) what framework conditions does the EU set for PPP...... literature and in policy practice as a globally disseminated governance scheme, in reality, a closer examination of the PPP reform landscape reveals significant differences in national governments’ PPP policy and regulation and in the amount of actually implemented PPP projects. By comparing the initiatives...

Private Tutoring: Evidence from India

OpenAIRE

Azam, Mehtabul

2015-01-01

Drawing on the nationally representative "Participation and Expenditure in Education" surveys, we document the incidence and cost of private tutoring at different stages of schooling over the last two decades in India. As private tutoring involve two decisions: a) whether to take private tuition or not, and b) how much to spend on private tutoring conditional on positive decision in (a), we analyze the determinants of the two decisions separately using a Hurdle model. We find that private tut...

Private-sector vaccine purchase costs and insurer payments: a disincentive for using combination vaccines?

Science.gov (United States)

Clark, Sarah J; Cowan, Anne E; Freed, Gary L

2011-04-01

Combination vaccines have been endorsed as a means to decrease the number of injections needed to complete the childhood immunization schedule, yet anecdotal reports suggest that private providers lose money on combination vaccines. The objective of this study was to determine whether practices purchasing combination vaccines had significantly different vaccine costs and reimbursement compared to practices that were not purchasing combination vaccines. Using cross-sectional purchase and insurer payment data collected from a targeted sample of private practices in five US states, we calculated the average total vaccine cost and reimbursement across the childhood immunization schedule. The average vaccine purchase cost across the childhood schedule was significantly higher for practices using a combined vaccine with diphtheria, tetanus, acellular pertussis vaccine, inactivated polio vaccine, and Hepatitis B vaccine (DTaP-IPV-HepB) than for practices using either separate vaccine products or a combined vaccine with Haemophilus influenzae, type b vaccine and Hepatitis B vaccine (Hib-HepB). The average insurer payment for vaccine administration across the childhood schedule was significantly lower for practices using DTaP-IPV-HepB combination vaccine than for practices using separate vaccine products. This study appears to validate anecdotal reports that vaccine purchase costs and insurer payment for combination vaccines can have a negative financial impact for practices that purchase childhood vaccines.

SWOT analysis & privatization in Croatia

Directory of Open Access Journals (Sweden)

Družić Ivo

2006-01-01

Full Text Available Legal framework for privatization in Croatia was based on two key laws: the Transformation Act of 1991, and the Privatization Act of 1993, amended in 1996. Early start of privatization process in 1990s in Croatia was marked by the transformation of socially-owned companies into stock holding companies or limited liability companies. The first step (1991-1993 of this process of almost 2700 companies which entered privatization was their evaluation and transformation into private ownership entities. The second step (1994- 1997 consisted of privatization of CPF portfolio. The portfolios change constantly, not only as a result of privatization but also because companies themselves change, as does their position in the market. The third step (1998 in the privatization process was voucher privatization. Privatization of large infrastructure and utility companies designated as public enterprises began in 1999 (Croatian Telecom and INA in 2002 (public enterprises are privatized on the basis of separate laws. Attempts to discuss privatization in Croatia in terms of SWOT analysis have been motivated by the stark difference among Croatian professional economists in an appraisal of Croatia's performance during the transition process in general and of the privatization process in particular. Therefore we considered the elements of SWOT analysis to be an acceptable way to delve into the confusing world of bickering arguments on the state and perspective of the Croatia's privatization process. In this paper we have tried to provide an impartial approach by employing two criteria i.e. strength and weaknesses in judging the events and results of the privatization process in Croatia. Strength of the overall privatization process can be mostly ascribed to the institutional swiftness on micro as well as on macro level. On the micro level 80% of the companies were formally privatized in the first two years despite unfavorable external conditions comprising the

Peer Learning in Instrumental Practicing.

Science.gov (United States)

Nielsen, Siw G; Johansen, Guro G; Jørgensen, Harald

2018-01-01

In higher music education (HME), the notion of "private teaching, private learning" has a long tradition, where the learning part rests on the student's individual practicing between instrumental lessons. However, recent research suggests that collaborative learning among peers is beneficial in several aspects, such as sense of belonging, motivation and self-efficacy. This is consistent with the concept of vicarious learning. In this study, we conducted a survey among bachelor music students in church music, performance or music education programs enrolled in a music academy ( N = 96), where parts of the questionnaire addressed peer learning and peer's influence on the students's instrumental practicing, and the degree of satisfaction with their practicing. These issues were seen in relation to gender, musical genre and study program. Overall, the students reported engaging in peer learning related to their instrumental practicing, to various degrees. This involved discussing practicing matters with peers, and practicing together with peers. However, student's reports of their views on peer learning, show that they perceive it more beneficial than the amount of time reported doing it would indicate. No significant gender differences were found, but students within improvised music/jazz engaged the most in peer learning, and church music students the least. Neither the degree of engaging in peer learning nor reported influence from peers correlated significantly with the degree of satisfaction. We discuss whether a general dissatisfaction is caused by being in a competitive learning environment combined with a privatized culture for learning. Finally, we suggest that collaborative forums for instrumental practicing within HME institutions can function as constructive and supportive arenas to enhance students learning and inner motivation.

Peer Learning in Instrumental Practicing

Science.gov (United States)

Nielsen, Siw G.; Johansen, Guro G.; Jørgensen, Harald

2018-01-01

In higher music education (HME), the notion of “private teaching, private learning” has a long tradition, where the learning part rests on the student's individual practicing between instrumental lessons. However, recent research suggests that collaborative learning among peers is beneficial in several aspects, such as sense of belonging, motivation and self-efficacy. This is consistent with the concept of vicarious learning. In this study, we conducted a survey among bachelor music students in church music, performance or music education programs enrolled in a music academy (N = 96), where parts of the questionnaire addressed peer learning and peer's influence on the students's instrumental practicing, and the degree of satisfaction with their practicing. These issues were seen in relation to gender, musical genre and study program. Overall, the students reported engaging in peer learning related to their instrumental practicing, to various degrees. This involved discussing practicing matters with peers, and practicing together with peers. However, student's reports of their views on peer learning, show that they perceive it more beneficial than the amount of time reported doing it would indicate. No significant gender differences were found, but students within improvised music/jazz engaged the most in peer learning, and church music students the least. Neither the degree of engaging in peer learning nor reported influence from peers correlated significantly with the degree of satisfaction. We discuss whether a general dissatisfaction is caused by being in a competitive learning environment combined with a privatized culture for learning. Finally, we suggest that collaborative forums for instrumental practicing within HME institutions can function as constructive and supportive arenas to enhance students learning and inner motivation. PMID:29599738

Peer Learning in Instrumental Practicing

Directory of Open Access Journals (Sweden)

Siw G. Nielsen

2018-03-01

Full Text Available In higher music education (HME, the notion of “private teaching, private learning” has a long tradition, where the learning part rests on the student's individual practicing between instrumental lessons. However, recent research suggests that collaborative learning among peers is beneficial in several aspects, such as sense of belonging, motivation and self-efficacy. This is consistent with the concept of vicarious learning. In this study, we conducted a survey among bachelor music students in church music, performance or music education programs enrolled in a music academy (N = 96, where parts of the questionnaire addressed peer learning and peer's influence on the students's instrumental practicing, and the degree of satisfaction with their practicing. These issues were seen in relation to gender, musical genre and study program. Overall, the students reported engaging in peer learning related to their instrumental practicing, to various degrees. This involved discussing practicing matters with peers, and practicing together with peers. However, student's reports of their views on peer learning, show that they perceive it more beneficial than the amount of time reported doing it would indicate. No significant gender differences were found, but students within improvised music/jazz engaged the most in peer learning, and church music students the least. Neither the degree of engaging in peer learning nor reported influence from peers correlated significantly with the degree of satisfaction. We discuss whether a general dissatisfaction is caused by being in a competitive learning environment combined with a privatized culture for learning. Finally, we suggest that collaborative forums for instrumental practicing within HME institutions can function as constructive and supportive arenas to enhance students learning and inner motivation.

Use of fertility drugs and risk of ovarian cancer: Danish Population Based Cohort Study

DEFF Research Database (Denmark)

Jensen, Allan; Sharif, Heidi; Frederiksen, Kirsten

2009-01-01

OBJECTIVE: To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. DESIGN: Population based cohort study. SETTING: Danish hospitals and private fertility clinics. PARTICIPANTS: 54,362 women with infertility problems referred...... confounding factors. RESULTS: Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), or gonadotrophin releasing...... hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs and number of cycles of use, length of follow-up, or parity. CONCLUSION: No convincing association was found between use of fertility drugs and risk of ovarian cancer....

Is the association between high strain work and depressive symptoms modified by private life social support: a cohort study of 1,074 Danish employees?

Science.gov (United States)

Madsen, Ida E H; Jorgensen, Anette F B; Borritz, Marianne; Nielsen, Martin L; Rugulies, Reiner

2014-07-08

Previous studies have shown that psychosocial working conditions characterized by high psychological demands and low decision latitude (i.e., high strain work) are associated with increased risk of depressive symptoms. Little is known, however, concerning how this association may be modified by factors outside the working environment. This article examines the modifying role of private life social support in the relation between high strain work and the development of severe depressive symptoms. Data were questionnaire-based, collected from a cross-occupational sample of 1,074 Danish employees. At baseline, all participants were free of severe depressive symptoms, measured by the Mental Health Inventory. High strain work was defined by the combination of high psychological demands at work and low control, measured with multi-dimensional scales. Private life social support was operationalized as the number of life domains with confidants and dichotomized as low (0-1 domains) or high (2 or more domains). Using logistic regression we examined the risk of onset of severe depressive symptoms, adjusting for sex, age, occupational position, and prior depressive symptoms. Separately, neither high strain work nor low private life social support statistically significantly predicted depressive symptoms. However, participants with joint exposure to high strain work and low private life social support had an Odds ratio (OR) for severe depressive symptoms of 3.41 (95% CI: 1.36-8.58), compared to participants with no work strain and high private life social support. There was no increased risk for participants with high strain work and high private life social support (OR = 1.32, 95% CI: 0.65-2.68). The interaction term for departure from additivity was, however, not statistically significant (p = 0.18). Our findings suggest that high strain work may increase risk of depressive symptoms in individuals with low private life social support, although the effect-modification was

Is the association between high strain work and depressive symptoms modified by private life social support: a cohort study of 1,074 Danish employees?

Science.gov (United States)

2014-01-01

Background Previous studies have shown that psychosocial working conditions characterized by high psychological demands and low decision latitude (i.e., high strain work) are associated with increased risk of depressive symptoms. Little is known, however, concerning how this association may be modified by factors outside the working environment. This article examines the modifying role of private life social support in the relation between high strain work and the development of severe depressive symptoms. Methods Data were questionnaire-based, collected from a cross-occupational sample of 1,074 Danish employees. At baseline, all participants were free of severe depressive symptoms, measured by the Mental Health Inventory. High strain work was defined by the combination of high psychological demands at work and low control, measured with multi-dimensional scales. Private life social support was operationalized as the number of life domains with confidants and dichotomized as low (0–1 domains) or high (2 or more domains). Using logistic regression we examined the risk of onset of severe depressive symptoms, adjusting for sex, age, occupational position, and prior depressive symptoms. Results Separately, neither high strain work nor low private life social support statistically significantly predicted depressive symptoms. However, participants with joint exposure to high strain work and low private life social support had an Odds ratio (OR) for severe depressive symptoms of 3.41 (95% CI: 1.36-8.58), compared to participants with no work strain and high private life social support. There was no increased risk for participants with high strain work and high private life social support (OR = 1.32, 95% CI: 0.65-2.68). The interaction term for departure from additivity was, however, not statistically significant (p = 0.18). Conclusions Our findings suggest that high strain work may increase risk of depressive symptoms in individuals with low private life social

Corporate Governance and Intellectual Capital: Evidence from Public and Private Universities

Science.gov (United States)

Wahid, Akma Hidayu Dol Abdu; Abu, Nor Asyiqin; Latif, Wannoraini Abdul; Smith, Malcolm

2013-01-01

This study was conducted to examine the perception of academics towards intellectual capital (IC) and governance practice at two Malaysian universities: University A (a Public University) and University B (a Private University). It also examines the factors which contribute to the retention of qualified academics and the relationship between…

Public-private Partnership in the Context of Realisation of the State Financial Policy

Directory of Open Access Journals (Sweden)

Ostapenko Victoriia M.

2014-02-01

Full Text Available In the result of the study the article analyses modern tendencies of development of economy of Ukraine. It marks out problems connected with realisation of the state financial policy. It considers the essence of the state financial policy, its directions (such as budget-tax and monetary-credit, structural components and tasks. It emphasises the place of the public-private partnership as an instrument of realisation of the financial policy. It justifies tasks in the process of realisation of goals of the modern financial policy, which could be carried out with the help of the public-private partnership. The prospect of further studies in this direction is formation of practical recommendations on the use of the public-private partnership in the process of realisation of the state financial policy. Further improvement of the public-private partnership is connected with development of efficient mechanisms of its introduction and optimisation of its financial structure.

A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

Science.gov (United States)

McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

2015-06-01

Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

Modeling groundwater nitrate concentrations in private wells in Iowa

Science.gov (United States)

Wheeler, David C.; Nolan, Bernard T.; Flory, Abigail R.; DellaValle, Curt T.; Ward, Mary H.

2015-01-01

Contamination of drinking water by nitrate is a growing problem in many agricultural areas of the country. Ingested nitrate can lead to the endogenous formation of N-nitroso compounds, potent carcinogens. We developed a predictive model for nitrate concentrations in private wells in Iowa. Using 34,084 measurements of nitrate in private wells, we trained and tested random forest models to predict log nitrate levels by systematically assessing the predictive performance of 179 variables in 36 thematic groups (well depth, distance to sinkholes, location, land use, soil characteristics, nitrogen inputs, meteorology, and other factors). The final model contained 66 variables in 17 groups. Some of the most important variables were well depth, slope length within 1 km of the well, year of sample, and distance to nearest animal feeding operation. The correlation between observed and estimated nitrate concentrations was excellent in the training set (r-square = 0.77) and was acceptable in the testing set (r-square = 0.38). The random forest model had substantially better predictive performance than a traditional linear regression model or a regression tree. Our model will be used to investigate the association between nitrate levels in drinking water and cancer risk in the Iowa participants of the Agricultural Health Study cohort.

Modeling groundwater nitrate concentrations in private wells in Iowa.

Science.gov (United States)

Wheeler, David C; Nolan, Bernard T; Flory, Abigail R; DellaValle, Curt T; Ward, Mary H

2015-12-01

Contamination of drinking water by nitrate is a growing problem in many agricultural areas of the country. Ingested nitrate can lead to the endogenous formation of N-nitroso compounds, potent carcinogens. We developed a predictive model for nitrate concentrations in private wells in Iowa. Using 34,084 measurements of nitrate in private wells, we trained and tested random forest models to predict log nitrate levels by systematically assessing the predictive performance of 179 variables in 36 thematic groups (well depth, distance to sinkholes, location, land use, soil characteristics, nitrogen inputs, meteorology, and other factors). The final model contained 66 variables in 17 groups. Some of the most important variables were well depth, slope length within 1 km of the well, year of sample, and distance to nearest animal feeding operation. The correlation between observed and estimated nitrate concentrations was excellent in the training set (r-square=0.77) and was acceptable in the testing set (r-square=0.38). The random forest model had substantially better predictive performance than a traditional linear regression model or a regression tree. Our model will be used to investigate the association between nitrate levels in drinking water and cancer risk in the Iowa participants of the Agricultural Health Study cohort. Copyright © 2015 Elsevier B.V. All rights reserved.

Socializing in an open drug scene: the relationship between access to private space and drug-related street disorder.

Science.gov (United States)

Debeck, Kora; Wood, Evan; Qi, Jiezhi; Fu, Eric; McArthur, Doug; Montaner, Julio; Kerr, Thomas

2012-01-01

Limited attention has been given to the potential role that the structure of housing available to people who are entrenched in street-based drug scenes may play in influencing the amount of time injection drug users (IDU) spend on public streets. We sought to examine the relationship between time spent socializing in Vancouver's drug scene and access to private space. Using multivariate logistic regression we evaluated factors associated with socializing (three+ hours each day) in Vancouver's open drug scene among a prospective cohort of IDU. We also assessed attitudes towards relocating socializing activities if greater access to private indoor space was provided. Among our sample of 1114 IDU, 43% fit our criteria for socializing in the open drug scene. In multivariate analysis, having limited access to private space was independently associated with socializing (adjusted odds ratio: 1.80, 95% confidence interval: 1.28-2.55). In further analysis, 65% of 'socializers' reported positive attitudes towards relocating socializing if they had greater access to private space. These findings suggest that providing IDU with greater access to private indoor space may reduce one component of drug-related street disorder. Low-threshold supportive housing based on the 'housing first' model that include safeguards to manage behaviors associated with illicit drug use appear to offer important opportunities to create the types of private spaces that could support a reduction in street disorder. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

THE USE OF ICT IN QUALITY EDUCATION MANAGEMENT IN PRIVATE GYMNASIUMS

Directory of Open Access Journals (Sweden)

I.V. Plish

2012-07-01

Full Text Available The article deals with the peculiarities of the use of information and communication technologies (ICT in the process of the quality education management in private gynasiums. The social importance and the novelty of private education as well as the role of the education quality management and in the same time the lack of practical realization of the effective mechanisms caused the search of the effective technologies of the quality management. The structure of information education environment was proposed into the article. The main goal is to give opportunity to be effective and operative in the process of decision making. The positive influence on the education process was underlined.

VARIOUS HISTORICAL CONSIDERATIONS REGARDING THE PUBLIC LAW–PRIVATE LAW DICHOTOMY

Directory of Open Access Journals (Sweden)

Emilian Ciongaru

2014-11-01

Full Text Available Throughout the history of law, has been structured logically in law institutions and branches being considered in a divided or unitary manner. But legal norms have obtained general recognition either taken as a unitary system or divided into divisions or branches as maximum logical-organizational structures. The law originally intersects with the process of formation and evolution of the state. The law has been formed unconsciously as the result of a psychological process in which the individual reacts to certain external stimuli. At the beginning, the law came under the form of nonunitary chaotic customs or practices. In the second phase, the law, though yet rudimentary, became a conscious action being imposed by a public force. The difference between the public law and the private law results from the fact that private law may be attributed to the structure of society, and the public law may be attributed to the superstructure of society. Even nowadays, the delimitation between the public law and the private law is not clear, because the most numerous legal relations refer both to the general interest and the private interest and, basically, the legal norms contribute to public order as the observation thereof brings social peace.

Publication and non-publication of drug trial results: a 10-year cohort of trials in Norwegian general practice.

Science.gov (United States)

Brænd, Anja Maria; Straand, Jørund; Jakobsen, Rune Bruhn; Klovning, Atle

2016-04-11

Previously, we identified a 10-year cohort of protocols from applications to the Norwegian Medicines Agency 1998-2007, consisting of 196 drug trials in general practice. The aim of this study was to examine whether trial results were published and whether trial funding and conflicts of interest were reported. Cohort study of trials with systematic searches for published results. Clinical drug trials in Norwegian general practice. We performed systematic literature searches of MEDLINE, Embase and CENTRAL to identify publications originating from each trial using characteristics such as test drug, comparator and patient groups as search terms. When no publication was identified, we contacted trial sponsors for information regarding trial completion and reference to any publications. We determined the frequency of publication of trial results and trial characteristics associated with publication of results. Of the 196 trials, 5 were never started. Of the remaining 191 trials, 71% had results published in a journal, 11% had results publicly available elsewhere and 18% of trials had no results available. Publication was more common among trials with an active comparator drug (χ(2) test, p=0.040), with a larger number of patients (total sample size≥median, p=0.010) and with a longer trial period (duration≥median, p=0.025). Trial funding was reported in 85% of publications and increased over time, as did reporting of conflicts of interest among authors. Among the 134 main journal articles from the trials, 60% presented statistically significant results for the investigational drug, and the conclusion of the article was favourable towards the test drug in 78% of papers. We did not identify any journal publication of results for 29% of the general practice drug trials. Trials with an active comparator, larger and longer trials were more likely to be published. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Defending the solo and small practice neurologist.

Science.gov (United States)

Jones, Elaine C; Evans, David A

2015-04-01

Changes in health care are having a dramatic effect on the practice of medicine. In 2005, a National Center for Health Statistics survey showed that 55%-70% of physicians are in small/solo practices. These data also demonstrated that 70% of physicians identified themselves as owners. Since passage of the Affordable Care Act (ACA) in 2010, neurologists report an 8% increase in academic practice settings, a 2% decrease in private practice settings, and a 5% decrease in solo practice settings. Surveys of family physicians showed that 60% are now employees of hospitals or larger groups. A survey by The Physicians Foundation showed that 89% of physicians believed that the traditional model of independent private practice is either "on shaky ground" or "a dinosaur soon to go extinct." With the changes expected from the ACA, solo/small practices will continue to face challenges and therefore must pay close attention to business and clinical metrics.

Corporal Punishment in Private Schools: The Case of Kathmandu, Nepal

Science.gov (United States)

Khanal, Jeevan; Park, Sae-Hoon

2016-01-01

The purpose of this study was to elaborate the situation of corporal punishment which is being practiced in Nepalese schools going against new policies that promote the non-violence teaching. It was based on original qualitative study of one private school of Kathmandu (the capital city of Nepal) having more than 2000 students and 100 teachers.…

Evaluation of the scope and practice of oral and maxillofacial ...

African Journals Online (AJOL)

2014-11-27

Nov 27, 2014 ... that developed as a result of the need to treat servicemen injured in ... for effective organization of training, health care planning .... Similarly McNally found 5% female applicants to oral and ... maxillofacial surgeons in Australia worked in both private .... Glass ceiling, preference, prejudice or cohort effect?

Biomarkers in patients with Chronic Obstructive Pulmonary Disease in general practice: A prospective cohort study

DEFF Research Database (Denmark)

Waldorff, Frans Boch; Halling, Anders; Ledderer, Loni

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a common chronic disease primarily treated in primary care. It is a complex and heterogeneous disease and the trajectory is difficult to predict. The overall aim of this study is to investigate predictors of the trajectory of COPD...... were a diagnosis of COPD (ICPC code R95-), age ≥ 40 years, Danish language speaking, no severe psychiatric or cognitive disease and ability to visit the GP surgery. Prevalent as well as incident patients diagnosed with COPD were eligible. Baseline data included a patient questionnaire and validated...... treated in primary care and to determine the added value of selected biomarkers such as microfibrillar-associated protein 4 (MFAP4) and surfactant protein D (SP-D). Methods: Prospective cohort study comprising COPD patients. A total of 38 Danish practices were included in the study. Criteria for inclusion...

Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France—The EPIPAGE-2 Cohort Study

Science.gov (United States)

Coquelin, Anaëlle; Cuttini, Marina; Khoshnood, Babak; Glorieux, Isabelle; Claris, Olivier; Durox, Mélanie; Kaminski, Monique; Ancel, Pierre-Yves; Arnaud, Catherine

2016-01-01

Objectives: To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. Design: Prospective national cohort study of all births before 32 weeks of gestation. Setting: Twenty-five French regions. Participants: All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). Interventions: None. Measurements and Main Results: Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8–7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies. PMID:27518584

Palliative sedation in Dutch general practice from 2005 to 2011: a dynamic cohort study of trends and reasons.

Science.gov (United States)

Donker, Gé A; Slotman, Frank G; Spreeuwenberg, Peter; Francke, Anneke L

2013-10-01

Little is known about the quantity and reasons for use of palliative sedation in general practice. To gain more insight into the trends of and reasons for palliative sedation in Dutch general practice. Dynamic cohort study using registrations and questionnaire data of Dutch GPs. Method Data collected in the years from 2005 until 2011 in the Dutch Sentinel General Practice Network were analysed. Trends and reasons for use of palliative sedation were analysed using multilevel analyses to control for clustering of observations within general practices. From 2005-2011, 183 cases were reported from 56 general practices. The incidence of palliative sedation fluctuated between 33.7 per 100 000 patients in 2006 and 15.2 in 2011. No rise or decline during the period was observed. Palliative sedation was applied in 5.7% of all deaths and most frequently used in younger patients with cancer. The mean number of refractory symptoms was 2.6 (SD 1.2); pain (69.4%), dyspnoea (53.0%), and fear (39.3%). Patient involvement in decision making before the start of palliative sedation (87.4%) was less frequently present in patients suffering from cardiovascular or chronic obstructive pulmonary disease and in older patients compared to patients with cancer (Ppalliative sedation in these cases was clearly motivated. Palliative sedation is performed in a small proportion of dying patients in Dutch general practice, without a rise or decline observed from 2005 to 2011. Patients with non-cancer diseases are less frequently involved in decision making than patients with cancer, possibly related to sudden deterioration.

Public private partnerships

NARCIS (Netherlands)